RESUMEN
Multimodal sensory feedback from upper-limb prostheses can increase their function and usability. Here we show that intuitive thermal perceptions during cold-object grasping with a prosthesis can be restored in a phantom hand through targeted nerve stimulation via a wearable thin-film thermoelectric device with high cooling power density and speed. We found that specific regions of the residual limb, when thermally stimulated, elicited thermal sensations in the phantom hand that remained stable beyond 48 weeks. We also found stimulation sites that selectively elicited sensations of temperature, touch or both, depending on whether the stimulation was thermal or mechanical. In closed-loop functional tasks involving the identification of cold objects by amputees and by non-amputee participants, and compared with traditional bulk thermoelectric devices, the wearable thin-film device reliably elicited cooling sensations that were up to 8 times faster and up to 3 times greater in intensity while using half the energy and 1/600th the mass of active thermoelectric material. Wearable thin-film thermoelectric devices may allow for the non-invasive restoration of thermal perceptions during touch.
RESUMEN
The human body is a template for many state-of-the-art prosthetic devices and sensors. Perceptions of touch and pain are fundamental components of our daily lives that convey valuable information about our environment while also providing an element of protection from damage to our bodies. Advances in prosthesis designs and control mechanisms can aid an amputee's ability to regain lost function but often lack meaningful tactile feedback or perception. Through transcutaneous electrical nerve stimulation (TENS) with an amputee, we discovered and quantified stimulation parameters to elicit innocuous (non-painful) and noxious (painful) tactile perceptions in the phantom hand. Electroencephalography (EEG) activity in somatosensory regions confirms phantom hand activation during stimulation. We invented a multilayered electronic dermis (e-dermis) with properties based on the behavior of mechanoreceptors and nociceptors to provide neuromorphic tactile information to an amputee. Our biologically inspired e-dermis enables a prosthesis and its user to perceive a continuous spectrum from innocuous to noxious touch through a neuromorphic interface that produces receptor-like spiking neural activity. In a Pain Detection Task (PDT), we show the ability of the prosthesis and amputee to differentiate non-painful or painful tactile stimuli using sensory feedback and a pain reflex feedback control system. In this work, an amputee can use perceptions of touch and pain to discriminate object curvature, including sharpness. This work demonstrates possibilities for creating a more natural sensation spanning a range of tactile stimuli for prosthetic hands.
RESUMEN
INTRODUCTION: The purpose of this study was to compare the fracture resistance to cyclic fatigue of ProTaper Next (PTN; Dentsply Tulsa Dental Specialties, Tulsa, OK), ProTaper Universal (PTU, Dentsply Tulsa Dental Specialties), and Vortex Blue (VB, Dentsply Tulsa Dental Specialties) rotary instruments. METHODS: Twenty instruments each of PTN X1-X5, PTU S1-F5, and VB 20/04-50/04 were rotated until fracture in a simulated canal of 90° and a 5-mm radius using a custom-made testing platform. The number of cycles to fracture (NCF) was calculated. Weibull analysis was used to predict the maximum number of cycles when 99% of the instrument samples survive. RESULTS: VB 20/04-30/04 had significantly higher NCF than PTU S1-F5 and PTN X1-X5. VB 35/04-45/04 had significantly higher NCF than PTU S2-F5 and PTN X2-X5. PTN X1 had higher NCF than PTU S1-F5. PTN X2 had higher NCF than PTU F2-F5. The Weibull distribution predicted the highest number of cycles at which 99% of instruments survive to be 766 cycles for VB 25/04 and the lowest to be 50 cycles for PTU F2. CONCLUSIONS: Under the limitations of this study, VB 20/04-45/04 were more resistant to cyclic fatigue than PTN X2-X5 and PTU S2-F5. PTN X1 and X2 were more resistant to cyclic fatigue than PTU F2-F5. The Weibull distribution appears to be a feasible and potentially clinically relevant model to predict resistance to cyclic fatigue.
