Cellulose-acetate coating of carbon cloth diffusion layer for liquid-fed fuel cell applications.

Direct glucose fuel cells (DGFCs) and direct methanol fuel cells (DMFCs) commonly supply the reducing agent in liquid (aq.) form. In this work, we present key characteristics of implementing cellulose acetate (CA) coatings, which can subsequently be deacetylated toward cellulose, on carbon cloth used as a fuel diffusion layer in aqueous fuel-fed cells. Specifically, we illustrate functionality with an abiotic glucose fuel cell. Carbon cloth with and without a CA coating (with varying deacetylation) was characterized in terms of liquid permeation rate, electronic conductivity, and roll-off angle wetting characteristics. Additionally, fuel cell power production was measured over a variety of fuel concentrations and alkalinities by generating polarization curve data. These coatings facilitated a significant increase in aqueous solution permeation and adhesion properties, as well as providing up to two-fold increases in maximum power generation in an alkaline DGFC, despite experiencing some decreased conductivity of the carbon cloth diffusion layer.

Activation of individual extrinsic thumb muscles and compartments of extrinsic finger muscles.

Mechanical and neurological couplings exist between musculotendon units of the human hand and digits. Studies have begun to understand how these muscles interact when accomplishing everyday tasks, but there are still unanswered questions regarding the control limitations of individual muscles. Using intramuscular electromyographic (EMG) electrodes, this study examined subjects' ability to individually initiate and sustain three levels of normalized muscular activity in the index and middle finger muscle compartments of extensor digitorum communis (EDC), flexor digitorum profundus (FDP), and flexor digitorum superficialis (FDS), as well as the extrinsic thumb muscles abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and flexor pollicis longus (FPL). The index and middle finger compartments each sustained activations with significantly different levels of coactivity from the other finger muscle compartments. The middle finger compartment of EDC was the exception. Only two extrinsic thumb muscles, EPL and FPL, were capable of sustaining individual activations from the other thumb muscles, at all tested activity levels. Activation of APL was achieved at 20 and 30% MVC activity levels with significantly different levels of coactivity. Activation of EPB elicited coactivity levels from EPL and APL that were not significantly different. These results suggest that most finger muscle compartments receive unique motor commands, but of the four thumb muscles, only EPL and FPL were capable of individually activating. This work is encouraging for the neural control of prosthetic limbs because these muscles and compartments may potentially serve as additional user inputs to command prostheses.

Toward higher-performance bionic limbs for wider clinical use.

Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.

The Point Digit II: Mechanical Design and Testing of a Ratcheting Prosthetic Finger.

INTRODUCTION: People with partial hand loss represent the largest population of upper limb amputees by a factor of 10. The available prosthetic componentry for people with digit loss provide various methods of control, kinematic designs, and functional abilities. Here, the Point Digit II is empirically tested and a discussion is provided comparing the Point Digit II with the existing commercially available prosthetic fingers. MATERIALS AND METHODS: Benchtop mechanical tests were performed using prototype Point Digit II prosthetic fingers. The battery of tests included a static load test, a static mounting tear-out test, a dynamic load test, and a dynamic cycle test. These tests were implemented to study the mechanisms within the digit and the ability of the device to withstand heavy-duty use once out in the field. RESULTS: The Point Digit II met or exceeded all geometric and mechanical specifications. The device can withstand over 300 lbs of force applied to the distal phalange and was cycled over 250,000 times without an adverse event representing 3 years of use. Multiple prototypes were utilized across all tests to confirm the ability to reproduce the device in a reliable manner. CONCLUSIONS: The Point Digit II presents novel and exciting features to help those with partial hand amputation return to work and regain ability. The use of additive manufacturing, unique mechanism design, and clinically relevant design features provides both the patient and clinician with a prosthetic digit, which improves upon the existing devices available.

Comparison of Myoelectric Control Schemes for Simultaneous Hand and Wrist Movement using Chronically Implanted Electromyography: A Case Series.

OBJECTIVE: A current biomedical engineering challenge is the development of a system that allows fluid control of multi-functional prosthetic devices through a human-machine interface. Here we probe this challenge by studying two subjects with trans-radial limb loss as they control a virtual hand and wrist system using 6 or 8 chronically implanted intramuscular electromyographic (iEMG) signals. The subjects successfully controlled a 4, 5, and 6 Degrees of Freedom (DoF's) virtual hand and wrist systems to perform a target matching task. APPROACH: Two control systems were evaluated where one tied EMG features directly to movement directions (Direct Control) and the other method determines user intent in the context of prior training data (Linear Interpolation). MAIN RESULTS: Subjects successfully matched most targets with both controllers but differences were seen as the complexity of the virtual limb system increased. The Direct Control method encountered difficulty due to crosstalk at higher DoF's. The Linear Interpolation method reduced crosstalk effects and outperformed Direct Control at higher DoF's. This work also studied the use of the Postural Control Algorithm to control the hand postures simultaneously with wrist degrees of freedom. SIGNIFICANCE: This work presents preliminary evidence that the PC algorithm can be used in conjunction with wrist control, that Direct Control with iEMG signals allows stable 4-DoF control, and that EMG pre-processing using the Linear Interpolation method can improve performance at 5 and 6-DoF's.

Optical vagus nerve modulation of heart and respiration via heart-injected retrograde AAV.

Vagus nerve stimulation has shown many benefits for disease therapies but current approaches involve imprecise electrical stimulation that gives rise to off-target effects, while the functionally relevant pathways remain poorly understood. One method to overcome these limitations is the use of optogenetic techniques, which facilitate targeted neural communication with light-sensitive actuators (opsins) and can be targeted to organs of interest based on the location of viral delivery. Here, we tested whether retrograde adeno-associated virus (rAAV2-retro) injected in the heart can be used to selectively express opsins in vagus nerve fibers controlling cardiac function. Furthermore, we investigated whether perturbations in cardiac function could be achieved with photostimulation at the cervical vagus nerve. Viral injection in the heart resulted in robust, primarily afferent, opsin reporter expression in the vagus nerve, nodose ganglion, and brainstem. Photostimulation using both one-photon stimulation and two-photon holography with a GRIN-lens incorporated nerve cuff, was tested on the pilot-cohort of injected mice. Changes in heart rate, surface electrocardiogram, and respiratory responses were observed in response to both one- and two-photon photostimulation. The results demonstrate feasibility of retrograde labeling for organ targeted optical neuromodulation.

Optogenetic stimulation of cholinergic fibers for the modulation of insulin and glycemia.

Previous studies have demonstrated stimulation of endocrine pancreas function by vagal nerve electrical stimulation. While this increases insulin secretion, expected concomitant reductions in circulating glucose do not occur. A complicating factor is the non-specific nature of electrical nerve stimulation. Optogenetic tools, however, provide the potential for cell-type specific neural stimulation using genetic targeting and/or spatially shaped excitation light. Here, we demonstrate light-activated stimulation of the endocrine pancreas by targeting parasympathetic (cholinergic) axons. In a mouse model expressing ChannelRhodopsin2 (ChR2) in cholinergic cells, serum insulin and glucose were measured in response to (1) ultrasound image-guided optical stimulation of axon terminals in the pancreas or (2) optical stimulation of axons of the cervical vagus nerve. Measurements were made in basal-glucose and glucose-stimulated conditions. Significant increases in plasma insulin occurred relative to controls under both pancreas and cervical vagal stimulation, while a rapid reduction in glycemic levels were observed under pancreatic stimulation. Additionally, ultrasound-based measurements of blood flow in the pancreas were increased under pancreatic stimulation. Together, these results demonstrate the utility of in-vivo optogenetics for studying the neural regulation of endocrine pancreas function and suggest its therapeutic potential for the control of insulin secretion and glucose homeostasis.

Combination of Simultaneous Artificial Sensory Percepts to Identify Prosthetic Hand Postures: A Case Study.

Multiple sources of sensory information are combined to develop hand posture percepts in the intact system, but the combination of multiple artificial somatosensory percepts by human prosthesis users has not been studied. Here, we report on a case study in which a person with transradial amputation identified prosthetic hand postures using artificial somatosensory feedback. He successfully combined five artificial somatosensory percepts to achieve above-chance performance of 95.0% and 75.7% in identifying four and seven postures, respectively. We studied how artificial somatosensation and the extant hand representation are combined in the decision-making process by providing two mappings between the prosthetic sensor and the location of the sensory percept: (1) congruent, and (2) incongruent. The participant's ability to combine and engage with the sensory feedback significantly differed between the two conditions. The participant was only able to successfully generalize prior knowledge to novel postures in the congruent mapping. Further, he learned postures more accurately and quickly in the congruent mapping. Finally, he developed an understanding of the relationships between postures in the congruent mapping instead of simply memorizing each individual posture. These experimental results are corroborated by a Bayesian decision-making model which tracked the participant's learning.

Design of a High-Speed Prosthetic Finger Driven by Peano-HASEL Actuators.

Current designs of powered prosthetic limbs are limited by the nearly exclusive use of DC motor technology. Soft actuators promise new design freedom to create prosthetic limbs which more closely mimic intact neuromuscular systems and improve the capabilities of prosthetic users. This work evaluates the performance of a hydraulically amplified self-healing electrostatic (HASEL) soft actuator for use in a prosthetic hand. We compare a linearly-contracting HASEL actuator, termed a Peano-HASEL, to an existing actuator (DC motor) when driving a prosthetic finger like those utilized in multi-functional prosthetic hands. A kinematic model of the prosthetic finger is developed and validated, and is used to customize a prosthetic finger that is tuned to complement the force-strain characteristics of the Peano-HASEL actuators. An analytical model is used to inform the design of an improved Peano-HASEL actuator with the goal of increasing the fingertip pinch force of the prosthetic finger. When compared to a weight-matched DC motor actuator, the Peano-HASEL and custom finger is 10.6 times faster, has 11.1 times higher bandwidth, and consumes 8.7 times less electrical energy to grasp. It reaches 91% of the maximum range of motion of the original finger. However, the DC motor actuator produces 10 times the fingertip force at a relevant grip position. In this body of work, we present ways to further increase the force output of the Peano-HASEL driven prosthetic finger system, and discuss the significance of the unique properties of Peano-HASELs when applied to the field of upper-limb prosthetic design. This approach toward clinically-relevant actuator performance paired with a substantially different form-factor compared to DC motors presents new opportunities to advance the field of prosthetic limb design.

On the development of optical peripheral nerve interfaces.

Limb loss and spinal cord injury are two debilitating conditions that continue to grow in prevalence. Prosthetic limbs and limb reanimation present two ways of providing affected individuals with means to interact in the world. These techniques are both dependent on a robust interface with the peripheral nerve. Current methods for interfacing with the peripheral nerve tend to suffer from low specificity, high latency and insufficient robustness for a chronic implant. An optical peripheral nerve interface may solve some of these problems by decreasing invasiveness and providing single axon specificity. In order to implement such an interface three elements are required: (1) a transducer capable of translating light into a neural stimulus or translating neural activity into changes in fluorescence, (2) a means for delivering said transducer and (3) a microscope for providing the stimulus light and detecting the fluorescence change. There are continued improvements in both genetically encoded calcium and voltage indicators as well as new optogenetic actuators for stimulation. Similarly, improvements in specificity of viral vectors continue to improve expression in the axons of the peripheral nerve. Our work has recently shown that it is possible to virally transduce axons of the peripheral nerve for recording from small fibers. The improvements of these components make an optical peripheral nerve interface a rapidly approaching alternative to current methods.

User surveys support designing a prosthetic wrist that incorporates the Dart Thrower's Motion.

AIM: Prosthetic devices are not meeting the needs of people with upper limb amputations. Due to controlsidelimitations, prosthetic wrists cannot yet be fully articulated. This study sought to determine which wrist motions users felt were most important for completing activities of daily living. We specifically invstigated whether adding a combinationof flexion and deviation known as the Dart Thrower's Motion to a prosthetic wrist would help improve functionality. METHODS: Fifteen participants with a trans-radial amputation, aged 25-64 years, who use a prosthesis completed an online survey and answered interview questions to determine which types of tasks pose particular challenges. Participants were asked what kinds of improvements they would like to see in a new prosthesis. A subset of five participants were interviewed in-depth to provide further information about difficulties they face using their device. RESULTS: The survey showed that participants had difficulty performing activities of daily living that involve a combination of wrist flexion and deviation known as the "Dart Throwers Motion". Interview responses confirmed that users have difficulty performing these tasks, especially those that require tools. Additionally, users said that they were more interested in having flexion and deviation than rotation in a prosthetic wrist. CONCLUSION: This research indicates that including the Dart Thrower's Motion in future designs of prosthetic wrists would improve these devices and people with upper limb amputations would be excited to see this improvement in their devices. Implications for Rehabilitation • Over one third of people with upper limb amputations do not use a prosthesis because prosthetic devices do not meet their needs.• The number of motions possible in state of the art prosthetic devices is limited by the small number of control sites available.• The Dart Thrower?s Motion is a wrist motion used for many activities of daily living but unavailable in commercial prosthetics leading many prosthetics users to have difficulty with these tasks.• Prosthetic use, and therefore quality of life, could be improved by including the Dart Thrower's Motion in a prosthesis.

Intravascular injections of adenoassociated viral vector serotypes rh10 and PHP.B transduce murine sciatic nerve axons.

Adenoassociated viral vectors provide a safe and robust method for expression of transgenes in nondividing cells such as neurons. Intravenous injections of these vectors provide a means of transducing motoneurons of peripheral nerves. Previous research has demonstrated that serotypes 1, rh10 and PHP.B can transduce motor neuron cell bodies in the spinal cord, but has not quantified expression in the peripheral nerve axon. Axonal labeling is crucial for optogenetic stimulation and detection of action potentials in peripheral nerve. Therefore, in this study, serotypes 1, PHP.B, and rh10 were tested for their ability to label axons of the murine sciatic and tibial nerve following intravenous injection. Serotype rh10 elicits expression in 10% of acetylcholine transferase positive axons of the sciatic nerve in immunohistochemically-stained sections. Serotype rh10 transduces a variety of axon diameters from <1-12 µm, while PHP.B transduces larger axons of diameter (4-16 µm). Expression was not seen with serotype 1. These results show the potential of serotypes PHP.B and rh10 delivery of transgenic products to axons of the peripheral nerve.

Real-Time Prosthetic Digit Actuation by Optical Read-out of Activity-Dependent Calcium Signals in an Ex Vivo Peripheral Nerve.

Improved neural interfacing strategies are needed for the full articulation of advanced prostheses. To address limitations of existing control interface designs, the work of our laboratory has presented an optical approach to reading activity from individual nerve fibers using activity-dependent calcium transients. Here, we demonstrate the feasibility of such signals to control prosthesis actuation by using the axonal fluorescence signal in an ex vivo mouse nerve to drive a prosthetic digit in real-time. Additionally, signals of varying action potential frequency are streamed post hoc to the prosthesis, showing graded motor output and the potential for proportional neural control. This proof-of-concept work is a novel demonstration of the functional use of activity-dependent optical read-out in the nerve.

Modeling and preliminary testing socket-residual limb interface stiffness of above-elbow prostheses.

The interface between the socket and residual limb can have a significant effect on the performance of a prosthesis. Specifically, knowledge of the rotational stiffness of the socket-residual limb (S-RL) interface is extremely useful in designing new prostheses and evaluating new control paradigms, as well as in comparing existing and new socket technologies. No previous studies, however, have examined the rotational stiffness of S-RL interfaces. To address this problem, a math model is compared to a more complex finite element analysis, to see if the math model sufficiently captures the main effects of S-RL interface rotational stiffness. Both of these models are then compared to preliminary empirical testing, in which a series of X-rays, called fluoroscopy, is taken to obtain the movement of the bone relative to the socket. Force data are simultaneously recorded, and the combination of force and movement data are used to calculate the empirical rotational stiffness of elbow S-RL interface. The empirical rotational stiffness values are then compared to the models, to see if values of Young's modulus obtained in other studies at localized points may be used to determine the global rotational stiffness of the S-RL interface. Findings include agreement between the models and empirical results and the ability of persons to significantly modulate the rotational stiffness of their S-RL interface a little less than one order of magnitude. The floor and ceiling of this range depend significantly on socket length and co-contraction levels, but not on residual limb diameter or bone diameter. Measured trans-humeral S-RL interface rotational stiffness values ranged from 24-140 Nm/rad for the four subjects tested in this study.

Functional Assessment of a Myoelectric Postural Controller and Multi-Functional Prosthetic Hand by Persons With Trans-Radial Limb Loss.

The functional assessment of myoelectric control algorithms by persons with amputation promotes the overarching goal of the field of prosthetic limb design: to replace what was lost. However, many studies use experimental paradigms with virtual interfaces and able-bodied subjects that do not capture the challenges of a clinical implementation with an amputee population. A myoelectric control system must be robust to variable physiology, loading effects of the prosthesis on the limb, and limb position effects during dynamic tasks. Here persons with transradial limb loss performed activities of daily living using a postural controller and multi-functional prosthetic hand in order to verify that the postural controller was robust to these clinical challenges. The Southampton Hand Assessment Procedure was performed by persons with limb loss and able-bodied subjects. The results indicate that persons with limb loss and able-limbed subjects achieved the same performance and therefore that the clinical challenges were overcome. Persons with limb loss achieved 55% of physiological hand function on average. Also, the postural controller is compared to other state of the art myoelectric controllers and prosthetic hands previously tested. This work confirms that the postural controller is potentially a clinically-viable method to control myoelectric multi-functional prosthetic hands.

Simulation of intramuscular EMG signals detected using implantable myoelectric sensors (IMES).

The purpose of this study was to test the feasibility of recording independent electromyographic (EMG) signals from the forearm using implantable myoelectric sensors (IMES), for myoelectric prosthetic control. Action potentials were simulated using two different volume conductor models: a finite-element (FE) model that was used to explore the influence of the electrical properties of the surrounding inhomogeneous tissues and an analytical infinite volume conductor model that was used to estimate the approximate detection volume of the implanted sensors. Action potential amplitude increased progressively as conducting electrodes, the ceramic electrode casing and high resistivity encapsulation tissue were added to the model. For the muscle fiber locations examined, the mean increase in EMG root mean square amplitude when the full range of material properties was included in the model was 18.2% (+/-8.1%). Changing the orientation of the electrode with respect to the fiber direction altered the shape of the electrode detection volume and reduced the electrode selectivity. The estimated detection radius of the IMES electrode, assuming a cylindrical muscle cross section, was 4.8, 6.2, and 7.5 mm for electrode orientations of 0 degree, 22.5 degrees, and 45 degrees with respect to the muscle fiber direction.

Design and Fabrication of a Six Degree-of-Freedom Open Source Hand.

Currently, most externally powered prostheses are controlled using electromyography (or EMG), which is the measure of the electrical signals that are produced when voluntary muscle is contracted. One of the major problems is that there are a limited number of muscular control sites that can be used, which limits the complexity of the hands that are controllable. Many upper-limb prosthetics researchers are searching for methods to simply and effectively control complex prosthetic hands, and a significant number of these researchers have utilized virtual hands and other simulations to perform testing of these control algorithms (oftentimes on able bodied subjects). Thus, these control techniques remain firmly planted in the virtual realm, and the authors postulate that the development of a physical hand would help to validate results obtained through use of virtual hands and could help establish whether or not a given control scheme is realistically applicable for use by amputees. The development of such a hand would be beneficial for researchers in the field. A six degree-of-freedom hand was developed with such a purpose in mind, and two of the major goals of the project were that the hand be inexpensive and open source. The hand design is being shared on .

A heuristic fuzzy logic approach to EMG pattern recognition for multifunctional prosthesis control.

This paper presents a heuristic fuzzy logic approach to multiple electromyogram (EMG) pattern recognition for multifunctional prosthesis control. Basic signal statistics (mean and standard deviation) are used for membership function construction, and fuzzy c-means (FCMs) data clustering is used to automate the construction of a simple amplitude-driven inference rule base. The result is a system that is transparent to, and easily "tweaked" by, the prosthetist/clinician. Other algorithms in current literature assume a longer period of unperceivable delay, while the system we present has an update rate of 45.7 ms with little postprocessing time, making it suitable for real-time application. Five subjects were investigated (three with intact limbs, one with a unilateral transradial amputation, and one with a unilateral transradial limb-deficiency from birth). Four subjects were used for system offline analysis, and the remaining intact-limbed subject was used for system real-time analysis. We discriminated between four EMG patterns for subjects with intact limbs, and between three patterns for limb-deficient subjects. Overall classification rates ranged from 94% to 99%. The fuzzy algorithm also demonstrated success in real-time classification, both during steady state motions and motion state transitioning. This functionality allows for seamless control of multiple degrees-of-freedom in a multifunctional prosthesis.

Extrinsic finger and thumb muscles command a virtual hand to allow individual finger and grasp control.

Fine-wire intramuscular electrodes were used to obtain electromyogram (EMG) signals from six extrinsic hand muscles associated with the thumb, index, and middle fingers. Subjects' EMG activity was used to control a virtual three-degree-of-freedom (DOF) hand as they conformed the hand to a sequence of hand postures testing two controllers: direct EMG control and pattern recognition control. Subjects tested two conditions using each controller: starting the hand from a predefined neutral posture before each new posture and starting the hand from the previous posture in the sequence. Subjects demonstrated their abilities to simultaneously, yet individually, move all three DOFs during the direct EMG control trials; however, results showed subjects did not often utilize this feature. Performance metrics such as failure rate and completion time showed no significant difference between the two controllers.