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The study of bio-inspired structures and their reproduction has always fascinated humans. The advent of soft robotics, thanks to soft materials, has enabled considerable progress in this field. Over the years, polyps, worms, cockroaches, jellyfish, and multiple anthropomorphic structures such as hands or limbs have been reproduced. These structures have often been used for gripping and handling delicate objects or those with complex unknown a priori shapes. Several studies have also been conducted on grippers inspired by the seahorse tail. In this paper, a novel biomimetic soft pneumatic actuator inspired by the tail of the seahorse Hippocampus reidi is presented. The actuator has been developed to make a leg to sustain a multi-legged robot. The prototyping of the actuator was possible by combining a 3D-printed reinforcement in thermoplastic polyurethane, mimicking the skeletal apparatus, within a silicone rubber structure, replicating the functions of the external epithelial tissue. The latter has an internal channel for pneumatic actuation that acts as the inner muscle. The study on the anatomy and kinematic behaviour of the seahorse tail suggested the mechanical design of the actuator. Through a test campaign, the actuator prototype was characterized by isotonic tests with an external null load, isometric tests, and activation/deactivation times. Specifically, the full actuator distension of 154.5 mm occurs at 1.8 bar, exerting a maximum force of 11.9 N, with an activation and deactivation time of 74.9 and 94.5 ms, respectively.

This paper reports on the design, implementation, and characterization of a current-mode analog-front-end circuit for capacitance-to-voltage conversion that can be used in connection with a large variety of sensors and actuators in industrial and rehabilitation medicine applications. The circuit is composed by: (i) an oscillator generating a square wave signal whose frequency and pulse width is a function of the value of input capacitance; (ii) a passive low-pass filter that extracts the DC average component of the square wave signal; (iii) a DC-DC amplifier with variable gain ranging from 1 to 1000. The circuit has been designed in the current-mode approach by employing the second-generation current conveyor circuit, and has been implemented by using commercial discrete components as the basic blocks. The circuit allows for gain and sensitivity tunability, offset compensation and regulation, and the capability to manage various ranges of variations of the input capacitance. For a circuit gain of 1000, the measured circuit sensitivity is equal to 167.34 mV/pF with a resolution in terms of capacitance of 5 fF. The implemented circuit has been employed to measure the variations of the capacitance of a McKibben pneumatic muscle associated with the variations of its length that linearly depend on the circuit output voltage. Under step-to-step conditions of movement of the pneumatic muscle, the overall system sensitivity is equal to 70 mV/mm with a standard deviation error of the muscle length variation of 0.008 mm.

Biochar is a rich carbon product obtained by pyrolysis of biomass under a limited supply of oxygen. It is composed mainly of aromatic molecules, but its agronomic value is hard to evaluate and difficult to predict due to its great variable characteristics depending on the type of starting biomass and the conditions of pyrolysis. Anyway, it could be used as soil amendment because it increases the soil fertility of acidic soils, increases the agricultural productivity, and seems to provide protection against some foliar and soilborne diseases. In this study, the effects of biochar, obtained from olive pruning, have been evaluated on tomato seedlings growth and on their response to systemic agents' infection alone or added with beneficial microorganisms ( Bacillus spp. and Trichoderma spp.). First, experimental data showed that biochar seems to promote the development of the tomato seedlings, especially at concentrations ranging from 1 to 20% (w/w with peat) without showing any antimicrobial effects on the beneficial soil bacteria at the tomato rhizosphere level and even improving their growth. Thus, those concentrations were used in growing tomato plants experimentally infected with tomato spotted wilt virus (TSWV) and potato spindle tuber viroid (PSTVd). The biochar effect was estimated by evaluating three parameters, namely, symptom expression, number of infected plants, and pathogen quantification, using RT-qPCR technique and -ΔΔCt analysis. Biochar at 10-15% and when added with Trichoderma spp. showed that it reduces the replication of PSTVd and the expression of symptoms even if it was not able to block the start of infection. The results obtained on TSWV-infected plants suggested that biochar could contribute to reducing both infection rate and virus replication. For systemic viral agents, such as PSTVd and TSWV, there are no curative control methods, and therefore, the use of prevention means, as can be assumed the use biochar, for example, in the nursery specialized in horticultural crops, can be of great help. These results can be an encouraging starting point to introduce complex biochar formulates among the sustainable managing strategies of plant systemic diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Luigi, Manglli, Dragone, Antonelli, Contarini, Speranza, Bertin, Tiberini, Gentili, Varvaro, Tomassoli and Faggioli.)

Powered ankle-foot prostheses for walking often have limitations in the range of motion and in push-off power, if compared to a lower limb of a healthy person. A new design of a powered ankle-foot prosthesis is proposed to obtain a wide range of motion and an adequate power for a push-off step. The design methodology for this prosthesis has three points. In the first one, a dimensionless kinematic model of the lower limb in the sagittal plane is built, through an experimental campaign with healthy subjects, to calculate the angles of lower limb during the gait. In the second point a multibody inverse dynamic model of the lower limb is constructed to calculate the foot-ground contact force, its point of application and the ankle torque too, entering as input data the calculated angles of the lower limb in the previous point. The third point requires, as input of the inverse dynamic model, the first dimensioning data of the ankle-foot prosthesis to obtain the load acting on the components of the prosthesis and the angle torque of the actuator during the gait cycle. Finally, an iteration cycle begins with the inverse dynamic model modifying the ankle torque and angle until these quantities during the gait are as close as possible to the physiological quantities. After the mechanical design and the construction of the prototype of the prosthesis, an experimental methodology was used for preliminary validation of the design. The preliminary tests in the laboratory on the prototype alone show that the range of motion of the ankle angle during the gait is close to a healthy person's: 27.6° vs. 29°. The pushing force of the distal area of the prototype is 1.000 N, instead of 1.600 N, because a budget reduction forced us to choose components for the prototype with lower performance.

This paper describes the results of research projects developed at the University of L'Aquila by the research group of the authors in the field of biomedical engineering, which have seen an important use of additive manufacturing technologies in the prototyping step and, in some cases, also for the realization of preindustrialization prototypes. For these projects, commercial 3D printers and technologies such as fused deposition modelling (FDM) were used; the most commonly used polymers in these technologies are acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA). The research projects concern the development of innovative actuators, such as pneumatic muscles and soft pneumatic actuators (SPAs), the development of active orthoses, such as a lower limb orthosis and, finally, the development of a variable-stiffness grasper to be used in natural orifice transluminal endoscopic surgery (NOTES). The main aspects of these research projects are described in the paper, highlighting the technologies used such as the finite element analysis and additive manufacturing.

Purpose: For off-road mobility, some manual or power assisted devices were conceived to be self-driven by paraplegics while for tetraplegics non power-assisted devices were conceived. These devices require one or more conductors who are subjected to a high physical demand thus potentially creating: precarious safety condition for the user an elevated physical demand of conductors could reduce the care and the attention to give to the user; the time of the outdoor adventure experience of the user could be limited., Methods: To address these issues, an innovative user-centered power assisted off-road wheelchair for the transportation of tetraplegics along mountain trails was developed. The device, structured like a trike, is driven by two healthy conductors; the user is placed in the middle of the frame. A movable seat provides for the transfer from the standard to the off-road wheelchair. An electrical motor, powered by a battery pack, provides for the actuation. All the design and prototype aspects, the control system and experimental tests are detailed., Results: The prototype satisfies mechanical, safety and duration requirements. No physical demand while using the device and for the transfer of the user to the device was identified. Fun and engaging tests were carried out and all the participants were involved. Implications for Rehabilitation The device has the potential to enhance the quality of life of tetraplegics in terms of new life experiences. The device revealed the real possibility of a full recreational experience, an enhanced participation and a better social integration of tetraplegics.

Background: In natural orifice transluminal endoscopic surgery (NOTES) the peritoneal cavity is reached through natural orifices (mouth, rectus and transvaginal duct), by means of little cuttings in the walls of hollow organs. Due to narrow spaces, NOTES needs robotic systems to assure operation/movement precision and patient safety. Variable stiffness actuation (VSA) assures both requirements., Methods: The authors developed a grasper for NOTES, provided with VSA, to use as an end-effector for snail robot devices. The present paper deals with basic concepts of VSA and describes the design and architecture of the grasper. Characterization and functional experiments were performed and results analysed., Results: A finite element model developed for the actuator design was validated, performance grasper characteristic curves were obtained, VSA was validated, and the gripping capability of several objects was assessed., Conclusion: The grasper satisfies technical design specifications. On the basis of the results obtained, a control system can be developed to test grasper in a simulated surgery environment., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Rectocele is defined as an erniation of the anterior rectal and vaginal wall in the vaginal lumen due to the loss of recto-vaginal septum. Rectal mucosal prolapse was characterized by the protrusion of the mucosa alone in the rectal lumen. The Authors, herein, reported the results of a new surgical technique defined Sequential Transfixed Stitch Technique (STST) using a new anoscope. MATERIALS AND METHODS; A total of 30 consecutive patients symptomatic III or IV stage rectocele assessed with clinical and instrumental criteria were submitted to STST using the new anoscope. The new anoscope, consisting of non-toxic metallic material, designed and realized according to surgery needs and tested by the authors, increases the vision of the anal canal can be fixed according to the operator's needs., Results: STST was correctly performed in all the cases without early and late complications. The mean value was of 17 according to the Agachan-Wexner for patients with rectocele, significantly improved score in comparison to pre-operatory condition (p<0.05). Surgical procedure of rectocele repair was judged satisfactory in 80% of the cases., Conclusions: The new operative anoscope was useful in III and IV stage rectocele repair with STST, ensuring ease of implementation of the binding repair in the absence of side effects for the patient.

A test protocol is defined for the purpose of measuring rectus femoris mechanomyographic (MMG) signals. The protocol is specified in terms of the following: measurement equipment, signal processing requirements, human postural requirements, test rig, sensor placement, sensor dermal fixation, and test procedure. Preliminary tests of the statistical nature of rectus femoris MMG signals were performed, and Gaussianity was evaluated by means of a two-sided Kolmogorov-Smirnov test. For all 100 MMG data sets obtained from the testing of two volunteers, the null hypothesis of Gaussianity was rejected at the 1%, 5%, and 10% significance levels. Most skewness values were found to be greater than 0.0, while all kurtosis values were found to be greater than 3.0. A statistical convergence analysis also performed on the same 100 MMG data sets suggested that 25 MMG acquisitions should prove sufficient to statistically characterize rectus femoris MMG. This conclusion is supported by the qualitative characteristics of the mean rectus femoris MMG power spectral densities obtained using 25 averages.

The authors present the characteristics and the advantages deriving from the use of a new accessory to be fitted on the isostatic anal retractor in order to further improve visualisation of the operative field during the treatment of pelvic and anal pathologies. The isostatic anal retractor consists of a system of rotating rings and valves which are positioned with surgical stitches on the patient's buttocks. The new accessory is characterised by one or more elastic systems that can be fixed to the retractor metal ring and attached by means of curved needles to flaps of anal mucosa, affording enhanced visibility of the operative field. A total of 25 patients--15 with mucosal prolapse, 5 with haemorrhoids and 5 with anal fistulas--were treated surgically for their respective pathologies using the isostatic anal retractor and the new accessory. None of the patients observed complained of complications related to the use of the anal retractor or the accessory. In 95% of patients submitted to the procedures using the new accessory, visualisation of the operative field was improved as compared to the use of the anal retractor alone. In 5 patients it was possible to use the new accessory advantageously applied only to the external ring of the retractor. Our operative team judged the use of new accessory to be satisfactory in all cases in which greater visibility of the operative field is required. Use of the new accessory use in association with the isostatic anal retractor proved efficacious for achieving better therapeutic results with the treatments performed, permitting greater operator autonomy and enhancing visualisation of the operative field with respect for sphincter function.

The authors illustrate the technical characteristics and the clinical results of a new anal retractor in proctology and pelviperineology This new device, designed and produced by the authors, enables the surgeon to operate in a traditional or isostatic modality. The small external diameter and the original morphology seem to guarantee a less invasive introduction into the anal canal with minimal mechanical damage to the anal sphincter. The main indications for its use are pelvic floor surgery and patients with a diagnosis of anal incontinence or with suspected sphincter damage. Forty consecutive patients referred to our Coloproctological Unit have been operated on with the new anal retractor with no complications. The operative results obtained with the new device are defined as good in 75% and optimal in 10%. The anal retractor seems easy to use in all the surgical procedures with a much better safety profile with regard to anal sphincter.

In this paper the authors present the technical characteristics and clinical results of a new anal retractor designed and produced by them. This new instrument, made of disposable material, allows the proctologist to operate completely alone thanks to a system of rotating rings which are fixed directly to the patient's legs by means of Velcro bands. Twenty consecutive patients with proctological diseases have been operated on to date with the new device. No complications were registered in our series. The rotation movement and overall stability of the retractor were judged sufficient in 6 cases and good in 14. Opening of the device proved asymmetrical in 20% of the cases without this affecting the surgical technique. Our surgical team considered the prototype ideal, and the operative space available to the surgeon much greater than with previous retractor models. No limitations have been observed in treating any of the proctological diseases. The possibility of performing sutures in the anal canal was judged to be good. In conclusion, our new anal retractor would appear to guarantee greater autonomy in proctological surgery with much better clinical and therapeutic results and lower costs.