Assisted Approach Research Articles

Classification model-based assisted preselection and environment selection approach for evolutionary expensive bilevel optimization

Classification model-based assisted preselection and environment selection approach for evolutionary expensive bilevel optimization

Comparison of Two Design Principles of Unpowered Ankle-Foot Orthoses for Supporting Push-Off: A Case Study.

Ankle propulsion is essential for efficient human walking. In recent years, several working principles have been investigated and applied to ankle-foot orthoses (AFOs) to enhance the work of the plantarflexor muscles and achieve proper propulsion during gait. Comparing the performance and effectiveness of different designs is difficult because researchers do not have a standardized set of criteria and procedures to follow. This leads to a wide range of tests being conducted, with variations in important factors such as walking speed and assistance provided, which greatly affect users' kinematics and kinetics. In this work, we investigate the possibilities and potential benefits of two of the most important design principles for supporting ankle propulsion with unpowered AFOs. To this end, we present and evaluate two AFO prototypes with springs parallel to the Achilles tendon based on: (i) a linear compression spring, and (ii) a customized leaf spring-cam transmission with a non-linear ankle torque-angle curve. The effects of both AFOs are reported for a case study with one healthy participant using both prototypes at two walking speeds under the same experimental conditions. Large reductions in muscular activity were found when the user received assistance, and ankle kinematics were influenced by the different assistance approaches. This case study was intended as a first step to provide insights on how two promising principles can passively support push-off during gait.

The importance of using an assistant teaching approach in graduate studies

The Article Abstract is not available.

An assisted multi-frame approach for super-resolution in hyperspectral images of rock samples

Imaging spectroscopy is decisive for accurately characterizing rock samples for geological and mineral applications, since slight differences in mineral composition can be easily recognized in spectral signatures. Although, instrument limitations prevent high spatial resolution pixels scanned along hundreds of spectral channels, which considerably reduces the data capabilities. Multi frame Super-Resolution (SR) techniques can overcome this issue by retrieving high-quality images using purely computational methods. However, these approaches still have important drawbacks because of inherent uncertainties when estimating the spatial variation between frames, which strongly penalize the spectral information, essential for lithology. In this paper we propose an assisted framework to provide fully controlled motion parameters of the imaging process, skipping the intricate registration task. Essentially, we use a stepping device to successively change the position of rock samples for each new frame acquisition. With accurate knowledge about motion parameters, we were able to overcome the uncertainties regarding spatial registration between frames. Therefore, a reasonable number of equations connecting the low-resolution frames and the super resolved image could be used to solve the optimization problem. Extensive experiments proved that the proposed assisted method achieved best performances (both qualitatively and quantitatively) compared with similar approaches. Moreover, detailed spectral analysis showed almost absolute consistency between the original low-resolution image and the super-resolved result, which is crucial to guarantee reliable mineral characterization.

Facile approach to fabricate stable multi-chamber colloid particles for compartmentalized encapsulation and reaction control of incompatible molecules

Compartmentalized delivery systems can achieve simultaneous encapsulation of multiple guest cargos in independent spaces and are becoming a topic of tremendous interest in medical and food disciplines. Herein, we reported a top-down assisted bottom-up approach to fabricate stable multi-chamber colloid (MCC) particles by using ferritin nanocages, which can be applied for compartmentalized loading of incompatible guest cargos. Our results demonstrated that the size of MCC particles can be regulated by controlling synthetic parameters. The primary amines of arginine and lysine residues distributed over the exterior surface and subunit-subunit interfaces of ferritin are responsible for the formation of covalent crosslinking bridges, thus, stabilizing the compartmentalized structure of MCC particles with pH value even lower to ∼2.0. Remarkably, by choosing Nile-red and FITC as guest cargos, LSCM images clearly demonstrated that Nile-red and FITC are compartmentalized encapsulated within each MCC particle, illustrating the compartmentalized loading capacity of MCC particles. Moreover, the MCC structures feature highly sealed independent compartments. When two incompatible guest cargos, chlorogenic acid (ChA) and iron core nanoparticles, are compartmentalized loaded within MCC particles, the protein shell barrier can efficiently hinder their physical contact and inhabit the redox reaction. Conversely, upon structural destruction, ChA and iron core nanoparticles are co-released and the redox reaction can be triggered, ultimately leading to the controlled release of ferrous ions for iron supplementation. This study provided a facile strategy for the construction of stable compartmentalized delivery systems, which have great potential for co-delivery of incompatible molecules in food and medical disciplines.

US Guided vs Landmark Guided in Paramedian Spinal in Elderly

Abstract Background The ultrasound-assisted paramedian technique reduces the technical difficulty of spinal anaesthesia in the elderly. Compared with the landmark-guided paramedian technique, the use of ultrasound reduced the number of needle manipulations required for success, increased the firstattempt success rate and reduced block-associated pain and discomfort. Aim of the Work The study aims to evaluate whether ultrasound assisted paramedian spinal anaesthesia in the elderly can achieve successful dural puncture with fewer needle passes compared with the conventional landmark guided paramedian technique. Patients and Methods After obtaining approval from the Research Ethical Committee of Faculty of Medicine, Ain shams University; this study conducted in the operating theatres of Ain Shams University Hospitals with sample size of 10 patients / group will be needed. The patients randomly divided pre-operatively into two groups using their computer-generated random numbers such that „even numbers‟ will be enrolled in “group-L” for patients receive spinal anaesthesia by the paramedian approach by landmark guided palpation and „odd numbers‟ will be enrolled in “group-s” for patients ultrasound assisted approach. Results Ultrasonography might improve the efficacy of spinal anaesthesia by improving the accuracy of identification of intervertebral level, depth measurement of the intrathecal space and location of the interlaminar window that permits needle passage compared with the landmark guided technique, ultrasound assisted spinal anaesthesia decreases the number of puncture attempts and improves the success rate at the first attempt in patients with potential technical difficulties we believe that individualisation is a key element of minimising technical difficulties. Because of the large intersubject variability in anatomy, the blind technique have a theoretical upper limit of success rate. Through which we obtained success rates of 90 and 100% at the first attempt and within two attempts, respectively, in the ultrasound group. Conclusion Ultrasound-assisted paramedian spinal anaesthesia significantly reduces the number of needle manipulations required for success, increases the success rate at first pass and decreases periprocedural pain and patient discomfort compared with the landmark-guided paramedian technique in the elderly. Our results suggest that the neuraxial ultrasonography enhances the efficacy and comfort of spinal anaesthesia in the elderly.

Valorization of Kappaphycus alvarezii through extraction of high-value compounds employing green approaches and assessment of the therapeutic potential of κ-carrageenan

This study utilizes different emerging green extraction technologies to recover maximum value-added products from Kappaphycus alvarezii and evaluate their bio-functional properties. Using the supercritical fluid extraction (SFE) method, the total lipid yield of 0.21 ± 0.2 % was obtained from the biomass. Linoleic acid, eicosapentaenoic acid, arachidonic acid, γ-linolenic acid, and docosahexaenoic acid were present in higher concentrations (9.12 %) in the lipid extracted with SFE as compared to hexane (5.5 %). Using an ultrasonication assisted approach, ~56 % of κ-carrageenan was recovered from SFE residual biomass, which contains 28.5 ± 1.9 % sulfate content. It exhibited a monosaccharide content of 3,6-anhydrogalactose (~24 %) and galactose (~53 %), as well as rheological properties within FAO limitations that can be explored for food-grade applications. ~58 % of the total protein (12.5 %) from SFE residual biomass was recovered using subcritical water hydrolysis method. The effectiveness of κ-carrageenan in suppressing the 3CLpro of SARS-CoV-2 using in vitro and in silico approaches was investigated. κ-Carrageenan effectively inhibited the main protease by up to 93 % at 1.6 mg mL−1. In silico results revealed that κ-carrageenan successfully binds to the active site of the main protease while retaining the structural integrity and stability of protein-ligand complexes.

Application of Severe Weather Nowcasting to Case Studies in Air Traffic Management

Effective and time-efficient aircraft assistance and guidance in severe weather environments remains a challenge for air traffic control. Air navigation service providers around the globe could greatly benefit from specific and adapted meteorological information for the controller position, helping to reduce the increased workload induced by adverse weather. The present work proposes a radar-based nowcasting algorithm providing compact meteorological information on convective weather near airports for introduction into the algorithms intended to assist in air-traffic management. The use of vertically integrated liquid density enables extremely rapid identification and short-term prediction of convective regions that should not be traversed by aircraft, which is an essential requirement for use in tactical controller support systems. The proposed tracking and nowcasting method facilitates the anticipation of the meteorological situation around an airport. Nowcasts of centroid locations of various approaching thunderstorms were compared with corresponding radar data, and centroid distances between nowcasted and observed storms were computed. The results were analyzed with Method for the Object-Based Evaluation from the Model Evaluation tools software (MET-10.0.1, Developmental Testbed Center, Boulder, CO, US) and later integrated into an assistance arrival manager software, showing the potential of this approach for automatic air traffic assistance in adverse weather scenarios.

New Strategies for Conservation of Gentile di Puglia Sheep Breed, an Autochthonous Capital of Millennial Tradition in Southern Italy.

Gentile di Puglia (GdP) is an autochthonous sheep breed of Southern Italy included among ovine breeds threatened by genetic erosion and extinction risk, which have been given attention by local and international institutions, thus emphasizing the need for germplasm conservation actions. In the present study, two assisted reproduction approaches, finalized for GdP conservation, were performed: (1) on-farm reproductive efficiency evaluation, expressed as pregnancy rate (PR), twin pregnancy rate (tPR), and body condition score (BCS), for three consecutive breeding cycles and (2) pre-pubertal lambs' immature cumulus-oocyte complex (COC) retrieval, vitrification, in vitro maturation (IVM), and assessment of meiotic stage and bioenergetic-oxidative status compared with those of other Italian and European commercial breeds. PR and tPR were progressively reduced over time. In all clinical examination times, BCS was significantly lower in nonpregnant ewes compared with pregnant ones. Fresh GdP pre-pubertal lamb COCs achieved meiotic maturation and showed healthy bioenergetic-oxidative status after IVM. Vitrification reduced the oocyte maturation rate in all groups. However, mature oocytes retained their cytoplasmic maturity, expressed as a mitochondria distribution pattern and activity, indicating promising developmental competence. In conclusion, clinical- and biotechnological-assisted reproduction approaches can support conservation strategies of GdP and other local sheep breeds in Southern Italy.

Quality by Design (QbD) enabled and Box-Behnken design assisted approach for formulation of tranexamic acid loaded stratum corneum lipid liposomes

Tranexamic acid, a highly hydrophilic drug, is used for treatment of hyperpigmentation but topical delivery of drug is limited by poor permeation across lipidic stratum corneum membrane. Stratum corneum lipid liposomes have lipidic composition similar to that of stratum corneum layer that aids in efficient topical delivery of drugs. For quantitative analysis of drug, a LC-MS/MS based approach was successfully developed. In this study a QbD based approach was applied to optimize tranexamic acid loaded stratum corneum lipid liposomes by working on elements of QTPPs, CQAs, CMAs, CPPs and risk assessment. A 33 Box-Behnken design was used for correlation between independent variables (lipid: cholesterol ratio, RPM of magnetic stirrer and number of cycles of probe sonication) and dependent variables (encapsulation efficiency and mean particle size). A robust model was achieved, which had potential of being explored for the identification of design space. Both the responses (CQAs) were later overlayed to find the optimality region and an optimized batch was thus obtained having encapsulation of 35.78% and mean particle size of 93.5 nm. The final optimized batch as per desirability was studied further for in vitro drug release and that showed a complete release (101.65%) within 6 h that followed a zero-order drug release kinetics. The study concludes a reliable and robust formulation model for stratum corneum lipid liposomes with reduced failure and variability. Study also focuses on encapsulation of tranexamic acid (hydrophilic drug) in lipidic carrier systems. This paper lays the groundwork for future preclinical and clinical studies of stratum corneum lipid liposomes containing tranexamic acid for topical administration.

Feasibility of Roux-en-Y Gastric Bypass with the novel robotic platform HUGO™ RAS.

Robotic assisted surgery is a rapidly developing field of minimally invasive bariatric surgery in the last 20 years. Its wide diffusion has led to the development and standardization of robotic assisted approaches for bariatric operations. In this study, we present the first four Roux-en-Y Gastric Bypass (RYGB) operations performed with the new Hugo™ RAS system (Medtronic, Minneapolis, MN, USA). In January and February 2023, 4 consecutive patients scheduled for minimal invasive Roux-en-Y-Bypass were selected and underwent the procedure robotic-assisted with the new platform. No exclusion criteria were applied. Four patients, two females and two males, underwent RYGB with a median BMI of 40 Kg/m2 (range: 36-46) and diabetes mellitus in two cases. The median docking time was 8 min (range: 7-8.5) and the median console time was 127.5 min (range: 95-150). A description of the operating theatre, robotic arms and docking setup is provided. Procedures were performed without intraoperative complications and no conversion to laparoscopy or open surgery was noted. No additional ports were needed to be placed. System's function and docking were uneventful. No early post-operative complications were observed. Based on our initial experience, RYGB with the Hugo™ RAS system is feasible. This study provides the configurations necessary to perform RYGB with the Hugo™ RAS system as well as general information and insights from our preliminary experience.

Diaphragmatic plication: current evidence and techniques in the management of the elevated hemidiaphragm

: Diaphragm plication is the preferred surgical intervention for elevation of the hemidiaphragm. This can be a consequence of trauma, damage to the phrenic nerve, or congenital eventration. There are numerous surgical approaches to diaphragmatic plication including open thoracic, open abdominal, minimally invasive transthoracic, minimally invasive transabdominal, and robotic assisted. All approaches are acceptable practices, but there has been a shift to more minimally invasive and video-assisted approaches. In this clinical practice review, we have assessed the current evidence and techniques used for hemidiaphragm elevation. Most evidence assessing the various techniques comes in the form of case studies, case series, and small institutional studies. Video-assisted thoracoscopic surgery is a commonly employed technique associated with positive outcomes as evidenced by improvement of pulmonary function test following the procedure, fewer chest tube days, decrease in self-reported dyspnea, and short hospital stays. Laparoscopic plication is also an acceptable technique. Multiple case studies showed overall positive outcomes with limited morbidity. Robotic assisted approaches were also reviewed. These interventions were shown to improve spirometry values and dyspnea scores. Minimal data exist on open abdominal approaches, and there are not currently enough data to assess their effectiveness. Open thoracic approaches were associated with improvements in spirometry as well as dyspnea scores. All surgical approaches discussed are acceptable strategies for the treatment of the elevated hemidiaphragm. No one intervention appears to be superior, but minimally invasive approaches have become more popular. The success of these procedures is largely believed to be based on surgeon preference and level of expertise.

Genetics and marker-assisted breeding for sex expression in cucumber.

Cucumber is an important vegetable crop that provides an accessible draft genome, which has significantly expedited research in various fields of molecular genetics. Cucumber breeders have been employing various methodologies to improve the yield and quality of the crop. These methodologies comprise enhancement of disease resistance, use of gynoecious sex types and their association with parthenocarpy, alterations in plant architecture, and enhancement of genetic variability. The genetics of sex expression are a complex trait in cucumbers but are very significant for the genetic improvement of cucumber crop. This review comprises an explanation of the current status of gene(s) involvement and its expression studies, the inheritance of genes, molecular markers, and genetic engineering associated with sex determination, as well as a discussion of the role of ethylene in sex expression and sex-determining genes of the ACS family. There is no doubt that gynoecy is an important trait among all sex forms of cucumber for heterosis breeding, but if it is associated with parthenocarpy, fruit yield can be enhanced to a greater extent under favorable conditions. However, little information is available with regard to parthenocarpy in gynoecious-type cucumber. This review sheds light on the genetics and molecular mapping of sex expression and could be beneficial especially to cucumber breeders and other scientists working on crop improvement via traditional and molecular assistant approaches.

Machine-learning assisted topology optimization for architectural design with artistic flavor

A machine-learning assisted topology optimization approach is proposed for architectural design with artistic flavor. This work establishes a novel framework to systematically integrate structural topology optimization with subjective human design preferences. To embed artistic flavor into the design, neural style transfer technique is adopted for measuring and generating the prior knowledge from a reference image with concerned artistic flavor. With the use of different convolutional layers in the VGG-19 (Visual Geometry Group) model-based CNN (Convolutional Neural Network), both style and content of the artistic flavor from low to high levels of abstraction can be constructed. Then, the measured knowledge can be integrated into pixel-based topology optimization as a formal similarity constraint. Both 2D and 3D problems are solved to illustrate the effectiveness of the proposed approach where inheritance of artistic heritage can be achieved in a systematic manner.

A feasibility study demonstrating that independence, quality of life, and adaptive behavioral skills can improve in children with Down syndrome after using assistive technology.

Enhancing independence and quality of life are key modifiable outcomes that are short- and long-term goals for children with Down syndrome and for their parents. Here we report the outcome of a 4-week feasibility study in a cohort of 26 children with Down Syndrome, 7-17 years old, who used an assistive technology approach that incorporated smart device software and step-by-step pictures (the MapHabit System). Parents reported improvements in children's activities of daily living, quality of life, and independence. They recommended this technology to other families. This report and its findings underscore the feasibility of using assistive technology in children with Down syndrome within home and family settings. A limiting factor is whether participants who did not complete the study, and thus were not included in analyses, might have impacted the study outcomes. The current findings that assistive technology can be used successfully and effectively in family and home settings set the stage for more informative systematic studies using assistive technology for this population. Trial registration: The clinical trial is registered with ClinicalTrials.gov Registration number: NCT05343468.

Data‐Driven Approach to Tailoring Mechanical Properties of a Soft Material

AbstractData‐driven, machine learning (ML)‐assisted approaches have been used to study structure‐property relationships at the atomic scale, which have greatly accelerated the screening process and new material discovery. However, such approaches are not easily applicable to modulating material properties of a soft material in a laboratory with specific ingredients. Moreover, it is desirable to relate material properties directly to the experimental recipes. Herein, a data‐driven approach to tailoring mechanical properties of a soft material is demonstrated using ML‐assisted predictions of mechanical properties based on experimental synthetic recipes. Polyurethane (PU) elastomer is used as a model soft material to demonstrate the approach and experimentally varied mechanical properties of the PU elastomer by modulating the mixing ratio between components of the elastomer. Twenty‐five experimental conditions are selected based on the design of experiment and use those data points to train a linear regression model. The resulting model takes desired mechanical properties as input and returns synthetic recipes of a soft material, which is subsequently validated by experiments. Lastly, the prediction accuracies of different machine learning algorithms is compared. It is believed that the approach is widely applicable to other material systems to establish experimental conditions and material property relationships for soft materials.

V-005 Robot assisted parastomal hernia repair of an ileal conduit stoma

Abstract Aim The optimal surgical treatment of a parastomal hernia after ileal conduit urinary division has yet to be determined. Data is scarce and reported recurrence rates after different approaches in parastomal hernia repair remain high. Material & Methods A 65-year-old male patient, who had a history of a radical cystectomy with an ileal conduit urinary diversion, presented with a recurrent symptomatic parastomal hernia. He had a previous repair of his parastomal hernia via an open retromuscular approach with a unilateral posterior component separation (transversus abdominis release). Results A robot assisted repair of the recurrent parastomal hernia was performed using a partial intraperitoneal onlay mesh technique (PIPOM). Intraoperatively, intraluminal Indocyanine green (ICG) was used to identify the ileal conduit loop. A closure of the defect was performed with a barbed suture whereafter the repair was reinforced with a PVDF IPST ‘Chimney’ parastomal mesh. The latter being partially covered by peritoneum. The postoperative course was uneventful, and the patient went home on postoperative day one. The patient had no complications and a well-functioning ileal conduit stoma 6 weeks after surgery. Conclusions The repair of a recurrent parastomal hernia after ileal conduit urinary division represents a surgical challenge. After a previous retromuscular approach, a robotic assisted approach using a partial intraperitoneal onlay mesh technique (PIPOM) represents a feasible technique with promising results.

Multimodal Robot-Assisted Instrument Interaction for Solo Laparoscopic Sacrocolpopexy

Laparoscopic sacrocolpopexy (LSC) involves at least three clinicians who are required to operate under non-ergonomic postures for long periods of time. Furthermore, LSC is characterized by miscommunication and high vaginal vault manipulation forces which possibly lead to overtensioning of tissue. This work presents a multimodal robotic assistance approach for solo LSC. Multimodality provides a set of instrument interaction modes that allows the surgeon to operate in close vicinity with the patient. It increases situational awareness and avoids miscommunication while ensuring safe vaginal vault exposure. The robotic setup is experimentally validated by ten gynecologists who performed a vaginal mesh fixation task on a box trainer. When compared to manual surgery, it was found that robotic assistance allows the solo surgeon to operate as fast (24.07±1.63 min vs. 23.75±1.54 min, p = 0.49) and with lower peak forces (12.23 ± 3.03N vs. 9.26 ± 1.41N, p = 0.02) applied to the vaginal vault. The results are promising as they show that the multimodal approach allows for robot-assisted solo surgery. This way, it frees clinicians from non-ergonomic tasks while maintaining similar surgery times and quality. Moreover, it reduces the risk of overtensioning of the vaginal tissue.

Easier way of managing gastric gastrointestinal stromal tumor located at unusual site: a case report

Intraluminal gastric gastrointestinal stromal tumors (GISTs) located at the posterior wall and near the gastroesophageal (GE) junction represent a surgical challenge. We present a easier laparoscopic assisted mini laparotomy approach for resection of gastric GISTs of such location. A 42 years old female presented with history of Malena and anemia. Endoscopic and contrast enhaced computerised tomography (CECT) scan findings were suggestive of GIST arising from posterior wall along lesser curvature in proximal body of stomach. We planned her for surgical resection of tumor. During laparoscopy, posterior wall stomach was completely mobilised after dividing gastrocolic and phrenogastric ligaments. Due to unfavourable location of tumor in posterior wall and proximity to GE junction, accessibility for negative resection margin was difficult, so we did mini laparotomy (approx 5 cm midline incision) and already mobilised stomach is delivered out, wedge resection of tumor done after assuring resection margin with direct palpation. GISTs of the posterior wall and in close proximity to the GE junction can be safely resected with laparoscopic assistance using such an approach. This technique is useful alternative in unavailability of simultaneous laparoscopy with endoscopy as required in laparoscopic and endoscopic cooperative surgery in such locations of tumor.

Integrating a tumour appropriate transanal or robotic assisted approach to total mesorectal excision in high-volume rectal cancer practice is safe and cost-effective.

Total mesorectal excision (TME) is accepted as the gold standard for oncological resection in rectal cancer. The best approach to TME is debated and often surgeons will select a preferred approach. In this study, we aimed to describe how both robotic (R-TME) and transanal (TaTME) TME can be integrated into high-volume rectal cancer surgeon practice with a comparison of clinical and oncological outcomes and cost analysis. A prospective comparative cohort study was performed in a high-volume rectal cancer centre comparing the previous 50 R-TME and 50 TaTME performed by the same surgeon. A comparison of tumour characteristics was performed to highlight a specific role for each technique. Clinical outcomes (operative duration, length of stay (LOS) and perioperative morbidity), cancer quality indicators (resection margin and completeness of TME) and cost analysis were compared. Statistical analysis was performed using IBM SPSS, version 20. R-TME was preferred in mid-rectal cancer, compared to TaTME preferred in low rectal cancer (9cm vs. 5cm, p < 0.001). Operative duration was longer in R-TME compared to TaTME (265 vs. 179min, p < 0.001). Major complications (CD III-IV complications) were experienced in 10% of R-TME and 14% of TaTME (p = 0.476). A 98% (n = 49) clear R0 resection margin was achieved with both R-TME and TaTME and mesorectum quality defined as 'complete' in 86% (n = 43) in R-TME and 82% (n = 41) in TaTME. Length of hospital stay was shorter in R-TME (5 vs. 7days, p = 0.624). An overall difference of €131 was observed favouring TaTME. In high-volume rectal cancer surgery practice, both R-TME and TaTME can be practised and tailored according to patients and tumour characteristics, with comparable clinical and cancer outcomes and is cost-effective.