[Navigation and robotics of the lateral skull base]

Computer-aided microscopic surgery of the lateral skull base is a rare intervention in daily practice. It is often a delicate and difficult minimally invasive intervention, since orientation between the petrous bone and the petrous bone apex is often challenging. In the case of aural atresia or tumors the normal anatomical landmarks are often absent, making orientation more difficult. Navigation support, together with imaging techniques such as CT, MR and angiography, enable the surgeon in such cases to perform the operation more accurately and, in some cases, also in a shorter time. However, there are no internationally standardised indications for navigated surgery on the lateral skull base. Miniaturised robotic systems are still in the initial validation phase.

Transformation of local medicinal knowledge in the Andean Highlands: Case studies from Peru and Bolivia

In the Andean highlands, indigenous environmental knowledge is currently undergoing major changes as a result of various external and internal factors. As in other parts of the world, an overall process of erosion of local knowledge can be observed. In response to this trend, some initiatives that adopt a biocultural approach aim at actively strengthening local identities and revalorizing indigenous environmental knowledge and practices, assuming that such practices can contribute to more sustainable management of biodiversity. However, these initiatives usually lack a sound research basis, as few studies have focused on the dynamics of indigenous environmental knowledge in the Andes and on its links with biodiversity management. Against this background, the general objective of this research project was to contribute to the understanding of the dynamics of indigenous environmental knowledge in the Andean highlands of Peru and Bolivia by investigating how local medicinal knowledge is socially differentiated within rural communities, how it is transformed, and which external and internal factors influence these transformation processes. The project adopted an actor-oriented perspective and emphasized the concept of knowledge dialogue by analyzing the integration of traditional and formal medicinal systems within family therapeutic strategies. It also aimed at grasping some of the links between the dynamics of medicinal knowledge and the types of land use systems and biodiversity management. Research was conducted in two case study areas of the Andes, both Quechua-speaking and situated in comparable agro-ecological production belts - Pitumarca District, Department of Cusco (Southern Peruvian Highlands) and the Tunari National Park, Department of Cochabamba (Bolivian inner-Andean valleys). In each case study area, the land use systems and strategies of 18 families from two rural communities, their environmental knowledge related to medicine and to the local therapeutic flora, and an appreciation of the dynamics of this knowledge were assessed. Data were collected through a combination of disciplinary and participatory action-research methods. It was mostly analyzed using qualitative methods, though some quantitative ethnobotanical methods were also used. In both case studies, traditional medicine still constitutes the preferred option for the families interviewed, independently of their age, education level, economic status, religion, or migration status. Surprisingly and contrary to general assertions among local NGOs and researchers, results show that there is a revival of Andean medicine within the younger generation, who have greater knowledge of medicinal plants than the previous one, value this knowledge as an important element of their way of life and relationship with “Mother Earth” (Pachamama), and, at least in the Bolivian case, prefer to consult the traditional healer rather than go to the health post. Migration to the urban centres and the Amazon lowlands, commonly thought to be an important factor of local medicinal knowledge loss, only affects people’s knowledge in the case of families who migrate over half of the year or permanently. Migration does not influence the knowledge of medicinal plants or the therapeutic strategies of families who migrate temporarily for shorter periods of time. Finally, economic status influences neither the status of people’s medicinal knowledge, nor families’ therapeutic strategies, even though the financial factor is often mentioned by practitioners and local people as the main reason for not using the formal health system. The influence of the formal health system on traditional medicinal knowledge varies in each case study area. In the Bolivian case, where it was only introduced in the 1990s and access to it is still very limited, the main impact was to give local communities access to contraceptive methods and to vaccination. In the Peruvian case, the formal system had a much greater impact on families’ health practices, due to local and national policies that, for instance, practically prohibit some traditional practices such as home birth. But in both cases, biomedicine is not considered capable of responding to cultural illnesses such as “fear” (susto), “bad air” (malviento), or “anger” (colerina). As a consequence, Andean farmers integrate the traditional medicinal system and the formal one within their multiple therapeutic strategies, reflecting an inter-ontological dialogue between different conceptions of health and illness. These findings reflect a more general trend in the Andes, where indigenous communities are currently actively revalorizing their knowledge and taking up traditional practices, thus strengthening their indigenous collective identities in a process of cultural resistance.

Multi-Contact Grasp Interaction for Virtual Environments

The grasping of virtual objects has been an active research field for several years. Solutions providing realistic grasping rely on special hardware or require time-consuming parameterizations. Therefore, we introduce a flexible grasping algorithm enabling grasping without computational complex physics. Objects can be grasped and manipulated with multiple fingers. In addition, multiple objects can be manipulated simultaneously with our approach. Through the usage of contact sensors the technique is easily configurable and versatile enough to be used in different scenarios.

Language Learning in 3D Virtual World

Second Life (SL) is an ideal platform for language learning. It is called a Multi-User Virtual Environment, where users can have varieties of learning experiences in life-like environments. Numerous attempts have been made to use SL as a platform for language teaching and the possibility of SL as a means to promote conversational interactions has been reported. However, the research so far has largely focused on simply using SL without further augmentations for communication between learners or between teachers and learners in a school-like environment. Conversely, not enough attention has been paid to its controllability which builds on the embedded functions in SL. This study, based on the latest theories of second language acquisition, especially on the Task Based Language Teaching and the Interaction Hypothesis, proposes to design and implement an automatized interactive task space (AITS) where robotic agents work as interlocutors of learners. This paper presents a design that incorporates the SLA theories into SL and the implementation method of the design to construct AITS, fulfilling the controllability of SL. It also presents the result of the evaluation experiment conducted on the constructed AITS.

XSAMPL3D: An Action Description Language for the Animation of Virtual Characters

In this paper we present XSAMPL3D, a novel language for the high-level representation of actions performed on objects by (virtual) humans. XSAMPL3D was designed to serve as action representation language in an imitation-based approach to character animation: First, a human demonstrates a sequence of object manipulations in an immersive Virtual Reality (VR) environment. From this demonstration, an XSAMPL3D description is automatically derived that represents the actions in terms of high-level action types and involved objects. The XSAMPL3D action description can then be used for the synthesis of animations where virtual humans of different body sizes and proportions reproduce the demonstrated action. Actions are encoded in a compact and human-readable XML-format. Thus, XSAMPL3D describtions are also amenable to manual authoring, e.g. for rapid prototyping of animations when no immersive VR environment is at the animator's disposal. However, when XSAMPL3D descriptions are derived from VR interactions, they can accomodate many details of the demonstrated action, such as motion trajectiories,hand shapes and other hand-object relations during grasping. Such detail would be hard to specify with manual motion authoring techniques only. Through the inclusion of language features that allow the representation of all relevant aspects of demonstrated object manipulations, XSAMPL3D is a suitable action representation language for the imitation-based approach to character animation.

Generierung von Konstruktionsmerkmalen zur Entwicklung eines bio-inspirierten Kommissionier- Greifers für die Intralogistik mittels Clusteranalyse

Kurzbeschreibung: In der Automatisierung von intralogistischen Kommissioniervorgängen ist ein großes Zukunftspotential erkennbar. Elementarer Bestandteil des Automatisierungsprozesses ist der Einsatz von Industrierobotern, die mit einem geeigneten Endeffektor, dem Greifer, ausgestattet werden müssen. Die Robotik ist in der Lage schneller, präziser und ausdauernder als die menschlichen Kommissionierer zu arbeiten und trägt damit entscheidend zur Effizienzsteigerung bei. Eine wesentliche Herausforderung für diesen Entwicklungsschritt zur Substitution der manuellen Kommissionierung ist die Konstruktion und Bereitstellung eines geeigneten Greifsystems. Am Lehrstuhl für Maschinenelemente und Technische Logistik der Helmut-Schmidt-Universität wurde mit der Erfahrung aus einem vorangegangenen Forschungsprojekt die Methode der Clusteranalyse erstmalig zur Untersuchung von Greifobjekten zur Entwicklung eines bionischen Universalgreifers für die Kommissionierung von Drogerieartikeln verwendet. Diese Abhandlung beschreibt einen Beitrag zur Entwicklung dieses Greifers am Beispiel handelsüblicher Drogerieartikel, die aktuell manuell kommissioniert werden. Diese werden hinsichtlich der für das Greifen relevanten Objektmerkmale geclustert und die daraus resultierenden Erkenntnisse in Form von Konstruktionsmerkmalen abgeleitet. Nach einer Analyse und Festlegung der greifrelevanten Merkmale der Greifobjekte wird eine Objektdatenbasis erstellt. Mit Hilfe geeigneter Methoden wird die gewonnene Datenbasis aufbereitet und reduziert. Im Anschluss werden die Greifobjekte bzw. deren Merkmalsausprägungen einer hierarchischen Clusteranalyse unterzogen. Hierbei werden die Grenzen der gebildeten Cluster mittels der zugehörigen Greifobjekte festgelegt und analysiert. Abschließend werden bestimmte greiferspezifische Merkmale auf die Anwendbarkeit in den Clustern überprüft und bewertet. Diese Betrachtungen ermöglichen es, dass spezielle Anforderungen an den Greifer, die direkt aus den Eigenschaften der Greifobjekte herrühren, zuverlässig erkannt und konstruktiv berücksichtigt werden können.

Comfort of two shoulder actuation mechanisms for arm therapy exoskeletons: a comparative study in healthy subjects

Robotic exoskeletons can be used to study and treat patients with neurological impairments. They can guide and support the human limb over a large range of motion, which requires that the movement trajectory of the exoskeleton coincide with the one of the human arm. This is straightforward to achieve for rather simple joints like the elbow, but very challenging for complex joints like the human shoulder, which is comprised by several bones and can exhibit a movement with multiple rotational and translational degrees of freedom. Thus, several research groups have developed different shoulder actuation mechanism. However, there are no experimental studies that directly compare the comfort of two different shoulder actuation mechanisms. In this study, the comfort and the naturalness of the new shoulder actuation mechanism of the ARMin III exoskeleton are compared to a ball-and-socket-type shoulder actuation. The study was conducted in 20 healthy subjects using questionnaires and 3D-motion records to assess comfort and naturalness. The results indicate that the new shoulder actuation is slightly better than a ball-and-socket-type actuation. However, the differences are small, and under the tested conditions, the comfort and the naturalness of the two tested shoulder actuations do not differ a lot.

In vitro accuracy evaluation of image-guided robot system for direct cochlear access

HYPOTHESIS A previously developed image-guided robot system can safely drill a tunnel from the lateral mastoid surface, through the facial recess, to the middle ear, as a viable alternative to conventional mastoidectomy for cochlear electrode insertion. BACKGROUND Direct cochlear access (DCA) provides a minimally invasive tunnel from the lateral surface of the mastoid through the facial recess to the middle ear for cochlear electrode insertion. A safe and effective tunnel drilled through the narrow facial recess requires a highly accurate image-guided surgical system. Previous attempts have relied on patient-specific templates and robotic systems to guide drilling tools. In this study, we report on improvements made to an image-guided surgical robot system developed specifically for this purpose and the resulting accuracy achieved in vitro. MATERIALS AND METHODS The proposed image-guided robotic DCA procedure was carried out bilaterally on 4 whole head cadaver specimens. Specimens were implanted with titanium fiducial markers and imaged with cone-beam CT. A preoperative plan was created using a custom software package wherein relevant anatomical structures of the facial recess were segmented, and a drill trajectory targeting the round window was defined. Patient-to-image registration was performed with the custom robot system to reference the preoperative plan, and the DCA tunnel was drilled in 3 stages with progressively longer drill bits. The position of the drilled tunnel was defined as a line fitted to a point cloud of the segmented tunnel using principle component analysis (PCA function in MatLab). The accuracy of the DCA was then assessed by coregistering preoperative and postoperative image data and measuring the deviation of the drilled tunnel from the plan. The final step of electrode insertion was also performed through the DCA tunnel after manual removal of the promontory through the external auditory canal. RESULTS Drilling error was defined as the lateral deviation of the tool in the plane perpendicular to the drill axis (excluding depth error). Errors of 0.08 ± 0.05 mm and 0.15 ± 0.08 mm were measured on the lateral mastoid surface and at the target on the round window, respectively (n =8). Full electrode insertion was possible for 7 cases. In 1 case, the electrode was partially inserted with 1 contact pair external to the cochlea. CONCLUSION The purpose-built robot system was able to perform a safe and reliable DCA for cochlear implantation. The workflow implemented in this study mimics the envisioned clinical procedure showing the feasibility of future clinical implementation.

Three-dimensional, task-specific robot therapy of the arm after stroke: a multicentre, parallel-group randomised trial

BACKGROUND: Arm hemiparesis secondary to stroke is common and disabling. We aimed to assess whether robotic training of an affected arm with ARMin--an exoskeleton robot that allows task-specific training in three dimensions-reduces motor impairment more effectively than does conventional therapy. METHODS: In a prospective, multicentre, parallel-group randomised trial, we enrolled patients who had had motor impairment for more than 6 months and moderate-to-severe arm paresis after a cerebrovascular accident who met our eligibility criteria from four centres in Switzerland. Eligible patients were randomly assigned (1:1) to receive robotic or conventional therapy using a centre-stratified randomisation procedure. For both groups, therapy was given for at least 45 min three times a week for 8 weeks (total 24 sessions). The primary outcome was change in score on the arm (upper extremity) section of the Fugl-Meyer assessment (FMA-UE). Assessors tested patients immediately before therapy, after 4 weeks of therapy, at the end of therapy, and 16 weeks and 34 weeks after start of therapy. Assessors were masked to treatment allocation, but patients, therapists, and data analysts were unmasked. Analyses were by modified intention to treat. This study is registered with ClinicalTrials.gov, number NCT00719433. FINDINGS: Between May 4, 2009, and Sept 3, 2012, 143 individuals were tested for eligibility, of whom 77 were eligible and agreed to participate. 38 patients assigned to robotic therapy and 35 assigned to conventional therapy were included in analyses. Patients assigned to robotic therapy had significantly greater improvements in motor function in the affected arm over the course of the study as measured by FMA-UE than did those assigned to conventional therapy (F=4.1, p=0.041; mean difference in score 0.78 points, 95% CI 0.03-1.53). No serious adverse events related to the study occurred. INTERPRETATION: Neurorehabilitation therapy including task-oriented training with an exoskeleton robot can enhance improvement of motor function in a chronically impaired paretic arm after stroke more effectively than conventional therapy. However, the absolute difference between effects of robotic and conventional therapy in our study was small and of weak significance, which leaves the clinical relevance in question.

The Social Imaginary of Culture/Civilization in the Arabic Literary Tradition

Charles Taylor’s contribution to social imaginaries offers an interpretive framework for better understanding modernity as secularity. One of its main aspects is conceiving of human society in linear, homogenous time (secular time). Looking into the Arabic intellectual tradition, I will argue in my paper that Taylor’s framework can help us understand major social and intellectual transformations. The Ottoman and Arabic modernization process during the 19th century has often been understood by focusing on certain core concepts. One of these is tamaddun, usually translated as “civilization.” I will be mostly talking about the works of two “pioneers” of Arab modernity (which is traditionally referred to as an-nahḍa, the so-called Arab Renaissance): the Syrian Fransīs Marrāsh and the Egyptian Rifāʿa aṭ-Ṭahṭāwī. First I will focus on Marrāsh’s didactic novel “The Forest of Truth” (1865), as it offers a complex view of tamaddun, which has sometimes been construed as merely a social and political reform program. The category of "social imaginary,” however, is useful in grasping the wider semantic scope of this concept, which is reading it as a signifier for human history conceived of in secular time, as Taylor defines it. This conceptualization of human history functioning within the immanent frame can also be observed in the introduction to “The Extraction of Pure Gold in the Description of Paris” (1834), a systematic account of a travel experience in France that was written by the other “pioneer,” aṭ-Ṭahṭāwī. Finally, in translating tamaddun as “the modern social imaginary of civilization/culture,” the talk aims to consider this imaginary as a major factor in the emergence of the “secular age.” Furthermore, it suggests the importance of studying (quasi-) literary texts, such as historiographical, geographical, and self-narratives in the Arabic literary tradition, in order to further elaborate continuities and ruptures in social imaginaries.

Short-arc tracklet association for geostationary objects

Measurement association and initial orbit determination is a fundamental task when building up a database of space objects. This paper proposes an efficient and robust method to determine the orbit using the available information of two tracklets, i.e. their line-of-sights and their derivatives. The approach works with a boundary-value formulation to represent hypothesized orbital states and uses an optimization scheme to find the best fitting orbits. The method is assessed and compared to an initial-value formulation using a measurement set taken by the Zimmerwald Small Aperture Robotic Telescope of the Astronomical Institute at the University of Bern. False associations of closely spaced objects on similar orbits cannot be completely eliminated due to the short duration of the measurement arcs. However, the presented approach uses the available information optimally and the overall association performance and robustness is very promising. The boundary-value optimization takes only around 2% of computational time when compared to optimization approaches using an initial-value formulation. The full potential of the method in terms of run-time is additionally illustrated by comparing it to other published association methods.

Semiautomatic Cochleostomy Target and Insertion Trajectory Planning for Minimally Invasive Cochlear Implantation

A major component of minimally invasive cochlear implantation is atraumatic scala tympani (ST) placement of the electrode array. This work reports on a semiautomatic planning paradigm that uses anatomical landmarks and cochlear surface models for cochleostomy target and insertion trajectory computation. The method was validated in a human whole head cadaver model (n = 10 ears). Cochleostomy targets were generated from an automated script and used for consecutive planning of a direct cochlear access (DCA) drill trajectory from the mastoid surface to the inner ear. An image-guided robotic system was used to perform both, DCA and cochleostomy drilling. Nine of 10 implanted specimens showed complete ST placement. One case of scala vestibuli insertion occurred due to a registration/drilling error of 0.79 mm. The presented approach indicates that a safe cochleostomy target and insertion trajectory can be planned using conventional clinical imaging modalities, which lack sufficient resolution to identify the basilar membrane.

Best Practices in Robot-assisted Radical Cystectomy and Urinary Reconstruction: Recommendations of the Pasadena Consensus Panel

CONTEXT Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes. OBJECTIVE A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction. No commercial support was obtained for the conference. EVIDENCE ACQUISITION A systematic review of the literature was performed in agreement with the PRISMA statement. EVIDENCE SYNTHESIS Systematic literature reviews and individual presentations were discussed, and consensus on all key issues was obtained. Most operative, intermediate-term oncologic, functional, and complication outcomes are similar between open RC (ORC) and RARC. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC generally requires longer operative time than ORC, particularly with intracorporeal reconstruction. Robotic assistance provides ergonomic value for surgeons. Surgeon experience and institutional volume strongly predict favorable outcomes for either open or robotic techniques. CONCLUSIONS RARC appears to be similar to ORC in terms of operative, pathologic, intermediate-term oncologic, complication, and most functional outcomes. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC can be more expensive than ORC, although high procedural volume may attenuate this difference. PATIENT SUMMARY Robot-assisted radical cystectomy (RARC) is an alternative to open surgery for patients with bladder cancer who require removal of their bladder and reconstruction of their urinary tract. RARC appears to be similar to open surgery for most important outcomes such as the rate of complications and intermediate-term cancer-specific survival. Although RARC has some ergonomic advantages for surgeons and may result in less blood loss during surgery, it is more time consuming and may be more expensive than open surgery.

What does professionalisation mean? Perceptions of professionalisation in swiss sport federations

Introduction: Organisational changes in sports federations are often associated with a drift from a volunteer driven to an increasingly business-like phenomenon (Shilbury & Ferkins, 2011). This process of transfor-mation is be called as “professionalization”. Accordingly, professionalization seems to be an appropriate strategy for sport organisations in order to meet organizational pressure due to challenges of a more complex and dynamic changing environment adequately. Despite the increasing research interest and the attempts for systematization on the phenomenon of professionalization it still remains unclear what does the term professionalization exactly mean (Dowling et al., 2014). Thus, there is a lack of a consistent concept of professionalization that is needed in order to explore different facets and perspectives of this phenomenon more validly. Against this background following question emerged: What is the suitable concept of professionalization for analyzing the actual ongoing processes of change, adaption or transformation in sport federations? Methods: Dealing with this question, following two-step approach was choosen: (1) In a first step a scholar’s perspective at professionalisation of sport organisations will be displayed in order to explore both the common ground as well as divergences and inconsistencies in previous approaches. Therefore, a literature review is indicated. (2) In a second step, and in contrast to previous studies we will consider a practical point of view by a so called second-order observation of experts to gain valuable insights into current thinking and acting towards professionalization in sport federations. In doing so, a hermeneutical approach is used, which is about understanding the meaning of contexts by grasping the everyday world, and draw insight and meaning from it (Shilbury et al., 2013). Accordance with hermeneutics, the explorative interpretive knowledge of expert interviews was used. The interviews were conducted with a sample of six selected experts, who have both dedicated insider knowledge and the overall view of all Swiss sport federations. Results and discussion: The summaries of literature review could be categorized into two research currents. The one defines professionalization as a structural process towards professional status of occupations. The other defines it in a broader sense as an organisational change towards a business-like approach. Whereas the first perspective there is a broad scientific consensus that second isn’t that clear, however. Explorative analysis of interview data reveals different themes in relation to professionalization of sports federation. First theme deals with a changed philosophy as more strategic alignment towards for-profit, efficiency and quality orientation. Second theme refers to paid work associated with more competence orientation and balanced governance between paid and voluntary work. Third theme deals with acting shift towards more rationalization and efficiency by implementation of innovative management and communication tools. Based on findings of both our review of scholar`s perspective as well insights from experts we will provide – in the sense of synthesis – a more clear understanding of what does professionalization mean that can be useful in terms of further studies. References: Dowling, M., Edwards, J. & Washington, M. (2014). Understanding the concept of professionalisation in sport management research. Sport Management Review, 17 (4), 520–529. Shilbury, D., Ferkins, L. & Smythe, L. (2013). Sport governance encounters: Insights from lived experiences. Sport Management Review, 16,349–363. Shilbury, D., & Ferkins, L. (2011). Professionalisation, sport governance and strategic capability. Managing Leisure, 16, 108–127.

Mechatronic feasibility of minimally invasive, atraumatic cochleostomy

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.