Search Results (3)

Introduction: Available guidelines recommend performing nephron-sparing surgery in selected renal cell carcinoma (RCC) patients. Many studies provided robot-assisted partial nephrectomy (RAPN) functional and oncological outcomes, with most of these including a wide timespan and a number of surgeons with different experiences, which might lead to the heterogeneity of the results. In this study, we aim to provide a contemporary report of RAPN patient outcomes performed at two referral centers by experienced surgeons. Materials and Methods: Overall, 333 RAPN patients treated at two European referral centers between 2019 and 2021 were identified. Continuous and categorical variables were reported using medians and proportions. Multi-variable logistic regression (MLR) models were fitted to test predictors of off-clamp technique use and trifecta achievement. Results: The median age was 65 (IQR: 57–73) years. The clinical stage distribution was as follows: 224 (67%) cT1a vs. 89 (26%) cT1b vs. 20 cT2 (7%). The median warm ischemia time was 14 (10–18) minutes, with trifecta being achieved in 74% (n = 240) of patients. In MLR models predicting off-clamp surgery, an increasing R.E.N.A.L. score was independently associated with a lower chance of attempting such a technique (OR: 0.69, p-value < 0.001). In models predicting trifecta achievement, both a higher R.E.N.A.L. score (OR: 0.78, p-value = 0.007) and the presence of multiple lesions (OR: 0.29, p-value = 0.007) were independently associated with lower chances of reaching the outcome. Significant upstaging of chronic kidney disease (CKD) stage was recorded in 9.4% of patients after one year of follow-up. Conclusions: We reported the contemporary outcomes of patients treated with RAPN by highly experienced surgeons from two referral centers. This report represents a valid benchmark that could be used for individual patient counseling in the decision-making process. Full article

Natural disasters, including earthquakes, floods, landslides, tsunamis, wildfires, and hurricanes, have become more common in recent years due to rapid climate change. For Post-Disaster Management (PDM), authorities deploy various types of user equipment (UE) for the search and rescue operation, for example, search and rescue robots, drones, medical robots, smartphones, etc., via the Internet of Robotic Things (IoRT) supported by cellular 4G/LTE/5G and beyond or other wireless technologies. For uninterrupted communication services, movable and deployable resource units (MDRUs) have been utilized where the base stations are damaged due to the disaster. In addition, power optimization of the networks by satisfying the quality of service (QoS) of each UE is a crucial challenge because of the electricity crisis after the disaster. In order to optimize the energy efficiency, UE throughput, and serving cell (SC) throughput by considering the stationary as well as movable UE without knowing the environmental priori knowledge in MDRUs aided two-tier heterogeneous networks (HetsNets) of IoRT, the optimization problem has been formulated based on emitting power allocation and user association combinedly in this article. This optimization problem is nonconvex and NP-hard where parameterized (discrete: user association and continuous: power allocation) action space is deployed. The new model-free hybrid action space-based algorithm called multi-pass deep Q network (MP-DQN) is developed to optimize this complex problem. Simulations results demonstrate that the proposed MP-DQN outperforms the parameterized deep Q network (P-DQN) approach, which is well known for solving parameterized action space, DQN, as well as traditional algorithms in terms of reward, average energy efficiency, UE throughput, and SC throughput for motionless as well as moveable UE. Full article

This paper presents a time-synchronization solution for operations performed by a heterogeneous set of robotic manipulators grouped into a production cell. The cell control is realized using master–slave architecture without an external control element. Information transmission in a cell is provided by a TCP/IP channel in which communication is ensured via sockets. The proposed problem solution includes an algorithm, which is verified and validated by simulation and tested in real environment. This algorithm requires minimal computational power thanks to an empirically oriented approach, which enables its processing directly by the control unit of each participating element of the robotic cell. The algorithm works on the basis of monitoring and evaluating time differences among sub-operations of master and slave devices. This ensures defined production cycle milestones of each robotic manipulator in the cell at the same time are attained. Dynamic speed adaptation of slave manipulators utilizing standard instructions of their native language is used. The proposed algorithm also includes a feedforward form of operations synchronization which responds to changes in the operating cycle of the master manipulator. The application of the solution proposal is supplemented with a visualization part. This part represents a complementary form of designed solution implementation. Full article