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Soft robots are known for their excellent safe interaction ability and promising in surgical applications for their lower risks of damaging the surrounding organs when operating than their rigid counterparts. To explore the potential of soft robots in cardiac surgery, this paper aims to propose an adaptive iterative learning controller for tracking the irregular motion of the beating heart.

In continuous beating heart surgery, providing a relatively stable operating environment for the operator is crucial. It is highly necessary to use position-tracking technology to keep the target and the surgical manipulator as static as possible. To address the position tracking and control challenges associated with dynamic targets, with a focus on tracking the motion of the heart, control design work has been carried out. Considering the lag error introduced by the material properties of the soft surgical robotic arm and system delays, a controller design incorporating iterative learning control with parameter estimation was used for position control. The stability of the controller was analyzed and proven through the construction of a Lyapunov function, taking into account the unique characteristics of the soft robotic system.

The tracking performance of both the proportional-derivative (PD) position controller and the adaptive iterative learning controller are conducted on the simulated heart platform. The results of these two methods are compared and analyzed. The designed adaptive iterative learning control algorithm for position control at the end effector of the soft robotic system has demonstrated improved control precision and stability compared with traditional PD controllers. It exhibits effective compensation for periodic lag caused by system delays and material characteristics.

Tracking the beating heart, which undergoes quasi-periodic and complex motion with varying accelerations, poses a significant challenge even for rigid mechanical arms that can be precisely controlled and makes tracking targets located at the surface of the heart with the soft robot fraught with considerable difficulties. This paper originally proposes an adaptive interactive learning control algorithm to cope with the dynamic object tracking problem. The algorithm has theoretically proved its convergence and experimentally validated its performance at the cable-driven soft robot test bed.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

Some studies have been reported in the past on diaphragmatic hernia (DH) surgery techniques using additive manufacturing (AM) technologies, symptoms of a hernia and post-surgery complications. But hitherto little has been reported on bibliographic analysis (BA) for health monitoring of bovine post-DH surgery for long-term management. Based on BA, this study aims to explore the sensor fabrication integrated with innovative AM technologies for health monitoring assistance of bovines post-DH surgery.

A BA based on the data extracted through the Web of Science database was performed using bibliometric tools (R-Studio and Biblioshiny).

After going through the BA and a case study, this review provides information on various 3D-printed meshes used over the sutured site and available Internet of Things-based solutions to prevent the recurrence of DH.

Research gaps exist for 3D-printed conformal sensors for health monitoring of bovine post-DH surgery.

This study analyzed the impact on the persistence of Chilean university students who had received a government-guaranteed loan (CAE).

Using academic and administrative data from 2016 to 2019, provided by 11 Chilean universities, a discrete-time survival model was constructed. The model was based on data of 5,276 students in the 2016 cohort and included sociodemographic variables, academic background prior to entering university and academic performance once in university. As a robustness check of our results to observable confounding, the analysis was repeated using a control group constructed using propensity score matching (PSM).

The results reveal that students who receive a bank loan (CAE) were more likely to remain in undergraduate studies for at least the first two years of university, as opposed to their peers who did not receive financial aid. In addition, they show the importance of academic performance in retention.

The article advances in the identification of the impact of bank loans on permanence. Although previous research has evaluated the impact of the CAE, it has been conducted on small samples of students. These studies also lacked student records associated with their academic performance at the university. The present research overcomes both weaknesses, allowing us to estimate the impact of the CAE on a larger population of students that is representative of the system.

Carpal tunnel syndrome (CTS) is a hand disease caused by the pressing of the median nerve present in the palmar side of the wrist. It causes severe pain in the wrist, triggering disturbance during sleep. Different products like splints, braces and gloves are available in the market to alleviate this disease but there was still a need to improve the wearability, comfort and cost of the product. This study was about designing a comfortable and cost-effective wearable system for mild-to-moderate CTS. Transcutaneous electrical nerve stimulation (TENS) therapy has been used to reduce the pain in the wrist.

After simulation by using Proteus software (which allowed the researchers to draw and simulate electrical circuits using ISIS, ARES and PCB design tools virtually), the circuit with optimum frequency, i.e. 33 Hz was selected, and the circuit was developed on a printed circuit board (PCB). The developed circuit was integrated successfully into the half glove structure.

The developed product had good thermophysiological comfort and hand properties as compared to the commercially available product of the same kind. In vivo testing (It involves the testing with living subjects like animals, plants or human beings) was performed which resulted in 85% confirmed viability of the product against CTS. A glove with an integrated circuit was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issue of CTS.

Industrial workers, individuals frequently using their hands or those diagnosed with CTS may wish to use this product as therapy. The attention could not be paid to the aesthetic or visual appeal of the developed product.

A very comfortable glove with integrated TENS electrodes was developed successfully to accommodate various sizes without any sex specifications in a cost-effective way to mitigate the issues of CTS.