Computed tomography (CT) is a useful modality for the management of craniofacial anomalies. A study was undertaken to assess whether CT measurements of the upper craniofacial skeleton accurately represent the bony region imaged. Measurements taken directly from five dry skulls (approximate ages: adults, over 18 years; child, 4 years; infant, 6 months) were compared to those from axial CT scans of these skulls. Excellent agreement was found between the direct (dry skull) and indirect (CT) measurements. The effect of head tilt on the accuracy of these measurements was investigated. The error was within clinically acceptable limits (less than 5 percent) if the angle was no more than +/- 4 degrees from baseline (0 degrees). Objective standardized information gained from CT should complement the subjective clinical data usually collected for the treatment of craniofacial deformities.

Craniofacial Skeletal Measurements Based on Computed Tomography. Part I: Accuracy and Reproducibility. Part II Normal Values and Growth Trends

Nowadays robots play an important role in society, mainly due to the significant benefits they provide when utilized for assisting human beings in the execution of dangerous or repetitive tasks. Medicine is one of the fields in which robots are gaining greater use and development, especially those employed in minimally invasive surgery (MIS). However, due to the particular conditions of the human body where robots have to act, the design of these systems is complex, not only from a technical point of view, but also because the clinical needs and the normativity aspects are important considerations that have to be taken into account in order to achieve better performances and more secure systems for patients and surgeons. Thus, this paper explores the clinical needs and the technical requirements that will trace the roadmap for the next scientific and technological advances in the field of robotic surgery, the metrics that should be defined for safe technology development and the standards that are being elaborated for boosting the industry and facilitating systems integration.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/rcs.1801

A research review on clinical needs, technical requirements, and normativity in the design of surgical robots.

Background
Many orthopaedic operations involve drilling and tapping before the insertion of screws into a bone. This drilling is usually performed manually, thus introducing many problems. These include attaining a specific drilling accuracy, preventing blood vessels from breaking, and minimizing drill oscillations that would widen the hole. Bone overheating is the most important problem. To avoid such problems and reduce the subjective factor, automated drilling is recommended.

Methods
Because numerous parameters influence the drilling process, this study examined some experimental methods. These concerned the experimental identification of technical drilling parameters, including the bone resistance force and temperature in the drilling process. During the drilling process, the following parameters were monitored: time, linear velocity, angular velocity, resistance force, penetration depth, and temperature.

Results
Specific drilling effects were revealed during the experiments. The accuracy was improved at the starting point of the drilling, and the error for the entire process was less than 0.2 mm. The temperature deviations were kept within tolerable limits. The results of various experiments with different drilling velocities, drill bit diameters, and penetration depths are presented in tables, as well as the curves of the resistance force and temperature with respect to time. Real-time digital indications of the progress of the drilling process are shown.

Conclusions
Automatic bone drilling could entirely solve the problems that usually arise during manual drilling. An experimental setup was designed to identify bone drilling parameters such as the resistance force arising from variable bone density, appropriate mechanical drilling torque, linear speed of the drill, and electromechanical characteristics of the motors, drives, and corresponding controllers. Automatic drilling guarantees greater safety for the patient. Moreover, the robot presented is user-friendly because it is simple to set robot tasks, and process data are collected in real time. Copyright © 2013 John Wiley & Sons, Ltd.

Design and performance study of an orthopaedic surgery robotized module for automatic bone drilling.

A review of the impact of the green landscape interventions on the urban microclimate of tropical areas

Robotic telesurgery is a new concept in surgical care that has gained relevance over the past two decades. Now, with the introduction of 5G mobile networks, this concept is becoming practical. Here, we report that surgeons successfully performed complex transoral laser microsurgeries on the vocal cords of an adult human cadaver located 15 km away from them. This was possible thanks to a high bandwidth and ultra-low latency 5G telecommunication system, which allowed for precise remote control of robotic instruments and full HD ( $1920\times 1280$ pixels) 3D visualization of the surgical site. During the operation, the mean video transmission latency was 102±9 ms with the maximum latency being 140 ms, but this was observed during less than 1% of the operation time. This latency did not cause any deterioration in surgeons’ performance. Our results demonstrate that surgical expertise can be exploited and shared efficiently using the new 5G telecommunication standard. This is critical for highly specialized operations such as the microsurgeries demonstrated here, which require surgical expertise that are not widely available. Therefore, the possibility to operate from a distance can bring significant benefits to healthcare systems, reducing costs and enhancing treatment quality for patients. In addition, it makes telementoring a reality, allowing expert surgeons to be present virtually in multiple operating rooms to guide and train less experienced colleagues.

5G Robotic Telesurgery: Remote Transoral Laser Microsurgeries on a Cadaver

Surgical robotics is a growing discipline, continuously expanding with an influx of new ideas and research. However, it is important that the development of new devices take account of past mistakes and successes. A structured approach is necessary, as with proliferation of such research, there is a danger that these lessons will be obscured, resulting in the repetition of mistakes and wasted effort and energy. There are several research paths for surgical robotics, each with different risks and opportunities and different methodologies to reach a profitable outcome. The main emphasis of this paper is on a methodology for ‘applied research’ in surgical robotics. The methodology sets out a hierarchy of criteria consisting of three tiers, with the most important being the bottom tier and the least being the top tier. It is argued that a robotic system must adhere to these criteria in order to achieve acceptability. Recent commercial systems are reviewed against these criteria, and are found to conform up to at least the bottom and intermediate tiers, the most important first two tiers, and thus gain some acceptability. However, the lack of conformity to the criteria in the top tier, and the inability to conclusively prove increased clinical benefit, is shown to be hampering their potential in gaining wide establishment.

/pdf/a-methodology-for-design-and-appraisal-of-surgical-robotic-321djypq83.pdf

A methodology for design and appraisal of surgical robotic systems

A numerical and experimental investigation of the effectiveness of green roofs in tropical environments: The case study of Mauritius in mid and late winter

Circular homes – An energy-water-materials nexus for community climate engagement and action at grassroots level in the built environment

The potential for the contribution of the built environment towards sustainable development is recognized around the world. The need to achieve thermal comfort has proven to be the prime source of energy consumption in buildings, with mechanical ventilation and air-conditioning known to represent more than half of the energy bill. The effect of climate change has exacerbated the problem, leading to a vicious cycle of emitting more greenhouse gases in bringing comfortable indoor environments, while contributing further to climate change with warmer summers and colder winters. A very effective way to decouple economic growth and urbanization with increasing carbon footprint of our building stock is through the integration of passive measures, which hold huge potential for climate zones characterized as hot and warm. Moreover, the variability of climate means that permanent passive measures do not represent the optimum configuration for harnessing the natural resources in the form of daylight, natural ventilation and solar radiation, calling for building controls to regulate these passive elements. Furthermore, the need to set suitable control strategies for modulating these passive measures require a knowledge base to understand their influence on the indoor environment with respect to the external climatic conditions. The complexity of the interaction between the external and internal environments through the building envelope has led to renewed interest in adopting an AI approach to the problem. This paper presents a methodology developed to assess and quantify the efficacy of passive measures with associated controls for regulating specific parameters pertaining to the indoor environment, and presents simulation results for the automation of window shading with respect to indoor temperature and illumination level as an example of the proposed framework.

Mahendra Gooroochurn

Papers

A methodology for design and appraisal of surgical robotic systems

A numerical and experimental investigation of the effectiveness of green roofs in tropical environments: The case study of Mauritius in mid and late winter

Circular homes – An energy-water-materials nexus for community climate engagement and action at grassroots level in the built environment

A Framework for AI-Based Building Controls to Adapt Passive Measures for Optimum Thermal Comfort and Energy Efficiency in Tropical Climates

A registration framework for preoperative CT to intraoperative white light images