Innovation in the time of SARS-CoV-2: A collaborative journey between NHS clinicians, engineers, academics and industry.

During the pandemic healthcare faced great pressure on the availability of protective equipment. This paper describes the entire novel innovative process of design optimisation, production and deployment of face-visors to NHS frontline workers during SARS-CoV-2 pandemic. The described innovative journey spans collaboration between clinicians and academic colleagues for design to the implementation with industry partners of a face-visor for use in a healthcare setting. It identifies the enablers and barriers to development along with the strategies employed to produce a certified reusable, adjustable, high volume and locally produced face-visor. The article also explores aspects of value, scalability, spread and sustainability all of which are essential features of innovation.

Real-Time Vision-Based Stiffness Mapping †.

This paper presents new findings concerning a hand-held stiffness probe for the medical diagnosis of abnormalities during palpation of soft-tissue. Palpation is recognized by the medical community as an essential and low-cost method to detect and diagnose disease in soft-tissue. However, differences are often subtle and clinicians need to train for many years before they can conduct a reliable diagnosis. The probe presented here fills this gap providing a means to easily obtain stiffness values of soft tissue during a palpation procedure. Our stiffness sensor is equipped with a multi degree of freedom (DoF) Aurora magnetic tracker, allowing us to track and record the 3D position of the probe whilst examining a tissue area, and generate a 3D stiffness map in real-time. The stiffness probe was integrated in a robotic arm and tested in an artificial environment representing a good model of soft tissue organs; the results show that the sensor can accurately measure and map the stiffness of a silicon phantom embedded with areas of varying stiffness.

Total mesorectal excision using a soft and flexible robotic arm: a feasibility study in cadaver models.

BACKGROUND: Sponsored by the European Commission, the FP7 STIFF-FLOP project aimed at developing a STIFFness controllable Flexible and Learn-able manipulator for surgical operations, in order to overcome the current limitations of rigid-link robotic technology. Herein, we describe the first cadaveric series of total mesorectal excision (TME) using a soft and flexible robotic arm for optic vision in a cadaver model. METHODS: TME assisted by the STIFF-FLOP robotic optics was successfully performed in two embalmed male human cadavers. The soft and flexible optic prototype consisted of two modules, each measuring 60 mm in length and 14.3 mm in maximum outer diameter. The robot was attached to a rigid shaft connected to an anthropomorphic manipulator robot arm with six degrees of freedom. The controller device was equipped with two joysticks. The cadavers (BMI 25 and 28 kg/m2) were prepared according to the Thiel embalming method. The procedure was performed using three standard laparoscopic instruments for traction and dissection, with the aid of a 30° rigid optics in the rear for documentation. RESULTS: Following mobilization of the left colonic flexure and division of the inferior mesenteric vessels, TME was completed down to the pelvic floor. The STIFF-FLOP robotic optic arm seemed to acquire superior angles of vision of the surgical field in the pelvis, resulting in an intact mesorectum in both cases. Completion times of the procedures were 165 and 145 min, respectively. No intraoperative complications occurred. No technical failures were registered. CONCLUSIONS: The STIFF-FLOP soft and flexible robotic optic arm proved effective in assisting a laparoscopic TME in human cadavers, with a superior field of vision compared to the standard laparoscopic vision, especially low in the pelvis. The introduction of soft and flexible robotic devices may aid in overcoming the technical challenges of difficult laparoscopic procedures based on standard rigid instruments.

Fingertip Fiber Optical Tactile Array with Two-Level Spring Structure.

Tactile perception is a feature benefiting reliable grasping and manipulation. This paper presents the design of an integrated fingertip force sensor employing an optical fiber based approach where applied forces modulate light intensity. The proposed sensor system is developed to support grasping of a broad range of objects, including those that are hard as well those that are soft. The sensor system is comprised of four sensing elements forming a tactile array integrated with the tip of a finger. We investigate the design configuration of a separate force sensing element with the aim to improve its measurement range. The force measurement of a single tactile element is based on a two-level displacement that is achieved thanks to a hybrid sensing structure made up of a stiff linear and flexible ortho-planar spring. An important outcome of this paper is a miniature tactile fingertip sensor that is capable of perceiving light contact, typically occurring during the initial stages of a grasp, as well as measuring higher forces, commonly present during tight grasps.

Multi-Axis Force/Torque Sensor Based on Simply-Supported Beam and Optoelectronics.

This paper presents a multi-axis force/torque sensor based on simply-supported beam and optoelectronic technology. The sensor's main advantages are: (1) Low power consumption; (2) low-level noise in comparison with conventional methods of force sensing (e.g., using strain gauges); (3) the ability to be embedded into different mechanical structures; (4) miniaturisation; (5) simple manufacture and customisation to fit a wide-range of robot systems; and (6) low-cost fabrication and assembly of sensor structure. For these reasons, the proposed multi-axis force/torque sensor can be used in a wide range of application areas including medical robotics, manufacturing, and areas involving human-robot interaction. This paper shows the application of our concept of a force/torque sensor to flexible continuum manipulators: A cylindrical MIS (Minimally Invasive Surgery) robot, and includes its design, fabrication, and evaluation tests.

Batch-specific discrimination using nuclear quadrupole resonance spectroscopy.

In this paper, we report on the identification of batches of analgesic paracetamol (acetaminophen) tablets using nitrogen-14 nuclear quadrupole resonance spectroscopy ((14)N NQR). The high sensitivity of NQR to the electron charge distribution surrounding the quadrupolar nucleus enables the unique characterization of the crystal structure of the material. Two hypothesis were tested on batches of the same brand: the within the same batch variability and the difference between batches that varied in terms of their batch number and expiry date. The multivariate analysis of variance (MANOVA) did not provide any within-batches variations, indicating the natural deviation of a medicine manufactured under the same conditions. Alternatively, the statistical analysis revealed a significant discrimination between the different batches of paracetamol tablets. Therefore, the NQR signal is an indicator of factors that influence the physical and chemical integrity of the material. Those factors might be the aging of the medicine, the manufacturing, or storage conditions. The results of this study illustrate the potential of NQR as promising technique in applications such as detection and authentication of counterfeit medicines.

Off-resonance effects in (14)N NQR signals from the pulsed spin-locking (PSL) and three-pulse echo sequence; a study for monoclinic TNT.

In NQR detection applications signal averaging by the summation of rapidly regenerated signals from multiple pulse sequences of the pulsed spin-locking (PSL) type is often used to improve sensitivity. It is important to characterise and if possible minimise PSL sequence off-resonance effects since they can make it difficult to optimise detection performance. We illustrate this with measurements of the variation of the decay time T2e and the amplitude of PSL signal trains with pulse spacing and excitation offset frequency for the 870 kHz ν+(14)N NQR line of monoclinic TNT under carefully stabilised temperature conditions. We have also carried out a similar study of signals from monoclinic TNT and 1H-1,2,3-triazole generated by a three-pulse echo sequence and the results are shown to agree well with a theoretical treatment appropriate to polycrystalline NQR samples such as TNT for which spin I=1, asymmetry parameter η≠0 and T1≫T2. Based on this theory we derive simple models for calculating TNT PSL signal trains and hence the pulse spacing and off-resonance dependence of signal amplitude and T2e which we compare to our experimental data. We discuss the influence of PSL echo summation on off-resonance effects in detected signal intensity and show how a phase-alternated multiple pulse sequence can be used in combination with the PSL sequence to eliminate variation in detection performance due to off-resonance effects.

(14)N NQR, relaxation and molecular dynamics of the explosive TNT.

Multiple pulse sequences are widely used for signal enhancement in NQR detection applications. Since the various (14)N NQR relaxation times, signal decay times and frequency of each NQR line have a major influence on detection sequence performance, it is important to characterise these parameters and their temperature variation, as fully as possible. In this paper we discuss such measurements for a number of the ν+ and ν- NQR lines of monoclinic and orthorhombic TNT and relate the temperature variation results to molecular dynamics. The temperature variation of the (14)N spin-lattice relaxation times T1 is interpreted as due to hindered rotation of the NO2 group about the C-NO2 bond with an activation energy of 89 kJ mol(-1) for the ortho and para groups of monoclinic TNT and 70 kJ mol(-1) for the para group of orthorhombic TNT.

Nitrogen-14 nuclear quadrupole resonance spectroscopy: a promising analytical methodology for medicines authentication and counterfeit antimalarial analysis.

We report the detection and analysis of a suspected counterfeit sample of the antimalarial medicine Metakelfin through developing nitrogen-14 nuclear quadrupole resonance ((14)N NQR) spectroscopy at a quantitative level. The sensitivity of quadrupolar parameters to the solid-state chemical environment of the molecule enables development of a technique capable of discrimination between the same pharmaceutical preparations made by different manufacturers. The (14)N NQR signal returned by a tablet (or tablets) from a Metakelfin batch suspected to be counterfeit was compared with that acquired from a tablet(s) from a known-to-be-genuine batch from the same named manufacturer. Metakelfin contains two active pharmaceutical ingredients, sulfalene and pyrimethamine, and NQR analysis revealed spectral differences for the sulfalene component indicative of differences in the processing history of the two batches. Furthermore, the NQR analysis provided quantitative information that the suspected counterfeit tablets contained only 43 ± 3%, as much sulfalene as the genuine Metakelfin tablets. Conversely, conventional nondestructive analysis by Fourier transform (FT)-Raman and FT-near infrared (NIR) spectroscopies only achieved differentiation between batches but no ascription. High performance liquid chromatography (HPLC)-UV analysis of the suspect tablets revealed a sulfalene content of 42 ± 2% of the labeled claim. The degree of agreement shows the promise of NQR as a means of the nondestructive identification and content-indicating first-stage analysis of counterfeit pharmaceuticals.

Artificial intelligence meets medical robotics.

Artificial intelligence (AI) applications in medical robots are bringing a new era to medicine. Advanced medical robots can perform diagnostic and surgical procedures, aid rehabilitation, and provide symbiotic prosthetics to replace limbs. The technology used in these devices, including computer vision, medical image analysis, haptics, navigation, precise manipulation, and machine learning (ML) , could allow autonomous robots to carry out diagnostic imaging, remote surgery, surgical subtasks, or even entire surgical procedures. Moreover, AI in rehabilitation devices and advanced prosthetics can provide individualized support, as well as improved functionality and mobility (see the figure). The combination of extraordinary advances in robotics, medicine, materials science, and computing could bring safer, more efficient, and more widely available patient care in the future. -Gemma K. Alderton.

Variable-pitch rectangular cross-section radiofrequency coils for the nitrogen-14 nuclear quadrupole resonance investigation of sealed medicines packets.

The performance of rectangular radio frequency (RF) coils capable of being used to detect nuclear quadrupole resonance (NQR) signals from blister packs of medicines has been compared. The performance of a fixed-pitch RF coil was compared with that from two variable-pitch coils, one based on a design in the literature and the other optimized to obtain the most homogeneous RF field over the whole volume of the coil. It has been shown from (14)N NQR measurements with two medicines, the antibiotic ampicillin (as trihydrate) and the analgesic medicine Paracetamol, that the latter design gives NQR signal intensities almost independent of the distribution of the capsules or pills within the RF coil and is therefore more suitable for quantitative analysis.

Magnetic-Field-Inspired Navigation for Robots in Complex and Unknown Environments.

Over the course of the past decade, we have witnessed a huge expansion in robotic applications, most notably from well-defined industrial environments into considerably more complex environments. The obstacles that these environments often contain present robotics with a new challenge - to equip robots with a real-time capability of avoiding them. In this paper, we propose a magnetic-field-inspired navigation method that significantly has several advantages over alternative systems. Most importantly, 1) it guarantees obstacle avoidance for both convex and non-convex obstacles, 2) goal convergence is still guaranteed for point-like robots in environments with convex obstacles and non-maze concave obstacles, 3) no prior knowledge of the environment, such as the position and geometry of the obstacles, is needed, 4) it only requires temporally and spatially local environmental sensor information, and 5) it can be implemented on a wide range of robotic platforms in both 2D and 3D environments. The proposed navigation algorithm is validated in simulation scenarios as well as through experimentation. The results demonstrate that robotic platforms, ranging from planar point-like robots to robot arm structures such as the Baxter robot, can successfully navigate toward desired targets within an obstacle-laden environment.

Learning to sense three-dimensional shape deformation of a single multimode fiber.

Optical fiber bending, deformation or shape sensing are important measurement technologies and have been widely deployed in various applications including healthcare, structural monitoring and robotics. However, existing optical fiber bending sensors require complex sensor structures and interrogation systems. Here, inspired by the recent renewed interest in information-rich multimode optical fibers, we show that the multimode fiber (MMF) output speckles contain the three-dimensional (3D) geometric shape information of the MMF itself. We demonstrate proof-of-concept 3D multi-point deformation sensing via a single multimode fiber by using k-nearest neighbor (KNN) machine learning algorithm, and achieve a classification accuracy close to 100%. Our results show that a single MMF based deformation sensor is excellent in terms of system simplicity, resolution and sensitivity, and can be a promising candidate in deformation monitoring or shape-sensing applications.

Plant Bioinspired Ecological Robotics.

Plants are movers, but the nature of their movement differs dramatically from that of creatures that move their whole body from point A to point B. Plants grow to where they are going. Bio-inspired robotics sometimes emulates plants' growth-based movement; but growing is part of a broader system of movement guidance and control. We argue that ecological psychology's conception of "information" and "control" can simultaneously make sense of what it means for a plant to navigate its environment and provide a control scheme for the design of ecological plant-inspired robotics. In this effort, we will outline several control laws and give special consideration to the class of control laws identified by tau theory, such as time to contact.

Automatic Fracture Characterization Using Tactile and Proximity Optical Sensing.

This paper demonstrates how tactile and proximity sensing can be used to perform automatic mechanical fractures detection (surface cracks). For this purpose, a custom-designed integrated tactile and proximity sensor has been implemented. With the help of fiber optics, the sensor measures the deformation of its body, when interacting with the physical environment, and the distance to the environment's objects. This sensor slides across different surfaces and records data which are then analyzed to detect and classify fractures and other mechanical features. The proposed method implements machine learning techniques (handcrafted features, and state of the art classification algorithms). An average crack detection accuracy of ~94% and width classification accuracy of ~80% is achieved. Kruskal-Wallis results (p < 0.001) indicate statistically significant differences among results obtained when analysing only integrated deformation measurements, only proximity measurements and both deformation and proximity data. A real-time classification method has been implemented for online classification of explored surfaces. In contrast to previous techniques, which mainly rely on visual modality, the proposed approach based on optical fibers might be more suitable for operation in extreme environments (such as nuclear facilities) where radiation may damage electronic components of commonly employed sensing devices, such as standard force sensors based on strain gauges and video cameras.

Quantitative 35Cl nuclear quadrupole resonance in tablets of the antidiabetic medicine Diabinese.

Pulsed (35)Cl nuclear quadrupole resonance (NQR) experiments have been performed on 250-mg tablets of the antidiabetic medicine Diabinese to establish the conditions needed for noninvasive quantitative analysis of the medicine in standard bottles. One important condition is the generation of a uniform radio-frequency (RF) field over the sample, which has been achieved by two designs of sample coil: one of variable pitch, and the other a resonator that has been fabricated from a single turn of copper sheet with a longitudinal gap bridged by tuning capacitors. The results from blind tests show that the number of tablets in a bottle could be predicted to within +/-3%.

An Attention-Controlled Hand Exoskeleton for the Rehabilitation of Finger Extension and Flexion Using a Rigid-Soft Combined Mechanism.

Hand rehabilitation exoskeletons are in need of improving key features such as simplicity, compactness, bi-directional actuation, low cost, portability, safe human-robotic interaction, and intuitive control. This article presents a brain-controlled hand exoskeleton based on a multi-segment mechanism driven by a steel spring. Active rehabilitation training is realized using a threshold of the attention value measured by an electroencephalography (EEG) sensor as a brain-controlled switch for the hand exoskeleton. We present a prototype implementation of this rigid-soft combined multi-segment mechanism with active training and provide a preliminary evaluation. The experimental results showed that the proposed mechanism could generate enough range of motion with a single input by distributing an actuated linear motion into the rotational motions of finger joints during finger flexion/extension. The average attention value in the experiment of concentration with visual guidance was significantly higher than that in the experiment without visual guidance. The feasibility of the attention-based control with visual guidance was proven with an overall exoskeleton actuation success rate of 95.54% (14 human subjects). In the exoskeleton actuation experiment using the general threshold, it performed just as good as using the customized thresholds; therefore, a general threshold of the attention value can be set for a certain group of users in hand exoskeleton activation.

Analysis of a Customized Clutch Joint Designed for the Safety Management of an Ultrasound Robot.

Robotic systems have great potential to assist ultrasound (US) examination. Currently, the safety management method to limit the force that a US robot can apply mostly relies on force sensing and software-based algorithms. This causes the concern that the potential failure of sensors, electrical systems, or software could lead to patient injuries. In this paper, we investigated a customized spring-loaded ball clutch joint designed for a newly developed US robot to passively limit the force applied. The working mechanism of the clutch was modelled and the kinematic-based analysis was performed to understand the variation of the limited force at different postures of the robot. The triggering torque of the clutch was found to be 3928 N·mm, which results in the mean limited force 22.10 ± 1.76 N at the US probe end based on potential postures. The real measurement of the implemented design indicated that the limited force could be set between 17 and 24 N at the neutral posture depending on the preload. With the maximum preload, the mean limited force was found to be 21.98 ± 0.96 N based on 30 repeated measurements. The practically measured results meet the expectation from the theoretical calculation, and the resulting small variation has indicated a good repeatability of the clutch. Based on this evidence, it is concluded that the proposed clutch meets the design aim that it can limit the force applied within a safe range while at the same time ensuring that the required force is applied at different postures.

Elasticity Versus Hyperelasticity Considerations in Quasistatic Modeling of a Soft Finger-Like Robotic Appendage for Real-Time Position and Force Estimation.

Various methods based on hyperelastic assumptions have been developed to address the mathematical complexities of modeling motion and deformation of continuum manipulators. In this study, we propose a quasistatic approach for 3D modeling and real-time simulation of a pneumatically actuated soft continuum robotic appendage to estimate the contact force and overall pose. Our model can incorporate external load at any arbitrary point on the body and deliver positional and force propagation information along the entire backbone. In line with the proposed model, the effectiveness of elasticity versus hyperelasticity assumptions (neo-Hookean and Gent) is investigated and compared. Experiments are carried out with and without external load, and simulations are validated across a range of Young's moduli. Results show best conformity with Hooke's model for limited strains with about 6% average normalized error of position; and a mean absolute error of less than 0.08 N for force applied at the tip and on the body, demonstrating high accuracy in estimating the position and the contact force.