A Simulator for Testing Planar Upper Extremity Rehabilitation Robot Control Algorithms

In this study, we took advantage of the emergence of accurate biomechanical human hand models to develop a system in which the interaction between a human arm and a rehabilitation robot while performing a planar trajectory tracking task can be simulated. Seven biomechanical arm models were based on the 11-degree-of-freedom Dynamic Arm Simulation model and implemented in OpenSim. The model of the robot was developed in MatlabSimulink and interaction between the arm and robot models was achieved using the OpenSim API. The models were tested by simulating the performance of each model while moving the end effector of a simulated planar robot model through an elliptical trajectory with an eccentricity of 0.94. Without assistance from the robot, the average root-mean-square error (RMSE) for all subjects was 3.98 mm. With the simulated robot providing assistive torque, the average RMSE error reduced to 2.88 mm. The test was repeated after modifying the length of the robot links, and an average RMSE of 2.91 mm recorded. A single-factor ANOVA test revealed that there was no significant difference in the RMSE for the two different robot geometries (p-value = 0.479), revealing that the simulator was not sensitive to robot geometry

Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection