Laparoscopic surgery constrains instrument motion around a fixed pivot point at the incision into a patient to minimize tissue trauma. Surgical robots achieve this through either hardware to software-based remote center of motion (RCM) constraints. However, accurate RCM alignment is difficult due to manual trocar placement, patient motion, and tissue deformation. Misalignment between the robot's RCM point and the patient incision site can cause unsafe forces at the incision site. This paper presents a sensorless force estimation-based framework for dynamically assessing and optimizing RCM misalignment in robotic surgery. Our experiments demonstrate that misalignment exceeding 20 mm can generate large enough forces to potentially damage tissue, emphasizing the need for precise RCM positioning. For misalignment $D\geq $ 20 mm, our optimization algorithm estimates the RCM offset with an absolute error within 5 mm. Accurate RCM misalignment estimation is a step toward automated RCM misalignment compensation, enhancing safety and reducing tissue damage in robotic-assisted laparoscopic surgery.

Alternative data provides valuable insights for lenders to evaluate a borrower's creditworthiness, which could help expand credit access to underserved groups and lower costs for borrowers. But some forms of alternative data have historically been excluded from credit underwriting because it could act as an illegal proxy for a protected class like race or gender, causing redlining. We propose a method for applying causal inference to a supervised machine learning model to debias alternative data so that it might be used for credit underwriting. We demonstrate how our algorithm can be used against a public credit dataset to improve model accuracy across different racial groups, while providing theoretically robust nondiscrimination guarantees.

Haptic feedback to the surgeon during robotic surgery would enable safer and more immersive surgeries but estimating tissue interaction forces at the tips of robotically controlled surgical instruments has proven challenging. Few existing surgical robots can measure interaction forces directly and the additional sensor may limit the life of instruments. We present a hybrid model and learning-based framework for force estimation for the Patient Side Manipulators (PSM) of a da Vinci Research Kit (dVRK). The model-based component identifies the dynamic parameters of the robot and estimates free-space joint torque, while the learning-based component compensates for environmental factors, such as the additional torque caused by trocar interaction between the PSM instrument and the patient's body wall. We evaluate our method in an abdominal phantom and achieve an error in force estimation of under 10% normalized root-mean-squared error. We show that by using a model-based method to perform dynamics identification, we reduce reliance on the training data covering the entire workspace. Although originally developed for the dVRK, the proposed method is a generalizable framework for other compliant surgical robots. The code is available at https://github.com/vu-maple-lab/dvrk_force_estimation.

Sensory substitution is an effective approach for displaying stable haptic feedback to a teleoperator under time delay. The finger is highly articulated, and can sense movement and force in many directions, making it a promising location for sensory substitution based on kinesthetic feedback. However, existing finger kinesthetic devices either provide only one-degree-of-freedom feedback, are bulky, or have low force output. Soft pneumatic actuators have high power density, making them suitable for realizing high force kinesthetic feedback in a compact form factor. We present a soft pneumatic handheld kinesthetic feedback device for the index finger that is controlled using a constant curvature kinematic model. \changed{It has respective position and force ranges of +-3.18mm and +-1.00N laterally, and +-4.89mm and +-6.01N vertically, indicating its high power density and compactness. The average open-loop radial position and force accuracy of the kinematic model are 0.72mm and 0.34N.} Its 3Hz bandwidth makes it suitable for moderate speed haptic interactions in soft environments. We demonstrate the three-dimensional kinesthetic force feedback capability of our device for sensory substitution at the index figure in a virtual telemanipulation scenario.

Given the rapidly expanding capabilities of generative AI models for radiology, there is a need for robust metrics that can accurately measure the quality of AI-generated radiology reports across diverse hospitals. We develop ReXamine-Global, a LLM-powered, multi-site framework that tests metrics across different writing styles and patient populations, exposing gaps in their generalization. First, our method tests whether a metric is undesirably sensitive to reporting style, providing different scores depending on whether AI-generated reports are stylistically similar to ground-truth reports or not. Second, our method measures whether a metric reliably agrees with experts, or whether metric and expert scores of AI-generated report quality diverge for some sites. Using 240 reports from 6 hospitals around the world, we apply ReXamine-Global to 7 established report evaluation metrics and uncover serious gaps in their generalizability. Developers can apply ReXamine-Global when designing new report evaluation metrics, ensuring their robustness across sites. Additionally, our analysis of existing metrics can guide users of those metrics towards evaluation procedures that work reliably at their sites of interest.

Gait asymmetry, a consequence of various neurological or physical conditions such as aging and stroke, detrimentally impacts bipedal locomotion, causing biomechanical alterations, increasing the risk of falls and reducing quality of life. Addressing this critical issue, this paper introduces a novel diagnostic method for gait symmetry analysis through the use of an assistive robotic Smart Walker equipped with an innovative asymmetry detection scheme. This method analyzes sensor measurements capturing the interaction torque between user and walker. By applying a seasonal-trend decomposition tool, we isolate gait-specific patterns within these data, allowing for the estimation of stride durations and calculation of a symmetry index. Through experiments involving 5 experimenters, we demonstrate the Smart Walker's capability in detecting and quantifying gait asymmetry by achieving an accuracy of 84.9% in identifying asymmetric cases in a controlled testing environment. Further analysis explores the classification of these asymmetries based on their underlying causes, providing valuable insights for gait assessment. The results underscore the potential of the device as a precise, ready-to-use monitoring tool for personalized rehabilitation, facilitating targeted interventions for enhanced patient outcomes.

The proliferation of robot-assisted minimally invasive surgery highlights the need for advanced training tools such as cost-effective robotic endotrainers. Current surgical robots often lack haptic feedback, which is crucial for providing surgeons with a real-time sense of touch. This absence can impact the surgeon's ability to perform delicate operations effectively. To enhance surgical training and address this deficiency, we have integrated a cost-effective haptic feedback system into a robotic endotrainer. This system incorporates both kinesthetic (force) and tactile feedback, improving the fidelity of surgical simulations and enabling more precise control during operations. Our system incorporates an innovative, cost-effective Force/Torque sensor utilizing optoelectronic technology, specifically designed to accurately detect forces and moments exerted on surgical tools with a 95% accuracy, providing essential kinesthetic feedback. Additionally, we implemented a tactile feedback mechanism that informs the surgeon of the gripping forces between the tool's tip and the tissue. This dual feedback system enhances the fidelity of training simulations and the execution of robotic surgeries, promoting broader adoption and safer practices.

In this study, we further investigate the robustness and generalization ability of an neural network (NN) based force estimation method, using the da Vinci Research Kit Si (dVRK-Si). To evaluate our method's performance, we compare the force estimation accuracy with several baseline methods. We conduct comparative studies between the dVRK classic and dVRK-Si systems to benchmark the effectiveness of these approaches. We conclude that the NN-based method provides comparable force estimation accuracy across the two systems, as the average root mean square error (RMSE) over the average range of force ratio is approximately 3.07% for the dVRK classic, and 5.27% for the dVRK-Si. On the dVRK-Si, the force estimation RMSEs for all the baseline methods are 2 to 4 times larger than the NN-based method in all directions. One possible reason is, we made assumptions in the baseline methods that static forces remain the same or dynamics is time-invariant. These assumptions may hold for the dVRK Classic, as it has pre-loaded weight and maintains horizontal self balance. Since the dVRK-Si configuration does not have this property, assumptions do not hold anymore, therefore the NN-based method significantly outperforms.

Performing intricate eye microsurgery, such as retinal vein cannulation (RVC), as a potential treatment for retinal vein occlusion (RVO), without the assistance of a surgical robotic system is very challenging to do safely. The main limitation has to do with the physiological hand tremor of surgeons. Robot-assisted eye surgery technology may resolve the problems of hand tremors and fatigue and improve the safety and precision of RVC. The Steady-Hand Eye Robot (SHER) is an admittance-based robotic system that can filter out hand tremors and enables ophthalmologists to manipulate a surgical instrument inside the eye cooperatively. However, the admittance-based cooperative control mode does not address crucial safety considerations, such as minimizing contact force between the surgical instrument and the sclera surface to prevent tissue damage. An adaptive sclera force control algorithm was proposed to address this limitation using an FBG-based force-sensing tool to measure and minimize the tool-sclera interaction force. Additionally, features like haptic feedback or hand motion scaling, which can improve the safety and precision of surgery, require a teleoperation control framework. We implemented a bimanual adaptive teleoperation (BMAT) control mode using SHER 2.0 and SHER 2.1 and compared its performance with a bimanual adaptive cooperative (BMAC) mode. Both BMAT and BMAC modes were tested in sitting and standing postures during a vessel-following experiment under a surgical microscope. It is shown, for the first time to the best of our knowledge in robot-assisted retinal surgery, that integrating the adaptive sclera force control algorithm with the bimanual teleoperation framework enables surgeons to safely perform bimanual telemanipulation of the eye without over-stretching it, even in the absence of registration between the two robots.

Robotic technologies are becoming increasingly popular in dentistry due to the high level of precision required in delicate dental procedures. Most dental robots available today are designed for implant surgery, helping dentists to accurately place implants in the desired position and depth. In this paper, we introduce the DentiBot, the first robot specifically designed for dental endodontic treatment. The DentiBot is equipped with a force and torque sensor, as well as a string-based Patient Tracking Module, allowing for real-time monitoring of endodontic file contact and patient movement. We propose a 6-DoF hybrid position/force controller that enables autonomous adjustment of the surgical path and compensation for patient movement, while also providing protection against endodontic file fracture. In addition, a file flexibility model is incorporated to compensate for file bending. Pre-clinical evaluations performed on acrylic root canal models and resin teeth confirm the feasibility of the DentiBot in assisting endodontic treatment.