Total Manipulation Time Research Articles

Patient-Specific 3D-Print Extracranial Vascular Simulators and Infrared Imaging Platform for Diagnostic Cerebral Angiography Training.

Tortuous aortic arch is always challenging for beginner neuro-interventionalists. Herein, we share our experience of using 3D-printed extracranial vascular simulators (VSs) and the infrared imaging platform (IRIP) in two training courses for diagnostic cerebral angiography in the past 4 years. A total of four full-scale patient-specific carotid-aortic-iliac models were fabricated, including one type I arch, one bovine variant, and two type III arches. With an angiography machine (AM) as the imaging platform for the practice and final test, the first course was held in March 2018 had 10 participants, including three first-year residents (R1), three second-year residents (R2), and four third-year residents (R3). With introduction of the IRIP as the imaging platform for practice, the second course in March 2022 had nine participants, including 3 R1s, 3 R2s, and 3 R3s. The total manipulation time (TMT) to complete type III aortic arch navigation was recorded. In the first course, the average TMT of the first trial was 13.1 min. Among 3 R1s and 3 R2s attending the second trial, the average TMT of the second trial was 3.4 min less than that of the first trial. In the second course using IRIP, the average TMT of the first and second trials was 6.7 min and 4.8 min, respectively. The TMT of the second trial (range 2.2~14.4 min; median 5.9 min) was significantly shorter than that of the first trial (range 3.6~18 min; median 8.7 min), regardless of whether AM or IRIP was used (p = 0.001). Compared with first trial, the TMT of the second trial was reduced by an average of 3.7 min for 6 R1s, which was significantly greater than the 1.7 min of R2 and R3 (p = 0.049). Patient-specific VSs with radiation-free IRIP could be a useful training platform for junior residents with little experience in neuroangiography.

A novel 3D-vision-based collaborative robot as a scope holding system for port surgery: a technical feasibility study.

A clear, stable, suitably located vision field is essential for port surgery. A scope is usually held by hand or a fixing device. The former yields fatigue and requires lengthy training, while the latter increases inconvenience because of needing to adjust the scope. Thus, the authors innovated a novel robotic system that can recognize the port and automatically place the scope in an optimized position. In this study, the authors executed a preliminary experiment to test this system's technical feasibility and accuracy in vitro. A collaborative robotic (CoBot) system consisting of a mechatronic arm and a 3D camera was developed. With the 3D camera and programmed machine vision, CoBot can search a marker attached to the opening of the surgical port, followed by automatic alignment of the scope's axis with the port's longitudinal axis so that optimal illumination and visual observation can be achieved. Three tests were conducted. In test 1, the robot positioned a laser range finder attached to the robot's arm to align the sheath's center axis. The laser successfully passing through two holes in the port sheath's central axis defined successful positioning. Researchers recorded the finder's readings, demonstrating the actual distance between the finder and the sheath. In test 2, the robot held a high-definition exoscope and relocated it to the setting position. Test 3 was similar to test 2, but a metal holder substituted the robot. Trained neurosurgeons manually adjusted the holder. The manipulation time was recorded. Additionally, a grading system was designed to score each image captured by the exoscope at the setting position, and the scores in the two tests were compared using the rank-sum test. The CoBot system positioned the finder successfully in all rounds in test 1; the mean height errors ± SD were 1.14 mm ± 0.38 mm (downward) and 1.60 mm ± 0.89 mm (upward). The grading scores of images in tests 2 and 3 were significantly different. Regarding the total score and four subgroups, test 2 showed a more precise, better-positioned, and more stable vision field. The total manipulation time in test 2 was 20 minutes, and for test 3 it was 52 minutes. The CoBot system successfully acted as a robust scope holding system to provide a stable and optimized surgical view during simulated port surgery, providing further evidence for the substitution of human hands, and leading to a more efficient, user-friendly, and precise operation.

Inertial Sensors as Real-Time Feedback Improve Learning Posterior-Anterior Thoracic Manipulation: A Randomized Controlled Trial

ObjectiveThe purpose of this study was to analyze the effect of real-time feedback on the learning process for posterior-anterior thoracic manipulation (PATM) comparing 2 undergraduate physiotherapy student groups. MethodsThe study design was a randomized controlled trial in an educational setting. Sixty-one undergraduate physiotherapy students were divided randomly into 2 groups, G1 (n = 31; group without feedback in real time) and G2 (n = 30; group with real-time feedback) participated in this randomized controlled trial. Two groups of physiotherapy students learned PATM, one using a traditional method and the other using real-time feedback (inertial sensor). Measures were obtained preintervention and postintervention. Intragroup preintervention and postintervention and intergroup postintervention scores were calculated. An analysis of the measures' stability was developed through an interclass correlation index. Time, displacement and velocity, and improvement (only between groups) to reach maximum peak and to reach minimum peak from maximum peak, total manipulation time, and stability of all outcome measures were the outcome measures. ResultsStatistically significant differences were found in all variables analyzed (intragroup and intergroup) in favor of G2. The values of interclass correlation ranged from 0.627 to 0.706 (G1) and between 0.881 and 0.997 (G2). ConclusionsThis study found that the learning process for PATM is facilitated when the student receives real-time feedback.

Comparison of cold lateral compaction and continuous wave of obturation techniques following manual or rotary instrumentation

To compare different combinations of root canal preparation and obturation technique. A total of 48 freshly extracted human maxillary central incisors were divided into two identical groups on the basis of root canal length and apical diameter. The root canals were prepared by manual crown-down pressureless technique or with a rotary system (ProFile; Dentsply Maillefer, Ballaigues, Switzerland) in a crown-down technique. The coronal diameter and apical size of the root canals were standardized in both preparation techniques. Each main group was then divided into two subgroups and obturated with either cold lateral compaction or continuous wave of obturation with System B (EIE-Analytic Technology, Orange, CA, USA). The distribution of filling material in each canal was assessed by stereomicroscopic examination of eight cross-sections on each tooth. Areas of sealer, gutta-percha and voids were measured on the digital images of a total of 384 samples. Manipulation time and apical extrusion for each group was also determined. Data were statistically analysed using Kruskal-Wallis, anova (Bonferroni/Dunn) or Student's t-test. The percentage of sealer, gutta-percha and voids area between the obturation techniques was not significantly different (P > 0.05). Continuous wave groups had significantly more apical extrusion of sealer (P < 0.05), while none of the obturation techniques had gutta-percha extrusion. Rotary instrumentation was significantly faster than the manual technique (P < 0.05); continuous wave obturation was significantly faster than lateral compaction (P < 0.05). Total manipulation time in the rotary/continuous wave group was significantly shorter than the other groups (P < 0.0001). The distribution of filling materials was similar in all combinations of instrumentation and obturation techniques. The continuous wave technique was faster than lateral compaction and it extruded more sealer.

Assessment of the ergonomically optimal operating surface height for laparoscopic surgery.

The aim of this study was to find the ergonomically optimal operating surface height for laparoscopic surgery in order to reduce discomfort in the upper extremities of the operators and the assistants. The operating surface height was defined as the level of the abdominal wall of a patient with pneumoperitoneum. Two pelvi-trainer tests were performed. One test was performed on six different operating surface heights. The (extreme) joint excursions of the shoulder, elbow, and wrist were measured by a video analysis method. Another test was performed by holding a laparoscope for 15 minutes while an electromyelograph of the biceps brachii was made. The results of both tests were evaluated subjectively by a questionnaire. The ergonomically optimal operating surface height lies between a factor 0.7 and 0.8 of the elbow height of the operator/assistant. At this height, the joint excursions stay in the neutral zone for more than 90% of the total manipulation time, and the activity of the biceps brachii when holding the laparoscope stays within 15% of the maximum muscle activity. The operating surface height influences the (extreme) upper joint excursions of the surgeon. The ergonomically optimal operating surface height reduces the discomfort in the shoulders, back, and wrists of the surgeon during laparoscopic surgery. This optimal table height range for laparoscopic surgery is lower than those currently available.

刺激複雑性に対する乳児の操作的探索行動の分析

Infants behaviors to the eight novel objects were recorded by V. T. R. They were analyzed with vision, contents of manipulation (vigorous manipulation with arms and hands(vertical shake, horizontal shake, hit drop), gentle manipulation with fingers (finger, pinch, scratch), oral behaviors (mouth, appropriate manipulation)) and other behaviors. The Ss were 66, 7-, 9-, 12-month old infants.Simple objects, viz.(1) Ring,(2) Bar,(3) Spoon,(4) Cup were manipulated with arms and mouthed more than complex objects, viz.(5) Figure Box,(6) Rainbow Spring,(7) Uneven Basket,(8) Decorative Rattle. Complex objects were visually regarded and manipulated with fingers more than simple objects in all age groups.Among complex objects, visually complex objects,(5),(6) were visually regarded and manipulated with arms more than tactually complex objects (7),(8).The latter were manipulated with fingers and received emotional responses (vocalization, look at the mother, being afraid) more than the former.The 9-and 12-month old infants had longer visual regard per response, larger percentage of looking within one trial, and longer manipulative latencies than 7-month old infants. And the total manipulation time decreased with age.The manipulations with arms decreased and the manipulations with fingers increased with the age. The latter had larger percentage of responses of visual regard than the former.Males had longer visual regard per response, total manipulation and vigorous manipulation with arms than females.Oral behaviors decreased with the age. But regarding objects (3) and (4), mouthing of their special round parts increased with the age, and 12-month old infants began to manipulate them appropriately.Looking at the mother increased with the age, and 12-month old infants began to point or show the stimulus to the mother.

Technique for Separating Weed Seed from Soil

A simple technique is described for rapid determination of weed seed, rhizome, corm, or bulb populations in soil. Soil samples were placed in nylon mesh bags. The soil was washed from the bags by machine leaving only a small residue including the desired propagules. These were hand separated and the soil population of a given plant species calculated. The total manipulation time per sample was approximately 10 min.

Semiautomatic Machine for Group Separation of Radioelements by Cation Exchange.

A technique for performing a five-group separation of radioelements by cation exchange is described. Suitable counting sources are prepared for each group on a semiautomatic machine. Twelve samples are analyzed simultaneously, and five counting sources for each sample are obtained and counted during an 8- hour day. Total manipulation time for the analyst during this period is about 1.5 hours. Detailed anaiytical results are presented for two samples: a synthetic mixture of the radioelements Sb/sup 125/. Zr, Nb; Cs, Ba/sup 137/; Co; Sr, Y/sup 90/; Ce, Pr/sup 144/; and a 3.6year-old mixture of fission products. The radioelements in the two samples report primarily in the following groups: Group I, Sb, Ru, Zr, Nb; Group II, Cs; Group III, Co; Group IV, Sr; and Group V, Y, rare earth elements. (auth)