Self-Aligning Finger Exoskeleton for the Mobilization of the Metacarpophalangeal Joint

In the context of hand and finger rehabilitation, kinematic compatibility is key for the acceptability and clinical exploitation of robotic devices. Different kinematic chain solutions have been proposed in the state of the art, with different trade-offs between characteristics of kinematic compatibility, adaptability to different anthropometries, and the ability to compute relevant clinical information. This study presents the design of a novel kinematic chain for the mobilization of the metacarpophalangeal (MCP) joint of the long fingers and a mathematical model for the real-time computation of the joint angle and transferred torque. The proposed mechanism can self-align with the human joint without hindering force transfer or inducing parasitic torque. The chain has been designed for integration into an exoskeletal device aimed at rehabilitating traumatic-hand patients. The exoskeleton actuation the unit has a series-elastic architecture for compliant human-robot interaction and has been assembled and preliminarily tested in experiments with eight human subjects. Performance has been investigated in terms of (i) the accuracy of the MCP joint angle estimation through comparison with a video-based motion tracking system, (ii) residual MCP torque when the exoskeleton is controlled to provide null output impedance and (iii) torque-tracking performance. Results showed a root-mean-square error (RMSE) below 5 degrees in the estimated MCP angle. The estimated residual MCP torque resulted below 7 mNm. Torque tracking performance shows an RMSE lower than 8 mNm in following sinusoidal reference profiles. The results encourage further investigations of the device in a clinical scenario

A low-power ankle-foot prosthesis for push-off enhancement

Passive ankle-foot prostheses are light-weighted and reliable, but they cannot generate net positive power, which is essential in restoring the natural gait pattern of amputees. Recent robotic prostheses addressed the problem by actively controlling the storage and release of energy generated during the stance phase through the mechanical deformation of elastic elements housed in the device. This study proposes an innovative low-power active prosthetic module that fits on off-the-shelf passive ankle-foot energy-storage-and-release (ESAR) prostheses. The module is placed parallel to the ESAR foot, actively augmenting the energy stored in the foot and controlling the energy return for an enhanced push-off. The parallel elastic actuation takes advantage of the amputee’s natural loading action on the foot’s elastic structure, retaining its deformation. The actuation unit is designed to additionally deform the foot and command the return of the total stored energy. The control strategy of the prosthesis adapts to changes in the user’s cadence and loading conditions to return the energy at a desired stride phase. An early verification on two transtibial amputees during treadmill walking showed that the proposed mechanism could increase the subjects’ dorsiflexion peak of 15.2% and 41.6% for subjects 1 and 2, respectively, and the cadence of about 2%. Moreover, an increase of 26% and 45% was observed in the energy return for subjects 1 and 2, respectively

Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses

BACKGROUND: Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap. METHODS: A comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities. RESULTS: The cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features—with implications towards prosthesis design tradeoffs. CONCLUSIONS: This study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12984-021-00944-x

Exploring olive genetic diversity in the Maltese Islands

comprehensive effort was devoted to exploring, collecting and characterizing the local Maltese olive germplasm, often represented by ancient, monumental trees and by plants of uncertain origin. SSR and cp-SSR analysis of all samples enabled the identification of 46 genotypes and establishment of the correspondence between ancient trees, main local varieties and other Mediterranean cultivars. The application of plastid markers enabled identification of two lineages among Maltese genotypes, with more than 50% represented by lineage E2. Twenty-nine cases of grafting were identified among the various genotypes and lineages. In most cases, E1 canopies were grafted on E2 rootstocks, but reverse cases were also observed. The phylogenetic study of Maltese genotypes, together with hundreds of cultivars from the Mediterranean Basin and beyond, highlights the richness of Maltese olive diversity and drawing attention to the genetic similarity of some Maltese olive genotypes with neighboring Italian and Algerian varieties. These results underline the long-lasting presence of the olive in the country, contributing to the reconstruction of its phylogeny and demonstrating a possible autochthonous origin of many samples. Some still-living ancient trees are at serious risk of extinction due to abandonment, urban expansion and environmental threats. This study supports the preservation of the Maltese olive germplasm and highlights its importance as a rich genetic source to face new agronomical challenges and future climatic constraints.This research was funded by GAL XLOKK of Malta as a part of Measure 19.3 of the EU LEADER Program 2014–2020.peer-reviewe

Characterization of Differentially Expressed Genes under Salt Stress in Olive

Climate change, currently taking place worldwide and also in the Mediterranean area, is leading to a reduction in water availability and to groundwater salinization. Olive represents one of the most efficient tree crops to face these scenarios, thanks to its natural ability to tolerate moderate salinity and drought. In the present work, four olive cultivars (Koroneiki, Picual, Royal de Cazorla and Fadak86) were exposed to high salt stress conditions (200 mM of NaCl) in greenhouse, in order to evaluate their tolerance level and to identify key genes involved in salt stress response. Molecular and physiological parameters, as well as plant growth and leaves’ ions Na+ and K+ content were measured. Results of the physiological measurements showed Royal de Cazorla as the most tolerant cultivar, and Fadak86 and Picual as the most susceptible ones. Ten candidate genes were analyzed and their complete genomic, CDS and protein sequences were identified. The expression analysis of their transcripts through reverse transcriptase quantitative PCR (RT-qPCR) demonstrated that only OeNHX7, OeP5CS, OeRD19A and OePetD were upregulated in tolerant cultivars, thus suggesting their key role in the activation of a salt tolerance mechanism

Consensus document on controversial issues in the diagnosis and treatment of prosthetic joint infections

Joint replacement surgery has been on the increase in recent decades and prosthesis infection remains the most critical complication. Many aspects of the primary prevention and clinical management of such prosthesis infections still need to be clarified