Precise Operation Research Articles

Chinese expert consensus on precision obesity metabolic surgery (2022 edition)

With the increasing prevalence of obesity and the popularity of bariatric surgery, more and more patients with obesity are undergoing bariatric surgery. "Precision Medicine" is a new generation of medical concepts. We introduce the concept of "precision medicine" into precision bariatric and metabolic surgery, in order to optimize and integrate modern surgical theory and technology with traditional surgical methods under the requirements of high precision and high efficiency standards, so as to achieve minimal trauma and invasion, maximal organ protection, minimal medical cost and best weight loss effect. Chinese Society for Metabolic and Bariatric Surgery (CSMBS) organized some domestic bariatric surgery experts to conduct four relevant problem-oriented and 36 clinically practical problems, including precise preoperative assessment, precise perioperative management, precise surgical operation, and precise postoperative management. Based on domestic and foreign literature evidence and combined with Chinese conditions and clinical experience, CSMBS has formulated a Chinese expert consensus on precision obesity metabolic surgery, aiming to provide guidance for the clinical practice of precision obesity metabolic surgery in our country.

Application of the concept of precision obesity metabolic surgery in laparoscopic Roux-en-Y gastric bypass

Due to the complexity and heterogeneity of obesity, the diagnosis and treatment of obesity vary greatly. Five to 10 percent of body weight can be lost through lifestyle modifications, nutritional and behavioral counseling, and the use of approved weight reduction medicines for obesity and diabetes; however, these non-surgical treatments are not effective for all patients. Compared to medical therapy, bariatric surgery is associated with higher rates of type 2 diabetes remission, lower mortality from vascular complications, and long-term, sustained weight loss. With the advent of precision medicine in surgical therapy, bariatric surgeons' fundamental understanding of laparoscopic Roux-en-Y gastric bypass surgery has evolved in recent years. The objective of surgery has shifted from short-term weight loss to the safe and successful long-term management of patient weight and comorbidities. In laparoscopic Roux-en-Y gastric bypass surgery, the concept of precision bariatric and metabolic surgery is mainly reflected in three aspects: accurate preoperative assessment, precise intraoperative operation, and comprehensive postoperative management. A new direction for the future development of precision laparoscopic Roux-en-Y gastric bypass surgery and obesity metabolic surgery is to formulate precise and individualized surgical treatment plans for patients and to use artificial intelligence and big data technology to improve the standardization of specialist data.

Precise application of sleeve gastrectomy

With the improvement of the national economy and living standards, the prevalence of obesity and related metabolic diseases is increasing yearly. The treatment effect of traditional diet control, physical exercise, and drug therapy are not ideal. Metabolic and bariatric surgery is not only aimed at weight loss, but also improves or resolves a variety of metabolic comorbidities, such as type 2 diabetes, hypertension, sleep apnea syndrome, and hyperlipidemia, enhancing the quality of life of patients. Surgical methods are also updated and iterated with the continuous development of metabolic surgery for weight loss. At present, more than 50% of the mainstream procedures are laparoscopic sleeve gastrectomy (LSG). The application of LSG should focus on precise surgical operations and indications to avoid or reduce adverse reactions and complications, so as to maximize the effect of bariatric surgery. At the same time, standardized postoperative management, multidisciplinary team (MDT) and in-hospital database construction, dietary nutrition and exercise guidance after discharge, and regular follow-up review are still important guarantees for the weight loss effect.

Clinical Attitudes, Behaviors and Perceived Stress Towards the COVID-19 Pandemic: A Questionnaire Survey among Swiss Dentists.

To investigate dentists' work conditions, awareness, protective measures, economic effects and perceived stress during the first two waves of the COVID-19 pandemic. This cross-sectional survey was conducted among 126 dentists working in the Frenchspeaking part of Switzerland, in particular in the Cantons of Vaud and Geneva. Data consisted of the answers to 40 questions assessing the knowledge, attitudes, workload and mental condition of the dentists during the first 2 waves of the COVID-19 pandemic. Swiss dentists received sufficient information about the COVID-19 pandemic and implemented protective measures. Differences were found between the 1st and the 2nd wave concerning the workload; during the first wave, the workload was low for the majority of dentists (60%), whereas during the second, it was moderate (53.4%) or high (41.3%). During both waves, the mental burden was also important, and was related mainly to financial issues and fear of infection. This survey reported that Swiss dentists were, in general, satisfied with the transmission of precise operating guidelines during the pandemic. However, a considerable psychological impact, mainly during the first wave, was revealed. With the implementation of proper strategic measures during the COVID-19 outbreak, dental practitioners will be prepared for future global health-care disruptions.

Image-based real-time feedback control of magnetic digital microfluidics by artificial intelligence-empowered rapid object detector for automated in vitro diagnostics.

In vitro diagnostics (IVD) plays a critical role in healthcare and public health management. Magnetic digital microfluidics (MDM) perform IVD assays by manipulating droplets on an open substrate with magnetic particles. Automated IVD based on MDM could reduce the risk of accidental exposure to contagious pathogens among healthcare workers. However, it remains challenging to create a fully automated IVD platform based on the MDM technology because of a lack of effective feedback control system to ensure the successful execution of various droplet operations required for IVD. In this work, an artificial intelligence (AI)-empowered MDM platform with image-based real-time feedback control is presented. The AI is trained to recognize droplets and magnetic particles, measure their size, and determine their location and relationship in real time; it shows the ability to rectify failed droplet operations based on the feedback information, a function that is unattainable by conventional MDM platforms, thereby ensuring that the entire IVD process is not interrupted due to the failure of liquid handling. We demonstrate fundamental droplet operations, which include droplet transport, particle extraction, droplet merging and droplet mixing, on the MDM platform and show how the AI rectify failed droplet operations by acting upon the feedback information. Protein quantification and antibiotic resistance detection are performed on this AI-empowered MDM platform, and the results obtained agree well with the benchmarks. We envision that this AI-based feedback approach will be widely adopted not only by MDM but also by other types of digital microfluidic platforms to offer precise and error-free droplet operations for a wide range of automated IVD applications.

Global Navigation Satellite System Real-Time Kinematic Positioning Framework for Precise Operation of a Swarm of Moving Vehicles.

The global navigation satellite system (GNSS) real-time kinematic (RTK) technique is used to achieve relative positioning centimeter levels among multiple agents on the move. A typical GNSS RTK estimates the relative positions of multiple rover receivers with respect to a single-base receiver. In a fleet of rover GNSS receivers, this approach is inefficient because each rover receiver only uses GNSS measurements of its own and those sent from a single-base receiver. In this study, we propose a novel GNSS RTK framework that facilitates the precise positioning of a swarm of moving vehicles through the GNSS measurements of multiple receivers and broadcasts fixed-integer ambiguities of GNSS carrier phases. The proposed framework not only provides efficient RTK positioning but also reliable performance with a limited number of GNSS satellites in view. Our experimental flight tests with six GNSS receivers showed that the systematic procedure of the proposed framework could maintain lower than 6 cm of 3D RMS positioning errors, whereas the conventional RTK failed to resolve the correct integer ambiguities of double difference carrier phase measurements more than 13% in five out of nine total baselines.

A Multi-DOF Manipulator Joint Trajectory Tracking and Monitoring Method Based on Decision Tree

Understanding trajectory tracking control concerns is crucial for industrial-grade manipulators to provide precise and risk-free operations for the safe environment. Consequently, the robot arms need precise aim for tracking a given target trajectory by the trajectory control input driving torque which can use smart AI-based techniques for precision. Similarly, a decision tree is a soft computing-based method of feature space partitioning which can certainly allow the movement of robots in an accurate manner. The control of robot arms is an important aspect for automating the process of sustainable development. Aiming at the problem of poor tracking accuracy of traditional Multi-Degree-of-Freedom Manipulator Joint Trajectory Monitoring (Multi-DoF MJTM) and long monitoring delay, this article proposes a Multi-DOF manipulator joint trajectory tracking method based on decision tree. The Multi-DoF manipulator is developed for the adaptive control object of the working machine, and it is combined with the output response feature to construct the kinematics model of the Multi-DoF manipulator mechanism of the walking machine. The joint trajectory reconstruction of the running trajectory is used to obtain the joint trajectory deviation of the Multi-DoF manipulator’s running trajectory through the multi-measurement system. Based on this, the Multi-DoF manipulator’s running trajectory joint trajectory tracking control equation is obtained to realize the joint trajectory tracking and monitoring of the manipulator. The features for a safe environment are also integrated. The experimental results show that the proposed method has high accuracy in tracking the trajectory of Multi-DoF manipulator joints, and the time delay for tracking and monitoring the trajectory of manipulator’s joints is also optimized.

An Additive Graphical Model for Discrete Data

We introduce a nonparametric graphical model for discrete node variables based on additive conditional independence. Additive conditional independence is a three-way statistical relation that shares similar properties with conditional independence by satisfying the semi-graphoid axioms. Based on this relation we build an additive graphical model for discrete variables that does not suffer from the restriction of a parametric model such as the Ising model. We develop an estimator of the new graphical model via the penalized estimation of the discrete version of the additive precision operator and establish the consistency of the estimator under the ultrahigh-dimensional setting. Along with these methodological developments, we also exploit the properties of discrete random variables to uncover a deeper relation between additive conditional independence and conditional independence than previously known. The new graphical model reduces to a conditional independence graphical model under certain sparsity conditions. We conduct simulation experiments and analysis of an HIV antiretroviral therapy dataset to compare the new method with existing ones. Supplementary materials for this article are available online.

Frenotomy procedure of a cleft lip and palate case

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease can be transmitted through direct or indirect contact with droplets from the infected person’s respiratory system. The aim of this study was a rapid review of the use of personal protective equipment against coronavirus in the field of dentistry.Methods: This study was a rapid cross-sectional review and research. A search was performed in Scopus and PubMed. The key words were PPE) personal protective equipment) with “Corona virus” OR “Coronavirus” OR “Covid 19” as well as thecombination of “oral health” and “dent” with “Corona virus” OR “Covid 19” OR “coronavirus.” Finally, we selected nine articles and excluded 545 irrelevant articles. We reviewed these nine studies in full text and excluded two of them as they were unrelated to the review of personal protective equipment.Results: One study showed that patients with COVID-19 who do not yet have symptoms might seek emergency dental treatment. Two researchers concluded that dentists had good information about how the virus was transmitted but did not know its symptoms well. One study concluded that the use of filtering facepiece respirators (FFRs) during the COVID-19 pandemic is essential to preventing exposure to aerosols and droplets, as it is more fluid-resistant and functions better than surgical masks, which cause flooding around the mouth and nose.Conclusion: This study shows that many dentists do not have enough information about the disease and proper personal protective equipment. This may be due to a lack of precise operating instructions.

Personal protective equipment against coronavirus in the field of dentistry: A rapid review

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) disease can be transmitted through direct or indirect contact of droplets. The aim of this study was rapid review of personal protective equipments in the field of dentistry against coronavirus.Method: This study was a rapid review and cross sectional research. A search was performed in Scopus and PubMed. The key words was PPE) personal protective equipment( with "Corona virus "OR "Coronavirus" OR "Covid 19" as well as the combination of "oral health" and "dent" with "Corona virus" OR "Covid 19" OR "coronavirus". Finally, we selected 9 articles and excluded 545 unrelated articles. We reviewed these 9 studies in full text and excluded 2 of them being unrelated to the review of personal protective equipment.Results: A study showed that patients with Covid-19 who do not yet have symptoms may seek emergency treatment. Two researchers concluded that dentists had good information about how the virus was transmitted but did not know its symptoms well. A study concluded that the use of filtering face piece respirators (FFRs) during the Covid-19 epidemic is essential to prevent the transmission of aerosols and droplets, as it has been shown to be more fluid-resistant and better than surgical masks which cause flooding around the mouth and nose. Conclusion: This study shows that to some extent a significant number of dentists do not have enough information about the disease and proper personal protective equipment. This may be due to the lack of precise operating instructions.

P‐2.12: Application status and prospect of mixed reality in medical surgery

The full text illustrates the specific application progress and application results of mixed reality technology in medical surgery by cite the case of the combination of mixed reality and medical surgery, and points out that mixed reality technology plays an important auxiliary role in medical surgery and can help accurate surgery. Positioning, precise operation, shortening the operation time, reducing blood loss and so on. Based on the above advantages, the application prospect of mixed reality technology in the field of medical surgery is very broad, and more and more scientific researchers are required to explore this aspectMixed reality technology can assist doctors in surgical operations, and has the main advantages of accurate positioning, precise operation, shortening the operation time, and reducing blood loss. More and more scientific researchers are required to continue to research and develop more applications that assist medical operations to proceed smoothly.

Sensorimotor Control Sharing With Vibrotactile Feedback for Body Integration Through Avatar Robot

An avatar robot can be operated by multiple users, augmenting the operation of a single user. In this study, we assembled a collaborative operation system for a 7-DoF robotic arm with a gripper controlled by two users. The users share the role of controlling the robot with one user controlling the arm and the other controlling the gripper. The actions of the two users must be seamlessly coordinated to ensure smooth and precise operations. Therefore, this study aimed to investigate vibrotactile feedback to promote recognition of the actions of a partner. A pick-and-place task was considered as a basic operation. First, an intensity adjustment was developed for vibrotactile feedback to ensure linear sensitivity and its usefulness was verified. An estimation test for the reaching motion showed that the target position was estimated accurately based on velocity feedback, indicating that the participants imaged the arm motion. Subsequently, collaboration tests with and without vibrotactile velocity feedback revealed a potential effect of vibrotactile feedback in terms of reducing the time required for completing the target task. Our experimental results indicate that vibrotactile feedback for partner's motion can be applied to achieve smooth collaborative operations using an avatar robot.

Fault Ride Through of Inverter-Interfaced Renewable Energy Sources for Enhanced Resiliency and Grid Code Compliance

Inverter-interfaced renewable energy sources (IIRESs) are typically controlled during fault conditions to meet fault ride-through (FRT) requirements, e.g., reactive current generation (RCG) requirements specified by grid codes (GCs). However, fault currents generated by inverters are different from the traditional sources, i.e., synchronous generators. Consequently, phase selection methods (PSMs) used by protection relays could suffer from erroneous fault type classification. This paper develops a dual current controller (DCC) that regulates the inverter's negative- and positive-sequence currents to simultaneously meet phase selection and RCG requirements. First, the negative-sequence-current angle is obtained based on the angles of both zero- and positive-sequence currents to enable a correct operation for phase selection. Then, the positive-sequence current angle is adjusted to reach a trade-off between RCG requirements and phase selection achieved by the negative-sequence current. Lastly, the reference currents of the IIRES are generated in the stationary frame without violating the inverter's current limits. The proposed DCC supports the grid voltage by meeting the RCG requirements and enhancing the grid reliability and resilience by enabling correct phase selection. Comprehensive time-domain and real-time simulation verify the precise operation of the proposed DCC under various fault conditions and GCs.

Clinical practice guidelines for endometriosis in Japan (The 3rd edition).

Clinical practice guidelines for endometriosis in Japan (The 3rd edition).

Improvement and Experimental Explore on Coordinated Control of Kinematic Mechanism of FDM 3D Printer

As the main component of the 3D printing industry, the fused deposition process covers all aspects of the industry with its advantages of low R&D investment, high practicability, and open source programs. However, due to process problems, problems have arisen in terms of printing efficiency and molding quality. To this end, we designed a large-scale multinozzle FDM printing device using the high-current fused deposition (FDM) printing principle. The defects of small size, slow printing speed, and low precision are deeply studied, and the machine structure is optimized according to the structural strength analysis. In this paper, the theoretical design and static analysis of the overall mechanical part of the large-scale FDM device are carried out, and then, the selection of the movement organization structure and movement method is theoretically analyzed. A modular flow chart is designed for the control system to coordinate and control the parallel and precise operation of multiple nozzles, and the relationship function between the main controller, power driver, and heating module is designed. By modifying the firmware parameter command, we can find out the optimal method running on the platform and discuss the function usage of the slicing software in detail. According to the current problems of FDM printing equipment, various factors affecting printing speed were analyzed from the perspective of printing accuracy, and the process parameters of 3D printer were studied through orthogonal experiments. Speed, nozzle temperature, idling speed, and fill rate were studied, and the relationship between factors affecting printing speed and printing accuracy was obtained. Use a simple model print to measure the overall performance of your product. The stability of the system is verified by short-term and long-term printing tests. The analysis results show that the forming performance and stability of the large-scale FDM are improved significantly.

Structural design and analysis of pneumatic prostate seed implantation robot applied in magnetic resonance imaging environment.

The method of MRI (Magnetic Resonance Imaging) image-guided robot for prostate seed implantation has developed rapidly in recent years. During the operation, although the puncture effect guided by MRI is very good, it is difficult for conventional robots driven by motors to work normally in this environment, which reduces the accuracy of seed implantation and affects the treatment effect. First, this paper designs a pneumatic prostate seed implantation robot that is compatible with MRI; the robot is composed of an execution module and an adjustment module, and can complete the positioning and adjustment of the robot's needle entry point, the pose adjustment of the puncture needle and the completion of seed implantation in the MRI space; meanwhile, the statics simulation analysis of its key components is carried out. Then, the kinematics analysis was carried out according to the designed robot structure, and the relationship between the posture of the needle tip and the change of the pneumatic cylinder was obtained; meanwhile, using MATLAB 2020 software, combined with the method of Monte Carlo random number sampling, the simulation analysis of the workspace was carried out. Finally, an experimental prototype is constructed to conduct puncture accuracy experiments, workspace experiments and performance comparison tests in MRI environment. The statics simulation results verify that the key components of the robot designed in this paper can meet the strength requirements of the robot. The simulation results of the workspace meet the requirements of space surgery for prostate seed implantation under the guidance of MRI environment. The puncture accuracy experimented to verify that increasing the puncture speed can improve the seed implantation accuracy, and the puncture deviation of the robot is less than the average deviation of the doctor's actual operation by 6.5mm. The working space experiment shows that the pitch range is -23.3°~27.8°, the movement range in the X direction is 0~210mm, the movement range in the Y direction is 0~101mm, and the lifting range in the Z direction is 0~81mm, which meets the workspace requirements under MRI. The performance comparison test results in the MRI environment show that the robot is well compatible with MRI instruments. The pneumatic prostate seed implantation robot designed in this paper has a reasonable structure and stable dynamic performance output, and can perform precise surgical operations in the MRI strong magnetic environment. The research work in this paper provides a design reference for the related research on the positioning accuracy of minimally invasive puncture surgery guided by MRI images.

A self-sensing soft pneumatic actuator with closed-Loop control for haptic feedback wearable devices

The intuitive and effective haptic feedback interaction is essential for human–machine interfaces. However, most current commercial haptic feedback solutions are rigid, simplex, and insufficient to fully immerse users in virtual and teleoperated environments. Here, we report the design, fabrication and performance of a low-cost and lightweight self-sensing actuator (SenAct) that provides accurate force and vibration feedback to recreate the tactile perception. The SenAct shows good performance such as fast response (10 ms), high robustness (>10,000 cycles), and large output force (up to 1.55 N) with high controllable resolution (up to 0.02 N) based on the real-time closed-loop control. It is capable of providing the corresponding haptic feedback to the wearer through external force or vibration signal input. With this prototype, we presented a haptic feedback glove that supports precise operation by enhancing immersion and comprehensive sensation. Furthermore, we demonstrated it could shape appropriate interaction in different scenarios, including touching or grasping objects in virtual reality and teleoperation, illustrating its potential applications in human-in-loop interaction system and metaverse.

Recent Process in Microrobots: From Propulsion to Swarming for Biomedical Applications.

Recently, robots have assisted and contributed to the biomedical field. Scaling down the size of robots to micro/nanoscale can increase the accuracy of targeted medications and decrease the danger of invasive operations in human surgery. Inspired by the motion pattern and collective behaviors of the tiny biological motors in nature, various kinds of sophisticated and programmable microrobots are fabricated with the ability for cargo delivery, bio-imaging, precise operation, etc. In this review, four types of propulsion—magnetically, acoustically, chemically/optically and hybrid driven—and their corresponding features have been outlined and categorized. In particular, the locomotion of these micro/nanorobots, as well as the requirement of biocompatibility, transportation efficiency, and controllable motion for applications in the complex human body environment should be considered. We discuss applications of different propulsion mechanisms in the biomedical field, list their individual benefits, and suggest their potential growth paths.

Image Semantic Segmentation of Underwater Garbage with Modified U-Net Architecture Model.

Autonomous underwater garbage grasping and collection pose a great challenge to underwater robots. To assist underwater robots in locating and recognizing underwater garbage objects efficiently, a modified U-Net-based architecture consisting of a deeper contracting path and an expansive path is proposed to accomplish end-to-end image semantic segmentation. In addition, a dataset for underwater garbage semantic segmentation is established. The proposed architecture is further verified in the underwater garbage dataset and the effects of different hyperparameters, loss functions, and optimizers on the performance of refining the predicted segmented mask are examined. It is confirmed that the focal loss function will lead to a boost in solving the target–background unbalance problem. Eventually, the obtained results offer a solid foundation for fast and precise underwater target recognition and operations.

Chopstick technique versus cross technique in LESS hysterectomy (CCLEH study): a prospective randomized controlled trial

BackgroundThe traditional cross technique can be used to complete most laparoendoscopic single-site surgery (LESS) procedures, but some relatively precise operations, such as vaginal stump suturing, are challenging. In practice, we have introduced a novel technique named the chopstick technique and applied it to more complex operations, such as cervical cancer operations, and found that it contributes to performing delicate surgery. The efficacy and safety of two different surgical techniques in LESS hysterectomy remain to be validated.MethodsPatients who undergo total hysterectomy will be enrolled in this RCT. Stratified randomization will be performed according to uterine size (< 10 cm, 10–15cm, ≥ 15 cm). The participants will be divided into the chopstick technique group or cross technique group to undergo laparoendoscopic single-site total hysterectomy (LESS-TH), and then the perioperative and postoperative data, including the total operation time and other times, transfer rates, estimated blood loss, surgeon fatigue, intraoperative and postoperative complications (within 8 weeks after surgery), health-related quality of life (EQ-5D) scores, postoperative hospital stay, and hospitalization expenses, will be evaluated. The primary outcome is the operating time for total hysterectomy under LESS, and the other outcomes are secondary outcomes.DiscussionIt is expected that the efficacy of the two techniques in LESS, the chopstick technique vs. the cross technique, will be compared and accumulate safety data on the new techniques will be accumulated.Trial registrationChiCTR2000040843, registered on June 16,2020Protocol version:Version 2.0; Date: 2020.05.10