Posterior open wound healing in immediate implant placement using reactive soft tissue versus absorbable collagen sponge: a retrospective cohort study

The soft and hard tissue healing of open wounds in immediate implant placement are yet to be explored. The aim of this study was to compare the clinical outcomes of open wound healing using reactive soft tissue (RST) and absorbable collagen sponge (ACS). Forty implants placed immediately in posterior sockets were included; autologous RST was used in 20 and ACS substitute was used in 20. Soft tissue healing was primarily assessed through a novel scoring system and the evaluation of gingival recession. The horizontal bone width (HBW) and interproximal marginal bone level (MBL) were measured on radiographs to observe the hard tissue healing. No significant difference in total soft tissue healing score was observed at 2 weeks postoperatively. Notably, the ACS group showed better tissue colour (P = 0.016) but worse fibrous repair (P = 0.043) scores than the RST group. Gingival recession levels were comparable in the two groups, both before tooth extraction and after placement of the restoration. Regarding hard tissue, HBW and MBL changes showed no intergroup differences. Within the limitations of this study, both RST and ACS seemed effective for open wound closure, achieving ideal soft and hard tissue healing in immediate implant placement.

Self-healing and adhesive MXene-polypyrrole/silk fibroin/polyvinyl alcohol conductive hydrogels as wearable sensor

Conductive hydrogels become increasing attractive for flexible electronic devices and biosensors. However, challenges still remain in fabrication of flexible hydrogels with high electrical conductivity, self-healing capability and adhesion property. Herein, a conductive hydrogel (PSDM) was prepared by solution-gel method using MXene and dopamine modified polypyrrole as conductive enhanced materials, polyvinyl alcohol and silk fibroin as gel networks, and borax as cross-linking agent. Notably, the PSDM hydrogels not only showed high permeability (13.82 mg∙cm-2∙h-1), excellent stretch ability (1235 %), high electrical conductivity (11.3 S/m) and long-term stability, but also exhibited high adhesion performance and self-healing properties. PSDM hydrogels displayed outstanding sensing performance and durability for monitoring human activities including writing, finger bending and wrist bending. The PSDM hydrogel was made into wearable flexible electrodes and realized accurate, sensitive and reliable detection of human electromyographic and electrocardiographic signals. The sensor was also applied in human-computer interaction by collecting electromyography signals of different gestures for machine learning and gesture recognition. According to 480 groups of data collected, the recognition accuracy of gestures by the electrodes was close to 100 %, indicating that the PSDM hydrogel electrodes possessed excellent sensing performance for high precision data acquisition and human-computer interaction interface.

[Early brain imaging changes and its influence on electrode impedance after implantation of 3.0 T MRI-compatible deep brain stimulation system in Parkinson's disease subthalamic nucleus]

Objective: To analyze the imaging changes of in the early period after subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD) and its impact on electrode impedance by the application of 3.0T MRI-compatible devices. Methods: A retrospective analysis was performed for the data of 43 PD patients who underwent 3.0T MRI-compatible STN-DBS surgery from October 2022 to April 2023 at the First Affiliated Hospital of USTC(Anhui Provincial Hospital), including 27 males and 16 females, aged 43-68 (56±5) years. All patients underwent postoperative 3.0T MRI, CT scans,and impedance measurements 1 week postoperatively.Fifteen patients underwent 3.0T MRI and impedance measurements 1 month postoperatively. The differences in impedance of electrode contacts before and after the 3.0T MRI scans were compared. The occurrence of peri-lead cerebral edema (PLE) in patients was analyzed, as well as the differences in PLE detection rates between the two imaging methods, and the differences in the incidence and volume of PLE at different microelectrode recordings, the occurrence and detection of postoperative PLE, and different microelectrode recording (MER) times and different time nodes were compared. The correlation between electrode impedance and the volume of edema around the nucleus was analyzed. Results: All 43 patients successfully underwent surgery, with a total of 86 electrodes implanted. There was no significant difference in electrode impedance values before and after the 3.0T MRI examinations at 1 week and 1 month postoperatively. The PLE detection rate with 3.0T MRI was 95.12%(39/43), which is significantly higher than that of CT imaging 17.07% (7/43)(χ2=50.705, P<0.001). One week after surgery, the incidence and volume of PLE were higher in the multiple MER group compared with the single MER group, but the difference was not statistically significant. The volume of PLE [M(Q1, Q3) 0 (0, 1.211) cm3] at 1 month was significantly smaller than that at 1 week [0.243 (0, 2.914) cm3] (Z=-3.408, P=0.001). The impedance of electrode contacts within 1 month postoperatively showed a trend of initial decrease followed by an increase, which was negatively correlated with SE volume(r=-0.317, P=0.014). Conclusions: The application of 3.0T MRI-compatible DBS devices in the surgical treatment of PD patients improves the accuracy of early postoperative imaging assessment. The electrode impedance is more stable as the edema around the nucleus subsided at 1 month after surgery, which is suitable for the first program control.

[Analysis of complications and learning curve effects related to deep brain stimulation surgery in 822 Parkinson's disesase patients with the same surgeon]

Objective: To analyze the complications related to deep brain stimulation(DBS) surgery in Parkinson's disease(PD) patients and to determine whether there is a learning curve effect in terms of complications. Methods: Retrospective analysis of the DBS surgical data of 822 PD patients performed by the same surgeon at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from December 2012 to December 2022. The complications related to DBS were evaluated and analyzed the complications of every 100 DBS surgery were further analyzed. Results: A total of 822 PD patients, 453 males and 369 females, aged 31-80 years old, were included. The minimum follow-up period after DBS surgery is 6 months. Surgical related complications occurred in 55 patients (6.69%), including 5 patients (0.61%) with slight bleeding around the electrode, 1 patient (0.12%) with cerebral infarction, 4 patients (0.49%) with postoperative epilepsy, 42 patients (5.11%) with postoperative delirium, 2 patients (0.24%) with respiratory distress, and 1 patient (0.12%) with acute cardiac insufficiency. There were 16 cases (1.94%) of hardware related complications in DBS, of which 4 cases (0.48%) had infection, 1 case (0.12%) had a broken angle at the connection between the pulse generator and the extension wire, 8 cases (0.97%) had an excessively tight extension wire, and 3 cases (0.36%) had an IPG bag hematoma. In the infected cases, 2 patients removed IPG and extension wires. There were 7 cases (0.85%) of stimulus related complications, including 4 cases (0.61%) with programmed sensory abnormalities, 1 case (0.12%) with postoperative abnormal movements and dance like movements, and 2 cases (0.24%) with psychiatric symptoms. A comprehensive analysis was conducted on the above complications, among which 8 cases (0.97%) were relatively serious complications. After active treatment, satisfactory results were achieved, and none of them affected the patient's DBS treatment effect and no patients died. For every 100 cases of DBS surgery complications were analyzed, the percentage of complications decreased significantly from 14.50% (58 cases) in the first 400 cases to 4.73% (20 cases) in the last 400 cases (P<0.001). Conclusion: DBS surgery is safe and has an acceptable low incidence of complications. The incidence of complications also decreases with the accumulation of experience, showing a learning curve effect.

Decomposition and Reconstruction of Human Palm Movements

OBJECTIVE

The human hand is known to have excellent manipulation ability compared to other primate hands. Without the palm movements, the human hand would lose more than 40% of its functions. However, uncovering the constitution of palm movements is still a challenging problem involving kinesiology, physiology, and engineering science.

METHODS

By recording the palm joint angles during common grasping, gesturing, and manipulation tasks, we built a palm kinematic dataset. Then, a method for extracting the eigen-movements to characterize the common motion correlation relationships of palm joints was proposed to explore the palm movement constitution.

RESULTS

This study revealed a palm kinematic characteristic that we named the joint motion grouping coupling characteristic. During natural palm movements, there are several joint groups with a high degree of motor independence, while the movements of joints within each joint group are interdependent. Based on these characteristics, the palm movements can be decomposed into seven eigen-movements. The linear combinations of these eigen-movements can reconstruct more than 90% of palm movement ability. Moreover, combined with the palm musculoskeletal structures, we found that the revealed eigen-movements are associated with joint groups that are defined by muscular functions, which provided a meaningful context for palm movement decomposition.

CONCLUSION

This paper suggests that some invariable characteristics underlie the variable palm motor behaviors and can be used to simplify palm movement generation.

SIGNIFICANCE

This paper provides important insights into palm kinematics, and helps facilitate motor function assessment and the development of better artificial hands.

Influences of dynamic load phase shifts on the energetics and biomechanics of humans

Using load-suspended backpacks to reduce vertical peak dynamic load exerted on humans can reduce metabolic costs. However, is it possible to further reduce metabolic cost by modulating dynamic load phase shift? If so, is anti-phase better than the others? In this study, we investigated the biomechanics, energetics and trunk response under phase shifts. Nine subjects wearing an active backpack with 19.4 kg loads walked on a treadmill at 5 km h-1 with four phase shift trials (T1-T4) and a load-locked trial (LK). Our results show that anti-phase trial (T3) assists ankle more and reduces the moment and gastrocnemius medialis activity, while T4 assists knee more and reduces the moment and rectus femoris activity. Due to the load injecting more mechanical energy into human in T3 and T4, the positive centre-of-mass work is significantly reduced. However, the gross metabolic rate is lowest in T4 and 4.43% lower than in T2, which may be because the activations of erector spinae and gluteus maximus are reduced in T4. In addition, T3 increases trunk extensor effort, which may weaken the metabolic advantage. This study provides guidance for improving assistance strategies and human-load interfaces and deepens the understanding of the energetics and biomechanics of human loaded walking.

Axonal damage and astrocytosis are biological correlates of grey matter network integrity loss: a cohort study in autosomal dominant Alzheimer disease

Brain development and maturation leads to grey matter networks that can be measured using magnetic resonance imaging. Network integrity is an indicator of information processing capacity which declines in neurodegenerative disorders such as Alzheimer disease (AD). The biological mechanisms causing this loss of network integrity remain unknown. Cerebrospinal fluid (CSF) protein biomarkers are available for studying diverse pathological mechanisms in humans and can provide insight into decline. We investigated the relationships between 10 CSF proteins and network integrity in mutation carriers (N=219) and noncarriers (N=136) of the Dominantly Inherited Alzheimer Network Observational study. Abnormalities in Aβ, Tau, synaptic (SNAP-25, neurogranin) and neuronal calcium-sensor protein (VILIP-1) preceded grey matter network disruptions by several years, while inflammation related (YKL-40) and axonal injury (NfL) abnormalities co-occurred and correlated with network integrity. This suggests that axonal loss and inflammation play a role in structural grey matter network changes.

Key points

Abnormal levels of fluid markers for neuronal damage and inflammatory processes in CSF are associated with grey matter network disruptions.The strongest association was with NfL, suggesting that axonal loss may contribute to disrupted network organization as observed in AD.Tracking biomarker trajectories over the disease course, changes in CSF biomarkers generally precede changes in brain networks by several years.

[Recombinant Schistosoma japonicum egg ribonuclease SjCP1412 inhibits the activation of LX-2 hepatic stellate cells in vitro]

OBJECTIVE

To investigate the effect of recombinant Schistosoma japonicum egg ribonuclease SjCP1412 (rSjCP1412) on proliferation, cell cycle, apoptosis and activation of human hepatic stellate cells LX-2 in vitro, and explore the underlying mechanisms.

METHODS

The rSjCP1412 protein was expressed in Escherichia coli BL21 by prokaryotic expression, and the highly purified soluble rSjCP1412 protein was prepared by Ni NTA affinity chromatography and urea gradient refolding dialysis. Yeast RNA was digested using 12.5, 25.0, 50.0 µg rSjCP1412 proteins at 37 °C for 2, 3, 4 h, and the enzymatic products were electrophoresed on 1.5% agarose gel to observe the RNAase activity of rSjCP1412 protein. The proliferation of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was measured using CCK-8 assay, and the apoptosis of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was detected using the Annexin V-FITC/PI double staining, while the percentage of LX-2 cells at G0/G1, S and G2/M phases of cell cycle following stimulation with different doses of rSjCP1412 protein for 48 h was detected by DAPI staining. The type I collagen, type III collagen and α-smooth muscle actin (α-SMA) mRNA expression was quantified using quantitative florescent real-time PCR (qPCR) assay and Western blotting at transcriptional and translational levels in LX-2 cells following stimulation with different doses of rSjCP1412 protein for 48 h, while soluble egg antigen (SEA) served a positive control and PBS without rSjCP1412 protein as a normal control in the above experiments. The expression of collagen I, α-SMA and Smad4 protein was determined using Western blotting in LX-2 cells following stimulation with rSjCP1412 protein, transforming growth factor-β1 (TGF-β1) alone or in combination, to examine the signaling for the effect of rSjCP1412 protein on LX-2 cells.

RESULTS

The rSjCP1412 protein was successfully expressed and the highly purified soluble rSjCP1412 protein was prepared, which had a RNase activity. Compared with the normal group, the survival rates of LX-2 cells significantly decreased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein and SEA for 48 h (F = 22.417 and 20.448, both P values < 0.05). The apoptotic rates of LX-2 cells significantly increased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h (F = 11.350, P < 0.05), and treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h resulted in arrest of LX-2 cells in G0/G1 phase (F = 20.710, P < 0.05). Treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h caused a significant reduction in relative expression levels of collagen I (F = 11.340, P < 0.05), collagen III (F = 456.600, P < 0.05) and α-SMA mRNA (F = 23.100, P < 0.05) in LX-2 cells, and both rSjCP1412 protein and SEA treatment caused a significant reduction in collagen I (F = 1 302.000, P < 0.05), α-SMA (F = 49.750, P < 0.05) and Smad4 protein expression (F = 52.420, P < 0.05) in LX-2 cells. In addition, rSjCP1412 protein treatment inhibited collagen I (F = 66.290, P < 0.05), α-SMA (F = 31.300, P < 0.05) and Smad4 protein expression (F = 27.010, P < 0.05) in LX-2 cells activated by TGF-β1.

CONCLUSIONS

rSjCP1412 protein may induce apoptosis of LX-2 cells and inhibit proliferation, cell cycle and activation of LX-2 cells through down-regulating Smad4 signaling molecules.

FSG-based divinable time-varying formation tracking of multiple Lagrangian agents with unknown disturbances and directed graphs

In this paper, a flexible shape generator (FSG) is designed to achieve the divinable transformation process of the time-varying formation, and consider the FSG-based time-varying formation tracking (TVFT) problem of multiple Lagrangian agents with unknown disturbances and directed graphs. A hierarchical control algorithm is newly designed to achieve the control goal without using the prior information of the system model and bounded disturbances, and the specific implementation of the proposed hierarchical algorithms is also provided. By using the Hurwitz criterion and adaptive system theory, the sufficient conditions are derived and the stability analysis show that the formation tracking errors of the considered system are uniform ultimate bounded. Several simulation examples are performed on five two-degree-of-freedom mechanical arms to show the effectiveness of theoretical results.

Muscle-Effort-Minimization-Inspired Kinematic Redundancy Resolution for Replicating Natural Posture of Human Arm

Replicating natural postures of human arms is essential to generate human-like behaviors in robotic applications for humans nearby. However, how to realize this requirement in interactive scenarios remains a challenge due to the kinematic redundancy and unknown postural control strategy of human arms. Inspired by the physiological characteristics that the musculoskeletal system is coordinated to minimize muscle effort in human behaviors, this paper aims to address the issue by solving a muscle effort minimization problem. It adopts a high-fidelity human arm musculoskeletal model (HAMM) and considers the implicit constraint (desired hand pose) and the inequality constraints (range of joint motion). The constrained minimization is in general nonconvex, consequently sensitive to initial guesses in iterative procedures. So, it is impracticable to solve it directly with existing gradient-based deterministic approaches or standard evolutionary algorithms. As the main contribution, a hybrid inverse kinematics algorithm was proposed for the HAMM with 7 independent and 13 mimic joints to obtain the feasible arm postures satisfying the minimization constraints. Using the arm swivel angle that parametrizes the kinematic redundancy of the HAMM, geometrically equidistant initial guess candidates can be generated over the 1-dimension feasible posture manifold. As another contribution, we present a two-phase global minimization algorithm to handle the nonconvexity of the constrained minimization. It consists of a local-search phase on the null-space of the geometric Jacobian matrix and a global-search phase with an initial guess resampling strategy. The proposed approach was validated by replicating the natural arm postures of 5 right-handed subjects in daily tasks.

Modulating Energy Among Foot-Ankle Complex With an Unpowered Exoskeleton Improves Human Walking Economy

Over the course of both evolution and development, the human musculoskeletal system has been well shaped for the cushion function of the foot during foot-strike and the impulsive function of the ankle joint during push-off. Nevertheless, an efficient energy interaction between foot structure and ankle joint is still lacking in the human body itself, which may limit the further potential of economical walking. Here we showed the metabolic expenditure of walking can be lessened by an unpowered exoskeleton robot that modulates energy among the foot-ankle complex towards a more effective direction. The unpowered exoskeleton recycles negative mechanical energy of the foot that is normally dissipated in heel-strike, retains the stored energy before mid-stance, and then transfers the energy to the ankle joint to assist the push-off. The modulation process of the exoskeleton consumes no input energy, yet reduces the metabolic cost of walking by 8.19 ± 0.96 % (mean ± s.e.m) for healthy subjects. The electromyography measurements demonstrate the activities of target ankle plantarflexors decreased significantly without added effort for the antagonistic muscle, suggesting the exoskeleton enhanced the subjects' energy efficiency of the foot-ankle complex in a natural manner. Furthermore, the exoskeleton also provides cushion assistance for walking, which leads to significantly decreased activity of the quadriceps muscle during heel-strike. Rather than strengthening the functions of existing biological structures, developing the complementary energy loop that does not exist in the human body itself also shows its potential for gait assistance.

A Conformational Variant of p53 (U-p53AZ) as Blood-Based Biomarker for the Prediction of the Onset of Symptomatic Alzheimer's Disease

BACKGROUND

Ongoing research seeks to identify blood-based biomarkers able to predict onset and progression of Alzheimer's disease (AD).

OBJECTIVE

The unfolded conformational variant of p53 (U-p53AZ), previously observed in AD individuals, was evaluated in plasma samples from individuals participating in the Australian Imaging, Biomarkers and Lifestyle (AIBL) cohort for diagnostic and prognostic assessment, validated on a neuropsychological-based diagnosis, over the course of six years.

DESIGN

Retrospective Longitudinal Prognostic biomarker study.

SETTING

Single-center study based on the AIBL cohort.

PARTICIPANTS

482 participants of the AIBL cohort, aged 60-85 years, without uncontrolled diabetes, vascular disease, severe depression or psychiatric illnesses.

MEASUREMENTS

The AlzoSure® Predict test, consisting of immunoprecipitation (IP) followed by liquid chromatography (LC) tandem mass spectrometry (MS/MS), was performed to quantify the AZ 284® peptide as readout of U-p53AZ and compared with an independent neuropsychological diagnosis. The amyloid load via amyloid β-positron emission tomography (Aβ-PET) and supporting clinical information were included where possible.

RESULTS

U-p53AZ diagnostic and prognostic performance was assessed in both time-independent and time-dependent (36, 72 and 90 months following initial sampling) analyses. Prognostic performance of Aβ-PET and survival analyses with different risk factors (gender, Aβ-PET and APOE ε4 allele status) were also performed. U-p53AZ differentiated neuropsychologically graded AD from non-AD samples, and its detection at intermediate/high levels precisely identified present and future symptomatic AD. In both time-independent and time-dependent prognostic analyses U-p53AZ achieved area under the curve (AUC) >98%, significantly higher than Aβ-PET AUCs (between 84% and 93%, P respectively <0.0001 and <0.001). As single factor, U-p53AZ could clearly determine the risk of AD neuropsychological diagnosis over time (low versus intermediate/high U-p53AZ hazard ratio=2.99). Proportional hazards regression analysis identified U-p53AZ levels as a major independent predictor of AD onset.

CONCLUSIONS

These findings support use of U-p53AZ as blood-based biomarker predicting whether individuals would reach neuropsychologically-defined AD within six years prior to AD diagnosis. Integration of U-p53AZ in screening processes could support refined participant stratification for interventional studies.

Flexible porous Gelatin/Polypyrrole/Reduction graphene oxide organohydrogel for wearable electronics

Conductive hydrogel-based flexible electronics have attracted immense interest in wearable sensor, soft robot and human-machine interface. However, the application of hydrogels in flexible electronics is limited by the deterioration of mechanical and electrical properties due to freezing at low temperature and desiccation after long-term use. Meanwhile, flexible electronics based on hydrogel are usually not breathable, which has a great impact on wearing comfort and signal stability in long-term sensing. In this work, an adjustable porous gelatin/polypyrrole/reduction graphene oxide (Gel/PPy/rGO) organohydrogel with high breathability (14 g∙cm^-2∙h^-1), conductivity (5.25 S/m), mechanical flexibility, anti-freezing and long-term stability is prepared via the combination method of biological fermentation and salt-out toughening crosslinking. The sensor fabricated from the prepared porous organohydrogel exhibits excellent sensing sensitivity, fast response ability, and good endurance, which monitors both weak and intense human activities effectively like finger bending, elbow bending, walking and running, and tiny pulse beating. A pressure sensor array prepared from the porous organohydrogel detects pressure variation in 2D sensitively. Furthermore, the porous organohydrogel is utilized as flexible electrodes for the accurate collection and recognition of human physiological signals (EMG, ECG) and as an interface between human and machine.

Fermentation-Inspired Gelatin Hydrogels with a Controllable Supermacroporous Structure and High Ductility for Wearable Flexible Sensors

Supermacroporous hydrogels have attracted wide concern due to their comfort and breathability in wearable health-monitoring applications. Size controllable supermacroporous structure and excellent mechanical properties are the most important for its application. However, they are normally fabricated by the cryogelation method, which is difficult to control pore size and maintain flexibility. Here, yeast fermentation-inspired gelatin hydrogels with a controllable supermacroporous structure and excellent mechanical properties were fabricated for the first time. The pore size can be controlled by adjusting the content of glucose and yeast, the ratio of glucose to yeast, fermentation time, and gelatin content during fermentation. The hydrogels demonstrated a controllable pore size range from 100 to 400 μm and rapid swelling characteristics. The mechanical properties were maintained by soaking ammonium sulfate solution for 12 h, showing maximum tensile and compressive strains over 300 and 99%, respectively. This novel approach can be easily applied to the preparation of supermacroporous and high ductility hydrogels under mild conditions. Furthermore, conductive hydrogels combined supermacroporous structures with conductive polyaniline and reduced oxidized graphene, and silver nanowires were prepared as wearable flexible sensors. The obtained sensors maintain well-distributed porosity, breathability, and mechanical flexibility, also showing excellent conductivity of 2.4 S m-1. Finally, the sensors were successfully applied to detect physiological signals and human-computer interaction.

pH-Switchable Antimicrobial Supramolecular Hydrogels for Synergistically Eliminating Biofilm and Promoting Wound Healing

Biofilm infection will cause chronic inflammation and hinder the normal healing process of wound. Here, based on the self-assembly of three designed amphiphilic pentapeptides named EK, GG, and DR, pH-switchable antibacterial hydrogels with amphiphilic fiber network are used for the eradication of biofilms and the rescue of delayed healing in infected wounds. These pentapeptides-based hydrogels exhibit an acidic pH-switchable antimicrobial effect and are biocompatible at neutral pH. Additionally, supramolecular nanofiber networks with physical cross-linking with thermosensitive polymers (PNIPAm) and loaded antibacterial oregano oil are further developed. In vitro experiments indicate that the antimicrobial activity of hydrogels comes from the disassembly of acidic pH-dependent nanofiber network and activated release of pentapeptides and oregano oil, which achieves synergistic biofilm eradication. Remarkably, DR-based supramolecular hydrogel improves the healing efficiency of the full-thickness wound of skin in vivo, which is manifested by increased wound closure rate, reduced inflammatory response, faster angiogenesis, and collagen deposition in the wound, exhibiting great potential as wound dressing. The proposed synergistic strategy of inhibiting biofilm formation and activating healing may provide an efficient method for the treatment of clinically infected wounds.

Characterization and Categorization of Various Human Lower Limb Movements Based on Kinematic Synergies

A proper movement categorization reduces the complexity of understanding or reproducing human movements in fields such as physiology, rehabilitation, and robotics, through partitioning a wide variety of human movements into representative sub-motion groups. However, how to establish a categorization (especially a quantitative categorization) for various human lower limb movements is rarely investigated in literature and remains challenging due to the diversity and complexity of the lower limb movements (diverse gait modes and interaction styles with the environment). Here we present a quantitative categorization for the various lower limb movements. To this end, a similarity measure between movements was first built based on limb kinematic synergies that provide a unified and physiologically meaningful framework for evaluating the similarities among different types of movements. Then, a categorization was established via hierarchical cluster analysis for thirty-four lower limb movements, including walking, running, hopping, sitting-down-standing-up, and turning in different environmental conditions. According to the movement similarities, the various movements could be divided into three distinct clusters (cluster 1: walking, running, and sitting-down-standing-up; cluster 2: hopping; cluster 3: turning). In each cluster, cluster-specific movement synergies were required. Besides the uniqueness of each cluster, similarities were also found among part of the synergies employed by these different clusters, perhaps related to common behavioral goals in these clusters. The mix of synergies shared across the clusters and synergies for specific clusters thus suggests the coexistence of the conservation and augmentation of the kinematic synergies underlying the construction of the diverse and complex motor behaviors. Overall, the categorization presented here yields a quantitative and hierarchical representation of the various lower limb movements, which can serve as a basis for the understanding of the formation mechanisms of human locomotion and motor function assessment and reproduction in related fields.

A portable exotendon assisting hip and knee joints reduces muscular burden during walking

Assistive devices are used to reduce human effort during locomotion with increasing success. More assistance strategies are worth exploring, so we aimed to design a lightweight biarticular device with well-chosen parameters to reduce muscle effort. Based on the experience of previous success, we designed an exotendon to assist in swing leg deceleration. Then we conducted experiments to test the performance of the exotendon with different spring stiffness during walking. With the assistance of the exotendon, peak activation of semitendinosus decreased, with the largest reduction of 12.3% achieved with the highest spring stiffness (p = 0.004). The peak activations of other measured muscles were not significantly different (p = 0.15-0.92). The biological hip extension and knee flexion moments likewise significantly decreased with the spring stiffness (p < 0.01). The joint angle was altered during the assisted phases with decreased hip flexion and knee extension. Meanwhile, the step frequency and the step length were also altered, while the step width remained unaffected. Gait variability changed only in the frontal plane, exhibiting lower step width variability. We conclude that passive devices assisting hip extension and knee flexion can significantly reduce the burden on the hamstring muscles, while the kinematics is easily altered.

Reducing the metabolic energy of walking and running using an unpowered hip exoskeleton

BACKGROUND

Walking and running are the most common means of locomotion in human daily life. People have made advances in developing separate exoskeletons to reduce the metabolic rate of walking or running. However, the combined requirements of overcoming the fundamental biomechanical differences between the two gaits and minimizing the metabolic penalty of the exoskeleton mass make it challenging to develop an exoskeleton that can reduce the metabolic energy during both gaits. Here we show that the metabolic energy of both walking and running can be reduced by regulating the metabolic energy of hip flexion during the common energy consumption period of the two gaits using an unpowered hip exoskeleton.

METHODS

We analyzed the metabolic rates, muscle activities and spatiotemporal parameters of 9 healthy subjects (mean ± s.t.d; 24.9 ± 3.7 years, 66.9 ± 8.7 kg, 1.76 ± 0.05 m) walking on a treadmill at a speed of 1.5 m s-1 and running at a speed of 2.5 m s-1 with different spring stiffnesses. After obtaining the optimal spring stiffness, we recruited the participants to walk and run with the assistance from a spring with optimal stiffness at different speeds to demonstrate the generality of the proposed approach.

RESULTS

We found that the common optimal exoskeleton spring stiffness for walking and running was 83 Nm Rad-1, corresponding to 7.2% ± 1.2% (mean ± s.e.m, paired t-test p < 0.01) and 6.8% ± 1.0% (p < 0.01) metabolic reductions compared to walking and running without exoskeleton. The metabolic energy within the tested speed range can be reduced with the assistance except for low-speed walking (1.0 m s-1). Participants showed different changes in muscle activities with the assistance of the proposed exoskeleton.

CONCLUSIONS

This paper first demonstrates that the metabolic cost of walking and running can be reduced using an unpowered hip exoskeleton to regulate the metabolic energy of hip flexion. The design method based on analyzing the common energy consumption characteristics between gaits may inspire future exoskeletons that assist multiple gaits. The results of different changes in muscle activities provide new insight into human response to the same assistive principle for different gaits (walking and running).

Towards locust-inspired gliding wing prototypes for micro aerial vehicle applications

In aviation, gliding is the most economical mode of flight explicitly appreciated by natural fliers. They achieve it by high-performance wing structures evolved over millions of years in nature. Among other prehistoric beings, locust is a perfect example of such natural glider capable of endured transatlantic flights that could inspire a practical solution to achieve similar capabilities on micro aerial vehicles. An investigation in this study demonstrates the effects of haemolymph on the flexibility of several flying insect wings proving that many species exist with further simplistic yet well-designed wing structures. However, biomimicry of such aerodynamic and structural properties is hindered by the limitations of modern as well as conventional fabrication technologies in terms of availability and precision, respectively. Therefore, here we adopt finite-element analysis to investigate the manufacturing-worthiness of a three-dimensional digitally reconstructed locust wing, and propose novel combinations of economical and readily available manufacturing methods to develop the model into prototypes that are structurally similar to their counterparts in nature while maintaining the optimum gliding ratio previously obtained in the aerodynamic simulations. The former is assessed here via an experimental analysis of the flexural stiffness and maximum deformation rate as EI s = 1.34 × 10-4 Nm2, EI c = 5.67 × 10-6 Nm2 and greater than 148.2%, respectively. Ultimately, a comparative study of the mechanical properties reveals the feasibility of each prototype for gliding micro aerial vehicle applications.

Common kinematic synergies of various human locomotor behaviours

Humans show a variety of locomotor behaviours in daily living, varying in locomotor modes and interaction styles with the external environment. However, how this excellent motor ability is formed, whether there are some invariants underlying various locomotor behaviours and simplifying their generation, and what factors contribute to the invariants remain unclear. Here, we find three common kinematic synergies that form the six joint motions of one lower limb during walking, running, hopping and sitting-down-standing-up (movement variance accounted for greater than 90%), through identifying the coordination characteristics of 36 lower limb motor tasks in diverse environments. This finding supports the notion that humans simplify the generation of various motor behaviours through re-using several basic motor modules, rather than developing entirely new modules for each behaviour. Moreover, a potential link is also found between these synergies and the unique biomechanical characteristics of the human musculoskeletal system (muscular-articular connective architecture and bone shape), and the patterns of inter-joint coordination are consistent with the energy-saving mechanism in locomotion by using biarticular muscles as efficient mechanical energy transducers between joints. Altogether, our work helps understand the formation mechanisms of human locomotion from a holistic viewpoint and evokes inspirations for the development of artificial limbs imitating human motor ability.

Regulating Metabolic Energy Among Joints During Human Walking Using a Multiarticular Unpowered Exoskeleton

Researchers have found that the walking economy can be enhanced by recycling ankle metabolic energy using an unpowered ankle exoskeleton. However, how to regulate multiarticular energy to enhance the overall energy efficiency of humans during walking remains a challenging problem, as multiarticular passive assistance is more likely to interfere with the human body's natural biomechanics. Here we show that the metabolic energy of the hip and knee musculature can be regulated to a more energy-effective direction using a multiarticular unpowered exoskeleton that recycles negative mechanical energy of the knee joint in the late swing phase and transfers the stored energy to assist the hip extensors in performing positive mechanical work in the stance phase. The biarticular spring-clutch mechanism of the exoskeleton performs a complementary energy recycling and energy transfer function for hip and knee musculature. Through the phased regulation of the hip and knee metabolic energy, the target muscle activities decreased during the whole assistive period of the exoskeleton, which was the direct reason for 8.6 ± 1.5% (mean ± s.e.m) reduction in metabolic rate compared with that of walking without the exoskeleton. The proposed unpowered exoskeleton enhanced the user's multiarticular energy efficiency, which equals improving musculoskeletal structure by adding a complementary loop for efficient energy recycling and energy transfer.

Flexible Capacitive Curvature Sensor with One-Time Calibration for Amphibious Gait Monitoring

Wearable devices developed with flexible electronics have great potential applications for human health monitoring and motion sensing. Although material softness and structural flexibility provide a deformable human-machine interface to adapt to joint bending or tissue stretching/compression, flexible sensors are inconvenient in practical uses as they usually require calibration every time they are installed. This article presents an approach to design and fabricate a flexible curvature sensor to measure human articular movements for amphibious applications. This flexible sensor employs the capacitive sensing principle, where the dielectric layer and electrodes are made from the polyurethane resin and eutectic gallium-indium (EGaIn) liquid metal; and the fabrication process is implemented with shape deposition molding for batch production. The sensing method for articular rotation angles employs the Euler beam model to make the sensor reusable after one-time calibration by compensating for the unpredicted manual installation error. The illustrative application to ankle sensing in amphibious gaits shows that the root-mean-square error is within 5° for different walking speeds (0.7-1.1 m/s) in treadmill tests and the maximum error is within 3° for underwater sensing with quasi-static measurements. It is expected that the proposed waterproof flexible sensor can push the boundaries of wearable robotics, human locomotion, as well as their related applications.

Untethered Multimode Fluidic Actuation: A New Approach to Soft and Compliant Robotics

Fluid actuated soft robots, or fluidic elastomer actuators, have shown great potential in robotic applications where large compliance and safe interaction are dominant concerns. They have been widely studied in wearable robotics, prosthetics, and rehabilitations in recent years. However, such soft robots and actuators are tethered to a bulky pump and controlled by various valves, limiting their applications to a small confined space. In this study, we report a new and effective approach to fluidic power actuation that is untethered, easy to design, fabricate, control, and allows various modes of actuation. In the proposed approach, a sealed elastic tube filled with fluid (gas or liquid) is segmented by adaptors. When twisting a segment, two major effects could be observed: (1) the twisted segment exhibits a contraction force and (2) other segments inflate or deform according to their constraint patterns. Utilizing such effects, various actuation modes could be realized. In this research, four modes of actuation are illustrated: (1) soft actuator and pump actuation, (2) serial actuation, (3) parallel actuation, and (4) agonist and antagonist actuation. Theoretic analysis and experimental studies for the basic actuation principle have been conducted. A case study on an anthropomorphic forearm based on the proposed twisting tube actuation has been developed to showcase the effectiveness of the actuation modes. The studies suggest that the proposed approach has a great potential in both soft and compliant robotics.

3M™ Petrifilm™ Staph Express Count Plate Method for the Enumeration of Staphylococcus aureus in Selected Dairy Foods: Collaborative Study

The 3M™ Petrifilm™ Staph Express Count plate method was compared with AOAC Official Method 975.55 for the enumeration of Staphylococcus aureus in selected foods. Five foods—ice cream, raw milk, yogurt, whey powder, and cheese—were analyzed for S. aureus by 12 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample, a low inoculation level, a medium inoculation level, and a medium inoculation level with background flora, each in duplicate. The mean log10 counts for the methods were comparable for all 5 foods. The repeatability and reproducibility variances of the 24 h Petrifilm Staph Express Count plate method were similar to those of the 72 h standard method.

A bilevel optimal motion planning (BOMP) model with application to autonomous parking

In this paper, we present a bilevel optimal motion planning (BOMP) model for autonomous parking. The BOMP model treats motion planning as an optimal control problem, in which the upper level is designed for vehicle nonlinear dynamics, and the lower level is for geometry collision-free constraints. The significant feature of the BOMP model is that the lower level is a linear programming problem that serves as a constraint for the upper-level problem. That is, an optimal control problem contains an embedded optimization problem as constraints. Traditional optimal control methods cannot solve the BOMP problem directly. Therefore, the modified approximate Karush–Kuhn–Tucker theory is applied to generate a general nonlinear optimal control problem. Then the pseudospectral optimal control method solves the converted problem. Particularly, the lower level is the $$J_2$$J2-function that acts as a distance function between convex polyhedron objects. Polyhedrons can approximate objects in higher precision than spheres or ellipsoids. As a result, a fast high-precision BOMP algorithm for autonomous parking concerning dynamical feasibility and collision-free property is proposed. Simulation results and experiment on Turtlebot3 validate the BOMP model, and demonstrate that the computation speed increases almost two orders of magnitude compared with the area criterion based collision avoidance method.

A Novel Tendon-Driven Soft Actuator with Self-Pumping Property

Soft actuators and robotics have been widely researched in recent years mainly due to their compliance to environments and safe interaction with humans. However, the need of tether and low energy efficiency of such actuators/robots has limited their practical applications. This article presents a novel tendon-driven soft actuator concept that has the property of self-pumping, called soft self-pumping actuator (SSPA) in this research. A SSPA is designed by assembling two soft pneumatic actuators (SPAs) face-to-face, whose air chambers are connected by two check valves. Actuation of the SSPA is achieved by tendons that allows precise and untethered control compared with traditional SPAs. The two chambers in the proposed actuators are precharged with air to a desired pressure to enlarge self-stiffness and to facilitate bending. When actuated, one chamber will be compressed and serve as a pump to inject its air into the other chamber, resulting in further bending of the actuator. The airflow involves energy transmission to help the intended actuation, thus improving energy efficiency. In experimental studies, differential chamber air pressure is found to reduce the force in initiating actuator bending. Experimental results have also shown that energy efficiency increase of up to 45% has been achieved compared with the same design but without air transmission. We believe that the proposed concept could lead to more novel designs of controllable and energy saving soft robots.

P4363The predictive capacity of two- and three-dimensional echocardiography detected right ventricular strain in disease severity of pre-capillary pulmonary hypertension

Background

Pulmonary hypertension (PH) patients have poor prognosis due to progressive right ventricular (RV) dysfunction. As a low-cost and non-invasive tool, echocardiography is by far the most widely used technique to investigate the RV structure and function in PH patients. Recent studies showed that RV longitudinal strain (RVLS) measured by two- or three-dimensional echocardiography (2DE, 3DE) was correlated with RV function parameters and have the potential to predict the prognosis of PH patients. However, few studies have compared the value of 2DE- and 3DE- RVLS to predict disease severity of pre-capillary PH patients. Therefore, our study aims to compare the capacity of RVLS assessed by 3DE and 2DE in predicting disease severity of pre-capillary PH patients.

Methods

We consecutively enrolled 57 patients (18 males and 39 females, 35±13 years) with pre-capillary PH diagnosed by right heart catheterization in our center. Standard transthoracic echocardiography was performed in all participants. 2DE- RVLS were obtained from speckle-tracking analyses using GE EchoPAC version 201; while 3DE- RVLS were analyzed by TomTec 4D RV-Function 2.0. On the basis of the risk assessment strategy of 2015 ESC Guidelines for the diagnosis and treatment of pulmonary hypertension, all the participants were classified into low risk or intermediate-high risk groups. Linear regression analyses were performed to evaluate the correlations between RVLS and peak oxygen consumption (PVO2). In addition, receive operating characteristic curves (ROC) were used to compare the predictive values of 2DE- and 3DE-RVLS and identify the optimal cut points for the detection of low risk based on the risk assessment strategy of 2015 ESC Guidelines.

Results

Linear regression analyses showed a significant correlation between PVO2 and 2DE- RVLS (r=−0.484, P<0.001), while a relatively weaker correlation was observed between PVO2 and 3DE- RVLS (r=−0.299, P=0.024). ROC curve showed 2DE-RVEF had a better capacity to classify pre-capillary PH patients into low or intermediate-high risk groups (2DE- vs 3DE-: AUC=0.78, P=0.003 vs AUC=0.69, P=0.044). Optimal cut-offs found 2DE-RVEF <−13.85% had a 73.3% sensibility and 75.0% specificity to predict low risk.

Conclusions

Both two- and three-dimensional echocardiography detected RVLS had the potential to evaluate disease severity of pre-capillary PH patients, but the former may have a better predictive capacity.

Improved photocatalytic degradation of perfluorooctanoic acid on oxygen vacancies-tunable bismuth oxychloride nanosheets prepared by a facile hydrolysis

Oxygen vacancies (OVs) defective BiOCl nanosheets are important for developing efficient hole (h⁺) oxidation. Herein, a facile hydrolysis without the use of organic solvent was developed for preparing OVs-controllable BiOCl nanosheets, which was then applied to degrade perfluorooctanoic acid (PFOA), a typical persistent organic pollutant, which is resistance to the oxidation by hydroxyl radicals (OH). As changing the alkali source in the preparation process, the ratio of OVs in BiOCl nanosheets increases from 0.573 to 0.981, and the photocatalytic performance of BiOCl for the degradation and defluorination of PFOA increases by 3-4 times. A linear relationship between the photocatalytic degradation of PFOA and the OVs amount in BiOCl was observed. The introduction of OVs in BiOCl not only offers localized states for trapping photo-generated electrons, but also acts as active sites for adsorbing PFOA, both of which are helpful to improve the h⁺-oxidation of PFOA. The photocatalytic degradation of PFOA was more effective at pH 4.6 compared to other previously reported highly acidic and alkaline conditions. These factors ultimately guaranteed the improved degradation and defluorination of PFOA over OVs-rich BiOCl nanosheets. This work provides a readily achievable tactic to induce OVs formation on nanocrystals for enhanced photocatalytic water treatment.

Fabrication and Dynamic Modeling of Bidirectional Bending Soft Actuator Integrated with Optical Waveguide Curvature Sensor

Soft robots exhibit many exciting properties due to their softness and body compliance. However, to interact with the environment safely and to perform a task effectively, a soft robot faces a series of challenges such as dexterous motion, proprioceptive sensing, and robust control of its deformable bodies. To address these issues, this article presents a method for fabrication and dynamic modeling of a novel bidirectional bending soft pneumatic actuator that embeds a curvature proprioceptive sensor. The bidirectional bending deformation was generated by two similar chambers with a sinusoidal shape for reducing the internal dampness during bending deformation. An optical waveguide made from flexible poly (methyl methacrylate) material that is immune to the inlet pressure was embedded into the actuator body to measure its bending angle. A dynamic modeling framework based on step response and parameter fitting was proposed to establish a simple differential equation that can describe the nonlinear behavior of the soft actuator. Hence, a sliding mode controller is designed based on this differential equation and the Taylor expansion. The proposed dynamical model and the sliding mode controller were validated by trajectory tracking experiments. The performance of the bidirectional bending soft actuator, such as the linear output of the curvature sensor in different inflating patterns, the proprioceptive sensitiveness to the external environment, the output force, and large bending range under relatively small pressure, was evaluated by relevant experimental paradigms. Prototypes from the novel design and fabrication process demonstrated the soft actuator's potential applications in industrial grasping and hand rehabilitation.

Environmental Features Recognition for Lower Limb Prostheses Toward Predictive Walking

This paper aims to present a robust environmental features recognition system (EFRS) for lower limb prosthesis, which can assist the control of prosthesis by predicting the locomotion modes of amputees and estimating environmental features in the following steps. A depth sensor and an inertial measurement unit are combined to stabilize the point cloud of environments. Subsequently, the 2D point cloud is extracted from origin 3D point cloud and is classified through a neural network. Environmental features, including slope of road, width, and height of stair, were also estimated via the 2D point cloud. Finally, the EFRS is evaluated through classifying and recognizing five kinds of common environments in simulation, indoor experiments, and outdoor experiments by six healthy subjects and three transfemoral amputees, and databases of five healthy subjects and three amputees are used to validate without training. The classification accuracy of five kinds of common environments reach up to 99.3% and 98.5% for the amputees in the indoor and outdoor experiments, respectively. The locomotion modes are predicted at least 0.6 s before the switch of actual locomotion modes. Most estimation errors of indoor and outdoor environments features are lower than 5% and 10%, respectively. The overall process of EFRS takes less than 0.023 s. The promising results demonstrate the robustness and the potential application of the presented EFRS to help the control of lower limb prostheses.

On the biological mechanics and energetics of the hip joint muscle-tendon system assisted by passive hip exoskeleton

Passive exoskeletons have potential advantages in reducing metabolic energy cost. We consider a passive elastic exoskeleton (peEXO) providing hip flexion moment to assist hip flexors during walking, our goal is to use a biomechanical model to explore the biological mechanics and energetics of the hip joint muscle-tendon-exotendon system for obtaining the optimum stiffness of this peEXO at the muscle-level. Based on our developed hip musculoskeletal model capable of replicating human-like behaviors, the hip peEXO is firstly abstracted as a spring (i.e. exotendon), we then simulate the peEXO assisted human walking over a series of stiffnesses, the biological muscle-tendon dynamics is optimally solved by minimizing the total metabolic cost of muscles. The simulation results are consistent with the experimental data of walking with an exoskeleton prototype. We find peEXO of minor stiffness helps reducing the muscle force, activation, and metabolic energy cost of hip flexors, especially the iliopsoas; while stiffer peEXO causes extra metabolic energy cost of antagonist muscles especially the gluteus maximus. With an optimum rotational stiffness of 350 Nm rad^-1, the peEXO can reduce the metabolic energy cost of walking by ~7.1% and the hip joint muscles simultaneously have a 3% muscle efficiency promotion. The changes in muscle-tendon dynamics indicate it is more economical to assist the hip joint compared with the ankle joint, and periods of high muscle activation are ideal assistance phases for hip joint muscles. The modeling framework provides deep insights into the potential muscle-level mechanisms which are difficult to study via experiments alone, which is helpful to recover the mechanism of how energy cost is reduced under the external passive assistance and guide the design of passive hip EXOs.

Minimizing the Sample Sizes of Clinical Trials on Preclinical and Early Symptomatic Stage of Alzheimer Disease

BACKGROUND

Clinical trials of investigational drugs for Alzheimer disease (AD) increasingly focus on the prodromal (symptomatic) stage of the illness and now its preclinical (asymptomatic) stage. Sensitive and specific cognitive and functional endpoints are needed to track subtle cognitive and functional changes in the early and preclinical stages to minimize sample sizes in these trials.

OBJECTIVES

To identify informative items in a standard clinical assessment protocol and a psychometric battery that are predictive of onset of dementia symptom.

DESIGN

Longitudinal retrospective study.

SETTING

Washington University (WU) Knight Alzheimer Disease Research Center (ADRC).

PARTICIPANTS

A total of 735 individuals at least 65 years old and cognitively normal at baseline from a longitudinal clinical cohort at the WU Knight ADRC.

MEASUREMENTS

The annual clinical assessment included a wide spectrum of functional and cognitive domains; a comprehensive psychometric battery was completed about 2 weeks after the clinical evaluation. Psychometricians are blinded to the results of the clinical evaluation and to the prior performance of the participants on the psychometric tests.

RESULTS

The mean age at baseline of the 735 participants was 74.30 and 62.31% were female. 240 individuals developed prodromal dementia symptoms (consistent with mild cognitive impairment due to AD and with very mild AD dementia) during longitudinal follow-up (mean follow-up=6.79 years). Among a total of 562 items in the clinical and cognitive assessments under analysis, 292 (52%) were identified as informative because their longitudinal changes were predictive of symptomatic onset. When these items were used to form the functional and cognitive composites, the longitudinal rates of changes were free of a learning effect and captured subtle longitudinal progression prior to symptomatic onset. The rates of change were much greater right after the symptomatic onset than those from the functional and cognitive composites formed using non-informative items. Although the sample sizes for prevention trials (prior to symptomatic onset) using the informative items still yield large numbers, the sample sizes for early treatment trial (after symptomatic onset) was much smaller than those derived from all the items or from the non-informative items alone.

CONCLUSIONS

The antecedent longitudinal changes in nearly half of the items in a clinical assessment protocol and a comprehensive cognitive battery did not show statistically significant ability to predict the dementia symptom onset, and hence may be non-informative to track the preclinical functional and cognitive progression of AD. The remaining items, on the other hand, captured some of the preclinical changes prior to the symptom onset, but performed much better right after the symptom onset. Currently ongoing prevention trials on preclinical AD of elderly individuals may need to re-assess the sample sizes and statistical power.

[Progress of clinical correlation research on migraine and glaucoma]

Migraine is a common primary headache disorder. The estimated annual prevalence rate of migraine in China is 9.3%. Migraine is typically involved with a series of ocular symptoms including glaucoma, visual performance tests relevant to glaucoma exhibited correlation between glaucoma and migraine. Even though migraine patients exhibit no glaucoma-related signs during intermissions of migraine attacks, the results of visual function tests (visual field, electrophysiology, ocular imaging) relevant to glaucoma still indicate abnormalities. It is fairly typical that most of the patients may neglect their ocular problems when migraine breaks out. Epidemiological data suggests an increasing prevalence of migraine patients with glaucoma, particularly normal tension glaucoma. This paper reviews and discusses the effect of migraine on the clinical assessment and diagnosis of glaucoma. (Chin J Ophthalmol, 2018, 54: 224-228).

Indistinguishable heralded single photon generation via relative temporal multiplexing of two sources

Generating N single photons simultaneously is a formidable challenge due to the lack of deterministic single photon sources. Recent work [New J. Phys. 19, 063013 (2017] has proposed a relative multiplexing scheme that can enhance the N single photons probability with a minimum of active switching resources. We experimentally demonstrate relative temporal multiplexing on two photon sources with a 90% additional enhancement over the standard temporal multiplexing scheme demonstrated previously. 88 ± 11% visibility of Hong-Ou-Mandel quantum interference verifies the indistinguishability of the heralded single photons after the synchronization. This proof-of-principle demonstration points out the potential significance of the relative multiplexing scheme for large-scale photonic quantum information processing.

Modulator figure of merit for short reach data links

The traditional Mach-Zehnder modulator (MZM) figure of merit (FOM) has been defined as (V_π²)/υ_3dBe, and works effectively for LiNbO₃ long haul modulators. However, for plasma dispersion based electro-optic modulators, or any modulator that has an inherent relationship between its bandwidth, required drive voltage, and optical insertion loss/gain, this FOM is inappropriate. This is particularly true for short reach links with no optical amplification. In the following, we propose a new modulator FOM (M-FOM) based on device metrics that are essential for short-reach links, such as the peak-to-peak drive voltage, modulator rise-fall time, and relative optical modulation amplitude. Link sensitivity measurements from two MZMs that have different bandwidths and optical losses are compared using our M-FOM to demonstrate its utility. Furthermore, we present a novel application protocol of our M-FOM to provide deeper insight into the relative system impact that modulator performance has on data links with no optical amplification, by taking the ratio of M-FOMs from two modulators driven with the same radio frequency drive power.

Simultaneous and Continuous Estimation of Shoulder and Elbow Kinematics from Surface EMG Signals

In this paper, we present a simultaneous and continuous kinematics estimation method for multiple DoFs across shoulder and elbow joint. Although simultaneous and continuous kinematics estimation from surface electromyography (EMG) is a feasible way to achieve natural and intuitive human-machine interaction, few works investigated multi-DoF estimation across the significant joints of upper limb, shoulder and elbow joints. This paper evaluates the feasibility to estimate 4-DoF kinematics at shoulder and elbow during coordinated arm movements. Considering the potential applications of this method in exoskeleton, prosthetics and other arm rehabilitation techniques, the estimation performance is presented with different muscle activity decomposition and learning strategies. Principle component analysis (PCA) and independent component analysis (ICA) are respectively employed for EMG mode decomposition with artificial neural network (ANN) for learning the electromechanical association. Four joint angles across shoulder and elbow are simultaneously and continuously estimated from EMG in four coordinated arm movements. By using ICA (PCA) and single ANN, the average estimation accuracy 91.12% (90.23%) is obtained in 70-s intra-cross validation and 87.00% (86.30%) is obtained in 2-min inter-cross validation. This result suggests it is feasible and effective to use ICA (PCA) with single ANN for multi-joint kinematics estimation in variant application conditions.

On Configuration Trajectory Formation in Spatiotemporal Profile for Reproducing Human Hand Reaching Movement

Most functional reaching activities in daily living generally require a hand to reach the functional position in appropriate orientation with invariant spatiotemporal profile. Effectively reproducing such spatiotemporal feature of hand configuration trajectory in real time is essential to understand the human motor control and plan human-like motion on anthropomorphic robotic arm. However, there are no novel computational models in literature toward reproducing hand configuration-to-configuration movement in spatiotemporal profile. In response to the problem, this paper presents a computational framework for hand configuration trajectory formation based on hierarchical principle of human motor control. The composite potential field is constructed on special Euclidean Group to induce time-varying configuration toward target. The dynamic behavior of hand is described by a second-order kinematic model to produce the external representation of high-level motor control. The multivariate regression relation between intrinsic and extrinsic coordinates of arm, is statistically analyzed for determining the arm orientation in real time, which produces the external representation of low-level motor control. The proposed method is demonstrated in an anthropomorphic arm by performing several highly curved self-reaching movements. The generated configuration trajectories are compared with actual human movement in spatiotemporal profile to validate the proposed method.

Distributed electrode Mach-Zehnder modulator with double-pass phase shifters and integrated inductors

A novel high-speed Mach-Zehnder modulator (MZM) fully integrated into a 90 nm CMOS process is presented. The MZM features 'double-pass' optical phase shifter segments, and the first use of integrated inductors in a 'velocity-matched' distributed-electrode configuration.