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Retinitis pigmentosa (RP) is a collection of retinal disorders characterized by the progressive degeneration of photoreceptor cells, leading to significant visual impairment and, in severe cases, blindness. RP affects individuals worldwide and can be inherited through various genetic patterns, making it a genetically diverse condition. Despite considerable advancements in diagnostic methods and supportive therapies, there is currently no cure for RP. The focus of existing management strategies is on slowing the progression of the disease and improving the quality of life for those affected. This comprehensive review explores the latest therapeutic approaches in the management of RP, highlighting advancements in genetic therapies, such as gene augmentation and editing, as well as cell-based treatments including stem cell transplantation and induced pluripotent stem cell (iPSC) technologies. Emerging methods like optogenetics and pharmacological interventions designed to preserve retinal function are also discussed. Additionally, the review examines technological innovations, including retinal prosthetics and the use of artificial intelligence, which hold the potential to revolutionize RP treatment. The challenges and limitations associated with these novel therapies, such as safety concerns, accessibility issues, and regulatory hurdles, are critically evaluated. By providing an overview of current research and future directions, this review aims to inform clinicians and researchers about the state of the art in RP treatment and the prospects for achieving significant therapeutic advancements.

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The last years brought many advances relevant to lower limb reconstruction. It feels like guided growth has been looked at from every angle, and still there are new emerging concepts like rotational guided growth waiting to be validated. New hexapod external devices are more accurate and easier to use, and new unilateral fixators allow for more versatile and stable fixation and lengthening. Intramedullary nail lengthening has found its place as a standard procedure for various diagnoses in children and young adults. First results of new and exciting approaches like extramedullary implantable nail lengthening and lengthening plates have been reported. Pharmaceutical treatment has changed the course of certain diseases and must be integrated and considered when making a reconstructive treatment plan. As reconstructive surgery is rapidly advancing so are the technical options for prosthetic fitting, which makes it difficult for caregivers as well as for parents to make the decision between reconstruction and amputation surgery for the most severe cases of congenital deficiencies. This review is highlighting new developments of lower limb reconstruction and is reviewing the current literature.

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It remains a significant challenge in prosthetic rehabilitation for combined hard and soft palate defects on account of two primary reasons. At first, conventional impressions can hardly get an accurate analogue and usually bring about a terrible experience for the patients. Secondly, conventional hard denture base resins used in obturator prostheses exhibit limitations in marginal sealing, undercut retention, and elastic buffering when in contact with the soft palate. This article presents a case where combined hard and soft palate defects were successfully and rapidly reconstructed by using digital intraoral impression technology and denture soft reline material.

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Recent advancements in soft robotics have been emerging as an exciting paradigm in engineering due to their inherent compliance, safe human interaction, and ease of adaptation with wearable electronics. Soft robotic devices have the potential to provide innovative solutions and expand the horizons of possibilities for biomedical applications by bringing robots closer to natural creatures. In this review, we survey several promising soft robot technologies, including flexible fluidic actuators, shape memory alloys, cable-driven mechanisms, magnetically driven mechanisms, and soft sensors. Selected applications of soft robotic devices as medical devices are discussed, such as surgical intervention, soft implants, rehabilitation and assistive devices, soft robotic exosuits, and prosthetics. We focus on how soft robotics can improve the effectiveness, safety and patient experience for each use case, and highlight current research and clinical challenges, such as biocompatibility, long-term stability, and durability. Finally, we discuss potential directions and approaches to address these challenges for soft robotic devices to move toward real clinical translations in the future.

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In this paper, we discuss the potential contribution of affective touch to the user experience and robot performance in human-robot interaction, with an in-depth look into upper-limb prosthesis use as a well-suited example. Research on providing haptic feedback in human-robot interaction has worked to relay discriminative information during functional activities of daily living, like grasping a cup of tea. However, this approach neglects to recognize the affective information our bodies give and receive during social activities of daily living, like shaking hands. The discussion covers the emotional dimensions of affective touch and its role in conveying distinct emotions. In this work, we provide a human needs-centered approach to human-robot interaction design and argue for an equal emphasis to be placed on providing affective haptic feedback channels to meet the social tactile needs and interactions of human agents. We suggest incorporating affective touch to enhance user experience when interacting with and through semi-autonomous systems such as prosthetic limbs, particularly in fostering trust. Real-time analysis of trust as a dynamic phenomenon can pave the way towards adaptive shared autonomy strategies and consequently enhance the acceptance of prosthetic limbs. Here we highlight certain feasibility considerations, emphasizing practical designs and multi-sensory approaches for the effective implementation of affective touch interfaces.

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Cranioplasty is a common surgical procedure used to restore the shape of the calvaria. Autogenous bone flaps provide biological repair with the least morbidity to the donor location. One method for reusing bone autograft during cranioplasty involves low-temperature preservation followed by autoclaving. According to the literature, there was a good to modest improvement in the skull's symmetry, cosmesis, scars, and contour. It was determined that autoclaved frozen autogenous cerebral bone flaps are a safe and reliable method of cranioplasty. Despite its apparent simplicity, cranioplasty has been found to carry a relatively high complication rate, ranging from 12% to 50%, which starkly contrasts with the standard elective craniotomy, with a complication rate typically ranging from 24% to 60%. Complications associated with autogenous bone flap procedures are varied. The presented case report primarily focuses on the duplication of autogenous bone flaps by using clear polymethyl methacrylate.

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Collaborative robots, or cobots, have become popular due to their ability to safely operate alongside humans in shared environments. These robots use compliant actuators as a key design element to prevent damage during unintended collisions. In prosthetic and orthotic applications, compliant actuators are crucial for ensuring user safety and comfort. However, most compliant cobots for these applications are excessively expensive and complex to construct. Our study introduces an innovative, cost-effective, and sensorised elastic actuator design tailored for prosthetics and orthotics. The design uses a modular approach and leverages 3D printing technology for rapid customisation, enabling efficient and affordable fabrication. Both hardware and software components are open-source, facilitating unrestricted access for students, researchers, and practitioners. Our design supports impedance and admittance control techniques, enhancing the system's capabilities. Validation results show a standard deviation of 9.67 Nm between calculated and measured torque in impedance control and 0.2563 radians between calculated and measured angles in admittance control. This allows for improved adaptability to varying operational requirements in prosthetics and orthotics. By introducing this educational framework encompassing a low-cost, sensorised elastic actuator design, we aim to address the need for accessible solutions in the field of collaborative robotics for prosthetics and orthotics.

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Prehension movements in primates have been extensively studied for decades, and hand transport and hand grip adjustment are usually considered as the main components of any object reach-to-grasp action. Evident temporal patterns were found for the velocity of the hand during the transport phase and for the digits kinematics during pre-shaping and enclosing phases. However, such kinematics were always analysed separately in regard to time, and never studied in terms of dependence one from another. Nevertheless, if a reliable one-to-one relationship is proven, it would allow reconstructing the digit velocity (and position) simply by knowing the hand acceleration during reaching motions towards the target object, ceasing the usual dependence seen in literature from time of movement and distance from the target. In this study, the aim was precisely to analyse reach-to-grasp motions to explore if such relationship exists and how it can be formulated. Offline and real-time results not only seem to suggest the existence of a time-independent, one-to-one relationship between hand transport and hand grip adjustment, but also that such relationship is quite resilient to the different intrinsic and extrinsic properties of the target objects such as size, shape and position.

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Congenital or acquired hand differences, including unilateral below-elbow deficiencies, present complex challenges in pediatric rehabilitation. Surgical management and prosthetic provision represent a big challenge to find a good balance for guaranteeing optimal hand function. There is no specific assessment tool for measuring these aspects in the Italian context. The present study investigates the psychometric properties of the ABILHAND-Kids in children with congenital unilateral below-elbow deficiencies and acquired amputation of the upper limb. We measure internal consistency using Cronbach coefficient alpha and the intraclass correlation coefficient (ICC) for measuring test-retest reliability. Differences in hand function in both children with acquired or congenital diseases were also investigated. Participants to the study were 107 (49 F and 58 M) children, with a mean (SD) age of 8.88 (4.25). For test retest reliability, conducted on a sub-sample of 58 children, the ICC was 0.92, while for internal consistency, the Cronbach coefficient alpha was 0.90. We did not find statistically significant differences in scoring (p = 0.33) in the use (mean 29.25 SD 6.58) or non-use of a prosthetic device (mean 30.74 SD 7.43), while statistically significant differences were found in hand function (p < 0.01) for children who had a congenital impairment (mean 31.87 SD 6.49) and children who had an acquired amputation (mean 27.77 SD 6.60). In conclusion, the ABILHAND-Kids showed good internal consistency and reliability and can capture differences in hand function in children with both congenital and acquired hand disorders.

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BACKGROUND: The purpose of this study was to compare the microgap size between engaging (E) and non-engaging (NE) abutments and screw morphology changes between E and NE abutments using scanning electron microscopy (SEM) before and after cyclic loading (CL). METHODS: Thirty-six implants were arranged into four groups as follows: Group 1, single units with E abutments; Group 2, single units with NE abutments; Group 3, three-unit fixed partial dentures with a hemi-engaging design; and Group 4, three-unit FPDs with two NE abutments. The microgap was evaluated using a stereomicroscope. SEM was used to qualitatively evaluate screw morphology. The specimens were subjected to axial loading first and then lateral loading (30°) using the settings; one million cycles (1.0 × 106 cycles) for each loading axis. RESULTS: There were no significant differences detected in the microgap sizes between the E and NE abutment groups. In addition, there were no significant changes in the microgap sizes after CL in the E or NE abutment specimens. More damage to the screws was noticed after CL compared to before, with no difference in the patterns of damage detected between the E and NE abutments. CONCLUSIONS: No significant difference in microgap size was detected between the E and NE abutments. Furthermore, there was no significant difference in microgap size between the different prosthetic designs. From the SEM qualitative evaluation, there were similar screw morphology changes after CL between the E and NE abutments.

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Phantom limb pain, a common challenge for amputees, lacks effective treatment options. Vibration therapy is a promising non-pharmacologic intervention for reducing pain intensity, but its efficacy in alleviating phantom limb pain requires further investigation. This study focused on developing prosthesis liners with integrated vibration motors to administer vibration therapy for phantom limb pain. The prototypes developed for this study addressed previous issues with wiring the electronic components. Two transfemoral amputees participated in a four-week at-home trial, during which they used the vibration liner and rated their initial and final pain intensity on a numeric rating scale each time they had phantom pain. Semi-structured interviews were conducted to gather feedback following the at-home trial. Both participants described relaxing and soothing sensations in their residual limb and phantom limb while using vibration therapy. One participant reported a relaxation of his phantom limb sensations, while both participants noted a decrease in the intensity of their phantom limb pain. Participants said the vibration liners were comfortable but suggested that the vibration could be stronger and that aligning the contacts could be easier. The results of this study highlight the potential effectiveness of using vibration therapy to reduce the intensity of phantom limb pain and suggest a vibration liner may be a feasible mode of administering the therapy. Future research should address optimizing the performance of the vibration liners to maximize their therapeutic benefits.

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OBJECTIVE: Investigating doctors' communicative practices for recommending surgery to amputees when the proposal counters patients' expectation. METHOD: Conversation Analysis of 77 videorecorded medical consultations at an Italian prosthesis clinic. RESULTS: Compared to the direct format doctors used to prescribe prosthesis, when suggesting surgery doctors adopted a more circuitous, indirect approach. They used a range of communication strategies, orientating to patients' likely resistance - indeed, patients were frequently observed to reject surgical options. CONCLUSIONS: Considering patients' expectations is part of a patient centred approach, hence the cautious ways in which doctors introduce the option of surgery. Moreover, doctors do not pursue recommending surgery when patients display their reluctance or resistance. PRACTICE IMPLICATIONS: Doctors in prosthetics clinics might adopt a more balanced communicative strategy that takes into account patients' perspectives, concerns and expectations, whilst but also providing patients with the necessary information to collaborate meaningfully to decision making.

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Noise is generally considered to be detrimental. In the right conditions, however, noise can improve signal detection or information transmission. This counterintuitive phenomenon is called stochastic resonance (SR). SR has generated significant interdisciplinary interest, particularly in physics, engineering, and medical and environmental sciences. In this review, we discuss a growing empirical literature that suggests that noise at the right intensity may improve the detection and processing of auditory, sensorimotor, and visual stimuli. We focus particularly on applications of SR in sensory biology and investigate whether SR-based technologies present a pathway to improve outcomes for individuals living with sensory impairments. We conclude that there is considerable evidence supporting the application of SR in developing sensory prosthetics. However, the progression of SR-based technologies is variable across the sensory modalities. We suggest opportunities for further advancements in each modality, considering the best approaches to maximise benefits and capitalise on progress already made. Overall, SR can offer opportunities to improve existing technologies or to motivate innovations.

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PURPOSE: Little information is available to women with lower limb absence (LLA) and their health care providers regarding the impacts they may experience during the perinatal period. This study explores the physical impacts of pregnancy on women with LLA, including mobility, prosthesis fit and prosthesis use. METHODS: We conducted semi-structured interviews with 19 women with LLA who had experienced pregnancy in the last 10 years. Interviews were analyzed using thematic analysis. RESULTS: Substantial variation exists in the experience of women's physical symptoms, prosthesis management and mobility. Physical symptoms were similar to any pregnant individual, but the impacts were more substantial. As volume change in the residual limb can impact prosthesis fit, self-management techniques and prosthetist adjustments were used to manage it. Pregnancy impacted the way in which women were mobile and the activities they chose to participate in. A wide variety of creative mobility solutions were utilized to complete activities including prosthesis use, assistive equipment and adaptive movement. CONCLUSIONS: Women with LLA and their health care providers must be aware of the wide range of experiences women face during pregnancy and treat each pregnancy uniquely. Planning ahead and working with a health care team can mitigate many of these challenges.

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The use of rapid prototyping technology has revolutionized the fabrication of intraoral prostheses. With the advancement of digital technology, its applications have expanded to extraoral prostheses and appliances to replace a variety of head and neck defects. The following clinical report illustrates the use of a new technique that allows the digital replication and recontouring of a stock tracheostomy tube to improve patient fit, comfort, and esthetics.

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As higher spatiotemporal resolution tactile sensing systems are being developed for prosthetics, wearables, and other biomedical applications, they demand faster sampling rates and generate larger data streams. Sparsifying transformations can alleviate these requirements by enabling compressive sampling and efficient data storage through compression. However, research on the best sparsifying transforms for tactile interactions is lagging. In this work we construct a library of orthogonal and biorthogonal wavelet transforms as sparsifying transforms for tactile interactions and compare their tradeoffs in compression and sparsity. We tested the sparsifying transforms on a publicly available high-density tactile object grasping dataset (548 sensor tactile glove, grasping 26 objects). In addition, we investigated which dimension wavelet transform-1D, 2D, or 3D-would best compress these tactile interactions. Our results show that wavelet transforms are highly efficient at compressing tactile data and can lead to very sparse and compact tactile representations. Additionally, our results show that 1D transforms achieve the sparsest representations, followed by 3D, and lastly 2D. Overall, the best wavelet for coarse approximation is Symlets 4 evaluated temporally which can sparsify to 0.5% sparsity and compress 10-bit tactile data to an average of 0.04 bits per pixel. Future studies can leverage the results of this paper to assist in the compressive sampling of large tactile arrays and free up computational resources for real-time processing on computationally constrained mobile platforms like neuroprosthetics.

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PURPOSE: Urologic prosthetics offer significant quality of life enhancements for patients with stress urinary incontinence and erectile dysfunction. Artificial urinary sphincter and penile prosthesis are the most commonly used prosthetics for these patients. Radiographic imaging offers important insight, guiding treatment when patients present with complications. Herein, we pictorialize normal radiographic findings and complications alike. METHODS: We reviewed our IRB-approved prosthetics database, highlighting patients with prosthetic complications with available imaging. We collected imaging from patients without complications for baseline reference. RESULTS: The radiographic appearance of orthotopic genitourinary prosthetics and a review of short- and long-term complications including hematoma, infection, malpositioning, leak and erosion are pictorialized. CONCLUSION: Radiologic imaging serves as a vital complement to history and physical examination, aiding in the identification of complications and potentially streamlining surgical preparations. It is important for radiologists to familiarize themselves with standard prosthetic nomenclature, normal positioning and appearance, along with imaging findings of common complications.

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A fundamentally new software method for automated measurement of morphometric parameters of computed tomographic image of the human radius has been designed. The parameters obtained by manual morphometry of computed tomograms using the RadiAnt DICOM Viewer software were compared with the results of the software product developed by us. The relative error in the measurement of morphometric parameters was about 10%. In the future, the presented software method of automated determination of morphometric parameters of the bone will enable modeling of individual prosthesis of the head of the radius based on the results of computed tomograms with consideration of the structural features of the human radius.

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