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In developing medical interventions using untethered milli- and microrobots, ensuring safety and effectiveness relies on robust methods for real-time robot detection, tracking, and precise localization within the body. The inherent non-transparency of human tissues significantly challenges these efforts, as traditional imaging systems like fluoroscopy often lack crucial anatomical details, potentially compromising intervention safety and efficacy. To address this technological gap, in this study, we build a virtual reality environment housing an exact digital replica (digital twin) of the operational workspace and a robot avatar. We synchronize the virtual and real workspaces and continuously send the robot position data derived from the image stream into the digital twin with short average delay time around 20–25 ms. This allows the operator to steer the robot by tracking its avatar within the digital twin with near real-time temporal resolution. We demonstrate the feasibility of this approach with millirobots steered in confined phantoms. Our concept demonstration herein can pave the way for not only improved procedural safety by complementing fluoroscopic guidance with virtual reality enhancement, but also provides a platform for incorporating various additional real-time derivative data, e.g., instantaneous robot velocity, intraoperative physiological data obtained from the patient, e.g., blood flow rate, and pre-operative physical simulation models, e.g., periodic body motions, to further refine robot control capacity. [ABSTRACT FROM AUTHOR]

Since the 1970s, the environmental impact assessment (EIA) has been employed as an environmental management tool to minimize or prevent the potential environmental impacts caused. Its use in Turkey was mandated from February 7, 1993. An EIA, which is of particular concern to the mining sector, is implemented in many sectors. In this study, after providing brief information about the EIA regulation, an analysis has been done by determining the status of mining activities in EIA applications. In conclusion, mining has comprised 31% share of EIA-required activities since 1993, when EIA regulation took effect in Turkey. In addition, it was learned that 16% of the applications related to mining activities were unable to get an EIA permit and could not launch their operation.

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Objective: This study aimed to assess the efficacy of a novel modified asymmetric chondro-perichondrial island graft in tympanoplasty. The design features a longer anterior segment compared to the posterior segment, addressing limitations of symmetrical grafts. We investigated the impact of this modified graft on hearing improvement and graft success rates in patients undergoing tympanoplasty surgery., Methods: This retrospective study evaluated 784 patients with chronic otitis media who underwent primary type I tympanoplasty with a modified asymmetric chondro-perichondrial island graft technique. Demographics and characteristics of all patients, preoperative location of the perforation, and Pure-Tone Audiometry (PTA) were assessed preoperatively, and graft success and postoperative hearing outcomes were evaluated at the 12-month follow-up., Results: This study evaluated the efficacy of a modified asymmetric chondro-perichondrial island graft in tympanoplasty. In 784 patients, the mean 12-month postoperative Air-Bone Gap (ABG) improvement was 17.3 dB with a 99% graft success rate. Preoperative ABG significantly improved from 24 dB to 6.6 dB postoperatively (p < 0.001). Perforation location did not affect ABG improvement (p = 0.193) but did influence graft success rate (p < 0.001). No sensorineural hearing loss, retraction pockets, or cholesteatoma were observed postoperatively., Conclusion: Tympanoplasty offers a well-established surgical approach for restoring hearing function and preventing recurrent otorrhea. The asymmetric cartilage-perichondrium island graft design has emerged as a promising technique to achieve optimal functional and anatomical outcomes in tympanoplasty., Level of Evidence: Level 4., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier España S.L.U.)