Reconstruction of critical-sized bone defects remains a tremendous challenge for surgeons worldwide. Despite the variety of surgical techniques, current clinical strategies for bone defect repair demonstrate significant limitations and drawbacks, including donor-site morbidity, poor anatomical match, insufficient bone volume, bone graft resorption, and rejection. Bone tissue engineering (BTE) has emerged as a novel approach to guided bone tissue regeneration. BTE focuses on in vitro manipulations with seed cells, growth factors and bioactive scaffolds using bioreactors. The successful clinical translation of BTE requires overcoming a number of significant challenges. Currently, insufficient vascularization is the critical limitation for viability of the bone tissue-engineered construct. Furthermore, efficacy and safety of the scaffolds cell-seeding and exogenous growth factors administration are still controversial. The in vivo bioreactor principle (IVB) is an exceptionally promising concept for the in vivo bone tissue regeneration in a predictable patient-specific manner. This concept is based on the self-regenerative capacity of the human body, and combines flap prefabrication and axial vascularization strategies. Multiple experimental studies on in vivo BTE strategies presented in this review demonstrate the efficacy of this approach. Routine clinical application of the in vivo bioreactor principle is the future direction of BTE; however, it requires further investigation for to overcome some significant limitations.
In our study, we tested a combination of virtual reality (VR) and robotics in the original adjuvant method of post-stroke lower limb walk restoration in acute phase using a simulation with visual and tactile biofeedback based on VR immersion and physical impact to the soles of patients. The duration of adjuvant therapy was 10 daily sessions of 15 min each. The study showed the following significant rehabilitation progress in Control ( N = 27) vs. Experimental ( N = 35) groups, respectively: 1.56 ± 0.29 (mean ± SD) and 2.51 ± 0.31 points by Rivermead Mobility Index ( p = 0.0286); 2.15 ± 0.84 and 6.29 ± 1.20 points by Fugl-Meyer Assessment Lower Extremities scale ( p = 0.0127); and 6.19 ± 1.36 and 13.49 ± 2.26 points by Berg Balance scale ( p = 0.0163). P -values were obtained by the Mann–Whitney U test. The simple and intuitive mechanism of rehabilitation, including through the use of sensory and semantic components, allows the therapy of a patient with diaschisis and afferent and motor aphasia. Safety of use allows one to apply the proposed method of therapy at the earliest stage of a stroke. We consider the main finding of this study that the application of rehabilitation with implicit interaction with VR environment produced by the robotics action has measurable significant influence on the restoration of the affected motor function of the lower limbs compared with standard rehabilitation therapy.
Natural biopolymers demonstrate significant bone and connective tissue-engineering application efficiency. However, the quality of the biopolymer directly depends on microstructure and biochemical properties. This study aims to investigate the biocompatibility and microstructural properties of demineralized human spongiosa Lyoplast® (Samara, Russian Federation). The graft’s microstructural and biochemical properties were analyzed by scanning electron microscopy (SEM), micro-computed tomography, Raman spectroscopy, and proteomic analysis. Furthermore, the cell adhesion property of the graft was evaluated using cell cultures and fluorescence microscopy. Microstructural analysis revealed the hierarchical porous structure of the graft with complete removal of the cellular debris and bone marrow components. Moreover, the proteomic analysis confirmed the preservation of collagen and extracellular proteins, stimulating and inhibiting cell adhesion, proliferation, and differentiation. We revealed the adhesion of chondroblast cell cultures in vitro without any evidence of cytotoxicity. According to the study results, demineralized human spongiosa Lyoplast® can be effectively used as the bioactive scaffold for articular hyaline cartilage tissue engineering.
A P300 brain-computer interface (BCI) is a paradigm, where text characters are decoded from event-related potentials (ERPs). In a popular implementation, called P300 speller, a subject looks at a display where characters are flashing and selects one character by attending to it. The selection is recognized as the item with the strongest ERP. The speller performs well when cortical responses to target and non-target stimuli are sufficiently different. Although many strategies have been proposed for improving the BCI spelling, a relatively simple one received insufficient attention in the literature: reduction of the visual field to diminish the contribution from non-target stimuli. Previously, this idea was implemented in a single-stimulus switch that issued an urgent command like stopping a robot. To tackle this approach further, we ran a pilot experiment where ten subjects operated a traditional P300 speller or wore a binocular aperture that confined their sight to the central visual field. As intended, visual field restriction resulted in a replacement of non-target ERPs with EEG rhythms asynchronous to stimulus periodicity. Changes in target ERPs were found in half of the subjects and were individually variable. While classification accuracy was slightly better for the aperture condition (84.3 ± 2.9%, mean ± standard error) than the no-aperture condition (81.0 ± 2.6%), this difference was not statistically significant for the entire sample of subjects (N = 10). For both the aperture and no-aperture conditions, classification accuracy improved over 4 days of training, more so for the aperture condition (from 72.0 ± 6.3% to 87.0 ± 3.9% and from 72.0 ± 5.6% to 97.0 ± 2.2% for the no-aperture and aperture conditions, respectively). Although in this study BCI performance was not substantially altered, we suggest that with further refinement this approach could speed up BCI operations and reduce user fatigue. Additionally, instead of wearing an aperture, non-targets could be removed algorithmically or with a hybrid interface that utilizes an eye tracker. We further discuss how a P300 speller could be improved by taking advantage of the different physiological properties of the central and peripheral vision. Finally, we suggest that the proposed experimental approach could be used in basic research on the mechanisms of visual processing.
The paper presents an augmented reality based solution for hand movement rehabilitation using visual and tactile feedback. The proposed approach to the rehabilitation process combines the effects on visual, auditory and tactile channels of perception and simulation scenarios. In order to develop a hand movement model capable of solving rehabilitation tasks there was studied the concept of immersive virtual reality. Original 3D models and scenes have been developed to simulate the basic hand positions and motor functions. To provide efficient hand motion fixation it is recommended to implement a mechanical position tracking system based on a sensor glove improved by using the resistive transducers. Augmented reality is implemented to inspire and motivate the user to perform the required exercises by generating the corresponding pictures. Personalized comparative analysis of the dynamics of the patient's initial condition and rehabilitation results help to study the motor function and restore everyday skills. The proposed solution allows achieving accuracy and adequacy of fingers movements sufficient to satisfy the requirements of medical rehabilitation applications.
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