Robotic-assisted navigation system for preoperative lung nodule localization: a pilot study.

Background: Preoperative percutaneous computed tomography (CT)-guided localization of pulmonary nodules plays a pivotal role in the diagnosis and treatment of early-stage lung cancer. However, conventional manual localization techniques have inherent limitations in achieving a high degree of accuracy. Consequently, a novel robotic-assisted navigation system was developed to attain precise localization of small lung nodules. This study aims to investigate the accuracy and safety of this system in clinical applications. Methods: Patients with peripheral solitary pulmonary nodules measuring less than 20 mm were enrolled. The robotic-assisted navigation system generated a three-dimensional (3D) model based on the patient's CT images, determining the optimal puncture path. The robotic arm then accurately located the nodule and, following percutaneous puncture, indocyanine green (ICG) was injected. The primary outcome measure was the accuracy of pulmonary nodule localization, while secondary outcomes included the complication rate, procedural duration, and total radiation exposure. Results: A total of 33 nodules were successfully localized using the robotic-assisted navigation system and resected through video-assisted thoracoscopic surgery (VATS). The first-pass success rate was 100%, with a median deviation of 6.1 mm [interquartile range (IQR), 2.5-7.2 mm] between the localizer and the nodule. The median localization time was 25.0 minutes, and the single and cumulative exam dose-length products (DLP) were 534.0 and 1491.0 mGy·cm, respectively. Notably, no observable complications were reported during the procedures. Conclusions: The innovative robotic-assisted navigation system demonstrated satisfactory accuracy and holds promise for improving the percutaneous localization of lung nodules. This method represents a safe and viable alternative to traditional CT-guided manual localization techniques.

Robot-assisted navigation for percutaneous localization of peripheral pulmonary nodule: an in vivo swine study.

Background: Robot-assisted surgery (RAS) systems have been developed but rarely applied to lung nodule localization. This study aimed to assess the feasibility and safety of using a robot-assisted navigation system in percutaneous lung nodule localization. Methods: A computed tomography (CT)-guided robot-assisted navigation system was used to localize the simulated peripheral nodule in the swine lung through fluorescent agent injection. After the localization, fluorescent thoracoscopic wedge resection was performed. The deviation between the target point and the needle tip was measured using a professional 3-dimensional (3D) distance measurement software. The primary outcome was the localization accuracy (deviation) of the localization. The secondary outcomes were the localization-related complication rate, the localization duration, and the success rate. Results: A total of 4 pigs were enrolled, and 20 peripheral lung nodules were created and localized successfully. All nodules underwent subsequent wedge resection for verification. The mean deviation by measuring the 3D distance was 3.81 mm [standard deviation (SD): 1.29 mm, 95% confidence interval (CI): 2.936-4.536 mm]. The technical success rate for localization was 100%, and the mean localization time was 14.69 minutes (SD: 4.67 minutes). The complication rate was 5% (1/20), with 1 pneumothorax after localization, and no mortality occurred. Conclusions: This pilot animal study demonstrated the promising potential of the robot-assisted navigation technique in peripheral lung nodule localization, with high accuracy and feasibility. Further clinical trials are needed to validate its safety compared to traditional manual localization.

Harnessing the Genetic Basis of Sorghum Biomass-Related Traits to Facilitate Bioenergy Applications.

The extensive use of fossil fuels and global climate change have raised ever-increasing attention to sustainable development, global food security and the replacement of fossil fuels by renewable energy. Several C4 monocot grasses have excellent photosynthetic ability, stress tolerance and may rapidly produce biomass in marginal lands with low agronomic inputs, thus representing an important source of bioenergy. Among these grasses, Sorghum bicolor has been recognized as not only a promising bioenergy crop but also a research model due to its diploidy, simple genome, genetic diversity and clear orthologous relationship with other grass genomes, allowing sorghum research to be easily translated to other grasses. Although sorghum molecular genetic studies have lagged far behind those of major crops (e.g., rice and maize), recent advances have been made in a number of biomass-related traits to dissect the genetic loci and candidate genes, and to discover the functions of key genes. However, molecular and/or targeted breeding toward biomass-related traits in sorghum have not fully benefited from these pieces of genetic knowledge. Thus, to facilitate the breeding and bioenergy applications of sorghum, this perspective summarizes the bioenergy applications of different types of sorghum and outlines the genetic control of the biomass-related traits, ranging from flowering/maturity, plant height, internode morphological traits and metabolic compositions. In particular, we describe the dynamic changes of carbohydrate metabolism in sorghum internodes and highlight the molecular regulators involved in the different stages of internode carbohydrate metabolism, which affects the bioenergy utilization of sorghum biomass. We argue the way forward is to further enhance our understanding of the genetic mechanisms of these biomass-related traits with new technologies, which will lead to future directions toward tailored designing sorghum biomass traits suitable for different bioenergy applications.

Effect of Torrefaction on the Physiochemical Characteristics and Pyrolysis of the Corn Stalk.

Torrefaction of biomass is one of the most promising pretreatment methods for deriving biofuels from biomass via thermochemical conversion processes. In this work, the changes in physicochemical properties and morphology features of the torrefied corn stalk, the changes in physicochemical properties and morphology features of the torrefied corn stalk were investigated. The results of this study showed that the elemental content and proximate analysis of the torrefied corn stalk significantly changed compared with those of the raw corn stalk. In particular, at 300 °C, the volatile content decreased to 41.79%, while the fixed carbon content and higher heating value increased to 42.22% and 21.31 MJ/kg, respectively. The H/C and O/C molar ratios of torrefied corn stalk at the 300 °C were drastically reduced to 0.99 and 0.27, respectively, which are similar to those of conventional coals in China. Numerous cracks and pores were observed in the sample surface of torrefied corn stalk at the torrefaction temperature range of 275 °C-300 °C, which could facilitate the potential application of the sample in the adsorption process and promote the release of gas products in pyrolysis. In the pyrolysis phase, the liquid products of the torrefied corn stalk decreased, but the H2/CO ratio and the lower heating value of the torrefied corn stalk increased compared with those of the raw corn stalk. This work paves a new strategy for the investigation of the effect of torrefaction on the physiochemical characteristics and pyrolysis of the corn stalk, highlighting the application potential in the conversion of biomass.

Using high-diffraction-efficiency holographic optical elements in a full-color augmented reality display system.

Holographic optical elements (HOEs) play an important role in augmented reality (AR) systems. However, the fabrication of full-color HOEs is difficult and the diffraction efficiency is low. In this paper, we use the time-scheduled iterative exposure method to fabricate full-color HOEs with high diffraction efficiency. Through this method, a full-color HOE with an average diffraction efficiency of 73.4% was implemented in a single photopolymer, the highest rate yet reported. In addition, the AR system is simulated by the geometric optics method combining k-vector circle and ray tracing and structured by combining laser micro-drop and high diffraction efficiency HOEs. A good color blending effect was achieved in a full-color AR system by using the reconstruction wavelength consistent with the recording light. It can present clear holographic images in a full-color AR display system.

Isovanillic acid protects mice against Staphylococcus aureus by targeting vWbp and Coa.

Aim: Our primary objective was to investigate the protective effects and mechanisms of isovanillic acid in mice infected with Staphylococcus aureus Newman. Methods: In vitro coagulation assays were used to validate vWbp and Coa as inhibitory targets of isovanillic acid. The binding mechanism of isovanillic acid to vWbp and Coa was investigated using molecular docking and point mutagenesis. Importantly, a lethal pneumonia mouse model was used to assess the effect of isovanillic acid on survival and pathological injury in mice. Results & Conclusion: Isovanillic acid reduced the virulence of S. aureus by directly binding to inhibit the clotting activity of vWbp and Coa, thereby reducing lung histopathological damage and improving the survival rate in mice with pneumonia.

Overexpression of lncRNA77580 Regulates Drought and Salinity Stress Responses in Soybean.

Emerging evidence indicates that long non-coding RNAs (lncRNAs) play important roles in diverse biological processes. However, the biological functions of most plant lncRNAs are still unknown. We previously discovered a soybean abiotic-stress-related lncRNA, lncRNA77580, and cloned the entire full-length sequence. Here, in order to fully identify the function of lncRNA77580 in soybean stress response, we created transgenic soybean lines overexpressing lncRNA77580. Compared with the wild type, overexpression of lncRNA77580 enhances the drought tolerance of soybean. However, the transgenic plants exhibit increased sensitivity to high salinity at the seedling stage. We found that lncRNA77580 modulates the transcription of different gene sets during salt and drought stress response. Under water deficit at the reproductive stage, lncRNA77580 overexpression increases the seed yield by increasing the seed number per plant. These results provide insight into the role of lncRNA77580 in soybean stress response.

Robot-Assisted Needle Insertion for CT-Guided Puncture: Experimental Study with a Phantom and Animals.

PURPOSE: This study aimed to evaluate the accuracy and safety of robotic CT-guided needle insertion in phantom and animal experiments. MATERIALS AND METHODS: A robotic system was developed for CT-guided needle insertion. For the phantom experiment, a specially made phantom containing multiple spherical was used. 15 robotic and manual insertions were conducted, and the accuracy, time, number of needle insertions, and radiation dose were compared between the robotic and manual insertion using Student's t-test. For the animal experiment, 20 robotic needle insertions were attempted toward simulated pulmonary nodules in the swine lung. The accuracy and safety of robotic CT-guided needle insertions were evaluated. RESULTS: In the phantom experiment, the mean accuracies of manual and robotic insertion were 1.8 ± 0.3 mm and 1.9 ± 0.2 mm. The accuracy of robotic needle insertion had no significant difference with manual needle insertion, but the number of needle insertions and radiation dose of the robotic needle placement significantly decreased compared to manual needle placement. In the animal experiment, the mean accuracy of the robotic needle insertion was 3.8 ± 1.3 mm. The time for the whole needle insertion was 14.4 ± 4.8 min. The whole robotic needle insertions were safe and only one mild pneumothorax occurred. CONCLUSION: CT-guided robotic needle insertion showed accuracy comparable to manual needle insertion, but the number of needle insertions, confirmatory scans, and radiation exposure had been reduced significantly. In future, we will further apply the robotic system to clinical experiments.

7,8-Dihydroxyflavone attenuates the virulence of Staphylococcus aureus by inhibiting alpha-hemolysin.

Staphylococcus aureus (S. aureus), a Gram-positive bacteria, is an incurable cause of hospital and community-acquired infections. Inhibition bacterial virulence is a viable strategy against S. aureus infections based on the multiple virulence factors secreted by S. aureus. Alpha-hemolysin (Hla) plays a crucial role in bacteria virulence without affecting bacterial viability. Here, we identified that 7,8-Dihydroxyflavone (7,8-DHF), a natural compound, was able to decrease the expression of and did not affect the in vitro growth of S. aureus USA300 at a concentration of 32 µg/mL. It was verified by western blot and RT-qPCR that the natural compound could inhibit the transcription and translation of Hla. Further mechanism studies revealed that 7,8-DHF has a negative effect on transcriptional regulator agrA and RNAIII, preventing the upregulation of virulence gene. Cytotoxicity assays showed that 7,8-DHF did not produce significant cytotoxicity to A549 cells. Animal experiments showed that the combination of 7,8-DHF and vancomycin had a more significant therapeutic effect on S. aureus infection, reflecting the synergistic effect of 7,8-DHF with antibiotics. In conclusion, 7,8-DHF was able to target Hla to protect host cells from hemolysis while limiting the development of bacterial resistance.

Working Pose and Layout Optimization of surgical robot.

It is quite a challenge on positioning surgical robot to optimal place in a crowded and special environment. Compared with the structured industrial environment, the unstructured operating room (OR) environment brings higher requirements for safety of the surgical robot. Meanwhile, the efficiency has significant impact on the ease of surgical robot and repositioning requires additional time and labor. This paper introduces a new method of pose and layout planning to deal with the problem of interaction between robot and environment in operating room. The optimal layout and working pose planning of robot in OR environment are accomplished through APF calculation, pose traversal and layout traversal. The feasibility of this method is validated in simulated OR environment.

A tendon-driven prosthetic hand using continuum structure.

In the current research of prosthetic hands, many degrees of freedom have been omitted in order to simplify the design and reduce the weight, such as the abduction degrees of freedom of the four fingers except the thumb, which impairs the range of mobility of the prosthetic hand to some extent. This paper presents TN hand, a 3D printed, tendon-driven prosthetic hand. We use continuum structure as the finger joint. The other four fingers except the middle finger can perform flexion/extension and abduction/adduction movements, which benefits hand mobility. The design and manufacture of the fingers were elaborated and the finger stiffness was tested through experiment. Then the ability of manipulating daily objects of TN hand was verified based on hand taxonomy. In addition, there is enough range of mobility for the TN hand to perform column chords due to the ability to abduct fingers.

Influence of multi-angle input of intraoperative fluoroscopic images on the spatial positioning accuracy of the C-arm calibration-based algorithm of a CAOS system.

Intraoperative fluoroscopic images, as one of the most important input data for computer-assisted orthopedic surgery (CAOS) systems, have a significant influence on the positioning accuracy of CAOS system. In this study, we proposed to use multi-angle intraoperative fluoroscopy images as input based on real clinical scenario, and the aim was to analyze the positioning accuracy and the error propagation rules with multi-angle input images compared with traditional two input images. In the experiment, the positioning accuracy of the C-arm calibration-based algorithm was studied, respectively, using two, three, four, five, and six intraoperative fluoroscopic images as input data. Moreover, the error propagation rules of the positioning error were analyzed by the Monte Carlo method. The experiment result showed that increasing the number of multi-angle input fluoroscopic images could reduce the positioning error of CAOS system, which has dropped from 1.01 to 0.61 mm. The Monte Carlo simulation analysis showed that for random input errors subject to normal distribution (µ = 0, σ = 1), the image positioning error dropped from 0.29 to 0.23 mm, and the staff gauge positioning error dropped from 1.36 to 1.19 mm, while the tracking device positioning error dropped from 3.41 to 2.13 mm. In addition, the results showed that image positioning error and staff gauge positioning error were all nonlinear error for the whole system, but tracker device positioning error was a strictly linear error. In conclusion, using multi-angle fluoroscopy images was helpful for clinic, which could improve the positioning accuracy of the CAOS system by nearly 30%. Graphical abstract The experiment process and Monte Carlo analysis of spatial positioning accuracy (A: Setup for the experiment; B: The process of Monte Carlo analysis; C: Results).

Intraoperative localization of small pulmonary nodules to assist surgical resection: A novel approach using a surgical navigation puncture robot system.

BACKGROUND: Localization and resection of nonvisible, nonpalpable pulmonary nodules during video-assisted thoracoscopic surgery is challenging. In this study we developed a surgical navigation puncture robot system in order to locate small pulmonary nodules before thoracoscopic surgery. METHODS: Four pigs were divided into group A and group B and underwent positioning puncture with the aid of the robotic system. The pigs in group A breathed freely during the experiment, whilst mechanical ventilation was used on the pigs in group B. RESULTS: Using the robotic system to locate nodules achieved good results. For group A, a total of nine simulated nodules were created and successfully localized. The mean positioning accuracy was 9.6 ± 4.9 mm (range, 3.2-17.4 mm), and the time required for system positioning was 7.1 ± 1.0 minutes (range, 5.6-8.2 minutes). For group B, a total of 23 simulated nodules were created and successfully localized. The mean positioning accuracy was 2.9 ± 1.5 mm (range, 0.7-5.9 mm), and the time required for system positioning was 7.8 ± 1.1 minutes (range, 6.3-9.7 minutes). CONCLUSIONS: The new method using a surgical navigation puncture robot system to locate small pulmonary nodules is feasible and safe, and its positioning accuracy is sufficient to meet clinical requirements. In addition, results indicated that breathing had a great influence on the positioning accuracy, mainly in the longitudinal direction. Our surgical navigation puncture robot system has wide future applications for accurately locating small pulmonary nodules in a clinical setting. KEY POINTS: Significant findings of the study: A new method using a surgical navigation puncture robot system was developed to locate small pulmonary nodules before thoracoscopic surgery. The results indicated that this method can provide accurate localization and permit smaller and more precise resections. WHAT THIS STUDY ADDS: A surgical navigation puncture robot system has wide future applications for accurately locating small pulmonary nodules in a clinical setting.

Influence of the quality of intraoperative fluoroscopic images on the spatial positioning accuracy of a CAOS system.

BACKGROUND: Spatial positioning accuracy is a key issue in a computer-assisted orthopaedic surgery (CAOS) system. Since intraoperative fluoroscopic images are one of the most important input data to the CAOS system, the quality of these images should have a significant influence on the accuracy of the CAOS system. But the regularities and mechanism of the influence of the quality of intraoperative images on the accuracy of a CAOS system have yet to be studied. METHODS: Two typical spatial positioning methods - a C-arm calibration-based method and a bi-planar positioning method - are used to study the influence of different image quality parameters, such as resolution, distortion, contrast and signal-to-noise ratio, on positioning accuracy. The error propagation rules of image error in different spatial positioning methods are analyzed by the Monte Carlo method. RESULTS: Correlation analysis showed that resolution and distortion had a significant influence on spatial positioning accuracy. In addition the C-arm calibration-based method was more sensitive to image distortion, while the bi-planar positioning method was more susceptible to image resolution. The image contrast and signal-to-noise ratio have no significant influence on the spatial positioning accuracy. The result of Monte Carlo analysis proved that generally the bi-planar positioning method was more sensitive to image quality than the C-arm calibration-based method. CONCLUSIONS: The quality of intraoperative fluoroscopic images is a key issue in the spatial positioning accuracy of a CAOS system. Although the 2 typical positioning methods have very similar mathematical principles, they showed different sensitivities to different image quality parameters. The result of this research may help to create a realistic standard for intraoperative fluoroscopic images for CAOS systems.

The development and error analysis of a kinematic parameters based spatial positioning method for an orthopedic navigation robot system.

BACKGROUND: Spatial positioning is the key function of a surgical navigation robot system, and accuracy is the most important performance index of such a system. METHODS: The kinematic parameters of a six degrees of freedom (DOF) robot arm were used to form the transformation from intraoperative fluoroscopy images to a robot's coordinate system without C-arm calibration and to solve the redundant DOF problem. The influences of three typical error sources and their combination on the final navigation error were investigated through Monte Carlo simulation. RESULTS: The navigation error of the proposed method is less than 0.6 mm, and the feasibility was verified through cadaver experiments. Error analysis suggests that the robot kinematic error has a linear relationship with final navigation error, while the image error and gauge error have nonlinear influences. CONCLUSIONS: This kinematic parameters based method can provide accurate and convenient navigation for orthopedic surgeries. The result of error analysis will help error design and assignment for surgical robots.

Effects of femtosecond laser pulse width on the formation of microstructured silicon.

We experimentally investigated the properties of surface microstructured silicon fabricated by 15 and 130 fs laser pulses. By changing parameters of femtosecond laser pulses, including laser flux, actual pulse acting time, and laser peak intensity, we found that the average height of spikes on the surface of microstructured silicon are only determined by the laser peak intensity. These results are important for the preparation and structure control of microstructured silicon.

[The author of Yi ding jie (Stepping to the Peak of Medicine) and its characteristics].

Yi ding jie (Stepping to the Peak of Medicine) was written by Huang Yuanying, a Hakka physician of Changting, Fujian at the turn of the Qing Dynasty and Republican period. Being a successful candidate of the imperial exam at the provincial level in the 20th year of Guangxu reign (1894) of the Qing Dynasty, he still practise as a physician. He had been a teacher of the Jiangxi Provincial Medical School and a supervisor of the Tingjun Middle School. He was conversant with the use of classical prescriptions, paid high attention to pulse taking. His work Yi ding jie is now collected in the Museum of Hakka Family Tree in Shanghang County, which was written in the form of traditional Chinese chapters of novel, bearing many case records, elaborating medical theory, reflecting from an aspect the medical level of Hakka medicine of that time, enlightening the inheritance of traditional Chinese medicine and its spreading for modern people.