The impact of diabetes on postoperative outcomes following spine surgery: A meta-analysis of 40 cohort studies with 2.9 million participants.

This study aimed to summarize the current progress in the field of robot-assisted laminectomy in spinal surgery. A systematic search of the Institute of Electrical and Electronics Engineers (IEEE) Xplore, PubMed, Embase, Web of science, The Cochrane Library, Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Biomedicine Literature Database (CBM-SinoMed) was performed for papers related to robotic-assisted laminectomy. A total of 27 articles were selected for inclusion in our study. Among the articles, 10 robotic system, 2 bone cutting strategies, 6 state recognition strategies were founded. The most commonly adopted type of robot system was the Nathoo A type (6/10). Bone cutting strategies were mainly formulated based on force information and medical image information, and state recognition was based on a variety of factors, including force, sound, vibration, medical images, current or a combination of parameters. Early research on robot-assisted laminectomy did not reflect good continuity, and the studies mainly focused on the type of robotic system. In recent years, more researchers have chosen the Nathoo A as the robot system type, and the focus of research has gradually shifted to laminectomy path planning and safety control strategies, such as state recognition. Although these studies have been able to perform laminectomy without penetrating the inner cortex of the lamina, most experiments have been performed in vitro, and clinical application is still untested.

/pdf/robot-assisted-laminectomy-in-spinal-surgery-a-systematic-4pe34v6vs1.pdf

Robot-assisted laminectomy in spinal surgery: a systematic review.

The potential of ultrafast lasers (pico- to femtosecond) in orthopedics-related procedures has been studied extensively for clinical adoption. As compared to conventional laser systems with continuous wave or longer wave pulse, ultrafast lasers provide advantages such as higher precision and minimal collateral thermal damages. Translation to surgical applications in the clinic has been restrained by limitations of material removal rate and pulse average power, whereas the use in surface texturing of implants has become more refined to greatly improve bioactivation and osteointegration within bone matrices. With recent advances, we review the advantages and limitations of ultrafast lasers, specifically in orthopedic bone ablation as well as bone implant laser texturing, and consider the difficulties encountered within orthopedic surgical applications where ultrafast lasers could provide a benefit. We conclude by proposing our perspectives on applications where ultrafast lasers could be of advantage, specifically due to the non-thermal nature of ablation and control of cutting.

/pdf/orthopedics-related-applications-of-ultrafast-laser-and-its-18mujub9.pdf

Orthopedics-Related Applications of Ultrafast Laser and Its Recent Advances

The hydrogen recirculation ejector plays a pivotal role in proton exchange membrane fuel cell systems. Nevertheless, a comprehensive grasp of the intricate two-phase flow characteristics within hydrogen recirculation ejectors remains elusive. This investigation delves into the condensation and droplet behaviors of an ejector designed for a 100 kW fuel cell stack. The analysis relies on a two-phase flow model that takes into account both homogeneous and heterogeneous condensation. The findings reveal that homogeneous condensation nuclei manifest within the mixing chamber when the stack power surpasses 31 kW. The average median diameter of homogeneous droplets at the ejector outlet measures 0.367 μm, whereas that of heterogeneous droplets stands at 1.265 μm, signifying a 26.5 % augmentation compared to their initial size. Additionally, two crucial factors impact droplet size: residence time and subcooling degree. At the 100 kW condition, the droplet residence time is a mere 0.272 ms, yielding a meager droplet flow rate of merely 1.79 mg/s. In contrast, at the 53 kW condition, the downstream of the mixing chamber exhibits the maximum subcooling degree, resulting in the maximum droplet flow rate of 22.12 mg/s. A temperature elevation of 2.68 K at the ejector outlet is observed due to the latent heat of condensation. Furthermore, condensation has a marginal impact on the entrainment ratio, with the most significant reduction being 4.18 %, averaging at 1.42 %. 

Condensation and droplet characteristics in hydrogen recirculation ejectors for PEM fuel cell systems

ABSTRACT Introduction The application of robotic navigation during spine surgery has advanced rapidly over the past two decades, especially in the last 5 years. Robotic systems in spine surgery may offer potential advantages for both patients and surgeons. This article serves as an update to our previous review and explores the current status of spine surgery robots in clinical settings. Areas covered We evaluated the literature published from 2020 to 2022 on the outcomes of robotics-assisted spine surgery, including accuracy and its influencing factors, radiation exposure, and follow-up results. Expert opinion The application of robotics in spine surgery has driven spine surgery into a new era of precision treatment through a form of artificial intelligence assistance that compensates for the limitations of human abilities. Modularized robot configurations, intelligent alignment and planning incorporating multimodal images, efficient and simple human – machine interaction, accurate surgical status monitoring, and safe control strategies are the main technical features for the development of orthopedic surgical robots. The use of robotics-assisted decompression, osteotomies, and decision-making warrants further study. Future investigations should focus on patients’ needs while continuing to explore in-depth medical – industrial collaborative development innovations that improve the overall utilization of artificial intelligence and sophistication in disease treatment.

Robotic navigation during spine surgery: an update of literature

Transient numerical study of CO2 two-phase flow in a needle adjustable ejector

Microchannel flat-tube heat exchangers (MCHX) have been introduced into refrigeration systems due to their high efficient heat transfer, lightweight and compact structure. In this work, a MCHX was introduced into a household freezer as the evaporator. The dynamic characteristics and performance were experimentally investigated and compared to the freezer with a traditional circular tube evaporator. Results showed that the refrigerant charge, compressor-on ratio, and daily power consumption of the freezer with the MCHX were reduced by 5.4%, 4.4% and 4.8%, respectively. In contrast to circular tubes, microchannel tubes in evaporators have a flattened rectangular with multiple flow channels. This design increases the surface area for heat transfer, allowing for enhanced heat transfer performance. The decreased refrigerant charge and good heat exchange performance for the MCHX evaporator contribute to a lower outlet temperature, improved cooling efficiency and lower power of the compressor. Results verified that the MCHX could be used as the evaporator in household freezers to reduce the power consumption and improve the system performance. 

Performance improvement of a household freezer with a microchannel flat-tube evaporator

The invention is applicable to the technical field of medical instruments, and relates to spinal laminectomy surgical equipment, which comprises a positioning robot, a navigation robot, an operation robot and a multi-robot system control system. The positioning robot is used for accurate positioning in an operation, the navigation robot is used for autonomously avoiding obstacles in the operationto realize stable navigation, and the operation robot is used for stably and safely excising a vertebral plate in the operation. Compared with the prior art, the surgical equipment has the advantagesthat through information processing of a multi-robot cooperative control system, quantitative control over vertebral laminectomy of a surgical power tool is achieved, meanwhile, a navigation robot actively avoids a pose tracker to mark a shelter, and finally the vertebral laminectomy is safely and effectively completed.

Spinal laminectomy surgical equipment

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Papers

Robot-assisted laminectomy in spinal surgery: a systematic review.

Transient numerical study of CO2 two-phase flow in a needle adjustable ejector

Performance improvement of a household freezer with a microchannel flat-tube evaporator

Spinal laminectomy surgical equipment