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Work related musculoskeletal disorders (WMSDs) are often caused by repetitive lifting, making them a significant concern in occupational health. Although wearable assist devices have become the norm for mitigating the risk of back pain, most spinal assist devices still possess a partially rigid structure that impacts the user comfort and flexibility. This paper addresses this issue by presenting a smart textile actuated spine assistance robotic exosuit (SARE), which can conform to the back seamlessly without impeding the user movement and is incredibly lightweight. The SARE can assist the human erector spinae to complete any action with virtually infinite degrees of freedom. To detect the strain on the spine and to control the smart textile automatically, a soft knitting sensor which utilizes fluid pressure as sensing element is used. The new device is validated experimentally with human subjects where it reduces peak electromyography (EMG) signals of lumbar erector spinae by around 32 percent in loaded and around 22 percent in unloaded conditions. Moreover, the integrated EMG decreased by around 24.2 percent under loaded condition and around 23.6 percent under unloaded condition. In summary, the artificial muscle wearable device represents an anatomical solution to reduce the risk of muscle strain, metabolic energy cost and back pain associated with repetitive lifting tasks., Comment: 6 pages, 7 figures

Heart failure (HF) is one of the most prevalent life-threatening cardiovascular diseases in which 6.5 million people are suffering in the USA and more than 23 million worldwide. Mechanical circulatory support of HF patients can be achieved by implanting a left ventricular assist device (LVAD) into HF patients as a bridge to transplant, recovery or destination therapy and can be controlled by measurement of normal and abnormal pulmonary arterial wedge pressure (PAWP). While there are no commercial long-term implantable pressure sensors to measure PAWP, real-time non-invasive estimation of abnormal and normal PAWP becomes vital. In this work, first an improved Harris Hawks optimizer algorithm called HHO+ is presented and tested on 24 unimodal and multimodal benchmark functions. Second, a novel fully Elman neural network (FENN) is proposed to improve the classification performance. Finally, four novel 18-layer deep learning methods of convolutional neural networks (CNNs) with multi-layer perceptron (CNN-MLP), CNN with Elman neural networks (CNN-ENN), CNN with fully Elman neural networks (CNN-FENN), and CNN with fully Elman neural networks optimized by HHO+ algorithm (CNN-FENN-HHO+) for classification of abnormal and normal PAWP using estimated HVAD pump flow were developed and compared. The estimated pump flow was derived by a non-invasive method embedded into the commercial HVAD controller. The proposed methods are evaluated on an imbalanced clinical dataset using 5-fold cross-validation. The proposed CNN-FENN-HHO+ method outperforms the proposed CNN-MLP, CNN-ENN and CNN-FENN methods and improved the classification performance metrics across 5-fold cross-validation. The proposed methods can reduce the likelihood of hazardous events like pulmonary congestion and ventricular suction for HF patients and notify identified abnormal cases to the hospital, clinician and cardiologist.

Spatially resolved transcriptomics (SRT) has evolved rapidly through various technologies, enabling scientists to investigate both morphological contexts and gene expression profiling at single-cell resolution in parallel. SRT data are complex and multi-modal, comprising gene expression matrices, spatial information, and often high-resolution histology images. Because of this complexity and multi-modality, sophisticated computational algorithms are required to accurately analyze SRT data. Most efforts in this domain have been made to utilize conventional machine learning and statistical approaches, exhibiting sub-optimal results due to the complicated nature of SRT datasets. To address these shortcomings, researchers have recently employed deep learning algorithms including various state-of-the-art methods mainly in spatial clustering, spatially variable gene identification, and alignment. While great progress has been made in developing deep learning-based models for SRT data analysis, further improvement is still needed to create more biologically aware models that consider aspects such as phylogeny-aware clustering or the analysis of small histology image patches. Additionally, strategies for batch effect removal, normalization, and handling overdispersion and zero inflation patterns of gene expression are still needed in the analysis of SRT data using deep learning methods. In this paper, we provide a comprehensive overview of these deep learning methods, including their strengths and limitations. We also highlight new frontiers, current challenges, limitations, and open questions in this field. Also, we provide a comprehensive list of all available SRT databases that can be used as an extensive resource for future studies.

Left ventricular assist devices (LVADs) are mechanical pumps, which can be used to support heart failure (HF) patients as bridge to transplant and destination therapy. To automatically adjust the LVAD speed, a physiological control system needs to be designed to respond to variations of patient hemodynamics across a variety of clinical scenarios. These control systems require pressure feedback signals from the cardiovascular system. However, there are no suitable long-term implantable sensors available. In this study, a novel real-time deep convolutional neural network (CNN) for estimation of preload based on the LVAD flow was proposed. A new sensorless adaptive physiological control system for an LVAD pump was developed using the full dynamic form of model free adaptive control (FFDL-MFAC) and the proposed preload estimator to maintain the patient conditions in safe physiological ranges. The CNN model for preload estimation was trained and evaluated through 10-fold cross validation on 100 different patient conditions and the proposed sensorless control system was assessed on a new testing set of 30 different patient conditions across six different patient scenarios. The proposed preload estimator was extremely accurate with a correlation coefficient of 0.97, root mean squared error of 0.84 mmHg, reproducibility coefficient of 1.56 mmHg, coefficient of variation of 14.44 %, and bias of 0.29 mmHg for the testing dataset. The results also indicate that the proposed sensorless physiological controller works similarly to the preload-based physiological control system for LVAD using measured preload to prevent ventricular suction and pulmonary congestion. This study shows that the LVADs can respond appropriately to changing patient states and physiological demands without the need for additional pressure or flow measurements.

Goal: This paper presents an algorithm for estimating pelvis, thigh, shank, and foot kinematics during walking using only two or three wearable inertial sensors. Methods: The algorithm makes novel use of a Lie-group-based extended Kalman filter. The algorithm iterates through the prediction (kinematic equation), measurement (pelvis position pseudo-measurements, zero-velocity update, and flat-floor assumption), and constraint update (hinged knee and ankle joints, constant leg lengths). Results: The inertial motion capture algorithm was extensively evaluated on two datasets showing its performance against two standard benchmark approaches in optical motion capture (i.e., plug-in gait (commonly used in gait analysis) and a kinematic fit (commonly used in animation, robotics, and musculoskeleton simulation)), giving insight into the similarity and differences between the said approaches used in different application areas. The overall mean body segment position (relative to mid-pelvis origin) and orientation error magnitude of our algorithm ($n=14$ participants) for free walking was $5.93 \pm 1.33$ cm and $13.43 \pm 1.89^\circ$ when using three IMUs placed on the feet and pelvis, and $6.35 \pm 1.20$ cm and $12.71 \pm 1.60^\circ$ when using only two IMUs placed on the feet. Conclusion: The algorithm was able to track the joint angles in the sagittal plane for straight walking well, but requires improvement for unscripted movements (e.g., turning around, side steps), especially for dynamic movements or when considering clinical applications. Significance: This work has brought us closer to comprehensive remote gait monitoring using IMUs on the shoes. The low computational cost also suggests that it can be used in real-time with gait assistive devices., Comment: 10 pages

This paper presents an algorithm that makes novel use of distance measurements alongside a constrained Kalman filter to accurately estimate pelvis, thigh, and shank kinematics for both legs during walking and other body movements using only three wearable inertial measurement units (IMUs). The distance measurement formulation also assumes hinge knee joint and constant body segment length, helping produce estimates that are near or in the constraint space for better estimator stability. Simulated experiments shown that inter-IMU distance measurement is indeed a promising new source of information to improve the pose estimation of inertial motion capture systems under a reduced sensor count configuration. Furthermore, experiments show that performance improved dramatically for dynamic movements even at high noise levels (e.g., $\sigma_{dist} = 0.2$ m), and that acceptable performance for normal walking was achieved at $\sigma_{dist} = 0.1$ m. Nevertheless, further validation is recommended using actual distance measurement sensors., Comment: 5 pages. arXiv admin note: text overlap with arXiv:1910.01808

Surgical robots have had clinical use since the mid 1990s. Robot-assisted surgeries offer many benefits over the conventional approach including lower risk of infection and blood loss, shorter recovery, and an overall safer procedure for patients. The past few decades have shown many emerging surgical robotic platforms that can work in complex and confined channels of the internal human organs and improve the cognitive and physical skills of the surgeons during the operation. Advanced technologies for sensing, actuation, and intelligent control have enabled multiple surgical devices to simultaneously operate within the human body at low cost and with more efficiency. Despite advances, current surgical intervention systems are not able to execute autonomous tasks and make cognitive decisions that are analogous to that of humans. This paper will overview a historical development of surgery from conventional open to robotic-assisted approaches with discussion on the capabilities of advanced intelligent systems and devices that are currently implemented in existing surgical robotic systems. It will also revisit available autonomous surgical platforms with comments on the essential technologies, existing challenges, and suggestions for the future development of intelligent robotic-assisted surgical systems towards the achievement of fully autonomous operation., Comment: 76 pages, 23 figures, 1 table

This paper presents an algorithm that makes novel use of a Lie group representation of position and orientation alongside a constrained extended Kalman filter (CEKF) to accurately estimate pelvis, thigh, and shank kinematics during walking using only three wearable inertial sensors. The algorithm iterates through the prediction update (kinematic equation), measurement update (pelvis height, zero velocity update, flat-floor assumption, and covariance limiter), and constraint update (formulation of hinged knee joints and ball-and-socket hip joints). The paper also describes a novel Lie group formulation of the assumptions implemented in the said measurement and constraint updates. Evaluation of the algorithm on nine healthy subjects who walked freely within a $4 \times 4$ m$^2$ room shows that the knee and hip joint angle root-mean-square errors (RMSEs) in the sagittal plane for free walking were $10.5 \pm 2.8^\circ$ and $9.7 \pm 3.3^\circ$, respectively, while the correlation coefficients (CCs) were $0.89 \pm 0.06$ and $0.78 \pm 0.09$, respectively. The evaluation demonstrates a promising application of Lie group representation to inertial motion capture under reduced-sensor-count configuration, improving the estimates (i.e., joint angle RMSEs and CCs) for dynamic motion, and enabling better convergence for our non-linear biomechanical constraints. To further improve performance, additional information relating the pelvis and ankle kinematics is needed., Comment: 6 pages. arXiv admin note: text overlap with arXiv:1910.00910

Goal: This paper presents an algorithm for accurately estimating pelvis, thigh, and shank kinematics during walking using only three wearable inertial sensors. Methods: The algorithm makes novel use of a constrained Kalman filter (CKF). The algorithm iterates through the prediction (kinematic equation), measurement (pelvis position pseudo-measurements, zero velocity update, flat-floor assumption, and covariance limiter), and constraint update (formulation of hinged knee joints and ball-and-socket hip joints). Results: Evaluation of the algorithm using an optical motion capture-based sensor-to-segment calibration on nine participants ($7$ men and $2$ women, weight $63.0 \pm 6.8$ kg, height $1.70 \pm 0.06$ m, age $24.6 \pm 3.9$ years old), with no known gait or lower body biomechanical abnormalities, who walked within a $4 \times 4$ m$^2$ capture area shows that it can track motion relative to the mid-pelvis origin with mean position and orientation (no bias) root-mean-square error (RMSE) of $5.21 \pm 1.3$ cm and $16.1 \pm 3.2^\circ$, respectively. The sagittal knee and hip joint angle RMSEs (no bias) were $10.0 \pm 2.9^\circ$ and $9.9 \pm 3.2^\circ$, respectively, while the corresponding correlation coefficient (CC) values were $0.87 \pm 0.08$ and $0.74 \pm 0.12$. Conclusion: The CKF-based algorithm was able to track the 3D pose of the pelvis, thigh, and shanks using only three inertial sensors worn on the pelvis and shanks. Significance: Due to the Kalman-filter-based algorithm's low computation cost and the relative convenience of using only three wearable sensors, gait parameters can be computed in real-time and remotely for long-term gait monitoring. Furthermore, the system can be used to inform real-time gait assistive devices., Comment: 11 pages

Left ventricular assist devices (LVADs) can provide mechanical support for a failing heart as bridge to transplant and destination therapy. Physiological control systems for LVADs should be designed to respond to changes in hemodynamic across a variety of clinical scenarios and patients by automatically adjusting the heart pump speed. In this study, a novel adaptive physiological control system for an implantable heart pump was developed to respond to interpatient and intrapatient variations to maintain the left-ventricle-end-diastolic-pressure (LVEDP) in the normal range of 3 to 15 mmHg to prevent ventricle suction and pulmonary congestion. A new algorithm was also developed to detect LVEDP from pressure sensor measurement in real-time mode. Model free adaptive control (MFAC) was employed to control the pump speed via simulation of 100 different patient conditions in each of six different patient scenarios, and compared to standard PID control. Controller performance was tracked using the sum of the absolute error (SAE) between the desired and measured LVEDP. The lower SAE on control tracking performance means the measured LVEDP follows the desired LVEDP faster and with less amplitude oscillations preventing ventricle suction and pulmonary congestion (mean and standard deviation of SAE(mmHg) for all 600 simulations were 18813+-29345 and 24794+-28380 corresponding to MFAC and PID controller respectively). In four out of six patient scenarios, MFAC control tracking performance was better than the PID controller. This study shows the control performance can be guaranteed across different patients and conditions when using MFAC over PID control, which is a step towards clinical acceptance of these systems.