Robotic Treatment Research Articles

РОБОТ-АССИСТИРОВАННЫЕ ОПЕРАЦИИ В ДЕТСКОЙ АБДОМИНАЛЬНОЙ ХИРУРГИИ: ПЕРВОНАЧАЛЬНЫЙ ОПЫТ

Purpose of this research was to apply the possibilities of robot-assisted surgery technology in children with abdominal pathology in terms of assessing feasibility and evaluating postoperative results. Material and methods used: the scientific study was carried out at the Irkutsk Oblast Regional Children's Clinical Hospital (Irkutsk, Russia) in Dec. 2022-June 2023. During this period, 11 robot-assisted procedures were performed on the abdominal organs. The study was conducted within the framework of the Clinical Trials Program for Medical Products approved by the Federal Service for Surveillance in Healthcare of the Russian Federation. All surgical procedures were implemented according to the same principles and patterns that the Authors have gathered previously with the Versius Surgical Robot. In all cases, the three robotic ports were used: a single 12-mm trocar for optics (intervened at the umbilicus) and two 5-mm trocars for robotic arms. Additionally, another 5-mm laparoport was installed for the assistant surgeon to work during the robotic intervention. During the study, patients' perioperative parameters related to data charts, surgical details and both early and long-term outcomes were recorded. Results: the total number of patients involved in robotic interventions on the abdominal organs was 11, 4 (36,4%) boys/7 (63,6%) girls. The mean age at the time of surgery was 10,9±5.1 y/o (Me 12.0 [7.0; 15.0] y/o), mean weight at the time of surgery was 39.7±18.0 kg (Me 43.0 [24.0; 53.8] kg). The distribution of reasons for surgical interventions was as follows: 3 (27,3%) patients with Nissen fundoplication, 3 (27,3%) patients with cholecystectomy, 2 (18,2%) patients with Heller esophagomyotomy with Dor fundoplication, 2 (18,2%) patients with splenic cyst fenestration and a single (9%) patient with enucleation of ovarian teratoma. The mean duration was 100±52.4 min (Me 70.0 [65.0; 122.5] min). None of the operations were accompanied by any intraoperative complications. There were also no conversions into laparoscopic and/or open surgeries. In the long-term period after the operations, the number of significant complications in the form of recurrence of symptoms of the initial disease did not increase, patients showed no digestive problems during the entire follow-up period as well. Conclusion: Russia’s initial experience with robotic-assisted abdominal surgery confirmed that robotics can be safely and effectively used in children. Fundoplication, esophagomyotomy and cholecystectomy are by far the most commonly performed basic interventions in pediatric surgery. Obviously, this is the first stage in the development of robotic abdominal surgery in children hence it would further involve a more complex procedure.

Effectiveness of combined robotics and virtual reality on lower limb functional ability in stroke survivors: A systematic review of randomized controlled trials.

Lower limb impairments are common consequences of stroke. Robotics and virtual reality (VR) play crucial roles in improving lower limb function post-stroke. This review aims to assess the effects of combined robot and VR interventions on lower limb functional ability poststroke and to provide recommendations for future studies in the rehabilitation field. PubMed, SCOPUS, CINAHL, MEDLINE, EMBASE, and Web of Science were searched from inception to March 1, 2024. Randomized controlled trials (RCTs) involving patients with a stroke, administering combined robot and VR compared with passive (i.e., rest) or active (any intervention), and including at least one outcome evaluating lower limb function (i.e., balance, gait, mobility, muscle tone, muscle strength, range of motion) or activities of daily living were selected. The Cochrane Collaboration tool was employed to evaluate the risk of bias in the included studies. Nine studies met the eligibility criteria. In total, 364 stroke survivors (Mean age 55.62 years) were involved in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," "moderate quality" (n=3), and "low quality" (n=1). There are mixed findings on the effects of combined robot and VR on lower limb functional ability in stroke survivors. The evidence for the effects of combined robot and VR on lower limb functional ability post-stroke is promising. Further trials with long-term follow-up are strongly warranted to understand the immediate and long-term effect of combined robot and VR intervention on various lower limb impairments and to define the optimal treatment protocols.

ADVANCES IN FUNCTIONAL ELECTRICAL STIMULATION FOR LOWER LIMB REHABILITATION INSTROKE: A REVIEW ON PHYSIOLOGIC AND THERAPEUTIC PERSPECTIVE

Stroke results in considerable impairment of lower limb (LL) function. The objective of rehabilitation is to restore pre-stroke motor skills through the promotion of neuroplasticity. Existing literature indicates that mere movement of the impacted limb does not necessarily enhance motor performance instead, the movements should engage the patient and activate the entire neuromuscular network responsible for the intended motion. Functional Electrical Stimulation (FES) stands out among various rehabilitation strategies and is endorsed in numerous stroke rehabilitation protocols as an adjunctive therapy alongside standard care interventions. The aim of this research is to offer a thorough examination of the use and physiological rationale of FES in post-stroke rehabilitation. Many studies advocate for incorporating FES into a contemporary stroke rehabilitation regimen, complemented by activities such as cycling, treadmill exercises, and robotic interventions, to optimize recovery outcomes in poststroke rehabilitation.

Qualitative outcomes and impact of a robotic intervention on children with autism spectrum disorder: A multiple embedded case study

Most studies of social robot interventions for children with autism spectrum disorder have been laboratory experiments focusing on component skills. There is insufficient evidence documenting the qualitative impact of such programmes on social development and participation of children with autism spectrum disorder. This study aimed to identify the qualitative outcomes of a robot-mediated social skills training programme for children with autism spectrum disorder, examine the impact of such programmes on children’s social participation and identify the essential elements of robotic interventions that are conducive to children’s social development. A case study approach with a multiple case study design was adopted. Sixteen children with autism spectrum disorder, aged 5–11 years, were included. Participants received 12 weekly sessions of robot-mediated social skills training. The successful outcomes relating to social participation were identified as enhanced verbal expression, social awareness and emotional reciprocity. The impacts of the programme on personal development were identified as enhanced self-esteem, self-confidence and emotional expression. Robot friendship, the role of the robot as a facilitator and the presence of a human instructor capable of leading the programme were identified as essential elements of the positive changes. The encounter with a social robot was regarded as meaningful and important to the children with autism spectrum disorder.

Nationwide Trends in Utilization of Minimally Invasive Techniques for Blunt Abdominal Trauma.

Despite increasing use of minimally invasive surgical (MIS) techniques for trauma, limited large-scale studies have evaluated trends, outcomes, and resource utilization at centers that utilize MIS modalities for blunt abdominal trauma. Operative adult admissions after blunt assault, falls, or vehicular collisions were tabulated from the 2016-2020 National Inpatient Sample. Patients who received diagnostic laparoscopy or other laparoscopic and robotic intervention were classified as MIS. Institutions with at least one MIS trauma operation in a year were defined as an MIS Performing Institution (MPI; rest: non-MPI). The primary endpoint was mortality, with secondary outcomes of reoperation, complication, postoperative length of stay (LOS), and hospitalization costs. Mixed regression models were used to determine the association of MPI status on the outcomes of interest. Throughout the study period, the proportion of MIS operations and MPI significantly increased from 22.6 to 29.8% and 45.9 to 58.8%, respectively. Of an estimated 77,480 patients, 66.7% underwent care at MPI. After adjustment, MPI status was not associated with increased odds of mortality (adjusted odds ratio [AOR] 1.09, 95% confidence interval [CI] [.96,1.24]), reoperation (AOR 1.02, CI [.87,1.19]), or any of the tabulated complications. There was additionally no difference in adjusted LOS (β-.18, CI [-.85, +.49]) or costs (β+$1600, CI [-1600, +4800]), between MPI and non-MPI. The use of MIS operations in blunt abdominal trauma has significantly increased, with performing centers experiencing no difference in mortality or resource utilization. Prospectively collected data on outcomes following MIS trauma surgery is necessary to elucidate appropriate applications.

Deploying Robot-Led Activities for People with Dementia at Aged Care Facilities: A Feasibility Study

ObjectivesTo explore the feasibility of deploying robot-led activities for people with dementia living in aged care facilities. DesignEmbedded mixed-methods design. Setting and ParticipantsEleven residents (aged ≥65 years) with mild to moderate cognitive impairment were recruited from 2 aged care facilities in Brisbane, Australia. MethodsWe implemented a novel control logic, “Adam Program,” for a human-like robot to provide proactive robot activities for people with dementia. Participants individually participated in a nonfacilitated robot intervention thrice a week for 5 weeks from November to December 2022. We video-recorded each intervention session and quantified participants’ visual, behavioral, and verbal engagement. A semi-structured interview was conducted at the end of the 5-week intervention. The treatment fidelity strategies and finances were reported and evaluated. The Bowen Feasibility Framework guided data analysis into 6 focus areas: acceptability, demand, implementation, efficacy, integration, and practicality. ResultsBased on participants’ perceptions, findings demonstrated adequate acceptability and demand for robot-led activities. Findings reported a high level of visual engagement (98.54%) and an increased trend of behavior engagement over 5 weeks. Participants independently communicated with Adam, with most (97.02%) verbal engagements free of human facilitation. The treatment fidelity strategies regarding the activity delivery, intervention received, and intervention skills are provided alongside the equipment expenses, revealing the feasibility of integrating robot-led activities for people with dementia in aged care facilities. Conclusions and ImplicationsUsing human-like robots to independently lead interactive activities for people with dementia at aged care facilities is feasible and acceptable. Although robot-led activities require further improvement, this study explored a practical-driven solution that provided guidelines for developing and implementing robot-led activities in aged care settings. Future studies could replicate similar robot-led activities for further investigation and evaluation. Strategies for multilevel determinants of Adam's implementation based on a context assessment are recommended for future research.

Value and Role of Obesity and Metabolic Surgery in the Study of Human Medicine, Academic Teaching and Advanced Training

In teaching, obesity and metabolic surgery play only a limited role. However, due to the rapidly increasing number of surgical interventions, communication of knowledge in the study of human medicine as well as in gastroenterological and surgical residency (general and abdominal surgery) is required.Narrative review. · Currently, lectures on obesity and metabolic surgery do not belong to the current surgical curriculum of human medicine at all University Medical Schools, which needs to be absolutely established step by step - based on their topicality and importance in the clinical spectrum of clinical care.. · This rapidly developing special area of abdominal surgery is characterized by specific and diverse interdisciplinarity.. · Multimorbidity, changes in resorption mechanisms but also psychological changes have a substantial impact on the indication and patient outcome.. · The increase in endoscopic, surgical and also robotic interventions and surgical methods in this special field requires a broad knowledge of all surgical disciplines in intervention preparation, perioperative and follow-up management of obesity-associated basic diagnosis. This objective is important even in the study of human medicine and further advanced training.. The inclusion of such complex contents on obesity and metabolic surgery into surgical teaching and into residency of general and abdominal surgery is essential to be future-oriented and prepared for the development of the discipline.

Optimizing shoulder elevation assist rate in exoskeletal rehabilitation based on muscular activity indices: a clinical feasibility study

BackgroundRestoring shoulder function is critical for upper-extremity rehabilitation following a stroke. The complex musculoskeletal anatomy of the shoulder presents a challenge for safely assisting elevation movements through robotic interventions. The level of shoulder elevation assistance in rehabilitation is often based on clinical judgment. There is no standardized method for deriving an optimal level of assistance, underscoring the importance of addressing abnormal movements during shoulder elevation, such as abnormal synergies and compensatory actions. This study aimed to investigate the effectiveness and safety of a newly developed shoulder elevation exoskeleton robot by applying a novel optimization technique derived from the muscle synergy index.MethodsTwelve chronic stroke participants underwent an intervention consisting of 100 robot-assisted shoulder elevation exercises (10 × 10 times, approximately 40 min) for 10 days (4–5 times/week). The optimal robot assist rate was derived by detecting the change points using the co-contraction index, calculated from electromyogram (EMG) data obtained from the anterior deltoid and biceps brachii muscles during shoulder elevation at the initial evaluation. The primary outcomes were the Fugl–Meyer assessment-upper extremity (FMA-UE) shoulder/elbow/forearm score, kinematic outcomes (maximum angle of voluntary shoulder flexion and elbow flexion ratio during shoulder elevation), and shoulder pain outcomes (pain-free passive shoulder flexion range of motion [ROM] and visual analogue scale for pain severity during shoulder flexion). The effectiveness and safety of robotic therapy were examined using the Wilcoxon signed-rank sum test.ResultsAll 12 patients completed the procedure without any adverse events. Two participants were excluded from the analysis because the EMG of the biceps brachii was not obtained. Ten participants (five men and five women; mean age: 57.0 [5.5] years; mean FMA-UE total score: 18.7 [10.5] points) showed significant improvement in the FMA-UE shoulder/elbow/forearm score, kinematic outcomes, and pain-free passive shoulder flexion ROM (P < 0.05). The shoulder pain outcomes remained unchanged or improved in all patients.ConclusionsThe study presents a method for deriving the optimal robotic assist rate. Rehabilitation using a shoulder robot based on this derived optimal assist rate showed the possibility of safely improving the upper-extremity function in patients with severe stroke in the chronic phase.

Modeling and control design of a bronchoscope robotics system

For the pulmonary nodule biopsy problem, this paper investigates an intervention robotics system based on the bronchoscope. To achieve precise control of the system, the mathematical model is established at first. The system mainly consists of an inserting tube and a tube tip, which are modeled based on a moving flexible beam and a soft robot, respectively. In order to reduce the harm to the patient during the operation, the robot system should suppress the vibration of the inserting tube during the process of tracking the desired trajectory in the bronchus. Therefore, we use the boundary control algorithm to design a controller capable of suppressing vibration for the inserting tube. Meanwhile, in order for the robot system to accurately select the bronchus corresponding to the branch, we designed a soft robot controller that can bend or deflect the soft robot to a specified posture. Finally, we used theoretical proof and numerical simulation to verify the conclusion.

Robotic Technology in Prosthetic Dentistry: A Review

Objective The purpose of the article is to present a narrative review of the literature related to application of robotic technology in prosthodontics. Dentistry has made a significant technical transition from manual techniques to digital technology. Applications of robotics have become more and more popular in many medical fields, including dentistry, as a means of streamlining manual procedures and enhancing accuracy. The main applications of robotic interventions in prosthodontics are in the design and manufacture of complete or partial dentures, as well as in assisting with dental implantology surgical procedures. In both situations, significant advancements have been made, enabling treatments with high success rates to be carried out with a better degree of accuracy with significantly reduced amount of time required for completion of procedure.  Materials And Methods A literature search was performed in the online databases – PubMed, Science Direct, Medline and Google Scholar with the following:  Conclusion Robotic assistance in prosthodontics has led to tremendous progress specially in laboratory work and placement of implants. However, using these intricately built robots for various prosthodontic procedures needs close supervision from a trained dentist. Clinical judgment and specialist competence of dentist are indispensable.

Towards MR-Guided Robotic Intracerebral Hemorrhage Evacuation: Aiming Device Design and ex vivo Ovine Head Trial.

Stereotactic neurosurgery is a well-established surgical technique for navigation and guidance during treatment of intracranial pathologies. Intracerebral hemorrhage (ICH) is an example of various neurosurgical conditions that can benefit from stereotactic neurosurgery. As a part of our ongoing work toward real-time MR-guided ICH evacuation, we aim to address an unmet clinical need for a skull-mounted frameless stereotactic aiming device that can be used with minimally invasive robotic systems for MR-guided interventions. In this paper, we present NICE-Aiming, a Neurosurgical, Interventional, Configurable device for Effective-Aiming in MR-guided robotic neurosurgical interventions. A kinematic model was developed and the system was used with a concentric tube robot (CTR) for ICH evacuation in (i) a skull phantom and (ii) in the first ever reported ex vivo CTR ICH evacuation using an ex vivo ovine head. The NICE-Aiming prototype provided a tip accuracy of 1.41±0.35 mm in free-space. In the MR-guided gel phantom experiment, the targeting accuracy was 2.07±0.42 mm and the residual hematoma volume was 12.87 mL (24.32% of the original volume). In the MR-guided ex vivo ovine head experiment, the targeting accuracy was 2.48±0.48 mm and the residual hematoma volume was 1.42 mL (25.08% of the original volume).

Human–robot mechanics model using hip torque identification with a dual-arm nursing-care transfer robot

In response to the growing demand for robotic interventions to mitigate the profound physical strain experienced by caregivers during transfers, dual-arm robotic systems have emerged as a focal point of interest in the caregiving community due to their adaptability and versatility. However, the accuracy of existing human–robot mechanics model is insufficient, impacting the execution of transfer tasks. To enhance the model’s precision, an improved model is proposed, integrating hip torque identification. This proposed methodology involves the simplification of the human structure based on the kinematic attributes associated with the embrace of individuals by robotic arms and the subsequent computation of its inertial parameters. Accordingly, the application of D’Alembert’s principle is employed to analyze the impact of embracing motion, human posture, and the position of human–robot contact on the forces exerted on the human. This culminates in the establishment of a model. Considering the static indeterminacy predicament inherent in the model, a biomechanical data set is curated for the dual-arm transfer scenario. Leveraging this data set, a deep neural network utilizing multilayer perceptron is trained to accurately identify hip torque, thereby improving the model. Accordingly, a robotic transfer platform featuring dual arms is developed and trailed on six subjects with varying anatomical profiles. The results show that the constructed model has high accuracy. This study provides critical mechanics insights for dual-arm transfer tasks, offering potential application value in the field of nursing and rehabilitation.

Managing social-educational robotics for students with autism spectrum disorder through business model canvas and customer discovery.

Social-educational robotics, such as NAO humanoid robots with social, anthropomorphic, humanlike features, are tools for learning, education, and addressing developmental disorders (e.g., autism spectrum disorder or ASD) through social and collaborative robotic interactions and interventions. There are significant gaps at the intersection of social robotics and autism research dealing with how robotic technology helps ASD individuals with their social, emotional, and communication needs, and supports teachers who engage with ASD students. This research aims to (a) obtain new scientific knowledge on social-educational robotics by exploring the usage of social robots (especially humanoids) and robotic interventions with ASD students at high schools through an ASD student-teacher co-working with social robot-social robotic interactions triad framework; (b) utilize Business Model Canvas (BMC) methodology for robot design and curriculum development targeted at ASD students; and (c) connect interdisciplinary areas of consumer behavior research, social robotics, and human-robot interaction using customer discovery interviews for bridging the gap between academic research on social robotics on the one hand, and industry development and customers on the other. The customer discovery process in this research results in eight core research propositions delineating the contexts that enable a higher quality learning environment corresponding with ASD students' learning requirements through the use of social robots and preparing them for future learning and workforce environments.

A systematic review of the effects of robotic exoskeleton training on energy expenditure and body composition in adults with spinal cord injury.

Metabolic diseases disproportionately affect people with spinal cord injury (SCI). Increasing energy expenditure and remodeling body composition may offset deleterious consequences of SCI to improve cardiometabolic health. Evidence is emerging that robotic exoskeleton use increases physical activity in SCI, but little is known about its effects on energy expenditure and body composition. This study therefore aimed to evaluate the impact of robotic exoskeleton training on body composition and energy expenditure in adults with SCI. A systematic literature review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five databases were searched to retrieve studies meeting pre-set eligibility criteria: adults with SCI, interventions evaluating the effects of robotic exoskeleton devices on body composition or energy expenditure. The PEDro scale guided quality assessments with findings described narratively. Of 2163 records, 10 studies were included. Robotic exoskeleton training does not significantly improve energy expenditure compared to other exercise interventions. Significant changes ( P < 0.05) in body composition, particularly reduced fat mass, however, were reported. High variability seen with the interventions was coupled with poor quality of the studies. While robotic exoskeleton interventions may propose modest cardiometabolic benefits in adults with SCI, further robust trials in larger samples are needed to strengthen these findings.

Machine learning and IoT Based Robotic Solution for Home Wrist Rehabilitation through Motion Capture Enabled Architecture

The present study investigates the effectiveness of an integrated approach that combines machine learning, robotic rehabilitation, and traditional methods for wrist rehabilitation among the hemiparesis population. Subjects with robotic rehabilitation at the four-week intervention period showed the ball’s significant difference in the flexion and extension angles and demonstrated the better overall outcomes from the robotic intervention . The machine learning models, in particular, the artificial neural networks, provided the prediction of rehabilitation outcomes and demonstrated the high accuracy, high precision, high recall, and high F1 score. This study supports the idea of the beneficial effects of combining robotic rehabilitation with machine learning algorithms and supports the notion that the two benefits could bring high synergistic effects above their individual potentials. The report also contributes to the development of the rehabilitation science of wrists, given that few studies have explored the applications of artificial intelligence methods or robotic rehabilitation beyond the context of feasibility reports. The findings of the current research could contribute useful insights for the decision-making practices of therapists and healthcare providers, also given the reliance on large data contributed by the previous interventions. Future study could investigate the long-term results, the cost-effectiveness of the approaches, and assist in developing the potential results of customization for individual patients.

Sensor-Based Measurement Method to Support the Assessment of Robot-Assisted Radiofrequency Ablation.

Digital surgery technologies, such as interventional robotics and sensor systems, not only improve patient care but also aid in the development and optimization of traditional invasive treatments and methods. Atrial Fibrillation (AF) is the most common cardiac arrhythmia with critical clinical relevance today. Delayed intervention can lead to heart failure, stroke, or sudden cardiac death. Although many advances have been made in the field of radiofrequency (RF) catheter ablation (CA), it can be further developed by incorporating sensor technology to improve its efficacy and safety. Automation can be utilized to shorten the duration of RF ablation, provided that the interactions between the tissue and the RF tools are well understood and adequately modeled. Further research is needed to develop the optimal catheter design. This paper describes the systematic methodology developed to support robot-assisted RF CA characterization measurements. The article describes the custom instruments developed for the experiments, particularly the contact force limiter, the measurement procedure, and the evaluation of the results, as enablers for new results. The aim was to establish an objective, repeatable, robust measurement method and adjacent procedure.

Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes

ObjectiveA vesicourethral anastomotic leak (VUAL) is a known complication following robotic-assisted radical prostatectomy. The natural history of a VUAL has been well described and is frequently managed with prolonged catheterization. With increasing emphasis on patient reported outcomes, catheter duration and VUAL are associated with significant short-term quality of life impairment. We aimed to present a case series of our robotic early post-prostatectomy anastomotic repair technique, defined as revision within 6 weeks from index surgery. MethodsA single institution prospective database identified eleven patients with a VUAL from July 2016 to October 2022 who underwent robotic early post-prostatectomy anastomotic repair by a single surgeon. Patients were diagnosed with a VUAL on pre-operative CT urogram or CT/fluoroscopic cystogram. The primary outcome was resolution of the anastomotic leak, defined as no contrast extravasation on post-operative cystography. Secondary outcomes included post-repair catheter duration and continence on the last follow-up defined as pad(s) per day. ResultsThe mean time to intervention after robotic-assisted radical prostatectomy was 21 days. Eight of the eleven (72.7%) patients had no evidence of extravasation on post-repair cystogram. The range from intervention to first cystogram was 7–20 days. The median catheter duration for those with successful intervention was 10 days. The median catheter duration for those with the leak on initial post-operative cystogram was 20 days. At a mean follow-up time of 25 months, eight (72.7%) patients reported using no pads per day, and three (27.3%) patients reported one pad per day. ConclusionManagement of a VUAL has traditionally relied on prolonged catheter drainage and the tincture of time. As the role of robotic reconstruction has been shown to be a viable modality for management of bladder neck contracture, it is important to reconsider prior dogmas of urologic care. Our case series suggests that an early repair is safe and has a high success rate. Early robotic intervention gives providers an additional tool in aiding patient recovery.

Educational Robots, Emotion Recognition and ASD: New Horizon in Special Education

Technology has always represented the key to human progress. It is believed that the use of supportive technological mediators can facilitate teaching/learning processes and enable everyone to learn how to critically manage technology without being its slave or passive user while contributing to the collective well-being. Educational robotics is a new frontier for learning that can offer numerous benefits to students. The use of robots can offer the possibility of creating inclusive educational settings in which all students, regardless of their abilities or disabilities, can participate meaningfully. The article proposes an analysis of the evidence obtained from a systematic literature review with reference to general educational robotics and social robotics for emotion recognition. Finally, as a practical implementation of an educational robotic intervention on emotion recognition, the “Emorobot Project” as part of the EU-funded “Ecosystem of Innovation—Technopole of Rome” Project in NextGenerationEU will be presented. The project’s aim is to foster the development of social skills in children with autism spectrum disorders through the creation of an open-source social robot that can recognize emotions. The project is intended to provide teachers with a supportive tool that allows them to design individual activities and later extend the activity to classmates. An educational robot can be used as a social mediator, a playmate during the learning phase that can help students develop social skills, build peer connection, reduce social isolation—one of the main difficulties of this disorder—and foster motivation and the acquisition of interpersonal skills through interaction and imitation. This can help ensure that all students have access to quality education and that no one is left behind.

Determinants of Performance for Robotics Teleoperated Activities: From Emergency Response to Decommissioning

After the nuclear accidents of Chernobyl and Fukushima, several countries concerned with nuclear energy production set up robotic accident intervention groups with the aim to intervene in place of humans in hostile environments with high levels of contamination or irradiation. It is the case of France. The operational feedback of such robotic groups may be of interest for teams performing decommissioning on nuclear facilities. In this aim, a comparative analysis of robotic intervention contexts was undertaken between training contexts and a real operating situation. This allowed us to confirm determinants of performance already identified in the literature and highlighted new determinants of performance for intervention in nuclear environments.

Associations between facial expressions and observational pain in residents with dementia and chronic pain.

To identify specific facial expressions associated with pain behaviors using the PainChek application in residents with dementia. This is a secondary analysis from a study exploring the feasibility of PainChek to evaluate the effectiveness of a social robot (PARO) intervention on pain for residents with dementia from June to November 2021. Participants experienced PARO individually five days per week for 15 min (once or twice) per day for three consecutive weeks. The PainChek app assessed each resident's pain levels before and after each session. The association between nine facial expressions and the adjusted PainChek scores was analyzed using a linear mixed model. A total of 1820 assessments were completed with 46 residents. Six facial expressions were significantly associated with a higher adjusted PainChek score. Horizontal mouth stretch showed the strongest association with the score, followed by brow lowering parting lips, wrinkling of the nose, raising of the upper lip and closing eyes. However, the presence of cheek raising, tightening of eyelids and pulling at the corner lip were not significantly associated with the score. Limitations of using the PainChek app were identified. Six specific facial expressions were associated with observational pain scores in residents with dementia. Results indicate that automated real-time facial analysis is a promising approach to assessing pain in people with dementia. However, it requires further validation by human observers before it can be used for decision-making in clinical practice. Pain is common in people with dementia, while assessing pain is challenging in this group. This study generated new evidence of facial expressions of pain in residents with dementia. Results will inform the development of valid artificial intelligence-based algorithms that will support healthcare professionals in identifying pain in people with dementia in clinical situations. The study adheres to the CONSORT reporting guidelines. One resident with dementia and two family members of people with dementia were consulted and involved in the study design, where they provided advice on the protocol, information sheets and consent forms, and offered valuable insights to ensure research quality and relevance. Australian and New Zealand Clinical Trials Registry number (ACTRN12621000837820).