Stochastic estimation of arm mechanical impedance during robotic stroke rehabilitation.

This paper presents a stochastic method to estimate the multijoint mechanical impedance of the human arm suitable for use in a clinical setting, e.g., with persons with stroke undergoing robotic rehabilitation for a paralyzed arm. In this context, special circumstances such as hypertonicity and tissue atrophy due to disuse of the hemiplegic limb must be considered. A low-impedance robot was used to bring the upper limb of a stroke patient to a test location, generate force perturbations, and measure the resulting motion. Methods were developed to compensate for input signal coupling at low frequencies apparently due to human-machine interaction dynamics. Data was analyzed by spectral procedures that make no assumption about model structure. The method was validated by measuring simple mechanical hardware and results from a patient's hemiplegic arm are presented.     

Effect of cyclic deformation on the pseudoelasticity characteristics of Ti-Ni alloys

Change in the pseudoelasticity characteristics of Ti-Ni alloys during tension cycling was investigated. The critical stress for inducing martensites and the hysteresis of a stress-strain curve decreased with increasing number of cyclic loading, while the permanent elongation increased. The degree of the change in these values showed a strong dependence on the maximum applied stress during stress-induced martensitic transformation. However, no change was induced by cyclic elastic deformation even though high stress was applied. It was also found that the stabilization of the pseudoelasticity characteristics during cyclic loading was established using special thermomechanical treatments which are effective to raise the critical stress for slip. Based on these results it is concluded that the cause for the effect of cyclic deformation is the generation of dislocations in the martensitic phase.     

Double mutagenesis of a positive charge cluster in the ligand-binding site of the ferric enterobactin receptor, FepA

Siderophores and colicins enter bacterial cells through TonB-dependent outer membrane proteins. Using site-directed substitution mutagenesis, we studied ligand recognition by a prototypic Escherichia coli siderophore receptor, FepA, that binds the iron chelate ferric enterobactin and colicins B and D. These genetic experiments identified a common binding site for two of the three ligands, containing multiple positive charges, within cell surface residues of FepA. Elimination of single residues in this region did not impair the adsorption or transport of ferric enterobactin, but double mutagenesis in the charge cluster identified amino acids (Arg-286 and Arg-316) that participate in siderophore binding and function in FepA-mediated killing by colicins B and D. Ferric enterobactin binding, furthermore, prevented covalent modification of FepA within this domain by either a fluorescent probe or an arginine-specific reagent, corroborating the involvement of this site in ligand recognition. These results identify, for the first time, residues in a TonB-dependent outer membrane protein that participate in ligand binding. They also explain the competition between ferric enterobactin and the colicins on the bacterial cell surface: all three ligands interact with the same arginine residues within FepA during their penetration through the outer membrane.     

Customized interactive robotic treatment for stroke: EMG-triggered therapy.

A system for electromyographic (EMG) triggering of robot-assisted therapy (dubbed the EMG game) for stroke patients is presented. The onset of a patient's attempt to move is detected by monitoring EMG in selected muscles, whereupon the robot assists her or him to perform point-to-point movements in a horizontal plane. Besides delivering customized robot-assisted therapy, the system can record signals that may be useful to better understand the process of recovery from stroke. Preliminary experiments aimed at testing the proposed system and gaining insight into the potential of EMG-triggered, robot-assisted therapy are reported.     

An intracorporeal (abdominal) left ventricular assist device. Initial clinical trials

We have initiated clinical trials with an intracorporeal (abdominal) partial artificial heart and ten preterminal postcardiotomy patients have been studied. During profound left ventricular failure, the device captures the entire cardiac output from the apex of the left ventricle at low pressures (20 to 40 mm Hg) and ejects (at 80 to 150 mm Hg) into the infrarenal abdominal aorta; the biological aortic valve opens only intermittently and the entire systemic circulation is pump generated. The device is six to ten times more effective than intra-aortic balloon pumping in man and has maintained systemic perfusion during clinical asystole and ventricular fibrillation. We have documented that the profoundly depressed postcardiotomy left ventricle, initially incapable of ejection, can recover during total left ventricular unloading with the abdominal left ventricular assist device support over a seven-day period.