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An innovative tactile approach to automatically detect mediums and underlying structures ahead on a cutting tool path has been implemented in surgery. In this paper a description of a mechatronic approach to surgery is described and shows the merits of the approach. This is supplemented by evidence of suitability of the method to a wider range of mediums and applications outside of surgical application.

This paper describes a mechatronics approach that provides vascular surgeons with the perception of movement and tissue interaction in the vicinity of the tip of a catheter in endovascular procedures. The current system described is experimental and used in phantom units. It integrates 3D visualization generated from scan with real-time tactile sensing in the vicinity of the tip of the catheter to update on the nature of tissue interaction, the curvature and relative orientation of the catheter sleeve and guide wire. This approach offers superior perception by the clinician, in contrast with current application of catheters used in this application. By being well informed of conditions at the working environment of the catheter tip the clinician will be able to administer therapies with greater precision in the surgical task and within a reduced operating time. The approach will reduce risk for patients and significantly reduce risks for the clinician, who is currently exposed to high doses of ionizing radiation during the process of catheter guidance.

Surface roughness on implant materials has been shown to be highly influential on the behavior of osteogenic cells. Four surface topographies were engineered on cobalt chromium molybdenum (CoCrMo) in order to examine this influence on human mesenchymal stem cells (MSC). These treatments were smooth polished (SMO), acid etched (AE) using HCl 7.4% and H2 SO4 76% followed by HNO3 30%, sand blasted, and acid etched using either 50 μm Al2 O3 (SLA50) or 250 μm Al2 O3 grit (SLA250). Characterization of the surfaces included energy dispersive X-ray analysis (EDX), contact angle, and surface roughness analysis. Human MSCs were cultured onto the four CoCrMo substrates and markers of cell attachment, retention, proliferation, cytotoxicity, and osteogenic differentiation were studied. Residual aluminum was observed on both SLA surfaces although this appeared to be more widely spread on SLA50, whilst SLA250 was shown to have the roughest topography with an Ra value greater than 1 μm. All substrates were shown to be largely non-cytotoxic although both SLA surfaces were shown to reduce cell attachment, whilst SLA50 also delayed cell proliferation. In contrast, SLA250 stimulated a good rate of proliferation resulting in the largest cell population by day 21. In addition, SLA250 stimulated enhanced cell retention, calcium deposition, and hydroxyapatite formation compared to SMO (p

Comparative lawyers have traditionally associated different forms of judicial organisation with different legal traditions. Civil law systems, on this view, have ‘career’ judiciaries. Judges enter ...

The current gold standard material for orthopedic applications is titanium (Ti), however, other materials such as cobalt-chromium-molybdenum (CoCrMo) are often preferred due to their wear resistance and mechanical strength. This study investigates if the bioactivity of CoCrMo can be enhanced by coating the surface with titanium oxide (TiO2 ) by atmospheric pressure chemical vapor deposition (CVD), thereby replicating the surface oxide layer found on Ti. CoCrMo, TiO2 -coated CoCrMo (CCMT) and Ti substrates were used for this study. Cellular f-actin distribution was shown to be noticeably different between cells on CCMT and CoCrMo after 24 h in osteogenic culture, with cells on CCMT exhibiting greater spread with developed protrusions. Osteogenic differentiation was shown to be enhanced on CCMT compared to CoCrMo, with increased calcium ion content per cell (p

Ideational approaches to politics are frequently criticised for indeterminacy. In comparative constitutional politics, critics have alleged that the ‘human rights revolution’ cannot explain why bills of rights were adopted in different places and different times. Ideational scholars have not responded convincingly. Focusing on the famous South African case study, and drawing on theories of belief formation and legitimation in interpretive political science, this paper argues that new beliefs can be explained by historically specifiable dilemmas. It uses process-tracing to show how scholars have mistakenly assumed that key players in the post-apartheid transition only adopted beliefs in rights in order to rationalise interests.

Ultraviolet (UV) photofunctionalization has been shown to be highly effective at improving the osteoconductivity of titanium and TiO2 coated materials. We aimed to assess whether the bioactivity of TiO2 coated cobalt chromium molybdenum (CoCrMo) could be enhanced by UV photofunctionalization of the surface TiO2 layer. Using atmospheric pressure chemical vapour deposition (APCVD) a thin layer of anatase TiO2 was deposited onto smooth CoCrMo discs (referred to as CCMT). Human mesenchymal stem cells (MSCs) were cultured onto CCMT substrates which had been treated with UV light for 24 hours and identical substrates which had not undergone UV treatment. UV treated CCMT promoted a superior cell response in the form of enhancing markers of cell adhesion. This included stimulating the development of larger cells with increased levels of the adhesion protein vinculin and cytoskeletal protein f-actin (p < 0.05). In addition, MSCs were shown to have superior retention to UV treated CCMT after 3 and 24 hours (p < 0.05). Other cellular processes including proliferation, attachment, migration and differentiation were not affected by UV photofunctionalization. Despite this, the enhancement in cellular adhesion alone should result in an improvement in MSC retention to implant surfaces following surgery, and as a consequence, increase MSC resistance to dislodgement from external forces such as blood flow and micro motion.

Copyright © 2014 Tom Williamson et al. Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade. The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy. Presented herein is preliminary work on the combination of two robotic systems for reducing invasiveness and trauma in cochlear implantation procedures. A robotic system for minimally invasive inner ear access was combined with a smart drilling tool for robust and safe cochleostomy; evaluation was completed on a single human cadaver specimen. Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

The editors of this handbook have succeeded in assembling a genuine all-star cast of contributors. Most of the 32 brief chapters summarise decades of research by their author on the topic. For mast...

This article explores how teaching about identity in Australia has been framed by the recent historical and political context. It analyses the influential characterisation of Australian identity during John Howard's period in office between 1996 and 2007. The findings of Australian education researchers relating to young people's sense of what it means to be Australian are reviewed. The author goes on to discuss the curriculum content, language, and underpinning intellectual frameworks of key areas of the emerging Australian Curriculum. Methodologically, the article draws upon the tools of critical policy and discourse analysis. The History, Geography, Civics and Citizenship curricula and related cross-curricular priorities are analysed in relation to their articulation of learning about identity. Some conclusions are drawn as to how Australian teachers can best be supported to address issues relating to identity in their school contexts. The author argues that teachers need help in developing the skills and confidence to see the emerging Australian Curriculum as a framework and not a straitjacket which prevents them from exploring unarticulated identity issues. He further concludes that there need to be curriculum opportunities to explore the political dimensions of identity issues in critical and participative ways.

This article explores a comparatively undocumented gap in the history of citizenship education in England. Drawing upon archival material from the Civic Education League, the study analyses calls for citizenship education around the time of the First World War and its aftermath. On the face of it social and political circumstances after 1918 were propitious for citizenship education. The article goes on to explain why arguments in favour of enhancing citizenship education in schools failed to gain significant purchase.

Many children are living in extreme poverty; barely meeting their daily survival needs. Yet in the more developed world we are spending billions of dollars per year on toys and games. Surely this money is better spent helping to evaluate the problems associated with world poverty? Surely it could be used to help the problems with water? Surely it is better spent on education in undeveloped countries? It is really simple – think before you buy.

The authors wish to acknowledge financial support by Cochlear Ltd., Australia, and clinical support from Queen Elizabeth Hospital, Birmingham, UK in this work and the advice and enthusiasm of Mechtron Design Ltd, UK.

Modifications to Titanium (Ti) implant surfaces enhance osseointegration by promoting bone-implant contact and peri-implant bone accrual; which in vitro analyses of osteoblastic cells suggest is due to an enhancement in cellular phenotypic maturation and function. To evaluate these effects on uncommitted cells, this study examined the osteogenic mineralisation and phenotypic marker expression of human marrow derived stromal cells (hBMSCs) from three unrelated donors cultured on tissue culture plastic (TCP), polished (P), rough-hydrophobic (SLA) and rough-hydrophilic (modSLA) Ti surfaces over the course of 21 days. Transcriptional analyses indicated a significant early up-regulation of both Runx2 (p

Pakistan studies textbooks occupy a central role in translating curriculum imperatives into the foundational stories identified by the authorities as core knowledge for classroom transmission, and consequently in constructing Pakistani young people’s identities. The purpose of this article is to explore the content of recently-crafted Pakistan studies textbooks in the Punjab in relation to identity-related issues at a point in time when domestic circumstances, critical diagnoses of flawed textbook approaches in the late twentieth century and a dynamic international context all pushed the previously dominant theocratic/Islamic discourse of curriculum policy towards more democratic and pluralistic pathways and the possibility of ‘enlightened moderation’. The specific focus of the study is upon how textbook writers’ interpreted and enacted policy objectives and guidelines regarding Pakistani national identity, internal ethnic and cultural diversity, and global perspectives in their writing of textbooks within the rubric of the revised 2006 secondary school Pakistan studies national curriculum., IARTEM e-journal, Vol. 7 No. 3 (2015)

Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit have provided tactile information from the digitphantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures., {"references":["Kha H. N., B. K. Chen, G. M. Clark, R. Jones, \"Stiffness Properties for\nNucleus Standard Straight and Contour Electrode Arrays\", Medical\nEngineering & Physics 26 (8), pp. 677-685, Jan 2004.","Kale S, Cervantes VM, Wu MR, Pisano DV, Sheth N, Olson ES, \"A\nnovel perfusion-based method for cochlear implant electrode insertion\"\nHearing research, 314 (1-2), pp. 33-41, May 2014.","Lawrence T. Cohen, Saunders E., Clark G. M. \"Psychophysics of a\nPrototype Perimodiolar Cochlear Implant Electrode Array\", Hearing\nresearch, 155 (1-2), pp. 63-81, 2001.","Adunka Oliver, Jan Kiefer and Chapel Hill, \"Impact of Electrode\nInsertion Depth on Intracochlear Trauma\", Otolaryngology-Head and\nNeck surgery 135, pp.374-382, 2006.","J. Wang, M., Bhatti, P. T., Arcand, B. Y., Beach, K., Friedrich, C.. R.,\nWise, K. D., \"A cochlear Electrode Array with Built-in Position\nSensing\", International conference on Micro Electro Mechanical\nsystems (MEMS), IEEE Xplore, 18th. 30 Jan.-3 Feb. 2005.","Frank Tendik, S. Shankar Sastry, Ronald S. Fearing, and Michael Cohn,\n\"Applications of Mechatronics in Minimally Invasive Surgery\",\nIEEE/ASME transactions on mechatronics, 3(1), p.34-42, 2006.","Peter S. Roland, Wolfgang Gstottner, Oliver Adunka, \"Method for\nhearing Preservation in cochlear implant surgery\", Operative\nTechnology in Otolaryngology 16, pp.93-100, 2005.","N. Donnelly, A. Bibas, D. Jiang, D. E. Bamiou, C. Santulli, G.\nJeronimidis and A. Fitzgerald, \"Effect of cochlear implant electrode\ninsertion on middle-ear function as measured by intra-operative laser\nDoppler vibrometry\", The journal of laryngolgy and otology, 123,\npp.723-729, 2009.","Joseph B. Roberson, Jr, M. D., \"Cochlear implant surgery: Minimally\ninvasive technique\", Operative Techniques in Otolaryngology, 16,\npp.74-77, 2005.\n[10] J. H. M. Frinjns, J. J. Briaire, A. Zarowski, B. M. Verbist and J.\nKuzma,\"Concept and initial testing of a new, bassaly perimodiolar\nelectrode design\", international congress series 1273 p.105-108, 2004.\n[11] Paolo Dario, Maria Chiarra Carrozza, Maurilio Marcacci(2000). A novel\nmechatronic tool for computer-assisted arthroscopy. IEEE transaction on\ninformation technology in biomedicine. 4(1), pp. 15-29.\n[12] S. Shimachi, Y. Fujiwara and Y. Hakozaki (2004). New sensing method\nof force acting on instrument for laparoscopic robot surgery, Computer\nAssisted Radiology and Surgery. Proceedings of the 18th International\nCongress and Exhibition International Congress Series, 1268, p.775-780.\n[13] Stephen J. Rebscher Hetherington A, Bonham B, Wardrop P, Whinney\nD, Leake P. A., \"Consideration for design of future cochlear implant\nelectrode arrays: electrode array stiffness, size, and depth of insertion\",\nJournal of Rehabilitation Research & Development (JRRD),45( 4)\npp.731-748, 2008.\n[14] John K. Niparko, Cochlear implants: principles and practices, 2nd ed.\nPhiladelphia, Lippincott Williams and Wilkins, 2009.\n[15] Uwe Baumann, Andrea Nobbe, \"The cochlear implant electrode-pitch\nfunction\", Hearing Research 213 (2006), pp34-42, 2006.\n[16] Madhukar Vable, Mechanics of Materials, Oxford University press, 2nd\nedition, August 2012.\n[17] Bernard Escude, Chris James, Olivier Deguine, Nadine Cochard, Elias\nEter and Bernard Fraysse, The Size of the Cochlea and Predictions of\nInsertion Depth Angles for Cochlear Implant Electrodes, Audiol\nNeurotol 2006;11(suppl 1), pp.27–33, 2006.\n[18] Lawrence T. Cohen, Saunders E., Clark G. M., \"Psychophysics of a\nprototype perimodiolar cochlear implant electrode array\", Hearing\nresearch, 155 (1-2), pp. 63-81, 2001.\n[19] Andress Hussong, Thomas S. Rau, Tobias Ortmaier, Bodo Heinmann,\nThomas Lenarz, Omid Majdani, \"An automated insertion tool for\ncochlear implants: another step towards atraumatic cochlear implant\nsurgery\", International Journal CARS, 5, pp.163-171, 2010.\n[20] Graeme M. Clark, Review, \"The multi-channel cochlear implant: Multidisciplinary\ndevelopment of electrical stimulation of the cochlea and the\nresulting clinical benefit\", Hearing research, 322, pp.4-13, 2015.\n[21] Oliver Adunka, Marc H. Unkelbach, Martin G. Mack, Andreas Radeloff,\nWolfgang Gstoettner, \"Predicting Basal Cochlear Length for Electric-\nAcoustic Stimulation\", Arch Otolaryngol Head Neck Surg. 2005;131,\npp.488-492, 2005.\n[22] Michael J. Wittbrodt, Charles R. Steele, Sunil Puria, \"Developing a\nPhysical Model of the Human Cochlea Using Microfabrication\nMethods\", Audio Neurotol 2006;11:104–112, Jan 2006."]}

Oral Diseases (2011) 17, 232–237 Aim: Genetic factors have recently been associated with presence of Aggregatibacter actinomycetemcomitans subgingivally in populations living in industrialized countries. The aim of this study was to analyse associations between Interleukin-6 (IL6) single nucleotide polymorphisms and presence and levels of A. actinomycetemcomitans and other subgingival microbes in a rural Indian population. Subjects and Methods: A total of 251 individuals from a rural village in India with a periodontal phenotype ranging from healthy to severe periodontitis were included. Checkerboard DNA-DNA analysis was performed to detect 40 periodontal taxa in subgingival plaque samples. Genomic DNA was extracted to genotype five polymorphisms in the IL6 promoter region. Results: The IL6 −174 GG genotype was associated with high (above median) counts of A. actinomycetemcomitans (both in all subjects and in periodontally healthy only) and with presence and counts of Capnocytophaga sputigena. Differences in detection of several other bacteria were noted between periodontitis and healthy subjects. Conclusions: These findings support the influence of genetic factors on the subgingival microbiota.

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2010 The Authors. This article describes a surgical robotic device that is able to discriminate tissue interfaces and other controlling parameters ahead of the drill tip. The advantage in such a surgery is that the tissues at the interfaces can be preserved. A smart tool detects ahead of the tool point and is able to control the interaction with respect to the flexing tissue, to avoid penetration or to control the extent of protrusion with respect to the position of the tissue. For surgical procedures, where precision is required, the tool offers significant benefit. To interpret the drilling conditions and the conditions leading up to breakthrough at a tissue interface, a sensing scheme is used that discriminates between the variety of conditions posed in the drilling environment. The result is a fully autonomous system, which is able to respond to the tissue type, behaviour, and deflection in real-time. The system is also robust in terms of disturbances encountered in the operating theatre. The device is pragmatic. It is intuitive to use, efficient to set up, and uses standard drill bits. The micro-drill, which has been used to prepare cochleostomies in the theatre, was used to remove the bone tissue leaving the endosteal membrane intact. This has enabled the preservation of sterility and the drilling debris to be removed prior to the insertion of the electrode. It is expected that this technique will promote the preservation of hearing and reduce the possibility of complications. The article describes the device (including simulated drill progress and hardware set-up) and the stages leading up to its use in the theatre. Queen Elizabeth Hospital, Birmingham, UK

Franch-Chillida F, Nibali L, Madden I, Donos N, Brett P. Association between interleukin-6 polymorphisms and periodontitis in Indian non-smokers. J Clin Periodontol 2010; 37: 137–144. doi: 10.1111/j.1600-051X.2009.01501.x. Abstract Aim: Genetic polymorphisms (SNPs) in the interleukin-6 (IL-6) gene have been associated with the presence of periodontitis. The aim of this study was to investigate the association between five SNPs in the IL-6 promoter region and the periodontal status of a rural Indian population. Materials and Methods: Two hundred and fifty-one systemically healthy volunteers were clinically assessed by a single calibrated examiner and divided into: healthy individuals and periodontitis patients based on the European Workshop on Periodontitis definitions and on a recently suggested definition, which takes into account age and clinical attachment levels. Their genomic DNA was analysed blindly using real-time polymerase chain reaction to study IL-6 variants. The association between genetic factors and the presence of periodontitis was assessed by logistic regression. Results: The IL-6−174 GG genotype was associated with periodontitis in non-smokers and older subjects (>45 years old). No statistically significant associations were detected between IL-6 haplotypes and periodontal status, after adjusting for confounders. Conclusions: The IL-6−174 polymorphism showed some evidence of an association with the periodontal status in non-smokers and older subjects in this rural Indian population. This association might be mediated by the effect of IL-6 on inflammatory responses.

Minimal access procedures in surgery offer benefits of reduced patient recovery time and less pain, yet for the surgeon the task is more complex, as both tactile and visual perception of the working site is reduced. In this paper, experimental evidence of the performance of a novel sensing system embedded in an actuated flexible digit element is presented. The digit represents a steerable tip element of devices such as endoscopes and laparoscopes. This solution is able to discriminate types of contact and tissue interaction, and to feed back this information with the shape of the flexible digit. As an alternative to this information, force level, force distribution, and other quantifiable descriptors can also be evaluated. These can be used to aid perception in processes such as navigation and investigation of tissues through palpation. The solution is pragmatic, and by virtue of its efficient mechanical construction and a polymer construction, it offers opportunities for a disposable element with suitability for magnetic resonance imaging (MRI) and other scanning environments. By using only four photonics sensing elements, full perception of tissue contact and the shape of the actuated digit can be described in the feedback of this information. The distributive sensory method applied to the sensory signals relies on the coupled values of the sensory data transients of the four deployed sensing elements to discriminate tissue interaction directly in near real time.

This paper describes an experiment that extends the distributive sensing approach to identify the three-dimensional location of an object in constant motion. Distributive sensing has previously been successful in the identification of size and location of statically placed objects. Here, a novel system is developed to measure balance or sway in patients. The experimental set-up consisted of a pendulum structure positioned on a supported steel plate. Three low-cost deflection sensors were positioned under the plate with the resulting signals used as inputs to a neural network implemented on a field-programmable gate array. The results show that the embedded system can accurately track the pendulum position in real time with a mean tracking error of around 6 per cent in all three dimensions. This evidence indicates that the technique is sufficiently sensitive and could be implemented in a pragmatic configuration for discriminating between balance and sway.

This paper describes an innovative sensing approach allowing capture, discrimination, and classification of transients automatically in gait. A walking platform is described, which offers an alternative design to that of standard force plates with advantages that include mechanical simplicity and less restriction on dimensions. The scope of the work is to investigate as an experiment the sensitivity of the distributive tactile sensing method with the potential to address flexibility on gait assessment, including patient targeting and the extension to a variety of ambulatory applications. Using infrared sensors to measure plate deflection, gait patterns are compared with stored templates using a pattern recognition algorithm. This information is input into a neural network to classify normal and affected walking events, with a classification accuracy of just under 90 per cent achieved. The system developed has potential applications in gait analysis and rehabilitation, whereby it can be used as a tool for early diagnosis of walking disorders or to determine changes between pre- and post-operative gait.

This paper investigates the vibration characteristics of the coupling system of a microscale fluid-loaded rectangular isotropic plate attached to a uniformly distributed mass. Previous literature has, respectively, studied the changes in the plate vibration induced by an acoustic field or by the attached mass loading. This paper investigates the issue of involving these two types of loading simultaneously. Based on Lamb's assumption of the fluid-loaded structure and the Rayleigh–Ritz energy method, this paper presents an analytical solution for the natural frequencies and mode shapes of the coupling system. Numerical results for microplates with different types of boundary conditions have also been obtained and compared with experimental and numerical results from previous literature. The theoretical model and novel analytical solution are of particular interest in the design of microplate-based biosensing devices.

Objective: To produce an autonomous drilling robot capable of performing a bony cochleostomy whilst minimising the damage to the underlying cochlear endosteum. Design: In this laboratory based study, a robotic drill was designed to measure the changes in force and torque experienced by the tool point during the drilling process. This information is used to predict the point of breakthrough and stop the drill prior to damaging the underlying endosteal membrane. Setting: Aston University. Participants: Five porcine cochleas. Main outcomes measures: An assessment was made of whether a successful bony cochleostomy was performed, the integrity of endosteal membrane was then assessed. Results: The autonomous surgical robotic drill successfully performed a bony cochleostomy and stopped without damaging the endosteal membrane in all five cases. Conclusions: The autonomous surgical robotic drill can perform a cochleostomy whilst minimising the trauma to the endosteal membrane. The system allows information about the state of the drilling process to be derived using force and torque data from the tool point. This information can be used to effectively predict drill breakthrough and implement a control strategy to minimise drill penetration beyond the far surface.

Aim: The aim of this analysis was to investigate the relationship between a vitamin D receptor (VDR) polymorphism and the diagnosis and progression of periodontitis. Material and Methods: Data were derived from two different studies, including 231 subjects with healthy periodontium, 224 aggressive periodontitis and 79 chronic periodontitis (CP) patients in a case-control investigation. Sixty-one of these CP patients also took part in an observational study with a 1-year follow-up, in which progression of periodontitis was determined at the subject level. All 534 subjects provided a blood sample from which genomic DNA was extracted to study VDR - 1056 TaqI polymorphism. Results: The interaction between smoking and VDR polymorphism was associated with the diagnosis of periodontitis in Caucasians [p = 0.001, odds ratio (OR) = 1.33, 95% confidence intervals (CI) = 1.12-1.57] and all subjects (p = 0.033, OR = 1.60, 95% CI = 1.04-2.48). In the longitudinal study, subjects were divided into two clusters at 1 year according to the median number of progressing sites (Acumulative attachment loss >2mm). Logistic regression analysis revealed that the interaction between VDR Taq-I polymorphism and smoking showed limited evidence of association with the "severe progression" cluster (p = 0.033, OR = 15.24, 95% CI= 1.24-187.42). Conclusions: Vitamin D receptor Taq-I TT polymorphism was moderately associated with both the presence and the progression of periodontitis in smokers, while no association was detected in non-smoking individuals. VDR genetic factors may interact with smoking in the pathogenesis of periodontitis.

The paper describes the tracking of the location of a moving load with an unknown, harmonically varying magnitude on a plate using the distributive sensing method. This method can lead to surface contact tracking systems of robust and simple mechanical construction. A mathematical identification model that relates the dynamics at strategically chosen sensing positions of the plate to the location of a force moving on a plate has been constructed using the distributive sensing method. This model involves numerical simulation of plate dynamics, genetic algorithms for sensor position optimisation, Karhunen–Loeve decomposition for data dimensionality reduction and neural networks for determining the contact locations of moving loads. Using this method, it is shown that the actual position of forces moving at various speeds can be determined to within 2% error of the value at speeds less than 3.2 m s−1. A technique explored involves a moving window frame of reference. The effects of moving window size and noise tolerance in the model are also investigated in the paper and show that the method is robust. Potential applications of the study are in tracking and identification of moving people, vehicles and other vibrating objects on mediums such as floors, bridges or industrial environments.

Background In this paper we consider two relatively frequently performed operations in the field of ear, nose and throat (ENT) surgery and consider how they could be improved by using robotic applications. We consider currently available robots and propose theoretical robotic solutions. Methods The application of robotic systems for both cochlear implantation and endoscopic sinus surgery was considered. Currently available robotic systems were reviewed and those with potential use in ENT surgery were identified. For aspects of operations where there is no available technology, hypotheses are presented on how robots could help. Results Three robotic systems were identified with potential usage in ENT: the Pathfinder™ neurosurgical robot, the Acrobot® knee replacement system and the autonomous smart drill for drilling a cochleostomy. Conclusions The challenge for the future of ENT is being able to perform tasks beyond the level of human perception and abilities. The examples presented here demonstrate that microtechnologies could be used to reduce complications, decrease operating time and improve clinical results. Copyright © 2007 John Wiley & Sons, Ltd.

The contributions for this book have been gathered over several years from conferences held in the series of Mechatronics and Machine Vision in Practice, the latest of which was held in Ankara, Turkey. The essential aspect is that they concern practical applications rather than the derivation of mere theory, though simulations and visualization are important components. The topics range from mining, with its heavy engineering, to the delicate machining of holes in the human skull or robots for surgery on human flesh. Mobile robots continue to be a hot topic, both from the need for navigation and for the task of stabilization of unmanned aerial vehicles. The swinging of a spray rig is damped, while machine vision is used for the control of heating in an asphalt-laying machine. Manipulators are featured, both for general tasks and in the form of grasping fingers. A robot arm is proposed for adding to the mobility scooter of the elderly. Can EEG signals be a means to control a robot? Can face recognition be achieved in varying illumination?"

A mechatronic surgical micro-drill applied in practice has enabled new techniques for measurement in otology to understand the dynamic response of the cochlea hearing organ. In the interest of reducing trauma and to reinforce preservation of residual hearing during surgery, results point to choices in technique as mechatronic devices offer significantly less disturbance than conventional surgical tools used in cochlear electrode implantation. The cochlea transforms mechanical disturbances induced from incident ambient sound to electrical neuro-signals interpreted in the brain as sound, and is a closed volume of fluids and delicate membranes. The mechatronic drilling technique can expose consistently sized membranes at the base of a hole drilled through the bone tissue shell of the cochlea. The dynamic deflection of membrane windows, in response to fluid pressure transients, enables contrast between intra-cochlear disturbances at different locations within the cochlea, and between normal hearing disturbance amplitude and disturbances induced by surgical processes.

Distributive tactile sensing is a method of tactile sensing in which a small number of sensors monitors the behaviour of a flexible substrate which is in contact with the object being sensed. This paper describes the first use of fibre Bragg grating sensors in such a system. Two systems are presented: the first is a one-dimensional metal strip with an array of four sensors, which is capable of detecting the magnitude and position of a contacting load. This system is favourably compared experimentally with a similar system using resistive strain gauges. The second system is a two-dimensional steel plate with nine sensors which is able to distinguish the position and shape of a contacting load, or the positions of two loads simultaneously. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact. Issues and limitations of the systems are discussed, along with proposed solutions to some of the difficulties.

This paper surveys the strategies adopted in England to support the development of teachers’ subject knowledge and confidence in relation to teaching Citizenship, which was introduced as a new statutory subject in the National Curriculum in 2002. It reviews examples of good practice and explores how a continuing professional development (CPD) strategy developed at several levels to support teachers and curriculum managers. It outlines the challenges and obstacles in relation to implementing effective Citizenship education in schools. It also underlines the fundamental importance of Citizenship education if young people are to understand and engage with contemporary events in the early Twenty First Century.

In this paper a surgical robotic system is described for microdrilling a stapedotomy. The stapedotomy procedure is a delicate operation that is challenging to achieve successfully owing to the fact that, under manual control, the surgeon is working at the thresholds of human perception and dexterity. The automated drilling system described in this paper is sensory guided along a single tool axis. Information on the state of the drilling process is derived from feed force and torque sensory data with respect to time and displacement. The information on the state of the process is used to select the strategy to move the drill bit along its trajectory in order to achieve a minimum level of protrusion of the drill bit beyond the far surface of the stapes footplate. The drilling system is able automatically to determine the unknowns of tissue thickness, hardness and flexibility. Detection of the onset of breakthrough, key to establishing the thickness, is by identification of features in the multiple sensory data that signify this condition. The system demonstrates acceptable performance in the laboratory with positional errors with respect to flexible target positions of approximately 20 μm.

Titanium (Ti) and Ti alloys are widely used as dental and orthopedic implants, but the effects of the surface characteristics of these materials, including roughness, on the response of target tissues in vivo are not well understood. The present study has therefore examined the effects of a moderately rough (sand-blasted, acid-etched; SLA) Ti surface, a highly rough (plasma-sprayed; TPS) surface, and a smooth surface (SMO) on bone cells in vitro. X-ray photoelectron spectroscopy showed that these surfaces had similar surface chemistry, while scanning electron microscopy suggested that the SLA provided a transiently less biocompatible surface, with initially less well-attached cells. SLA also delayed bone cell growth compared with SMO, whereas the TPS surface elicited the greatest increase in cell numbers. In addition, expression profiling using the ATLAS™ gene array showed marked differences in gene responses after 3 h of incubation; this increased further after 24 h, with TPS generating the largest number of up- and down-regulated genes compared with SLA and SMO. A number of osteoblast genes were also identified as ‘roughness’ genes on the basis of their similar response on SLA and TPS, compared with SMO. These findings show, for the first time, that the surface roughness of Ti has a profound effect on the profile of genes expressed by bone cells and suggest that improvements in the biological activity and possibly the clinical efficacy of these materials could be achieved by selective regulation of gene expression mediated via modification of surface roughness.

This paper describes research on measurement of tactile sense using a flexible digit appropriate to endoscopy and minimal access surgery. It is envisaged that the sensing method will facilitate the navigation of flexible invasive devices, such as endoscopes, and also aid diagnosis using tactile perception as well as visual observation. The proposed master-slave digit system incorporates the application of the distributive sensing method applied to tactile sensing in order to discriminate different contact conditions of the flexible digit. The paper concentrates on the description of the application of this method and places this in the context of the user and the integrated system. The approach to sensing is able to discriminate the position, magnitude, distributed profile and width of the applied contacting load by using only four sensing points. Values to describe these parameters are evaluated to an accuracy greater than 93 per cent.

We have previously reported that loss-of-function mutations in the cathepsin C gene (CTSC) result in Papillon Lefevre syndrome, an autosomal recessive condition characterized by palmoplantar keratosis and early,onset, severe periodontitis. Others have also reported CTSC mutations in patients with severe prepubertal periodontitis, but without any skin manifestations. The possible role of CTSC variants in more common types of non-mendelian, early-onset, severe periodontitis ("aggressive periodontitis") has not been investigated. In this study, we have investigated the role of CTSC in all three conditions. We demonstrate that PLS is genetically homogeneous and the mutation spectrum that includes three novel mutations (c.386T>A/p. V129E, c.935A>G/p.Q312R, and c.1235A>G/p.Y412C) in 21 PLS families (including eight from our previous study) provides an insight into structure-function relationships of CTSC. Our data also suggest that a complete loss-of-function appears to be necessary for the manifestation of the phenotype, making it unlikely that weak CTSC mutations are a cause of aggressive periodontitis. This was confirmed by analyses of the CTSC activity in 30 subjects with aggressive periodontitis and age-sex matched controls, which demonstrated that there was no significant difference between these two groups (1,728.7 +/- SD 576.8 mu moles/mg/min vs. 1,678.7 +/- SD 527.2 mu moles/mg/min, respectively, p = 0.73). CTSC mutations were detected in only one of two families with prepubertal periodontitis; these did not form a separate functional class with respect to those observed in classical PLS. The affected individuals in the other prepubertal periodontitis family not only lacked CTSC mutations, but in addition did not share the haplotypes at the CTSC locus. These data suggest that prepubertal periodontitis is a genetically heterogeneous disease that, in some families, just represents a partially penetrant PLS. (C) 2004 Wiley-Liss, Inc.

Severe periodontitis is associated with elevated inflammatory markers in otherwise healthy populations. However, the nature of this association has not been determined. Our aim was to assess whether the degree of response to periodontal therapy was associated with changes in serological markers of systemic inflammation. Ninety-four systemically healthy subjects with severe generalized periodontitis participated in a prospective six-month blind intervention trial. Periodontal parameters and inflammatory markers [C-reactive Protein (CRP) and Interleukin-6 (IL-6)] were evaluated prior to and 2 and 6 mos after delivery of standard non-surgical periodontal therapy. Six months after treatment, significant reductions in serum IL-6 (p < 0.001, median decrease 0.2 ng/L, 95% CI 0.1–0.4 ng/L) and CRP (p < 0.0001, median decrease 0.5 mg/L, 95% CI 0.4–0.7) were observed. Decreases in inflammatory markers were significant in subjects with above average clinical response to periodontal therapy after correction for possible confounders. Periodontitis may add to the systemic inflammatory burden of affected individuals.

The distributive approach to tactile sensing is a novel approach. The method relies on the distributed deformation of the surface in response to the applied load to a few sensing points within the surface area. The description of the contacting load is then interpreted into meaningful descriptors typically by using a neural network or fuzzy rules. The method has been shown to interpret descriptors such as load position, load value and load width and relies on strong coupling between the sensory data retrieved. This opposes the design aims in many alternative tactile sensing systems that formulate load description from isolated discrete data detected over an array of sensing elements, or that delineate force descriptions through a structure that minimises coupling on Cartesian axes. For distributive tactile sensors, the performance can be optimised through placement of sensing points such that the obtained information is optimal. This paper examines the effect on performance of sensor location points on an experimental one-dimensional surface designed for this purpose. The algorithm interpreting load descriptors was a back-propagation neural network. The critical parameter of sensor location is optimised using the genetic algorithm (GA) and principal component analysis (PCA) approach. It is shown that when an optimised configuration is used load position can be predicted to within 5% of the full range by using as few as two sensing elements, and that performance is improved by using additional sensor points. The results of this study are a basis for selecting sensor locations to achieve high performance with planar one- and two-dimensional distributive tactile surfaces.

Several studies have examined the role of enamel matrix proteins in root formation and periodontal regeneration, although most of these have focused on a few specific genes which had previously been implicated. However, recent advances in expressional profiling have made it possible to examine the range of genetic responses involved in these processes. In the present experiments, we have therefore utilized this technique to determine the effects of enamel matrix proteins on the gene activities of periodontal ligament cells in vitro. Such cells were found to have an elevated level of RNA synthesis compared with control cells. Moreover, hybridization of the cDNA prepared from this RNA to gene array filters showed that there was differential expression of 121 genes, most of which had not previously been associated with periodontal regeneration. Some of these selective changes in gene activity might thus reflect the fundamental events that underlie periodontal development.

The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design.

This article explores the intersections between museum learning – in a distinctive Tasmanian setting, the possibilities of a new national History curriculum, and the evolving views and professional practices of pre-service primary teachers at one Australian university. Following a brief overview of the framework for local and Australian history that is embedded in the ACH, the relevant literature around museum education, and the specific museum context, the article draws upon a survey of second year pre-service primary teachers’ views towards history, museums, and a pedagogical planning task and analyses features of students’ work. It concludes with some wider reflections on the value of teacher education engaging in community partnerships with cultural institutions such as museums.

Titanium (Ti) implants with micro-rough topography and high surface free energy promote osseointegration, which in vitro analyses suggest is due to a novel enhancement in cellular osteogenic differentiation and function. The AXL receptor tyrosine kinase (AXL) is expressed on mesenchymal stromal cells (MSCs) and is implicated with its ligand, Growth arrest-specific 6 (GAS6), in the negative regulation of osteogenic differentiation, and may be modulated in the enhanced osteogenic differentiation of MSCs on modified Ti surfaces. This hypothesis was tested by culturing human MSCs on tissue culture plastic (TCP), polished (P), micro-rough-hydrophobic (SLA) and micro-rough hydrophilic (modSLA) Ti surfaces for seven days. Total RNA and protein levels of AXL and GAS6 were examined by real time PCR and ELISA, respectively. The effects of deregulating the signalling pathway in hMSCs with either receptor agonist or antagonist were investigated by analysing calcium mineralisation and soluble osteoblastic marker synthesis. The MSCs were found to significantly down-regulate AXL and GAS6 earlier on rough surfaces compared to smooth over seven days. Addition of the receptor agonist caused a relative decrease in calcium mineralisation that was most marked for TCP compared to any Ti surface. The antagonist did not affect mineralisation but caused a relative increase in osteoblastic soluble protein levels on rough surfaces only. Gene expression data showed an up-regulation of RUNX2 and beta-catenin with the receptor antagonist. These findings suggest that a down-regulation of AXL correlates with increased cellular mineralisation on the modified surfaces and that it might be a putative biomarker for assessing the clinical efficacy of endosseous implants.

During cochlear implantation, hearing preservation is a concern. Minimizing disturbances to the cochlea and protection of the underlying endosteal membrane during the formation of a cochleostomy are considered important factors. The robotic micro-drill system tested in this article is the first example of an autonomous surgical drill successfully producing a cochleostomy, which keeps the underlying endosteal membrane intact. This study compares induced disturbances within the cochlea during formation of cochleostomy using the robotic micro-drill with that of conventional manual drilling. The disturbance of the endosteal membrane is measured using a Microscope Scanning Vibrometer at a third window, produced in the cochlea. Results show that the highest velocity amplitude measured was associated with manual drilling technique. The robotic micro-drill technique produced only about 1% of the peak velocity amplitude seen in manual drilling and exhibited much more uniform behaviour, while keeping the underlying membrane intact. The technique applied when using the robotic drill could be a major step in reducing the trauma to the cochlea, by reducing disturbance levels.