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Animals have evolved to rapidly detect and recognize brief and intermittent encounters with odor packages, exhibiting recognition capabilities within milliseconds. Artificial olfaction has faced challenges in achieving comparable results-existing solutions are either slow; or bulky, expensive, and power-intensive-limiting applicability in real-world scenarios for mobile robotics. Here, we introduce a miniaturized high-speed electronic nose, characterized by high-bandwidth sensor readouts, tightly controlled sensing parameters, and powerful algorithms. The system is evaluated on a high-fidelity odor delivery benchmark. We showcase successful classification of tens-of-millisecond odor pulses and demonstrate temporal pattern encoding of stimuli switching with up to 60 hertz. Those timescales are unprecedented in miniaturized low-power settings and demonstrably exceed the performance observed in mice. It is now possible to match the temporal resolution of animal olfaction in robotic systems. This will allow for addressing challenges in environmental and industrial monitoring, security, neuroscience, and beyond.

Creative movement, in the form of music- and dance-based exercise and rehabilitation, can serve as a model for learning and memory, visuospatial orientation, mental imagery, and multimodal sensory-motor integration. This review summarizes the advancement in cognitive neuroscience aimed at determining cognitive processes and brain structural and functional correlates involved in dance or creative movement, as well as the cognitive processes which accompany such activities. We synthesize the evidence for the use of cognitive, motor, and cognitive-motor function in dance as well as dance's potential application in neurological therapy and neurorehabilitation. Finally, we discuss how partnered interaction and sensorimotor integration in dance, and "dancing robots" could shed light on future application of dance as rehabilitation, of dance used in technology and potential mechanisms of benefit from dance-based activities., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Active systems of self-propelled agents, e.g., birds, fish, and bacteria, can organize their collective motion into myriad autonomous behaviors. Ubiquitous in nature and across length scales, such phenomena are also amenable to artificial settings, e.g., where brainless self-propelled robots orchestrate their movements into spatial-temporal patterns via the application of external cues or when confined within flexible boundaries. Like their natural counterparts, these approaches typically require many units to initiate collective motion, so controlling the ensuing dynamics is challenging. Here, we demonstrate a simple mechanism that leverages nonlinear elasticity to tame near-diffusive motile particles in forming structures capable of directed motion and other emergent behaviors. Our elasto-active system comprises two centimeter-sized self-propelled microbots connected with elastic beams. These microbots exert forces that suffice to buckle the beam and set the structure in motion. We first rationalize the physics of the interaction between the beam and the microbots. Then we use reduced-order models to predict the interactions of our elasto-active structures with boundaries, e.g., walls and constrictions, and demonstrate how they can exhibit remarkable emergent behaviors such as maze navigation. These findings demonstrate that allowing and understanding changes in body morphology can enhance the capabilities of active matter systems and enable the design of robotic materials capable of space exploration, adaptation, and complex interactions with their surrounding environment., Competing Interests: Competing interests statement:The authors declare no competing interest.

Objectives: Automated dispensing cabinets (ADCs) offer improved medication safety, greater efficiency and return on investment. However, integrating ADCs into medication dispensing processes can be challenging in complex hospital environments. This study aimed to draft suggestions to help hospitals adopt ADCs., Methods: Two-day visits were organised in seven European hospitals operating ADCs. Investigators used an observational grid, a questionnaire and interviews, each divided into the themes of medication processes before and after the introduction of ADCs, the major steps followed and the resources involved, ergonomics and staff perceptions., Results: ADCs were integrated into four global hospital medication dispensing systems (packs of drugs are distributed from the central pharmacy to wards for dispensing) and three nominative systems-that is, patient-specific ones (drug doses prescribed for individuals are distributed from the central pharmacy to wards with ADC as supplementary stock). A general ADC project implementation timeline was shaped: main drivers of automation to initiate the project, visit of other sites, pilot test (with IT integration and staff training), and evaluation phase (satisfaction, safety, efficiency) to justify a possible expansion. Users (7 pharmacists, 21 nurses, 7 data engineers) identified facilitators (such as a dedicated project manager, a pilot phase, an intuitive device), barriers and any improvements needed (training for incoming staff, reorganisation of ward workflow, dynamic inventories)., Conclusions: Despite their diverse pharmacy organisations, each hospital raised similar challenges and reported analogous major steps in project implementation. Although integration processes are complex, ADCs rapidly provide users with benefits. By following the practical advice and recommendations from these hospitals, new adopters might reduce the risks of failed ADC projects and accelerate their integration., Competing Interests: Competing interests: None declared., (© European Association of Hospital Pharmacists 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Episodic memories are experienced as belonging to a self that persists in time. We review evidence concerning the nature of human episodic memory and of the sense of self and how these emerge during development, proposing that the younger child experiences a persistent self that supports a subjective experience of remembering. We then explore recent research in cognitive architectures for robotics that has investigated the possibility of forms of synthetic episodic and autobiographical memory. We show that recent advances in generative modeling can support an understanding of the emergence of self and of episodic memory, and that cognitive architectures which include a language capacity are showing progress towards the construction of a narrative self with autobiographical memory capabilities for robots. We conclude by considering the prospects for a more complete model of mental time travel in robotics and the implications of this modeling work for understanding human episodic memory and the self in time. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

Humans adapt their locomotion seamlessly in response to changes in the body or the environment. It is unclear how such adaptation improves performance measures like energy consumption or symmetry while avoiding falling. Here, we model locomotor adaptation as interactions between a stabilizing controller that reacts quickly to perturbations and a reinforcement learner that gradually improves the controller's performance through local exploration and memory. This model predicts time-varying adaptation in many settings: walking on a split-belt treadmill (i.e. with both feet at different speeds), with asymmetric leg weights, or using exoskeletons - capturing learning and generalization phenomena in ten prior experiments and two model-guided experiments conducted here. The performance measure of energy minimization with a minor cost for asymmetry captures a broad range of phenomena and can act alongside other mechanisms such as reducing sensory prediction error. Such a model-based understanding of adaptation can guide rehabilitation and wearable robot control., (© 2024. The Author(s).)

Purpose: This study aimed to determine the selection criteria for circular collimator (CC)- and multileaf collimator (MLC)-based stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT) plans for brain metastases (BM) and benign intracranial disease (BID) in terms of geometric parameters using CyberKnife (CK)., Methods: Forty-eight and eighty-five patients with BM and BID, respectively, were included. Two plans using CC and MLC were created for each case. Six dosimetric parameters and mathematical scores (MS) were extracted from each plan to assess plan quality. Two geometric parameters in BM-equivalent radius (rGTV) and sphericity index (SI) of the gross tumor volume-and three in BID-rGTV, SI, and the distance between the GTV and organ at risk (dOAR)-were calculated. Their effect on the superiority of CC- or MLC-based plans in terms of dosimetric parameters and MS was evaluated using multiple regression analysis., Results: The rGTV was associated with improved dosimetric parameters of MLC-based plans, especially the GTV conformity in BM and BID cases (β: 0.70 and 0.51) and the OAR sparing in BM cases (β: 0.82), where β represents the regression coefficient. Based on the MS, where the weights for the GTV coverage and OAR sparing were equal, the thresholds at which the MLC-based plans become comparable or superior to the CC-based plans in BM and BID were rGTV > 7.6 and >17.5 mm, respectively. Meanwhile, SI and dOAR were weakly correlated (β ≤ 0.30)., Conclusions: In SRS/SRT plans for BM and BID cases using CyberKnife, geometric parameters, especially rGTV, must be considered when selecting CC or MLC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved.)

Background: Digital tools are being increasingly used worldwide in primary knee arthroplasty. This study aimed to analyze the utilization density of digital tools, the preferred alignment strategies, and the obstacles and benefits of implementing these technologies in German-speaking countries., Materials and Methods: An online survey with 57 questions about digital tools in primary knee arthroplasty and their usage was conducted among members of the Arthroplasty Working Group (AE). The survey included questions on navigation, robotics, patient-specific instruments, individualized implants, and augmented reality., Results: The survey revealed that 18% of hospitals use navigation and 17% use robotic systems in primary total knee arthroplasty surgery. The main reasons for not implementing supportive technologies were high acquisition and ongoing costs, as well as longer surgical duration. Patient-specific instruments and individualized implants currently play a minor role. Patient-specific alignment strategies, such as kinematic (navigation: 35%; robotics: 44%) and functional alignment (navigation: 15%; robotics: 35%), are preferred in this context. With conventional instrumentation predominantly mechanical alignment was applied (79%)., Discussion: The results indicate a relatively high utilization density of digital tools, which are mainly used to perform personalized alignment strategies in primary knee arthroplasty in German-speaking countries. This was particularly evident in high-volume hospitals. Economic aspects were the main reasons for not using these technologies. Future developments should aim to simplify the systems and thus achieve improved cost efficiency., (© 2024. The Author(s).)

This paper describes an original dataset of children's speech, collected through the use of JIBO, a social robot. The dataset encompasses recordings from 110 children, aged 4-7 years old, who participated in a letter and digit identification task and extended oral discourse tasks requiring explanation skills, totaling 21 h of session data. Spanning a 2-year collection period, this dataset contains a longitudinal component with a subset of participants returning for repeat recordings. The dataset, with session recordings and transcriptions, is publicly available, providing researchers with a valuable resource to advance investigations into child language development., (© 2024 Acoustical Society of America.)

Background: Upper limb rehabilitation robot is a relatively new technology, but its effectiveness remains debatable due to the inconsistent results of clinical trials. This article intends to assess how upper limb rehabilitation robots help the functional recovery of stroke patients., Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies to explore the effect of upper limb rehabilitation robots on upper limb motor function, muscle tone, and daily living activities., Results: Eighteen trials with 573 stroke patients met the inclusion criteria. The results showed that compared to conventional rehabilitation training, patients who received upper limb robotic therapy (RT) had significantly improved Fugl-Meyer Upper Extremity Motor Assessment (FMA-UE) scores (weighted mean differences [WMD]: 5.27, 95% confidence intervals [CI]: 3.36, 7.17), Action Research Arm Test (ARAT) scores (WMD: 4.07, 95% CI: -4.14, 12.28), Modified Barthel Index (MBI) scores (WMD: 9.55, 95% CI: 6.37, 12.73), and modified Ashworth Scale (MAS) scores (WMD: -0.28, 95% CI: -0.50, 0.06), with no significant heterogeneity., Conclusions: Upper limb robot-assisted training is superior to conventional training in terms of improving upper limb motor impairment, ability to perform daily living activities, and muscle tone recovery, which supports the application of robots in clinical practice., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Various backdrivable lower-limb exoskeletons have demonstrated the electromechanical capability to assist volitional motions of able-bodied users and people with mild to moderate gait disorders, but there does not exist a control framework that can be deployed on any joint(s) to assist any activity of daily life in a provably stable manner. This paper presents the modular, multi-task optimal energy shaping ( M-TOES ) framework, which uses a convex, data-driven optimization to train an analytical control model to instantaneously determine assistive joint torques across activities for any lower-limb exoskeleton joint configuration. The presented modular energy basis is sufficiently descriptive to fit normative human joint torques (given normative feedback from signals available to a given joint configuration) across sit-stand transitions, stair ascent/descent, ramp ascent/descent, and level walking at different speeds. We evaluated controllers for four joint configurations (unilateral/bilateral, hip/knee) of the modular backdrivable lower limb unloading exoskeleton (M-BLUE) exoskeleton on eight able-bodied users navigating a multi-activity circuit. The two unilateral conditions significantly lowered overall muscle activation across all tasks and subjects ( p < 0.001). In contrast, bilateral configurations had a minimal impact, possibly attributable to device weight and physical constraints.

Background: Injuries of the superficial medial collateral ligament (sMCL) and anteromedial structures of the knee result in excess valgus rotation and external tibial rotation (ER) as well as tibial translation., Purpose: To evaluate a flat reconstruction of the sMCL and anteromedial structures in restoring knee kinematics in the combined MCL- and anteromedial-deficient knee., Study Design: Controlled laboratory study., Methods: Eight cadaveric knee specimens were tested in a 6 degrees of freedom robotic test setup. Force-controlled clinical laxity tests were performed with 200 N of axial compression in 0°, 30°, 60°, and 90° of flexion: 8 N·m valgus torque, 5 N·m ER torque, 89 N anterior tibial translation (ATT) force, and an anteromedial drawer test consisting of 89 N ATT force under 5 N·m ER torque. After determining the native knee kinematics, we transected the sMCL, followed by the deep medial collateral ligament (dMCL). Subsequently, a flat reconstruction of the sMCL with anteromedial limb, mimicking the function of the anteromedial corner, was performed. Mixed linear models were used for statistical analysis ( P < .05)., Results: Cutting of the sMCL led to statistically significant increases in laxity regarding valgus rotation, ER, and anteromedial translation in all tested flexion angles ( P < .05). ATT was significantly increased in all flexion angles but not at 60° after cutting of the sMCL. A combined instability of the sMCL and dMCL led to further increased knee laxity in all tested kinematics and flexion angles ( P < .05). After reconstruction, the knee kinematics were not significantly different from those of the native state., Conclusion: Insufficiency of the sMCL and dMCL led to excess valgus rotation, ER, ATT, and anteromedial tibial translation. A combined flat reconstruction of the sMCL and the anteromedial aspect restored this excess laxity to values not significantly different from those of the native knee., Clinical Relevance: The presented reconstruction might lead to favorable results for patients with MCL and anteromedial injuries with an anteromedial rotatory knee instability., Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Purpose: This paper evaluates the accuracy and safety of a long bone fracture reduction robot under different surgical modes., Methods: A long bone fracture reduction robot system was developed, which can be controlled via an autonomous surgical mode or a master-slave surgical mode. Reduction experiments were conducted on a long bone cadaver specimen. The accuracy and safety of the robotic reduction were compared across the different surgical modes., Results: When the fracture reduction was completed by the robot, the translational deviation was less than 2 mm, and the angular deviation was less than 3° The autonomous reduction time was 140 s, while the master-slave reduction time was 200 s., Conclusions: Based on CT imaging verification, the accuracy of the robot in both autonomous and master-slave surgical modes meets clinical requirements. Future work will focus on further optimizing the robot system., Competing Interests: Declaration of competing interest All authors disclosed no relevant relationships., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Cephalopod skins evolve multiple functions in response to environmental adaptation, encompassing nonlinear mechanoreponse, damage tolerance property, and resistance to seawater. Despite tremendous progress in skin-mimicking materials, the integration of these desirable properties into a single material system remains an ongoing challenge. Here, drawing inspiration from the structure of reflectin proteins in cephalopod skins, a long-term anti-salt elastomer with skin-like nonlinear mechanical properties and extraordinary damage resistance properties is presented. Cation-π interaction is incorporated to induce the geometrically confined nanophases of hydrogen bond domains, resulting in elastomers with exceptional true tensile strength (456.5 ± 68.9 MPa) and unprecedently high fracture energy (103.7 ± 45.7 kJ m -2 ). Furthermore, the cation-π interaction effectively protects the hydrogen bond domains from corrosion by high-concentration saline solution. The utilization of the resultant skin-like elastomer has been demonstrated by aquatic soft robotics capable of grasping sharp objects. The combined advantages render the present elastomer highly promising for salt enviroment applications, particularly in addressing the challenges posed by sweat, in vivo, and harsh oceanic environments., (© 2024 Wiley‐VCH GmbH.)

Objectives: To compare the accuracy of robotic and dynamic navigation systems in assisting zygomatic implant (ZI) using an in vitro model experiment., Methods: Preoperative cone-beam computed tomography (CBCT) images of patients who underwent ZI treatment between 2011 and 2023 were collected from local databases. Corresponding three-dimensional resin models were printed and assigned to two groups: the robotic and dynamic navigation system groups. Following preoperative plans, ZIs were placed in the models with the assistance of either a robotic or dynamic navigation system. Deviations in the in vitro navigation surgery were measured and compared between the groups., Results: A total of 110 ZIs were placed in 56 models, with 55 ZIs in each group. No significant differences were observed in entry and angle deviations between the groups (p>0.05). However, the exit deviation in the robotic system group (2.39±1.24 mm) was larger than that in the dynamic navigation group (1.83±1.25 mm) (p<0.05). On the exit side, the Z-axis deviation in the robotic group (left: -0.28±1.43 mm, right: -0.21±1.30 mm) was smaller than that in the dynamic navigation group (left: 0.76±1.11 mm, right: 0.85±1.52 mm) (p<0.05), while no significant differences were found in X- and Y-axis deviations (p>0.05)., Conclusions: Compared with the dynamic navigation system, the robotic system can effectively prevent ZI overextension. However, its accuracy on the exit side is slightly lower than that of the dynamic navigation system., Clinical Significance: This preliminary in vitro study showed that the accuracy of the robotic system was slightly inferior to that of the dynamic navigation system in terms of exit deviation when used in ZI placement. Further clinical studies are required to confirm these findings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Upper limb impairments are among the most common consequences following a stroke. Recently, robot-assisted therapy (RT) and virtual reality (VR) have been used to improve upper limb function in stroke survivors., Objectives: This review aims to investigate the effects of combined RT and VR on upper limb function in stroke survivors and to provide recommendations for researchers and clinicians in the medical field., Methods: We searched PubMed, SCOPUS, REHABDATA, PEDro, EMBASE, and Web of Science from inception to March 28, 2024. Randomized controlled trials (RCTs) involving stroke survivors that compared combined RT and VR interventions with either passive (i.e., sham, rest) or active (i.e., traditional therapy, VR, RT) interventions and assessed outcomes related to upper limb function (e.g., strength, muscle tone, or overall function) were included. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included studies., Results: Six studies were included in this review. In total, 201 patients with stroke (mean age 57.84 years) were involved in this review. Four studies were considered 'high quality', while two were considered as 'moderate quality' on the Cochrane Collaboration tool. The findings showed inconsistent results for the effects of combined RT and VR interventions on upper limb function poststroke., Conclusion: In conclusion, there are potential effects of combined RT and VR interventions on improving upper limb function, but further research is needed to confirm these findings, understand the underlying mechanisms, and assess the consistency and generalizability of the results., (© 2024. Fondazione Società Italiana di Neurologia.)

Background: Involving users has become a prominent principle in the development of Health Information Technologies (HIT) and has led to an uprise in agile and cocreation methods. Previous literature shows how the two can be combined in one method, but also suggest that using such a method may come with challenges, for which the solutions are unclear., Purpose: To identify the challenges of using a method that combines agile and cocreation, provide solutions for these challenges, and evaluate its usage., Methods and Materials: The setting for this research was the Agile Cocreation of Robots for Aging (ACCRA) project. The research consisted of three phases: 1) evaluating the Agile Cocreation method to identify challenges in its usage, by analysing documents from the project (e-mails, meeting notes), 2) solving the challenges to improve the method, by designing solutions in a cocreation session; and 3) evaluating the usage of the improved version via a survey among engineers and user researchers involved in the project., Results: We identified three main challenges and developed three solutions, which were used in the next phase of the project. First, to engage all stakeholders in cocreation, we implemented more fun and playful materials. Second, to bridge the differences between engineers and user researchers we invested in face-to-face meetings. Third, to manage knowledge in the project we intensified our meeting schedule to weekly meetings. In the quantitative evaluation of the improved cocreation method, the engineers and user researchers were positive about the agile cocreation method and about our improvements., Conclusion: When developing HIT, a method that combines agile and cocreation is useful because it helps to identify user needs and to translate these needs into technology. To identify the needs of these users and other stakeholders it is important to involve them as active partners in cocreation using fun and playful materials. Engineers and user researchers should bridge their differences and meet face-to-face as much as possible., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Industrial robots are increasingly commonplace, but research on prototypical accidents and injuries has been sparse, hindering evidence-based safety strategies. Using Severe Injury Reports (SIRs) from the U.S. Occupational Safety and Health Administration (OSHA), we identified 77 robot-related accidents from 2015-2022. Of these, 54 involved stationary robots, resulting in 66 injuries, mainly finger amputations and fractures to the head and torso. Mobile robots caused 23 accidents, leading to 27 injuries, mainly fractures to the legs and feet. A two-stage deductive-inductive thematic analysis was performed using text data from the final narratives in the reports to discover patterns in tasks, precipitating mechanisms, and contributing factors. Findings highlight the need for guards and collision avoidance systems that detect individual extremities. Post-contact strategies should focus on mitigating finger amputations. More structured and detailed narratives in the SIRs are needed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To investigate alterations of whole-brain network after stroke and therapeutic mechanisms of robot-assisted gait training (RAGT)., Methods: 21 stroke patients and 20 healthy subjects were enrolled, with the stroke patients randomized to either control group (n = 11) or robot group (n = 10), and resting-state functional magnetic resonance imaging data were collected. The global network metrics were obtained using graph theory analysis and compared between stroke patients and healthy subjects, and the effect of the RAGT on the whole-brain networks was explored., Results: Compared to healthy subjects, area under the curve (AUC) for small-worldness (σ), clustering coefficient (Cp), global efficiency (Eg) and mean local efficiency (Eloc) were significantly lower in stroke patients, whereas AUC for characteristic path length (Lp) were significantly higher. Compared with the control group, patients in robot group showed significant improvement in lower limb motor function, balance function and walking function after intervention, with a significant reduction in the AUC of Cp. Moreover, the improvement of walking function was positively correlated with the changes of AUC of σ and Eg, and negatively correlated with the changes of AUC of Cp., Conclusions: Small-worldness and network efficiency were significantly reduced after stroke, whereas RAGT decreased characteristic path length and promoted normalization of the whole-brain network, and this change was associated with improvement in walking function. Our findings reveal the mechanism by which RAGT regulates network reorganization and neuroplasticity after stroke., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Personal Assistive RObot (PARO) interventions have been used to treat agitation and mood symptoms of dementia effectively. However, the effects of a PARO intervention on physiological and cognitive function are unclear. To examine the effects of a group-based PARO intervention for older adults with mild dementia., Design: Using a group-based PARO intervention randomized controlled trial with 2-arm parallel groups., Setting and Participants: Older adults with mild dementia aged 65 years or older from 4 dementia day care centers were recruited., Methods: Physiological parameters were assessed using the finger tapping test (FTT) and heart rate variability (HRV). The Mini-Mental State Examination (MMSE), Geriatric Depression Scale-Short Form (GDS-SF), University of California Los Angeles loneliness scale-version 3 (UCLA-3), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS) were assessed before the intervention, end of the intervention, and 1-month after the intervention., Results: Using a repeated-measures generalized linear model, significant time × group interactions were found in the MMSE [F(2, 115) = 19.54, P < .001], FTT [F(2, 115) = 4.87, P = .01], HRV high-frequency [F(2, 115) = 3.57, P = .03], and high-frequency/low-frequency ratio [F(2, 115) = 0.96, P = .01], UCLA-3 [F(2, 115) = 54.7, P < .001], GDS-SF [F(2, 115) = 3.36, P = .04], and WEMWBS [F(2, 115) = 5.93, P < .001]. Furthermore, psychological parameters improved significantly and continuously even 1 month after the PARO intervention was finished. Physiological parameters significantly improved at week 6, but the effects had diminished by week 10., Conclusions and Implications: A PARO intervention may effectively improve the physiological and psychological responses of people with mild dementia., Competing Interests: Disclosure The authors declare no conflicts of interest., (Copyright © 2024 Post-Acute and Long-Term Care Medical Association. Published by Elsevier Inc. All rights reserved.)

Multidrug combination therapy in the inner ear faces diverse challenges due to the distinct physicochemical properties of drugs and the difficulties of overcoming the oto-biologic barrier. Although nanomedicine platforms offer potential solutions to multidrug delivery, the access of drugs to the inner ear remains limited. Micro/nanomachines, capable of delivering cargo actively, are promising tools for overcoming bio-barriers. Herein, a novel microrobot-based strategy to penetrate the round window membrane (RWM) is presented and multidrug in on-demand manner is delivered. The tube-type microrobot (TTMR) is constructed using the template-assisted layer-by-layer (LbL) assembly of chitosan/ferroferric oxide/silicon dioxide (CS/Fe 3 O 4 /SiO 2 ) and loaded with anti-ototoxic drugs (curcumin, CUR and tanshinone IIA, TSA) and perfluorohexane (PFH). Fe 3 O 4 provides magnetic actuation, while PFH ensures acoustic propulsion. Upon ultrasound stimulation, the vaporization of PFH enables a microshotgun-like behavior, propelling the drugs through barriers and driving them into the inner ear. Notably, the proportion of drugs entering the inner ear can be precisely controlled by varying the feeding ratios. Furthermore, in vivo studies demonstrate that the drug-loaded microrobot exhibits superior protective effects and excellent biosafety toward cisplatin (CDDP)-induced hearing loss. Overall, the microrobot-based strategy provides a promising direction for on-demand multidrug delivery for ear diseases., (© 2024 Wiley‐VCH GmbH.)

Objectives: This systematic review aims to assess existing research concerning the use of robotic systems to execute percutaneous lung biopsy. Methods: A systematic review was performed and identified 4 studies involving robotic systems used for lung biopsy. Outcomes assessed were operation time, radiation dose to patients and operators, technical success rate, diagnostic yield, and complication rate. Results: One hundred and thirteen robot-guided percutaneous lung biopsies were included. Technical success and diagnostic yield were close to 100%, comparable to manual procedures. Technical accuracy, illustrated by needle positioning, showed less frequent needle adjustments in robotic guidance than in manual guidance ( P < .001): 2.7 ± 2.6 (range 1-4) versus 6 ± 4 (range 2-12). Procedure time ranged from comparable to reduced by 35% on average (20.1 ± 11.3 minutes vs 31.4 ± 10.2 minutes, P = .001) compared to manual procedures. Patient irradiation ranged from comparable to reduced by an average of 40% (324 ± 114.5 mGy vs 541.2 ± 446.8 mGy, P = .001). There was no significant difference in reported complications between manual biopsy and biopsies that utilized robotic guidance. Conclusion: Robotic systems demonstrate promising results for percutaneous lung biopsy. These devices provide adequate accuracy in probe placement and could both reduce procedural duration and mitigate radiation exposure to patients and practitioners. However, this review underscores the need for larger, controlled trials to validate and extend these findings., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Francois H. Cornelis is a consultant for GE Healthcare and XACT robotics.

The intersection of mathematical cognition, metacognition, and advanced technologies presents a frontier with profound implications for human learning and artificial intelligence. This paper traces the historical roots of these concepts from the Pythagoreans and Aristotle to modern cognitive science and explores their relevance to contemporary technological applications. We examine how the Pythagoreans' view of mathematics as fundamental to understanding the universe and Aristotle's contributions to logic and categorization have shaped our current understanding of mathematical cognition and metacognition. The paper investigates the role of Boolean logic in computational processes and its relationship to human logical reasoning, as well as the significance of Bayesian inference and fuzzy logic in modelling uncertainty in human cognition and decision-making. We also explore the emerging field of Chemical Artificial Intelligence and its potential applications. We argue for unifying mathematical metacognition with advanced technologies, including artificial intelligence and robotics, while identifying the multifaceted benefits and challenges of such unification. The present paper examines essential research directions for integrating cognitive sciences and advanced technologies, discussing applications in education, healthcare, and business management. We provide suggestions for developing cognitive robots using specific cognitive tasks and explore the ethical implications of these advancements. Our analysis underscores the need for interdisciplinary collaboration to realize the full potential of this integration while mitigating potential risks., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Strawberry, being an important economic crop, requires a large amount of human labor for harvesting operations. Efficient and non-destructive harvesting by strawberry harvesting robots requires the precise location of the picking points. Current algorithms for locating picking points encounter significant issues with location errors and minimal effective information in complex situations., Results: To improve the accuracy of the location of picking points, this study proposes a visual location method based on composite models. This method employs object detection and instance segmentation models to detect fruits and segment peduncles sequentially, thereby enabling the identification of picking points and inclination on the peduncle. Different object detection algorithms and instance segmentation models were validated to explore the optimal model combination, and the Convolutional Block Attention Module (CBAM) was integrated into YOLOv8s-seg to construct YOLOv8s-seg-CBAM. Test results show that the composite model built with YOLOv8s and YOLOv8s-seg-CBAM achieved a peduncle detection accuracy of 86.2%, with an inference time of 30.6 ms per image., Conclusion: The picking point visual location method based on YOLOv8s and YOLOv8s-seg-CBAM composite models can better balance accuracy and efficiency and can provide more accurate guidance for automated harvesting. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)

Background: The antecubital fossa is an important site for venepuncture and intravenous procedures. The size and location of a vein can affect the success of venepuncture and intravenous access. Several studies have investigated the superficial vein morphometry, but they had small sample sizes or focused on specific populations or groups. Therefore, we conducted a prospective study with large participants in general population to analyse the morphology of the antecubital superficial vein and identify the association of sex, age and body mass index (BMI) with the size and location of the vein., Methods: This study collected images of superficial veins prospectively using autonomous robotic ultrasound on the antecubital area between October and November 2020. We measured the superficial vein depth, vertical diameter and horizontal diameter at the antecubital area, extracted population characteristics (sex, age and BMI), and analysed a relationship between the vein dimensions and the characteristics., Results: In this study, data from 461 participants (201 males and 260 females) with mean age of 41.1 years were produced. The mean vein depth, mean vertical diameter and mean horizontal diameter (±standard deviation) were 4.81 (±2.17), 3.01 (±1.10) and 4.46 (±1.60) mm, respectively. We found significant differences in vein dimensions between males and females, with males having larger vertical and horizontal diameters than females ( p  < 0.001). The study also revealed significant differences in vein depth and dimensions among age groups and BMI subgroups ( p  < 0.001)., Conclusions: These findings revealed that the superficial vein in the antecubital area was oval, with a larger horizontal diameter than vertical diameter. Morphometry revealed differences in sex, age and BMI. Understanding variations in vein dimensions among different subgroups can help medical professionals improve success rate of venous access and patient safety., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Seoyeon Park, Yunmyeong Kim and Deokgeun Nam are employees of AIRS Medical. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Our society, in general, and health care, in particular, faces notable challenges due to the emergence of innovative digital technologies. The use of socially assistive robots in aged care is a particular digital application that provokes ethical reflection. The answers we give to the ethical questions associated with socially assistive robots are framed by ontological and anthropological considerations of what constitutes human beings and how the meaning of being human relates to how these robots are conceived. Religious beliefs and secular worldviews, each of which may participate fully in pluralist societies, have an important responsibility in this foundational debate, as anthropological theories can be inspired by religious and secular viewpoints. This article identifies seven anthropological considerations grounded in the synthesis of biblical scriptures, Roman Catholic documents, and recent research literature. We highlight the inspirational quality of these anthropological considerations when dealing with ethical issues regarding the development and use of socially assistive robots in aged care. With this contribution, we aim to foster a global and inclusive dialogue on digitalization in aged care that deeply challenges our basic understanding of what constitutes a human being and how this notion relates to machine artefacts., (© 2024 John Wiley & Sons Ltd.)

The objective was to determine if gravity support for the left arm of right-handed participants would increase left arm use during a 3D reaching task in virtual reality. Twelve healthy control participants each completed 630 reaching movements broken into 6 blocks. The majority of targets were placed close to the mid-sagittal plane at three heights and participants were free to use either limb when reaching for targets. The hand had to stay in the target for a prescribed dwell time before the target disappeared. For all reaching tasks within a block, the left arm gravity support was set to either 0% or 75% of full arm support. The blocks also varied in the dwell time (2, 4, or 6 sec). The order of blocks was balanced across participants in terms of gravity support level and dwell time. EMG level in the left medial deltoid decreased with increasing gravity support (p<.001) and was higher for higher targets compared to lower targets (p<.001). The odds of using the left arm were 1.95 times higher with gravity support compared to no support (p<.001). With gravity support, we expected greater shifts towards the left arm in tasks that were more energetically demanding. This was not the case, as the increased use was evenly distributed across all target heights, and use decreased or remained unchanged with increasing dwell time. Results are discussed relative to current models of limb choice and the potential use of robotic gravity support to overcome learned non-use in stroke patients.

Magnetic nanorobots are emerging players in thrombolytic therapy due to their noninvasive remote actuation and drug loading capabilities. Although the nanorobots with a size under 100 nm are ideal to apply in microvascular systems, the propulsion performance of nanorobots is inevitably compromised due to the limited response to magnetic fields. Here, we demonstrate a nattokinase-loaded magnetic vortex nanorobot (NK-MNR) with an average size around 70 nm and high saturation magnetization for mechanical propelling and thermal responsive thrombolysis under a magnetic field with dual frequencies. The nanorobots are stable in suspension and undergo the magneto-steered assembly into chain-like NK-MNRs, which are regulated to generate magnetic forces to mechanically damage and penetrate the thrombus by the low-frequency rotating magnetic field. Synergistically, enhanced magnetic hyperthermia is triggered by an alternating magnetic field of high frequency, enabling heat-induced NK release and fibrinolysis. In this dual frequency-regulated magnetothrombolysis (fRMT) strategy, nanorobots collaborate under the dual magnetic energy conversion model to achieve the vasculature recanalization rate of 81.0% in thrombotic mice. Overall, the nanorobot with the special magnetic vortex property and multimodel controls is a promising nanoplatform for in vivo focalized microvascular thrombolysis.

A locomotor system that can function across different environmental conditions and produce a range of performances is one of the most critical abilities needed for extant and extinct animals in order to survive and maximise their competitive fitness. Recent engineering-inspired paleontological studies have reconstructed feasible locomotor patterns in extinct animals. However, it is still challenging to describe how extinct animals successfully adjust their locomotor patterns to new situations (e.g., changes in locomotor speed and morphology). In this study, we develop a novel reconstruction method based on a bio-inspired control system. We focus on plesiosaurs, an extinct aquatic reptile group which has two pairs of flipper-shaped limbs, and demonstrate that a highly optimised, flexible locomotor pattern for all four flippers can be reconstructed based on a decentralized control scheme formulated from extant animals' locomotion. The results of our robotic experiments show that a simple, local sensory feedback mechanism allows the plesiosaur-like robot to exploit the fluid flow between the flippers and generate efficient swimming patterns in response to changes in locomotor conditions. Our new method provides further evidence how decentralized control systems can produce a pathway between extinct and extant animals in order to understand the how extinct animals moved and how these movement patterns may have evolved., (© 2024. The Author(s).)

Introduction: Early rehabilitation post-spinal surgery is vital for patients' recovery. Robot-assisted gait training (RAGT) shows promise but requires further study to establish a specific protocol and gauge its effects on both patients and physical therapists. This study aimed to determine the impact of a newly developed protocol for early RAGT on patients' functional enhancement and satisfaction levels after spinal surgery, as well as on the physical therapists who implemented the therapy., Methods: First, we developed the protocol in collaboration with three physiatrists and two physical therapists with extensive experience in musculoskeletal rehabilitation. The protocol was updated three times, each after three rounds of face-to-face meetings. Afterward, we conducted a cross-sectional study involving five physical therapists and 32 post-spinal surgery patients at a tertiary hospital rehabilitation center. The intervention consisted of five sessions of RAGT. Main outcome measures included the Functional Ambulation Category (FAC), the ambulation item of the Modified Barthel Index (MBI ambulation), and satisfaction surveys for both patients and physical therapists., Results: RAGT typically started 17.91 ± 9.76 days postoperatively and was successfully applied with no remarkable adverse effects. The FAC scores increased from 2.65 ± 1.21 to 3.78 ± 0.71 (p = 0.006), and MBI ambulation increased from 7.69 ± 2.71 to 10.66 ± 2.90 ( p < 0.001) between transfer and discharge. Satisfaction with the robot, RAGT, and treatment, assessed using a 5-point Likert scale, were 3.30 ± 0.79, 3.72 ± 0.85, and 3.08 ± 0.84, respectively. Satisfaction was notably the highest for alleviating fear of falling, whereas managing pain and discomfort during position changes scored the lowest. Physical therapists rated RAGT satisfaction, impact on the working environment, and treatment stability at 3.0 ± 0.65, 2.80 ± 0.67, and 3.50 ± 0.61, respectively., Conclusion: Early spinal surgery rehabilitation with RAGT improved patients' functionality and gait satisfaction. While physical therapists considered RAGT safe, its impact on their work environment was limited. Integrating RAGT into post-spinal surgery rehabilitation demands ongoing protocol refinement, custom robot development, and efficacy evaluations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jee, Jang, Shin, Kim and Park.)

This preclinical feasibility study investigates the potential of utilizing the hinotori™ robot system for esophagectomy. In three human cadaver models, the esophagus was successfully mobilized and resected using the hinotori™ system, with a mean thoracic procedure time of 57 minutes. The system allowed for precise dissection and radical lymphadenectomy without arm collision, attributed to its versatile design and docking-free trocars. Standard robot-specific patient positioning, including a 35° left lateral inclination, and trocar placement in a posterior axillary line configuration were employed. Notably, trocars suitable for both laparoscopy and the hinotori™ robot were utilized, providing flexibility in trocar selection. Unique features, such as the ergonomic console and pointer-based pivot point identification system, contributed to procedural success. While these findings highlight the promising potential of the hinotori™ system in advancing esophageal surgery, further clinical studies are warranted to validate its reproducibility and clinical utility. Additionally, enhancements to the pivot point identification system and evaluation of the arm base's features may further optimize surgical outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Micro/nanorobots (MNRs) hold great promise for various applications due to their capability to execute complex tasks in hard-to-reach micro/nano cavities. However, the developed magnetic MNRs, as marionettes of external magnetic fields, lack built-in intelligence for self-targeting, while chemotactic MNRs suffer from limited self-targeting range. Here, we demonstrate magnetic-chemotactic ZnO/Fe-Ag Janus microrobots (JMRs) capable of rapid, remote self-targeting for bacterial elimination. The JMRs utilize the magnetic Fe engine for coarse navigation from a distance, allowing for external control to swiftly guide them to the vicinity of a hidden/uncharted target that establishes a local chemical gradient ([CO 2 ] or [H + ] gradient). Once in proximity, the inherent chemotaxis of the JMRs takes over, the chemotactic engine enables them to autonomously accumulate at the target site along the chemical gradient in high precision. Upon reaching the target, the ZnO/Fe-Ag JMRs can release Zn 2+ and Ag + to eliminate bacteria residing there. The proposed strategy of integrating on-board chemotaxis with external magnetic field-driven propulsion paves the way for efficient precise therapies using MNRs, especially in targeted drug/energy delivery involving remote hidden or uncharted targets.

Although various walking training robots have been developed and their effectiveness has been recognised, operating these robots requires the implementation of safety measures to avoid the risk of falling. This study aimed to confirm whether arm swing rhythm training in the sitting position using an arm swing rhythm-assisted robot, WMR, improved subsequent walking. Healthy older adults (N = 20) performed arm swing rhythm training in a sitting position for 1 min × three times while being presented with tactile stimulation synchronised with the arm swing rhythm from a robot. An increase in walking performance was observed with increases in stride length and speed. In addition, the stabilisation of the gait pattern was observed, with a decrease in the proportion of the double-foot support phase and an increase in the proportion of the swing phase in one gait cycle. These results suggest that arm swing rhythm training in a sitting position using WMR improves gait in older adults. This will lead to the realisation of safe and low-cost robot-based walking training in sitting position., (© 2024. The Author(s).)

Avian feather intricate adaptable architecture to wing deformations has catalyzed interest in feathered flapping-wing aircraft with high maneuverability, agility, and stealth. Yet, to mimic avian integrated somatic sensation within stringent weight constraints, remains challenging. Here, we propose an avian-inspired embodied perception approach for biohybrid flapping-wing robots. Our feather-piezoelectric mechanoreceptor leverages feather-based vibration structures and flexible piezoelectric materials to refine and augment mechanoreception via coupled oscillator interactions and robust microstructure adhesion. Utilizing convolutional neural networks with the grey wolf optimizer, we develop tactile perception of airflow velocity and wing flapping frequency proprioception. This method also senses pitch angle via airflow direction and detects wing morphology through feather collisions. Our low-weight, accurate perception of flapping-wing robot flight states is validated by motion capture. This investigation constructs a biomechanically integrated embodied perception system in flapping-wing robots, which holds significant promise in reflex-based control of complex flight maneuvers and natural bird flight surveillance., (© 2024. The Author(s).)

The worldwide nursing shortage has led to the exploration of using robotics to support care delivery and reduce nurses' workload. In this observational, mixed-method study, we examined the implementation of a robotic nurse assistant (RNA) in a hospital ward to support vital signs measurements, medication, and item delivery. Human-robot interaction was assessed in four domains: usability, social acceptance, user experience, and its societal impact. Patients in a general medicine ward were recruited to participate in a one-time trial with the RNA and a post-trial 75-question survey. Patients' interactions with the RNA were video recorded for analysis including patients' behaviours, facial emotions, and visual attention. Focus group discussions with nurses elicited their perceptions of working with the RNA, areas for improvement, and scalability. Sixty-seven patients aged 21-79 participated in the trial. Eight in 10 patients reported positive interactions with the RNA. When the RNA did not perform to expectations, only 25% of patients attributed fault to the RNA. Video analysis showed patients at ease interacting with the RNA despite some technical problems. Nurses saw potential for the RNA taking over routine tasks. However, they were sceptical of real time savings and were concerned with the RNA's ability to work well with older patients. Patients and nurses suggested greater interactivity between RNA and patients. Future studies should examine potential timesaving and whether time saved translated to nurses performing higher value clinical tasks. The utility of improved RNA's social capability in a hospital setting should be explored as well., (© 2024. The Author(s).)

Current developments in single-cell mass spectrometry (MS) aim to deepen proteome coverage while enhancing analytical speed to study entire cell populations, one cell at a time. Custom-built microanalytical capillary electrophoresis (μCE) played a critical role in the foundation of discovery single-cell MS proteomics. However, requirements for manual operation, substantial expertise, and low measurement throughput have so far hindered μCE-based single-cell studies on large numbers of cells. Here, we design and construct a robotic capillary (RoboCap) platform that grants single-cell CE-MS with automation for proteomes limited to less than ∼100 nL. RoboCap remotely controls precision actuators to translate the sample to the fused silica separation capillary, using vials in this work. The platform is hermetically enclosed and actively pressurized to inject ∼1-250 nL of the sample into a CE separation capillary, with errors below ∼5% relative standard deviation (RSD). The platform and supporting equipment were operated and monitored remotely on a custom-written Virtual Instrument (LabView). Detection performance was validated empirically on ∼5-250 nL portions of the HeLa proteome digest using a trapped ion mobility mass spectrometer (timsTOF PRO). RoboCap improved CE-ESI sample utilization to ∼20% from ∼3% on the manual μCE, the closest reference technology. Proof-of-principle experiments found proteome identification and quantification to robustly return ∼1,800 proteins (∼13% RSD) from ∼20 ng of the HeLa proteome digest on this earlier-generation detector. RoboCap automates CE-MS for limited sample amounts, paving the way to electrophoresis-based high-throughput single-cell proteomics.

Microrobots hold broad application prospects in the field of precision medicine, such as intravenous drug injection, tumor resection, opening blood vessels and imaging during abdominal surgery. However, the rapid and controllable preparation of biocompatible hydrogel microparticles still poses challenges. This study proposes the one-step direct acquisition of biocompatible sodium alginate and gelatin methacrylate (GelMA) hydrogel microparticles using an oil-free aqueous solution, ensuring production with a controllable generation frequency. An adaptive interface shearing platform is established to fabricate alginate/GelMA microparticles using a mixture of the hydrogel, photoinitiator, and Fe 3 O 4 nanoparticles (NPs). By adjusting the static magnetic field intensity ( B s ), vibration frequency, and flow rate ( Q ) of the dispersed phase, the size and morphology of the hydrogel microparticles can be controlled. These hydrogel microparticle robots exhibit magnetic responsiveness, demonstrating precise rotating and rolling movements under the influence of an externally rotating magnetic field (RMF). Moreover, hydrogel microparticle robots with a specific critical frequency ( C f ) can be customized by adjusting the B s and the concentration of Fe 3 O 4 NPs. The directional in situ untethered motion of the hydrogel microparticle robots can be successfully realized and accurately controlled in the climbing over obstacles and in vitro experiments of animals, respectively. This versatile and fully biodegradable microrobot has the potential to precisely control movement to bone tissue and the natural cavity of the human body, as well as drug delivery.

This article reviews the establishment and progress of the Multidisciplinary Paediatric Robotic Program in a high-volume paediatric surgery department at Hôpital Necker-Enfants Malades, Paris, France. A major foundational principle of the program was to establish a safe and secure environment for patients and staff, both pre-operatively, intra-operatively and post-operatively. This founding principle when applied systematically has allowed increasing confidence across the program and service. The robotic platform allows for precision surgery when approaching tumours, with freedom of movement adapted to meticulous vascular and organ dissection. Surgical feasibility is based on tumour characteristics, pre-operative imaging, with a focus on vascular and organ involvement, considering goals of surgery and surgical experience. Case complexity has been gradually increased (where appropriate) through an iterative process. The future of surgery is robotic, and even more so image-guided surgery, and this synergy has been instrumental when approaching tumour surgery in children. The current principles that guide application of robot-assisted surgery in paediatric tumours are presented. With this blueprint, excellent oncological outcomes can be achieved while utilising a minimally invasive approach in children with selected endocrine, neuroblastic and renal tumours., Competing Interests: Conflict of interest TB is an official proctor for Intuitive Surgical. None of the other authors have any disclosures., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: To investigate preoperative predictors of surgical success for patients undergoing robotic ureteral reconstruction (RUR) for management of distal ureteral strictures. Methods: We retrospectively reviewed our multi-institutional Collaborative of Reconstructive Robotic Ureteral Surgery database to identify all consecutive patients undergoing RUR for surgical repair of distal ureteral strictures between 04/2012 and 12/2022. Procedures included refluxing reimplant (58.5%), side to side reimplant (18.0%), ureteroureterostomy (12.7%), non-refluxing reimplant (6.3%), buccal mucosa ureteroplasty (2.8%), and appendiceal bypass ureteroplasty (1.7%). Patients were grouped according to whether they were surgically successful. Preoperative variables between both groups were compared using chi-square tests. All variables with associations of p < 0.2 underwent a binary logistic regression analysis to determine predictive variables of success for RUR ( p ≤ 0.05 considered statistically significant). Results: Overall, 284 patients met inclusion criteria. Univariate analysis showed obesity ( p = 0.03), smoking history ( p = 0.10), abdominopelvic radiation history ( p = 0.14), immunocompromised state ( p = 0.12), and ureteral rest ( p = 0.01) were notable preoperative factors ( p < 0.2). Binary logistic regression analysis further revealed the odds of surgical success in patients with obesity was 0.32 times (CI: 0.12-0.83, p = 0.02) the odds of success for patients without obesity. The odds of surgical success in patients who underwent preoperative ureteral rest was 4.2 times (CI: 1.51-11.77, p < 0.01) the odds of success for patients who did not undergo preoperative ureteral rest. Conclusion: Preoperative factors including obesity and ureteral rest may affect surgical success of RUR for management of distal ureteral strictures.

Esophageal surgery is deemed one of the most complex visceral operations. There is a well-documented correlation between higher caseload and better outcomes, with hospitals that perform more surgeries experiencing significantly lower mortality rates. The approach to caseload per year varies across different countries within Europe. Germany increased the minimum annual required caseload of complex esophageal surgeries from 10 to 26 starting in 2023. Furthermore, the new regulations present challenges for surgical training and staff recruitment, risking the further fragmentation of training programs. Enhanced regional cooperation is proposed as a solution to ensure comprehensive training. This review explores the benefits of robotic-assisted minimally invasive esophagectomy (RAMIE) in improving surgical precision and patient outcomes and aims to evaluate how the caseload per year influences the quality of patient care and the efficacy of surgical training, especially with the integration of advanced robotic techniques.

Complex traumatic acetabular fractures with concomitant hip dislocations are an orthopaedic emergency often requiring open reduction and internal fixation; however, total hip arthroplasty (THA) for acute acetabular fractures may be indicated in certain scenarios. This study reports the case of a 65-year-old male who had a motor vehicle collision that resulted in acetabular fracture dislocation with concomitant femoral head fracture. The patient underwent acute image-free robotic THA. At 6-month follow-up, the patient had good pain management and was doing well after surgery. With the reported technique using a reamer basket, an image-free robotic system can be used in acute THA in patients to achieve appropriate cup positioning., (© 2024 The Authors.)

Background: Robotic exoskeletons have changed rehabilitation care available to people after spinal cord injury (SCI). Yet, the current evidence base is insufficient to identify the optimal dose and neurophysiological mechanism of robotic exoskeleton gait training (RGT) as an effective rehabilitation approach. This study will (1) examine whether the frequency of RGT after motor incomplete SCI impacts function and health outcomes, (2) analyze the neuroplastic effects of RGT dose, and (3) evaluate the safety, tolerability, and feasibility of delivering RGT., Methods: We will enroll 144 participants with motor incomplete SCI admitted to inpatient rehabilitation within 6 months of SCI. Participants will be randomized based on injury severity and level into one of 3 RGT frequency groups (high, moderate, low) or none/usual care only. Participants will complete 24 RGT sessions and be assessed at admission and discharge to inpatient rehabilitation, post-RGT intervention, 1-month post-RGT, and 9-month post-SCI. Outcomes include Walking Index for Spinal Cord Injury-II, health outcomes (gait speed, Spinal Cord Independence Measure, pain, fatigue, spasticity, general health, quality of life, physical activity), and motor evoked potential amplitudes obtained using transcranial magnetic stimulation., Discussion: Successful completion of this study will provide an evidence-based intervention, specifically tailored to meet the unique needs of people with SCI, which supports walking recovery; maximizing health, function, and ultimately participation. The intervention will further support widespread clinical implementation of exoskeleton use during acute rehabilitation., Trial Registration: ClinicalTrials.gov NCT05218447. Registered on June 23, 2022., (© 2024. The Author(s).)

Imitation learning (IL), a burgeoning frontier in machine learning, holds immense promise across diverse domains. In recent years, its integration into robotics has sparked significant interest, offering substantial advancements in autonomous control processes. This paper presents an exhaustive insight focusing on the implementation of imitation learning techniques in agricultural robotics. The survey rigorously examines varied research endeavors utilizing imitation learning to address pivotal agricultural challenges. Methodologically, this survey comprehensively investigates multifaceted aspects of imitation learning applications in agricultural robotics. The survey encompasses the identification of agricultural tasks that can potentially be addressed through imitation learning, detailed analysis of specific models and frameworks, and a thorough assessment of performance metrics employed in the surveyed studies. Additionally, it includes a comparative analysis between imitation learning techniques and conventional control methodologies in the realm of robotics. The findings derived from this survey unveil profound insights into the applications of imitation learning in agricultural robotics. These methods are highlighted for their potential to significantly improve task execution in dynamic and high-dimensional action spaces prevalent in agricultural settings, such as precision farming. Despite promising advancements, the survey discusses considerable challenges in data quality, environmental variability, and computational constraints that IL must overcome. The survey also addresses the ethical and social implications of implementing such technologies, emphasizing the need for robust policy frameworks to manage the societal impacts of automation. These findings hold substantial implications, showcasing the potential of imitation learning to revolutionize processes in agricultural robotics. This research significantly contributes to envisioning innovative applications and tools within the agricultural robotics domain, promising heightened productivity and efficiency in robotic agricultural systems. It underscores the potential for remarkable enhancements in various agricultural processes, signaling a transformative trajectory for the sector, particularly in the realm of robotics and autonomous systems., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mahmoudi, Davar, Sohrabipour, Bist, Tao and Wang.)

Objective: Immune-mediated necrotizing myopathy associated with anti-signal recognition particle antibodies is a rare and debilitating condition characterized by significant muscle weakness and resultant disability. Although there are existing recommendations for physical therapy and exercise for patients with myositis in current literature, effective rehabilitation guidelines for such patients have not been fully established., Case Report: A 42-year-old woman presented with subacute onset proximal upper and lower limb weakness and dysphagia. She was diagnosed with anti-SRP immune-mediated necrotizing myopathy and was promptly initiated on aggressive immunosuppressive therapy. Despite this, she had significant impairment in function, including the inability to ambulate., Intervention and Outcome: The patient underwent an intensive structured inpatient rehabilitation programme consisting of strength and endurance exercises combined with functional exercises and robot-assisted gait training. This resulted in major improvements in objective outcomes including Functional Independence Measure, Modified Barthel Index, 10-metre-walk test and 6-minute-walk test scores. The programme was well tolerated by the patient with no adverse events., Conclusion: This case details the crucial role of a structured rehabilitation programme in the holistic management of a patient with anti-SRP immune-mediated necrotizing myopathy. It also highlights the use of robotics in gait training, resulting in successful functional outcomes for the patient., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s).)

Collective motion, such as milling, flocking, and collective turning, is a common and captivating phenomenon in nature, which arises in a group of many self-propelled individuals using local interaction mechanisms. Recently, vision-based mechanisms, which establish the relationship between visual inputs and motion decisions, have been applied to model and better understand the emergence of collective motion. However, previous studies often characterize the visual input as a transient Boolean-like sensory stream, which makes it challenging to capture the salient movements of neighbors. This further hinders the onset of the collective response in vision-based mechanisms and increases demands on visual sensing devices in robotic swarms. An explicit and context-related visual cue serving as the sensory input for decision-making in vision-based mechanisms is still lacking. Here, we hypothesize that body orientation change (BOC) is a significant visual cue characterizing the motion salience of neighbors, facilitating the emergence of the collective response. To test our hypothesis, we reveal the significant role of BOC during collective U-turn behaviors in fish schools by reconstructing scenes from the view of individual fish. We find that an individual with the larger BOC often takes on the leading role during U-turns. To further explore this empirical finding, we build a pairwise interaction mechanism on the basis of the BOC. Then, we conduct experiments of collective spin and collective turn with a real-time physics simulator to investigate the dynamics of information transfer in BOC-based interaction and further validate its effectiveness on 50 real miniature swarm robots. The experimental results show that BOC-based interaction not only facilitates the directional information transfer within the group but also leads to scale-free correlation within the swarm. Our study highlights the practicability of interaction governed by the neighbor's body orientation change in swarm robotics and the effect of scale-free correlation in enhancing collective response., (© 2024. The Author(s).)

Objectives: To evaluate the effectiveness of lower limb robotic rehabilitation (LLRR) on cardiovascular health among individuals with stroke undergoing rehabilitation., Design: Systematic reviews and meta-analysis., Data Sources: PubMed, Web of Science, Science Direct, Embase, China National Knowledge Infrastructure, Wangfang and VIP databases were searched from inception to 9 October 2023., Eligibility Criteria: Randomised controlled trials (RCTs) involving LLRR among individuals with stroke were included. We considered the potential impact of LLRR on the resting heart rate (HRrest), peak of oxygen uptake (VO 2 peak), peak of systolic blood pressure (SBPpeak) and peak of diastolic blood pressure (DBPpeak). Only studies published in Chinese or English were included., Data Extraction and Synthesis: Two reviewers independently extracted data and assessed the risk of bias. Results were reported as ‌Hedges' g with 95% CIs. Meta-analyses were performed using a random effects model in STATA v17.0. The study was reported in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement., Results: Five RCTs with 179 patients were included in the meta-analysis. According to the Guideline Development Tool results, half of the evidence grades were moderate. The results of the meta-analysis showed that there were significant differences among robotic rehabilitation group than the control group in VO 2 peak (standard mean difference (SMD): 0.71, 95% CI: (0.28, 1.13), p < 0.001, I 2 =45.61%), but insignificant difference found in HRrest (SMD: 0.30, 95% CI: (-0.12, 0.73), p=0.16, I 2 =34.25%), SBPpeak (SMD: 0.04, 95% CI: (-0.44, 0.52), p=0.86, I 2 =28.75%) and DBPpeak (SMD: 0.46, 95% CI: (-3.82, 4.73), p=0.83, I 2 =0.00%). No significant heterogeneity was found among articles. The risk of bias assessment revealed that two studies showed low bias in most domains., Conclusion: Individuals undergoing stroke rehabilitation may benefit from LLRR with improved VO 2 peak but insignificantly impacted HRrest, SBPpeak and DBPpeak., Prospero Registration Number: CRD42022382259., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR., Methods: We performed a retrospective comparative study including all consecutive patients treated with RALUVR or OUVR for benign lower ureteral pathologies between January 2013 and December 2022 at our center. Logistic regression analyses were used to assess the predictors of complication ≥ Clavien-Dindo (CD) III within 90 days, prolonged length of stay (LOS), and 90-day overall success. The Kaplan-Meier method and Cox regression analyses were used to assess vesicoureteral reflux-free (VU-RFS) and stenosis-free (SFS) survivals., Results: Overall, 44 patients underwent RALUVR (n = 19; 43%) and OUVR (n = 25; 57%). In univariable logistic regression analyses, the use of RALUVR vs. OUVR was not significantly associated with postoperative complications ≥ CDIII (OR = 0.98; 95% CI=[0.17-5.09]; p = 0.98), and 90-day overall success (OR = 1.43; 95% CI=[0.24-11.28]; p = 0.7). Despite a shorter median LOS after RALUVR vs. OUVR (4 vs. 10 days, respectively; p < 0.001), multivariable logistic regression analysis showed no impact of the surgical approach on prolonged LOS (OR = 0.51, 95% CI=[0.03-13.86]; p = 0.65). No significant difference was observed in 2-year VU-RFS (72.9% vs. 100%, respectively; p = 0.2) and 2-year SFS between the RALUVR and OUVR groups (85.7% vs. 87.7%, respectively; p = 0.8). In Cox regression analysis, the use of RALUVR vs. OUVR was not significantly associated with VU-RFS (HR = 4.26; 95% CI=[0.38-47.84]; p = 0.24) or SFS (HR = 1.32; 95% CI=[0.22-8.01]; p = 0.76)., Conclusion: We observed that RALUVR provides similar perioperative and functional outcomes as compared to OUVR, except for potentially shorter LOS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Danaher (2016) has argued that increasing robotization can lead to retribution gaps: Situations in which the normative fact that nobody can be justly held responsible for a harmful outcome stands in conflict with our retributivist moral dispositions. In this paper, we report a cross-cultural empirical study based on Sparrow's (2007) famous example of an autonomous weapon system committing a war crime, which was conducted with participants from the US, Japan and Germany. We find that (1) people manifest a considerable willingness to hold autonomous systems morally responsible, (2) partially exculpate human agents when interacting with such systems, and that more generally (3) the possibility of normative responsibility gaps is indeed at odds with people's pronounced retributivist inclinations. We discuss what these results mean for potential implications of the retribution gap and other positions in the responsibility gap literature., (© 2024. The Author(s).)