Highly integrated bionic prostheses resolve the thermal asymmetry between residual amputated and contralateral limbs

Residual limbs after amputation present colder temperatures than unaffected contralateral limbs. This temperature asymmetry has been attributed to autonomic and cognitive factors, such as changes in body representation. An ideal limb replacement should restore the body representation and resolve the temperature asymmetry, but conventional prostheses, commonly characterized as disembodied, fail to do so. Neuromusculoskeletal prostheses are a new concept of artificial limbs that directly interface with the user\u27s nerves, muscles, and skeleton, and are operated in daily life by bidirectionally transferring control and somatosensory information. Here, we show that the temperature asymmetry commonly found in people with amputations is resolved when using a neuromusculoskeletal prosthesis but reappears when it is removed. A potential explanation for this phenomenon might be the increased embodiment reported by users of neuromusculoskeletal prostheses, which in turn would suggest unconscious perceptual mechanisms mediating the temperature asymmetry commonly found between intact and residual limbs after amputation

Experimental Characterisation of Body-Centric Radio Channels Using Wireless Sensors

PhDWireless sensors and their applications have become increasingly attractive for industry, building automation and energy control, paving the way for new applications of sensor networks which go well beyond traditional sensor applications. In recent years, there has been a rapid growth in the number of wireless devices operating in close proximity to the human body. Wearable sensor nodes are growing popular not only in our normal living lifestyle, but also within healthcare and military applications, where different radio units operating in/on/off body communicate pervasively. Expectations go beyond the research visions, towards deployment in real-world applications that would empower business processes and future business cases. Although theoretical and simulation models give initial results of the antenna behaviour and the radio channel performance of wireless body area network (WBAN) devices, empirical data from different set of measurements still form an essential part of the radio propagation models. Usually, measurements are performed in laboratory facilities which are equipped with bulky and expensive RF instrumentation within calibrated and controllable environments; thus, the acquired data has the highest possible reliability. However, there are still measurement uncertainties due to cables and connections and significant variations when designs are deployed and measured in real scenarios, such as hospitals wards, commercial buildings or even the battle field. Consequently, more flexible and less expensive measurement tools are required. In this sense, wireless sensor nodes offer not only easiness to deploy or flexibility, but also adaptability to different environments. In this thesis, custom-built wireless sensor nodes are used to characterise different on-body radio channels operating in the IEEE 802.15.4 communication standard at the 2.45 GHz ISM band. Measurement results are also compared with those from the conventional technique using a Vector Network Analyser. The wireless sensor nodes not only diminished the effect of semi-rigid or flexible coaxial cables (scattering or radiation) used with the Vector Network Analyser (VNA), but also provided a more realistic response of the radio link channel. The performance of the wireless sensors is presented over each of the 16 different channels present at the 2.45 GHz band. Additionally, custom-built wireless sensors are used to characterise and model the performance of different on-body radio links in dynamic environments, such as jogging, rowing, and cycling. The use of wireless sensors proves to be less obstructive and more flexible than traditional measurements using coaxial cables, VNA or signal generators. The statistical analysis of different WBAN channels highlighted important radio propagation features which can be used as sport classifiers models and motion detection. Moreover, specific on-body radio propagation channels are further explored, with the aim to recognize physiological features such as motion pattern, breathing activity and heartbeat. The time domain sample data is transformed to the frequency domain using a non-parametric FFT defined by the Welch’s periodogram. The Appendix-Section D explores other digital signal processing techniques which include spectrograms (STFT) and wavelet transforms (WT). Although a simple analysis is presented, strong DSP techniques proved to be good for signal de-noising and multi-resolution analysis. Finally, preliminary results are presented for indoor tracking using the RSS recorded by multiple wireless sensor nodes deployed in an indoor scenario. In contrast to outdoor environments, indoor scenarios are subject to a high level of multipath signals which are dependent on the indoor clutter. The presented algorithm is based on path loss analysis combined with spatial knowledge of each wireless sensor

Millimeter-wave liquid crystal polymer based conformal antenna array for 5G applications

This letter presents the design, fabrication, and performance evaluation of a flexible millimeter-wave (mm-wave) antenna array for the fifth generation (5G) wireless networks operating at Ka-band (26.5-40 GHz). The single element antenna is comprised of a coplanar-waveguide-fed rectangular patch tapered at its sides with two vertically oriented slots. The ground is designed with L-shaped stubs to converge the dispersed radiation pattern for improving the directivity and gain. The antenna fabrication is accomplished by two advanced methods of laser-milling and inkjet printing on a thin film of flexible liquid crystal polymer. A novel and time-efficient method for postprinting sintering is also proposed in this letter. The design is extended in a two-element array for the gain enhancement. Measurements have validated that the proposed antenna array exhibits a bandwidth of 26-40 GHz with a peak gain of 11.35 dBi at 35 GHz, and consistent high gain profile of above 9 dBi in the complete Ka-band. These features recommend the proposed antenna array as an efficient solution for integration in future flexible 5G front ends and mm-wave wearable devices

Analysis and Design of a Bypass Socket for Transradial Amputations

The ability to measure functional performance of a prosthesis is hindered by the lack of an equalized mechanical platform to test from. Researchers and designers seeking to increase the pace of development have attempted novel mounts for prostheses so these can be used by able-bodied participants. Termed bypass sockets, these can increase the sampling pool during prosthetic evaluations. Here, we present an open-source, 3D printable prosthetic bypass socket for below-elbow (transradial) amputations. Methods to quantify the effectiveness of bypass sockets are limited and therefore we propose the use of a validated and clinically relevant evaluation tool, the Assessment of Capacity for Myoelectric Control (ACMC). We performed the ACMC in six able-bodied subjects with limited experience with myoelectric prostheses and found the participants to be rated from non- to somewhat capable using the ACMC interpretation scale. In addition, we conducted a secondary evaluation consisting of a subset of tasks of the Cybathlon competition aimed at eliciting fatigue in the participants. All participants completed said tasks, suggesting that the bypass socket is suitable for extended use during prosthesis development.Clinical Relevance - The design and validation of the bypass socket presented here can facilitate the development of upper limb prosthetic systems

Competitive motivation increased home use and improved prosthesis self-perception after Cybathlon 2020 for neuromusculoskeletal prosthesis user

Background Assistive technologies, such as arm prostheses, are intended to improve the quality of life of individuals with physical disabilities. However, certain training and learning is usually required from the user to make these technologies more effective. Moreover, some people can be encouraged to train more through competitive motivation. Methods In this study, we investigated if the training for and participation in a competitive event (Cybathlon 2020) could promote behavioral changes in an individual with upper limb amputation (the pilot). We defined behavioral changes as the active time while his prosthesis was actuated, ratio of opposing and simultaneous movements, and the pilot\u27s ability to finely modulate his movement speeds. The investigation was based on extensive home-use data from the period before, during and after the Cybathlon 2020 competition. Results Relevant behavioral changes were found from both quantitative and qualitative analyses. The pilot\u27s home use of his prosthesis nearly doubled in the period before the Cybathlon, and remained 66% higher than baseline after the competition. Moreover, he improved his speed modulation when controlling his prosthesis, and he learned and routinely operated new movements in the prosthesis (wrist rotation) at home. Additionally, as confirmed by semi-structured interviews, his self-perception of the prosthetic arm and its functionality also improved. Conclusions An event like the Cybathlon may indeed promote behavioral changes in how competitive individuals with amputation use their prostheses. Provided that the prosthesis is suitable in terms of form and function for both competition and at-home daily use, daily activities can become opportunities for training, which in turn can improve prosthesis function and create further opportunities for daily use. Moreover, these changes appeared to remain even well after the event, albeit relevant only for individuals who continue using the technology employed in the competition

Improved control of a prosthetic limb by surgically creating electro-neuromuscular constructs with implanted electrodes

: Remnant muscles in the residual limb after amputation are the most common source of control signals for prosthetic hands, because myoelectric signals can be generated by the user at will. However, for individuals with amputation higher up the arm, such as an above-elbow (transhumeral) amputation, insufficient muscles remain to generate myoelectric signals to enable control of the lost arm and hand joints, thus making intuitive control of wrist and finger prosthetic joints unattainable. We show that severed nerves can be divided along their fascicles and redistributed to concurrently innervate different types of muscle targets, particularly native denervated muscles and nonvascularized free muscle grafts. We engineered these neuromuscular constructs with implanted electrodes that were accessible via a permanent osseointegrated interface, allowing for bidirectional communication with the prosthesis while also providing direct skeletal attachment. We found that the transferred nerves effectively innervated their new targets as shown by a gradual increase in myoelectric signal strength. This allowed for individual flexion and extension of all five fingers of a prosthetic hand by a patient with a transhumeral amputation. Improved prosthetic function in tasks representative of daily life was also observed. This proof-of-concept study indicates that motor neural commands can be increased by creating electro-neuromuscular constructs using distributed nerve transfers to different muscle targets with implanted electrodes, enabling improved control of a limb prosthesis

Upper Limb Stroke Rehabilitation Using Surface Electromyography: A Systematic Review and Meta-Analysis

Background: Upper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke. Aim: Synthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke. Methods: PubMed, SCOPUS, and PEDro databases were systematically searched for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols. Results: Twenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I2 55%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I2 73%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline. Conclusion: This review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions

Improving air quality in metropolitan Mexico City : an economic valuation

Mexico City has for years experienced high levels of ozone and particulate air pollution. In 1995-99 the entire population of the Mexico City metropolitan area was exposed to annual average concentrations of fine particulate pollution (particulates with a diameter of less than 10micrometers, or PM10) exceeding 50 micrograms per cubic meter, the annual average standard in both Mexico and the United States. Two million people were exposed to annual average PM10 levels of more than 75 micrograms per cubic meter. The daily maximum one-hour ozone standard was exceeded at least 300 days a year. The Mexico Air Quality Management Team documents population-weighted exposures to ozone and PM10 between 1995 and 1999, project exposures in 2010, and computes the value of four scenarios for 2010: A 10 percent reduction in PM10 and ozone. A 20 percent reduction in PM10 and ozone. Achievement of ambient air quality standards across the metropolitan area. A 68 percent reduction in ozone and a 47 percent reduction in PM10 across the metropolitan area. The authors calculate the health benefits of reducing ozone and PM10 for each scenario using dose-response functions from the peer-reviewed literature. They value cases of morbidity and premature mortality avoided using three approaches: Cost of illness and forgone earnings only (low estimate). Cost of illness, forgone earnings, and willingness to pay for avoided morbidity (central case estimate). Cost of illness, forgone earnings, willingness to pay for avoided morbidity, and willingness to pay for avoided mortality (high estimate). The results suggest that the benefits of a 10 percent reduction in ozone and PM10 in 2010 are about $760 million (in 1999 U.S. dollars) annually in the central case. The benefits of a 20 percent reduction in ozone and PM10 are about$1.49 billion annually. In each case the benefits of reducing ozone amount to about 15 percent of the total benefits. By estimating the magnitude of the benefits from air pollution control, the authors provide motivation for examining specific policies that could achieve the air pollution reductions that they value. They also provide unit values for the benefits from reductions in ambient air pollution (for example, per microgram of PM10) that could be used as inputs into a full cost-benefit analysisof air pollution control strategies.Montreal Protocol,Public Health Promotion,Global Environment Facility,Air Quality&Clean Air,Health Monitoring&Evaluation,Montreal Protocol,Air Quality&Clean Air,Health Monitoring&Evaluation,Global Environment Facility,Transport and Environment