Applying Physiologically Relevant Strains to Tenocytes in an In Vitro Cell Device Induces In Vivo Like Behaviors.

We have developed a novel cell stretching device (called Cell Gym) capable of applying physiologically relevant low magnitude strains to tenocytes on a collagen type I coated membrane. We validated our device thoroughly on two levels: (1) substrate strains, (2) cell level strains. Our cell level strain results showed that the applied stretches were transferred to cells accurately (∼90%). Our gene expression data showed that mechanically stimulated tenocytes (4%) expressed a lower level of COL I gene. COX2 gene was increased but did not reach statistical significance. Our device was then tested to see if it could reproduce results from an in vivo study that measured time-dependent changes in collagen synthesis. Our results showed that collagen synthesis peaked at 24 hrs after exercise and then decreased, which matched the results from the in vivo study. Our study demonstrated that it is important to incorporate physiologically relevant low strain magnitudes in in vitro cell mechanical studies and the need to validate the device thoroughly to operate the device at small strains. This device will be used in designing novel tendon tissue engineering scaffolds in the future.

Glove-Based Hand Gesture Recognition for Diver Communication.

We have developed a smart dive glove that recognizes 13 static hand gestures used in diving communication. The smart glove employs five dielectric elastomer sensors to capture finger motion and implements a machine learning classifier in the onboard electronics to recognize gestures. Five basic classification algorithms are trained and assessed: the decision tree, support vector machine (SVM), logistic regression, Gaussian naïve Bayes, and multilayer perceptron. These basic classifiers were selected as they perform well in multiclass classification problems, can be trained using supervised learning, and are model-based algorithms that can be implemented on a microprocessor. The training dataset was collected from 24 participants providing for a range of different hand sizes. After training, the algorithms were evaluated in a dry environment using data collected from ten new participants to test how well they cope with new information. Furthermore, an underwater experiment was conducted to assess any impact of the underwater environment on each algorithm's classification. The results show all classifiers performed well in a dry environment. The accuracies and F1-scores range between 0.95 and 0.98, where the logistic regressor and SVM have the highest scores for both the accuracy and F1-score (0.98). The underwater results showed that all algorithms work underwater; however, the performance drops when divers must focus on buoyancy control, breathing, and diver trim.

Quantitative CT with finite element analysis: towards a predictive tool for bone remodelling around an uncemented tapered stem.

PURPOSE: We used quantitative CT in conjunction with finite element analysis to provide a new tool for assessment of bone quality after total hip arthroplasty in vivo. The hypothesis of this prospective five-year study is that the combination of the two modalities allows 3D patient-specific imaging of cortical and cancellous bone changes and stress shielding. METHOD: We tested quantitative CT in conjunction with finite elements on a cohort of 29 patients (31 hips) who have been scanned postoperatively and at one year, two years and five years follow-up. The method uses cubic Hermite finite element interpolation for efficient mesh generation directly from qCT datasets. The element Gauss points that are used for the geometric interpolation functions are also used for interpolation of osteodensitometry data. RESULTS: The study showed changes of bone density suggestive of proximal femur diaphysis load transfer with osteointegration and moderate metaphyseal stress shielding. Our model revealed that cortical bone initially became porous in the greater trochanter, but this phenomenon progressed to the cortex of the lesser trochanter and the posterior aspect of the metaphysis. The diaphyseal area did not experience major change in bone density for either cortical or cancellous bone. CONCLUSION: The combination of quantitative CT with finite element analysis allows visualization of changes to bone density and architecture. It also provides correlation of bone density/architectural changes with stress patterns enabling the study of the effects of stress shielding on bone remodelling in vivo. This technology can be useful in predicting bone remodeling and the quality of implant fixation using prostheses with different design and/or biomaterials.

Squeezing More Juice out of Dielectric Elastomer Generators.

Dielectric elastomer generators are soft structures capable of converting mechanical energy into electrical energy. Here, we develop a theoretical model of the triangular harvesting cycle that enables the harvesting of most of the available electrical energy while not requiring active monitoring of the charge-voltage state on the DEG. This cycle is therefore interesting for small-scale generators for which a monitoring circuit would be energetically too costly. Our model enables the identification of the optimal value of the circuit's parameters such as storage capacitor and priming voltage values and show that for capacitance swings up to 6, 94% of the available electrical energy can be harvested. The model is experimentally validated with a conical generator, and the effect of non-constant deformation amplitudes is examined. Energy densities up to 46 mJcm-3 were obtained for an electric field of 50 V µm-1.

One Soft Step: Bio-Inspired Artificial Muscle Mechanisms for Space Applications.

Soft robots, devices with deformable bodies and powered by soft actuators, may fill a hitherto unexplored niche in outer space. All space-bound payloads are heavily limited in terms of mass and volume, due to the cost of launch and the size of spacecraft. Being constructed from stretchable materials allows many possibilities for compacting soft robots for launch and later deploying into a much larger volume, through folding, rolling, and inflation. This morphability can also be beneficial for adapting to operation in different environments, providing versatility, and robustness. To be truly soft, a robot must be powered by soft actuators. Dielectric elastomer transducers (DETs) offer many advantages as artificial muscles. They are lightweight, have a high work density, and are capable of artificial proprioception. Taking inspiration from nature, in particular the starfish podia, we present here bio-inspired inflatable DET actuators powering low-mass robots capable of performing complex motion that can be compacted to a fraction of their operating size.

Accuracy of computer-assisted navigation for femoral head resurfacing decreases in hips with abnormal anatomy.

Computer-assisted navigation systems for hip resurfacing arthroplasty are designed to minimize the chance of implant malposition. However, there is little evidence computer navigation is useful in the presence of anatomical deformity. We therefore determined the accuracy of an image-free resurfacing hip arthroplasty navigation system in the presence of a pistol grip deformity of the head and femoral neck junction and of a slipped upper femoral epiphysis deformity. We constructed an artificial phantom leg from machined aluminum with a simulated hip and knee. The frontal and lateral plane implant-shaft angles for the guide wire of the femoral component reamer were calculated with the computer navigation system and with an electronic caliper combined with micro-CT. There was a consistent disagreement between the navigation system and our measurement system in both the frontal plane and lateral plane with the pistol grip deformity. We found close agreement only for the frontal plane angle calculation in the presence of the slipped upper femoral epiphysis deformity, but calculation of femoral head size was inaccurate. The use of image-free navigation for the positioning of the femoral component appears questionable in these settings.

Biomechanical evaluation of different designs of glenospheres in the SMR reverse total shoulder prosthesis: range of motion and risk of scapular notching.

BACKGROUND: Reverse total shoulder arthroplasty is a treatment option for cuff tear arthropathy. Scapular notching remains a concern. This biomechanical study compared the range-of-motion in different designs of glenospheres and hence the relative risk of scapular notching. METHOD: A precision coordinate device was used to investigate four different designs of glenospheres (SMR prosthesis); 36 mm concentric (Standard), 36 mm eccentric, 44 mm concentric, and 44 mm eccentric glenospheres. The centre of rotation in each design was first established. The position of the humeral prosthesis was recorded in the plane of the scapula to compare the degree of adduction and the total range-of-motion. RESULTS: Eccentric glenospheres were found to improve range-of-motion by allowing a higher degree of adduction. Larger diameter glenospheres were found to improve range-of-motion by increasing adduction and abduction. Compared to the 36 mm concentric (standard) glenosphere, the 36 mm eccentric glenosphere improved adduction by 14.5 degrees, the 44 mm concentric glenosphere improved adduction by 11.6 degrees, the 44 mm eccentric glenosphere improved adduction by 17.7 degrees. CONCLUSION: Eccentric glenospheres with a center-of-rotation placed more inferiorly were shown to improve adduction. This design may reduce the clinical incidence of scapular notching.

Capacitive Stretch Sensing for Robotic Skins.

Various types of artificial skins have been developed to provide robots with a sense of touch. Because of their compliance, dielectric elastomer (DE) capacitive sensors are particularly suitable for soft robots. Although the electrodes of DE sensors exhibit nonlinear effects such as transient resistance changes and resistance peaks, this does not affect the capacitance readout representing stretch, as long as the frequency of the excitation voltage used for capacitance measurement is sufficiently low. At higher frequencies, however, the approximation of a DE sensor with an ideal capacitor and a series resistor accounting for electrode resistivity leads to an underestimation of capacitance in static sensors. We demonstrate how this effect is amplified by peaks and transient changes of electrode resistance caused by periodic stretching. At high frequencies, distinctive capacitance undershoots occurred that correlated with the change of electrode resistance. The close match between a simulation of the DE sensor as an R-C transmission line and recorded data supports the hypothesis of the undershoot having been caused by dynamic electrode resistance changes and the lumped parameter approximation. Our results show that nonlinear responses in DE sensors can be avoided by appropriately adjusting the excitation frequency.

Orthogonal cutting of cancellous bone with application to the harvesting of bone autograft.

Autogenous bone graft harvesting results in cell death within the graft and trauma at the donor site. The latter can be mitigated by using minimally invasive tools and techniques, while cell morbidity may be reduced by improving cutter design and cutting parameters. We have performed orthogonal cutting experiments on bovine cancellous bone samples, to gain a basic understanding of the cutting mechanism and to determine design guidelines for tooling. Measurements were performed at cutting speeds from 11.2 to 5000 mm/min, with tool rake angles of 23 degrees, 45 degrees and 60 degrees, and depths of cut in the range of 0.1-3.0 mm. Horizontal and vertical cutting forces were measured, and the chip formation process video recorded. Continuous chip formation was observed for rake angles of 45 degrees and 60 degrees , and depths of cut greater than 0.8 mm. Chip formation for depths of cut greater than 1.0 mm was accompanied by bone marrow extruding out of the free surfaces and away from the rake face. Specific cutting energies decreased with increasing rake angle, increasing depth of cut and increasing cutting speed. Our orthogonal cutting experiments showed that a rake angle of 60 degrees and a depth of cut of 1mm, will avoid excessive fragmentation, keep specific cutting energy low and promote bone marrow extrusion, which may be beneficial for cell survival. We demonstrate how drill bit clearance angle and feed rate can be calculated facilitating a 1mm depth of cut.

The use of sparse CT datasets for auto-generating accurate FE models of the femur and pelvis.

The finite element (FE) method when coupled with computed tomography (CT) is a powerful tool in orthopaedic biomechanics. However, substantial data is required for patient-specific modelling. Here we present a new method for generating a FE model with a minimum amount of patient data. Our method uses high order cubic Hermite basis functions for mesh generation and least-square fits the mesh to the dataset. We have tested our method on seven patient data sets obtained from CT assisted osteodensitometry of the proximal femur. Using only 12 CT slices we generated smooth and accurate meshes of the proximal femur with a geometric root mean square (RMS) error of less than 1 mm and peak errors less than 8 mm. To model the complex geometry of the pelvis we developed a hybrid method which supplements sparse patient data with data from the visible human data set. We tested this method on three patient data sets, generating FE meshes of the pelvis using only 10 CT slices with an overall RMS error less than 3 mm. Although we have peak errors about 12 mm in these meshes, they occur relatively far from the region of interest (the acetabulum) and will have minimal effects on the performance of the model. Considering that linear meshes usually require about 70-100 pelvic CT slices (in axial mode) to generate FE models, our method has brought a significant data reduction to the automatic mesh generation step. The method, that is fully automated except for a semi-automatic bone/tissue boundary extraction part, will bring the benefits of FE methods to the clinical environment with much reduced radiation risks and data requirement.

Soft Dielectric Elastomer Oscillators Driving Bioinspired Robots.

Entirely soft robots with animal-like behavior and integrated artificial nervous systems will open up totally new perspectives and applications. To produce them, we must integrate control and actuation in the same soft structure. Soft actuators (e.g., pneumatic and hydraulic) exist but electronics are hard and stiff and remotely located. We present novel soft, electronics-free dielectric elastomer oscillators, which are able to drive bioinspired robots. As a demonstrator, we present a robot that mimics the crawling motion of the caterpillar, with an integrated artificial nervous system, soft actuators and without any conventional stiff electronic parts. Supplied with an external DC voltage, the robot autonomously generates all signals that are necessary to drive its dielectric elastomer actuators, and it translates an in-plane electromechanical oscillation into a crawling locomotion movement. Therefore, all functional and supporting parts are made of polymer materials and carbon. Besides the basic design of this first electronic-free, biomimetic robot, we present prospects to control the general behavior of such robots. The absence of conventional stiff electronics and the exclusive use of polymeric materials will provide a large step toward real animal-like robots, compliant human machine interfaces, and a new class of distributed, neuron-like internal control for robotic systems.

Lower Extremity Lateral Skin Stretch Perception for Haptic Feedback.

Tactile feedback in recent decades has allowed humans to receive information through technology beyond traditional visual and auditory senses. Lateral skin stretch has the potential to be a mode of tactile feedback, reliably enabling the perception of directional cues through the use of a single actuator. Experiments were conducted to explore sensitivity to skin stretch on nine locations on the human lower leg. Thirty-two stimuli were presented to subjects, exploring effects of displacement (from 0.2-2.0 mm) and speed (from 0.5-4.0 mm/s) on the perception of left and right directions. Higher accuracy came from stimuli having higher displacements and speeds. Three of the locations: soleus, calcaneal tendon (upper), and fibularis longus (lower) all had a mean accuracy of at least 85 percent and are suitable locations for a skin stretch tactile feedback device.

Analyzing bone remodeling patterns after total hip arthroplasty using quantitative computed tomography and patient-specific 3D computational models.

BACKGROUND: Computational models in the form of finite element analysis technique that incorporates bone remodeling theories along with DEXA scans has been extensively used in predicting bone remodeling patterns around the implant. However, majority of such studies used generic models. Therefore, the aim of this study is to develop patient-specific finite element models of total hip replacement patients using their quantitative computed tomography (QCT) scans and accurately analyse bone remodelling patterns after total hip arthroplasty (THA). METHODS: Patient-specific finite element models have been generated using the patients' QCT scans from a previous clinical follow-up study. The femur was divided into five regions in proximal-distal direction and then further divided into four quadrants for detailed analysis of bone remodeling patterns. Two types of analysis were performed-inter-patient and intra patient to compare them and then the resulting bone remodeling patterns were quantitatively analyzed. RESULTS: Our results show that cortical bone density decrease is higher in diaphyseal region over time and the cancellous bone density decreases significantly in metaphyseal region over time. In metaphyseal region, posterior-medial (P-M) quadrant showed high bone loss while diaphyseal regions show high bone loss in anterior-lateral (A-L) quadrant. CONCLUSIONS: Our study demonstrated that combining QCT with 3D patient-specific models has the ability of monitoring bone density change patterns after THA in much finer details. Future studies include using these findings for the development of a bone remodelling algorithm capable of predicting surgical outcomes for THA patients.

Validation of an efficient method of assigning material properties in finite element analysis of pelvic bone.

Bone in the pelvis is a composite material with a complex anatomical structure that is difficult to model computationally. Rather than assigning material properties to increasingly smaller elements to capture detail in three-dimensional finite element (FE) models, properties can be assigned to Gauss points within larger elements. As part of a validation process, we compared experimental and analytical results from a composite beam under four-point load to FE models with material properties assigned to refined elements and Gauss points within larger elements. Both FE models accurately predicted deformation and the analytical predictions of internal shear stress.

A novel method for measuring medial compartment pressures within the knee joint in-vivo.

A novel method for the measurement of knee joint forces in-vivo is described. A thin (0.2mm) flexible electronic pressure sensor was inserted through a narrow arthroscopic portal into the osteoarthritic medial compartment of the knee joint. The sensor partially covered the load bearing area. The surgery was performed under local anaesthetic during normal arthroscopic examination following patient consent. Results are presented for 11 patients. The method was used in a pilot study to assess the effects of four valgus knee braces on medial compartment forces. An analysis of variance could not detect un-loading by any brace although there were large variations in force output. These variations may be attributable to shifts in the sensor position. In-vivo measurement of joint force is technically feasible.

Finite element analysis of retroacetabular osteolytic defects following total hip replacement.

Periprosthetic osteolysis in the retroacetabular region with cancellous bone loss is a recognized phenomenon in the long-term follow-up of total hip replacement. The effects on load transfer in the presence of defects are less well known. A finite element model incorporating a retroacetabular defect behind a cementless component was validated against a 4th generation sawbone pelvis. Computational predictions of surface strain and von Mises stresses were closely correlated to experimental findings. The presence of a cancellous defect increased von Mises stress in the cortical bone of the medial wall of the pelvis. At a load of 600 N this was under the predicted failure stress for cortical bone. Increases in the cup size relative to the acetabulum caused increased stress in the cortical bone of the lateral wall of the pelvis, adjacent to the acetabulum. We are confident that our modeling approach can be applied to patient specific defects to predict pelvis stress with large loads and a range of activities.

The cell injury device: a high-throughput platform for traumatic brain injury research.

A novel, automated system for delivering controlled scratch-induced trauma to brain cells cultured in multi-well plates was created and characterized. The system is equipped with high-throughput imaging and analysis capabilities, enabling quantitative measurements of cell migration. The scratch-area coefficient of variation of the device was between 3.9% and 8.4%, a significant improvement over traditional manual methods, which provided a scratch-area coefficient of variation of between 10.7% and 19.6%. The device's inexpensive imaging and analysis capabilities were comparable to a well-known system, the Discovery-1 (Molecular Devices), with no significant difference found between the two. When used for drug screening, the gap area of Neuro2a cells after 72h was significantly larger in samples containing UO126 (20µM), averaging 0.89mm(2)±0.21mm(2); compared with an average vehicle control gap area of 0.42mm(2)±0.1mm(2). A gradient response could also be detected among samples with increasing UO126 concentrations (0-20µM), due to decreased migration and/or proliferation of cells into the gap over the time period. Our device provides an inexpensive method for delivering a standardized, closely controlled pressure/scratch to brain cells cultured in multi-well plates. The system provides more consistent patterns of scratch-induced trauma to cultured cells when compared to traditional methods. This device is an effective platform for quantifying the injury response of cells, and has applications in testing the effectiveness of drugs on cell migration and proliferation which might potentially treat traumatic brain injury.

A technique for optimizing electrode placement for electromyographic control of prostheses.

We present a technique that enables optimization of Electromyographic (EMG) electrode placement for grasp recognition. Previous works have shown that sophisticated control techniques for prosthetic devices are becoming available; however the issue of electrode placement has yet to be addressed. By processing a rich field of data, it is possible to determine which of the data sets will allow for greatest accuracy in prosthetic control. Data has been collected and processed from 128 sites on a human forearm while two different grasps were performed. Using two different feature extraction techniques - integral of absolute value and differential absolute value - the difference in means between performing each grasp type has been analyzed. This resulted in several regions around the wrist and the elbow that would be optimal for this particular setup. While the optimization process has been used here for discrimination between two particular grasps, it has the potential to extend to any desired actuation pattern.

Tensile strength of surgical knots in abdominal wound closure.

Abdominal wound dehiscence is a surgical catastrophe that can be attributed to patients or technical factors. The technical properties of the monofilament sutures and knots that are commonly used in abdominal closure are poorly understood. The aim of this study was to compare the tensile strength of monofilament sutures tied with conventional knots. To do this, the knot-holding capacity of four types of knots (square, surgeons', Aberdeen and loop) were tested using three types of gauge 1 monofilament suture, namely nylon, polyglyconate and polydioxanone, using a tensiometer. We found that the knot-holding capacity of the loop knot was between twofold and threefold greater than all the other knots examined. In comparing suture types, polyglyconate had the highest knot-holding capacity for all the knots that were examined and there was no difference in the tensile strength of nylon and polyglyconate tied in a square, surgeons' or Aberdeen knot (P < 0.05). In conclusion, our findings suggest that closure of an abdominal wound would be best commenced with a loop knot, using gauge 1 polyglyconate and finished with either an Aberdeen square or surgeons' knot would be appropriate.

Development and validation of patient-specific finite element models of the hemipelvis generated from a sparse CT data set.

To produce a patient-specific finite element (FE) model of a bone such as the pelvis, a complete computer tomographic (CT) or magnetic resonance imaging (MRI) geometric data set is desirable. However, most patient data are limited to a specific region of interest such as the acetabulum. We have overcome this problem by providing a hybrid method that is capable of generating accurate FE models from sparse patient data sets. In this paper, we have validated our technique with mechanical experiments. Three cadaveric embalmed pelves were strain gauged and used in mechanical experiments. FE models were generated from the CT scans of the pelves. Material properties for cancellous bone were obtained from the CT scans and assigned to the FE mesh using a spatially varying field embedded inside the mesh while other materials used in the model were obtained from the literature. Although our FE meshes have large elements, the spatially varying field allowed them to have location dependent inhomogeneous material properties. For each pelvis, five different FE meshes with a varying number of patient CT slices (8-12) were generated to determine how many patient CT slices are needed for good accuracy. All five mesh types showed good agreement between the model and experimental strains. Meshes generated with incomplete data sets showed very similar stress distributions to those obtained from the FE mesh generated with complete data sets. Our modeling approach provides an important step in advancing the application of FE models from the research environment to the clinical setting.