The vascular interventional surgery (VIS) is the most popular treatment for the cardiovascular and cerebrovascular diseases. Master-slave VIS robot is a promising technology to further improve the operation accuracy and surgical safety of both the patient and surgeon. The surgical outcome of robot assisted VIS highly depends on surgeon’s operating skills. However, current VIS robot systems affect the exerting of surgeon’s operating skills with different degrees due to the master manipulators with rigid-link structure or low detecting accuracy. To address this issue, a novel vascular interventional surgery robot based on surgeon’s operating skills is developed in this paper. A master manipulator is developed to contactlessly measure the surgeon’s operating motion. The surgeon operates the catheter with no limit, just as the operating manner in conventional VIS. It is enabled by measuring the catheter’s axial motion through tracking the edge of a series of markers with a macro camera, and by measuring the catheter’s rotational motion via a high-precise MEMS (Micro-Electro-Mechanic-System) gyroscope. Then, the developed master manipulator is integrated with a slave robot to construct the master-slave VIS robot system. Experimental results show that the detecting accuracy of the developed master manipulator are 0.71° and 0.104mm. Experimental results of surgical tasks implemented in EVE (endovascular evaluator) indicate that the developed robot system is superior to the system using a phantom as the master manipulator according to the metrics including operating time, path length, maximum speed and maximum accelerate.

Digital subtracted angiography (DSA) remains the gold standard for diagnosis of cerebral vascular diseases and provides intraprocedural guidance. This practice involves extensive usage of x-ray and iodinated contrast medium, which can induce side effects. In this study, we examined the accuracy of 3-dimensional (3D) registration of magnetic resonance angiography (MRA) and DSA imaging for cerebral vessels, and tested the feasibility of using preprocedural MRA for real-time guidance during endovascular procedures.Twenty-three patients with suspected intracranial arterial lesions were enrolled. The contrast medium-enhanced 3D DSA of target vessels were acquired in 19 patients during endovascular procedures, and the images were registered with preprocedural MRA for fusion accuracy evaluation. Low-dose noncontrasted 3D angiography of the skull was performed in the other 4 patients, and registered with the MRA. The MRA was overlaid afterwards with 2D live fluoroscopy to guide endovascular procedures.The 3D registration of the MRA and angiography demonstrated a high accuracy for vessel lesion visualization in all 19 patients examined. Moreover, MRA of the intracranial vessels, registered to the noncontrasted 3D angiography in the 4 patients, provided real-time 3D roadmap to successfully guide the endovascular procedures. Radiation dose to patients and contrast medium usage were shown to be significantly reduced.Three-dimensional MRA and angiography fusion can accurately generate cerebral vasculature images to guide endovascular procedures. The use of the fusion technology could enhance clinical workflow while minimizing contrast medium usage and radiation dose, and hence lowering procedure risks and increasing treatment safety.

Background: Operating an aircraft is associated with a large mental workload; however, knowledge of the mental workload of ROV operators is limited. The purpose of this study was to establish a digital system for assessing the mental workload of remotely operated vehicle (ROV) operators using hemodynamic parameters, and compare results of different groups with different experience levels. Method: Forty-one trainee pilots performed flight tasks once daily for 5 consecutive days in a flight simulation. Forty-five pilots experienced pilots and 68 experienced drivers were also included. Hemodynamic responses were measured by functional near-infrared spectroscopy (fNIRS). Results: The median duration of peak oxyhemoglobin was 147.13 s (interquartile range [IQR] 21.97, 401.70 s) in the left brain and 180.74 s (IQR 34.37, 432.01 s) in the right brain in the experienced pilot group, and 184.42 s (IQR 3.41, 451.81 s) on day 5 in the left brain and 160.30 s (IQR 2.62, 528.20 s) in the right brain in the trainee group. Conclusion: Navigation training reduces peak oxyhemoglobin duration, and may potentially be used as a surrogate marker for mental workload of ROV operators. Peak oxyhemoglobin concentration during s task may allow development of a simplified scheme for optimizing flight performance based on the mental workload of a pilot.

Retinoblastoma is a common intraocular malignant tumor in children. However, the molecular and genetic mechanisms of retinoblastoma remain unclear. The gene expression dataset GSE110811 was retrieved from Gene Expression Omnibus. After preprocessing, coexpression modules were constructed by weighted gene coexpression network analysis (WGCNA), and modules associated with clinical traits were identified. In addition, functional enrichment analysis was performed for genes in the indicated modules, and protein‑protein interaction (PPI) networks and subnetworks were constructed based on these genes. Eight coexpression modules were constructed through WGCNA. Of these, the yellow module had the highest association with severity and age (r=0.82 and P=3e‑07; r=0.72 and P=3e‑05). The turquoise module had the highest association with months (r=‑0.63 and P=5e‑04). The genes in the two modules participate in multiple pathways of retinoblastoma, and by combining the PPI network and subnetworks; 10 hub genes were identified in the two modules. The present study identified coexpression modules and hub genes associated with clinical traits of retinoblastoma, providing novel insight into retinoblastoma progression.