Diagnosis and treatment of subsegmental pulmonary embolism

Subsegmental pulmonary embolism(SSPE) affects the 4 th division and more distal pulmonary arterial branches. SSPE can be isolated or affect multiple subsegments, be symptomatic or incidental(unsuspected) and may or may not be associated with deep vein thrombosis. Symptoms, clinical risk scores and biomarkers are less sensitive for diagnosing SSPE compared to more central pulmonary embolism. The diagnosis is confirmed using radiological imaging,predominately computed tomographic pulmonary angiogram(CTPA) or ventilation/perfusion scanning. The increasing utilization of CTPAs may have resulted in overdiagnosis driven by smaller pulmonary emboli. There is insufficient evidence of improved mortality or reduced venous thromboembolism recurrence with anticoagulation treatment for SSPE however,the major and clinically significant haemorrhage risks are well described. As the resolution of diagnostic imaging has improved, we may be viewing the natural physiological filtering process performed by the lungs that may not require treatment.

Static-to-kinematic modeling and experimental validation of tendon-driven quasi continuum manipulators with nonconstant subsegment stiffness

Continuum robots with high flexibility and compliance have the capability to operate in confined and cluttered environments. To enhance the load capacity while maintaining robot dexterity, we propose a novel non-constant subsegment stiffness structure for tendon-driven quasi continuum robots(TDQCRs) comprising rigid-flexible coupling subsegments.Aiming at real-time control applications, we present a novel static-to-kinematic modeling approach to gain a comprehensive understanding of the TDQCR model. The analytical subsegment-based kinematics for the multisection manipulator is derived based on screw theory and product of exponentials formula, and the static model considering gravity loading,actuation loading, and robot constitutive laws is established. Additionally, the effect of tension attenuation caused by routing channel friction is considered in the robot statics, resulting in improved model accuracy. The root-mean-square error between the outputs of the static model and the experimental system is less than 1.63% of the arm length(0.5 m). By employing the proposed static model, a mapping of bending angles between the configuration space and the subsegment space is established. Furthermore, motion control experiments are conducted on our TDQCR system, and the results demonstrate the effectiveness of the static-to-kinematic model.