PowerPoint Presentation

Smart Prosthetics and Body RepairJohn Farserotu, CSEM WiseSkinHeinrich Hofmann, EPFL MagnetoTheranosticsStphanie Lacour, EPFL SpineRepairBert Mller, UniBas SmartSphincterStefan Weber, UniBE HearRestoreChair: Christofer Hierold, ETHZ

John Farserotu, CSEM

WiseSkinWiseSkin Artificial Skin for Tactile Prosthetics

Presented by J. FarserotuNano-tera Annual meeting 2014EPFL , 20 May 2014

Copyright 2013 CSEM | WiseSkin | Christian Antfolk | Page NThe problemAmputation of a hand or limb is a catastrophic event resulting in significant disability with major consequences for daily activities and quality of life. Although functional myoelectric prostheses are available today (e.g. hand), their use remains limited due to a lack of sensory function in the prostheses. As the worlds population grows and ages, so does the number of people living with disabilities including lost limbs (e.g. trauma, diabetes or cancer).A sense of tactility is needed for providing feedback for control of prosthetic limbs and to perceive the prosthesis as a real part of the body thus inducing a sense of body ownership and a natural sensation of touch. Copyright 2014 CSEM | Wireless | J. Farserotu | Page 4

Modern electric hands. A: bebionic (RSLSteeper). B: i-Limb Ultra (touchbionics). C: Michelangelo (Otto Bock)Today, there is no solution for restoration of a natural sense of touch for persons using prosthetic limbsBackgroundAdvances in the fields of micro, nano and biological systems are converging to enable miniaturized sensor devices that are ever more powerful. This opens the door for new solutions made of intelligent materialsSmart Gloves and Smart ClothesSmart / Artificial Skin, which may be viewed as a kind of body sensor network, consisting of one to potentially large number of devices. Potential applications include:Health (e.g. prosthetics)Safety (e.g. handling of potentially hazardous materials)Tactile robots for performing fine manipulation (e.g. factory and service robots).

Our focus in WiseSkin is on tactile prosthetics, however the potential imoact is broader

4BackgroundThe WiseSkin solution

Transduce the artificial skin outputs into appropriate tactile signals to be applied on the phantom map of amputees.

Phantom mappingNon-invasive! Copyright 2013 CSEM | WiseSkin | Christian Antfolk | Page NTechnical challengesReliable sensors / sensing (e.g. pressure and shear) to feel objects, grip and rapidly adjust (moving hand). Ease of use, freedom of movement, natural look and feel of the prosthetic demand highly miniaturized sensors placed almost anywhereMinimum impact on autonomy of the myoelectric prosthesis. Scalability / modularity are critical (e.g. communication, processing); potentially many sensors (100-150 mechanoreceptors/cm2 at fingertip of human hand).Real-time response and low latency are needed to react to slipping or falling, use of the prosthesis without actually watchingSensory feedback / actuation is essential and the Humanelectronics interface is key (e.g. electrodes, vibration).Advanced material engineering for sensing: piezoelectric AlN on elastomers, metallized PDMS waveguide, stretchable sensorssource: www.sciencedaily.com

WiseSkin pushes the forefront of technology in miniature, ULP sensor and communication devices, materials and sensory feedback systems. Copyright 2013 CSEM | Title | Author | Page NKey innovations / benefitsWireless and sensor technologyReliable, miniature, soft-MEMS sensors (e.g. pressure)Scalable routing, adaptable MAC, robust, event driven, HD-WSNConformal power distribution systemStretchable power distribution and signal transmission layers (e.g. gold, liquid metal)Electro-mechanical sensor integration, interconnects and flexible miniature antennaTactile sensory perception and human-electronics interface (HEI)Study and test of a non-invasive HEI on real patientsMulti-sensory perception, MRI brain imaging analysis (e.g. phantom finger somatotopy)WiseSkin system and technology integrationA flexible, stretchable artificial skin / smart material that is relatively easy to manufactureRestore a natural sensation of touch, ease of sensor placement, coverage of large areas Copyright 2012 CSEM | Wireless | J. Farserotu | Page 7

WiseSkin provides a natural sense of touch!nanotera people seem to like the words technology integration, system integration. Our project fits well in this.

SomatotopyFrom Wikipedia, the free encyclopediaJump to: navigation, searchSomatotopy is the point-for-point correspondence of an area of the body to a specific point on the central nervous system.[1] Typically, the area of the body corresponds to a point on the primary somatosensory cortex (postcentral gyrus). This cortex is typically represented as a sensory homunculus which orients the specific body parts and their respective locations upon the homunculus. Areas such as the appendages, digits, penis,[2] and face can draw their sensory locations upon the somatosensory cortex. The areas which are finely controlled (i.e. the digits) have larger portions of the somatosensory cortex whereas areas which are coarsely controlled (i.e. the trunk) have smaller portions. Areas such as the viscera do not have sensory locations on the post central gyrus.

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Haptic applications of WiseSkinHealth and MedicalTactile prosthetics (non-invasive as well as invasive) Braille display for the blind, rehabilitation, surgical simulatorsRobotsHealth: Surgical robotics (maybe soon), Service robots : e.g. Assisted LivingIndustrial: Factories, harsh environments e.g. undersea/spaceCommercialTouch screens (haptic feedback), computer gamesSafety and securitySmart gloves (e.g. firefighters, screening, haptic interface)

And more!

Copyright 2013 CSEM | Title | Author | Page NThank you for your attention! Copyright 2013 CSEM | WiseSkin | Christian Antfolk | Page N

Heinrich Hofmann, EPFL

MagnetoTheranosticsParticle compositionCharacterisation Tox screeningFunctionalisation of particles with antibodiesNanocomposite formulationIN VITROSpecific absorption in metastasesIN VIVOBiodistribution MRI detectionIN VITROHeating capacityIN VIVOInduced tumor in miceClinical study in dogsDevelopment of temperature simulation toolImprovement of magnetic generatorTheranosticsin human clinical trail

http://howtogetridofallthings.com

http://beforeitsnews.com/health/2012/04/targeted-nanoparticles-show-success-in-clinical-trials-1990861.html

http://jochenebmeier.wordpress.com

http://www.ways2gogreenblog.com/2013/05/30/best-practices-for-going-green-with-your-heating-and-cooling/

http://de.wikipedia.org/wiki/Humanismus

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Documentation with Electronic Sample Book (ESB)Project Layout

MagnetoTheranosticsRTD 2013From superparamagnetic nanoparticles to cancer detection and treatmentS. Barbieri, J. Bastiaansen,D. BovinS. Ehrenberger , H. Richter,G. Borchart, M. Clapstick, H. Hofmann, O. Jordan, N.Kuster, P.Kircher, B.von Rechenberg, M.Stuber, H.ThoenyDetermination of the optimal size of superparamagnetic nanoparticles

PhysicsMagnetisationAnisotropy constantRelaxation timeRelaxation mechanismBiologyCoatingBiocompatibilityAntibodyResidence timeCellular up takeProtein coronaClinicsFrequencyMag field strengthsIron MetabolismBiodistributionSpecific adsorptionClearing mechanism

The big barriersAccepted methods for biocompatibility tests of (inorganic) nanoparticlesRegulations for the use of inorganic nanoparticles for diagnostic and therapeutic applicationsGood manufacturing practice at academic levelReproducibility (at batch to batch and research level)Acceptance of nanotechnology

Openings for a solutionHighly interdisciplinary research including all aspects from basic science up to clinical research and development of manufacturing and test methodsSeveral up and downstream research projects in parallel to the core project preparing the ground for translation of results to big pharmacy and clinicsEducation at all levelsContact with of regulatory bodies (SMA, EMA, FDA) from beginningUse only materials which is approved by the regulatory bodies

19982018

Stphanie Lacour, EPFL

SpineRepairSpinal Cord Stimulation for Locomotor Disorders

Stphanie P. Lacour

Nano-tera annual review meeting

20 May 2014nano-tera annual review meeting S.P. Lacour 20 May 2014

Image: Nitin N. Bhatia, Am. Assoc. of Orthopedic Surgeons 2.5M people with Spinal Cord Injury (SCI) worldwide

half never recover walkingContext

Rob Summers standing during electrical stimulation of the spinal cordDan Dry/University of LouisvilleMissiondevelop and optimize enabling technologies to implement spinal cord neuroprosthesisnano-tera annual review meeting S.P. Lacour 20 May 2014An integrated Spinal NeuroprosthesisDevelopment of animal models of SCI, a test-bed for human trials

Development of improved implantable technology

Gaining understanding of the physiology of the spinal cord as movement generator

Our aims:

Treadmill or ladderKinematic analysis platform

Implantable platform

nano-tera annual review meeting S.P. Lacour 20 May 2014Technological advances biology, nanomaterials, engineering

where and how to stimulate

1 mm

500mElectrodesSpinal cordbiologically transparent implantslow-power, real-time control electronics

Implantable telemetryImplantable stimulatornano-tera annual review meeting S.P. Lacour 20 May 2014Project impact

In the neural prosthetic community

improve patients quality of life

significant impact on the prosthetic market

further applications beyond spinal cord injury reaching an even wider industrial as well as patient community. nano-tera annual review meeting S.P. Lacour 20 May 2014Grgoire CourtineJrme Gandar, David Borton, Jean Laurens, Nikolaus Wenger, Natalia Pavlova, Pavel Musienko, Simone Duis

Silvestro Micera Marco Capogrosso, Eduardo Martin Moraud, Stanisa Raspopovic

Stphanie P. Lacour Arthur Hirsch, Ivan Minev

Janos VrsFlurin Stauffer, Alexandre Larmagnac

Andreas HierlemannYongHong Tao, Yihui Chen

Alain-Serge PorretDaniel Severac, Vincent Peiris, Pierre-Franois Ruedi, Dragan Manic

The Teamnano-tera annual review meeting S.P. Lacour 20 May 2014

Bert Mller, UniBas

SmartSphincterPanel discussion: Smart prostheticsand body repair - SmartSphincterAnnual Plenary Meeting Nano-Tera.chSwissTech Convention Center, EPF LausanneMay 20, 2014

Bert MllerUniversity of Basel and University Hospital Basel, Switzerland

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SmartSphincter: Smart muscle for incontinence treatmentFrom the medical point of view: complex musclesFrom an engineering point of view: simplest musclesOpen/CloseDefinition of the target specifications for biomimetic designAnatomical restrictions (geometry, comfort)Necessary mechanical parameters (forces/pressures)Time response (more critical for urinary than fecal incontinence)Choice of actuatorChallenge: Stretchable electrodes for dielectric EAP-based actuatorsHundred thousands of nanometer-thin polymer layersHundred thousands of contactsConventional electrodes (e.g. 20 nm Au) dominate the mechanics:Liquid metal electrodes (demonstrated on m scale)Unidirectional wrinkles

25Applications of low-voltage, dielectric EAP nanometer-thin actuatorsFecal and urinary incontinenceActuators and sensors within the human body (similarities to tissues: high fracture toughness, large actuation strain, inherent vibration damping, low energy consumption)Tactile displays often termed artificial skinHinge-less devices in robotics incl. grippers and wipersFlow control in micro- and nano-fluidics (lab-on-a-chip)

High-risk but wide variety of potential applications26

Collaborative initiative of clinics, academia, and industry

Stefan Weber, UniBE

HearRestoreHearRestore: Image-guided micro surgery for hearing aid implantation

Stefan Weber University of BernBoker Tof and Toda Raba.

It is a great pleasure and honor for me to be here today. Leo Joskowicz29Hearing impairment A common disability

Social and clinical relevance Humans: 25% with hearing lossNewborns: 4 hearing disordersGold standard for deafnessHearing aid implantation (i.e. CI)Problems Invasiveness HospitalizationDeveloped world only30

Cochlea Implants 31

MED-EL Innsbruck

Imaging & 3D PlanningSafety

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Approach: Image Guided MicrosurgeryModelling

Precision guidance

323D mesh generated from CT images. The bone was segmented with a simple threshold to separate from soft tissue. The resulting mesh was contacted in comsol with two steel electrodes to inject a current. The picture shows the current density as colors and the current density vectors as red arrows and white ribbons.

Preparation for clinical trials (Tera)33

University of BernARTORG Center, Inselspital ENT Department Institute for Surgical Technologies and BiomechanicsBern University of Applied ScienceCSEM NeuchatelIndustryProject Partners

34I would like to thank the image guided microsurgery team at the ARTORG center, Marco Caversaccio and the ENT department at Inselspital, CO-ME for providing us with funding over the past 4 years, as well as all of our other funding sources and partners.34