This article examines hazardous ground irregularities that remain undetectable by the white cane used by visually impaired individuals. Additionally, the development of a multi-beam laser ranging system is described. Integrated into the cane handle, this system is designed to provide comprehensive ground awareness and sufficient anticipation at a walking speed of 1 m/s. The system employs a near-infrared multi-beam laser sensor with a holographic grating generating four diamond-shaped beams, in conjunction with a high-resolution CMOS sensor. Through optical triangulation and real-time processing, the device estimates the height of obstacles or drop-offs relative to the walking surface. Vibrotactile feedback informs the user of detected hazards, with distinct vibration patterns differentiating between elevation changes and drop-offs. Preliminary trials with blind participants in controlled environments demonstrate that the system is feasible, responsive, energy-efficient, and fully compatible with conventional white cane use.

Today, there are commercially available high-performance electric wheelchairs, capa-ble of responding to strong limitations. However, despite these advancements, there is a significant portion of the population with severe disabilities who cannot access this mobility solution due to safety reasons. Indeed, either due to motor issues preventing reliable control of the wheelchair's commands, or associated visual or cognitive pathologies, the use of an electric wheelchair by these individuals would put them at risk and could also constitute a danger to those around them. This is why our research team is working on the development of augmented wheelchairs that allow a greater autonomy. We are mainly developing a system compatible with all electric wheel-chairs on the market, capable of making them anti-collision and anti-fall on uneven ground (sidewalks, stairs, etc.). In this article, we present our solution regarding the anti-collision function, in particular the sensors used to do this, as well as the strategy. We will focus on the shortcomings and weaknesses of various types of sensors and demonstrate how, by combining them in a certain way, we can develop a collision avoidance device capable of managing the diversity of everyday life situations. The two types of sensors that will be combined here are an in-house developed special near infrared sensor from the laboratory and a commercially available ultrasonic sensor. We will present the internal operation of the sensors, their limitations, experimental tests involving integration with the wheelchair, and the structure of the complete device.

We present a protocol for evaluating the efficiency of an electronic white cane for improving the mobility of blind people. The electronic cane used during the test is the Tom Pouce III, made of LIDAR sensors (light detection and ranging) with tactile feedback. The protocol comprises two parts. The first part, the "detection test", evaluates the efficiency of the sensors in the Tom Pouce III for detecting the obstacles found in everyday life (thin and large poles, apertures) under different environmental conditions (darkness, sun light, rain). The second part of the test, the "mobility test", compares the ability of blind participants to cross a 25 m path by avoiding obstacles with the simple white cane and the electronic cane. The 12 blind participants had between 2 and 20 years of experience of everyday usage of Tom Pouce devices. The results show a significant improvement in the capacity to avoid obstacles with the electronic cane relative to the simple white cane, and there was no speed difference. There was no correlation between the results and the years of experience of the users.

Due to pathologies or age-related problems, in some disabled people, motor impairment is associated with cognitive and/or visual impairments. This combination of limitations unfortunately leads to an inability to move around independently. Indeed, their situation does not allow them to use a conventional electric wheelchair, for safety reasons, and for the moment there is no other technological solution providing safe movement capacity. This lack of access to an autonomous travel solution has the consequence of weakening the intellectual, personal, social, cultural and moral development, as well as the life expectancy, of the people concerned. In this context, our team is working on the development of an optoelectronic system that secures the displacement of electric wheelchairs. This is a large project that requires the development of several functionalities such as: the anti-collision of the wheelchair with its environment, the prevention of falls from the wheelchair on uneven levels, and the adaptation of the system mechanically and electronically to the majority of commercially available electric wheelchair models, among others. In this article, we introduce our solution for detecting dangerous height differences, also called “negative obstacles”, through the creation of a dedicated sensor. This sensor works by optical triangulation and can embed several laser beams in order to extend its detection zone. It has the particularity of being robust in direct sunlight and rain and has a sufficiently high measurement rate to be suitable for the displacement of electric wheelchairs. We develop an adapted algorithm, and point out compromises, in particular between the orientation of the laser beams and the maximal speed of the wheelchair.

To assess the performance of 405 nm–induced autofluorescence for the characterization of primary liver nodules on ex vivo resected specimens. Forty resected liver specimens bearing 53 primary liver nodules were included in this IRB-approved prospective study. Intratissular spectroscopic measurements were performed using a 25-G fibered-needle on all ex vivo specimens: 5 autofluorescence measurements were performed in both nodules and adjacent parenchyma. The spectra derivatives of the 635 and 670 nm autofluorescence peaks observed in nodules and in adjacent liver parenchyma were compared (Kruskal–Wallis and Mann–Whitney when appropriate). A total of 42 potentially evolutive primary liver nodules—34 hepatocellular carcinomas, 4 intrahepatic cholangiocarcinomas, 4 hepatocellular adenomas—and 11 benign nodules—5 focal nodular hyperplasias, 6 regenerative nodules—were included. Both 635 and 670 nm Δderivatives were significantly higher in benign as compared to potentially evolutive (PEV) nodules (respectively 32.9 ± 4.5 vs 15.3 ± 1.4; p < 0.0001 and 5.7 ± 0.6 vs 2.5 ± 0.1; p < 0.0001) with respective sensitivity and specificity of 78% and 91% for distinguishing PEV from benign nodules. 405 nm–induced autofluorescence enables the discrimination of benign from PEV primary liver nodules, suggesting that autofluorescence imaging could be used to optimize US targeted liver biopsies. • 405 nm–induced autofluorescence can distinguish liver tumors from the adjacent liver parenchyma. • The analysis of autofluorescence imaging observed within primary liver tumors can discriminate benign tumors from those requiring follow-up or targeted liver biopsy. • In current practice, autofluorescence imaging could be embedded within biopsy needle, to enable, in addition to ultrasound guidance, optimal targeting of liver nodules which could optimize tissue sampling.

Presentation and analysis of the first experimentation of autonomous navigation, for a young man suffering from category 4 blindness, associated with disorders of the sensitivity of the limbs, moving thanks to the feelings of the accelerations and decelerations of an anti-collision and anti-fall electric wheelchair.

For many people around the world, electric wheelchairs remain a practical means of regaining mobility. Unfortunately, some are not able to use power wheelchairs because of difficulties using a standard joystick. People suffering from neuromuscular diseases who experience a loss in muscular strength can find it difficult to use a standard joystick. In this paper, we explore an alternative steering device in the form of a tactile interface on smartphones. We outline some design choices that are meant to alleviate some of the challenges that may rise with respect to users with neuromuscular diseases. We then detail a study that investigates the usability of this interface over two phases. In the first one, 11 users with neuromuscular diseases tried this type of steering in free learning sessions. 4 among them took part in the second phase where we tested their kinematic performance between the use of the tactile steering interface and the joystick. The paper presents data and observations from both phases and tries to detect tendencies and draw hypotheses that can guide further in-depth clinical testing of the tactile steering for wheelchair users suffering from neuromuscular diseases. Overall, the user performance with the tactile interface was close to or the same as their performance with the joystick. In addition, the users reported a lesser level of physical demand of the tactile steering over the joystick and some of them even preferred the former over the latter.

Les fauteuils roulants electriques constituent un moyen efficace de retrouver une certaine mobilite pour de nombreuses personnes dans le monde. Malheureusement, certaines ne sont pas en mesure d'utiliser un fauteuil roulant electrique en raison de difficultes eprouvees lors de l'utilisation d'un joystick standard. Les personnes atteintes de maladies neuromusculaires souffrant d'une perte de force musculaire ont du mal a utiliser un joystick. Dans cet article, nous explorons l'utilisation d'une interface tactile sur un smartphone pour le pilotage de fauteuils roulants electriques. Onze utilisateurs atteints de maladies neuromusculaires ont teste notre prototype lors de seances d'initiation. Parmi eux, quatre ont pu participer a une experience dans laquelle nous avons evalue leur performance cinematique lors de l’utilisation de l’interface de pilotage tactile et du joystick. Cet article presente des donnees et des observations issues de ces deux campagnes (initiation et evaluation), met en evidence des tendances et degage des hypotheses qui peuvent guider vers des essais cliniques plus approfondis concernant le pilotage tactile pour des utilisateurs de fauteuils roulants souffrant de maladies neuromusculaires. Dans l’ensemble, les performances des utilisateurs avec la tablette etaient proches de celles du joystick. En outre, les utilisateurs ont signale un sentiment de moindre fatigue physique avec l'interface tactile par rapport au joystick

Power wheelchairs remain an efficient means of regaining mobility for many people around the world. Unfortunately, some are not able to use power wheelchairs because of difficulties using a standard joystick. People with neuromuscular diseases who experience a loss in muscular strength find it difficult to use of a joystick. In this paper, we explore steering power wheelchairs using a tactile interface on a smartphone. Eleven users with neuromuscular diseases tried this type of steering in free learning sessions. Four among them were able to take part in an experiment where we evaluated their kinematic performance between the use of the tactile steering interface and the joystick. The paper presents data and observations from both sessions and tries to detect tendencies and draw hypotheses that can guide further and in-depth clinical testing of the tactile steering for wheelchair users suffering from neuromuscular diseases. Overall, the user performance with the tablet was close or the same as their performance with the joystick. In addition, the users reported a lesser level of physical demand of the tactile steering over the joystick Les fauteuils roulants électriques constituent un moyen efficace de retrouver une certaine mobilité pour de nombreuses personnes dans le monde. Malheureusement, certaines ne sont pas en mesure d'utiliser un fauteuil roulant électrique en raison de difficultés éprouvées lors de l'utilisation d'un joystick standard. Les personnes atteintes de maladies neuromusculaires souffrant d'une perte de force musculaire ont du mal à utiliser un joystick. Dans cet article, nous explorons l'utilisation d'une interface tactile sur un smartphone pour le pilotage de fauteuils roulants électriques. Onze utilisateurs atteints de maladies neuromusculaires ont testé notre prototype lors de séances d'initiation. Parmi eux, quatre ont pu participer à une expérience dans laquelle nous avons évalué leur performance cinématique lors de l’utilisation de l’interface de pilotage tactile et du joystick. Cet article présente des données et des observations issues de ces deux campagnes (initiation et évaluation), met en évidence des tendances et dégage des hypothèses qui peuvent guider versdes essais cliniques plus approfondis concernant le pilotage tactile pour des utilisateurs de fauteuils roulants souffrant de maladies neuromusculaires. Dans l’ensemble, les performances des utilisateurs avec la tablette étaient proches de celles du joystick. En outre, les utilisateurs ont signalé un sentiment de moindre fatigue physique avec l'interface tactile par rapport au joystick

Power Wheelchairs can be a necessity for many people to have a certain level of mobility. Unfortunately, some of them may not be able to use one because they cannot safely manipulate a joystick. In a previous study, we proposed a tactile interface to steer power wheelchairs and started a first round of experimentation with able-bodied users. In this paper, we present recent tests of our steering interface in both formal and informal settings with some users with mobility impairment from different profiles. In the formal tests, two wheelchair users performed three different common tasks: straight line following, 90° corner and doorway passing with both our tactile steering interface and a joystick. The steering performance of the tactile interface was close or similar to that of the joystick. We also outline lessons that we learned from these tests for future improvements.

OBJECTIVES:To assess the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses in freshly removed surgical specimens, in preparation for its clinical development.METHODS:Sixty-four breast masses from consenting patients who had undergone either a lumpectomy or a mastectomy were included. Label-free fluorescence spectral acquisitions were obtained with a 25G fibre-containing needle inserted into the mass. Data from benign and malignant masses were compared to establish the most discriminating thresholds and measurement algorithms. Accuracy was verified using the bootstrap method.RESULTS:The final histological examination revealed 44 invasive carcinomas and 20 benign lesions. The maximum intensity of fluorescence signal was discriminant between benign and malignant masses (p < .0001) whatever their sizes. Statistical analysis indicated that choosing five random measurements per mass was the best compromise to obtain high sensitivity and high negative predictive value with the fewest measurements. Thus, malignant tumours were identified with a mean sensitivity, specificity, negative and positive predictive value of 98.8%, 85.4%, 97.2% and 93.5%, respectively.CONCLUSION:This new in situ tissue autofluorescence evaluation device allows accurate discrimination between benign and malignant breast masses and deserves clinical development.KEY POINTS:• A new device allows in situ label-free fluorescence analysis of ex vivo breast masses • Maximum fluorescence intensity discriminates benign from malignant masses (p < .0001) • Five random measurements allow a high negative predictive value (97.2%).

Breast lesions diagnosis and characterization need additional cost-effective techniques to avoid unnecessary invasive procedures, such as core needle biopsies, in the case of benign tumors. Endogenous fluorescence is an effective method to highlight in situ metabolic and/or structural changes between cancerous and non-cancerous lesions. In this context, we developed an original set-up, consisting of a 405 nm laser diode transmitting light through a 25 Gauge (0.45 mm x 50mm) 14° sharp fibered needle to excite intranodular fluorophores around the needle tip and providing real-time labelfree fluorescence spectral analysis of lesions from 450 nm to 650 nm. The objective was to help radiologists to classify suspicious masses in vivo and in real-time within the lesion. We reported the results of spectral differences between 14 invasive lobular carcinomas and 6 intraductal papilloma enrolled in a clinical study.

Power wheelchairs are, for many people, the only way to regain an autonomy of mobility. Unfortunately, some categories of people with disabilities do not have access to one because of the incompatibility of the classical steering device (joystick) with their disability. In a previous publication, we introduced a new tactile interface for steering a wheelchair. In this paper, we present a pilot kinematic evaluation of this interface. We analyzed the performance of able bodied users with the joystick and with the touch interface according to different stability criteria of the piloting in three different situations: straight line following, 90° corner and doorway passing. The overall performance of the tactile interface was close to the joystick's and opens up to some improvement strategies before a clinical study with targeted users.

Purpose - The purpose of this paper is to design and test effective indoor navigation solutions for visually impaired people in situations where GPS, bluetooth or Wi-Fi signals are unavailable. The authors use the inertial measurement units (IMU), the compass and the barometer of a smart phone. Design/methodology/approach - The authors have used commercial Android smart phones with IMU, compass and barometer to record a path and to give navigation instructions in an adapted way using a mobility-specific vocabulary. The method proposed is to save paths taking into account different indoor waypoints such as the stairs (change from one floor to another) and the change of direction of the trajectory of the path (e.g. one-fourth turn right or left), recording data from the IMU sensor's, compass and barometer of the smart phone. Having this information and the characteristics of the each segment (distance, azimuth to the north and pressure) of the path, it is possible to provide functional navigation guidance to the visually impaired subject. Three different visually impaired people (one partially sighted and two fully blind) and three sighted people have tested the paths. The efficiency of the navigation is analyzed in terms of distance and time using the comparison between blind and sighted people. Findings - The main finding is that it is possible to guide visually impaired people some hundreds of meters just using the sensors of a smart phone under certain conditions: the visually impaired person has to understand the guidance instructions and respect some strategies (e.g. not to walk diagonally across vast spaces). Additionally it is observed that the visually impaired participants walked distances, which are not much different to the optimal values. On the other hand; because of their hesitations using their white cane to find free paths, they take in some cases 50 percent more time to arrive (for a few minutes path, this time is not critical and even more efficient than looking for a guide). One thing to highlight is that even with this hesitation, the subjects arrived to the final destination. Originality/value - This paper demonstrates how an IMU coupled to a compass and a barometer from a Smart Phone employing a spoken mobility language (e.g. next corridor to the left; at the end of the stairs turn right, turn left, etc.) can guide visually impaired people inside buildings.

In the framework of an augmented multimodal electric wheelchair for people with multiple disabilities, we propose a new user interface based on an Android application on a tablet to steer the wheelchair. The proposed system aims at overcoming some of the problems encountered with the traditional joystick interface like the involuntary arm extensions due to spasticity conditions. These often lead to unwanted movement of the chair and, in many cases, to accidents. The application uses different output modalities to allow the user keep his/her attention on the navigation task without having to visually focus on the tablet screen. We conducted some preliminary tests with some people with disabilities to engage them in the design process and get their feedback on the first prototype. The general impression was positive with insight on future improvements to the system.

The GPS devices adapted for the visually impaired people are used most of the time in urban areas. Additionally, the heading of the GPS is not updated correctly in pedestrian navigation. If the person hesitates at low speed and losses his orientation, he has to walk some tens of meters in order to have updated information. Another technical problem is that the GPS signal can be lost because of bad reception conditions. To reduce the technical problems, the authors propose a GPS-IMU (accelerometers and gyrometers) coupled to a compass app. In our approach, this system is used to give the possibility to the visually impaired people to hike without sighted intervention. The application has two parts; one part to save the GPS coordinates of the path in situ with the corresponding comments and the other part to navigate. The tests were done with three visually impaired (two partially blind people and a fully blind person) experts in the use of the app during the night in 4.65 km road passing from urban areas and rustic paths. The results were presented taking into considerations the rate between the average speed in doing the turnings of the path and the average speed in straight lines. The results are very encouraging because the three visually impaired people arrived to the final destination without any kind of sighted help even in extreme conditions of the tests (the rustic path was not clear enough to be detected with the white cane and the tests were done in a rainy day during the night).

Background Pre-therapeutic pathological diagnosis is a crucial step of the management of pulmonary nodules suspected of being non small cell lung cancer (NSCLC), especially in the frame of currently implemented lung cancer screening programs in high-risk patients. Based on a human ex vivo model, we hypothesized that an embedded device measuring endogenous fluorescence would be able to distinguish pulmonary malignant lesions from the perilesional lung tissue. Methods Consecutive patients who underwent surgical resection of pulmonary lesions were included in this prospective and observational study over an 8-month period. Measurements were performed back table on surgical specimens in the operative room, both on suspicious lesions and the perilesional healthy parenchyma. Endogenous fluorescence signal was characterized according to three criteria: maximal intensity (Imax), wavelength, and shape of the signal (missing, stable, instable, photobleaching). Results Ninety-six patients with 111 suspicious lesions were included. Final pathological diagnoses were: primary lung cancers (n = 60), lung metastases of extra-thoracic malignancies (n = 27) and non-tumoral lesions (n = 24). Mean Imax was significantly higher in NSCLC targeted lesions when compared to the perilesional lung parenchyma (p<0,0001) or non-tumoral lesions (p<0,0001). Similarly, photobleaching was more frequently found in NSCLC than in perilesional lung (p<0,0001), or in non-tumoral lesions (p<0,001). Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions. Considering lung metastases, both mean Imax and wavelength of the targeted lesions were not different from those of the perilesional lung tissue. In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01). Conclusion Our results demonstrate that endogenous fluorescence applied to the diagnosis of lung nodules allows distinguishing NSCLC from the surrounding healthy parenchyma and from non-tumoral lesions. Inconclusive results were found for lung metastases due to the heterogeneity of this population.

Les premières étapes dans le diagnostic du cancer du sein sont la mammographie et l’échographie. Nous avons développé une aiguille fibrée biseautée pour effectuer pendant l’échographie une mesure de la fluorescence naturelle à l’intérieur du nodule suspect.

The main research about indoor navigation is about the use of Wi-Fi, Bluetooth or Ultra Wide band technology for locating one person in a building. These systems give an absolute position of the person; however, it is mandatory to put the hotspots of every technology in the building for calculating this position. An Inertial Measurement Unit is usually placed on the foot because, it is easier to compute the distance. The aim of this work is to use inexpensive sensors which come in a Smart Phone, which are handheld, or belt mounted for guiding one visually impaired in two main tests: the subway station and the commercial center. We are not intending neither to put any hotspot or landmarks on the place nor to use the IMU on the foot for ergonomic reasons. The results and performances are better in the subway stations than in the commercial centers.