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1.
EJNMMI Res ; 13(1): 103, 2023 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-38019303

RESUMEN

BACKGROUND: Metabolic imaging is routinely used to demonstrate aortitis in patients with giant-cell arteritis. We aimed to investigate the preclinical model of aortitis in BALB/c IL1rn-/- mice using [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography-magnetic resonance (PET-MR), gamma counting and immunostaining. We used 15 first-generation specific and opportunistic pathogen-free (SOPF) 9-week-old IL1rn-/- mice, 15 wild-type BALB/cAnN mice and 5 s-generation specific pathogen-free (SPF) 9-week-old IL1rn-/-. Aortic [18F]FDG uptake was assessed as the target-to-background ratio (TBR) using time-of-flight MR angiography as vascular landmarks. RESULTS: [18F]FDG uptake measured by PET or gamma counting was similar in the first-generation SOPF IL1rn-/- mice and the wild-type group (p > 0.05). However, the first-generation IL1rn-/- mice exhibited more interleukin-1ß (p = 0.021)- and interleukin-6 (p = 0.019)-positive cells within the abdominal aorta than the wild-type mice. In addition, the second-generation SPF group exhibited significantly higher TBR (p = 0.0068) than the wild-type mice on the descending thoracic aorta, unlike the first-generation SOPF IL1rn-/- mice. CONCLUSIONS: In addition to the involvement of interleukin-1ß and -6 in IL1rn-/- mouse aortitis, this study seems to validate [18F]FDG PET-MR as a useful tool for noninvasive monitoring of aortitis in this preclinical model.

2.
Commun Biol ; 6(1): 979, 2023 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-37749272

RESUMEN

Sex-specific differences in habitat selection and space use are common in ungulates. Yet, it is largely unknown how this behavioral dimorphism, ultimately leading to sexual segregation, translates to population-level patterns and density gradients across landscapes. Alpine chamois (Rupicapra rupicapra r.) predominantly occupy habitat above tree line, yet especially males may also take advantage of forested habitats. To estimate male and female chamois density and determinants thereof, we applied Bayesian spatial capture-recapture (SCR) models in two contrasting study areas in the Alps, Germany, during autumn. We fitted SCR models to non-invasive individual encounter data derived from genotyped feces. Sex-specific densities were modeled as a function of terrain ruggedness, forest canopy cover, proportion of barren ground, and site severity. We detected pronounced differences in male and female density patterns, driven primarily by terrain ruggedness, rather than by sex-specific effects of canopy cover. The positive effect of ruggedness on density was weaker for males which translated into a higher proportion of males occupying less variable terrain, frequently located in forests, compared to females. By estimating sex-specific variation in both detection probabilities and density, we were able to quantify and map how individual behavioral differences scale up and shape spatial patterns in population density.


Asunto(s)
Rupicapra , Animales , Masculino , Femenino , Teorema de Bayes , Genotipo , Caracteres Sexuales , Alemania
3.
Sci Robot ; 8(82): eadg6042, 2023 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-37729423

RESUMEN

A major advantage of surgical robots is that they can reduce the invasiveness of a procedure by enabling the clinician to manipulate tools as they would in open surgery but through small incisions in the body. Neurosurgery has yet to benefit from this advantage. Although clinical robots are available for the least invasive neurosurgical procedures, such as guiding electrode insertion, the most invasive brain surgeries, such as tumor resection, are still performed as open manual procedures. To investigate whether robotics could reduce the invasiveness of major brain surgeries while still providing the manipulation capabilities of open surgery, we created a two-armed joystick-controlled endoscopic robot. To evaluate the efficacy of this robot, we developed a set of neurosurgical skill tasks patterned after the steps of brain tumor resection. We also created a patient-derived brain model for pineal tumors, which are located in the center of the brain and are normally removed by open surgery. In comparison, testing with existing manual endoscopic instrumentation, we found that the robot provided access to a much larger working volume at the trocar tip and enabled bimanual tasks without compression of brain tissue adjacent to the trocar. Furthermore, many tasks could be completed faster with the robot. These results suggest that robotics has the potential to substantially reduce the invasiveness of brain surgery by enabling certain procedures currently performed as open surgery to be converted to endoscopic interventions.


Asunto(s)
Robótica , Humanos , Neurocirujanos , Extremidad Superior , Mano , Endoscopios
5.
Conserv Biol ; 37(6): e14132, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37259636

RESUMEN

The wolf (Canis lupus) is among the most controversial of wildlife species. Abundance estimates are required to inform public debate and policy decisions, but obtaining them at biologically relevant scales is challenging. We developed a system for comprehensive population estimation across the Italian alpine region (100,000 km2 ), involving 1513 trained operators representing 160 institutions. This extensive network allowed for coordinated genetic sample collection and landscape-level spatial capture-recapture analyses that transcended administrative boundaries to produce the first estimates of key parameters for wolf population status assessment. Wolf abundance was estimated at 952 individuals (95% credible interval 816-1120) and 135 reproductive units (i.e., packs) (95% credible interval 112-165). We also estimated that mature individuals accounted for 33-45% of the entire population. The monitoring effort was spatially estimated thereby overcoming an important limitation of citizen science data. This is an important approach for promoting wolf-human coexistence based on wolf abundance monitoring and an endorsement of large-scale harmonized conservation practices.


Una estrategia multidisciplinaria para la estimación del tamaño poblacional de los lobos para la conservación a largo plazo Resumen El lobo (Canis lupus) está entre las especies de fauna más controversiales. Se requieren estimaciones de abundancia para informar al debate público y las decisiones políticas, pero es un reto obtenerlos en escalas con relevancia biológica. Desarrollamos un sistema para la estimación completa de la población en la región alpina de Italia (100,000 km2 ), con la participación de 1,513 operadores entrenados que representan a 160 instituciones. Esta red extensa permitió una colecta coordinada de muestras genéticas y análisis de captura-recaptura espacial que trascendieron las fronteras administrativas para así producir las primeras estimaciones de los parámetros clave para la evaluación del estado de la población de los lobos. Se estimó la abundancia en 952 individuos (95% intervalo de confianza 816-1120) y 135 unidades reproductivas (es decir, manadas) (95% intervalo de confianza 112-165). También estimamos que los individuos maduros representaban el 33-45% de toda la población. El esfuerzo de monitoreo se estimó espacialmente, por lo que sobrepasó una limitación importante de la ciencia ciudadana. Esta estrategia es importante para promover la coexistencia entre lobos y humanos con base en el monitoreo de la abundancia y el apoyo a las prácticas armonizadas de conservación a gran escala.


Asunto(s)
Lobos , Animales , Humanos , Lobos/genética , Conservación de los Recursos Naturales , Densidad de Población , Animales Salvajes
6.
Microorganisms ; 11(5)2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37317135

RESUMEN

(1) Background: This paper discusses the impact of agricultural activities on stream health, particularly in relation to dairy cow fecal pollution. The study explores the fecal microbiome of cattle and the potential ecological implications of aging fecal pollution on waterways. (2) Methods: The study examines changes in the bacterial community available for mobilization from in-situ decomposing cowpats and the effects of simulated rainfall. The microbiome of individual cowpats was monitored over 5.5 months. We used 16S rRNA metagenomics and machine learning software, FEAST (Fast Expectation-mAximization for microbial Source Tracking), for bacterial and fecal source assignments. (3) Results: The phyla Bacillota and Bacteroidota are dominant in the fecal microbiota of fresh cow feces but shift to Pseudomonodota, Actinomycetota, and environmental Bacteroidota in aged cowpats. Potential impacts of these bacterial community shifts on inputs to local agricultural streams are discussed in relation to water quality monitoring and aging sources of fecal contamination. We identified taxon orders that are potential indicators of fresh cattle sources (Oscillospirales and Bacteroidales) and aged sources (Peptostreptococcales-Tissierellales) in water bodies. (4) The paper highlights that bacterial metagenomic profiling can inform our understanding of the ecology of microbial communities in aquatic environments and the potential impacts of agricultural activities on ecosystem health.

7.
Nat Ecol Evol ; 7(7): 1092-1103, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37365343

RESUMEN

Protected areas (PAs) play a vital role in wildlife conservation. Nonetheless there is concern and uncertainty regarding how and at what spatial scales anthropogenic stressors influence the occurrence dynamics of wildlife populations inside PAs. Here we assessed how anthropogenic stressors influence occurrence dynamics of 159 mammal species in 16 tropical PAs from three biogeographic regions. We quantified these relationships for species groups (habitat specialists and generalists) and individual species. We used long-term camera-trap data (1,002 sites) and fitted Bayesian dynamic multispecies occupancy models to estimate local colonization (the probability that a previously empty site is colonized) and local survival (the probability that an occupied site remains occupied). Multiple covariates at both the local scale and landscape scale influenced mammal occurrence dynamics, although responses differed among species groups. Colonization by specialists increased with local-scale forest cover when landscape-scale fragmentation was low. Survival probability of generalists was higher near the edge than in the core of the PA when landscape-scale human population density was low but the opposite occurred when population density was high. We conclude that mammal occurrence dynamics are impacted by anthropogenic stressors acting at multiple scales including outside the PA itself.


Asunto(s)
Biodiversidad , Conservación de los Recursos Naturales , Humanos , Animales , Teorema de Bayes , Bosques , Mamíferos , Animales Salvajes
8.
J Thorac Cardiovasc Surg ; 166(3): 679-687.e1, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37156367

RESUMEN

OBJECTIVES: We sought to develop an ex vivo trachea model capable of producing mild, moderate, and severe tracheobronchomalacia for optimizing airway stent design. We also aimed to determine the amount of cartilage resection required for achieving different tracheobronchomalacia grades that can be used in animal models. METHODS: We developed an ex vivo trachea test system that enabled video-based measurement of internal cross-sectional area as intratracheal pressure was cyclically varied for peak negative pressures of 20 to 80 cm H2O. Fresh ovine tracheas were induced with tracheobronchomalacia by single mid-anterior incision (n = 4), mid-anterior circumferential cartilage resection of 25% (n = 4), and 50% per cartilage ring (n = 4) along an approximately 3-cm length. Intact tracheas (n = 4) were used as control. All experimental tracheas were mounted and experimentally evaluated. In addition, helical stents of 2 different pitches (6 mm and 12 mm) and wire diameters (0.52 mm and 0.6 mm) were tested in tracheas with 25% (n = 3) and 50% (n = 3) circumferentially resected cartilage rings. The percentage collapse in tracheal cross-sectional area was calculated from the recorded video contours for each experiment. RESULTS: Ex vivo tracheas compromised by single incision and 25% and 50% circumferential cartilage resection produce tracheal collapse corresponding to clinical grades of mild, moderate, and severe tracheobronchomalacia, respectively. A single anterior cartilage incision produces saber-sheath type tracheobronchomalacia, whereas 25% and 50% circumferential cartilage resection produce circumferential tracheobronchomalacia. Stent testing enabled the selection of stent design parameters such that airway collapse associated with moderate and severe tracheobronchomalacia could be reduced to conform to, but not exceed, that of intact tracheas (12-mm pitch, 0.6-mm wire diameter). CONCLUSIONS: The ex vivo trachea model is a robust platform that enables systematic study and treatment of different grades and morphologies of airway collapse and tracheobronchomalacia. It is a novel tool for optimization of stent design before advancing to in vivo animal models.


Asunto(s)
Broncoscopía , Traqueobroncomalacia , Ovinos , Animales , Traqueobroncomalacia/diagnóstico , Traqueobroncomalacia/cirugía , Tráquea/cirugía , Stents , Modelos Animales
9.
Sci Rep ; 13(1): 4561, 2023 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-36941335

RESUMEN

Forests in Europe are exposed to increasingly frequent and severe disturbances. The resulting changes in the structure and composition of forests can have profound consequences for the wildlife inhabiting them. Moreover, wildlife populations in Europe are often subjected to differential management regimes as they regularly extend across multiple national and administrative borders. The red deer Cervus elaphus population in the Bohemian Forest Ecosystem, straddling the Czech-German border, has experienced forest disturbances, primarily caused by windfalls and bark beetle Ips typographus outbreaks during the past decades. To adapt local management strategies to the changing environmental conditions and to coordinate them across the international border, reliable estimates of red deer density and abundance are highly sought-after by policymakers, wildlife managers, and stakeholders. Covering a 1081-km2 study area, we conducted a transnational non-invasive DNA sampling study in 2018 that yielded 1578 genotyped DNA samples from 1120 individual red deer. Using spatial capture-recapture models, we estimated total and jurisdiction-specific abundance of red deer throughout the ecosystem and quantified the role of forest disturbance and differential management strategies in shaping spatial heterogeneity in red deer density. We hypothesised that (a) forest disturbances provide favourable habitat conditions (e.g., forage and cover), and (b) contrasting red deer management regimes in different jurisdictions create a differential risk landscape, ultimately shaping density distributions. Overall, we estimated that 2851 red deer (95% Credible Interval = 2609-3119) resided in the study area during the sampling period, with a relatively even overall sex ratio (1406 females, 95% CI = 1229-1612 and 1445 males, 95% CI = 1288-1626). The average red deer density was higher in Czechia (3.5 km-2, 95% CI = 1.2-12.3) compared to Germany (2 km-2, 95% CI = 0.2-11). The effect of forest disturbances on red deer density was context-dependent. Forest disturbances had a positive effect on red deer density at higher elevations and a negative effect at lower elevations, which could be explained by partial migration and its drivers in this population. Density of red deer was generally higher in management units where hunting is prohibited. In addition, we found that sex ratios differed between administrative units and were more balanced in the non-intervention zones. Our results show that the effect of forest disturbances on wild ungulates is modulated by additional factors, such as elevation and ungulate management practices. Overall density patterns and sex ratios suggested strong gradients in density between administrative units. With climate change increasing the severity and frequency of forest disturbances, population-level monitoring and management are becoming increasingly important, especially for wide-ranging species as both wildlife and global change transcend administrative boundaries.


Asunto(s)
Ciervos , Ecosistema , Masculino , Femenino , Animales , Bosques , Europa (Continente) , Animales Salvajes
10.
World Neurosurg ; 176: 127-139, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36639101

RESUMEN

Intraoperative MRI has been increasingly used to robotically deliver electrodes and catheters into the human brain using a linear trajectory with great clinical success. Current cranial MR guided robotics do not allow for continuous real-time imaging during the procedure because most surgical instruments are not MR-conditional. MRI guided robotic cranial surgery can achieve its full potential if all the traditional advantages of robotics (such as tremor-filtering, precision motion scaling, etc.) can be incorporated with the neurosurgeon physically present in the MRI bore or working remotely through controlled robotic arms. The technological limitations of design optimization, choice of sensing, kinematic modeling, physical constraints, and real-time control had hampered early developments in this emerging field, but continued research and development in these areas over time has granted neurosurgeons far greater confidence in using cranial robotic techniques. This article elucidates the role of MR-guided robotic procedures using clinical devices like NeuroBlate and Clearpoint that have several thousands of cases operated in a "linear cranial trajectory" and planned clinical trials, such as LAANTERN for MR guided robotics in cranial neurosurgery using LITT and MR-guided putaminal delivery of AAV2 GDNF in Parkinson's disease. The next logical improvisation would be a steerable curvilinear trajectory in cranial robotics with added DOFs and distal tip dexterity to the neurosurgical tools. Similarly, the novel concept of robotic actuators that are powered, imaged, and controlled by the MRI itself is discussed in this article, with its potential for seamless cranial neurosurgery.


Asunto(s)
Neurocirugia , Procedimientos Quirúrgicos Robotizados , Robótica , Humanos , Procedimientos Neuroquirúrgicos/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Imagen por Resonancia Magnética
11.
Ecology ; 104(1): e3887, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36217822

RESUMEN

Spatial capture-recapture (SCR) is now routinely used for estimating abundance and density of wildlife populations. A standard SCR model includes sub-models for the distribution of individual activity centers (ACs) and for individual detections conditional on the locations of these ACs. Both sub-models can be expressed as point processes taking place in continuous space, but there is a lack of accessible and efficient tools to fit such models in a Bayesian paradigm. Here, we describe a set of custom functions and distributions to achieve this. Our work allows for more efficient model fitting with spatial covariates on population density, offers the option to fit SCR models using the semi-complete data likelihood (SCDL) approach instead of data augmentation, and better reflects the spatially continuous detection process in SCR studies that use area searches. In addition, the SCDL approach is more efficient than data augmentation for simple SCR models while losing its advantages for more complicated models that account for spatial variation in either population density or detection. We present the model formulation, test it with simulations, quantify computational efficiency gains, and conclude with a real-life example using non-invasive genetic sampling data for an elusive large carnivore, the wolverine (Gulo gulo) in Norway.


Asunto(s)
Animales Salvajes , Animales , Teorema de Bayes , Probabilidad , Densidad de Población , Noruega
12.
Ecology ; 104(2): e3934, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36458376

RESUMEN

Open-population spatial capture-recapture (OPSCR) models use the spatial information contained in individual detections collected over multiple consecutive occasions to estimate not only occasion-specific density, but also demographic parameters. OPSCR models can also estimate spatial variation in vital rates, but such models are neither widely used nor thoroughly tested. We developed a Bayesian OPSCR model that not only accounts for spatial variation in survival using spatial covariates but also estimates local density-dependent effects on survival within a unified framework. Using simulations, we show that OPSCR models provide sound inferences on the effect of spatial covariates on survival, including multiple competing sources of mortality, each with potentially different spatial determinants. Estimation of local density-dependent survival was possible but required more data due to the greater complexity of the model. Not accounting for spatial heterogeneity in survival led to up to 10% positive bias in abundance estimates. We provide an empirical demonstration of the model by estimating the effect of country and density on cause-specific mortality of female wolverines (Gulo gulo) in central Sweden and Norway. The ability to make population-level inferences on spatial variation in survival is an essential step toward a fully spatially explicit OPSCR model capable of disentangling the role of multiple spatial drivers of population dynamics.


Asunto(s)
Densidad de Población , Femenino , Humanos , Teorema de Bayes , Dinámica Poblacional , Noruega , Suecia
13.
Int Symp Med Robot ; 20232023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38415070

RESUMEN

Magnetic ball chains are well suited to serve as the steerable tips of endoluminal robots. While it has been demonstrated that these robots produce a larger reachable workspace than magnetic soft continuum robots designed using either distributed or lumped magnetic material, here we investigate the orientational capabilities of these robots. To increase the range of orientations that can be produced at each point in the workspace, we introduce a comparatively-stiff outer sheath from which the steerable ball chain is extended. We present an energy-based kinematic model and also derive an approximate expression for the range of achievable orientations at each point in the workspace. Experiments are used to validate these results.

14.
IEEE Int Conf Robot Autom ; 2023: 4717-4723, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38444998

RESUMEN

This paper introduces a novel class of hyperredundant robots comprised of chains of permanently magnetized spheres enclosed in a cylindrical polymer skin. With their shape controlled using an externally-applied magnetic field, the spherical joints of these robots enable them to bend to very small radii of curvature. These robots can be used as steerable tips for endoluminal instruments. A kinematic model is derived based on minimizing magnetic and elastic potential energy. Simulation is used to demonstrate the enhanced steerability of these robots in comparison to magnetic soft continuum robots designed using either distributed or lumped magnetic material. Experiments are included to validate the model and to demonstrate the steering capability of ball chain robots in bifurcating channels.

15.
Int Symp Med Robot ; 20232023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38356963

RESUMEN

Mechanics-based models have been developed to describe the shape of tendon-actuated continuum robots. Models have also been developed to describe the shape of concentric tube robots, i.e., nested combinations of precurved superelastic tubes. While an important class of continuum robots used in endoscopic and intracardiac medical applications combines these two designs, existing models do not cover this combination. Tendon-actuated models are limited to a single tube while concentric tube models do not include tendon-produced forces and moments. This paper derives a mechanics-based model for this hybrid design and assesses it using numerical and physical experiments involving a pair of tendon-actuated tubes. It is demonstrated that, similar to concentric tube robots, relative twisting between the tendon-actuated tubes is an important factor in determining overall robot shape.

16.
Rep U S ; 2023: 8461-8466, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38352692

RESUMEN

A hybrid continuum robot design is introduced that combines a proximal tendon-actuated section with a distal telescoping section comprised of permanent-magnet spheres actuated using an external magnet. While, individually, each section can approach a point in its workspace from one or at most several orientations, the two-section combination possesses a dexterous workspace. The paper describes kinematic modeling of the hybrid design and provides a description of the dexterous workspace. We present experimental validation which shows that a simplified kinematic model produces tip position mean and maximum errors of 3% and 7% of total robot length, respectively.

17.
Sci Robot ; 7(71): eade5834, 2022 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-36288269

RESUMEN

Science Robotics welcomes papers demonstrating technical and scientific advances, with potential for influence beyond robotics.


Asunto(s)
Robótica
18.
Sci Total Environ ; 853: 158509, 2022 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-36063947

RESUMEN

In rural environments, the sources of fecal contamination in freshwater environments are often diffuse and a mix of fresh and aged fecal sources. It is important for water monitoring purposes, therefore, to understand the impacts of weathering on detection of the fecal source markers available for mobilization from livestock sources. This study targets the impacts of rainfall events on the mobilization of fecal source tracking (FST) markers from simulated cowpats decomposing in situ for five-and-a-half-months. The FST markers analysed were Escherichia coli, microbial source tracking (MST) markers, fecal steroids and a fecal ageing ratio based on the ratio between counts of river microflora and total coliforms. There was a substantial concentration of E. coli (104/100 mL) released from the ageing cowpats suggesting a long-term reservoir of E. coli in the cowpat. Mobilization of fecal markers from rainfall-impacted cowpats, however, was markedly reduced compared with fecal markers in the cowpat. Overall, the Bacteroidales bovine-associated MST markers were less persistent than E. coli in the cowpat and rainfall runoff. The ten fecal steroids, including the major herbivore steroid, 24-ethylcoprostanol, are shown to be stable markers of bovine pollution due to statistically similar degradation rates among all steroids. The mobilizable fraction for each FST marker in the rainfall runoff allowed generation of mobilization decline curves and the derived decline rate constants can be incorporated into source attribution models for agricultural contaminants. Findings from this study of aged bovine pollution sources will enable water managers to improve attribution of elevated E. coli to the appropriate fecal source in rural environments.


Asunto(s)
Escherichia coli , Contaminación del Agua , Bovinos , Animales , Contaminación del Agua/análisis , Monitoreo del Ambiente , Heces/química , Microbiología del Agua , Agua/análisis
19.
IEEE Trans Robot ; 38(1): 477-490, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36035379

RESUMEN

This paper presents a novel continuum robot sheath for use in single-port minimally invasive procedures such as neuroendoscopy in which the sheath is designed to deliver multiple robotic arms. Actuation of the sheath is achieved by using precurved superelastic tubes lining the working channels used for arm delivery. These tubes perform a similar role to push/pull tendons, but can accomplish shape change of the sheath via rotation. A kinematic model using Cosserat rod theory is derived which is based on modeling the system as a set of eccentrically aligned precurved tubes constrained along their length by an elastic backbone. The specific case of a two-arm sheath is considered in detail. Simulation and experiments are used to investigate the validate the concept and model.

20.
Proc IEEE Inst Electr Electron Eng ; 110(7): 847-870, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35756186

RESUMEN

Continuum robots are not constructed with discrete joints but, instead, change shape and position their tip by flexing along their entire length. Their narrow curvilinear shape makes them well suited to passing through body lumens, natural orifices, or small surgical incisions to perform minimally invasive procedures. Modeling and controlling these robots are, however, substantially more complex than traditional robots comprised of rigid links connected by discrete joints. Furthermore, there are many approaches to achieving robot flexure. Each presents its own design and modeling challenges, and to date, each has been pursued largely independently of the others. This article attempts to provide a unified summary of the state of the art of continuum robot architectures with respect to design for specific clinical applications. It also describes a unifying framework for modeling and controlling these systems while additionally explaining the elements unique to each architecture. The major research accomplishments are described for each topic and directions for the future progress needed to achieve widespread clinical use are identified.

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