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Control Evaluation of Antagonistic Series Elastic Actuation for a Robotic Endoscope Joint

Journal of Bionic Engineering 2022年第4期19卷 965-974页

作者： Lorin Fasel nicolas Gerig Philippe C.Cattin Georg Rauter BIROMED-Lab Department of Biomedical EngineeringUniversity of Basel4123AllschwilSwitzerland CIAN Department of Biomedical EngineeringUniversity of Basel4123AllschwilSwitzerland

Haptic feedback is typically missing during telemanipulation of surgical robots in minimally invasive surgeries,i.e.,surgeons cannot feel the interaction forces between the instruments and tissues.Instead,surgeons have to solely rely on visual feedback,which increases complexity of guiding the instruments and poses the safety threat of unperceivable contacts outside the field of view.We propose a novel series elastic actuation design for articulated robotic endoscopes to overcome these limitations and evaluate an according device with one joint.Similar to the actuation of human fingers,the joint is driven by antagonistic tendons.Springs are integrated in the transmission between the tendons and the motors outside of the endoscope shaft.We estimated the joint angle and thereby the endoscope shape,measured spring deflection,estimated tendon forces from that deflection,and implemented force control for the endoscope joint.Zero torque control and impedance control were evaluated under application of both a continuous force and an impact force to the endoscope tip.The springs reduced impact forces at the tip of the endoscope through their inherent compliance.At the same time,feeding back the estimated force resulted in a stable tendon force control and a tunable endoscope joint control:Zero torque control effectively reduced the external forces,while the endoscope joint showed the expected stiffness in impedance control.These results show that antagonistic series elastic actuation is a promising concept for endoscope joint actuation and that it can lead towards safer robot–tissue interactions in surgical robotics.

关键词： Minimally invasive surgery RAMIS Robot-assisted surgery Haptic feedback Force control Tendon-driven robotics

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Cavefish mount a rapid and sustained regenerative response following skeletal muscle injury

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Zoological Research 2023年第4期44卷 776-778页

作者： Luke Olsen Huzaifa Hassan Fanning Xia Sarah Keaton nicolas Rohner Stowers Institute for Medical Research Kansas CityMO 64110USA Department of Molecular&Integrative Physiology University of Kansas Medical CenterKansas CityKS 66160USA Department of Biological Sciences DePaul UniversityChicagoIL 60614USA

Dear Editor,Physical injury and tissue damage are prevalent throughout the animal kingdom,with the ability to regenerate quickly and efficiently providing a selective advantage.In most vertebrates,skeletal muscle possesses a remarkable ability to regenerate,making it a valuable model for investigating the cellular processes underpinning tissue regeneration.Following damage,skeletal muscle mounts a complex regenerative cascade centered around dedicated muscle stem cells,i.e.,satellite cells.These satellite cells are,in turn,regulated by both resident and infiltrating innate immune cells of myeloid lineage,which play a crucial role in activating and guiding the transition of satellite cells towards maturation(Chen et al.,2020;Tidball,2017;Tidball&Villalta,2010).While critical for muscle regeneration,the innate immune system is energetically costly,resulting in many species decreasing immune investment under nutrient-limited environments.Whether this reduced investment results in a decreased capacity to mount a regenerative response following tissue damage remains unclear.Here,we utilized an emerging evolutionary model,the Mexican tetra(Astyanax mexicanus),to investigate the consequences of shifts in immune system investment on skeletal muscle regeneration.

关键词： sustained mount injury

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Reproductive seasonality of Astyanax mexicanus cavefish

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Zoological Research 2023年第4期44卷 698-700页

作者： Luis Espinasa nicolas Rohner Sylvie Rétaux School of Science Marist CollegePoughkeepsieNY 12601USA Stowers Institute for Medical Research Kansas CityMO 64110USA Department of Molecular and Integrative Physiology University of Kansas Medical CenterKansas CityKS 66160USA Paris-Saclay Institute of Neuroscience CNRS and UniversitéParis-SaclaySaclay 91400France

DEAR EDITOR,The characiform fish Astyanax is a well-studied model system for understanding evolutionary development and genomics in cave biology.Nonetheless,considerable gaps remain in our understanding of its field ecology.Here,we conducted a fouryear field study and found that while cavefish spawned yearround,reproductive peaks occurred in January to February.

关键词： cave ecology fish

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How does a data strategy enable customer value?The case of FinTechs and traditional banks under the open finance framework

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Financial Innovation 2022年第1期8卷 2045-2078页

作者： Laura Grassi nicolas Figini Lorenzo Fedeli School of Management Politecnico di Milanovia Lambruschini 4bMilanItaly

The coupling of data and digital innovation opens the way for new business in the financial services sector,where customers are placed at the centre of decisions and data can help to develop customer knowledge.To carry out our research,we adopted a multi-case study approach to explore how a data strategy is developed in the retail banking industry,together with its relationship with customer value,paying particular attention to the heterogeneity between traditional banks and financial technology companies(FinTechs).Two main points emerged from the study.Firstly,there are three possible approaches to Open Finance,which are mainly defined by their different corporate cultures,organisational configurations,technological architecture and data value.Secondly,it is not enough to be a FinTech to be best placed to exploit the market,as some traditional banks share the FinTechs’approach to Open Finance.Designing new tailored products,customising their prices and offering them over the right channels through targeted communication are all data-driven initiatives that stem from cross-or up-selling potential,core to the retail banking industry for turning a customer into a cash flow,thus enabling value to be created for customers.Our findings additionally revealed that there is a form of external information asymmetry between the customer and the bank,and that there is also an internal asymmetry between bank departments,as their visibility on information about the same customer may differ.

关键词： FinTech Open finance Customer orientation Customer centric Data valorisation Open banking

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Escitalopram-induced hepatitis:A case report

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World Journal of Clinical Cases 2022年第8期10卷 2468-2473页

作者： Guillaume Wabont Laurie Ferret nicolas Houdre Antoine Lepied Johana Bene Etienne Cousein Department of Pharmacy Valenciennes HospitalValenciennes 59300France Department of Emergency Medicine Valenciennes HospitalValenciennes 59300France Department of Psychiatry Valenciennes HospitalValenciennes 59300France Department of Pharmacology Lille University HospitalLille 59000France

BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week af

关键词： Escitalopram Hepatitis Cholestasis Pharmacovigilance Case report

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Acceptability of a task sharing and shifting model between family physicians and physiotherapists in French multidisciplinary primary healthcare centres:a cross-sectional survey

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Family Medicine and Community Health 2022年第2期10卷 11-19页

作者： Amélie Kechichian François Desmeules Pauline Girard nicolas Pinsault Themas Team TIMC-IMAG LaboratoryUMR CNRS-UGAGrenobleFrance Department of Physiotherapy University Grenoble-AlpesGrenobleAuvergne-Rhône AlpesFrance Maisonneuve-Rosemont Hospital Research Centre University of Montreal Affiliated Research CenterMontrealQuébecCanada School of Rehabilitation University of MontrealFaculty of MedicineMontrealQuébecCanada Department of General Medicine Faculty of MedicineUniversity Grenoble-AlpesGrenobleFrance

Objectives The rising prevalence of musculoskeletal disorders increases pressure on primary care services.In France,patients with musculoskeletal disorders are referred to physiotherapist(PT)by family physician(FP).To improve access to musculoskeletal care,a new model of task sharing and shifting is implemented between FPs and PTs for patients with acute low back pain.This new model enables French PTs to expand their usual scope of practice by receiving patients as first-contact practitioner,diagnosing low back pain,prescribing sick leave and analgesic medication.The aim of this study is to investigate the acceptability of FPs and PTs regarding this new model.Design A cross-sectional survey design was used.Acceptability was measured using a questionnaire on the perception of the model and the perception of PTs’skills to manage low back pain.Descriptive analyses were performed to compare results among participants.Setting French FPs and PTs working in multidisciplinary primary healthcare centres were invited to complete an online survey.Participants A total of 174 respondents completed the survey(81 FPs and 85 PTs).Results A majority of participants had a positive perception of the task sharing and shifting model.A majority of the participants were mostly or totally favourable towards the implementation of the model(FPs:n=46,82%and PTs:n=40,82%).The perceived level of competencies of PTs to manage acute low back pain was high.The confidence level of FPs was higher than that of PTs regarding PTs’ability to adequately diagnose low back pain,refer patient to physiotherapy and prescribe sick leave or analgesic medication.Conclusion Based on this limited sample of participants,there appears to be good acceptability of the task sharing and shifting model for acute low back pain.Additional studies are needed to better determine the factors affecting the acceptability of such a model.

关键词： shifting centre sectional

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Prospective study comparing hepatic steatosis assessment by magnetic resonance imaging and four ultrasound methods in 105 successive patients

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World Journal of Gastroenterology 2023年第22期29卷 3548-3560页

作者： Remi Collin Benoit Magnin Constance Gaillard Carine nicolas Armand Abergel Benjamin Buchard Gastroenterology and Endoscopy Unit Dupuytren University HospitalLimoges 87000France Department of Hepatology and Gastroenterology Clermont-Ferrand University HospitalClermont-Ferrand 63000France Department of Radiology Clermont-Ferrand University HospitalClermont-Ferrand 63000France

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is becoming a major health problem,resulting in hepatic,metabolic and cardio-vascular morbidity.AIM To evaluate new ultrasonographic tools to detect and measure hepatic steatosis.METHODS We prospectively included 105 patients referred to our liver unit for NAFLD suspicion or follow-up.They underwent ultrasonographic measurement of liver sound speed estimation(SSE)and attenuation coefficient(AC)using Aixplorer MACH 30(Supersonic Imagine,France),continuous controlled attenuation parameter(cCAP)using Fibroscan(Echosens,France)and standard liver ultrasound with hepato-renal index(HRI)calculation.Hepatic steatosis was then classified according to magnetic resonance imaging proton density fat fraction(PDFF).Receiver operating curve(ROC)analysis was performed to evaluate the diagnostic performance in the diagnosis of steatosis.RESULTS Most patients were overweight or obese(90%)and had metabolic syndrome(70%).One third suffered from diabetes.Steatosis was identified in 85 patients(81%)according to PDFF.Twenty-one patients(20%)had advanced liver disease.SSE,AC,cCAP and HRI correlated with PDFF,with respective Spearman correlation coefficient of-0.39,0.42,0.54 and 0.59(P<0.01).Area under the receiver operating characteristic curve(AUROC)for detection of steatosis with HRI was 0.91(0.83-0.99),with the best cut-off value being 1.3(Se=83%,Sp=98%).The optimal cCAP threshold of 275 dB/m,corresponding to the recent EASL-suggested threshold,had a sensitivity of 72%and a specificity of 80%.Corresponding AUROC was 0.79(0.66-0.92).The diagnostic accuracy of cCAP was more reliable when standard deviation was<15 dB/m with an AUC of 0.91(0.83-0.98).An AC threshold of 0.42 dB/cm/MHz had an AUROC was 0.82(0.70-0.93).SSE performed moderately with an AUROC of 0.73(0.62-0.84).CONCLUSION Among all ultrasonographic tools evaluated in this study,including new-generation tools such as cCAP and SSE,HRI had the best performance.It is also the simplest and most available method as most ultrasound

关键词： Non-alcoholic fatty liver disease Ultrasonography Steatosis assessment Magnetic resonance imaging Controlled attenuation parameter

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Ochronotic arthropathy of bilateral hip joints:A case report

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World Journal of Clinical Cases 2023年第1期11卷 210-217页

作者： nicolas Yap San Min Urba Rafi Juan Wang Bin He Lei Fan Department of Orthopedics The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina Department of Ultrasonography The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina

BACKGROUND Ochronosis,also known as alkaptonuria,is a rare autosomal recessive selfmetabolic disease arising from deficiency of homogentisate 1,2 dioxygenase enzyme.It affects several organs and muscoskeletal structures.We herein report a case of a patient who presented with severe hip arthropathy complicated with late stage ochronosis.CASE SUMMARY A 56-year-old male patient was admitted in our department in 2019 with complaints of chronic low backache and left hip pain.After the required investigations were done,lumbar disc herniation and severe hip arthritis were the initial diagnosis.A total left hip arthroplasty was performed.Ochronotic osteoarthritis was only obtained post-surgery as confirmatory diagnosis.He was again admitted mid 2022 with the same complaints on the right hip.Subsequently,he underwent a total right hip arthroplasty.Post-operative recovery and follow-ups were deemed very satisfactory.CONCLUSION Ochronosis is an unusual diagnosis for a patient who presents with typical hip arthritis.Thus,unless meticulous history taking and advanced laboratory tests,the diagnosis can easily be missed by surgeons.

关键词： Alkaptonuria Metabolic disease Ochronotic osteoarthropathy Hip arthritis Bilateral hip arthroplasty Case report

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Attosecond magnetization dynamics in non-magnetic materials driven by intense femtosecond lasers

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npj Computational Materials 2023年第1期9卷 1959-1968页

作者： Ofer Neufeld nicolas Tancogne-Dejean Umberto De Giovannini Hannes Hübener Angel Rubio Max Planck Institute for the Structure and Dynamics of Matter and Center for Free-Electron Laser Science Hamburg 22761Germany Universitàdegli Studi di Palermo Dipartimento di Fisica e Chimica—Emilio SegrèPalermo I-90123Italy Center for Computational Quantum Physics(CCQ) The Flatiron InstituteNew YorkNY 10010USA

Irradiating solids with ultrashort laser pulses is known to initiate femtosecond timescale magnetization dynamics.However,sub-femtosecond spin dynamics have not yet been observed or predicted.Here,we explore ultrafast light-driven spin dynamics in a highly nonresonant strong-field regime.Through state-of-the-art ab initio calculations,we predict that a nonmagnetic material can transiently transform into a magnetic one via dynamical extremely nonlinear spin-flipping processes,which occur on attosecond timescales and are mediated by cascaded multi-photon and spin–orbit interactions.These are nonperturbative nonresonant analogs to the inverse Faraday effect,allowing the magnetization to evolve in very high harmonics of the laser frequency(e.***.here up to the 42nd,oscillating at~100 attoseconds),and providing control over the speed of magnetization by tuning the laser power and wavelength.Remarkably,we show that even for linearly polarized driving,where one does not intuitively expect the onset of an induced magnetization,the magnetization transiently oscillates as the system interacts with light.This response is enabled by transverse light-driven currents in the solid,and typically occurs on timescales of~500 attoseconds(with the slower femtosecond response suppressed).An experimental setup capable of measuring these dynamics through pump–probe transient absorption spectroscopy is simulated.Our results pave the way for attosecond regimes of manipulation of magnetism.

关键词： tuning transient dynamics

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Crohn’s disease: Why the ileum?

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World Journal of Gastroenterology 2023年第21期29卷 3222-3240页

作者： nicolas Richard Guillaume Savoye Mathilde Leboutte Asma Amamou Subrata Ghosh Rachel Marion-Letellier University of Rouen Normandie INSERMADEN UMR 1073NutritionInflammation and Microbiota-Gut-Brain AxisRouen F-76000France CHU Rouen Department of GastroenterologyRouen University Hospital-Charles NicolleRouen F-76000France Institute for Research and Innovation in Biomedicine University of Rouen NormandieRouen F-76000France APC Microbiome Ireland Biosciences BuildingUniversity College CorkCork T12 YT20Ireland

Crohn’s disease(CD)is an inflammatory bowel disease characterized by immunemediated flares affecting any region of the intestine alternating with remission periods.In CD,the ileum is frequently affected and about one third of patients presents with a pure ileal type.Moreover,the ileal type of CD presents epidemiological specificities like a younger age at onset and often a strong link with smoking and genetic susceptibility genes.Most of these genes are associated with Paneth cell dysfunction,a cell type found in the intestinal crypts of the ileum.Besides,a Western-type diet is associated in epidemiological studies with CD onset and increasing evidence shows that diet can modulate the composition of bile acids and gut microbiota,which in turn modulates the susceptibility of the ileum to inflammation.Thus,the interplay between environmental factors and the histological and anatomical features of the ileum is thought to explain the specific transcriptome profile observed in CD ileitis.Indeed,both immune response and cellular healing processes harbour differences between ileal and non-ileal CD.Taken together,these findings advocate for a dedicated therapeutic approach to managing ileal CD.Currently,interventional pharmacological studies have failed to clearly demonstrate distinct response profiles according to disease site.However,the high rate of stricturing disease in ileal CD requires the identification of new therapeutic targets to significantly change the natural history of this debilitating disease.

关键词： Ileum Crohn’s disease Bile acids Paneth cells Diet Genetics Strictures

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