bluuebunny/crossref_metadata_2025 huggingface dataset:
The respective contribution of cognitive control and working memory to semantic and subjective organization in aging.
Authors: Frick Aurélien
Published: June 2023

Organizing information is beneficial to episodic memory performance. Among several possible organizational strategies, two consist of organizing the information in semantic clusters (semantic organization) or self-organizing the information based on new associations that do not exist in semantic memory (subjective organization). Here, we investigated in a single study how these two organizational behaviors were underlined by different controlled processes and whether these relations were subjected to age-related differences. We tested 123 younger adults (n = 63) and older adults (n = 60) on two episodic memory tasks, one where the words were organizable and another where the words were not organizable, allowing for semantic and subjective organization, respectively. Additionally, participants were tested on three cognitive control tasks (Wisconsin Card Sorting Test, Stroop Test and Trail Making Test) and three working memory tasks (Backward Digit Span, Alpha Span and N-back test). Results revealed well-established age-related differences in terms of recall performance and organizational strategy implementation. More importantly, we found evidence that the different cognitive tests statistically yielded two different latent factors, a cognitive control factor and a working memory factor. Based on this dissociation, we found that only cognitive control contributed to semantic organization in all age groups whereas only working memory contributed to subjective organization, also in all age groups. These results shed new lights on our understanding of how controlled processes differently contribute to organizational behaviors in episodic memory.
The underlying processes of episodic memory development: From a unique contribution of representation to the increasing use of semantic organization supported by cognitive control
Authors: Frick Aurélien , Wright Helen
Published: June 2023

Episodic memory development is linked to better clustering of items semantically related at recall. Previous studies have suggested that the use of clustering occurs relatively late in children’s development, and does not systematically lead to benefits. Here, we investigated how Control (the fluid goal-directed cognitive processes supporting adaptive and flexible behaviors) and Representation (crystallized schemas or general knowledge about the world) contribute to recall and clustering in childhood. To this end, 104 children aged from 8 to 13 years-old were administered a free-recall task and tests assessing Control and Representation. Results showed that the use of clustering, although it emerges from 8 years-old, was only beneficial for recall after 11 years-old. Regarding the respective contribution of Control and Representation, we observed that only Representation accounted for recall in the younger children (8–11 years), whereas both Representation, but to a lesser extent, and clustering supported by Control, improved recall from age 12. These results offer new insights into the development of episodic memory through childhood and the underlying mechanisms.
Large-scale evaluation of cold start mitigation in adaptive fact learning: Knowing "what" matters more than knowing "who"
Authors: van der Velde Maarten , Sense Florian , Borst Jelmer P , van Rijn Hedderik
Published: June 2023

Adaptive learning systems offer a personalised digital environment that continually adjusts to the learner and the material, with the goal of maximising learning gains.Whenever such a system encounters a new learner, or when a returning learner starts studying new material, the system first has to determine the difficulty of the material for that specific learner. Failing to address this "cold start" problem leads to suboptimal learning and potential disengagement from the system, as the system may present problems of an inappropriate difficulty or provide unhelpful feedback. In a simulation study conducted on a large educational data set from an adaptive fact learning system (about 100 million trials from almost 140 thousand learners), we predicted individual learning parameters from response data. Using these predicted parameters as starting estimates for the adaptive learning system yielded a more accurate model of learners' memory performance than using default values. We found that predictions based on the difficulty of the fact ("what") generally outperformed predictions based on the ability of the learner ("who"), though both contributed to better model estimates. This work extends a previous smaller-scale lab-based experiment in which using fact-specific predictions in a cold start scenario improved learning outcomes. The current findings suggest that similar cold start alleviation may be possible in real-world educational settings. The improved predictions can be harnessed to increase the efficiency of the learning system, mitigate the negative effects of a cold start, and potentially improve learning outcomes.
Cognitive Fatigue in Young, Middle-Aged, and Older: A Response Time Distribution Approach
Authors: Gilsoul Jessica , Libertiaux Vincent , Depierreux Frédérique , Collette Fabienne
Published: June 2023

Cognitive fatigue arises after a long-lasting task, as attested by increases in reaction times (RTs). However, most studies have focused on young people. Therefore, we investigated cognitive fatigue through changes in RT distributions in three age groups - young, middle-aged and older – during a 160-minute Stroop task. Task duration was divided into four blocks and the ex-Gaussian parameters (μ, σ, τ) were extracted from individual RT distributions in each time block for each item type. The results showed a significant Group effect on μ. Young people had smaller μ values than the other two groups, meaning that middle-aged and older people performed the whole task slower than young people. By contrast, τ showed no Group effect but increased with Time-on-Task in middle-aged people. Older people did not show τ increase with Time-on-Task, which echoes studies showing some resistance to task monotony in this population. Globally, our results showed dissociated age and Time-on-Task effect on the ex-Gaussian parameters.
GROUNDING ONTOLOGIES: CONSIDERING DIVERSITY AND PRACTICE IN CONCEPTIONS OF NON-HUMANS IN AN AMAZONIAN SOCIETY
Authors: Revilla-Minaya Caissa
Published: June 2023

People’s environmental conceptions influence the manner in which they engage with the world around them and are fundamental to processes of environmental decision-making. In order to fully grasp the meaning of such conceptions, ontological approaches exhort anthropologists to reconceptualize their own notions in order to understand people’s statements. Such approaches foreground difference, to the extent that members of distinct societies are considered to live in fundamentally different, incommensurable worlds. These theoretical postures, however, have been criticized for their emphasis on radical alterity and for portraying ontologies as homogeneous and static, ignoring cultural change and ethnographic heterogeneity, typical of anthropological research. Additionally, important theoretical and methodological issues are still unresolved, e.g., how to know if people’s utterances are meant to be taken as literal truths. This paper addresses this criticism and empirically explores conceptual arrangements by considering diversity and practice as constitutive of ontologies. Using qualitative and quantitative methods, this study explores the variety of notions of non-human beings held by members of an Indigenous Matsigenka community in Amazonian Peru. Ethnographic participant observation and a Bayesian statistical analysis of patterns of agreement and disagreement among community members suggest that ontological configurations are diverse, sometimes multiple and context-dependent, and are associated with specialized roles that influence people’s engagements with non-human beings in their daily lives. An understanding of these diverse, enacted conceptions sheds light on nuances of how humans interact with their surroundings.
A Fuzzy Set Extension of Schelling's Spatial Segregation Model
Authors: Ishida Atsushi
Published: June 2023

This study explores a possible segregation mechanism assuming fuzzy group membership. We construct a fuzzy set extension of Schelling's spatial segregation model. In the fuzzy Schelling model, each agent is assumed to have fuzzy membership in groups, which is typically assumed to represent the strength of the agent's group identity. The degree of membership is represented by the value of the membership function. The model assumes that agents want to be with agents with the same or stronger (less fuzzy) group identity than themselves. Agents decide whether to stay or move depending on whether their neighborhood satisﬁes their desires. Analyzing a series of simulations reveals that: First, the fuzzy Schelling model can reproduce segregation at the macro level; here, segregation is formed by the accumulation of agents' modest desires and actions. This is the most important property of the Schelling model. Second, agents' behavior and situation differ depending on the fuzziness of their membership. Notably, agents with less fuzzy membership play an important role in the system's equilibrium. Third, the tendency to reach equilibrium differs depending on the density of the space, required similarity level in the neighborhood, and initial distribution of membership values. Finally, we discuss the implications of the results.
A comparative interpreting studies view of interpreting in religious contexts
Authors: Downie Jonathan
Published: June 2023

This article applies Comparative Interpreting Studies to research on interpreting in religious contexts and the relevance of this literature to Interpreting Studies more broadly. Comparative Interpreting Studies is an approach that looks to plot the commonalities of all interpreting practice. It is argued that actual observed interpreter behaviors, rather than assumed professional standards, provide a justifiable unit of comparison. The behavior of interpreters in religious contexts is discussed, alongside the split between prescriptive and descriptive approaches to analyzing this behavior and the importance of spiritual and emotional aspects. Differences in research approaches on interpreting in religious contexts are shown to shadow debates within Interpreting Studies and thus offer insights that may be cautiously generalized. Such generalizations align with recent research in a variety of interpreting contexts and lead to a call for interpreting researchers to give more attention to the wider social, organizational, and personal contexts of interpreting.
Gendered Relationship of Childbearing with Earnings Accumulated by Midlife in Two Nordic Countries
Authors: Nisén Jessica , Erlandsson Anni , Jalovaara Marika
Published: June 2023

Nordic countries are considered advanced in gender equality, but also in these countries women still take longer family leaves and have lower earnings than men. This study provides novel insight by assessing the differences in accumulated earnings by midlife associated with childbearing among women and men in Finland and Sweden. We place particular attention to the magnitude of gender gaps in accumulated earnings across groups. We hypothesize larger gender gaps among those with a larger number of children, among those with a lower level of education, and overall, in Finland. The study is based on full-population register data, with highly accurate measures of earnings across decades. Our results indicate that women born in 1974–1975 accumulated on average 32 % and 29 % less labor earnings than men by age 44 in Finland and Sweden, respectively. Childbearing strongly modifies the gender gap especially in Finland, and the highly educated have moderately smaller gaps in both countries.
Reassembling Agency: Epistemic Practices in the Age of Artificial Intelligence
Authors: Lee Francis
Published: June 2023

This article reflects on how sociology can understand and analyze the role of AI and data-driven methods in scientific practice without buying into the current AI hype. Drawing on analytical sensibilities developed in actor-network theory the article introduces the concept of agencing (agency as a verb) which refers to how scientists debate and configure the balance between human and machine agency in their work. The article suggests that we can come to a more nuanced understanding of the effects of AI in science by attending to actors’ agencing practices. The article draws on a decade long engagement with various digital practices in biosciences and uses this as a foil to discuss the more general question of agency in science. By discussing three ideal types of agencing, the article argues that AI and big data should not be regarded as a sweeping rupture in the tooling and practices of science, but rather as a continuation of long-standing patterns of practice. That is, agency, and the space for action and judgment, is organized differently in a big data or AI driven laboratory, however, it would be a mistake to understand this as a completely new configuration of epistemic agency. Rather we might understand these changes in the AI laboratory as building on statistical epistemic configurations going as far back as the birth of statistics in sociology in the 1700s and 1800s. But what are the consequences of introducing AI-analyses for biomedical knowledge production? What happens to biomedicine when human judgment and the traditional scientific method are supplemented with, and sometimes replaced by, AI and the analysis of large amounts of data? This text responds to a call for reflection on how “Artificial entities with humanlike properties would blur the distinction between human and non-human entities in important respects and challenge the particularity of man.” This paper explores these questions from the point of view of agency and human judgment. What happens to human agency and judgment in scientific experiments with the introduction of AI? The paper discusses these changes from the point of view of the concepts hybrid agency, asking how the AI and data revolutions are reshaping how science is done, and how knowledge is produced in a world imbued with non-human actors that seem to be making inroads in all arenas of human life..
The New Generationalism: Generational Antagonism and Partisan Polarization
Authors: Lindner Andrew Micah
Published: June 2023

Despite the prevalence of generational labels like Boomers, Gen X, Millennials, and Gen Z in popular discourse, most studies of generationalism have been restricted to content analyses of generational rhetoric. This study investigates the prevalence of negative generationalism, or negative affective sentiment towards perceived generational out-groups, within the U.S. public and considers how it may be linked with partisan political identities. Using a nationally representative survey of 1,232 Americans, this research examines the association between generational self-identity and partisan identity using feeling thermometer scores for four generational groups (Boomers, Gen Xers, Millennials, and Gen Z) and the two major political parties (Democrats and Republicans). I also report the findings of an experimental manipulation testing the extent to which generational priming exacerbates affective partisan polarization. The results reveal strong evidence of positive affect towards one's generational in-group, but a less consistent pattern of negative generationalism. Neither the correlational nor the experimental outcomes support a strong and consistent link between generationalism and partisanship, though Republicans feel significantly warmer towards Baby Boomers and colder towards Gen Z than independents. Despite the largely null findings concerning partisanship, this study reveals that these generational labels do appear to bear some degree of social meaning as social identities for people, pointing to new directions for future sociological research on generationalism.
SLAM-based Surgical Guidance For Breast Reconstruction Surgery
Authors:   Brigham and Women's Hospital, Harvard Medical School, US, Fu Elise , Alarcón de la Lastra Ángela ,   Brigham and Women's Hospital, Harvard Medical School, US, Zhou Haoyin ,   Brigham and Women's Hospital, Harvard Medical School, US, Zhang Ruisi ,   Brigham and Women’s Hospital, Harvard Medical School, US, Broyles Justin ,   Brigham and Women’s Hospital, Harvard Medical School, US, Ayyala Haripriya ,   Yale Medical School, US, Pomahac Bohdan ,   Yale Medical School, US, Jayender Jagadeesan ,   Brigham and Women's Hospital, Harvard Medical School, US
Published: June 2023

In 2018, 31.3% of the patients with stage I and stage II cancer underwent mastectomy in the United States. The loss of the breast mound post mastectomy alters the physical appearance of the patient and can have signifi- cant detrimental effect on the body image and mental health of patients [1]. Breast reconstruction surgery (BRS) using DIEP (deep inferior epigastric perforators) flap utilizes redundant lower abdominal skin and fat for reconstruction of breast mound. Due to its composition of fat similar to native breast, the flap has the advantage of superior aesthetic contours of the reconstructed breast [2], [3]. However, in order to establish the best flap shape and volume, the surgeon must have finesse and intuition [4]. Asymmetry of the breast can lead to a lower quality of life and a badly reconstructed breast is a constant reminder of the disease. Thus, it is crucial to have an accurate, reliable and accessible method to assess breast volume and shape to plan the reconstruction. Our study proposes the use of a low-cost RGB-D camera to scan the contralateral breast of a patient who has undergone mastectomy and 3D print a mirrored mold to guide the surgeon to establish the best shape (see Figure 1)
Computational Analysis of Design Parameters for a Bimanual Concentric Push-Pull Robot
Authors:   University of North Carolina at Chapel Hill, US, Qin Tony , Connor Peter ,   Vanderbilt University, US, Dang Khoa ,   University of Tennessee, Knoxville, US, Alterovitz Ron ,   University of North Carolina at Chapel Hill, US, Webster Robert ,   Vanderbilt University, US, Rucker Caleb ,   University of Tennessee, Knoxville, US
Published: June 2023

Colorectal cancer is a pervasive disease: an estimated 4.6% of men and 4.2% of women will suffer from it in their lifetime [1]. Precancerous polyps can be small (<5 mm) medium (6-9 mm) or large (>10 mm) [2]. Small polyps are most frequent, but polyps too large for immediate endoscopic removal during screening occur 135,000 times per year in the US alone [1]. There are two primary options for removing these polyps: endoscopic removal or partial colectomy. Endoscopic procedures, such as endoscopic submucosal dissection (ESD), are less invasive and reduce the risk of infection, reoccurence, and other adverse events [3]. Despite this, approximately 50,000 patients each year undergo partial colectomies for polyps which could have been removed endoscopically [4]. A primary obstacle to wider use of endoscopic pro- cedures is how challenging they are for physicans to perform, due to the limited dexterity of existing trans- endoscopic tools [5]. Currently tools come straight out the tip of the colonscope and moving them requires moving the tip of the colonoscope [6]. To enable tools to move independent of the colonoscope, we propose an endoscopically deployable, flexible robotic system, as shown in Fig. 1. This system deploys a flexible robotic arm through each channel of a standard 2-channel colonoscope. Each arm is composed of a setup sheath followed by a steerable sheath, with each sheath built using a concentric push-pull robot (CPPR) [7]. Each arm has a hollow central lumen through which tools (e.g. forceps, electrosurgery probes, etc.) can be passed. This design adds dexterity and provides the physician with two independent manipulators, with the goal of making ESD easier to perform.
Ultrasonically-Lubricated Catheters: A Proof of Concept
Authors:   Delft University of Technology, Netherlands, Atalla Mostafa A. , Tuijp Jeroen J. ,   Delft University of Technology, Netherlands, Wiertlewski Michaël ,   Delft University of Technology, Netherlands, Sakes Aimée ,   Delft University of Technology, Netherlands
Published: June 2023

Over the past few decades, minimally-invasive en- dovascular interventions have proved its benefits over conventional open heart surgeries, leading to shorter recovery times and lower infection rates. In a typical endovascular procedure, the interventionist inserts a catheter in the radial or femoral artery and navigates it through the arteries to the heart, where the intervention is performed. In order to safely reach the heart, the catheters (and guidewires) used during these procedures need to easily follow the curves in the vascular system, while creating as little friction as possible with the blood vessel wall. If these devices exhibit high friction, there is a risk of damage to the mucous membranes or the intima of the blood vessels, which may lead to infectious diseases or thrombus formation [1], [2]. While low friction is beneficial to avoid damage to the membranes and blood vessel wall, it makes holding a specific location in open spaces, such as inside the heart, difficult. This is particularly true when high forces need to be applied, such as when cutting or puncturing tissues. This suggests the need for new advanced catheters whose frictional properties are controllable and can be adjusted depending on the phase of the catheterization proce- dure; for instance, having low friction while navigating through the vasculature and switching to a high friction state while executing the surgical task. In this work, we propose a novel concept of a variable friction catheter, which comprises discrete modules for friction control. We hereby present the proof-of-concept of the friction control modules, which we characterized in simulation and experimentally. Finally, we present the preliminary results of the sliding friction experiments.
A Deep Learning Model for Tip Force Estimation on Steerable Catheters Via Learning-From-Simulation
Authors:   Concordia University, Canada, Roshanfar Majid , Fekri Pedram ,   Concordia University, Canada, Dargahi Javad ,   Concordia University, Canada
Published: June 2023

Atrial Fibrillation (AFib) is the most common arrhyth- mia among the elderly population, where electrical activity becomes chaotic, leading to blood clots and strokes. During Radio Frequency Ablation (RFA), the arrhythmogenic sites within the cardiac tissue are burned off to reduce the undesired pulsation. Manual catheters are used for most atrial ablations, however, robotic catheter intervention systems provide more precise map- ping. Several studies showed excessive contact forces (> 0.45 N) increase the incidence of tissue perforation, while inadequate force (< 0.1 N) results in ineffective ablation. Fig.1 shows a schematic of a cardiac RFA catheter used for AFib treatment. For robot-assisted RFA to be safe and effective, real-time force estimation of catheter’s tip is required. As a solution, finite element (FE) analysis can provide a useful tool to estimate the real-time tip contact force. In this work, a nonlinear planar FE model of a steerable catheter was first developed with parametric material properties in ANSYS software. After that, a series of simulations based on each mechanical property was performed, and the deformed shape of the catheter was recorded. Next, validation was conducted by comparing the results of the simulation with experimental results between the range of 0-0.45 N to determine the material properties. Despite the previous work, which was a study to estimate the tip contact force of a catheter using a deep convolutional neural network [1], [2], the main contribution of this study was proposing a synthetic data generation, so as to train a light deep learning (DL) architecture for tip force estimation according to the FE simulations. Due to the availability of real-time X-ray images during RFA procedures (fluoroscopy), the shape of the catheter is available intraoperatively. The proposed solution not only feeds the data-hungry methods based on DL with a sufficient amount of data, but also shows the feasibility of replacing the fast, accurate, and light-weight learning-based methods with slow simulations.
DEBI: a new mechanical device for safer needle insertions
Authors:   Imperial College London, UK, Aktas Ayhan , Franco Enrico ,   Imperial College London, UK
Published: June 2023

Over 1 million core-needle breast biopsies are performed every year in the US alone [1], while gastrointestinal and prostate biopsies are estimated in similar numbers. The cost of core-needle breast biopsies ranges between $500 for manual procedures to $6,000 for image-guided procedures [2]. A retrospective study indicated that approximately 2.5% of breast biopsies fail [3]. Needle bending has been identified as a significant cause of error in biopsies and is particularly likely to occur at the insertion stage [2]. The associated risks include: i) biopsy of the wrong site leading to misdiagnosis; ii) puncture of sensitive areas in proximity of the insertion path; iii) repeated insertions, thus longer procedure du- ration and increased patient discomfort. Biopsy needles are also prone to buckling, which can damage the needle permanently. Common techniques for correcting needle bending in clinical settings include repeating the inser- tion (which can be time-consuming) or using a needle guide (which reduces the maximum insertion depth). In research, axial rotation is typically employed for steering bevel-tip needles, but it is less effective for needles with an axial-symmetric tip [4]. Additionally, straight insertions require continuous axial rotation, which can damage soft tissue due to the spinning of the bevel tip [5]. Alternative approaches employ steerable needles, which are not yet part of clinical practice [6]. We have developed a mechanical device that detects needle bending as soon as it occurs and that immediately reduces the insertion force thus helping to avoid deep insertions with deflected needles and the associated risks. Unlike existing solutions, our design does not require actuators or sensors hence it can be made MRI- safe, sterilisable or disposable. Finally, our device can be used with a variety of standard needles, including multi-bevel needles (e.g. diamond tip or conical tip).
Implementation of a Novel Handheld Endoscopic Operation Platform (EndoGRASP)
Authors:   The Chinese University of Hong Kong, Hong Kong, Lam Chun Ping , Ho Ming Ho ,   Multi-scale Medical Robotics Center, Hong Kong, Siu Shi Pan ,   Multi-scale Medical Robotics Center, Hong Kong, Lau Ka Chun ,   Multi-scale Medical Robotics Center, Hong Kong, Yam Yeung ,   The Chinese University of Hong Kong, Hong Kong, Chiu Philip Wai Yan ,   The Chinese University of Hong Kong, Hong Kong
Published: June 2023

Flexible endoscopes are widely used due to their effective treatment of various conditions with minimal surgery. Existing ESD platform, such as Incisionless operation platform (IOP) [1] and ANUBIScope [2], while they may offer reliable support for endoscopic bending, they lack the ability to provide precise motorized motion or may potentially restrict the maneuverability of the platform in confined endoluminal environments. Another more advanced operation platform, namely EndoMaster [3], while providing excellent visualization of the surgical area due to its compact design, which allowed for easy docking and prevented interference from the working arms, however, its complex operational requirements, where the surgeon must control the console remotely and manipulate the robotic arms using hand controls, can be time-consuming and challenging for the surgeon to master. Over-the-Scope Clip (OTSC) [4] use a device that places clips over the endoscope to hold tissue before removal, but the effectiveness of these clips in securing the tissue is sometimes inadequate, resulting in incomplete tissue acquisition and suboptimal surgical outcomes. Existing operating systems face challenges such as limited mobility, insufficient tissue collection, complex setup, and high costs. EndoGRASP, a novel handheld endoscopic platform, addresses these issues with its flexible robotic overtube and actuation unit. Optimized for efficient endoscopic submucosal dissection, it enhances patient safety and ensures precise, motorized control of the endoscope and instruments.
Flexible Magnetic Soft Stent for Mobile Flow Diversion
Authors:   Max Planck Institute for Intelligent Systems, Germany, Wang Tianlu , Sitti Metin ,   Max Planck Institute for Intelligent Systems, Germany
Published: June 2023

With the advantages in dimensions and exceptional locomotion capabilities, small-scale mobile robots have offered new opportunities for medical interventions in hard-to-reach regions, including the distal arteries in the circulatory systems. In this field, the wireless soft robots fabricated with compliant materials further provide unique adaptation capabilities and, thus, many exciting potential applications [1]. Although various locomotion abilities have been demonstrated and studied from the aspects of robot design, control strategies, and soft- bodied interactions [2], rare effective functions other than drug delivery have been properly incorporated into these robots for potential in-vivo utilities. Our group has recently developed a medical robotic system with a stent- shaped magnetic soft device (Stentbot) and the associated spatial magnetic actuation setup, which realized the on- demand local drug delivery and the flow diversion using a millimeter wireless robot design [3]. Its flexible locomotion capabilities have indicated its benefits of working as a mobile flow diverter if clinical migrations or misplacements happen when treating brain aneurysms using stent-like structures. However, this single-material development traded off the performance in locomotion abilities and the efficacy of flow diversion. For example, pure mesh-like structures ensure full body adaptation for the retrievable locomotion among the lumens with varying diameters, but the effectiveness of flow diversion is reduced since flow could go through the meshes freely. On the other hand, a full surface-sealed, hollow tube structure where all the gaps among meshes are filled could have a perfect flow diversion effect. However, the radial stiffness of the structure is notably increased, such that the shape adaptation capability is reduced. Therefore, there is a missing solution for the effective flow diverter with proper adaptation for the future treatments of brain aneurysms and other diseases, such as arteriovenous malformation.
Extracting Unusual Movements during Robotic Surgical Tasks: A Semi-Supervised Learning Approach
Authors:   University of Texas at Austin, United States, Zheng Yi , Majewicz-Fey Ann ,   University of Texas at Austin, United States
Published: June 2023

Although modern features in surgical robots such as 3D vision, “wrist” instruments, tremor abolition, and motion scaling have greatly enhanced surgical dexterity, technical skill is a major challenge for surgeons and trainees. Surgeons who get constructive and real-time feedback can make more significant improvement in their performance [1]. Recent years, the research in automated surgical skill assessment has made considerable progress, however, the majority of surgical evaluation methods are post- operation analysis. Few studies introduced real-time sur- gical performance evaluations, for example, using Con- volutional Neural Network [2], Codebook and Support Vector Machine [3], and Convolutional Neural Network - Long Short Term Memory [4]. One common limitation of these studies is data leakage during training which results in a higher estimate of model performance. Moreover, these studies cannot depict an intuitive repre- sentation of what actually differentiates expertise levels. In this study, we introduce a method to extract the unusual movements which are rarely seen in Experts and identify the types of the unusual movements. We believe detecting and correcting the unusual movements is an important aspect for surgeons to improve their skills.
Proof of Concept Implementation of Forbidden Region Dynamic Active Constraints in Minimally Invasive Surgery
Authors:   Imperial College London, UK, Cui Zejian , Rodriguez Y Baena Ferdinando ,   Imperial College London, UK
Published: June 2023

Active Constraints (AC), also named as Virtual Fixtures (VF), are a strategy to provide anisotropic haptic guid- ance for surgeons during use so that motions that comply with safety requirements are permitted, while those that breach safety requirements are negated. AC can be helpful also in a teleoperative surgical scenario, in which surgeons operating on the surgeon-side interface are sep- arated from the patient-side, where surgical instruments are held and manipulatd by a robot. One challenging as- pect of incorporating AC into a modern clinical setting is how to efficiently update pre-constructed AC geometries in real time to account for dynamic tissue movement. In this study, we designed a pipeline for implementing Forbidden Region AC (FRAC), where tissue move- ment is constantly captured by a depth-sensing camera. The effectiveness of the pipeline has been confirmed through in vitro trajectory tracking experiments along a deforming aorta phantom. Our experimental results demonstrate the capability of our method to provide timely corrective guidance when a violation of the safety region is detected.
Global versus local kinematic skills assessment on robotic assisted hysterectomies
Authors:   Univ Rennes,INSERM, LTSI - UMR 1099, France, Huaulmé Arnaud , Timoh Krystel Nyango ,   Department of Obstetrics and Gynecology, Rennes University Hospital, Rennes, France, Jan Victor ,   Univ Rennes,INSERM, LTSI - UMR 1099, France, Guerin Sonia ,   Department of Obstetrics and Gynecology, Rennes University Hospital, Rennes, France, Jannin Pierre ,   Univ Rennes,INSERM, LTSI - UMR 1099, France
Published: June 2023

Surgical skills assessment is a crucial step to help understanding surgical expertise and to provide technical knowledge to beginners. Scores, such as GOALS [1], have been designed to assess surgical skills. However, these scores are subjective and need experts to compute them. With the advent of robotic surgery, it is possible to compute Automated Performance Metrics (APMs) based on the motion of robotic arms to assess surgical skills. Several studies have demonstrated statistically significant differences between APMs from different levels of expertise [2], [3]. The majority of these studies performed a global analysis, i.e., studying the surgical procedure or training task as a whole. By using the Surgical Process Model (SPM) methodology [4], it is possible to describe the surgery at different levels of granularity and break it down into a sequence of elements. Riffaud et al. [5], decomposed Lumbar Disc herniation surgery by phases and demonstrated that the main expertise differences in terms of duration are due to specific phases or actions. In this paper, we will combine SPM and APMs to study global and local kinematic skills during robotic-assisted hysterectomies.
Integrating a Real-time Surgical Robot Dynamic Simulator with 3D Slicer
Authors:   Johns Hopkins University, US, Fan Hongyi , Munawar Adnan ,   Johns Hopkins University, US, Sahu Manish ,   Johns Hopkins University, US, Taylor Russell ,   Johns Hopkins University, US, Kazanzides Peter ,   Johns Hopkins University, US
Published: June 2023

Background Medical robotics, particularly image- guided robotic systems, have revolutionized the surgical field by improving precision and accuracy. 3D Slicer(1), an open-source platform, has become a crucial tool in this field as it allows for visualization, processing, and registration of 2D and 3D medical imaging data, making it an essential component in current research in robotic intervention(2) (3). However, there is a missing compo- nent in 3D Slicer - a native physics engine for simulating the interaction of a robot with the anatomy. AMBF(4), an open-source software, was designed to address this issue by simulating the kinematics, dynamics, and in- teraction of complex surgical robots. By integrating 3D Slicer and AMBF using Robot Operating System (ROS), we can empower researchers to utilize both the extensive capabilities of 3D Slicer for visualization, processing, and registration of medical imaging data, and the physics- based constraint of AMBF for simulating the interac- tion of a robot with the anatomy. By combining these two platforms, researchers will have a comprehensive tool to study and develop projects in medical robotics, ulti- mately contributing to the advancement of the field.
A Soft Continuum Robot with Multi-Modal Shape and Contact Force Sensing for Minimally Invasive Surgery
Authors:   Boston University, US, McCandless Max , Wise Frank Julia ,   Boston University, US, Russo Sheila ,   Boston University, US
Published: June 2023

Minimally invasive surgery (MIS), e.g., interventional endoscopy and single-incision laparoscopy, has paved the way toward increased patient safety, fewer postop- erative complications, and shorter recovery times [1]. The inherent compliant nature of soft robots makes them suitable for addressing current limitations in MIS, such as the lack of dexterity of rigid robotic devices; however, soft robots often lack adequate shape and contact sensing which makes them difficult to control [2], [3]. The future of laparoscopic surgical tools is moving toward flexible and soft robotic solutions for safer interaction with hu- man tissue [4]. However, newly developed technologies lack effective embedded sensing [5]. This work presents a fully soft robot combining i) a soft optical sensorized multi-modal gripper for tip tracking and contact force sensing with ii) a multi-directional bending module with integrated 3D shape sensing (Fig. 1, a-b). The gripper embeds two soft pneumatic actuators to deploy the jaws, two soft pneumatic actuators to control grasping, and two fully soft optical waveguide sensors (WG) (one in each jaw) with tuned roughness to monitor both actuator tip positions and subsequent contact force on an object.
Scalable and Spatially Selective Actuation of Living Microrobots
Authors:   ETH Zurich, Switzerland, Mirkhani Seyed Nima , Gwisai Tinotenda ,   ETH Zurich, Switzerland, Christiansen Michael G. ,   ETH Zurich, Switzerland, Schuerle Simone ,   ETH Zurich, Switzerland
Published: June 2023

In drug delivery, one key challenge is to minimize off- target accumulation in healthy regions, which can lead to toxicity or other associated complications. To address this challenge, drug delivery platforms can be designed either to localize the accumulation of active compounds to the target site or to selectively activate the portion that arrives in the targeted tissue. In the case of living bacterial therapeutics or bacteria-based biohybrid microrobots, bacteria can be equipped with onboard sensing, aiding their preferred accumulation in target regions such as tumors [1]. Nevertheless, robust tumor colonization by bacteria is still limited by low administrable doses and biological barriers that permit only a small portion to reach a target site after intravenous administration. Therefore, strategies that provide a means to target external energy to bacteria in a spatially selective manner can offer a much-needed element for enhanced targeting of living therapeutics [2]. Magnetotactic bacteria (MTB) are a group of bacteria noted for their intrinsic responsiveness to magnetic fields, and have been investigated as a drug carriers and potential living therapeutics. We previously demonstrated the possibility for enhancing tumor colonization using a scalable magnetic torque-based control approach employing a homogenous rotational magnetic field [3]. Here, we increase the spatial selectivity of this technique by employing a magnetostatic selection field that suppresses off target torque-based actuation.
Priority-Based Shared Control for Peg Transfer Task
Authors:   Imperial College London, UK, Hu Zhaoyang Jacopo , Chen Longrui ,   Imperial College London, UK, Huang Yanpei ,   Imperial College London, UK, Burdet Etienne ,   Imperial College London, UK, Rodriguez Y Baena Ferdinando ,   Imperial College London, UK
Published: June 2023

Supervisory methods in shared control allow a dynamic adjustment of the level of autonomy in a surgical robot based on the current task demands and the capabilities of the human operator. Several benchmarks [1] are avail- able to evaluate the performance of these controllers, however the operator can struggle with the task due to inexperience or limited environmental information. In this paper, we propose an admittance control strategy based on guidance priority adaptation to enable a human operator to assume a supervisory role during one-handed peg transfer task (Figure 1). We implement an epsilon- greedy maximum entropy inverse reinforcement learning (EG MaxEnt IRL) [2] algorithm to enable an agent to control the surgical tool in a virtual environment while the human supervises the procedure. We successfully implement the proposed method and observe that the supervisory method can be further improved with a cooperative control, specifically a segmented control.
Incident Angle Study for Designing an Endoscopic Tool for Intraoperative Brain Tumor Detection
Authors:   Duke University, Department of Mechanical Engineering and Materials Science, US, Yamamoto Kent , Zachem Tanner ,   Duke University, Department of Mechanical Engineering and Materials Science, US, Ross Weston ,   Duke University School of Medicine, Department of Neurosurgery, US, Codd Patrick ,   Duke University Department of Mechanical Engineering and Materials Science, Duke University School of Medicine, US
Published: June 2023

Surgery is one of the most prevalent methods of control- ling and eradicating tumor growth in the human body, with a projection of 45 million surgical procedures per year by 2030 [1]. In brain tumor resection surgeries, pre- operative images used for the detection and localization of the cancer regions become less reliable throughout surgery when used intraoperatively due to the brain moving during the procedure, referred to as brain shift. To solve the brain shift problem, intraoperative MRI (iMRI) has been used, but it is costly, time intensive, and only available at the most advanced care facilities [2]. Intraoperative fluorescence-guided methods, both exoge- nous (introducing foreign fluorophore molecules into the body) and endogenous (utilizing innate fluorophores within the body), have been investigated as an alternative to iMRI to circumvent the brain shift problem. This paper introduces the proposed design, shown in Fig. 1(a), of an endoscopic tool for intraoperative brain tumor detection incorporating a laser-based endogenous fluorescence method previously explored by [3], called TumorID, depicted in Fig. 1(b). The device has also been deployed on ex-vivo pituitary adenoma tissue by [4] for intraoperative pituitary adenoma identification and subtype classification. This study explores whether a non-perpendicular angle of incidence (AoI) will sig- nificantly affect the emitted spectral data. With a better understanding of the relationship between AoI and col- lected spectra, the results can help shed light on the potential steering modality ( optical [5] or fiber [6]) and end-effector movement profile for the proposed optics- based endoscopic tool.
Usability study of human-computer interfaces for 3D model manual registration in augmented reality application for surgery
Authors:   Istituto Italiano di Tecnologia, Italy, Neri Alberto , Penza Veronica ,   Istituto Italiano di Tecnologia, Italy, Mattos Leonardo S. ,   Istituto Italiano di Tecnologia, Italy
Published: June 2023

Augmented reality (AR) is becoming essential in several surgical specialities [1]. Fusing patient-specific preoper- ative information, typically 3D models extracted from CT scans or MRI, on the real-time surgical images allows the surgeon to have detailed information on the anatomical structure of the surgical target intra- operatively. As stated in [2] and [3], an AR system’s first step consists of an initial rigid registration of the 3D models on the surgical image. Most of the approaches are manual or semi-automatic. While the latter exploits physical landmarks on the tissue or 3D surface features, the manual approach requires Human- Computer Interfaces (HCI) to manipulate the models. The choice of the HCI is fundamental to develop an easy-to-use application with a short learning curve. In fact, the way the manual registration is performed can impact the users’ physical and mental stress, influencing their final performances. This paper presents a human-centred usability study that aims to evaluate two modern HCI devices com- monly proposed for 3D model manipulation in surgical augmented reality applications, i.e., the SpaceMouse® and UltraLeap® . Accordingly, a software interface was developed to allow the manipulation of 3D models in a minimally invasive partial nephrectomy scenario. Subjects were asked to perform a rigid manual registration of a kidney’s 3D model on the image of the real kidney. Quantitative and qualitative evaluation was performed to assess the cognitive and physical load imposed on the operators, which can support an informed selection of HCI to maximize system usability and operator perfor- mance. These trials were performed under study protocol 229/2019 - ID 4621, approved by the Regional Ethics Committee of Liguria (Italy).
Feasibility of Mobile Application for Surgical Robot Teleoperation
Authors:   Johns Hopkins University, US, Deo Akhil , Kazanzides Peter ,   Johns Hopkins University, US
Published: June 2023

In recent years, robotic surgery has gained popularity due to its numerous advantages, including greater control and access for surgeons, shorter recovery times, and lower levels of pain for patients [1]. However, surgical robot systems require extensive training for surgeons to master their use. Simulation-based training has become a component of surgical education [2], providing a safe environment for trainees to acquire and refine their skills. However, most existing training platforms require bulky and expensive control consoles, which limits their availability and convenience. The development of a low- cost and easily deployed control console can address these limitations, thereby potentially enhancing the effectiveness of robotic surgery training. A system that satisfies these criteria can also enable medical robotics research in low-resource environments, where cost and accessibility are the most significant impediments to research. This paper describes the creation and evaluation of an iPhone application for these purposes.