Towards design guidelines for physical interfaces on industrial exoskeletons: Overview on evaluation metrics

On exoskeletons, physical interfaces with the body are one of the key enabling component to promote user acceptance, comfort and force transmission efficiency. A structured design workflow is needed for any application-driven product, such as industrial exoskeletons. In this paper, we review objective and subjective evaluation metrics that can be applied to physical interfaces. These indexes can be evaluated to create an ordered list of requirements to guide their future design. Pressure magnitude, duration, distribution, direction and time to don and doff are relevant objective indexes related to interfaces. Pain, comfort and ease of operation are subjective indexes. We propose that collecting a suitable set of metrics will lay the foundation for effective design guideline for industrial exoskeletons

Back-Support Exoskeletons for Occupational Use: An Overview of Technological Advances and Trends

OCCUPATIONAL APPLICATIONSMany new occupational back-support exoskeletons have been developed in the past few years both as research prototypes and as commercial products. These devices are intended..

Towards standard specifications for back-support exoskeletons

Back-support exoskeletons have shown the potential to improve workplace ergonomics by reducing the risk of low-back injury. To support the rapidly expanding landscape and to correspondingly promote correct adoption, standard specifications for back-support exoskeletons are desirable. We propose a list of properties and discuss their relevance to industrial applications

Basic functionality of a prototype wearable assistive soft exoskeleton for people with gait impairments : a case study

XoSoft is a soft modular wearable assistive exoskeleton for peo- ple with mild to moderate gait impairments. It is currently being developed by a European Consortium (www.xosoft.eu) and aims to provide tailored and active lower limb support during ambu- lation. During development, user-centered design principles were followed in parallel with the aim of providing functional support during gait. A prototype was developed and was tested for practi- cability, usability, comfort and assistive function (summarized as basic functionality) with a potential end user. The prototype con- sisted of a garment, electromagnetic clutch-controlled elastic bands supporting knee- and hip flexion and a backpack containing the sensor and actuator control of the system. The participant had ex- perienced a stroke and presented with unilateral impairment of the lower and upper extremities. In testing, he donned and doffed the prototype independently as far as possible, and performed walk- ing trials with the system in both active (powered on) and pas- sive (powered off) modes. Afterwards, the participant rated the perceived pressure and various elements of usability. Results high- lighted aspects of the system for improvement during future phases of XoSoft development, and also identified useful aspects of proto- type design to be maintained. The basic functionality of XoSoft could be assumed as satisfactory given that it was the first version of a working prototype. The study highlights the benefits of this participatory evaluation design approach in assistive soft robotics development

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection. \ua9 2018 The Author(s). Published by Baishideng Publishing Group Inc. All rights reserved

Dynamic and Static Assistive Strategies for a Tailored Occupational Back-Support Exoskeleton: Assessment on Real Tasks Carried Out by Railway Workers

This study on occupational back-support exoskeletons performs a laboratory evaluation of realistic tasks with expert workers from the railway sector. Workers performed both a static task and a dynamic task, each involving manual material handling (MMH) and manipulating loads of 20 kg, in three conditions: without an exoskeleton, with a commercially available passive exoskeleton (Laevo v2.56), and with the StreamEXO, an active back-support exoskeleton developed by our institute. Two control strategies were defined, one for dynamic tasks and one for static tasks, with the latter determining the upper body’s gravity compensation through the Model-based Gravity Compensation (MB-Grav) approach. This work presents a comparative assessment of the performance of active back support exoskeletons versus passive exoskeletons when trialled in relevant and realistic tasks. After a lab characterization of the MB-Grav strategy, the experimental assessment compared two back-support exoskeletons, one active and one passive. The results showed that while both devices were able to reduce back muscle activation, the benefits of the active device were triple those of the passive system regarding back muscle activation (26% and 33% against 9% and 11%, respectively), while the passive exoskeleton hindered trunk mobility more than the active mechanism

Exoskeleton kinematic design robustness: An assessment method to account for human variability

Exoskeletons are wearable devices intended to physically assist one or multiple human joints in executing certain activities. From a mechanical point of view, they are kinematic structures arranged in parallel to the biological joints. In order to allow the users to move while assisted, it is crucial to avoid mobility restrictions introduced by the exoskeleton’s kinematics. Passive degrees of freedom and other self-alignment mechanisms are a common option to avoid any restrictions. However, the literature lacks a systematic method to account for large inter- and intra-subject variability in designing and assessing kinematic chains. To this end, we introduce a model-based method to assess the kinematics of exoskeletons by representing restrictions in mobility as disturbances and undesired forces at the anchor points. The method makes use of robotic kinematic tools and generates useful insights to support the design process. Though an application on a back-support exoskeleton designed for lifting tasks is illustrated, the method can describe any type of rigid exoskeleton. A qualitative pilot trial is conducted to assess the kinematic model that proved to predict kinematic configurations associated to rising undesired forces recorded at the anchor points, that give rise to mobility restrictions and discomfort on the users

Liver Transplantation for Hepatic Metastases from Colorectal Cancer: Current Knowledge and Open Issues

More than 40% of patients with colorectal cancer present liver metastases (CRLM) during the course of their disease and up to 50% present with unresectable disease. Without surgical interventions, survival for patients treated with systemic therapies alone is dismal. In the past, liver transplantation (LT) for patients with unresectable CRLM failed to show any survival benefit due to poor selection, ineffective chemotherapeutic regimens, unbalanced immunosuppression and high perioperative mortality. Since then and for many years LT for CRLM was abandoned. The turning point occurred in 2013, when the results from the Secondary Cancer (SECA I) pilot study performed at Oslo University were published reporting a 60% 5-year overall survival after LT in patients with unresectable CRLM. These results effectively reignited the interest in LT as a potential therapy for CRLM, and several trials are undergoing. The aims of this article are to give a comprehensive overview of the available evidence on LT for CRLM, discuss the open issues in this rapidly evolving field, and highlight possible ways to address the future of this fascinating therapeutic alternative for selected patients with CRLM