Publications by authors named "Matteo Bianchi"

82 Publications

A Novel Device Decoupling Tactile Slip and Hand Motion in Reaching Tasks: The HaptiTrack Device.

IEEE Trans Haptics 2021 Apr 22;PP. Epub 2021 Apr 22.

Hand reaching is a complex task that requires the integration of multiple sensory information from muscle, joints and the skin, and an internal model of the motor command. Recent studies in neuroscience highlighted the important role of touch for the control of hand movement while reaching for a target. We present a novel device, the HaptiTrack device, to physically decouple tactile slip motion and hand movements. The new device generates precisely controlled 2D motion of a contact plate, measures contact forces, and provides hand and finger tracking through an external tracking system. By means of a control algorithm described in this manuscript, the velocity of tactile slip can be changed independently from the velocity of the hand sliding on the device's surface. Due to these multiple features, the device can be a powerful tool for the evaluation of tactile sense during hand reaching movements in healthy and pathological conditions.
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http://dx.doi.org/10.1109/TOH.2021.3075024DOI Listing
April 2021

Toward brain-heart computer interfaces: a study on the classification of upper limb movements using multisystem directional estimates.

J Neural Eng 2021 Feb 18. Epub 2021 Feb 18.

Research Center E. Piaggio, Information Engineering, University of Pisa School of Engineering, Largo L. Lazzarino, 1, Pisa, Toscana, 56126, ITALY.

Objective: Brain-computer interfaces (BCI) exploit computational features from brain signals to perform a given task. Despite recent neurophysiology and clinical findings indicating the crucial role of functional interplay between brain and cardiovascular dynamics in locomotion, heartbeat information remains to be included in common BCI systems. In this study, we exploit the multidimensional features of directional and functional interplay between electroencephalographic and heartbeat spectra to classify upper limb movements into three classes.

Approach: We gathered data from 26 healthy volunteers that performed 90 movements; the data were processed using a recently proposed framework for brain-heart interplay (BHI) assessment based on synthetic physiological data generation. Extracted BHI features were employed to classify, through sequential forward selection scheme and k-nearest neighbors algorithm, among resting state and three classes of movements according to the kind of interaction with objects.

Main Results: The results demonstrated that the proposed brain-heart computer interface (BHCI) system could distinguish between rest and movement classes automatically with an average 90% of accuracy.

Significance: Further, this study provides neurophysiology insights indicating the crucial role of functional interplay originating at the cortical level onto the heart in the upper limb neural control. The inclusion of functional BHI insights might substantially improve the neuroscientific knowledge about motor control, and this may lead to advanced BHCI systems performances.
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http://dx.doi.org/10.1088/1741-2552/abe7b9DOI Listing
February 2021

Enhancing the localization of uterine leiomyomas through cutaneous softness rendering for robot-assisted surgical palpation application.

IEEE Trans Haptics 2021 Feb 8;PP. Epub 2021 Feb 8.

Integrating tactile feedback for lump localization in Robot-assisted Minimally-Invasive Surgery (RMIS) represents an open research issue. Main reasons for this are related e.g. to the need for a transparent connection with the teleoperating console, and an intuitive decoding of the delivered information. In this work, we focus on the specific case of RMIS treatment of uterine leiomyomas or fibroids, where little has been done in haptics to improve the outcomes of robotics-enabled palpation tasks. We propose the usage of a wearable haptic interface for softness rendering as a lump display. The device was integrated in a teleoperation architecture that simulates a robot-assisted surgical palpation task of leiomyomas. Our work moved from an ex-vivo sample characterization of uterine tissues to show the effectiveness of our interface in conveying meaningful softness information. We extensively tested our system with gynecologic surgeons in palpation tasks with silicone specimens, which replicated the characteristics of uterine tissues with embedded leyomiomas. Results show that our system enables a softness-based discrimination of the embedded fibroids comparable to the one that physicians would achieve using directly their fingers in palpation tasks. Furthermore, the feedback provided by the haptic interface was perceived as comfortable, intuitive, and highly useful for fibroid localization.
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http://dx.doi.org/10.1109/TOH.2021.3057796DOI Listing
February 2021

Control Architecture for Human-Like Motion With Applications to Articulated Soft Robots.

Front Robot AI 2020 11;7:117. Epub 2020 Sep 11.

Centro di Ricerca "Enrico Piaggio", Università di Pisa, Pisa, Italy.

Human beings can achieve a high level of motor performance that is still unmatched in robotic systems. These capabilities can be ascribed to two main enabling factors: (i) the physical proprieties of human musculoskeletal system, and (ii) the effectiveness of the control operated by the central nervous system. Regarding point (i), the introduction of compliant elements in the robotic structure can be regarded as an attempt to bridge the gap between the animal body and the robot one. Soft articulated robots aim at replicating the musculoskeletal characteristics of vertebrates. Yet, substantial advancements are still needed under a control point of view, to fully exploit the new possibilities provided by soft robotic bodies. This paper introduces a control framework that ensures natural movements in articulated soft robots, implementing specific functionalities of the human central nervous system, i.e., learning by repetition, after-effect on known and unknown trajectories, anticipatory behavior, its reactive re-planning, and state covariation in precise task execution. The control architecture we propose has a hierarchical structure composed of two levels. The low level deals with dynamic inversion and focuses on trajectory tracking problems. The high level manages the degree of freedom redundancy, and it allows to control the system through a reduced set of variables. The building blocks of this novel control architecture are well-rooted in the control theory, which can furnish an established vocabulary to describe the functional mechanisms underlying the motor control system. The proposed control architecture is validated through simulations and experiments on a bio-mimetic articulated soft robot.
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http://dx.doi.org/10.3389/frobt.2020.00117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805700PMC
September 2020

Underwater Robotics Competitions: The European Robotics League Emergency Robots Experience With FeelHippo AUV.

Front Robot AI 2020 31;7. Epub 2020 Jan 31.

Department of Industrial Engineering, University of Florence, Florence, Italy.

Underwater robots are nowadays employed for many different applications; during the last decades, a wide variety of robotic vehicles have been developed by both companies and research institutes, different in shape, size, navigation system, and payload. While the market needs to constitute the real benchmark for commercial vehicles, novel approaches developed during research projects represent the standard for academia and research bodies. An interesting opportunity for the performance comparison of autonomous vehicles lies in robotics competitions, which serve as an useful testbed for state-of-the-art underwater technologies and a chance for the constructive evaluation of strengths and weaknesses of the participating platforms. In this framework, over the last few years, the Department of Industrial Engineering of the University of Florence participated in multiple robotics competitions, employing different vehicles. In particular, in September 2017 the team from the University of Florence took part in the European Robotics League Emergency Robots competition held in Piombino (Italy) using FeelHippo AUV, a compact and lightweight Autonomous Underwater Vehicle (AUV). Despite its size, FeelHippo AUV possesses a complete navigation system, able to offer good navigation accuracy, and diverse payload acquisition and analysis capabilities. This paper reports the main field results obtained by the team during the competition, with the aim of showing how it is possible to achieve satisfying performance (in terms of both navigation precision and payload data acquisition and processing) even with small-size vehicles such as FeelHippo AUV.
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http://dx.doi.org/10.3389/frobt.2020.00003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805705PMC
January 2020

The Sensor-Based Biomechanical Risk Assessment at the Base of the Need for Revising of Standards for Human Ergonomics.

Sensors (Basel) 2020 Oct 10;20(20). Epub 2020 Oct 10.

Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00040 Rome, Italy.

Due to the epochal changes introduced by "Industry 4.0", it is getting harder to apply the varying approaches for biomechanical risk assessment of manual handling tasks used to prevent work-related musculoskeletal disorders (WMDs) considered within the International Standards for ergonomics. In fact, the innovative human-robot collaboration (HRC) systems are widening the number of work motor tasks that cannot be assessed. On the other hand, new sensor-based tools for biomechanical risk assessment could be used for both quantitative "direct instrumental evaluations" and "rating of standard methods", allowing certain improvements over traditional methods. In this light, this Letter aims at detecting the need for revising the standards for human ergonomics and biomechanical risk assessment by analyzing the WMDs prevalence and incidence; additionally, the strengths and weaknesses of traditional methods listed within the International Standards for manual handling activities and the next challenges needed for their revision are considered. As a representative example, the discussion is referred to the lifting of heavy loads where the revision should include the use of sensor-based tools for biomechanical risk assessment during lifting performed with the use of exoskeletons, by more than one person (team lifting) and when the traditional methods cannot be applied. The wearability of sensing and feedback sensors in addition to human augmentation technologies allows for increasing workers' awareness about possible risks and enhance the effectiveness and safety during the execution of in many manual handling activities.
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http://dx.doi.org/10.3390/s20205750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599507PMC
October 2020

Molecular pathways in patients with systemic lupus erythematosus revealed by gene-centred DNA sequencing.

Ann Rheum Dis 2021 01 9;80(1):109-117. Epub 2020 Oct 9.

Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linköping University, Linköping, Sweden.

Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease with extensive heterogeneity in disease presentation between patients, which is likely due to an underlying molecular diversity. Here, we aimed at elucidating the genetic aetiology of SLE from the immunity pathway level to the single variant level, and stratify patients with SLE into distinguishable molecular subgroups, which could inform treatment choices in SLE.

Methods: We undertook a pathway-centred approach, using sequencing of immunological pathway genes. Altogether 1832 candidate genes were analysed in 958 Swedish patients with SLE and 1026 healthy individuals. Aggregate and single variant association testing was performed, and we generated pathway polygenic risk scores (PRS).

Results: We identified two main independent pathways involved in SLE susceptibility: T lymphocyte differentiation and innate immunity, characterised by HLA and interferon, respectively. Pathway PRS defined pathways in individual patients, who on average were positive for seven pathways. We found that SLE organ damage was more pronounced in patients positive for the T or B cell receptor signalling pathways. Further, pathway PRS-based clustering allowed stratification of patients into four groups with different risk score profiles. Studying sets of genes with priors for involvement in SLE, we observed an aggregate common variant contribution to SLE at genes previously reported for monogenic SLE as well as at interferonopathy genes.

Conclusions: Our results show that pathway risk scores have the potential to stratify patients with SLE beyond clinical manifestations into molecular subsets, which may have implications for clinical follow-up and therapy selection.
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http://dx.doi.org/10.1136/annrheumdis-2020-218636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788061PMC
January 2021

A novel mechatronic system for evaluating elbow muscular spasticity relying on Tonic Stretch Reflex Threshold estimation.

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:3839-3843

Muscular spasticity represents one of the most common motor disorder associated to lesions of the Central Nervous System, such as Stroke, and affects joint mobility up to the complete prevention of skeletal muscle voluntary control. Its clinical evaluation is hence of fundamental relevance for an effective rehabilitation of the affected subjects. Standard assessment protocols are usually manually performed by humans, and hence their reliability strongly depends on the capabilities of the clinical operator performing the procedures. To overcome this limitation, one solution is the usage of mechatronic devices based on the estimation of the Tonic Stretch Reflex Threshold, which allows for a quite reliable and operator-independent evaluation. In this work, we present the design and characterization of a novel mechatronic device that targets the estimation of the Tonic Stretch Reflex Threshold at the elbow level, and, at the same time, it can potentially act as a rehabilitative system. Our device can deliver controllable torque/velocity stimulation and record functional parameters of the musculo-skeletal system (joint position, torque, and multi-channel ElectroMyoGraphyc patterns), with the ultimate goals of: i) providing significant information for the diagnosis and the classification of muscular spasticity, ii) enhancing the recovery evaluation of patients undergoing through therapeutic rehabilitation procedures and iii) enabling a future active usage of this device also as therapeutic tool.Clinical relevance- The contribution presented in this work proposes a technological advancement for a device-based evaluation of motion impairment related to spasticity, with a major potential impact on both the clinical appraisal and the rehabilitation procedures.
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http://dx.doi.org/10.1109/EMBC44109.2020.9176011DOI Listing
July 2020

Genetic and clinical basis for two distinct subtypes of primary Sjögren's syndrome.

Rheumatology (Oxford) 2021 02;60(2):837-848

Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala, Sweden.

Objectives: Clinical presentation of primary Sjögren's syndrome (pSS) varies considerably. A shortage of evidence-based objective markers hinders efficient drug development and most clinical trials have failed to reach primary endpoints.

Methods: We performed a multicentre study to identify patient subgroups based on clinical, immunological and genetic features. Targeted DNA sequencing of 1853 autoimmune-related loci was performed. After quality control, 918 patients with pSS, 1264 controls and 107 045 single nucleotide variants remained for analysis. Replication was performed in 177 patients with pSS and 7672 controls.

Results: We found strong signals of association with pSS in the HLA region. Principal component analysis of clinical data distinguished two patient subgroups defined by the presence of SSA/SSB antibodies. We observed an unprecedented high risk of pSS for an association in the HLA-DQA1 locus of odds ratio 6.10 (95% CI: 4.93, 7.54, P=2.2×10-62) in the SSA/SSB-positive subgroup, while absent in the antibody negative group. Three independent signals within the MHC were observed. The two most significant variants in MHC class I and II respectively, identified patients with a higher risk of hypergammaglobulinaemia, leukopenia, anaemia, purpura, major salivary gland swelling and lymphadenopathy. Replication confirmed the association with both MHC class I and II signals confined to SSA/SSB antibody positive pSS.

Conclusion: Two subgroups of patients with pSS with distinct clinical manifestations can be defined by the presence or absence of SSA/SSB antibodies and genetic markers in the HLA locus. These subgroups should be considered in clinical follow-up, drug development and trial outcomes, for the benefit of both subgroups.
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http://dx.doi.org/10.1093/rheumatology/keaa367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850528PMC
February 2021

Patient-Specific Bicuspid Aortic Valve Biomechanics: A Magnetic Resonance Imaging Integrated Fluid-Structure Interaction Approach.

Ann Biomed Eng 2021 Feb 17;49(2):627-641. Epub 2020 Aug 17.

Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.

Congenital bicuspid aortic valve (BAV) consists of two fused cusps and represents a major risk factor for calcific valvular stenosis. Herein, a fully coupled fluid-structure interaction (FSI) BAV model was developed from patient-specific magnetic resonance imaging (MRI) and compared against in vivo 4-dimensional flow MRI (4D Flow). FSI simulation compared well with 4D Flow, confirming direction and magnitude of the flow jet impinging onto the aortic wall as well as location and extension of secondary flows and vortices developing at systole: the systolic flow jet originating from an elliptical 1.6 cm orifice reached a peak velocity of 252.2 cm/s, 0.6% lower than 4D Flow, progressively impinging on the ascending aorta convexity. The FSI model predicted a peak flow rate of 22.4 L/min, 6.7% higher than 4D Flow, and provided BAV leaflets mechanical and flow-induced shear stresses, not directly attainable from MRI. At systole, the ventricular side of the non-fused leaflet revealed the highest wall shear stress (WSS) average magnitude, up to 14.6 Pa along the free margin, with WSS progressively decreasing towards the belly. During diastole, the aortic side of the fused leaflet exhibited the highest diastolic maximum principal stress, up to 322 kPa within the attachment region. Systematic comparison with ground-truth non-invasive MRI can improve the computational model ability to reproduce native BAV hemodynamics and biomechanical response more realistically, and shed light on their role in BAV patients' risk for developing complications; this approach may further contribute to the validation of advanced FSI simulations designed to assess BAV biomechanics.
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http://dx.doi.org/10.1007/s10439-020-02571-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990108PMC
February 2021

Integrating Wearable Haptics and Obstacle Avoidance for the Visually Impaired in Indoor Navigation: A User-Centered Approach.

IEEE Trans Haptics 2021 Jan-Mar;14(1):109-122. Epub 2021 Mar 24.

Recently, in the attempt to increase blind people autonomy and improve their quality of life, a lot of effort has been devoted to develop technological travel aids. These systems can surrogate spatial information about the environment and deliver it to end-users through sensory substitution (auditory, haptic). However, despite the promising research outcomes, these solutions have met scarce acceptance in real-world. Often, this is also due to the limited involvement of real end users in the conceptual and design phases. In this article, we propose a novel indoor navigation system based on wearable haptic technologies. All the developmental phases were driven by continuous feedback from visually impaired persons. The proposed travel aid system consists of a RGB-D camera, a processing unit to compute visual information for obstacle avoidance, and a wearable device, which can provide normal and tangential force cues for guidance in an unknown indoor environment. Experiments with blindfolded subjects and visually impaired participants show that our system could be an effective support during indoor navigation, and a viable tool for training blind people to the usage of travel aids.
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http://dx.doi.org/10.1109/TOH.2020.2996748DOI Listing
March 2021

Exploiting upper-limb functional principal components for human-like motion generation of anthropomorphic robots.

J Neuroeng Rehabil 2020 05 13;17(1):63. Epub 2020 May 13.

Research Center "Enrico Piaggio", University of Pisa, Largo Lucio Lazzarino 1, Pisa, 56126, Italy.

Background: Human-likeliness of robot movements is a key component to enable a safe and effective human-robot interaction, since it contributes to increase acceptance and motion predictability of robots that have to closely interact with people, e.g. for assistance and rehabilitation purposes. Several parameters have been used to quantify how much a robot behaves like a human, which encompass aspects related to both the robot appearance and motion. The latter point is fundamental to allow the operator to interpret robotic actions, and plan a meaningful reactions. While different approaches have been presented in literature, which aim at devising bio-aware control guidelines, a direct implementation of human actions for robot planning is not straightforward, still representing an open issue in robotics.

Methods: We propose to embed a synergistic representation of human movements for robot motion generation. To do this, we recorded human upper-limb motions during daily living activities. We used functional Principal Component Analysis (fPCA) to extract principal motion patterns. We then formulated the planning problem by optimizing the weights of a reduced set of these components. For free-motions, our planning method results into a closed form solution which uses only one principal component. In case of obstacles, a numerical routine is proposed, incrementally enrolling principal components until the problem is solved with a suitable precision.

Results: Results of fPCA show that more than 80% of the observed variance can be explained by only three functional components. The application of our method to different meaningful movements, with and without obstacles, show that our approach is able to generate complex motions with a very reduced number of functional components. We show that the first synergy alone accounts for the 96% of cost reduction and that three components are able to achieve a satisfactory motion reconstruction in all the considered cases.

Conclusions: In this work we moved from the analysis of human movements via fPCA characterization to the design of a novel human-like motion generation algorithm able to generate, efficiently and with a reduced set of basis elements, several complex movements in free space, both in free motion and in case of obstacle avoidance tasks.
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http://dx.doi.org/10.1186/s12984-020-00680-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218840PMC
May 2020

Whole-genome genotyping and resequencing reveal the association of a deletion in the complex interferon alpha gene cluster with hypothyroidism in dogs.

BMC Genomics 2020 Apr 16;21(1):307. Epub 2020 Apr 16.

Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.

Background: Hypothyroidism is a common complex endocrinopathy that typically has an autoimmune etiology, and it affects both humans and dogs. Genetic and environmental factors are both known to play important roles in the disease development. In this study, we sought to identify the genetic risk factors potentially involved in the susceptibility to the disease in the high-risk Giant Schnauzer dog breed.

Results: By employing genome-wide association followed by fine-mapping (top variant p-value = 5.7 × 10), integrated with whole-genome resequencing and copy number variation analysis, we detected a ~ 8.9 kbp deletion strongly associated (p-value = 0.0001) with protection against development of hypothyroidism. The deletion is located between two predicted Interferon alpha (IFNA) genes and it may eliminate functional elements potentially involved in the transcriptional regulation of these genes. Remarkably, type I IFNs have been extensively associated to human autoimmune hypothyroidism and general autoimmunity. Nonetheless, the extreme genomic complexity of the associated region on CFA11 warrants further long-read sequencing and annotation efforts in order to ascribe functions to the identified deletion and to characterize the canine IFNA gene cluster in more detail.

Conclusions: Our results expand the current knowledge on genetic determinants of canine hypothyroidism by revealing a significant link with the human counterpart disease, potentially translating into better diagnostic tools across species, and may contribute to improved canine breeding strategies.
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http://dx.doi.org/10.1186/s12864-020-6700-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160888PMC
April 2020

Mapping Polyclonal Antibody Responses in Non-human Primates Vaccinated with HIV Env Trimer Subunit Vaccines.

Cell Rep 2020 03;30(11):3755-3765.e7

Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA; IAVI Neutralizing Antibody Center and the Collaboration for AIDS Vaccine Discovery (CAVD), The Scripps Research Institute, La Jolla, CA 92037, USA; Scripps Consortium for HIV/AIDS Vaccine Development (CHAVD), The Scripps Research Institute, La Jolla, CA 92037, USA. Electronic address:

Rational immunogen design aims to focus antibody responses to vulnerable sites on primary antigens. Given the size of these antigens, there is, however, potential for eliciting unwanted, off-target responses. Here, we use our electron microscopy polyclonal epitope mapping approach to describe the antibody specificities elicited by immunization of non-human primates with soluble HIV envelope trimers and subsequent repeated viral challenge. An increased diversity of epitopes recognized and the approach angle by which these antibodies bind constitute a hallmark of the humoral response in most protected animals. We also show that fusion peptide-specific antibodies are likely responsible for some neutralization breadth. Moreover, cryoelectron microscopy (cryo-EM) analysis of a fully protected animal reveals a high degree of clonality within a subset of putatively neutralizing antibodies, enabling a detailed molecular description of the antibody paratope. Our results provide important insights into the immune response against a vaccine candidate that entered into clinical trials in 2019.
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http://dx.doi.org/10.1016/j.celrep.2020.02.061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153566PMC
March 2020

Numerical evaluation of transcatheter aortic valve performance during heart beating and its post-deployment fluid-structure interaction analysis.

Biomech Model Mechanobiol 2020 Oct 24;19(5):1725-1740. Epub 2020 Feb 24.

Department of Biomedical Engineering, Health Sciences Center T08-050, Stony Brook University, Stony Brook, NY, 11794-8084, USA.

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that provides an effective alternative to open-heart surgical valve replacement for treating advanced calcific aortic valve disease patients. However, complications, such as valve durability, device migration, paravalvular leakage (PVL), and thrombogenicity may lead to increased overall post-TAVR morbidity and mortality. A series of numerical studies involving a self-expandable TAVR valve were performed to evaluate these complications. Structural studies were performed with finite element (FE) analysis, followed by computational fluid dynamics (CFD) simulations, and fluid-structure interaction (FSI) analysis. The FE analysis was utilized to study the effect of TAVR valve implantation depth on valve anchorage in the Living Heart Human Model, which is capable of simulating beating heart during repeated cardiac cycles. The TAVR deployment cases where no valve migration was observed were then used to calculate the post-deployment thrombogenic potential via CFD simulations. FSI analysis followed to further assess the post-deployment TAVR hemodynamic performance for different implantation depths. The deployed valves PVL, geometric and effective orifice areas, and the leaflets structural and flow stress magnitudes were compared to determine the device optimal landing zone. The combined structural and hemodynamic analysis indicated that with the TAVR valve deployed at an aft ventricle position an optimal performance was achieved in the specific anatomy studied. Given the TAVR's rapid expansion to younger lower-risk patients, the comprehensive numerical methodology proposed here can potentially be used as a predictive tool for both procedural planning and valve design optimization to minimize the reported complications.
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http://dx.doi.org/10.1007/s10237-020-01304-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483251PMC
October 2020

Design and Validation of the Readable Device: A Single-Cell Electromagnetic Refreshable Braille Display.

IEEE Trans Haptics 2020 Jan-Mar;13(1):239-245. Epub 2020 Jan 31.

Blindness represents one of the major disabling societal causes, impacting the life of visually impaired people and their families. For what concerns the access to written information, one of the main tools used by blind people is the traditional Braille code. This is the reason why in the recent years, there has been a technological effort to develop refreshable Braille devices. These consist of multiple physical dots that dynamically change their configuration to reproduce different sequences of the letters in Braille code. Although promising, these approaches have many drawbacks, which are mainly related to costs, design complexity, portability, and power consumption. Of note, while many solutions have been proposed for multi-cell devices, the investigation of the potentialities of single-cell refreshable systems has received little attention so far. This investigation could offer effective and viable manners to overcome the aforementioned drawbacks, likely fostering a widespread adoption of such assistive technologies with end-users. In this article, we present the design and characterization of a new cost-effective single-cell Electromagnetic Refreshable Braille Display, the Readable system. We also report on tests performed with blindfolded and blind expert Braille code readers. Results demonstrate the effectiveness of our device in correctly reproducing alphanumeric content, opening promising perspectives in every-day life applications.
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http://dx.doi.org/10.1109/TOH.2020.2970929DOI Listing
November 2020

On the Role of Lateral Force in Texture-Induced Motion Bias During Reaching Tasks.

IEEE Trans Haptics 2020 Jan-Mar;13(1):233-238. Epub 2020 Jan 31.

In the previous work, we reported that tactile information (tactile slip) during finger sliding and reaching actions over a textured surface contributes to the control of the hand movement. More specifically, we observed a significant bias in the motion trajectories, which was explained by the tactile estimate accounted by the tactile flow model-i.e. a perceived motion direction always perpendicular to the ridge orientation, and its integration with the muscular-skeletal proprioceptive cues. However, to which extent this observed behavior also depends on the reaction force exerted by the surface ridges on the finger pad during the dynamic interaction still represents a largely unexplored research question. If not properly addressed, this point could rise the alternative explanation that the systematic bias is determined by the insufficient compensation of the reaction force by participants. In this article, we investigate the role of the lateral component of the reaction force on the surface plane (lateral force) in texture-related motion bias. We asked participants to slide their finger straight on a lubricated ridged plate towards a target goal displayed in a virtual reality environment. They exerted two different levels of normal force, which produced two different levels of lateral force during the finger interaction with the ridges. The effect of ridge orientation was found to be larger for the high compared to the low force level. However, also in the latter case, we still observed the same biased trajectories reported in our previous work, despite the negligible value of the lateral force. This supports our hypothesis that the motor bias arises from the integration of the tactile motion estimate, biased by the texture, and the other proprioceptive cues.
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http://dx.doi.org/10.1109/TOH.2020.2970927DOI Listing
November 2020

Correction to: Patient-specific simulation of transcatheter aortic valve replacement: impact of deployment options on paravalvular leakage.

Biomech Model Mechanobiol 2020 04;19(2):779

Department of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.

This is to inform that the original article was published without the "Conflict of Interest" statement.
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http://dx.doi.org/10.1007/s10237-020-01287-7DOI Listing
April 2020

The Role of Haptic Stimuli on Affective Reading: a Pilot Study.

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:4938-4941

The affective role of touch has opened new perspectives in human-machine interaction. This paper presents an emotion recognition algorithm to investigate the role of tactile stimuli conveyed through a wearable haptic system during affective reading. To this end, a group of 32 healthy volunteers underwent an emotional stimulation by reading affective texts, with and without the concurrent presence of pleasant haptic stimuli. Throughout the experiment, autonomic nervous system dynamics was quantified through heart rate variability (HRV) and electrodermal activity (EDA) analyses. EDA and HRV features were then used as input of a SVM-RFE learning algorithm for an automatic recognition of neutral and arousing texts. The affective recognition of the reading was performed in the presence or absence of the haptic stimulation. Results show that the affective perception induced by the neutral and arousing reading were discriminated with a significantly improved accuracy (+14.5%) when a caress-like haptic stimulus was conveyed to the user.
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http://dx.doi.org/10.1109/EMBC.2019.8857337DOI Listing
July 2019

A functional analysis-based approach to quantify upper limb impairment level in chronic stroke patients: a pilot study.

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:4198-4204

The accurate assessment of upper limb motion impairment induced by stroke - which represents one of the primary causes of disability world-wide - is the first step to successfully monitor and guide patients' recovery. As of today, the majority of the procedures relies on clinical scales, which are mostly based on ordinal scaling, operator-dependent, and subject to floor and ceiling effects. In this work, we intend to overcome these limitations by proposing a novel approach to analytically evaluate the level of pathological movement coupling, based on the quantification of movement complexity. To this goal, we consider the variations of functional Principal Components applied to the reconstruction of joint angle trajectories of the upper limb during daily living task execution, and compared these variations between two conditions, i.e. the affected and non-affected arm. A Dissimilarity Index, which codifies the severity of the upper limb motor impairment with respect to the movement complexity of the non-affected arm, is then proposed. This methodology was validated as a proof of concept upon a set of four chronic stroke subjects with mild to moderate arm and hand impairments. As a first step, we evaluated whether the derived outcomes differentiate between the two conditions upon the whole data-set. Secondly, we exploited this concept to discern between different subjects and impairment levels. Results show that: i) differences in terms of movement variability between the affected and nonaffected upper limb are detectable and ii) different impairment profiles can be characterized for single subjects using the proposed approach. Although provisional, these results are very promising and suggest this approach as a basis ingredient for the definition of a novel, operator-independent, sensitive, intuitive and widely applicable scale for the evaluation of upper limb motion impairment.
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http://dx.doi.org/10.1109/EMBC.2019.8857732DOI Listing
July 2019

Biomechanical modeling of transcatheter aortic valve replacement in a stenotic bicuspid aortic valve: deployments and paravalvular leakage.

Med Biol Eng Comput 2019 Oct 1;57(10):2129-2143. Epub 2019 Aug 1.

School of Mechanical Engineering, Tel Aviv University, Tel Aviv, Israel.

Calcific aortic valve disease (CAVD) is characterized by stiffened aortic valve leaflets. Bicuspid aortic valve (BAV) is the most common congenital heart disease. Transcatheter aortic valve replacement (TAVR) is a treatment approach for CAVD where a stent with mounted bioprosthetic valve is deployed on the stenotic valve. Performing TAVR in calcified BAV patients may be associated with post-procedural complications due to the BAV asymmetrical structure. This study aims to develop refined computational models simulating the deployments of Evolut R and PRO TAVR devices in a representative calcified BAV. The paravalvular leakage (PVL) was also calculated by computational fluid dynamics simulations. Computed tomography scan of severely stenotic BAV patient was acquired. The 3D calcium deposits were generated and embedded inside a parametric model of the BAV. Deployments of the Evolut R and PRO inside the calcified BAV were simulated in five bioprosthesis leaflet orientations. The hypothesis of asymmetric and elliptic stent deployment was confirmed. Positioning the bioprosthesis commissures aligned with the native commissures yielded the lowest PVL (15.7 vs. 29.5 mL/beat). The Evolut PRO reduced the PVL in half compared with the Evolut R (15.7 vs. 28.7 mL/beat). The proposed biomechanical computational model could optimize future TAVR treatment in BAV patients. Graphical abstract.
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http://dx.doi.org/10.1007/s11517-019-02012-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801083PMC
October 2019

Spatially Separating Haptic Guidance From Task Dynamics Through Wearable Devices.

IEEE Trans Haptics 2019 Oct-Dec;12(4):581-593. Epub 2019 May 27.

Haptic devices have a high potential for delivering tailored training to novices. These devices can simulate forces associated with real-world tasks, or provide guidance forces that convey task completion and learning strategies. It has been shown, however, that providing both task forces and guidance forces simultaneously through the same haptic interface can lead to novices depending on guidance, being unable to demonstrate skill transfer, or learning the wrong task altogether. This paper presents a novel solution whereby task forces are relayed via a kinesthetic haptic interface, while guidance forces are spatially separated through a cutaneous skin stretch modality. We explore different methods of delivering cutaneous based guidance to subjects in a dynamic trajectory following task. We next compare cutaneous guidance to kinesthetic guidance, as is traditional to spatially separated assistance. We further investigate the role of placing cutaneous guidance ipsilateral versus contralateral to the task force device. The efficacies of each guidance condition are compared by examining subject error and movement smoothness. Results show that cutaneous guidance can be as effective as kinesthetic guidance, making it a practical and cost-effective alternative for spatially separated assistance.
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http://dx.doi.org/10.1109/TOH.2019.2919281DOI Listing
May 2020

On the Time-Invariance Properties of Upper Limb Synergies.

IEEE Trans Neural Syst Rehabil Eng 2019 07 22;27(7):1397-1406. Epub 2019 May 22.

In this paper, we present a novel approach to dynamically describe human upper limb trajectories, addressing the question on whether and to which extent synergistic multi-joint behavior is observed and preserved over time evolution and across subjects. To this goal, we performed experiments to collect human upper limb joint angle trajectories and organized them in a dataset of daily living tasks. We then characterized the upper limb poses at each time frame through a technique that we named repeated-principal component analysis (R-PCA). We found that, although there is no strong evidence on the predominance of one principal component (PC) over the others, the subspace identified by the first three PCs takes into account most of the motion variability. We evaluated the stability of these results over time, showing that during the reaching phase, there is a strong consistency of these findings across participants. In other words, our results suggest that there is a time-invariant low-dimensional approximation of upper limb kinematics, which can be used to define a suitable reduced dimensionality control space for upper limb robotic devices in motion phases.
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http://dx.doi.org/10.1109/TNSRE.2019.2918311DOI Listing
July 2019

Skin Stretch Haptic Feedback to Convey Closure Information in Anthropomorphic, Under-Actuated Upper Limb Soft Prostheses.

IEEE Trans Haptics 2019 Oct-Dec;12(4):508-520. Epub 2019 May 8.

Restoring hand function in individuals with upper limb loss is a challenging task, made difficult by the complexity of human hands from both a functional and sensory point of view. Users of commercial prostheses, even sophisticated devices, must visually attend to the hand to know its state, since in most cases they are not provided with any direct sensory information. Among the different types of haptic feedback that can be delivered, particularly information on hand opening is likely to reduce the requirement of constant visual attention. In recent years, there has been a trend of using underactuated, compliant multi-fingered hands as upper limb prostheses, in part due to their simplicity and ease of use attributed to low degree-of-freedom (d.o.f.) actuation. The trend toward underactuation encourages the design of one d.o.f. haptic devices to provide intuitive sensory feedback from the prosthesis. However, mapping the closure of a multi-d.o.f. prosthetic hand to a simple and intuitive haptic cue is not a trivial task. In this paper, we explore the use of a one d.o.f. skin stretch haptic device, the rice haptic rocker, to provide intuitive proprioceptive feedback indicating overall hand closure of an underactuated prosthesis. The benefits and challenges of the system are assessed in multi-tasking and reduced vision scenarios for an object-size discrimination task, in an effort to simulate challenges in daily life, and are compared against the haptic resolution of the device using the just noticeable difference. Finally, an evaluation done with a prosthesis user, in the form of a truncated version of the Activities Measure for Upper Limb Amputees (AM-ULA), shows possible benefits of the addition of haptic feedback in tasks with reduced visual attention.
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http://dx.doi.org/10.1109/TOH.2019.2915075DOI Listing
May 2020

Wearable haptic interfaces for applications in gynecologic robotic surgery: a proof of concept in robotic myomectomy.

J Robot Surg 2019 Aug 6;13(4):585-588. Epub 2019 May 6.

Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.

Uterine fibromatosis is common in women, with an estimated prevalence of up to 15-50% after 35 years. About 80% of women affected by fibromatosis have symptoms and require medical or surgical treatment. Nowadays, the gold standard for the surgical treatment of uterine fibromatosis is the use of minimally invasive surgery. The surgical skills and improvements offered by robotic approach can be relevant in reproductive surgery, in particular in minimally invasive myomectomy. However, the lack of tactile feedback of robotic platform is an important technical drawback that can reduce the accuracy of surgical procedures. Here, we present the design and the preliminary test of the wearable fabric, yielding display wearable haptic interfaces able to generate a real-time tactile feedback in terms of stiffness for applications in gynecologic robotic surgery. We preliminarily tested the device in the simulation of a real scenario of conservative myomectomy with the final purpose of increasing the accuracy and precision during surgery. The future goal is the integration of a haptic device with the commercially available robotic surgical systems with the purpose of improving the precision and accuracy of the surgical operation, thus allowing a better understanding concerning the anatomical relationship of the target structures. This in turn could determine a change in the surgical strategy in some cases, letting some patients selected for a demolitive approach retaining their uterus. This could improve surgical outcomes in fertile women enrolled for minimally invasive surgery for uterine fibroids and may be a facilitation for young gynecological surgeons or during residency teaching plans and learning programs.
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http://dx.doi.org/10.1007/s11701-019-00971-wDOI Listing
August 2019

In Vitro Durability and Stability Testing of a Novel Polymeric Transcatheter Aortic Valve.

ASAIO J 2020 02;66(2):190-198

From Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York.

Transcatheter aortic valve replacement (TAVR) has emerged as an effective therapy for the unmet clinical need of inoperable patients with severe aortic stenosis (AS). Current clinically used tissue TAVR valves suffer from limited durability that hampers TAVR's rapid expansion to younger, lower risk patients. Polymeric TAVR valves optimized for hemodynamic performance, hemocompatibility, extended durability, and resistance to calcific degeneration offer a viable solution to this challenge. We present extensive in vitro durability and stability testing of a novel polymeric TAVR valve (PolyNova valve) using 1) accelerated wear testing (AWT, ISO 5840); 2) calcification susceptibility (in the AWT)-compared with clinically used tissue valves; and 3) extended crimping stability (valves crimped to 16 Fr for 8 days). Hydrodynamic testing was performed every 50M cycles. The valves were also evaluated visually for structural integrity and by scanning electron microscopy for evaluation of surface damage in the micro-scale. Calcium and phosphorus deposition was evaluated using micro-computed tomography (μCT) and inductive coupled plasma spectroscopy. The valves passed 400M cycles in the AWT without failure. The effective orifice area kept stable at 1.8 cm with a desired gradual decrease in transvalvular pressure gradient and regurgitation (10.4 mm Hg and 6.9%, respectively). Calcium and phosphorus deposition was significantly lower in the polymeric valve: down by a factor of 85 and 16, respectively-as compared to a tissue valve. Following the extended crimping testing, no tears nor surface damage were evident. The results of this study demonstrate the potential of a polymeric TAVR valve to be a viable alternative to tissue-based TAVR valves.
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http://dx.doi.org/10.1097/MAT.0000000000000980DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136031PMC
February 2020

Predicting Object-Mediated Gestures From Brain Activity: An EEG Study on Gender Differences.

IEEE Trans Neural Syst Rehabil Eng 2019 03 11;27(3):411-418. Epub 2019 Feb 11.

Recent functional magnetic resonance imaging (fMRI) studies have identified specific neural patterns related to three different categories of movements: intransitive (i.e., meaningful gestures that do not include the use of objects), transitive (i.e., actions involving an object), and tool-mediated (i.e., actions involving a tool to interact with an object). However, fMRI intrinsically limits the exploitation of these results in a real scenario, such as a brain-machine interface. In this paper, we propose a new approach to automatically predict intransitive, transitive, or tool-mediated movements of the upper limb using electroencephalography (EEG) spectra estimated during a motor planning phase. To this end, high-resolution EEG data gathered from 33 healthy subjects were used as input of a three-class k-nearest neighbors classifier. Different combinations of EEG-derived spatial and frequency information were investigated to find the most accurate feature vector. In addition, we studied gender differences further splitting the dataset into only-male data, and only-female data. A remarkable difference was found between accuracies achieved with male and female data, the latter yielding the best performance (78.55% of accuracy for the prediction of intransitive, transitive, and tool-mediated actions). These results potentially suggest that different gender-based models should be employed for the future BMI applications.
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http://dx.doi.org/10.1109/TNSRE.2019.2898469DOI Listing
March 2019

Editorial: Mapping Human Sensory-Motor Skills for Manipulation Onto the Design and Control of Robots.

Front Neurorobot 2019 22;13. Epub 2019 Jan 22.

Department of Information Engineering and Mathematics, University of Siena, Siena, Italy.

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http://dx.doi.org/10.3389/fnbot.2019.00001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349763PMC
January 2019

Brain Dynamics Induced by Pleasant/Unpleasant Tactile Stimuli Conveyed by Different Fabrics.

IEEE J Biomed Health Inform 2019 11 16;23(6):2417-2427. Epub 2019 Jan 16.

In this study, we investigated brain dynamics from electroencephalographic (EEG) signals during affective tactile stimulation conveyed by the dynamical contact with different fabrics. Thirty-three healthy subjects (16 females) were enrolled to interact with a haptic device able to mimic caress-like stimuli conveyed by strips of different fabrics moved back and forth at different velocities. Specifically, two velocity levels (i.e., 9.4 and 65 mm/sec) and two kinds of fabric (i.e., burlap and silk) were selected to deliver pleasant and unpleasant affective elicitations, according to subjects' self-assessment. EEG power spectra and functional connectivity were then calculated and analyzed. Experimental results, reported in terms of p-value topographic maps, demonstrated that caresses administered through unpleasant fabrics increased brain activity in the θ (4-8 Hz), α (8-14 Hz), and β (14-30 Hz) bands, whereas the use of pleasant fabrics enhanced functional connections in specific areas (e.g., frontal, occipital, and temporal cortices) depending on the oscillations frequency and caressing velocity. Furthermore, we adopted K-NN algorithms to automatically recognize the pleasantness of the haptic stimulation at a single-subject level using EEG power spectra, achieving a recognition accuracy up to 74.24%. Finally, we showed how brain oscillation power in the α and β bands over contralateral frontal- and central-cortex were the most informative features characterizing the pleasantness of a tactile stimulus on the forearm.
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http://dx.doi.org/10.1109/JBHI.2019.2893324DOI Listing
November 2019