Reducing Motor Variability Enhances Myoelectric Control Robustness Across Untrained Limb Positions.

The limb position effect is a multi-faceted problem, associated with decreased upper-limb prosthesis control acuity following a change in arm position. Factors contributing to this problem can arise from distinct environmental or physiological sources. Despite their differences in origin, the effect of each factor manifests similarly as increased input data variability. This variability can cause incorrect decoding of user intent. Previous research has attempted to address this by better capturing input data variability with data abundance. In this paper, we take an alternative approach and investigate the effect of reducing trial-to-trial variability by improving the consistency of muscle activity through user training. Ten participants underwent 4 days of myoelectric training with either concurrent or delayed feedback in a single arm position. At the end of training participants experienced a zero-feedback retention test in multiple limb positions. In doing so, we tested how well the skill learned in a single limb position generalized to untrained positions. We found that delayed feedback training led to more consistent muscle activity across both the trained and untrained limb positions. Analysis of patterns of activations in the delayed feedback group suggest a structured change in muscle activity occurs across arm positions. Our results demonstrate that myoelectric user-training can lead to the retention of motor skills that bring about more robust decoding across untrained limb positions. This work highlights the importance of reducing motor variability with practice, prior to examining the underlying structure of muscle changes associated with limb position.

Delaying feedback during pre-device training facilitates the retention of novel myoelectric skills: a laboratory and home-based study.

Objective.The objective of this study was to assess the impact of delayed feedback training on the retention of novel myoelectric skills, and to demonstrate the use of this training approach in the home environment.Approach.We trained limb-intact participants to use a motor learning-based upper-limb prosthesis control scheme called abstract decoding. A delayed feedback paradigm intended to prevent within-trial adaptation and to facilitate motor learning was used. We conducted two multi-day experiments. Experiment 1 was a laboratory-based study consisting of two groups trained over a 4 day period with concurrent or delayed feedback. An additional follow-up session took place after 18 days to assess the retention of motor skills. Experiment 2 was a home-based pilot study that took place over five consecutive days to investigate delayed feedback performance when using bespoke training structures.Main Results.Approximately 35 000 trials were collected across both experiments. Experiment 1 found that the retention of motor skills for the delayed feedback group was significantly better than that of their concurrent feedback counterparts. In addition, the delayed feedback group improved their retention of motor skills across days, whereas the concurrent feedback group did not. Experiment 2 demonstrated that by using a bespoke training protocol in an environment that is more conducive to learning, it is possible for participants to become highly accurate in the absence of feedback.Significance.These results show that with delayed feedback training, it is possible to retain novel myoelectric skills. Using abstract decoding participants can activate four distinct muscle patterns without using complex algorithms. The accuracy achieved in the pilot study supports the feasibility of motor learning-based upper-limb prosthesis control after home-based myoelectric training.

Vitality surveillance at distance using thin-film tandem-like narrowband near-infrared photodiodes with light-enhanced responsivity.

Remote measurement of vital sign parameters like heartbeat and respiration rate represents a compelling challenge in monitoring an individual's health in a noninvasive way. This could be achieved by large field-of-view, easy-to-integrate unobtrusive sensors, such as large-area thin-film photodiodes. At long distances, however, discriminating weak light signals from background disturbance demands superior near-infrared (NIR) sensitivity and optical noise tolerance. Here, we report an inherently narrowband solution-processed, thin-film photodiode with ultrahigh and controllable NIR responsivity based on a tandem-like perovskite-organic architecture. The device has low dark currents (<10-6 mA cm-2), linear dynamic range >150 dB, and operational stability over time (>8 hours). With a narrowband quantum efficiency that can exceed 200% at 850 nm and intrinsic filtering of other wavelengths to limit optical noise, the device exhibits higher tolerance to background light than optically filtered silicon-based sensors. We demonstrate its potential in remote monitoring by measuring the heart rate and respiration rate from distances up to 130 cm in reflection.

Identification of the Origin of Ultralow Dark Currents in Organic Photodiodes.

Organic bulk heterojunction photodiodes (OPDs) attract attention for sensing and imaging. Their detectivity is typically limited by a substantial reverse bias dark current density (Jd ). Recently, using thermal admittance or spectral photocurrent measurements, Jd has been attributed to thermal charge generation mediated by mid-gap states. Here, the temperature dependence of Jd in state-of-the-art OPDs is reported with Jd down to 10-9  mA cm-2 at -0.5 V bias. For a variety of donor-acceptor bulk-heterojunction blends it is found that the thermal activation energy of Jd is lower than the effective bandgap of the blends, by ca. 0.3 to 0.5 eV, but higher than expected for mid-gap states. Ultra-sensitive sub-bandgap photocurrent spectroscopy reveals that the minimum photon energy for optical charge generation in OPDs correlates with the dark current thermal activation energy. The dark current in OPDs is attributed to thermal charge generation at the donor-acceptor interface mediated by intra-gap states near the band edges.

Evidencing the effectiveness of upper limb prostheses: a multi-stakeholder perspective on study requirements.

The provision of upper limb prosthetic devices through the National Health Services (NHS) within the United Kingdom is driven by national policies. NHS England have recently published a new policy to provide multi-grip myoelectric hands. The policy highlighted that there was limited evidence to support its deployment and it will be reviewed should new information arise. The clear identification of the evidence gap provides an opportunity for the academic research community to conduct studies that will inform future iterations of this and other upper limb prosthetic related policies. This paper presents a summary of findings and recommendations based on two multi-stakeholder workshops held in June 2022 and July 2022, which explored the design requirements for policy-driven research studies. The workshops involved people from a broad range of stakeholder groups: policy, academia, NHS clinical and management, industry, and a person with upper limb absence. The workshop discussions focused on the research questions that NHS England identified in the policy evidence review: (1) Clinical Effectiveness; (2) Cost Effectiveness; (3) Safety; and (4) Patient Subgroups. The recommendations based on stakeholder discussions included the need to gather qualitative and quantitative research evidence, use goal-based outcome measures, and conduct longitudinal studies. Future research studies also need to address the complexities of conducting national and international policy-driven research, such as clinical resource capacity and participant involvement.

Increasing Voluntary Myoelectric Training Time Through Game Design.

In virtual prosthetic training research, serious games have been investigated for over 30 years. However, few game design elements are used and assessed for their effect on the voluntary adherence and repetition of the performed task. We compared two game-based versions of an established myoelectric-controlled virtual prosthetic training task with an interface without game elements of the same task [for video, see (Garske, 2022)]. Twelve limb-intact participants were sorted into three groups of comparable ability and asked to perform the task as long as they were motivated. Following the task, they completed a questionnaire regarding their motivation and engagement in the task. The investigation established that participants in the game-based groups performed the task significantly longer when more game design elements were implemented in the task (medians of 6 vs. 9.5 vs. 14 blocks for groups with increasing number of different game design elements). The participants in the game-based versions were also more likely to end the task out of fatigue than for reasons of boredom or frustration, which was verified by a fatigue analysis of the myoelectric signal. We demonstrated that the utilization of game design methodically in virtual myoelectric training tasks can support adherence and duration of a virtual training, in the short-term. Whether such short-term enhanced engagement would lead to long-term adherence remains an open question.

Multiscale nest-site selection of ducks in the western boreal forest of Alberta.

There is limited data regarding the nesting ecology of boreal ducks and their response to industrial development, despite this region being an important North American breeding area. We investigated how landcover and oil and gas development affect third-order nest-site selection of boreal ducks. We located duck nests in Alberta's western boreal forest between 2016 and 2018. We used multiscale analysis to identify how scale affects the selection of a resource using generalized linear mixed-effects models and determined what scale-optimized combination of landscape features were most important in describing where ducks nest. We located 136 nests of six species of upland nesting ducks between 2016 and 2018. The magnitude, direction, and best spatial scale varied by resource. For landcover, ducks selected nest-sites associated with mineral wetlands (300 m) and open water (300 m). Ducks avoided greater densities of seismic lines (300 m) and pipelines (2500 m) but selected nest-sites associated with borrow pits (300 m) and roads (1000 m). We used our models to predict important duck nesting habitat in the boreal forest, which can support conservation and management decisions. We recommend conservation actions target the conservation of mineral wetlands and associated habitats within this working landscape. Further research is necessary to understand the adaptive consequences of nest-site selection and how industrial development influences important nest predators.

Internet of Things for beyond-the-laboratory prosthetics research.

Research on upper-limb prostheses is typically laboratory-based. Evidence indicates that research has not yet led to prostheses that meet user needs. Inefficient communication loops between users, clinicians and manufacturers limit the amount of quantitative and qualitative data that researchers can use in refining their innovations. This paper offers a first demonstration of an alternative paradigm by which remote, beyond-the-laboratory prosthesis research according to user needs is feasible. Specifically, the proposed Internet of Things setting allows remote data collection, real-time visualization and prosthesis reprogramming through Wi-Fi and a commercial cloud portal. Via a dashboard, the user can adjust the configuration of the device and append contextual information to the prosthetic data. We evaluated this demonstrator in real-time experiments with three able-bodied participants. Results promise the potential of contextual data collection and system update through the internet, which may provide real-life data for algorithm training and reduce the complexity of send-home trials. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.

Towards User-Centred Prosthetics Research Beyond the Laboratory.

The purpose of this study was to explore a range of perspectives on how academic research and clinical assessment of upper-limb prosthetics could happen in environments outside of laboratories and clinics, such as within peoples' homes. Two co-creation workshops were held, which included people who use upper limb prosthetic devices (hereafter called users), clinicians, academics, a policy stakeholder, and a representative from the upper-limb prosthetics industry (hereafter called professionals). The discussions during the workshops indicate that research and clinical assessment conducted remotely from a laboratory or clinic could inform future solutions that address user needs. Users were open to the idea of sharing sensor and contextual data from within their homes to external laboratories during research studies. However, this was dependent upon several considerations, such as choice and control over data collection. Regarding clinical assessment, users had reservations of how data may be used to inform future prosthetic prescriptions whilst, clinicians were concerned with resource implications and capacity to process user data. The paper presents findings of the discussions shared by participants during both workshops. The paper concludes with a conjecture that collecting sensor and contextual data from users within their home environment will contribute towards literature within the field, and potentially inform future care policies for upper limb prosthetics. The involvement of users during such studies will be critical and can be enabled via a co-creation approach. In the short term, this may be achieved through academic research studies, which may in the long term inform a framework for clinical in-home trials and clinical remote assessment.

Ultralow dark current in near-infrared perovskite photodiodes by reducing charge injection and interfacial charge generation.

Metal halide perovskite photodiodes (PPDs) offer high responsivity and broad spectral sensitivity, making them attractive for low-cost visible and near-infrared sensing. A significant challenge in achieving high detectivity in PPDs is lowering the dark current density (JD) and noise current (in). This is commonly accomplished using charge-blocking layers to reduce charge injection. By analyzing the temperature dependence of JD for lead-tin based PPDs with different bandgaps and electron-blocking layers (EBL), we demonstrate that while EBLs eliminate electron injection, they facilitate undesired thermal charge generation at the EBL-perovskite interface. The interfacial energy offset between the EBL and the perovskite determines the magnitude and activation energy of JD. By increasing this offset we realized a PPD with ultralow JD and in of 5 × 10-8 mA cm-2 and 2 × 10-14 A Hz-1/2, respectively, and wavelength sensitivity up to 1050 nm, establishing a new design principle to maximize detectivity in perovskite photodiodes.

Long-Term Myoelectric Training with Delayed Feedback in the Home Environment.

Myoelectric prosthesis users typically do not receive immediate feedback from their device. They must be able to consistently produce distinct muscle activations in the absence of augmented feedback. In previous experiments, abstract decoding has provided real-time visual feedback for closed loop control. It is unclear if the performance in those experiments was due to short-term adaptation or motor learning. To test if similar performance could be reached without short-term adaptation, we trained participants with a delayed feedback paradigm. Feedback was delayed until after the ~1.5 s trial was completed. Three participants trained for five days in their home environments, completing a cumulative total of 4920 trials. Participants became highly accurate while receiving no real-time feedback of their control input. They were also able to retain performance gains across days. This strongly suggests that abstract decoding with delayed feedback facilitates motor learning, enabling four class control without immediate feedback.

Remote creation of clinical-standard myoelectric trans-radial bypass sockets during COVID-19.

To enable the progression of research during the COVID-19 lockdown, a novel remote method of creating clinical standard trans-radial bypass sockets was devised as a collaboration between an engineering team and a clinical research group. The engineering team recruited two able-bodied participants, marked areas of interest on the participant's limb and captured limb geometry and electrode sites with a high definition optical scanner. The resulting 3D scan was modified to make electrode sites and areas of interest recessed and tactile. Models were 3D printed to scale and posted to the clinical team to manufacture the sockets. A modified lamination process was used, comprising plaster casting and rectifiying the model by hand. The recessed areas of the 3D printed model were used to guide the process. The bypass sockets were returned to the engineering team for testing. A simple electromyography (EMG) tracking task was performed using clinical electrodes to validate the skin-electrode contact and alignment. This paper demonstrates a validated method for remotely creating transradial bypass sockets. There is potential to extrapolate this method to standard socket fittings with further research.

A Network-Enabled Myoelectric Platform for Prototyping Research Outside of the Lab.

We present a network-enabled myoelectric platform for performing research outside of the laboratory environment. A low-cost, flexible, modular design based on common Internet of Things connectivity technology allows home-based research to be piloted. An outline of the platform is presented followed by technical results obtained from ten days of home-based tests with three participants. Results show the system enabled collection of close to 12,000 trials during around 28 cumulative hours of use. Home-based testing of multiple participants in parallel offers efficiency gains and provides a intuitive route toward long-term testing of upper-limb prosthetic devices in more naturalistic settings.Clinical relevance- In-home myoelectric training reduces clinician time. Network-enabled systems with back-end dashboards allow clinicians to monitor patients myoelectric ability over time and will provide a new way of accessing information about how upper-limb prosthetics are commonly used.

Serious Games Are Not Serious Enough for Myoelectric Prosthetics.

Serious games show a lot of potential for use in movement rehabilitation (eg, after a stroke, injury to the spinal cord, or limb loss). However, the nature of this research leads to diversity both in the background of the researchers and in the approaches of their investigation. Our close examination and categorization of virtual training software for upper limb prosthetic rehabilitation found that researchers typically followed one of two broad approaches: (1) focusing on the game design aspects to increase engagement and muscle training and (2) concentrating on an accurate representation of prosthetic training tasks, to induce task-specific skill transfer. Previous studies indicate muscle training alone does not lead to improved prosthetic control without a transfer-enabling task structure. However, the literature shows a recent surge in the number of game-based prosthetic training tools, which focus on engagement without heeding the importance of skill transfer. This influx appears to have been strongly influenced by the availability of both software and hardware, specifically the launch of a commercially available acquisition device and freely available high-profile game development engines. In this Viewpoint, we share our perspective on the current trends and progress of serious games for prosthetic training.

Effect of Light-Induced Halide Segregation on the Performance of Mixed-Halide Perovskite Solar Cells.

Light-induced halide segregation hampers obtaining stable wide-band-gap solar cells based on mixed iodide-bromide perovskites. So far, the effect of prolonged illumination on the performance of mixed-halide perovskite solar cells has not been studied in detail. It is often assumed that halide segregation leads to a loss of open-circuit voltage. By simultaneously recording changes in photoluminescence and solar cell performance under prolonged illumination, we demonstrate that cells instead deteriorate by a loss of short-circuit current density and that the open-circuit voltage is less affected. The concurrent red shift, increased lifetime, and higher quantum yield of photoluminescence point to the formation of relatively emissive iodide-rich domains under illumination. Kinetic Monte Carlo simulations provide an atomistic insight into their formation via exchange of bromide and iodide, mediated by halide vacancies. Localization of photogenerated charge carriers in low-energy iodide-rich domains and subsequent recombination cause reduced photocurrent and red-shifted photoluminescence. The loss in photovoltaic performance is diminished by partially replacing organic cations by cesium ions. Ultrasensitive photocurrent spectroscopy shows that cesium ions result in a lower density of sub-band-gap defects and suppress defect growth under illumination. These defects are expected to play a role in the development and recovery of light-induced compositional changes.

Co-creation and User Perspectives for Upper Limb Prosthetics.

People who either use an upper limb prosthesis and/or have used services provided by a prosthetic rehabilitation centre, experience limitations of currently available prosthetic devices. Collaboration between academia and a broad range of stakeholders, can lead to the development of solutions that address peoples' needs. By doing so, the rate of prosthetic device abandonment can decrease. Co-creation is an approach that can enable collaboration of this nature to occur throughout the research process. We present findings of a co-creation project that gained user perspectives from a user survey, and a subsequent workshop involving: people who use an upper limb prosthesis and/or have experienced care services (users), academics, industry experts, charity executives, and clinicians. The survey invited users to prioritise six themes, which academia, clinicians, and industry should focus on over the next decade. The prioritisation of the themes concluded in the following order, with the first as the most important: function, psychology, aesthetics, clinical service, collaboration, and media. Within five multi-stakeholder groups, the workshop participants discussed challenges and collaborative opportunities for each theme. Workshop groups prioritised the themes based on their discussions, to highlight opportunities for further development. Two groups chose function, one group chose clinical service, one group chose collaboration, and another group chose media. The identified opportunities are presented within the context of the prioritised themes, including the importance of transparent information flow between all stakeholders; user involvement throughout research studies; and routes to informing healthcare policy through collaboration. As the field of upper limb prosthetics moves toward in-home research, we present co-creation as an approach that can facilitate user involvement throughout the duration of such studies.

Perception of Game-Based Rehabilitation in Upper Limb Prosthetic Training: Survey of Users and Researchers.

BACKGROUND: Serious games have been investigated for their use in multiple forms of rehabilitation for decades. The rising trend to use games for physical fitness in more recent years has also provided more options and garnered more interest for their use in physical rehabilitation and motor learning. In this study, we report the results of an opinion survey of serious games in upper limb prosthetic training. OBJECTIVE: This study investigates and contrasts the expectations and preferences for game-based prosthetic rehabilitation of people with limb difference and researchers. METHODS: Both participant groups answered open and closed questions as well as a questionnaire to assess their user types. The distribution of the user types was compared with a Pearson chi-square test against a sample population. The data were analyzed using the thematic framework method; answers fell within the themes of usability, training, and game design. Researchers shared their views on current challenges and what could be done to tackle these. RESULTS: A total of 14 people with limb difference and 12 researchers participated in this survey. The open questions resulted in an overview of the different views on prosthetic training games between the groups. The user types of people with limb difference and researchers were both significantly different from the sample population, with χ25=12.3 and χ25=26.5, respectively. CONCLUSIONS: We found that the respondents not only showed a general willingness and tentative optimism toward the topic but also acknowledged hurdles limiting the adoption of these games by both clinics and users. The results indicate a noteworthy difference between researchers and people with limb difference in their game preferences, which could lead to design choices that do not represent the target audience. Furthermore, focus on long-term in-home experiments is expected to shed more light on the validity of games in upper limb prosthetic rehabilitation.

3D-Printing and Upper-Limb Prosthetic Sockets: Promises and Pitfalls.

Modernising the way upper-limb prosthetic sockets are made has seen limited progress. The casting techniques that are employed in clinics today resemble those developed over 50 years ago and there is still a heavy reliance on manual labour. Modern manufacturing methods such as 3D scanning and printing are often presented as ready-to-use solutions for producing low-cost functional devices, with public perceptions being largely shaped by the superficial media representation and advertising. The promise is that modern socket manufacturing methods can improve patient satisfaction, decrease manufacturing times and reduce the workload in the clinic. However, the perception in the clinical community is that total conversion to digital methods in a clinical environment is not straightforward. Anecdotally, there is currently a disconnect between those developing technology to produce prosthetic devices and the actual needs of clinicians and people with limb difference. In this paper, we demonstrate strengths and drawbacks of a fully digitised, low-cost trans-radial diagnostic socket making process, informed by clinical principles. We present volunteer feedback on the digitally created sockets and provide expert commentary on the use of digital tools in upper-limb socket manufacturing. We show that it is possible to utilise 3D scanning and printing, but only if the process is informed by expert knowledge. We bring examples to demonstrate how and why the process may go wrong. Finally, we provide discussion on why progress in modernising the manufacturing of upper-limb sockets has been slow yet it is still too early to rule out digital methods.

Arduino-Based Myoelectric Control: Towards Longitudinal Study of Prosthesis Use.

Understanding how upper-limb prostheses are used in daily life helps to improve the design and robustness of prosthesis control algorithms and prosthetic components. However, only a very small fraction of published research includes prosthesis use in community settings. The cost, limited battery life, and poor generalisation may be the main reasons limiting the implementation of home-based applications. In this work, we introduce the design of a cost-effective Arduino-based myoelectric control system with wearable electromyogram (EMG) sensors. The design considerations focused on home studies, so the robustness, user-friendly control adjustments, and user supports were the main concerns. Three control algorithms, namely, direct control, abstract control, and linear discriminant analysis (LDA) classification, were implemented in the system. In this paper, we will share our design principles and report the robustness of the system in continuous operation in the laboratory. In addition, we will show a first real-time implementation of the abstract decoder for prosthesis control with an able-bodied participant.

Highly Deformed o-Carborane Functionalised Non-linear Polycyclic Aromatics with Exceptionally Long C-C Bonds.

The effect of substituting o-carborane into the most sterically hindered positions of phenanthrene and benzo(k)tetraphene is reported. Synthesised via a Bull-Hutchings-Quayle benzannulation, the crystal structures of these non-linear acenes exhibited the highest aromatic deformation parameters observed for any reported carborane compound to date, and among the largest carboranyl C-C bond length of all organo-substituted o-carboranes. Photoluminescence studies of these compounds demonstrated efficient intramolecular charge-transfer, leading to aggregation induced emission properties. Additionally, an unusual low-energy excimer was observed for the phenanthryl compound. These are two new members of the family of carborane-functionalised non-linear acenes, notable for their peculiar structures and multi-luminescent properties.