Intelligent medicine and beyond

With the developments of medical artificial intelligence (AI), meta-data analysis, intelligence-aided drug design and discovery, surgical robots and image-navigated precision treatments, intelligent medicine (IM) as a new era evolved from ancient medicine and biomedical medicine, has become an emerging topic and important criteria for clinical applications. It is fully characterized by fundamental research-driven, new-generation technique-directed as well as state-of-the-art paradigms for advanced disease diagnosis and therapy leading to an even broader future of modern medicine. As a fundamental subject and also a practice-oriented field, intelligent medicine is highly trans-disciplinary and cross-developed, which has emerged the knowledge of modern medicine, basic sciences and engineering. Basically, intelligent medicine has three domains of intelligent biomaterials, intelligent devices and intelligent techniques. Intelligent biomaterials derive from traditional biomedical materials, and currently are endowed with multiple functionalities for medical uses. For example, micro-/nanorobots, smart responsive biomaterials and digital drugs are representative intelligent biomaterials which have been already commercialized and applied to clinical uses. Intelligent devices, such as surgical robots, rehabilitation robots and medical powered exoskeleton, are an important majority in the family of intelligent medicine. Intelligent biomaterials and intelligent devices are more and more closely integrated with each other especially on the occasions of intelligence acquisition, remote transmission, AI-aided analysis and management. In comparison, intelligent techniques are internalized in the former two domains and are playing a critical role in the development of intelligent medicine. Representative intelligent techniques of telemedicine, image-navigated surgery, virtual/augmented reality and AI-assisted image analysis for early-stage disease assessments have been employed in nowadays clinical operations which to a large extent relieved medical labors. In the past decades, China has been in the leading groups compared to international colleagues in the arena of intelligent medicine, and a series of eminent research has been clinically translated for practical uses in China. For instance, the first 5G-aided remote surgery has been realized in Fujian Province in January 2019, which for the first time validated their applicability for human uses. The surgical robots have found China as the most vigorous market, and more than 10 famous Chinese companies are developing versatile surgical robots for both Chinese people and people all over the world. China also applied AI techniques to new drug developments especially in early 2020 when COVID-19 epidemic roared, and several active molecules and drug motifs have been discovered for early-stage COVID-19 screening and treatments. Based on the significance of intelligent medicine and its rapid developments in both basic research and industrials, this review summarized the comprehensive viewpoints of the Y6 Xiangshan Science Conferences titled with Fundamental Principles and Key Technologies of Intelligent Medicine, and gave an in-depth discussion on main perspectives of future developments of the integration of biomaterial and devices, the integration of bioinformatics and medical hardware, and the synergy of biotechnology and intelligence information. It is expected that this featuring article will further promote intelligent medicine to an even broader community not only for scientists but also for industrials, and in the long run embrace a perspective future for its blooming and rich contributions in China in the coming 5 years.

Intelligent medicine and beyond

With the developments of medical artificial intelligence (AI), meta-data analysis, intelligence-aided drug design and discovery, surgical robots and image-navigated precision treatments, intelligent medicine (IM) as a new era evolved from ancient medicine and biomedical medicine, has become an emerging topic and important criteria for clinical applications. It is fully characterized by fundamental research-driven, new-generation technique-directed as well as state-of-the-art paradigms for advanced disease diagnosis and therapy leading to an even broader future of modern medicine. As a fundamental subject and also a practice-oriented field, intelligent medicine is highly trans-disciplinary and cross-developed, which has emerged the knowledge of modern medicine, basic sciences and engineering. Basically, intelligent medicine has three domains of intelligent biomaterials, intelligent devices and intelligent techniques. Intelligent biomaterials derive from traditional biomedical materials, and currently are endowed with multiple functionalities for medical uses. For example, micro-/nanorobots, smart responsive biomaterials and digital drugs are representative intelligent biomaterials which have been already commercialized and applied to clinical uses. Intelligent devices, such as surgical robots, rehabilitation robots and medical powered exoskeleton, are an important majority in the family of intelligent medicine. Intelligent biomaterials and intelligent devices are more and more closely integrated with each other especially on the occasions of intelligence acquisition, remote transmission, AI-aided analysis and management. In comparison, intelligent techniques are internalized in the former two domains and are playing a critical role in the development of intelligent medicine. Representative intelligent techniques of telemedicine, image-navigated surgery, virtual/augmented reality and AI-assisted image analysis for early-stage disease assessments have been employed in nowadays clinical operations which to a large extent relieved medical labors. In the past decades, China has been in the leading groups compared to international colleagues in the arena of intelligent medicine, and a series of eminent research has been clinically translated for practical uses in China. For instance, the first 5G-aided remote surgery has been realized in Fujian Province in January 2019, which for the first time validated their applicability for human uses. The surgical robots have found China as the most vigorous market, and more than 10 famous Chinese companies are developing versatile surgical robots for both Chinese people and people all over the world. China also applied AI techniques to new drug developments especially in early 2020 when COVID-19 epidemic roared, and several active molecules and drug motifs have been discovered for early-stage COVID-19 screening and treatments. Based on the significance of intelligent medicine and its rapid developments in both basic research and industrials, this review summarized the comprehensive viewpoints of the Y6 Xiangshan Science Conferences titled with Fundamental Principles and Key Technologies of Intelligent Medicine, and gave an in-depth discussion on main perspectives of future developments of the integration of biomaterial and devices, the integration of bioinformatics and medical hardware, and the synergy of biotechnology and intelligence information. It is expected that this featuring article will further promote intelligent medicine to an even broader community not only for scientists but also for industrials, and in the long run embrace a perspective future for its blooming and rich contributions in China in the coming 5 years. © 2023 Chinese Academy of Sciences. All rights reserved.

A review on tele-manipulators for remote diagnostic procedures and surgery

With modern medicine and healthcare services improving in leaps and bounds, the integration of telemedicine has helped in expanding these specialised healthcare services to remote locations. Healthcare telerobotic systems form a component of telemedicine, which allows medical intervention from a distance. It has been nearly 40 years since a robotic technology, PUMA 560, was introduced to perform a stereotaxic biopsy in the brain. The use of telemanipulators for remote surgical procedures began around 1995, with the Aesop, the Zeus, and the da Vinci robotic surgery systems. Since then, the utilisation of robots has steadily increased in diverse healthcare disciplines, from clinical diagnosis to telesurgery. The telemanipulator system functions in a master–slave protocol mode, with the doctor operating the master system, aided by audio-visual and haptic feedback. Based on the control commands from the master, the slave system, a remote manipulator, interacts directly with the patient. It eliminates the requirement for the doctor to be physically present in the spatial vicinity of the patient by virtually bringing expert-guided medical services to them. Post the Covid-19 pandemic, an exponential surge in the utilisation of telerobotic systems has been observed. This study aims to present an organised review of the state-of-the-art telemanipulators used for remote diagnostic procedures and surgeries, highlighting their challenges and scope for future research and development.

Technology and HealthCare in the Coming Era

The fast-emerging technologies in this century fueled by covid19 crises has taught every stakeholder (technology giants, pharmacists, hospitals, patients etc.) a great lesson. Hospital with good healthcare system will have some of these technologies while there are least developed countries with no infrastructure and no technology. Using technology in healthcare will change the working of existing healthcare system to brighter one. This paper will portray different technology trends like Artificial Intelligence, Machine Learning, Block chain, Robotic Surgery, Smart devices, telemedicine and so on. The promises and the obstacles with impact of the technology are discussed too. © 2022 IEEE.

Robotic Manipulation System Design and Control for Non-Contact Remote Diagnosis in Otolaryngology: Digital Twin Approach

The COVID-19 pandemic has emphasized the need for non-contact medical robots to alleviate the heavy workload and emotional stress experienced by healthcare professionals while preventing infection. In response, we propose a non-contact robotic diagnostic system for otolaryngology clinics, utilizing a digital twin model for initial design optimization. The system employs a master-slave robot architecture, with the slave robot comprising a flexible endoscope manipulation robot and a parallel robot arm for controlling additional medical instruments. The novel 4 degrees of freedom (DOF) control mechanism enables the single robotic arm to handle the endoscope, facilitating the process compared to the traditional two-handed approach. Phantom experiments were conducted to evaluate the effectiveness of the proposed flexible endoscope manipulation system in terms of diagnosis completion time, NASA task load index (NASA-TLX), and subjective risk score. The results demonstrate the system's usability and its potential to alternate conventional diagnosis. © 2013 IEEE.

Robotic surgery implementation in an isolated overseas territory - The case of Reunion Island.

INTRODUCTION: In February 2020, robotic surgery was introduced in University Hospital of St Pierre in Reunion Island. The aim of this study was to evaluate the implementation of robotic assisted surgery in the hospital and its impact on operating times and patient outcomes. METHODS: Data was prospectively collected on patients undergoing laparoscopic robotic assisted surgery between February 2020 and February 2022. Information included patient demographics, type of surgery, operating times and length of stay. RESULTS: Over the two-year study period, 137 patients underwent laparoscopic robotic assisted surgery performed by 6 different surgeons. 89 of the surgeries were in gynecology, including 58 hysterectomies, 37 were in digestive surgery, and 11 in urology. The installation and docking times decreased across all specialties and were found to be significantly reduced when comparing the first and last 15 hysterectomies: mean installation time decreased from 18.7 to 14.5 minutes (p=0.048), mean docking time decreased from 11.3 to 7.1 minutes (p = 0.009). CONCLUSIONS: The implementation of robotic assisted surgery in an isolated territory such as Reunion Island was slow due to a lack of trained surgeons, supply difficulties and Covid crisis. Despite these challenges, the use of robotic surgery allowed for technically more challenging surgeries and demonstrated similar learning curves to other centers.

Robotic Morgagni's hernia repair in adults - A single centre experience.

BACKGROUND: This study was aimed at reporting the surgical outcomes and evaluating the safety and feasibility of robotic repair of Morgagni's repair in adults. METHODS: This is a retrospective analysis of seven cases of Morgagni's hernia in adults, managed by robotic method in a tertiary-level thoracic surgery centre over 9 years. A detailed analysis of all perioperative variables including complications was carried out. RESULTS: A total of seven patients underwent Robotic Morgagni's hernia repair during the study period. Males (71.4%) were predominant in the patient cohort. Median age group was 33 years (range: 28-78 years). All patients were pre-obese with median body mass index of 29.4 (range: 27.5-29.9). All patients underwent robotic-assisted hernia repair with no conversions. Omentum was the most common hernial content (100%). In all cases, the defect was reinforced with a composite mesh. Median operative time was 140 min (range: 120-160). Median hospital stay of 3 days (range: 2-4 days). No post-procedural complications. All the patients had complete resolution of presenting symptoms. No recurrence was noted in the median follow-up period of 32 months (range: 6-78 months). CONCLUSION: Robotic-assisted surgical repair of Morgagni's hernia in adults is safe, feasible and effective. However, studies with larger sample size and multi-institutional collaboration are recommended for further conclusions.

Recent Advances in Sensor Technology for Biomedical Applications: A Review

Sensor technology has become an integral part of the diagnosis, monitoring, therapeutic and surgical areas of medical science. Various sensors like glucose biosensors for diagnosis of diabetes mellitus or fluorescent sensors for gene expression and protein localization have become a common part of the biomedical field. Due to their widespread applications, various advances and improvements have taken place in medical sensor technology which has led to an increase in the ease and accuracy of diagnosis as well as treatment of diseases. This review article aims at studying various novel and innovative developments in biosensors, fibre optic sensors, sensors used for microelectromechanical systems, flexible sensors and wearable sensors. This article also explores new sensing methodologies and techniques in different medical domains like dentistry, robotic surgery and diagnosis of severe life-threatening diseases like cancer and diabetes. Various sensors and systems used for rapid detection of the SARS-CoV-2 virus which is responsible for the COVID-19 pandemic have also been discussed in this article. Comparison of novel sensor-based systems for detection of various medical parameters with traditional techniques is included. Further research is necessary to develop low cost, highly accurate and easy-to-use medical devices with the help of these innovative sensor technologies. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Changes to same day discharge after minimally invasive hysterectomy throughout COVID-19 pandemic.

BACKGROUND: Minimally invasive hysterectomy is a common gynecologic procedure. Numerous studies have found that a same day discharge (SDD) is safe following this procedure. Research has found that SDDs decrease resource strain, nosocomial infections, and financial burden for both the patient and healthcare system. Due to the recent COVID-19 pandemic, the safety of hospital admissions and elective surgeries was called into question. OBJECTIVE: To assess the rates of SDD among patients who underwent a minimally invasive hysterectomy before and during the COVID-19 pandemic. STUDY DESIGN: A retrospective chart review was performed from September 2018 to December 2020 on 521 patients, who met inclusion criteria. Descriptive analysis, chi-square tests of association, and multivariable logistic regression were used for analysis. RESULTS: There was a significant difference between rate of SDDs pre-COVID-19 (12.5%) versus during the COVID-19 period (28.6%) (p < 0.001). Surgical complexity was predictive of not being discharged the same day of surgery (odds ratio [OR] = 4.4, 95% confidence interval [CI] = 2.2-8.8), as was surgical completion time after 4 p.m. (OR = 5.2, 95% CI = 1.1-25.2). There was no difference in readmissions (p = 0.209) and emergency department (ED) visits (p = 0.973) between SDD and overnight stay. CONCLUSION: Rates of SDD for patients undergoing minimally invasive hysterectomy were significantly increased during the COVID-19 pandemic. SDDs are safe; the number of readmissions and ED visits did not increase among patients who were discharged on the same day.

Robotic Surgery, Robotic Tele-Surgery, and the COVID-19 Pandemic. Review Article

Background: The COVID-19 virus sweeps the whole world, with millions of people infected and a hundred thousand dead. This pandemic does not affect normal people only;it affects surgeons also. The number of surgeons worldwide is limited, especially experienced ones at risk of infection and death. Patients pay the cost of surgical shutdown by postponing their scheduled surgical procedure, which may affect their health and make them more morbid. During the pandemic, surgery is limited during the pandemic to emergent cases. There is a need to establish a way to provide surgical service from experienced surgeons without the possibility of virus transmission to these experienced surgical staff. Robotic and robotic telesurgery is emerging, a recent diagnostic and therapeutic tool that offers excellent surgical service without affecting the surgical team. Robotic surgery can be used in different fields of surgery in emergent and non-emergent cases during the pandemic and after the pandemic settles down. The aim: was to evaluate the role of robotic surgery, and Tele-surgery in offering global surgical services for emergent and non-emergent cases during and after the pandemic fades away. It is a way to face future pandemics without affecting higher senior surgical staff, especially during the lockdown period. Evaluate the role of Tele-surgery as a way of continuous training for younger surgeons during the pandemic. Conclusion: robotic and robotic Tele-surgery is an excellent method for providing surgical services by experienced surgeons to patients. © 2022 Surgical Society of Northern Greece. All rights reserved.

Robotic stray energy with constant-voltage versus constant-power regulating electrosurgical generators.

INTRODUCTION: Stray energy from surgical energy instruments can cause unintended thermal injuries. There are no published data regarding electrosurgical generators and their influence on stray energy transfer during robotic surgery. There are two approved generators for the DaVinci Xi robotic platform: a constant-voltage regulating generator (cVRG) and a constant-power regulating generator (cPRG). The purpose of this study was to quantify and compare stray energy transfer in the robotic Xi platform using a cVRG versus a cPRG. METHODS: An ex vivo bovine model was used to simulate a standard multiport robotic surgery. The DaVinci Xi (Intuitive Surgical, Sunnyvale, CA) robotic platform was attached to a trainer box using robotic ports. A 5 s, open-air activation of the monopolar scissors was done with commonly used electrosurgical settings using a cPRG (ForceTriad, Covidien-Medtronic, Boulder, CO) or cVRG (ERBE VIO 300 dV 2.0, ERBE USA, Marietta, GA). Stray energy transfer was quantified as the change in tissue temperature (°C) nearest the tip of the assistance grasper (which was not in direct contact with the active monopolar scissors). RESULTS: Stray energy transfer occurred with both generators. Utilizing common, comparable settings for standard coagulation, significantly less stray energy was transferred with the cVRG versus cPRG (4.4 ± 1.6 °C vs. 41.1 ± 13.0 °C, p < 0.001). Similarly, less stray energy was transferred using cut modes with the cVRG compared to the cPRG (5.61 ± 1.79 °C vs. 33.9 ± 18.4 °C, p < 0.001). CONCLUSION: Stray energy transfer increases tissue temperatures more than 45C in the DaVinci Xi robotic platform. Low voltage modalities, such as cut or blend; as well as a cVRG generator, significantly reduces stray energy. Robotic surgeons can minimize the risk of stray energy injuries by using these low risk modes and/or generator.

Time to endoscopic vacuum therapy-lessons learned after > 150 robotic-assisted minimally invasive esophagectomies (RAMIE) at a German high-volume center.

OBJECTIVE OF THE STUDY: In esophageal surgery, anastomotic leak (AL) remains one of the most severe and critical adverse events after oncological esophagectomy. Endoscopic vacuum therapy (EVT) can be used to treat AL; however, in the current literature, treatment outcomes and reports on how to use this novel technique are scarce. The aim of this study was to evaluate the outcomes of patients with an AL after IL RAMIE and to determine whether using EVT as an treatment option is safe and feasible. MATERIAL AND METHODS: This study includes all patients who developed an Esophagectomy Complications Consensus Group (ECCG) type II AL after IL RAMIE at our center between April 2017 and December 2021. The analysis focuses on time to EVT, duration of EVT, and follow up treatments for these patients. RESULTS: A total of 157 patients underwent an IL RAMIE at our hospital. 21 patients of these (13.4%) developed an ECCG type II AL. One patient died of unrelated Covid-19 pneumonia and was excluded from the study cohort. The mean duration of EVT was 12 days (range 4-28 days), with a mean of two sponge changes (range 0-5 changes). AL was diagnosed at a mean of 8 days post-surgery (range 2-16 days). Closure of the AL with EVT was successful in 15 out of 20 patients (75%). Placement of a SEMS (Self-expandlable metallic stent) after EVT was performed in four patients due to persisting AL. Overall success rate of anastomotic sealing independently of the treatment modality was achieved in 19 out of 20 Patients (95%). No severe EVT-related adverse events occurred. CONCLUSION: This study shows that EVT can be a safe and effective endoscopic treatment option for ECCG type II AL.

Covering the Broad Spectrum of Intelligent Systems: From Neuromorphic Engineering to Robotics

Table 1 Highly cited articles published in Advanced Intelligent Systems in 2019/2020 with more than 25 citations in 2021 (Web of Science, 13 December 2022) Article Title (Article Type) Authors (Corresponding*) DOI 2021 Citations Wearable and Stretchable Strain Sensors: Materials, Sensing Mechanisms, and Applications (Review) Hamid Souri*, Hritwick Banerjee, Ardian Jusufi, Norbert Radacsi, Adam A. Stokes, Inkyu Park, Metin Sitti, Morteza Amjadi* https://doi.org/10.1002/aisy.202000039 61 Robotics, Smart Wearable Technologies, and Autonomous Intelligent Systems for Healthcare During the COVID-19 Pandemic: An Analysis of the State of the Art and Future Vision (Essay) Mahdi Tavakoli*, Jay Carriere, Ali Torabi https://doi.org/10.1002/aisy.202000071 52 Soft Actuators for Soft Robotic Applications: A Review (Review) Nazek El-Atab, Rishabh B. Mishra, Fhad Al-Modaf, Lana Joharji, Aljohara A. Alsharif, Haneen Alamoudi, Marlon Diaz,Nadeem Qaiser, Muhammad Mustafa Hussain* https://doi.org/10.1002/aisy.202000128 35 Magnetic Actuation Systems for Miniature Robots: A Review (Review) Zhengxin Yang, Li Zhang* https://doi.org/10.1002/aisy.202000082 29 Artificial Intelligence and Machine Learning Empower Advanced Biomedical Material Design to Toxicity Prediction (Review) Ajay Vikram Singh*, Daniel Rosenkranz, Mohammad Hasan Dad Ansari, Rishabh Singh, Anurag Kanase, Shubham Pratap Singh, Blair Johnston, Jutta Tentschert, Peter Laux, Andreas Luch https://doi.org/10.1002/aisy.202000084 29 Complementary Metal-Oxide Semiconductor and Memristive Hardware for Neuromorphic Computing (Progress Report) Mostafa Rahimi Azghadi*, Ying-Chen Chen, Jason K. Eshraghian, Jia Chen,Chih-Yang Lin, Amirali Amirsoleimani, Adnan Mehonic, Anthony J. Kenyon, Burt Fowler, Jack C. Lee, Yao-Feng Chang* https://doi.org/10.1002/aisy.201900189 25 However, impact factor won't be the only metric reported by Wiley journals anymore. The scope of Advanced Intelligent Systems covers timely topics that are not only of interest to scientists and engineers but are also closely followed by the general public. Since the launch of the journal, several papers published in the journal have been highlighted by social media platforms and news outlets. Table 2 Papers published in 2022 with an Altmetric score above 40 (Altmetric, 13 Dec 2022) Article Title Authors (Corresponding*) DOI Altmetric Score An Autonomous Chemically Fueled Artificial Protein Muscle Matthias C. Huber, Uwe Jonas, Stefan M. Schiller* https://doi.org/10.1002/aisy.202100189 189 Neuromorphic Metamaterials for Mechanosensing and Perceptual Associative Learning Katherine S. Riley, Subhadeep Koner, Juan C. Osorio, Yongchao Yu, Harith Morgan, Janav P. Udani, Stephen A. Sarles*, Andres F. Arrieta* https://doi.org/10.1002/aisy.202200158 178 All-Electric Nonassociative Learning in Nickel Oxide Sandip Mondal*, Zhen Zhang, A. N. M. Nafiul Islam, Robert Andrawis, Sampath Gamage, Neda Alsadat Aghamiri, Qi Wang, Hua Zhou, Fanny Rodolakis, Richard Tran, Jasleen Kaur, Chi Chen, Shyue Ping Ong, Abhronil Sengupta, Yohannes Abate, Kaushik Roy, Shriram Ramanathan https://doi.org/10.1002/aisy.202200069 110 Autonomous Nanocrystal Doping by Self-Driving Fluidic Micro-Processors Fazel Bateni, Robert W. Epps, Kameel Antami, Rokas Dargis, Jeffery A. Bennett, Kristofer G. Reyes, Milad Abolhasani* https://doi.org/10.1002/aisy.202200017 61 Overcoming the Force Limitations of Magnetic Robotic Surgery: Magnetic Pulse Actuated Collisions for Tissue-Penetrating-Needle for Tetherless Interventions Onder Erin*, Xiaolong Liu, Jiawei Ge, Justin Opfermann, Yotam Barnoy, Lamar O. Mair, Jin U. Kang, William Gensheimer, Irving N. Weinberg, Yancy Diaz-Mercado, Axel Krieger* https://doi.org/10.1002/aisy.202200072 43 Our promotional activities to enhance the visibility of the journal and its papers continued in 2022.

2022 CONFERENCE POSTER COLLECTION: THE OFFICIAL VOICE OF PERIOPERATIVE NURSING

[...]new OR caregivers moved from an observation to an immersion in SPD, allowing them to truly gain an understanding of the importance of the processes and the SPD technician's role. Given this scenario, the implementation of guidelines throughout the perioperative period is of fundamental importance, as they are essential to assist decisions about the most appropriate health care in specific circumstances, guiding and qualifying the practice. The oldest guideline is the Protocol for the Surveillance of Surgical Site Infection, version 6, by Public Health England, which dates to 2013, and the most recent is the Surgical Site Infection Event (SSI), published in 2020 by the Centers for Disease Control and Prevention. Implementing an Ultraviolet Germicidal Irradiation (UVGI) System in Surgical Services, NMRTC, Camp Pendleton, During the COVID-19 Pandemic Annissa Cromer, Regina Leassear, Angela Spruill Within Surgical Services at Navy Medicine Readiness and Training Command, Camp Pendleton, an adjunct method to regular cleaning protocols was implemented to ensure complete disinfection of harmful pathogens.

Analysis and Improvement in Healthcare Operation Utilizing Automation

The development of various medications, vaccines and surgical methods in healthcare has been significantly contributing to longer life expectancy. However, there are still various challenges that need to be addressed in the healthcare system. One of the biggest challenges in streamlining processes is that medical staff are required to do various repetitive tasks manually. This study aims to examine how automation and robotics can be utilized to improve the efficiency of healthcare/biomedical services. The high-end collaborative robot, the 'YuMi' robot is proposed to modify and streamline biomedical lab operations to work side-by-side with biomedical lab technicians to assist various repetitive and routine tasks. Four potential frameworks (i.e., aged care, sorting and dispensing medicines, assisting at surgical operations and sample collection) are developed to identify potential applications of the Yumi robot. With the Covid-19 pandemic situation, there is an immediate need for safe sample collections and patient interaction to mitigate the outbreak of the virus. In this study, a framework for the sample collection and testing of Covid-19 is also proposed to minimize the risks of medical staff and local transmissions. Samples testing of suspected patients, travellers, and those in close contact with Covid-19 patients will proceed without direct interactions with healthcare workers, eventually, minimizing exposure and spread of this communicable disease. © 2022 IEEE.

Robotic Abdominal Surgery and COVID-19: A Systematic Review of Published Literature and Peer-Reviewed Guidelines during the SARS-CoV-2 Pandemic.

Background: Significant concern emerged at the beginning of the SARS-CoV-2 pandemic regarding the safety and practicality of robotic-assisted surgery (RAS). We aimed to review reported surgical practice and peer-reviewed published review recommendations and guidelines relating to RAS during the pandemic. Methods: A systematic review was performed in keeping with PRISMA guidelines. This study was registered on Open Science Framework. Databases were searched using the following search terms: 'robotic surgery', 'robotics', 'COVID-19', and 'SARS-CoV-2'. Firstly, articles describing any outcome from or reference to robotic surgery during the COVID-19/SARS-CoV-2 pandemic were considered for inclusion. Guidelines or review articles that outlined recommendations were included if published in a peer-reviewed journal and incorporating direct reference to RAS practice during the pandemic. The ROBINS-I (Risk of Bias in Non-Randomised Studies of Intervention) tool was used to assess the quality of surgical practice articles and guidelines and recommendation publications were assessed using the AGREE-II reporting tool. Publication trends, median time from submission to acceptance were reported along with clinical outcomes and practice recommendations. Results: Twenty-nine articles were included: 15 reporting RAS practice and 14 comprising peer-reviewed guidelines or review recommendations related to RAS during the pandemic, with multiple specialities (i.e., urology, colorectal, digestive surgery, and general minimally invasive surgery) covered. Included articles were published April 2020-December 2021, and the median interval from first submission to acceptance was 92 days. All surgical practice studies scored 'low' or 'moderate' risk of bias on the ROBINS-I assessment. All guidelines and recommendations scored 'moderately well' on the AGREE-II assessment; however, all underperformed in the domain of public and patient involvement. Overall, there were no increases in perioperative complication rates or mortalities in patients who underwent RAS compared to that expected in non-COVID practice. RAS was deemed safe, with recommendations for mitigation of risk of viral transmission. Conclusions: Continuation of RAS was feasible and safe during the SARS-CoV-2 pandemic where resources permitted. Post-pandemic reflections upon published robotic data and publication patterns allows us to better prepare for future events and to enhance urgent guideline design processes.

An Overview of Augmenting AI Application in Healthcare

Artificial intelligence (AI) is showing a paradigm shift in all spheres of the world by mimicking human cognitive behavior. The application of AI in healthcare is noteworthy because of availability of voluminous data and mushrooming analytics techniques. The various applications of AI, especially, machine learning and neural networks are used across different areas in the healthcare industry. Healthcare disruptors are leveraging this opportunity and are innovating in various fields such as drug discovery, robotic surgery, medical imaging, and the like. The authors have discussed the application of AI techniques in a few areas like diagnosis, prediction, personal care, and surgeries. Usage of AI is noteworthy in this COVID-19 pandemic situation too where it assists physicians in resource allocation, predicting death rate, patient tracing, and life expectancy of patients. The other side of the coin is the ethical issues faced while using this technology like data transparency, bias, security, and privacy of data becomes unanswered. This can be handled better if strict policy measures are imposed for safe handling of data and educating the public about how treatment can be improved by using this technology which will tend to build trust factor in near future. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.