Researchers have developed a new method for producing malleable microstructures -- for instance, vascular stents that are 40 times smaller than previously possible. In the future, such stents could be used to help to widen life-threatening constrictions of the urinary tract in fetuses in the womb. Approximately one in every thousand children develops a urethral stricture, sometimes even when they are still a fetus in the womb. In order to prevent life-threatening levels of urine from accumulating in the bladder, paediatric surgeons like Gaston De Bernardis at the Kantonsspital Aarau have to surgically remove the affected section of the urethra and sew the open ends of the tube back together again. It would be less damaging to the kidneys, however, if a stent could be inserted to widen the constriction while the fetus is still in the womb. Stents have been used to treat blocked coronary vessels for some time now, but the urinary tract in foetuses is much narrower in comparison. It's not possible to produce stents with such small dimensions using conventional methods, which is why De Bernardis approached the Multi-Scale Robotics Lab at ETH Zurich. The lab's researchers have now developed a new method that enables them to produce highly detailed structures measuring less than 100 micrometres in diameter, as they report in a recently published journal article. Indirect 4D printing "We've printed the world's smallest stent with features that are 40 times smaller than any produced to date," says Carmela De Marco, lead author of the study and Marie Sk?odowska-Curie fellow in Bradley Nelson's research group. The group calls the method they've developed indirect 4D printing. They use heat from a laser beam to cut a three-dimensional template -- a 3D negative -- into a micromould layer that can be dissolved with a solvent. Next, they fill the negative with a shape-memory polymer and set the structure using UV light. In the final step, they dissolve the template in a solvent bath and the three-dimensional stent is finished. It's the stent's shape-memory properties that give it its fourth dimension. Even if the material is deformed, it remembers its original shape and returns to this shape when warm. "The shape-memory polymer is suitable for treating urethral strictures. When compressed, the stent can be pushed through the affected area. Then, once in place, it returns to its original shape and widens the constricted area of the urinary tract," De Bernardis says. But the stents are still a long way from finding real-world application. Before human studies can be conducted to show whether they are suitable for helping children with congenital urinary tract defects, the stents must first be tested in animal models. However the initial findings are promising, "We firmly believe that our results can open the door to the development of new tools for minimally invasive surgery," De Marco says.
Purdue University researchers have developed a new fabric innovation that allows wearers to control electronic devices through clothing. "It is the first time there is a technique capable to transform any existing cloth item or textile into a self-powered e-textile containing sensors, music players or simple illumination displays using simple embroidery without the need for expensive fabrication processes requiring complex steps or expensive equipment," said Ramses Martinez, an assistant professor in the School of Industrial Engineering and in the Weldon School of Biomedical Engineering in Purdue's College of Engineering. The technology is featured in the July 25 edition of Advanced Functional Materials. "For the first time, it is possible to fabricate textiles that can protect you from rain, stains, and bacteria while they harvest the energy of the user to power textile-based electronics," Martinez said. "These self-powered e-textiles also constitute an important advancement in the development of wearable machine-human interfaces, which now can be washed many times in a conventional washing machine without apparent degradation. Martinez said the Purdue waterproof, breathable and antibacterial self-powered clothing is based on omniphobic triboelectric nanogeneragtors (RF-TENGs) -- which use simple embroidery and fluorinated molecules to embed small electronic components and turn a piece of clothing into a mechanism for powering devices. The Purdue team says the RF-TENG technology is like having a wearable remote control that also keeps odors, rain, stains and bacteria away from the user. "While fashion has evolved significantly during the last centuries and has easily adopted recently developed high-performance materials, there are very few examples of clothes on the market that interact with the user," Martinez said. "Having an interface with a machine that we are constantly wearing sounds like the most convenient approach for a seamless communication with machines and the Internet of Things." The technology is being patented through the Purdue Research Foundation Office of Technology Commercialization. The researchers are looking for partners to test and commercialize their technology. Their work aligns with Purdue's Giant Leaps celebration of the university's global advancements in artificial intelligence and health as part of Purdue's 150th anniversary. It is one of the four themes of the yearlong celebration's Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues.
While the presence of beta-amyloid plaques in the brain may be a hallmark of Alzheimer’s disease, giving patients an amyloid PET scan is not an effective method for measuring their cognitive function, according to a new study from researchers in the Perelman School of Medicine and Thomas Jefferson University. The researchers concluded that fluorodeoxyglucose (FDG) PET, which measures the brain’s glucose consumption as a marker of neural activity, is a stronger approach for assessing the progression and severity of Alzheimer’s and mild cognitive impairment (MCI) as compared to florbetapir-PET scans, which reveal amyloid protein deposits in the brain. This suggests that FDG-PET is also a better means for determining the effectiveness of Alzheimer’s therapies, as well as tracking patients’ disease advancement, in both clinical and research settings. Results of this study are detailed in the August issue of the Journal of Alzheimer’s Disease. PET imaging using the radiotracers FDG and florbetapir to quantify cognitive decline in patients with Alzheimer’s disease (AD), mild cognitive impairment (MCI), and healthy controls. (Image: Penn Medicine News) “Both florbetapir-PET and FDG-PET are approved diagnostic methods for Alzheimer’s disease, and both appear to be effective in indicating some sort of cognitive impairment. However, we have now shown that FDG-PET is significantly more precise in clinical studies, and it is also available for routine use with modest costs,” says the study’s co-principal investigator Abass Alavi, a professor of radiology at Penn. “Our results support the notion that amyloid imaging does not reflect levels of brain function, and therefore it may be of limited value for assessing patients with cognitive decline.” Two of the most significant biomarkers found in Alzheimer’s are decreased glucose uptake and the accumulation of amyloid plaques in the brain. PET scans use different radioactive drugs, called radiotracers, to measure these biomarkers within the brain tissue of patients with cognitive impairment. FDG-PET is one of the most commonly used imaging techniques to diagnose Alzheimer’s. However, in recent years, several other radiotracers, such as florbetapir, have been developed to detect the deposition of amyloid plaques. Recently, the effectiveness of amyloid imaging as a strategy for monitoring dementia symptoms has been called into question.
Certain traits may define a type of obstructive sleep apnea that can be effectively treated with an oral appliance, according to new research published online in the Annals of the American Thoracic Society. With OSA there are times during sleep when air cannot flow normally into the lungs. The collapse of the soft tissues in the back of the throat or tongue usually causes the airflow obstruction. Continuous positive airway pressure, or CPAP, is considered the gold standard for preventing the obstruction by blowing air through a mask into the nose and throat. However, many patients have trouble sleeping with CPAP. For these patients, an oral appliance that moves the lower jaw forward to prevent the periods of obstructed airflow is often an alternative. In "Polysomnographic Endotyping to Select Obstructive Sleep Apnea Patients for Oral Appliances," Ahmad A. Bamagoos and colleagues identify five traits that appear to determine the effectiveness of an oral appliance in treating OSA. "Sleep apnea is not all the same, but we only recently developed ways to look at a sleep study and determine what traits cause the condition in different patients," said senior author Scott Sands, PhD, assistant professor of medicine at Harvard Medical School and Brigham and Women's Hospital in Boston. "Since oral appliances work by improving the collapsibility of the upper airway, patients without really severe collapsibility are more likely to benefit from an oral appliance, while those with sleep apnea caused by other traits, such as exaggerated reflex responses to drops in oxygen levels, are less likely to benefit." The researchers used their new technology to measure the traits causing sleep apnea through polysomnography, the test used to diagnose sleep apnea. For this study, the researchers analyzed polysomnographic data already gathered from 93 adults (average age: 56) who were diagnosed with moderate to severe OSA. The authors looked at two traits related to the upper airway: collapsibility and muscle compensation. The researchers found that patients without severe collapsibility benefitted more from the oral appliance than those without this trait. Those with a weaker reflex response of the throat muscles that act to maintain an open airway (lower muscle compensation) also benefitted more than those with a stronger reflex response. Patients with very mild collapsibility, indicating deficits in other traits, responded less well. The researchers also found that three traits unrelated to the upper airway helped predict those patients who would respond less well to an oral appliance: higher loop gain, lower arousal threshold and higher ventilatory response to arousal. Loop gain is a measure of how aggressively the brain and lungs respond to falling oxygen and rising carbon dioxide in the blood. Arousal threshold is a measure of how easily a person wakes up from sleep; deeper sleep (higher arousal threshold) promotes better breathing. Based on these five traits, oral appliances were predicted to be effective in treating sleep apnea in more than half (61 percent) of the participants. Patients in this group experienced a 73 percent reduction in the Apnea-Hypopnea Index, which is the number of breathing pauses per hour lasting 10 seconds or longer. (Apnea means no airflow and hypopnea means reduction in airflow). With an oral appliance, they had just eight apneas/hypopneas per hour. The other patient group experienced a smaller reduction in the Apnea-Hypopnea Index and had twice the number of breathing pauses remaining with the oral appliance. The authors said that responses to oral appliances in their study could not be predicted by the severity of sleep apnea or how overweight patients were. "Surprisingly, it didn't seem to matter whether sleep apnea was moderate or very severe," Dr. Sands said. "Oral appliance therapy was remarkably effective in some quite overweight patients with very severe OSA." Based on these findings, the authors write that, if their results are upheld in future studies, an oral appliance could be considered, along with CPAP, as a first-line therapy for treating a certain type of OSA. "While CPAP is great for some, there remains a large group of patients who really struggle with it," Dr. Sands said. "For these folks, this study highlights the potential benefit of measuring the underlying causes of their sleep apnea to estimate whether an oral appliance might be an equivalent or better choice over CPAP for the treatment of their sleep apnea." Dr. Sands added that once the most useful measures for predicting patient outcomes are established, he believes they will be readily incorporated into routine sleep recording systems.
Patients fitted with an orthopedic prosthetic commonly experience a period of intense pain after surgery. In an effort to control the pain, surgeons inject painkillers into the tissue during the operation. When that wears off a day or two later, the patients are given morphine through a catheter placed near the spine. Yet catheters are not particularly comfortable, and the drugs spread throughout the body, affecting all organs. Researchers in EPFL's Microsystems Laboratory are now working on a biodegradable implant that would release a local anesthetic on-demand over several days. Not only would this implant reduce patients' post-op discomfort, but there would be no need for further surgery to remove it. They developed a tiny biodegradable electronic circuit, made from magnesium, that could be heated wirelessly from outside the body. Once integrated into the final device, the circuit will allow to release controlled amounts of anesthetic in a specific location over several days. After that, the implant will degrade safely inside the body. This research has been published in Advanced Functional Materials. One capsule with several reservoirs The electronic circuit -- a resonant circuit in the shape of a small spiral -- is just a few microns thick. When exposed to an alternating electromagnetic field, the spiral resonator produces an electric current that creates heat. The researchers' end-goal is to pair the resonators with painkiller-filled capsules and then insert them into the tissue during surgery. The contents of the capsules could be released when an electromagnetic field sent from outside the body melts the capsule membrane. "We're at a key stage in our project, because we can now fabricate resonators that work at different wavelengths," says Matthieu Rüegg, a PhD student and the study's lead author. "That means we can release the contents of the capsules individually by selecting different frequencies." The heat-and-release process should take less than a second. A novel manufacturing technique The researchers had to get creative when it came time to manufacture their biodegradable resonators. "We immediately ruled out any fabrication process that involved contact with water, since magnesium dissolves in just a few seconds," says Rüegg. They ended up shaping the magnesium by depositing it on a substrate and then showering it with ions. "That gave us more flexibility in the design stage," he adds. They were eventually able to create some of the smallest magnesium resonators in the world: two microns thick, with a diameter of three millimeters. The team's invention is not quite ready for the operating room. "We still need to work on integrating the resonators into the final device and show that it's possible to release drugs both in vitro and in vivo," concludes Ruegg.
As part of the SMC Corporation, which operates in 83 countries and runs more than 31 production facilities, SMC Deutschland GmbH offers a comprehensive portfolio of products ranging from valves to thermo-chillers in more than 12,000 basic models and over 700,000 variants to suit a whole host of different industries. This makes it Germany's leading partner and solution provider for pneumatic and electric automation technology. To defend this sought-after position, the company is committed to constantly optimizing and developing its portfolio. For example, SMC has recently overhauled its pulse valves and brought them to market in their latest incarnation - the JSXFA series. The pulse valves in the JSXFA series really come into their own whenever the production process requires maximum power from a single blast of air. Capable of achieving 15 percent higher peak pressure, while also reducing compressed air consumption by a third, these new valves are at the top of their class in terms of pure performance data. Not only that, but their response time is now almost twice as fast as that of previous models, and their service life has been increased to an impressive 10 million cycles. "By achieving high peak pressure while also maintaining very low air consumption, the new pulse valves are suitable for any application that requires a powerful blast of air," explains Olaf Hagelstein, product manager at SMC Deutschland. In his view, one of the key applications for these valves will be cleaning filter elements. When it comes to effectively cleaning and removing extremely fine particles, he believes a powerful pressure pulse makes all the difference. "But, of course, the pulse valves are also ideal for removing any unwanted goods from the production line with a blast of air," he adds. "Ultimately, increasing performance while also reducing energy consumption is an appealing proposition for any industry. It's something all blow-off and cleaning applications can benefit from."
Medical advancements can come at a physical cost. Often following diagnosis and treatment for cancer and other diseases, patients' organs and cells can remain healed but damaged from the medical condition. In fact, one of the fastest growing medical markets is healing and/or replacing organs and cells already treated, yet remain damaged by cancer, cardiovascular disease and other medical issues. The global tissue engineering market is expected to reach $11.5 billion by 2022. That market involves researchers and medical scientists working to repair tissues damaged by some of the world's most debilitating cancers and diseases. One big challenge remains for the market - how to monitor and continuously test the performance of engineered tissues and cells to replace damaged ones. Purdue University researchers have come up with a 3D mapping technology to monitor and track the behavior of the engineered cells and tissues and improve the success rate for patients who have already faced a debilitating disease. The technology is published in the June 19 edition of ACS Nano. My hope is to help millions of people in need. Tissue engineering already provides new hope for hard-to-treat disorders, and our technology brings even more possibilities." Chi Hwan Lee, an assistant professor of biomedical engineering and mechanical engineering in Purdue's College of Engineering, who leads the research team The Purdue team created a tissue scaffold with sensor arrays in a stackable design that can monitor electrophysiological activities of cells and tissues. The technology uses the information to produce 3D maps to track activity. "This device offers an expanded set of potential options to monitor cell and tissue function after surgical transplants in diseased or damaged bodies," Lee said. "Our technology offers diverse options for sensing and works in moist internal body environments that are typically unfavorable for electronic instruments." Lee said the Purdue device is an ultra-buoyant scaffold that allows the entire structure to remain afloat on the cell culture medium, providing complete isolation of the entire electronic instrument from the wet conditions inside the body. Lee and his team have been working with Sherry Harbin, a professor in Purdue's Weldon School of Biomedical Engineering, to test the device in stem cell therapies with potential applications in the regenerative treatment of diseases. Their works align with Purdue's Giant Leaps celebration, celebrating the global advancements in health as part of Purdue's 150th anniversary. Health, including disease monitoring and treatment, is one of the four themes of the yearlong celebration's Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues. Lee and the other researchers worked with the Purdue Research Foundation Office of Technology Commercialization to patent the new device.
Allergies and different types of asthma are becoming more common worldwide, and air pollution and indoor air problems put a strain on the respiratory organs of increasing numbers of people. From the 1990s onwards, Professor of Biomedical Technology and Head of the Physiological Signal Analysis Group Tapio Seppänen has focused on the research of respiratory wave signals with his research team. Their long-term work has resulted in a mobile respiratory measurement tool called the Respiratory effort test. “We wanted to create a quick, easy and affordable way to measure the ease or difficulty of breathing”, says Professor Seppänen. “We explored the possibilities of using a mobile phone to measure respiration. Today's mobile phones contain many sensors and advanced measurement technology, making them a versatile measuring tool.” The mobile phone travels with everyone, without the need for separate measuring devices. Now the Respiratory effort test is in the phase of clinical testing, and a global patent application has been submitted. Chest movements reveal heavy breathing Traditionally, respiratory events in the upper and lower airways are measured with a whole body plethysmograph, BodyBox, only available in the largest hospitals. The measurement is conducted in an airtight box, by inhaling into a tube. Measurements performed with BodyBox require trained personnel and a visit to a hospital. Lasting one whole hour, the examination can be strenuous for the patient. The Respiratory effort test provides the same information within a few minutes by using the patient’s own mobile phone. “In this respect, we have replaced the BodyBox with a mobile phone,” Tapio Seppänen laughs. "We use a mobile phone to measure the breathing, and mathematical models to calculate details related to the respiratory wave. The resulting information can be used to interpret abnormal respiratory events.” As breathing becomes constricted, the airways contract and air resistance grows. This also increases the amount of breathing work. “Chest movement reflects the breathing work performed by the diaphragm and intercostal muscles between the ribs. They create a vacuum to draw in air, and when relaxing, they let the air flow out,” Seppänen says. “If there is a stenosis in the airways, you will have to press with your muscles and do more work to move the airflow. As a result, the chest movement changes. We can calculate such a blockage on the basis of the signal shape.” “The Respiratory effort test uses artificial intelligence in a medical application. The application recognises patterns in the respiratory event, that is, the machine is taught how to find a pattern reliably. The application also instructs the user on how to take the measurement correctly. In other words, a person has dialogue with a machine.” Measurements within a few minutes In addition to Tapio Seppänen, the Respiratory effort test is developed by Professor Olli-Pekka-Alho from the Ear, Nose and Throat Clinic, MSc Tiina Seppänen, who is working on her doctoral dissertation in the field of medical technology, and Project Researcher Niina Palmu. Niina Palmu is an expert in the commercialisation of health technology, and she is also involved in the commercialisation of the Respiratory effort test. She also examines how patients can best be guided through the measurement process. “During the measurement, a mobile phone is placed in the correct position on the chest. Inhalation takes place according to precise instructions: at first, you breathe through your nose, mouth closed, in and out, taking big breaths but in a normal manner,” says Palmu. This provides material on respiratory events taking place in the upper airways. “Then you breathe through your mouth, holding your nose in order to obtain a result of the respiratory event taking place in the lower airway. Finally, the Respiratory effort test provides results on the ease of breathing separately for the upper and lower airways, and the overall result,” Niina Palmu says. A measurement can be taken at home, at the workplace or at a doctor's office. “In order to make the measurements taken at home reliable, we need to instruct the user on how to conduct the measurements correctly. This is one of our research questions: how to instruct people?” Niina Palmu says contemplatively. “The device must also be instructive; it must indicate whether the measurement has been taken correctly,” adds Seppänen. The Respiratory effort test has many target groups In interviews with doctors, measurements based on a smartphone received a surprised and enthusiastic reception. “It is handy to measure with a device that is already in your pocket,” says Niina Palmu. “The Respiratory effort test is a convenient method for assessing the effectiveness of treatment and for home monitoring. Asthmatics’ drug response can be assessed by using the test. Moreover, measurements can be taken several times a day, at different times of the day and in different situations. You can also do this at the workplace if there are problems with indoor air, or outdoors in surrounded pollution or street dust”, describes Tapio Seppänen. The Respiratory effort test also supports parents in assessing the situation of an asthmatic child or young person. A measurement makes it is easier to decide whether to administer more medication or take the child to see a doctor. “If you have a pulmonary disease, asthma or COPD, you will adapt to it. The situation starts to feel normal, even if it is objectively poor. A measurement gives you the right picture of the situation”, says Tapio Seppänen. Before the Respiratory effort test can enter the market, there is a long and thorough test phase ahead. 'Clinical testing lasts for years, as this is a medical device. We are now looking for funding for the validation phase,” Seppänen and Palmu say. MobiResp project, in which the Respiration effort test was developed, received Proof of Concept funding from the University of Oulu in 2017. The New business from business ideas (TUTLI) funding granted by Business Finland made it possible to identify the innovation’s business opportunities. Research funding is still needed before the Respiration effort test can be placed on the market. Text: Satu Räsänen Physiological Signal Analysis Group Center for Machine Vision and Signal Analysis
Chondral injuries of the knee are a common source of pain in athletes but one of the main methods of diagnosing and staging these injuries, MRI, has a specificity of 73 percent and sensitivity of 42 percent. Using arthroscopy to stage the degree of the injury is a more accurate way to evaluate the knee prior to surgery. The doctors reviewed 98 patients who had autologous chondrocyte implantation, osteochondral allograft transplantation and meniscus allograft transplantation. "Based on our review, a change in treatment plan was made in 47 percent of cases in which staging arthroscopy was used to evaluate articular cartilage surfaces," said lead researcher Dr. Hytham S. Salem of Rothman Institute. Arthroscopy is performed after a standard sterile skin preparation and involves injecting local anesthetic subcutaneously at the portal sites and within the knee joint. It is often performed in office while patients are awake and alert. "The results of our study indicate that staging arthroscopy is an important step in determining the most appropriate treatment plan for chondral defects prior to OCA, ACI and MAT," Salem said. "Addressing all knee's pathology can be important for the success of cartilage restoration surgery, and treatment plans may change based on the extent and location of cartilage damage."
Badri Roysam, chair of the University of Houston Department of Electrical and Computer Engineering, is leading a $3.19 million project to create new technology that could provide an unprecedented look at the injured brain. The technology is a marriage, as Roysam calls it, between a new generation of “super microscopes,” that deliver detailed multi-spectral images of brain tissue, and the UH supercomputer at the HPE Data Science Institute, which interprets the data. “By allowing us to see the effects of the injury, treatments and the body’s own healing processes at once, the combination offers unprecedented potential to accelerate investigation and development of next-generation treatments for brain pathologies,” said Roysam, co-principal investigator with John Redell, assistant professor at UTHealth McGovern Medical School. Funded by the National Institute of Neurological Disorders and Stroke (NINDS), the project also includes NINDS scientist Dragan Maric and UH professors Hien Van Nguyen and Saurabh Prasad. The team is tackling the seemingly familiar concussion, suffered globally by an estimated 42 million people. This mild traumatic brain injury, usually caused by a bump, blow, or jolt to the head, disrupts normal brain function, setting off a cascading series of molecular and cellular alterations that can result in neurological, cognitive and behavioral changes. Concussions have long confounded scientists who face technological limitations that hinder a more comprehensive understanding of the pathological changes triggered by concussion, causing an inability to design effective treatment regimens. Until now. “We can now go in with eyes wide open whereas before we had only a very incomplete view with insufficient detail,” said Roysam. “The combinations of proteins we can now see are very informative. For each cell, they tell us what kind of brain cell it is, and what is going on with that cell.” The impact is immediate Injury to the brain causes immediate changes among all brain cells, severing some connections and potentially causing blood to leak into the brain — where blood is never supposed to be — by breaching the blood/brain barrier. After a concussion, the brain tissue becomes a complex “battleground,” said Roysam, with a mix of changes caused by the injury, secondary changes due to drug treatments, side effects and the body’s natural processes. Untangling these processes will allow the team to develop new medication “cocktails” of two or more drugs. “We will present a carefully validated and broadly applicable toolkit with unprecedented potential to accelerate investigation and develop next-generation treatments for brain pathologies,” said Roysam. Once validated, the new technology can also be applied to strokes, brain cancer and other degenerative diseases of the brain.