A Human Gesture Mapping Method to Control a Multi‐Functional Hand for Robot‐Assisted Laparoscopic Surgery: The MUSHA Case

This work presents a novel technique to control multi-functional hand for robot-assisted laparoscopic surgery. We tested the technique using the MUSHA multi-functional hand, a robot-aided minimally invasive surgery tool with more degrees of freedom than the standard commercial end-effector of the da Vinci robot. Extra degrees of freedom require the development of a proper control strategy to guarantee high performance and avoid an increasing complexity of control consoles. However, developing reliable control algorithms while reducing the control side's mechanical complexity is still an open challenge. In the proposed solution, we present a control strategy that projects the human hand motions into the robot actuation space. The human hand motions are tracked by a LeapMotion camera and mapped into the actuation space of the virtualized end-effector. The effectiveness of the proposed method was evaluated in a twofold manner. Firstly, we verified the Lyapunov stability of the algorithm, then an user study with 10 subjects assessed the intuitiveness and usability of the system

Upper Body Pose Estimation Using Wearable Inertial Sensors and Multiplicative Kalman Filter

Estimating the limbs pose in a wearable way may benefit multiple areas such as rehabilitation, teleoperation, human-robot interaction, gaming, and many more. Several solutions are commercially available, but they are usually expensive or not wearable/portable. We present a wearable pose estimation system (WePosE), based on inertial measurements units (IMUs), for motion analysis and body tracking. Differently from camera-based approaches, the proposed system does not suffer from occlusion problems and lighting conditions, it is cost effective and it can be used in indoor and outdoor environments. Moreover, since only accelerometers and gyroscopes are used to estimate the orientation, the system can be used also in the presence of iron and magnetic disturbances. An experimental validation using a high precision optical tracker has been performed. Results confirmed the effectiveness of the proposed approach

Exploiting Intrinsic Kinematic Null Space for Supernumerary Robotic Limbs Control

Supernumerary robotic limbs (SRLs) gained increasing interest in the last years for their applicability as healthcare and assistive technologies. These devices can either support or augment human sensorimotor capabilities, allowing users to complete tasks that are more complex than those feasible for their natural limbs. However, for a successful coordination between natural and artificial limbs, intuitiveness of interaction and perception of autonomy are key enabling features, especially for people suffering from motor disorders and impairments. The development of suitable human-robot interfaces is thus fundamental to foster the adoption of SRLs.With this work, we describe how to control an extra degree of freedom by taking advantage of what we defined the Intrinsic Kinematic Null Space, i.e. the redundancy of the human kinematic chain involved in the ongoing task. Obtained results demonstrated that the proposed control strategy is effective for performing complex tasks with a supernumerary robotic finger, and that practice improves users' control ability

Rendering of Pressure and Textures Using Wearable Haptics in Immersive VR Environments

Haptic systems have only recently started to be designed with wearability in mind. Compact, unobtrusive, inexpensive, easy-to-wear, and lightweight haptic devices enable researchers to provide compelling touch sensations to multiple parts of the body, significantly increasing the applicability of haptics in many fields, such as robotics, rehabilitation, gaming, and immersive systems. In this respect, wearable haptics has a great potential in the fields of virtual and augmented reality. Being able to touch virtual objects in a wearable and unobtrusive way may indeed open new exciting avenues for the fields of haptics and VR. This work presents a novel wearable haptic system for immersive virtual reality experiences. It conveys the sensation of touching objects made of different materials, rendering pressure and texture stimuli through a moving platform and a vibrotactile abbrv-doi-hyperref-narrowmotor. The device is composed of two platforms: one placed on the nail side of the finger and one in contact with the finger pad, connected by three cables. One small servomotor controls the length of the cables, moving the platform towards or away from the fingertip. One voice coil actuator, embedded in the platform, provides vibrotactile stimuli to the user

Uniform convergence to equilibrium for granular media

We study the long time asymptotics of a nonlinear, nonlocal equation used in the modelling of granular media. We prove a uniform exponential convergence to equilibrium for degenerately convex and non convex interaction or confinement potentials, improving in particular results by J. A. Carrillo, R. J. McCann and C. Villani. The method is based on studying the dissipation of the Wasserstein distance between a solution and the steady state

Changes in growth hormone receptor gene expression during therapy in children with juvenile idiopathic arthritis.

Background: High levels of cytokines in juvenile idiopathic arthritis (JIA) can alter target cell sensitivity to growth hormone (GH) leading to short stature in adulthood. We hypothesized that the down-regulation of GH receptor (GHR) gene expression could be involved in growth failure of children with JIA. Methods: In 18 (12 F and 6 M) prepubertal JIA patients and 13 age- and sex-matched healthy children, we evaluated serum growth-promoting factors and inflammatory indexes. We also measured GHR gene expression, by real-time PCR, in lymphocytes of patients and controls. All parameters were evaluated in patients before and after treatment of JIA. Results: The most interesting (p = 0.007) result was the increase in GHR mRNA expression in all JIA patients. Moreover, we observed a significant (p = 0.0156) decrease in IL-6 levels in JIA patients after 2 years of therapy (19.37 +/- 41.01) with respect to basal values (90.84 +/- 124.71). On the contrary, IGF-I significantly (p = 0.0005) increased to a mean SDS value of 0 (range -1.69 to +1.70 SDS) with respect to values at disease onset (-0.64 SDS). Conclusions: Our preliminary data suggest that the restoration of both GHR gene expression and IGF-I secretion correlate with inactive disease in JIA children

Haptic Guidance in Dynamic Environments Using Optimal Reciprocal Collision Avoidance

Human guidance in situations where the users cannot rely on their main sensory modalities, such as assistive or search-and-rescue scenarios, is a challenging task. In this letter, we address the problem of guiding users along collision-free paths in dynamic environments, assuming that they cannot rely on their main sensory modalities. In order to safely guide the subjects, we adapt the optimal reciprocal collision avoidance to our specific problem. The proposed algorithm takes into account the stimuli which can be displayed to the users and the motion uncertainty of the users when reacting to the provided stimuli. The proposed algorithm was evaluated in three different dynamic scenarios. A total of 18 blindfolded human subjects were asked to follow haptic cues in order to reach a target area while avoiding real static obstacles and moving users. Three metrics such as time to reach the goal, length of the trajectories, and minimal distance from the obstacles are considered to compare results obtained using this approach and experiments performed without visual impairments. Experimental results reveal that blindfolded subjects are successfully able to avoid collisions and safely reach the targets in all the performed trials. Although in this letter we display directional cues via haptic stimuli, we believe that the proposed approach can be general and tuned to work with different haptic interfaces and/or feedback modalities

In vitro biosafety profile evaluation of multipotent mesenchymal stem cells derived from the bone marrow of sarcoma patients.

BACKGROUND: In osteosarcoma (OS) and most Ewing sarcoma (EWS) patients, the primary tumor originates in the bone. Although tumor resection surgery is commonly used to treat these diseases, it frequently leaves massive bone defects that are particularly difficult to be treated. Due to the therapeutic potential of mesenchymal stem cells (MSCs), OS and EWS patients could benefit from an autologous MSCs-based bone reconstruction. However, safety concerns regarding the in vitro expansion of bone marrow-derived MSCs have been raised. To investigate the possible oncogenic potential of MSCs from OS or EWS patients (MSC-SAR) after expansion, this study focused on a biosafety assessment of MSC-SAR obtained after short- and long-term cultivation compared with MSCs from healthy donors (MSC-CTRL). METHODS: We initially characterized the morphology, immunophenotype, and differentiation multipotency of isolated MSC-SAR. MSC-SAR and MSC-CTRL were subsequently expanded under identical culture conditions. Cells at the early (P3/P4) and late (P10) passages were collected for the in vitro analyses including: the sequencing of genes frequently mutated in OS and EWS, evaluation of telomerase activity, assessment of the gene expression profile and activity of major cancer pathways, cytogenetic analysis on synchronous MSC, and molecular karyotyping using a comparative genomic hybridization (CGH) array. RESULTS: MSC-SAR displayed comparable morphology, immunophenotype, proliferation rate, differentiation potential, and telomerase activity to MSC-CTRL. Both cell types displayed signs of senescence in the late stages of culture with no relevant changes in cancer gene expression. However, cytogenetic analysis detected chromosomal anomalies in the early and late stages of MSC-SAR and MSC-CTRL after culture. CONCLUSIONS: Our results demonstrated that the in vitro expansion of MSC does not influence or favor malignant transformation since MSC-SAR were not more prone than MSC-CTRL to deleterious changes during culture. However, the presence of chromosomal aberrations supports rigorous phenotypic, functional and genetic evaluation of the biosafety of MSCs, which is important for clinical applications

Emergence of antitumor cytolytic T cells is associated with maintenance of hematologic remission in children with acute myeloid leukemia.

Although the graft-versus-leukemia effect of allogeneic bone marrow transplantation (BMT) is of paramount importance in the maintenance of disease remission, the role played by the autologous T-cell response in antitumor immune surveillance is less defined. We evaluated the emergence of antileukemia cytotoxic T-lymphocyte precursors (CTLp's) and the correlation of this phenomenon with maintenance of hematologic remission in 16 children with acute myeloid leukemia (AML), treated with either chemotherapy alone (5 patients) or with autologous BMT (A-BMT, 11 patients). Antileukemia CTLp's were detectable in 8 patients in remission after induction chemotherapy; none of them subsequently had a relapse. Of the 8 patients who did not show detectable CTLp frequency while in remission after induction chemotherapy, 7 subsequently experienced leukemia relapse. In patients undergoing A-BMT, molecular fingerprinting of the TCR-Vbeta repertoire, performed on antileukemia lines, demonstrated that selected antileukemia T-cell clonotypes, detectable in bone marrow before transplantation, survived ex vivo pharmacologic purging and were found in the recipient after A-BMT. These data provide evidence for an active role of autologous T cells in the maintenance of hematologic remission and also suggest that quantification of antileukemia CTLp frequency may be a useful tool to identify patients at high risk for relapse, thus potentially benefiting from an allogeneic antitumor effect

Automated Large-Scale Production of Paclitaxel Loaded Mesenchymal Stromal Cells for Cell Therapy Applications

Mesenchymal stromal cells (MSCs) prepared as advanced therapies medicinal products (ATMPs) have been widely used for the treatment of different diseases. The latest developments concern the possibility to use MSCs as carrier of molecules, including chemotherapeutic drugs. Taking advantage of their intrinsic homing feature, MSCs may improve drugs localization in the disease area. However, for cell therapy applications, a significant number of MSCs loaded with the drug is required. We here investigate the possibility to produce a large amount of Good Manufacturing Practice (GMP)-compliant MSCs loaded with the chemotherapeutic drug Paclitaxel (MSCs-PTX), using a closed bioreactor system. Cells were obtained starting from 13 adipose tissue lipoaspirates. All samples were characterized in terms of number/viability, morphology, growth kinetics, and immunophenotype. The ability of MSCs to internalize PTX as well as the antiproliferative activity of the MSCs-PTX in vitro was also assessed. The results demonstrate that our approach allows a large scale expansion of cells within a week; the MSCs-PTX, despite a different morphology from MSCs, displayed the typical features of MSCs in terms of viability, adhesion capacity, and phenotype. In addition, MSCs showed the ability to internalize PTX and finally to kill cancer cells, inhibiting the proliferation of tumor lines in vitro. In summary our results demonstrate for the first time that it is possible to obtain, in a short time, large amounts of MSCs loaded with PTX to be used in clinical trials for the treatment of patients with oncological diseases