Operator Preference Research Articles

Explainable artificial intelligence for reliable water demand forecasting to increase trust in predictions

The “EU Artificial Intelligence Act” sets a framework for the implementation of artificial intelligence (AI) in Europe. As a legal assessment reveals, AI applications in water supply systems are categorised as high-risk AI if a failure in the AI application results in a significant impact on physical infrastructure or supply reliability. The use case of water demand forecasts with AI for automatic tank operation is for example categorised as high-risk AI and must fulfil specific requirements regarding model transparency (traceability, explainability) and technical robustness (accuracy, reliability). To this end, six widely established machine learning models, including both transparent and opaque models, are applied to different datasets for daily water demand forecasting and the requirements regarding model accuracy, transparency and technical robustness are systematically evaluated for this use case. Opaque models generally achieve higher prediction accuracy compared to transparent models due to their ability to capture the complex relationship between parameters like for example weather data and water demand. However, this also makes them vulnerable to deviations and irregularities in weather forecasts and historical water demand. In contrast, transparent models rely mainly on historical water demand data for the utilised dataset and are less influenced by weather data, making them more robust against various data irregularities. In summary, both transparent and opaque models can fulfil the requirements regarding explainability but differ in their level of transparency and robustness to input errors. The choice of model depends also on the operator's preferences and the context of the application.

Implementing Autonomous Control in the Digital-Twins-Based Internet of Robotic Things for Remote Patient Monitoring.

Conventional patient monitoring methods require skin-to-skin contact, continuous observation, and long working shifts, causing physical and mental stress for medical professionals. Remote patient monitoring (RPM) assists healthcare workers in monitoring patients distantly using various wearable sensors, reducing stress and infection risk. RPM can be enabled by using the Digital Twins (DTs)-based Internet of Robotic Things (IoRT) that merges robotics with the Internet of Things (IoT) and creates a virtual twin (VT) that acquires sensor data from the physical twin (PT) during operation to reflect its behavior. However, manual navigation of PT causes cognitive fatigue for the operator, affecting trust dynamics, satisfaction, and task performance. Also, operating manual systems requires proper training and long-term experience. This research implements autonomous control in the DTs-based IoRT to remotely monitor patients with chronic or contagious diseases. This work extends our previous paper that required the user to manually operate the PT using its VT to collect patient data for medical inspection. The proposed decision-making algorithm enables the PT to autonomously navigate towards the patient's room, collect and transmit health data, and return to the base station while avoiding various obstacles. Rather than manually navigating, the medical personnel direct the PT to a specific target position using the Menu buttons. The medical staff can monitor the PT and the received sensor information in the pre-built virtual environment (VE). Based on the operator's preference, manual control of the PT is also achievable. The experimental outcomes and comparative analysis verify the efficiency of the proposed system.

Prophylactic administration of glycopyrrolate prevents vasovagal responses induced by pulsed field ablation in patients with atrial fibrillation

Abstract Background The FarapulseTM system was the first pulsed field ablation device to receive regulatory approval. Vagal Responses (VR) during pulmonary vein isolation (PVI) with this pentaspline device are frequent and often require back-up pacing or the administration of parasympathetic drugs. Glycopirrolate (GLY) is a medication of the muscarinic anticholinergic group; its efficacy for VR prevention when administered prophylactically before PVI has never been reported. Objective To evaluate the effectiveness of prophylactic intravenous administration of GLY on VRs induced by PFA. Methods Consecutive AF patients undergoing first-time PVI with PFA via the FarapulseTM system between April and October 2023 were prospectively enrolled in 3 European centers. Prophylactic administration of GLY (0.2 mg intravenous administration before femoral vein puncture) [Group GLY(+)] was adopted based on operator’s preference. VR was defined as at least one of the following: sinus bradycardia (<40 beats/min), asystole (>6 sec), or atrioventricular block (AVB) occurring immediately after a pulsed electric field application. VRs and maximum pause duration (maximum RR interval) were determined for each PV. Temporary backup pacing was performed as per the operator's preference. Results We enrolled 141 patients [GLY(+): 64 patients; GLY(-): 77 patients] undergoing PVI with the pentaspline FarapulseTM system. Median age was 54.1 years (54.1- 70), and 76 (54%) patients were males with an average CHA2DS2-VASc Score of 1.0 (0 – 2). A total of 563 PVs, including 3 left common PVs and 2 accessory middle PVs, were successfully isolated with the FarapulseTM PFA system. There were no statistically significant differences in baseline and procedural characteristics between two groups. VRs during PVI occurred in a total of 53 (37.6%) patients. GLY administration reduced significantly the incidence of any VRs (4.7% vs 64.9%; p<0.001) (Figure 1A). Additionally, GLY resulted in a lower incidence of VRs during LSPV (4.7% vs 62.3%; p<0.001) and LIPV (1.6% vs 9.1%; p<0.001) (Figure 1B) isolation and the need for temporary backup pacing during LSPV (24.7% vs 1.6%; p<0.001) isolation. Maximum pause duration was significantly shorter in the GLY(+) group after PFA of LSPV (1195 vs 3459 sec; p<0.001), LIPV (1128 vs 1556 sec; p<0.001), RSPV (1138 vs 1607 sec; p<0.001) and RIPV (1103 vs 1343 sec; p<0.001) compared to GLY(-) group (Figure 1C). Conclusions Glycopyrrolate is highly effective in the prevention of VRs induced by PFA ablation in AF patients undergoing first-time PVI.Figure 1

Durable pulmonary vein isolationwith optimized high-power and very high-power short-duration temperature-controlled ablation: A step-by-step guide.

Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power-controlled ablation catheters with conventional power ranges was the norm. There has been increased adoption of a high-power and very high-power short-duration ablation practice propelled by the availability of the temperature-controlled radiofrequency QDOT MICRO catheter. There are fundamental differences in biophysics between very high-powered temperature guided ablation and conventional ablation strategy that may impact patient outcomes. The catheter's design and ablation modes offer flexibility in technique while accommodating the individual operator's clinical discretion and preference to deliver a durable, transmural, and contiguous lesion set. Here, we provide recommendations for 3 different workflows using the QDOT MICRO catheter in a step-by-step manner for pulmonary vein isolation based on our cumulative experience as early adopters of the technology and the data available in the scientific literature. With standardization, temperature-controlled ablation with the QDOT MICRO catheter provides operators the flexibility of implementing different ablation strategies to ensure durable contiguous pulmonary vein isolation depending on patient characteristics.

Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry

BackgroundVascular complications (VCs) still represent one of the principal concerns of trans-femoral trans-catheter aortic valve replacement (TF-TAVR). New-generation devices can minimize such complications but the arterial access management is left to the operator's choice. This study aims to describe the rate of VCs in a contemporary cohort of patients undergoing TAVR with new-generation devices and to determine whether an ultrasound-guided (USG) vs. a fluoroscopy-guided (FG) femoral access management has an impact on their prevention. MethodsThis is a prospective, observational, multicenter study. Consecutive patients undergoing TAVR with new-generation devices were analyzed from January 2022 to October 2022 in five tertiary care centers. Femoral accesses were managed according to the operator's preferences. All the patients underwent a pre-discharge peripheral ultrasound control. VCs and bleedings were the main endpoints of interest. ResultsA total of 458 consecutive patients were enrolled (274 in the USG group and 184 in the FG group). VCs occurred in 6.5 % of the patients (5.2 % minor and 1.3 % major). There was no difference between the USG and the FG groups in terms of any VCs (7.3 % vs. 5.4 %; p = 0.4), or any VARC-3 bleedings (6.9 % vs 6 %, p = 0.9). At logistic regression analysis, the two guidance strategies did not result as predictors of VCs (odds Ratio 0.8, 95 % Confidence Interval 0.46–1.4; P = 0.4). ConclusionsIn a contemporary cohort of patients undergoing TAVR with new-generation devices, the occurrence of VCs is low and mostly represented by minor VCs. USG and FG modalities did not affect the rate of VCs.

The Impacts of Unreliable Autonomy in Human-Robot Collaboration on Shared and Supervisory Control for Remote Manipulation

This work compared human-robot shared and supervisory control of remote robots for dexterous manipulation, and examined how the reliability of robot autonomy affects human operator performance, workload, and preference for robot assistance. Specifically, we implemented two human-robot collaboration (HRC) paradigms for remote manipulation: (1) shared control, where humans controlled gross manipulation and the robot autonomy controlled precise manipulation actions, and (2) supervisory control, where the robot autonomy controlled both gross and precise manipulation actions but relied on humans to detect and correct errors. We conducted two user studies: one to compare the effectiveness of the two HRC paradigms when assistive autonomy is reliable, and the other to examine the impact of error type and frequency on tasks and human operators in the two HRC paradigms when assistive autonomy is unreliable. Our results show that: (1) the interface with a higher level of reliable autonomy yields significantly better performance, lower workload, and higher user preference but lower engagement, and (2) the frequency and type of the error have significant impacts on the task performance and human workload but only partially affects the operator's preference and usage of autonomy.

Zero fluoroscopy ablation for atrioventricular nodal reentrant tachycardia and typical atrial flutter is equally safe and effective with EnSite NavX, Carto3, and Rhythmia mapping systems.

Our purpose was to compare the procedural characteristics, success rate, and complication rate of the conventional fluoroscopic (CF) and the zero-fluoroscopic (ZF) approach in patients undergoing catheter ablation of AVNRT or typical atrial flutter (Aflu). 186 consecutive patients with an indication for AVNRT or Aflu ablation were enrolled. Based on the operator's preference, the patients were assigned to either CF or ZF group. In the ZF group EnSite NavX, Carto3, or Rhythmia EAMS were used for catheter guidance. The median age was 56 (IQR = 42-68) years, 144 patients had AVNRT, and 42 had Aflu ablation. CF approach was chosen in 123 cases, while ZF in 63 cases. ZF approach was used more often in case of AVNRT patients [56 (39%) vs. 7 (17%), p = 0.006] and in the case of female patients [43 (68%) vs. 20 (32%), p = 0.008]. Acute procedural success was obtained in all cases. There was no difference in the complication rate (1 vs. 1, p > 0.99) between the two groups. No difference was found regarding the procedure time between the CF and ZF groups [CF: 55 (46-60) min, ZF 60 (47-65) min; p = 0.487] or in the procedure time for the different EAMS [EnSite NavX: 58 (50-63) min, Carto3: 60 (44.5-66.3) min, Rhythmia: 55 (35-69) min; p = 0.887]. A similar success rate was seen at the 3-month follow-up in the two groups [41 (100%) vs. 96 (97%); p = 0.55]. The ZF approach demonstrated non-inferiority in safety and efficacy compared with CF for the AVNRT and Aflu ablations.

Review on Design and Analysis of Drill Head of Boring Machine by using Vibration Conditioning Monitoring

Abstract: In terms of both productivity and product quality, machine tools are now held to high standards in the industrial sector. Vibration is a crucial indicator of a product's quality. If the patterns of vibration produced by machine tools during cutting operations are recognised, the structure of the machine tool may be built in a way that separates its frequency response from the imposed frequency. The most effective method for managing all machining operations and maintaining machinery operation is tool condition monitoring. Monitoring tool condition affects production costs, tool life expectancy, tool quality, dimensional accuracy within a given tolerance, and surface polish in a machine shop. Here, the machining process is entirely dependent on the operator's whims and preferences. So, it is more difficult for a novice operator to identify the tool wear point and it is more difficult for the operator to operate the machine. A systematic process is needed for the machining procedure to get around this challenge. Determining the inherent frequency and mode forms of the radial drilling machine construction is the aim of this research as a consequence. Finite element analysis was used to identify the innate frequencies and mode shapes of the radial drilling machine structure.

Wind curtailment mitigation in presence of battery energy storage and electric vehicle: A comprehensive multi-objective decision-support framework

Concern to maintain exploitation of power system in secure mode, the wind curtailment (WR) caused by the perpetual fluctuating of wind power (WP) can menace the operational power system schedule. The mentioned phenomenon will intensify by high WP penetration into the power system. In addition, incorporating plugged-in hybrid electric vehicles (PHEVs) into the power system along with the WP intermittent will increase the vagueness rating of the problem. Due to the expansion and development of battery energy storage (BES), the possibility of power shortage compensating and accumulating additional power produced by wind farms (WFs) has been engendered. Providing a stochastic scenario-based structure with different correlation levels can increase the robustness of the model. Here, a two-stage model has been proposed to overcome such a high-dimensioned problem. The first stage determined the scheduled power output of thermal generators (TGs) as the unit commitment (UC) problem to minimize operational costs. Next, by reckoning the supplementary constraints, the scheduled WP, which is re-optimized, will be obtained. The second stage has employed to detect the BES capacity. In this stage, the intelligent parking lots (IPLs) assign price-based signal impetus to the PHEVs to participate in economic dispatch. Due to the prominence of being equipped with the supreme decision-making facility for the intelligent decision-maker operator (IDMO), the augmented epsilon-constraint method has been employed to capture the Pareto sets of some multi-objective functions. The optimum solution has been selected by the decision-making method (DMM) according to the operator's preferences. The results of proposed Multi-Objective Decision-Support (MODS) model show that the total operation cost and BES sizing have dropped by 68 and 6.1 percent, respectively. The performance of the proposed model has been testified through the IEEE-30 bus system via GAMS software.

Balloon Trocar Is a Suitable Instrument for Retroperitoneal Para-aortic Lymphadenectomy in Gynecologic Malignant Diseases

To demonstrate the surgical technique of retroperitoneal para-aortic lymphadenectomy to prevent peritoneal rupture in gynecologic malignant disease. In this video, the authors describe how to use a balloon trocar to create a safe and efficient working space without peritoneal rupture. A step-by-step video demonstration of a surgical technique. Department of Gynecology and Obstetrics, Mie University, Tsu, Japan. Para-aortic lymphadenectomy is a part of most gynecologic oncology procedures for primary and recurrent gynecologic malignancies. There are 2 approaches to para-aortic lymphadenectomy: transperitoneal and retroperitoneal approaches. Although there are no significant differences between these approaches (such as in terms of the number of isolated lymph nodes or related complications), they are performed based on the operator's preference. The retroperitoneal approach is an unfamiliar surgical technique compared with usual laparotomy and laparoscopic surgery, and its disadvantages include a steeper learning curve for attaining proficiency. It is also difficult to develop the retroperitoneal space without a peritoneal rupture. In this video, we demonstrate the use of balloon trocars to create a retroperitoneal compartment. The patient was placed in the lithotomy position with the pelvis elevated at 5° to 10°. The left internal iliac approach, which is considered the standard approach, was used in this case (Fig 1). After identifying the left psoas muscles and the ureter crossing the common iliac artery, dissection of the left para-aortic lymph node was initiated (Supplemental Video 1, 2). Herein, we demonstrated a successful surgical technique for retroperitoneal para-aortic lymphadenectomy to prevent peritoneal ruptures.

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination.

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination.

Filling Materials Efficacy on Preventing Biofilm Formation Inside Screw Access Channels of Implant Abutments.

The choice of the material used to fill screw access channels in implant-supported prostheses depends, in most cases, on operator's preference, without considering the susceptibility of biofilm colonization. Therefore, the aim of this study was to determine and compare the total amount of biofilm formed on different materials used to fill screw access channels in implant abutments. For this propose, titanium implant analogs were attached on abutments and divided into 5 groups: positive control (no filling material); negative control (closed with resin); and filled with cotton, gutta-percha, or polytetrafluoroethylene (PTFE). The analogs with attached abutments were then immersed in a brain heart infusion medium containing Candida albicans (strain 10231 from American Type Culture Collection [ATCC]) and incubated aerobically at 37°C with gentle agitation. After 15 days, materials were removed, and total viable biofilm on each material was quantified by methyl tetrazolium reduction assay at 490 nm. All experiments were performed in triplicate. Data were processed by IBM SPSS Statistic software using 1-way analysis of variance and Bonferroni post hoc tests to analyze differences between groups, with an overall significance level of P < .001. A significant difference was observed between cotton and gutta-percha (P < .017) and between cotton and PTFE (P < .025). However, there was no statistical difference between gutta-percha and PTFE (P > .050). Thus, this in vitro experiment showed that gutta-percha and PTFE presented lower biofilm formation compared with cotton when used to fill screw access channels. These results can provide a basis for future clinical studies that can be a guide to decreasing the occurrence of gaps and bacterial growth inside the implant/abutment attachment site. In addition, controlled in vivo studies are necessary to confirm the clinical viability of findings of this study.

Glenotemporal osteotomy with bone grafting versus Dautrey's procedure for the management of chronic recurrent temporomandibular joint dislocation and hypermobility: A retrospective study

AbstractAimThe aim of the current study was to retrospectively compare Dautery's procedure and glenotemporal osteotomy in the treatment of chronic recurrent temporomandibular joint dislocation and hypermobility.Materials and Methods28 patients presented with chronic recurrent dislocation of the TMJ during the period of the study. Three cases were omitted as they were operated using surgical techniques other than Dautrey's procedure or glenotemporal osteotomy. Another two cases were excluded because of incomplete data.Results23 patients, 18 females and 5 males were included in this study. Group I included nine patients who had Dautrey's procedure and group II included 14 patients for whom glenotemporal osteotomy and bone grafting was performed. The mean age was 26.2 years (ranging from 14.5 to 54 years). The mean postoperative mouth opening in group I was 29 mm (ranging from 23 to 36 mm). The mean postoperative mouth opening in group II was 28.5 mm (ranging from 21 to 41 mm). Statistical analysis failed to reveal a significant difference in complications between both groups.ConclusionsDautrey's procedure and glenotemporal osteotomy are valuable surgical options in the treatment of chronic TMJ dislocation. The choice of the procedure may be left to the operator's preference.

Avoiding complications in percutaneous osteoplasty

Percutaneous osteoplasty techniques include cement injection either solely performed or in combination to hardware such as cannulated screws, peek implants or other metallic hardware including micro-needles and Kirschner wires. Depending on bone and local forces applied, fracture and osseous defect characteristics as well as symptoms and operator's preference percutaneous osteoplasty techniques include cementoplasty, fixation by internal cemented screw and augmented osteoplasty. Literature data support efficacy and safety of these techniques, focusing mainly on the minimal invasive nature of these approaches along with minimum overall morbidity and mortality and an impressive pain reduction effect. Percutaneous osteoplasty techniques in the peripheral skeleton are indicated for pain palliation or for prevention of impeding pathologic fractures. Although safe, osteoplasty techniques are not without risk of complications and adverse events. Complications are classified based either upon clinical impact or timing of occurrence; complications' reviewing and grading should be performed on terms of a uniform and accurate reproducible and validated categorization system. Significant factors for avoiding complications in percutaneous osteoplasty techniques include proper training, patient- and lesion-tailored approach, high-quality imaging guidance, sterility as well as appropriate selection of technique and materials. The present article reports the possible complications of percutaneous osteoplasty techniques and reviews the prerequisites necessary for avoiding and managing these adverse events.

Duration, deviation and operator's perception of static computer assisted implant placements by inexperienced clinicians.

This study measured the duration, deviation and operator's perception of implant placement by fully guided (FG), pilot-guided (PG) and freehand (FH) protocols by postgraduate students with minimal implant experience. Twenty postgraduate students participated in the study. Half of them placed single anterior (S-Ant) and single posterior (S-Post) implants, and the other half placed anterior (B-Ant) and posterior (B-Post) implants in a wide edentulous area. The PG placement involved surgical guides that only controlled pilot drilling, whilst the FG placement controlled all the drilling steps and implant placement. The duration of implant placement and the operator's perception (ease of drilling, ease of implant placement and operator's preference) were measured. The deviations of placed implants were quantified by measuring the trueness and angulation deviations in relation to the planned implants. The PG placement was the quickest for inserting implants, followed by FG and FH placements, respectively (p<.05). The location of the implant had influenced the duration of implant placement only for the PG placement. In relation to ease of drilling, ease of implant placement and operator's preference, there was no significant difference amongst the different placement protocols or implant locations. The FG placement was associated with least deviations, followed by PG and FH placements, respectively (p<.05). In the hands of postgraduate students with minimal implant experience, FG and PG placements reduced the implant placement duration in comparison with FH placement. The FG placement was consistently more accurate followed by PG placement.

Evaluation of Effectiveness of Three New Gingival Retraction Systems: A Comparative Study

To analyze the clinical effectiveness of three new gingival retraction systems: knitted retraction cord, expanding polyvinyl siloxane, and aluminium chloride containing paste. Twenty patients were enrolled with age-group of more than 18 years and who required fixed prosthesis with minimum of two abutments. A preliminary impression of the arch was made with a stock metal tray and irreversible hydrocolloid impression material. Group WR-impression without retraction, Group A-impression after retraction with gingival retraction cord, Group B-impression after retraction with expanding polyvinyl siloxane, and Group C-impression after retraction with aluminium chloride containing paste. A total of four impressions were made for each abutment tooth. Each impression was given a label 1WR, 1A, 1B, 1C-20WR, 20A, 20B, 20C: where 1 denoted the sample number. Comparison of the stereomicroscopic images was done using image analysis software. Time required from start of placement of gingival displacement agents till completion was recorded in seconds with the help of a stop clock. The mean gingival retraction was found to be the highest for subjects of Group C followed by Group A, Group B, and Group WR. This difference was found to be statistically significant. Highly significant mean difference in time of placement was observed between Group A and Group B, between Group B and Group C, and between Group C and Group A. The aluminium chloride containing paste was found effective in almost all the variables considered. The choice of particular gingival retraction system/technique is dependent upon the clinical variables and on operator's preference.

Right-Sided Permanent Pacemaker Implantation in Patients with Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava: 3-Case Series, Technique and Discussion

Persistent left superior vena cava (PLSVC) is the most common variant of abnormal venous return to the heart. While usually asymptomatic, it is known to complicate transvenous cardiac procedures, such as implantation of cardiac electronic devices and ablations. PLSVC can present with or without the concomitant absence of right superior vena cava (RSVC). Depending on the operator's preference, implantation of permanent cardiac pacemakers (PPMs) may be performed from the left or right side. As most often the PLSVC is only identified at the time of intervention, it follows that the variant with the absence of RSVC can be diagnosed in practice only when implanting from the right side. For this reason, the true prevalence of this variant is largely unknown because most published cases of cardiac device implantations in patients with PLSVC have been performed from the left side. We present a short 3-case series of PPM implantations in a tertiary center from the right side in patients with PLSVC and absent RSVC. We found that the use of a standard curve for ventricular lead septal placement and a wide C-curve for right atrial lead placement in these patients was a feasible technique with good outcomes.

Effect of Impression Technique and Operator Experience on Impression Time and Operator-Reported Outcomes.

To investigate the effect of impression technique (conventional preliminary alginate and digital scan) and operator experience in impression making (experienced in digital and conventional, experienced in conventional and inexperienced in digital, and inexperienced in conventional and digital) on impression time, satisfaction and stress levels, and the preference of the operators. One patient was assigned for each of the 60 operators, who were experienced in impression techniques at different levels (Group 1: experienced in conventional and digital, Group 2: experienced in conventional and inexperienced in digital, Group 3: inexperienced in conventional and digital). They made conventional impressions (irreversible hydrocolloid) and digital scans (Trios 3) from the same patient. The impression times were recorded at each step (patient registration, maxillary arch, mandibular arch, and bite registration) and in total. A visual analog scale (VAS) was used for the operator satisfaction for applicability, comfort, and hygiene; the State-Trait Anxiety Inventory form (STAI-TX1) was used for stress, and a questionnaire was completed to measure the operator's impression preference. The data were analyzed with a 2-way ANOVA and Chi-square test (α = 0.05). A significant interaction was found between the operator experience in impression making and the impression technique on time for maxillary and mandibular arch impressions and total time (p ≤ 0.002). Operator experience and impression technique interaction had a significant effect on comfort and average VAS scores (p ≤ 0.016). Whereas, no significant effect of this interaction was found on stress (p ≥ 0.195). Operator experience in impression making had a significant effect on applicability (p < 0.001), and the impression technique had a significant effect on hygiene VAS scores (p < 0.001). Operators in Group 1 and Group 3 preferred the digital scans, however, operators in Group 2 had no preference (p = 0.022). Operator experience in impression making and impression technique had varying effects on clinician's impression time, comfort, applicability, hygiene, and preference. Operators needed less time for the impressions they were experienced with. Operator stress level was not affected by the operator experience in impression making and the impression technique. Dental students and operators experienced in both techniques were satisfied with the digital scans and they preferred digital scans. Operators experienced with conventional impressions were satisfied with conventional impressions but didn't have a preference for the impression type.

Reproducibility of pulmonary vein isolation guided by the ablation index: 1-year outcome of the AIR registry.

Ablation index (AI) is a new lesion quality marker that has been demonstrated to allow a high single-procedure arrhythmia-free survival in single-center studies. This prospective, multi-center study was designed to evaluate the reproducibility of pulmonary vein (PV) isolation guided by the AI. A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV isolation and were divided in four study groups according to operator's preference in choosing the ablation catheter (a contact force (ST) or contact force surround flow (STSF) catheter) and the AI setting (330-450 or 380-500 at anterior wall or posterior wall, respectively). At 12 months a high rate of freedom from AF recurrences was observed in patients with both paroxysmal and persistent AF (91% vs 83.3%;P = .039). There was no difference in the rate of AF recurrence among the four study groups (4.5% in group ST330-450, 12.2% in group ST 380-500, 14.9% in group STSF330-450, 9.4% in group STSF380-500;P = .083). Recurrence was also similar between patients treated with a ST (8%) or STSF catheter (12.1%;P = .2), and within patients targeting an AI settings of 330 to 450 (10.9%) or 380 to 500 (10.3%;P = .64). In patients with paroxysmal AF, there was no difference (P = .12) in the 1-year freedom from AF recurrence among 14 operators that performed ≥10 ablation procedure. An ablation protocol respecting strict criteria for contiguity and quality lesion resulted in high rate of 1-year freedom from AF recurrence, irrespective of the ablation catheters, AI settings, and operator.

Field trials of an energy‐aware mission planner implemented on an autonomous surface vehicle

AbstractMission planning for autonomous marine vehicles is nontrivial due to the dynamic and uncertain nature of the marine environment. Communication can be low‐bandwidth and is not always guaranteed, so the operator must rely on the vehicles to adjust their plans according to the realized state of the environment. This paper presents the improvements made to an energy‐aware mission planner that allows it to generate and adjust plans for an autonomous surface vehicle (ASV) operating in an uncertain environment. The energy‐aware mission planning problem was redefined as a stochastic programming problem, and a two‐stage solver was developed to provide an initial plan for the ASV and then adjust it during run‐time according to predefined recourse actions. The mission planner and ASV were trialed in Lake Waverley, Tasmania. Adjusting the recourse action criteria demonstrated that the ASV could exhibit conservative or opportunistic behaviors according to the operator's preference of safety margin. In the pursuit of extending the planner's second‐stage so that it can predict a suitable recourse action ahead of time, a hybrid long short‐term memory energy forecaster was trained from the Waverley mission data. Comparison of the error between the forecaster and the test data shows that the forecaster has a reliable forecast horizon of about 10 s.