Difference between revisions of "Team:Pasteur Paris/Scenario"

 
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             <div id="indexContent">
 
             <div id="indexContent">
 +
<p><a href="#Introduction" class="link">Introduction</a></p>
 
                 <p><a href="#Choice" class="link">NeuronArch’s choice</a></p>
 
                 <p><a href="#Choice" class="link">NeuronArch’s choice</a></p>
 
                 <p><a href="#Implant" class="link">Surgical implantation</a></p>
 
                 <p><a href="#Implant" class="link">Surgical implantation</a></p>
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         </div>
 
         <div id="MainContent">
 
         <div id="MainContent">
 +
<div class="block title">
 +
                <h1 id="Introduction">Introduction</h1>
 
             <div class="block full">
 
             <div class="block full">
                 <p>Sometimes, severe injuries lead to amputation. Civilians as well as soldiers may be concerned, due to accidents, vascular issues, or even artillery wounds for the last category. Amputations are more frequently located on lower limbs<sup>[1]</sup> (<b>Figure 1</b>). However, bionic prostheses are nowadays developed mainly for the arms, not for the legs. For the prosthetic industry, designing bionic arms is more challenging because of its capacity to push technological boundaries in order to reproduce movements, sense of feeling, etc. Based on this observation, we focused on a trans-humeral amputation scenario. Nevertheless, NeuronArch’s solution is transposable in different anatomical amputation locations.</p>
+
                 <p>Sometimes, severe injuries unfortunately lead to amputation. Civilians as well as soldiers may be concerned, due to accidents, vascular issues, or even artillery wounds for the last category. Amputations are more frequently located on lower limbs<sup>[1]</sup> (<b>Figure 1</b>). However, bionic prostheses are nowadays developed mainly for the arms, not for the legs. For the prosthetic industry, designing bionic arms is more challenging because of its capacity to push technological boundaries in order to reproduce movements, sense of feeling, etc. Based on this observation, we focused on a trans-humeral amputation scenario. Nevertheless, NeuronArch’s solution is transposable in different anatomical amputation locations.</p>
                 <img src="https://static.igem.org/mediawiki/2018/e/e2/T--Pasteur_Paris--Scenario_Figure_1.svg">
+
                 <img src="https://static.igem.org/mediawiki/2018/b/b5/T--Pasteur_Paris--Scenario_Figure_1V2.svg">
 
                 <div class="legend"><b>Figure 1: </b>Amputation locations</div>
 
                 <div class="legend"><b>Figure 1: </b>Amputation locations</div>
 
             </div>
 
             </div>
             <div class="block title"><h3 style="text-align: left;">NeuronArch’s choice</h3></div>
+
             <div class="block title"><h3 id="Choice" style="text-align: left;">NeuronArch’s choice</h3></div>
 
             <div class="block full">
 
             <div class="block full">
                 <p>After a serious accident, the patient is transferred to a hospital. The doctor makes a diagnosis: the injury is too severe and amputation is inevitable. If the situation allows, medical staff presents different relevant options to the patient. The first option is a classic amputation procedure. At best, it would allow the patient to have a myo-electrical prosthesis. The second option is the NeuronArch solution. The NeuronArch device would allow the patient to wear bionic prothesis, while the NeuronArch app would monitor his health and prosthesis status. In addition, this solution could be partially supported by Social Security in the next few years. After weighing both options, the patient obviously goes for the NeuronArch option!</p>
+
                 <p>After a serious accident, the patient is transferred to a hospital. The doctor makes a diagnosis: the injury is too severe and amputation is inevitable. If the situation allows, medical staff presents different relevant options to the patient. The first option is a classic amputation procedure. At best, it would allow the patient to have a myoelectric prosthesis. The second option is the NeuronArch solution. The NeuronArch device would allow the patient to wear a bionic prosthesis, while the NeuronArch app would monitor his health and prosthesis status. In addition, this solution could be partially supported by Social Security in the next few years. After weighing both options, the patient obviously goes for the NeuronArch option!</p>
 
             </div>
 
             </div>
             <div class="block title"><h3 style="text-align: left;">Surgical implantation</h3></div>
+
             <div class="block title"><h3 id="Implant" style="text-align: left;">Surgical implantation</h3></div>
 
             <div class="block full">
 
             <div class="block full">
 
                 <p>The first step for a new NeuronArch holder is to order a NeuronArch kit, including:<br>
 
                 <p>The first step for a new NeuronArch holder is to order a NeuronArch kit, including:<br>
 
- the NeuronArch device, making the bridge between the stump and a bionic prosthesis;<br>
 
- the NeuronArch device, making the bridge between the stump and a bionic prosthesis;<br>
- an implantation stem featuring the engineered biofilm;<br>
+
- an implantation stem featuring the engineered biofilm<br>
- a charging station, to recharge the device and synchronize data with a distant server;<br>
+
- a charging station, to recharge the device and synchronize data with a remote server<br>
- a personal access to the app / website, to monitor information, such as device’s battery level, health status, etc.
+
- a personal access to the app/website, to monitor information, such as the device’s battery level, the patient's health status, etc.
 
</p>
 
</p>
                 <p>When the kit delivered, an orthopedic surgeon will osseointegrate the stem (<b>Figure 2</b>). This stem is sent in a sealed package. During surgery, the surgeon drills the bone in its center along its longitudinal axis, while a nurse lifts the NeuronArch stem out of the package. Thanks to a syringe, the nurse drains the culture liquid of the biofilm, contained in a protective cap. Once empty, this cap stays in place in order to allow the surgeon to manipulate the stem with surgical clips without damaging the biofilm and the membrane. The specialist inserts the stem into the bone (Figure 3). The orthopedist places some screws to hold the device in place (to be removed subsequently). The surgeon can now take the protection cap out thanks to a simple quarter turn system, and then complete the surgery by stitching the stump.</p>
+
                 <p>Once the kit has been delivered, a surgeon will osseointegrate the stem (<b>Figure 2</b>). This stem is sent in a sealed package. During surgery, the surgeon drills the bone in its center along its longitudinal axis, while a nurse lifts the NeuronArch stem out of the package. The nurse drains the culture liquid of the biofilm, contained in a protective cap with a syringe. Once empty, this cap stays in place in order to allow the surgeon to manipulate the stem with surgical clips without damaging the biofilm and the membrane. The stem is inserted into the bone (Figure 3). Some screws are placed to secure the device (to be removed subsequently). The surgeon can now take the protection cap off by a simple quarter turn system and then complete the surgery by stitching the stump.
            </div>
+
    </p>       
 +
              <p> After surgery, NeuronArch implant holder starts a rehabilitation phase. A complete healing and implant-bone adhesion is necessary before to wear the NeuronArch device and the bionic prosthesis. During this period of time, nerves start to regrow thanks to a chemical inducer medication system. Later, doctor and patient install and set up the NeuronArch device to start collecting data and machine learning.</p>
 +
</div>
 
             <div class="block two-third">
 
             <div class="block two-third">
 
                 <img src="https://static.igem.org/mediawiki/2018/0/0c/T--Pasteur_Paris--Scenario_Figure_2bis.jpg">
 
                 <img src="https://static.igem.org/mediawiki/2018/0/0c/T--Pasteur_Paris--Scenario_Figure_2bis.jpg">
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             </div>
 
             </div>
 
             <div class="block full">
 
             <div class="block full">
                 <img src="https://static.igem.org/mediawiki/2018/6/62/T--Pasteur_Paris--Scenario_Figure3bis.svg">
+
                 <img src="https://static.igem.org/mediawiki/2018/3/34/T--Pasteur_Paris--Scenario_Figure_3V2.svg">
 
                 <div class="legend"><b>Figure 3: </b>Diagrams of osseointegration steps</div>
 
                 <div class="legend"><b>Figure 3: </b>Diagrams of osseointegration steps</div>
 
             </div>
 
             </div>
             <div class="block title"><h3 style="text-align: left;">Daily life</h3></div>
+
 
 +
             <div class="block title"><h3 id="Life" style="text-align: left;">Daily life</h3></div>
 
             <div class="block full">
 
             <div class="block full">
                 <p>In the morning, after a night without, the holder plugs the NeuronArch device (<b>Figure 4</b>) and his bionic prosthesis to the stem. Installation is simple, with an ergonomic quarter turn system. His bionic arm moves in an intuitive way thanks to the connection between nerves and the prosthesis, made possible by NeuronArch. With the app he installed on his smartphone (<b>Figure 5</b>), he is now able to check the battery status of his device, to consult his health data or to take an appointment with his primary doctor or his prosthetist (<b>Figure 6</b>). </p>
+
                 <p>In the morning, after a night without, the holder plugs the NeuronArch device (<b>Figure 4</b>) and his bionic prosthesis to the stem. Installation is simple, with an ergonomic quarter turn system. His bionic arm moves in an intuitive way due to the connection between his nerves and his prosthesis, made possible by NeuronArch. With the app, he installed on his smartphone (<b>Figure 5</b>), he is now able to check the battery status of his device, consult his health data or take an appointment with his primary doctor or his prosthetist (<b>Figure 6</b>). </p>
 
             </div>
 
             </div>
 
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             </div>
 
             </div>
 
             <div class="block full">
 
             <div class="block full">
                 <p>At night, battery is low and collected data needs to be transmitted to the server, in order update his health data and to improve machine learning. Thus, the amputee removes his prosthesis and put the NeuronArch device on the charging station (<b>Figure 7</b>). After several hours, the device is charged, data is synchronized (<b>Figure 8</b>), and NeuronArch is ready to start a new day.</p>
+
                 <p>At night, the battery is low and collected data need to be transmitted to the NeuronArch server, to update them and improve machine learning. Therefore, the amputee removes his prosthesis and puts the NeuronArch device on the charging station (<b>Figure 7</b>). After several hours, the device is charged, data are synchronized (<b>Figure 8</b>), and NeuronArch is ready to start a new day.</p>
 
             </div>
 
             </div>
 
             <div class="block two-third">
 
             <div class="block two-third">
 
                 <img src="https://static.igem.org/mediawiki/2018/d/da/T--Pasteur_Paris--Scenario_Figure_7.jpg">
 
                 <img src="https://static.igem.org/mediawiki/2018/d/da/T--Pasteur_Paris--Scenario_Figure_7.jpg">
                 <div class="legend"><b>Figure 7: </b>NeuronArch device laying on charging station</div>
+
                 <div class="legend"><b>Figure 7: </b>NeuronArch device being put on its charging station</div>
 
             </div>
 
             </div>
 
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                 <div class="legend"><b>Figure 8: </b>Recharging and synchronization</div>
 
                 <div class="legend"><b>Figure 8: </b>Recharging and synchronization</div>
 
             </div>
 
             </div>
             <div class="block title"><h3 style="text-align: left;">Doctor</h3></div>
+
             <div class="block title"><h3 id="Doctor" style="text-align: left;">Doctor</h3></div>
 
             <div class="block full">
 
             <div class="block full">
                 <p>For his semestral check up, the NeuronArch holder goes to the doctor. In order to share data collected the last six months and his health status with the specialist, the patient shows his personal QR code available on the app (<b>Figure 9</b>). This code acts like a key that maintains his personal data secure. When scanning it, the doctor access to the patient’s dashboard and is now able to provide adapted advice and treatments regarding the situation. </p>
+
                 <p>For his semestral check-up, the NeuronArch holder goes to the doctor. To share data collected the last six months and his health status with the specialist, the patient shows his personal QR code available on the app (<b>Figure 9</b>). This code acts as a key that maintains his personal data secure. When scanning it, the doctor accesses to the patient’s dashboard and is now able to provide adapted advice and treatments depending on the situation. </p>
 
             </div>
 
             </div>
 
             <div class="block two-third">
 
             <div class="block two-third">
 
                 <img src="https://static.igem.org/mediawiki/2018/9/92/T--Pasteur_Paris--Scenario_Figure_9.jpg">
 
                 <img src="https://static.igem.org/mediawiki/2018/9/92/T--Pasteur_Paris--Scenario_Figure_9.jpg">
                 <div class="legend"><b>Figure 9: </b>During a medical appointment</div>
+
                 <div class="legend"><b>Figure 9: </b>Patient/doctor appointment</div>
 
             </div>
 
             </div>
             <div class="block title"><h3 style="text-align: left;">Maintenance</h3></div>
+
             <div class="block title"><h3 id="Maintenance" style="text-align: left;">Maintenance</h3></div>
 
             <div class="block full">
 
             <div class="block full">
                 <p>Whether the NeuronArch device encounter a hardware issue, maintenance is made possible (<b>Figure 10</b>). The plastic case, containing the electronic parts, can be unsealed thanks to height screws. To perform this maintenance process, a prosthetist specifically trained can open and check the whole device. If something wrong, the prosthetist will repair or replace the defective parts. The embedded SD card is encrypted, to keep personal data far from prying eyes. NeuronArch have been designed to last a life time.</p>
+
                 <p>Whenever the NeuronArch device encounters a hardware issue, maintenance is possible (<b>Figure 10</b>). The plastic case, which contains the electronic parts, can be unsealed by removing the height screws. In order to perform this maintenance task, a prosthetist specifically trained needs to open and check the whole device. If something is wrong, the prosthetist will repair or replace the defective parts. The embedded SD card is encrypted, to keep personal data far from prying eyes. NeuronArch have been designed to last a lifetime.</p>
 
             </div>
 
             </div>
 
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             <div class="block two-third">
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             <div class="block title"><h1>REFERENCES</h1></div>
 
             <div class="block title"><h1>REFERENCES</h1></div>
 
             <div class="block full">
 
             <div class="block full">
                 <ul style="text-align: left;">
+
                 <ul style="text-align: left;list-style: disc;">
 
                     <li style="list-style-type: decimal;">JM. André and J. Paysant, Les amputés en chiffres : épidémiologie, Cofemer, 2006</li>
 
                     <li style="list-style-type: decimal;">JM. André and J. Paysant, Les amputés en chiffres : épidémiologie, Cofemer, 2006</li>
 
                 </ul>
 
                 </ul>

Latest revision as of 14:53, 10 November 2018

""

Introduction

Sometimes, severe injuries unfortunately lead to amputation. Civilians as well as soldiers may be concerned, due to accidents, vascular issues, or even artillery wounds for the last category. Amputations are more frequently located on lower limbs[1] (Figure 1). However, bionic prostheses are nowadays developed mainly for the arms, not for the legs. For the prosthetic industry, designing bionic arms is more challenging because of its capacity to push technological boundaries in order to reproduce movements, sense of feeling, etc. Based on this observation, we focused on a trans-humeral amputation scenario. Nevertheless, NeuronArch’s solution is transposable in different anatomical amputation locations.

Figure 1: Amputation locations

NeuronArch’s choice

After a serious accident, the patient is transferred to a hospital. The doctor makes a diagnosis: the injury is too severe and amputation is inevitable. If the situation allows, medical staff presents different relevant options to the patient. The first option is a classic amputation procedure. At best, it would allow the patient to have a myoelectric prosthesis. The second option is the NeuronArch solution. The NeuronArch device would allow the patient to wear a bionic prosthesis, while the NeuronArch app would monitor his health and prosthesis status. In addition, this solution could be partially supported by Social Security in the next few years. After weighing both options, the patient obviously goes for the NeuronArch option!

Surgical implantation

The first step for a new NeuronArch holder is to order a NeuronArch kit, including:
- the NeuronArch device, making the bridge between the stump and a bionic prosthesis;
- an implantation stem featuring the engineered biofilm
- a charging station, to recharge the device and synchronize data with a remote server
- a personal access to the app/website, to monitor information, such as the device’s battery level, the patient's health status, etc.

Once the kit has been delivered, a surgeon will osseointegrate the stem (Figure 2). This stem is sent in a sealed package. During surgery, the surgeon drills the bone in its center along its longitudinal axis, while a nurse lifts the NeuronArch stem out of the package. The nurse drains the culture liquid of the biofilm, contained in a protective cap with a syringe. Once empty, this cap stays in place in order to allow the surgeon to manipulate the stem with surgical clips without damaging the biofilm and the membrane. The stem is inserted into the bone (Figure 3). Some screws are placed to secure the device (to be removed subsequently). The surgeon can now take the protection cap off by a simple quarter turn system and then complete the surgery by stitching the stump.

After surgery, NeuronArch implant holder starts a rehabilitation phase. A complete healing and implant-bone adhesion is necessary before to wear the NeuronArch device and the bionic prosthesis. During this period of time, nerves start to regrow thanks to a chemical inducer medication system. Later, doctor and patient install and set up the NeuronArch device to start collecting data and machine learning.

Figure 2: Stem with its protection cap
Figure 3: Diagrams of osseointegration steps

Daily life

In the morning, after a night without, the holder plugs the NeuronArch device (Figure 4) and his bionic prosthesis to the stem. Installation is simple, with an ergonomic quarter turn system. His bionic arm moves in an intuitive way due to the connection between his nerves and his prosthesis, made possible by NeuronArch. With the app, he installed on his smartphone (Figure 5), he is now able to check the battery status of his device, consult his health data or take an appointment with his primary doctor or his prosthetist (Figure 6).

Figure 4: NeuronArch device implementation
Figure 5: NeuronArch app notification
Figure 6: NeuronArch app scenario

At night, the battery is low and collected data need to be transmitted to the NeuronArch server, to update them and improve machine learning. Therefore, the amputee removes his prosthesis and puts the NeuronArch device on the charging station (Figure 7). After several hours, the device is charged, data are synchronized (Figure 8), and NeuronArch is ready to start a new day.

Figure 7: NeuronArch device being put on its charging station
Figure 8: Recharging and synchronization

Doctor

For his semestral check-up, the NeuronArch holder goes to the doctor. To share data collected the last six months and his health status with the specialist, the patient shows his personal QR code available on the app (Figure 9). This code acts as a key that maintains his personal data secure. When scanning it, the doctor accesses to the patient’s dashboard and is now able to provide adapted advice and treatments depending on the situation.

Figure 9: Patient/doctor appointment

Maintenance

Whenever the NeuronArch device encounters a hardware issue, maintenance is possible (Figure 10). The plastic case, which contains the electronic parts, can be unsealed by removing the height screws. In order to perform this maintenance task, a prosthetist specifically trained needs to open and check the whole device. If something is wrong, the prosthetist will repair or replace the defective parts. The embedded SD card is encrypted, to keep personal data far from prying eyes. NeuronArch have been designed to last a lifetime.

Figure 10: Maintenance operation

REFERENCES

  • JM. André and J. Paysant, Les amputés en chiffres : épidémiologie, Cofemer, 2006