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The present study investigated whether Japanese 3-, 4-, and 5-year-old children exhibit a yes bias to questions from a physically present humanoid robot, Nao. The robot asked the children yes-no questions about familiar and unfamiliar objects. To both types of questions, the 3-year-old children exhibited a yes bias while the 5-year-old children exhibited a nay-saying bias to questions about unfamiliar objects. The 4-year-old children did not exhibit any response biases. These results were not dramatically different from children's response tendencies toward humans reported in previous studies. The results demonstrate that as children might not spontaneously discriminate a real humanoid robot from humans in social situations, they do not hesitate to answer its questions. Robot usage in education and childcare is discussed.

Background: The field of robotic-assisted surgery is rapidly growing as many robotic surgical devices are in development and about to enter the market. Currently, there is no universally accepted language for labeling the different robotic systems. To facilitate this communication, we created what is, to our knowledge, the first classification of surgical robotic technologies that organizes and classifies surgical robots used for endoscopy, laparoscopy and thoracoscopy. Methods: We compiled a list of surgical robots intended to be used for endoscopy, laparoscopy, and/or thoracoscopy by searching United States, European, Hong Kong, Japan, and Korean databases for approved devices. Devices showcased at the 2023 Annual Meeting for the Society of Robotic Surgery were added. We also systematically reviewed the literature for any existing surgical robotic classifications or categorizations. We then created a multidisciplinary committee of 8 surgeons and 2 engineers to construct a proposed classification of the devices included in our search. Results: We identified 40 robotic surgery systems intended to be used for endoscopy, laparoscopy and/or thoracoscopy. The proposed classification organizes robotic devices with regard to architecture, port design, and configuration (modular carts, multi-arm integrated cart, table-attachable or arm-table integration). Conclusion: This 3-level classification of robotic surgical devices used for endoscopy, laparoscopy and/or thoracoscopy describes important characteristics of robotic devices systematically. [ABSTRACT FROM AUTHOR]

Introduction: With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance. Methods: In our explorative qualitative case study we conducted semistructured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools. Results: We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons. Discussion: Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed. [ABSTRACT FROM AUTHOR]

In response to the challenges posed by a rapidly aging society and its associated socio-economic difficulties, the Japanese government has encouraged the adoption of AI and robotics technologies for care. Conspicuous investments in these technologies in Japan underscore the dominance of techno-politics of innovation and the advocacy for the robotization of care practices. Such narratives — disseminated by the Japanese state, industry, media, and academia — often overlook the perspectives of the expected users of these technologies. This paper, rooted in a 14-month-long ethnographic study conducted at robotics labs in Japan and the UK in 2022–2023, examines the performance and ethical implications of technoscientific imaginaries portraying Socially Assistive Robots (SARs) as already reliable, safe, and efficient. It sheds light on the intricate relationship between science, technology, the state, and society, emphasizing their use as instruments of power for state-led national development objectives. Moreover, it exposes how technology is presented, creating an illusion of efficiency while neglecting the necessity of involving society in co-designing and co-producing these technologies. The paper ultimately advocates for responsible innovation, emphasizing in particular the need for user involvement to ensure these technologies are not only more efficient and reliable, but also more accessible, inclusive, and fairer. [ABSTRACT FROM AUTHOR]

Japanese care centers have seen an increasing reliance on robotic assistance in service and social-care tasks, which poses questions about ethics, governance, and caregiving practices. This article addresses the concept of robotics as a media technology, and the role of human agency in shaping imagination as an interpretive framework as it reflects on two specific points of debate; (1) whether the humanoid robot Pepper, deployed in an elder-care nursing home in Japan, has some form of agency in its interaction with a nursing home resident; and (2) whether appropriate anthropological debates about being (properly reframed with regard to difference) provide insight into the reality of robot care. Adapting an approach by anthropologist Boellstorff (2016), whose work focuses on the reality of virtual worlds, this article analyzes whether questions regarding the real of robot care are questions of being, i.e. of ontology. Conflating the interhuman with the real and the robotic with the unreal—or, in this case, conflating human care with the real (authentic) and robot care with the unreal (artificial)—can negatively affect our ability to discuss the reality of the robotic. The ontological turn can yield important insights, but its potential is lost if what is real is preassigned to the physical. [ABSTRACT FROM AUTHOR]

Background: Gait disorder remains a major challenge for individuals with stroke, affecting their quality of life and increasing the risk of secondary complications. Robot-assisted gait training (RAGT) has emerged as a promising approach for improving gait independence in individuals with stroke. This study aimed to evaluate the effect of RAGT in individuals with subacute hemiparetic stroke using a one-leg assisted gait robot called Welwalk WW-1000. Methods: An assessor-blinded, multicenter randomized controlled trial was conducted in the convalescent rehabilitation wards of eight hospitals in Japan. Participants with first-ever hemiparetic stroke who could not walk at pre-intervention assessment were randomized to either the Welwalk group, which underwent RAGT with conventional physical therapy, or the control group, which underwent conventional physical therapy alone. Both groups received 80 min of physical therapy per day, 7 days per week, while the Welwalk group received 40 min of RAGT per day, 6 days per week, as part of their physical therapy. The primary outcome was gait independence, as assessed using the Functional Independence Measure Walk Score. Results: A total of 91 participants were enrolled, 85 of whom completed the intervention. As a result, 91 participants, as a full analysis set, and 85, as a per-protocol set, were analyzed. The primary outcome, the cumulative incidence of gait-independent events, was not significantly different between the groups. Subgroup analysis revealed that the interaction between the intervention group and stroke type did not yield significant differences in either the full analysis or per-protocol set. However, although not statistically significant, a discernible trend toward improvement with Welwalk was observed in cases of cerebral infarction for the full analysis and per-protocol sets (HR 4.167 [95%CI 0.914–18.995], p = 0.065, HR 4.443 [95%CI 0.973–20.279], p = 0.054, respectively). Conclusions: The combination of RAGT using Welwalk and conventional physical therapy was not significantly more effective than conventional physical therapy alone in promoting gait independence in individuals with subacute hemiparetic stroke, although a trend toward earlier gait independence was observed in individuals with cerebral infarction. Trial registration: This study was registered with the Japan Registry of Clinical Trials (https://jrct.niph.go.jp; jRCT 042180078) on March 3, 2019. [ABSTRACT FROM AUTHOR]

Welwalk is a one-leg robotic-assisted gait system for stroke hemiplegic patients. This study examined the feasibility and efficacy of gait training using Welwalk (Welwalk training) for hemiplegic patients in the early phase after stroke onset, via cooperation between acute care and rehabilitation hospitals. Seven acute stroke patients (mean number of days fromonset = 7.9) with severe lower extremity paralysis participated. Patients underwent Welwalk training for 40 min/d, 5 d/wk in an acute care hospital, then 7 d/wk in a rehabilitation hospital with a seamless transition. Functional IndependenceMeasure scores for walking were assessed weekly. The endpoint was reaching Functional Independence Measurewalk score of 5 (supervision level). The primary outcomewas improvement efficiency of Functional IndependenceMeasure walk, which was the increase in Functional IndependenceMeasure walk score divided by the number of weeks required. Functional Independence Measure walk score for all patients improved from 1.1 to 5 (P = 0.01, r = 0.96). The mean number of weeks to achieve Functional Independence Measure walk score of 5 was 5 wks, and the improvement efficiency of Functional Independence Measure walk had a mean value of 0.9. No adverse events were reported duringWelwalk training. Hemiparetic patients' gait independence may be safely and rapidly improved by startingWelwalk training in the early phase after stroke onset. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate whether the sustained use of the "Hug," a "hugging" type robotic transfer support device, could increase the level of quality of care. The effect of proficiency on using the device was examined in terms of time spent for transfer, ratio of transfers using the device, and range of targets. The results were compared between skilled care facilities that had used the device for >24 months and unskilled facilities. The time spent for transfer at the unskilled facility was 4.6 min (2nd week after introduction), was reduced to 3.0 min (5th week), and 1.5 min at the skilled facility. The usage ratio at the unskilled facility was 13% and 30% (2nd and 5th week, respectively), while it was 97% in the skilled facility. Further, we identified wider in the range of target care recipients in the skilled facility. It takes time to master the use of Hug; however, its use was associated with many positive aspects, especially from the perspective of care recipients, e.g., better care, use of their own legs, and reduced time for transfers. These findings suggest that the widespread use of Hug would improve the quality of care. Less physically burdened on the caregivers using Hug, they can afford to talk to the care recipients. Using recipient's own legs during transfers, it prevents leg muscle disuse. As reduced time for transfers, recipients will have more opportunities to get out of bed. [ABSTRACT FROM AUTHOR]

This study aims to provide an overview of the service system view (SSV), and the current status of its adoption for the development and implementation of assistive technology (AT). The role of ATs in the global aging scenario is anticipated; however, their diffusion is cumbersome. The SSV captures stakeholders, technologies, and their interactions as integrated systems. Based on this perspective, several approaches for designing long‐term care services have been proposed that would be helpful for the successful implementation of ATs. However, the existing geriatrics and gerontology literature seldom addresses these topics. Based on a literature review, this study first illustrates the challenges of using ATs in the real world. The existing literature highlights the sociotechnical challenges of utilizing ATs, such as the changes required in care work and resistance to them. To overcome the challenges, three approaches associated with the SSV have been introduced: service design, service engineering and living labs. This paper also introduces recent national projects in Japan that have adopted these approaches. As the importance of the SSV is growing for the successful implementation of ATs, the ability to adopt the SSV and its approaches is anticipated. In relation to geriatrics and gerontology studies, the impact on older adults' quality of life, as well as the economic effect, needs to be analyzed in future research. Geriatr Gerontol Int 2024; 24: 74–80. [ABSTRACT FROM AUTHOR]

Background: Currently, widely used robotic surgical systems do not provide force feedback. This study aimed to evaluate the impact and benefits of a force feedback function on the suturing procedure. Methods: Twenty surgeons were recruited and divided into young (Y-group, n = 11) and senior (S-group, n = 9) groups, based on their years of surgical experience. The effect of the force feedback function on suturing quality was evaluated using an objective assessment system (A-LAP mini, Kyoto Kagaku Co., Ltd., Kyoto, Japan). Each participant completed the suturing task on intestinal model sheets with the robotic contact force feedback on and off. The task accomplishment time (s), maximal force (Newton, N) applied to the robotic forceps, and quality of suturing (assessed by A-LAP mini) were recorded as performance parameters. Results: In total, the maximal force applied to the robotic forceps was significantly decreased with the robotic force feedback switched on (median [interquartile range]: 2.8 N (2.3–3.2)) as compared with when the feedback was switched off (3.4 N (2.7–4.0), P < 0.001). The contact force feedback function did not affect the objectively assessed suturing score (18 points (17.7–19.0) versus 18 points (17.0–19.0), P = 0.421). The contact force feedback function slightly shortened the task accomplishment time in the Y-group (552.5 s (466.5–832) versus 605.5 s (476.2–689.7), P = 0.851) but not in the S-group (566 s (440.2–703.5) versus 470.5 s (419.7–560.2), P = 0.164). Conclusions: With the contact force feedback function, the suturing task was completed with a smaller maximal force, while maintaining the quality of suturing. Because the benefits are more apparent in young surgeons, robots with the contact force feedback function will facilitate the educational process in novice surgeons. [ABSTRACT FROM AUTHOR]

This work is the extended version of a paper presented at the conference HMM2021, about the history of mechanical engineering. First, the initial cultural and industrial steps in the robotic field in Japan are introduced, to display the beginning of this interlaced path, before WW2; then, in the context of the aftermaths of the war, some famous anime heroes are presented as ancestors of the coming mecha anime series. The rising research in the field of robotics and more generally the developments of contemporary Japanese automation industry are then drawn, as a technological substrate for mecha conception. In particular, Masahiro Mori studies are taken into consideration to identify an actual robot design pattern to apply to the following comparative description and examination of the different mecha; finally, thanks to this analysis, the common breeding ground whence robotics and mecha (and their reciprocal influences) arise, is outlined. [ABSTRACT FROM AUTHOR]

Aim: Minimally invasive surgeries for endometrial cancer are increasing worldwide. In Japan, some articles have examined surgical outcomes, but only a few have addressed oncological outcomes. This study aims to compare robot surgery, laparoscopic surgery, and laparotomy in terms of surgical and oncological outcomes within a low‐risk group for endometrial cancer recurrence. Methods: This study included patients with endometrial cancer deemed to be at low risk of recurrence and who underwent surgery between January 2011 and December 2020. We studied 99 patients who underwent robot surgery, 85 patients who underwent laparotomy, and 77 patients who underwent laparoscopic surgery. Surgical and oncological outcomes were compared retrospectively for these groups of patients. Results: The median follow‐up period was 47, 61, and 60 months in the laparotomy, laparoscopy, and robotic groups, respectively. The three groups had similar perioperative and pathological data. No significant differences in overall survival and disease‐free survival were observed among the groups. Univariate and multivariate analyses conducted on the overall study population for disease‐free survival and overall survival showed that the surgical approach did not have any influence. Minimally invasive surgery groups had longer operating times compared to the laparotomy group, but they had significantly less blood loss. The number of resected pelvic lymph nodes was similar, and the complication rate was not significant. Conclusions: Robot‐assisted surgery and laparoscopic surgery were found to be less invasive and showed similar oncologic outcomes compared to laparotomy surgery for endometrial cancer in patients with a low risk of recurrence. [ABSTRACT FROM AUTHOR]

Background: To investigate the impact of different urinary diversion (UD) techniques on the peri- and postoperative complications of robot-assisted radical cystectomy (RARC) with ileal conduit. Methods: We retrospectively analyzed 373 patients undergoing RARC with ileal conduit at 11 institutions in Japan between April 2018 and December 2021. Propensity score weighting was performed to adjust for confounding factors such as age, sex, body mass index, performance status, American Society of Anesthesiologists score, previous abdominal surgery, neoadjuvant chemotherapy, and preoperative high T stage (≥ cT3) and high N stage (≥ cN1). Perioperative complications were then compared among three groups: extracorporeal, intracorporeal, and hybrid urinary diversion (ECUD, ICUD, and HUD, respectively). Results: A total of 150, 68, and 155 patients received ECUD, HUD, and ICUD, respectively. Bowel reconstruction time and UD time were significantly shorter in the ECUD group (p < 0.001), and console time was significantly longer and blood loss was significantly higher in the ICUD group (p < 0.001). For postoperative complications (Clavien–Dindo Classification grade ≥ 3), surgical site infection (p = 0.004), pelvic abscess (p = 0.013), anastomotic urine leak (p = 0.007), and pelvic organ prolapse (p = 0.011) significantly occurred in the ECUD group. For all grades, ileus was more common in the HUD group, whereas anastomotic stricture was more common in the ECUD group compared with the other groups (p < 0.05). Conclusions: Severe complications did not increase after HUD and ICUD compared with ECUD; however, console time tended to be longer and blood loss was slightly higher during RARC. [ABSTRACT FROM AUTHOR]

Owing to Japan's aging society and labor shortages, the food and agricultural industries are facing a significant demand for robotic food handling technologies. Considering the large variety of food products, available robotic end-effectors are limited. Our primary goal is to maximize the applicability of existing end-effectors and efficiently develop novel ones, and therefore, it is necessary to categorize food products and end-effectors from the viewpoint of robotic handling and establish their relationships through an effective evaluation approach. This study proposes a system for evaluating robotic end-effectors to identify appropriate ones and develop new ones. The evaluation system consists of food categorization based on food properties related to robotic handling, categorization of robotic end-effectors based on their grasping principles, a robotic system with visual recognition based on Robot Operating System 2 (ROS 2) to conduct handling tests, a scoring system for performance evaluation, and a visualization approach for presenting the results and comparisons. Based on food categorization, 14 real food items and their corresponding samples were chosen for handling tests. Seven robotic end-effectors, both commercialized and under development, were selected for evaluation. Using the proposed evaluation system, we quantitatively compared the performance of different end-effectors in handling different food items. We also observed differences in the handling of real food items and samples. The overall performance of an end-effector can be visualized and quantitatively evaluated to demonstrate its versatility in handling various food items. [ABSTRACT FROM AUTHOR]

The introduction of companion robots into nursing homes has positive effects on older people with dementia (PwD) but increases the physical and psychological burden on the nursing staff, such as learning how to use them, fear of breakdowns, and concern about hygiene, and the concerns of the nursing home administrator, such as increased turnover and reduced quality of care due to this. To solve this problem, it is necessary to investigate the acceptability of robots from the viewpoints of all stakeholders: PwD as receivers, nursing staff as caregivers, and nursing home administrator as a care facility administrator. However, there is still missing hypothesis about how their acceptability is structured and involved with each other. This study proposes three technology acceptance model (TAMs) from the perspectives of PwD, nursing staff, and nursing home administrator. The models are conceptualized based on the qualitative and quantitative analysis of the results of our two experiments involving a baby-like interactive robot to stimulate PwD in the same nursing home (one with low acceptance of all stakeholders and the other with their high acceptance) in addition to the comparison with other companion robots. Based on the proposed models, we discuss an integrated TAM for the acceptance of companion robots in long-term care facilities. We also discuss the possibility of applying our approach, which examines the perspectives of various stakeholders on technology acceptance, to other areas such as health care and education, the ethical consideration of introducing a baby-like robot and some limitations. [ABSTRACT FROM AUTHOR]

This research investigates the effectiveness of a talking teddy bear robot in facilitating creative conversations with an older adult (TN) in her 70s and living alone. She interacted with the robot for three days. The robot responded to TN's phonological information to encourage continuation of the dialogue. Analysis of TN's speech patterns showed active participation, such as discussing daily events, sharing opinions, and asking questions. TN rated the robot's responses as fair and appreciated its friendly performance. The expressive abilities of the robot both facilitated communication and improved social interactions. [ABSTRACT FROM AUTHOR]

Background: Robotic gastrectomy (RG) using the da Vinci Surgical System for gastric cancer was approved for national medical insurance coverage in Japan in April 2018, and its number has been rapidly increasing since then. Aim: We reviewed and compared current evidence on RG and conventional laparoscopic gastrectomy (LG) to identify the differences in surgical outcomes. Methods: Three independent reviewers systematically reviewed the data collected from a comprehensive literature search by an independent organization, focusing on the following nine endpoints: mortality, morbidity, operative time, estimated blood loss volume, length of postoperative hospital stay, long-term oncologic outcome, quality of life, learning curve, and cost. Results: Compared to LG, RG has lower intraoperative blood loss volume, shorter length of hospital stay, and shorter learning curve, but both procedures have similar mortality. Contrarily, its disadvantages include longer procedural time and higher costs. Although the morbidity rate and long-term outcomes are almost comparable, RG showed superior potentials. Currently, the outcomes of RG are considered comparable to or better than LG. Conclusion: RG might be applicable to all gastric cancer patients who fulfill the indication of LG at institutions that meet specific criteria and are approved to claim the National Health Insurance costs for the use of the surgical robot in Japan. [ABSTRACT FROM AUTHOR]

Etsuko Ichihara is a media artist who utilises digital media and robotic technologies, exploring Japanese traditional beliefs of the spirit and the supernatural in her recent works. Ichihara repurposes paranormal and folk religious ideas concerning the figure of the shaman, an ogre-like demon that features in some Japanese festivals, and ritual offerings, but reinvents these traditional elements through technological mediation. I discuss Ichihara's distinctive engagement with a contemporised notion of spirituality in Japan. In particular, this essay argues that Ichihara's media art aims to connect Japanese people in order to create sociality and community. Ichihara appropriates Japanese animistic beliefs and tailors them for a mediated and technologised Japan, utilising what might be called a 'techno-spiritual Japanese-ness', that is, self-orientalising tropes that paradoxically generate the means for social relations. [ABSTRACT FROM AUTHOR]

Background: Although automated dispensing robots have been implemented for medication dispensing in Japan, their effect is yet to be fully investigated. In this study, we evaluated the effect of automated dispensing robots and collaborative work with pharmacy support staff on medication dispensing. Methods: A robotic dispensing system integrating the following three components was established: (1) automated dispensing robot (Drug Station®), which is operated by pharmacy support staff, (2) automated dispensing robot for powdered medicine (Mini DimeRo®), and (3) bar-coded medication dispensing support system with personal digital assistance (Hp-PORIMS®). Subsequently, we evaluated the incidences of dispensing errors and dispensing times before and after introducing the robotic dispensing system. Dispensing errors were classified into two categories, namely prevented dispensing errors and unprevented dispensing errors. The incidence of dispensing errors was calculated as follows: incidence of dispensing errors = total number of dispensing errors/total number of medication orders in each prescription. Results: After introducing the robotic dispensing system, the total incidence of prevented dispensing errors was significantly reduced (0.204% [324/158,548] to 0.044% [50/114,111], p < 0.001). The total incidence of unprevented dispensing errors was significantly reduced (0.015% [24/158,548] to 0.002% [2/114,111], p < 0.001). The number of cases of wrong strength and wrong drug, which can seriously impact a patient's health, reduced to almost zero. The median dispensing time of pharmacists per prescription was significantly reduced (from 60 to 23 s, p < 0.001). Conclusions: The robotic dispensing system enabled the process of medication dispensing by pharmacist to be partially and safely shared with automated dispensing robots and pharmacy support staff. Therefore, clinical care for patients by pharmacists could be enhanced by ensuring quality and safety of medication. [ABSTRACT FROM AUTHOR]

Societies of the East are often contrasted with those of the West in their stances toward technology. This paper explores these perceived differences in the context of international ethics guidance for artificial intelligence (AI) and robotics. Japan serves as an example of the East, while Europe and North America serve as examples of the West. The paper's principal aim is to demonstrate that Western values predominate in international ethics guidance and that Japanese values serve as a much-needed corrective. We recommend a hybrid approach that is more inclusive and truly 'international'. Following an introduction, the paper examines distinct stances toward robots that emerged in the West and Japan, respectively, during the aftermath of the Second World War, reflecting history and popular culture, socio-economic conditions, and religious worldviews. It shows how international ethics guidelines reflect these disparate stances, drawing on a 2019 scoping review that examined 84 international AI ethics documents. These documents are heavily skewed toward precautionary values associated with the West and cite the optimistic values associated with Japan less frequently. Drawing insights from Japan's so-called 'moonshot goals', the paper fleshes out Japanese values in greater detail and shows how to incorporate them more effectively in international ethics guidelines for AI and robotics. [ABSTRACT FROM AUTHOR]

Background: Investigations on the biomechanical characteristics of the anterior horn of the lateral meniscus (AHLM) related to anterior cruciate ligament (ACL) tibial tunnel reaming have revealed increased contact pressure between the femur and tibia, decreased attachment area, and decreased ultimate failure strength. Purpose/Hypothesis: The purpose of this study was to investigate the influence of a complete radial tear of the AHLM on force distribution in response to applied anterior and posterior drawer forces and internal and external rotation torques. We hypothesized that the AHLM plays an important role in knee stability, primarily at lower knee flexion angles. Study Design: Controlled laboratory study. Methods: A total of 9 fresh-frozen cadaveric knee specimens and a robotic testing system were used. Anterior and posterior drawer forces up to 89 N and internal and external rotation torques up to 4 N·m were applied at 0°, 30°, 60°, and 90° of knee flexion. A complete AHLM tear was then made 10 mm from the lateral border of the tibial attachment of the ACL, and the same tests performed in the intact state were repeated. Next, the recorded intact knee motion was reproduced in the AHLM-torn knee, and the change in the resultant force after an AHLM tear was determined by calculating the difference between the 2 states. Results: In the torn AHLM, the reduction in the resultant force at 0° for external rotation torque (34.8 N) was larger than that at 60° (5.2 N; P <.01) and 90° (6.7 N; P <.01). Conclusion: The AHLM played a role in facilitating knee stability against an applied posterior drawer force of 89 N and external rotation torque of 4 N·m, especially at lower knee flexion angles. Clinical Relevance: This study provides information about the effects of AHLM injuries that may occur during single-bundle ACL reconstruction using a round tunnel. [ABSTRACT FROM AUTHOR]

Diffusion tensor imaging (DTI) enables the investigation of white matter properties in vivo by applying a tensor model to the diffusion of water molecules in the brain. Using DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), an attempt has been made to detect age-related alterations in the white matter microstructure in aging research. However, the use of comprehensive DTI measures to examine the effects of cognitive intervention/training on white matter fiber health in older adults remains limited. Recently, we developed a cognitive intervention program called Photo-Integrated Conversation Moderated by Robots (PICMOR), which utilizes one of the most intellectual activities of daily life, conversations. To examine the effects of PICMOR on cognitive function in older adults, we conducted a randomized controlled trial and found that verbal fluency task scores were improved by this intervention. Based on these behavioral findings, we collected in this pilot study diffusion-weighted images from the participants to identify candidate structures for white matter microstructural changes induced by this intervention. The results from tract-based spatial statistics analyses showed that the intervention group, who participated in PICMOR-based conversations, had significantly higher FA values or lower MD, AD, or RD values across various fiber tracts, including the left anterior corona radiata, external capsule, and anterior limb of the internal capsule, compared to the control group, who participated in unstructured free conversations. Furthermore, a larger improvement in verbal fluency task scores throughout the intervention was associated with smaller AD values in clusters, including the left side of these frontal regions. The present findings suggest that left frontal white matter structures are candidates for the neural underpinnings responsible for the enhancement of verbal fluency. Although our findings are limited by the lack of comparable data at baseline, we successfully confirmed the hypothesized pattern of group differences in DTI indices after the intervention, which fits well with the results of other cognitive intervention studies. To confirm whether this pattern reflects intervention-induced white matter alterations, longitudinal data acquisition is needed in future research. [ABSTRACT FROM AUTHOR]

The number of robotic inguinal hernia repair (RIHR) surgeries performed by younger surgeons and surgical residents has been growing worldwide. As a result, there has been growing interest in the pace at which surgeons develop their competencies. In Japan, the number of robotic surgeries with the double bipolar technique for gastric cancer is increasing. We devised an RIHR technique for a right‐hand‐dominant surgeon. This article describes the procedure and step‐by‐step instructions for this technique. We also assessed the learning curve of a surgeon experienced in the laparoscopic transabdominal preperitoneal (TAPP) approach and robotic gastrectomy. This was a retrospective review of 31 inguinal hernia patients (40 lesions) between December 2018 and April 2021 operated by a single surgeon. The cumulative summation technique (CUSUM) was used to construct a learning curve for robotic proficiency by analyzing the times for peritoneal flap creation, mesh placement, and peritoneal closure. The postoperative course, namely, the length of hospital stay, 30‐d complications, and 30‐d readmission rates, was evaluated. The CUSUM graph for the total time for each phase indicated an initial decrease at lesion 12 and another decrease at lesion 36, generating three distinct performance phases: learning (n = 12 procedures), competence (n = 24), and mastery (n = 4). Between the early and late periods, no significant differences in patient characteristics or surgical outcomes were found. The learning curve for this technique was divided into three performance phases, and the technique was safely achievable in 36 procedures by a surgeon with previous experience in laparoscopic TAPP. [ABSTRACT FROM AUTHOR]

The present study investigated whether Japanese 3‐, 4‐, and 5‐year‐old children exhibit a yes bias to questions from a physically present humanoid robot, Nao. The robot asked the children yes‐no questions about familiar and unfamiliar objects. To both types of questions, the 3‐year‐old children exhibited a yes bias while the 5‐year‐old children exhibited a nay‐saying bias to questions about unfamiliar objects. The 4‐year‐old children did not exhibit any response biases. These results were not dramatically different from children's response tendencies toward humans reported in previous studies. The results demonstrate that as children might not spontaneously discriminate a real humanoid robot from humans in social situations, they do not hesitate to answer its questions. Robot usage in education and childcare is discussed. [ABSTRACT FROM AUTHOR]

The elder population in Japan is increasing drastically, causing a number of issues that have not yet surfaced in most Western countries. Demographic data from Japan reveal that the Japanese have the longest lifespan globally, resulting in the world's highest population of older adults. Concurrently, the country has a rapidly declining birth rate. As the population ages, the workforce is shrinking and leaving a high number of elders with fewer caregivers to meet their needs. At present, the Japanese government is developing robotic care solutions to overcome the elder care labor shortage and implementing a new agenda to introduce social robots into the field. This article discusses professional women in Japan and their burden of caring for aging relatives and how introducing robotic care devices might reduce current anxieties regarding the provision of elder care. It analyzes the elder care strategies of 12 white-collar professional women in their forties and fifties and examines the extent to which gendered, expected at-home caregiving affects their professional commitments and associated anxieties. The findings below provide crucial insight into the most effective strategies that can be used by Japanese women to balance their careers with responsibilities to care for older relatives, particularly when it is impossible to predict the intensity of caregiving in the future. [ABSTRACT FROM AUTHOR]

Focusing on the early work and collaborations of the Japanese architect Arata Isozaki, this paper researches links between the robotic culture of postwar Japan and the surge of figuration in postmodernism, challenging the commonly held view that this architectural movement emerged in the West. Specifically, the paper looks at how Isozaki's robotic creation for Expo '70 embodied the notion of theatrical mask, which characterized both postmodern ideals and early Japanese robotics, and influenced his own architectural work. Delving into Isozaki's creative exchanges with the film director Hiroshi Teshigahara and the novelist Kōbō Abe, coming into contact with each other in the 1950s, a synergy between cinema, literature, and architecture is highlighted, considering their speculations about possible technological means of reconstructing the human face in light of the symbolic dimension of this enterprise for Japan as a nation, and for architecture as a discipline. [ABSTRACT FROM AUTHOR]

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This essay tracks the 'human' emergent in human-centred technologies (HCTs) in Japan. A primary aim of HCTs is to extract the true intention of the user and actualise it as machine action. Beyond this, HCT researchers maintained that creating such technologies would give them access to the truth of the human itself. In this essay, I examine the games of truth played in HCT, in which teachers exercise authority over students by defining their true intentions for them, and students learned what they needed to become good researchers. I then show how through analogical relations, human subjects with esteemed qualities became what HCTs must be, and HCTs a means for imagining what human beings truly are. What emerged were truths that transcended human and machine: all are systems of information and, in the end, the right machine can approach humanity enough to fulfil even the most human of responsibilities. [ABSTRACT FROM AUTHOR]

This article presents the experience of a longlasting collaboration in robotics between the countries of Japan and Italy. The diversity of the approaches to robotics research and technology in the two countries and, at the same time, the similarity of some social drives for robotics progress have created a stimulus for generating new thinking about robotics. Not only has this occurred at the main participant institutions of Waseda University in Tokyo and Scuola Superiore Sant?Anna in Pisa, Italy, but it has also happened worldwide. The authors present a summary of the Italy-Japan workshops, exploring topics on 1) humanoid robotics, 2) the application of robotics for exploration and rescue, 3) biorobotics, 4) the use of robots in education, 5) the ethics of robotics, 6) robotics for sports, and 7) robotics for the arts. The experience of the workshops represents an example of an open-minded approach to robotics that is grounded on social challenges, explored through multidisciplinary discussion. Such interdisciplinary research efforts deserve to be shared with the international robotics community. Indeed, this approach could be used as a base model to foster further international collaborations among countries as well. [ABSTRACT FROM AUTHOR]

• Surveys for home-care robots were conducted in Japan, Ireland, and Finland. • The study built a model of ethical perceptions regarding the use of home-care robots. • Our final model had explanatory power across countries with different backgrounds. • This model can also be applied to explain ethical perceptions by attributes. To date, research on ethical issues regarding care robots for older adults, family caregivers, and care workers has not progressed sufficiently. This study aimed to build a model that universally explains the relationship between the use of care robots and ethical awareness, such as regarding personal information and privacy protection in home care. We examined data obtained from cross-sectional surveys conducted in Japan (n=528), Ireland (n=296), and Finland (n=180). We performed a confirmatory factor analysis by using responses to 11 items related to the ethical use of care robots. We evaluated the model based on the chi-square to degrees of freedom ratio, the comparative fit index, and the root mean square error of approximation. Subsequently, we compared the model with the Akaike's information criterion. Ten items were adopted in the final model. There were 4 factors in the model: 'acquisition of personal information', 'use of personal information for medical and long-term care', 'secondary use of personal information', and 'participation in research and development'. All factor loadings of the final model ranged between 0.63 and 0.92, which were greater than 0.6, showing that the factors had a high influence on the model. The final model was applied to each country; the fit was relatively good in Finland and poor in Ireland. Although the three countries have different geographies, cultures, demographics, and systems, this study showed that the impact of ethical issues regarding the use of care robots in home care can be universally explained by the same model. [ABSTRACT FROM AUTHOR]

Purpose: There are no definitive prognostic factors for patients with pathological Grade Group 5 (pGG 5) prostate cancer (PCa) undergoing robot-associated radical prostatectomy (RARP). This study aimed to explore the prognostic factors among patients with pGG 5 PCa in a large Japanese cohort (MSUG94)., Methods: This retrospective, multi-institutional cohort study was conducted between 2012 and 2021 at ten centers in Japan and included 3195 patients. Patients with clinically metastatic PCa (cN1 or cM1) and those receiving neoadjuvant and/or adjuvant therapy were excluded. Finally, 217 patients with pGG5 PCa were analyzed., Results: The median follow-up period was 28.0 months. The 3- and 5-year biochemical recurrence-free survival (BCRFS) rates of the overall population were 66.1% and 57.7%, respectively. The optimal threshold value (47.2%) for the percentage of positive cancer cores (PPCC) with any GG by systematic biopsy was chosen based on receiver operating characteristic curve analysis. Univariate analysis revealed that the prostate-specific antigen level at diagnosis, pT, pN, positive surgical margins (PSMs), lymphovascular invasion, and PPCC were independent prognostic factors for BCRFS. A multivariate analysis revealed that PSMs and PPCC were independent prognostic factors for BCRFS. Using these two predictors, we stratified BCRFS, metastasis-free survival (MFS), and castration-resistant PCa-free survival (CRPC-FS) among patients with pGG 5 PCa., Conclusion: The combination of PSMs and PPCC may be an important predictor of BCRFS, MFS, and CRPC-FS in patients with pGG 5 PCa undergoing RARP., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The quality of life of patients is an important consideration when selecting treatments for localized prostate cancer (PCa). We retrospectively compared sexual function after robot-assisted radical prostatectomy (RARP) and carbon-ion radiotherapy (CIRT) using propensity score matching., Methods: In total, 127 Japanese PCa patients treated with RARP and 190 treated with CIRT monotherapy were evaluated. We evaluated the Expanded Prostate Cancer Index Composite (EPIC) score before treatment and 12 and 24 months after treatment. After propensity score matching, data from 101 patients from each group were analyzed. The study protocol was approved by the Institutional Review Board of Gunma University Hospital (no. IRB2020-050, 1839)., Results: After propensity score matching, the mean EPIC sexual function summary scores in the RARP and CIRT groups were 46.4 and 48.2, respectively. At 12 and 24 months after treatment, these scores were 27.9 (39.9% decrease) and 28.2 (39.2% decrease) in the RARP group and 41.4 (14.1% decrease) and 41.6 (13.7% decrease) in the CIRT group, respectively. Both groups demonstrated significantly decreased scores after 12 and 24 months of treatment compared to before treatment (all p < 0.05). At 12 and 24 months, the sexual function summary score was significantly higher in the CIRT group than in the RARP group (p < 0.001)., Conclusions: There was a smaller decrease in the EPIC sexual function score in the CIRT group than in the RARP group. These results provide useful information for treatment decision-making of Japanese PCa patients., (© 2024. The Author(s).)

Objectives: To investigate preoperative patient factors that may predict the occurrence of perioperative complications following robot-assisted radical cystectomy at a single center in Japan., Methods: From 2013 to 2022, 103 patients underwent RARC at our institution. Complications within 90 days after surgery were assessed using the Clavien-Dindo classification. Preoperative characteristics and surgical outcomes were compared between cohorts with and without complications ≥grade 3. Logistic regression analysis was used to identify the risk factors associated with perioperative complications., Results: Overall, 27% of patients (27/103) experienced grade 3 or higher complications. The cohort that developed complications ≥grade 3 exhibited significantly higher Charlson comorbidity index (p = 0.046) and significantly lower estimated glomerular filtration rate (p = 0.048). Charlson comorbidity index ≥2 (p = 0.037) and estimated glomerular filtration rate <53 (p = 0.008) were independent predictors for the occurrence of complications ≥grade 3. The incidence of complications ≥grade 3 was 61.5% in the group possessing both factors, which was significantly higher than those in the groups possessing neither factor nor only one of the two factors., Conclusions: Our results suggest that the Charlson comorbidity index and preoperative estimated glomerular filtration rate may be predictors of perioperative complications. It is important to evaluate the patient's preoperative characteristics and choose the surgical procedure accordingly., (© 2023 The Japanese Urological Association.)

Background: Robotic pancreaticoduodenectomy (RPD) is technically demanding, and 20-50 cases are required to surpass the learning curve. This study aimed to show our experience of 76 cases from the introduction of RPD and report the changes in surgical results owing to the accumulation of cases and optimization of surgical techniques., Methods: A total of 76 patients who underwent RPD between November 2009 and May 2023 at the Fujita Health University Hospital were divided into three groups: competency (n = 23, Nov 2009-Mar 2020), proficiency (n = 31, Apr 2020-Jun 2022), and mastery (n = 22, Jul 2022-May 2023) phases. In the mastery phase, for the education of new surgeons and maintenance of surgical quality, optimization of the procedure, including hanging maneuver with or without stapling transection of the retropancreatic tissue was implemented. The surgical outcomes were compared between the groups., Results: The mean operation time decreased over time despite of the participation of newly started operators in mastery phase [competency: 921.5 min (IQR 775-996 min) vs. proficiency: 802.8 min (IQR 715-887 min) vs. mastery: 609.2 min (IQR 514-699 min), p < 0.001]. Additionally, Clavien-Dindo ≥ grade IIIa complications decreased from 52.2% in competency phase to 35.5% and 9.1% in proficiency and mastery phases, respectively (p = 0.005)., Conclusion: Operation time and major complications decreased along the learning curve from the introduction of RPD. In addition, optimization of the procedure, including hanging maneuver of the retropancreatic tissue seemed to be effective in reducing operation time and educating new RPD surgeons., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

To investigate the incidence and risk factors of inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) using a multicentric database. The present study used a multicentric database (the MSUG94) containing data on 3,195 Japanese patients undergoing RARP between 2012 and 2021. Surgical procedures utilized for IH prevention were as follows: isolation of the vas deferens, transection of the vas deferens, isolation of the spermatic vessels, and separation of the peritoneum from the internal inguinal ring. The primary and secondary endpoints were IH-free survival and any association between post-RARP IH and clinical covariates. The prophylactic effect of the above procedures were also assessed. IH prevention was attempted in 1,465 (46.4%) patients at five of the nine hospitals. During follow-up (median 24 months), post-RARP IH developed in 243 patients. The post-RARP IH-free survival rates at years 1, 2, and 3 were 94.3%, 91.7%, and 90.5%, respectively. Old age (hazard ratio [HR] 1.037; 95% confidence interval [CI] 1.014-1.061; p = 0.001), low BMI (HR 0.904; 95% CI 0.863-0.946: p < 0.001), and low hospital volume (HR 1.385; 95% CI 1.003-1.902; p = 0.048) were independently associated with IH development. None of the procedures for IH prevention were associated with IH development. Our findings may represent the current, real-world status of post-RARP IH in Japan. The prophylactic effects of the surgical procedures for IH prevention should be further investigated in well-designed, prospective studies to optimize the surgical technique., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Introduction: We aimed to evaluate the safety and short-term outcomes of robotic-assisted transabdominal preperitoneal repair for inguinal hernia in 12 pioneering hospitals in Japan., Methods: Clinical data of patients who underwent robotic-assisted transabdominal preperitoneal repair between September 1, 2016, and December 31, 2021 were collected. Primary outcome measures were intra-operative adverse events and post-operative complications, whereas secondary outcomes were surgical outcomes, including chronic pain, recurrence, and learning curve., Results: In total, 307 patients were included. One case of inferior epigastric arterial injury was reported; no cases of bowel or bladder injury were reported. Thirty-five seromas were observed, including four (1.3%) cases that required aspiration. The median operative time of a unilateral case was 108 minutes (interquartile range: 89.8-125.5), and post-operative pain was rated 1 (interquartile range: 0-2) on the numerical rating scale. In complicated cases, such as recurrent inguinal hernias and robotic-assisted radical prostatectomy-associated hernias, dissection and suture were safely achieved, and no complications were observed, except for non-symptomatic seroma. All patients underwent robotic procedures, and there was no chronic post-operative inguinal pain, although one case of hernia recurrence was reported. Regarding the learning curve, plateau performance was achieved after 7-10 cases in terms of operative time (P < .001)., Conclusion: Robotic-assisted transabdominal preperitoneal repair can be safely introduced in Japan. Regardless of the involvement of many surgeons, the mastery of robotic techniques was achieved relatively quickly. The advantage of robotic technology such as wristed instruments may expand the application of minimally invasive hernia repair for complicated cases., (© 2023 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)

Purpose: We created a clinically applicable nomogram to predict locally advanced prostate cancer using preoperative parameters and performed external validation using an external independent validation cohort., Patients and Methods: From a retrospective multicenter cohort study of 3622 Japanese patients with prostate cancer who underwent robot-assisted radical prostatectomy at ten institutions, the patients were divided into two groups (MSUG cohort and validation cohort). Locally advanced prostate cancer was defined as pathological T stage ≥ 3a. A multivariable logistic regression model was used to identify factors strongly associated with locally advanced prostate cancer. Bootstrap area under the curve was calculated to assess the internal validity of the prediction model. A nomogram was created as a practical application of the prediction model, and a web application was released to predict the probability of locally advanced prostate cancer., Results: A total of 2530 and 427 patients in the MSUG and validation cohorts, respectively, met the criteria for this study. On multivariable analysis, initial prostate-specific antigen, prostate volume, number of cancer-positive and cancer-negative biopsy cores, biopsy grade group, and clinical T stage were independent predictors of locally advanced prostate cancer. The nomogram predicting locally advanced prostate cancer was demonstrated (area under the curve 0.72). Using a nomogram cutoff of 0.26, 464 of 1162 patients (39.9%) could be correctly diagnosed with pT3, and 2311 of 2524 patients (91.6%) could avoid underdiagnosis., Conclusions: We developed a clinically applicable nomogram with external validation to predict the probability of locally advanced prostate cancer in patients undergoing robot-assisted radical prostatectomy., (© 2023. Society of Surgical Oncology.)