Scaling a Hydraulic Motor for Minimally Invasive Medical Devices.

Aligned with the medical device industry's trend of miniaturization, academic and commercial researchers are constantly attempting to reduce device sizes. Many applications require miniature actuators (2 mm range) to perform mechanical work; however, biocompatible micromotors are not readily available. To that end, a hydraulic motor-driven cutting module that aims to combine cutting and drug delivery is presented. The hydraulic motor prototype developed has an outside diameter (OD) of ~4 mm (twice the target size) and a 1 mm drive shaft to attach a cutter. Four different designs were explored and fabricated using additive manufacturing. The benchtop experimental data of the prototypes are presented herein. For the prototype motor with fluid inlet perpendicular to the blades, the average angular velocity was 10,593 RPM at a flowrate of 3.6 mL/s and 42,597 RPM at 10.1 mL/s. This design was numerically modeled using 3D-transient simulations in ANSYS CFX (version 2022 R2) to determine the performance characteristics and the internal resistance of the motor. Simplified mathematical models were also used to compute and compare the peak torque with the simulation estimates. The viability of current design represents a crucial milestone in scaling the hydraulic motor to a 2 mm OD to power a microcutter.

Manufacturing Scalable Carbon Nanotube-Silicone/Kevlar Fabrics.

Carbon nanotube (CNT) hybrid composites were formed by combining a CNT and silicone elastomer solution with Kevlar yarn, Kevlar fabric, and Kevlar veil materials. The integration of a CNT-silicone matrix with Kevlar yarn and fabric materials produced a composite with moderate electrical and thermal conductivity due to CNT fabric combined with the strength of Kevlar fabric or yarn. In the material synthesis, a notable difficulty was that the CNT-silicone did not bond strongly to the Kevlar. The composites passed the Vertical Flame Test ASTM D6413 and the Forced Air Oven Test NFPA 1971. These hybrid composites can have multiple applications in areas requiring favorable conductivity, strength, and flame and heat resistance. The application areas include firefighter apparel, military equipment, conductive/smart structures, and flexible electronics. The synthesis process used to manufacture CNT-silicone/Kevlar composites yielded composite sheets with an area of 2250 cm2. The process is scalable and customizable for the synthesis of CNT composites with tailored properties. Improvements in the bonding of CNT-silicone to Kevlar are being investigated.

Design and Modeling of a Miniature Hydraulic Motor for Powering a Cutting Tool for Minimally Invasive Procedures.

Miniaturization of multifunctional instruments is key to evolving less invasive medical procedures. The current work outlines steps towards developing a miniature motor to power a cutting tool of a millimeter-scale robot/device (target outside diameter ~2 mm) for minimally invasive procedures. Multiple motor concepts were explored and ranked using a Pugh matrix. The single-rotor hydraulic design was deemed most viable for prototyping and scale-down to the target size. Prototypes were manufactured to be progressively smaller using additive manufacturing. The smallest prototype fabricated was 2:1 scale of the desired final size with a 2 mm outside diameter (OD) rotor and a device OD of 4 mm. The scaled prototypes with an 8 mm rotor were lab tested and achieved average speeds of 5000-6000 RPM at a flowrate of 15-18 mL/s and 45 PSI water pressure. Ansys CFX was used as a design tool to explore the parameter space and 3D transient simulations were implemented using the immersed solid method. The predicted rotor RPM from the modeling matched the experimental values within 3% error. The model was then used to develop performance curves for the miniature hydraulic motor. In summary, the single-rotor hydraulic design shows promise for miniaturization to the target 2 mm size.

Reversible vancomycin susceptibility within emerging ST1421 Enterococcus faecium strains is associated with rearranged vanA-gene clusters and increased vanA plasmid copy number.

Vancomycin variable enterococci (VVE) are van-positive enterococci with a vancomycin-susceptible phenotype (VVE-S) that can convert to a resistant phenotype (VVE-R) and be selected for during vancomycin exposure. VVE-R outbreaks have been reported in Canada and Scandinavian countries. The aim of this study was to examine the presence of VVE in whole genome sequenced (WGS) Australian bacteremia Enterococcus faecium (Efm) isolates collected through the Australian Group on Antimicrobial resistance (AGAR) network. Eight potential VVEAus isolates, all identified as Efm ST1421, were selected based on the presence of vanA and a vancomycin-susceptible phenotype. During vancomycin selection, two potential VVE-S harboring intact vanHAX genes, but lacking the prototypic vanRS and vanZ genes, reverted to a resistant phenotype (VVEAus-R). Spontaneous VVEAus-R reversion occurred at a frequency of 4-6 × 10-8 resistant colonies per parent cell in vitro after 48 h and led to high-level vancomycin and teicoplanin resistance. The S to R reversion was associated with a 44-bp deletion in the vanHAX promoter region and an increased vanA plasmid copy number. The deletion in the vanHAX promoter region enables an alternative constitutive promoter for the expression of vanHAX. Acquisition of vancomycin resistance was associated with a low fitness cost compared with the corresponding VVEAus-S isolate. The relative proportion of VVEAus-R vs. VVEAus-S decreased over time in serial passages without vancomycin selection. Efm ST1421 is one of the predominant VanA-Efm multilocus sequence types found across most regions of Australia, and has also been associated with a major prolonged VVE outbreak in Danish hospitals.

Carbon Hybrid Materials-Design, Manufacturing, and Applications.

Carbon nanotubes (CNTs) have extraordinary properties and are used for applications in various fields of engineering and research. Due to their unique combination of properties, such as good electrical and thermal conductivity and mechanical strength, there is an increasing demand to produce CNTs with enhanced and customized properties. CNTs are produced using different synthesis methods and have extraordinary properties individually at the nanotube scale. However, it is challenging to achieve these properties when CNTs are used to form macroscopic sheets, tapes, and yarns. To further improve the properties of macroscale forms of CNTs, various types of nanoparticles and microfibers can be integrated into the CNT materials. The nanoparticles and microfibers can be chosen to selectively enhance the properties of CNT materials at the macroscopic level. In this paper, we propose a technique to manufacture carbon hybrid materials (CHMs) by combining CNT non-woven fabric (in the form of sheets or tapes) with microfibers to form CNT-CF hybrid materials with new/improved properties. CHMs are formed by integrating or adding nanoparticles, microparticles, or fibers into the CNT sheet. The additive materials can be incorporated into the synthesis process from the inlet or the outlet of the reactor system. This paper focuses on CHMs produced using the gas phase pyrolysis method with microparticles/fibers integrated at the outlet of the reactor and continuous microfiber tapes integrated into the CNT sheet at the outlet using a tape feeding machine. After synthesis, characterizations such as microscopy and thermogravimetric analysis were used to study the morphology and composition of the CNTs, and examples for potential applications are discussed in this paper.

Flexible and Lightweight Carbon Nanotube Composite Filter for Particulate Matter Air Filtration.

Particulate Matter (PM) has become an important source of air pollution. We proposed a flexible and lightweight carbon nanotube (CNT) composite air filter for PM removal. The developed CNT filtering layers were fabricated using a floating catalyst chemical vapor deposition (FC-CVD) synthesis process and then combined with conventional filter fabrics to make a composite air filter. Filtration performance for CNT filtering layer alone and composited with other conventional filter fabrics for particles size 0.3 µm to 2.5 µm was investigated in this study. The CNT composite filter is highly hydrophobic, making it suitable for humid environments. The CNT composite filter with two layers of tissue CNT performed best and achieved a filtration efficiency over 90% with a modest pressure drop of ~290 Pa for a particle size of 2.5 µm. This CNT composite filter was tested over multiple cycles to ensure its reusability. The developed filter is very light weight and flexible and can be incorporated into textiles for wearable applications or used as a room filter.

Electrochemically Activated CNT Sheet as a Cathode for Zn-CO2 Batteries.

High demand for electrochemical storage devices is increasing the need for high-performance batteries. A Zn-CO2 battery offers a promising solution for CO2 reduction as well as energy storage applications. For this study, a Zn-CO2 battery was fabricated using a Carbon Nanotube (CNT) sheet as a cathode and a Zn plate as an anode. The electrochemical activation technique was used to increase the surface area of the CNT electrode by roughly 4.5 times. Copper (Cu) as a catalyst was then deposited onto the activated CNT electrode using electrodeposition method and different Cu loadings were investigated to optimize CO2 reduction. The final assembled Zn-CO2 battery has a 1.6 V output voltage at a current density of 0.063 mA/cm2, which is higher than most devices reported in the literature. This study demonstrates the importance of activation process which enabled more catalyst loading on the cathode resulted in additional active sites for electroreduction process. This paper presents the activated CNT sheet as a promising cathode material for Zn-CO2 batteries.

Chlorosulfonic Acid Stretched Carbon Nanotube Sheet for Flexible and Low-Voltage Heating Applications.

The carbon nanotube (CNT) is celebrated for its electrothermal property, which indicates the capability of a material to transform electrical energy into heat due to the Joule effect. The CNT nanostructure itself, as a one-dimensional material, limits the electron conduction path, thereby creating a unique heating phenomenon. In this work, we explore the possible correlation between CNT alignment in sheets and heating performance. The alignment of carbon nanotubes is induced by immersion and stretching in chlorosulfonic acid (CSA) solution. The developed CSA-stretched CNT sheet demonstrated excellent heating performance with a fast response rate of 6.5 °C/s and reached 180 °C in less than 30 s under a low voltage of 2.5 V. The heating profile of the stretched CNT sheet remained stable after bending and twisting movements, making it a suitable heating material for wearable devices, heatable smart windows, and in de-icing or defogging applications. The specific strength and specific conductance of the CSA-stretched CNT sheet also increased five- and two-fold, respectively, in comparison to the pristine CNT sheet.

Carbon Nanotube Sheet-Synthesis and Applications.

Decades of extensive research have matured the development of carbon nanotubes (CNTs). Still, the properties of macroscale assemblages, such as sheets of carbon nanotubes, are not good enough to satisfy many applications. This paper gives an overview of different approaches to synthesize CNTs and then focuses on the floating catalyst method to form CNT sheets. A method is also described in this paper to modify the properties of macroscale carbon nanotube sheets produced by the floating catalyst method. The CNT sheet is modified to form a carbon nanotube hybrid (CNTH) sheet by incorporating metal, ceramic, or other types of nanoparticles into the high-temperature synthesis process to improve and customize the properties of the traditional nanotube sheet. This paper also discusses manufacturing obstacles and the possible commercial applications of the CNT sheet and CNTH sheet. Manufacturing problems include the difficulty of injecting dry nanoparticles uniformly, increasing the output of the process to reduce cost, and safely handling the hydrogen gas generated in the process. Applications for CNT sheet include air and water filtering, energy storage applications, and compositing CNTH sheets to produce apparel with anti-microbial properties to protect the population from infectious diseases. The paper also provides an outlook towards large scale commercialization of CNT material.

Discovery of Isoxazole Amides as Potent and Selective SMYD3 Inhibitors.

We report herein the discovery of isoxazole amides as potent and selective SET and MYND Domain-Containing Protein 3 (SMYD3) inhibitors. Elucidation of the structure-activity relationship of the high-throughput screening (HTS) lead compound 1 provided potent and selective SMYD3 inhibitors. The SAR optimization, cocrystal structures of small molecules with SMYD3, and mode of inhibition (MOI) characterization of compounds are described. The synthesis and biological and pharmacokinetic profiles of compounds are also presented.

Visual Acuity and Self-Reported Visual Function among Migrant Farmworkers.

PURPOSE: Visual impairment presents significant risks for occupational injuries among farmworkers, a vulnerable population with limited access to vision care. Although previous research has noted farmworkers' low lifetime experience with vision screening and high rates of complaints of eye ailments and poor vision, there have been few screening data collected to evaluate these self-reports. The objectives of this analysis are to (1) describe farmworker visual health using standardized visual acuity screening data and self-reported visual function, and (2) to compare the screening and self-report data. METHODS: Data are from a cross-sectional study of eye health among Latino migrant farmworkers in North Carolina with uncorrected vision (n = 289). Workers were recruited using methods to achieve a representative sample of a hard-to-reach population. Visual acuity data were collected using Snellen Tumbling E charts for nearsightedness and farsightedness. Binocular data are reported here. Interviews were conducted to obtain personal characteristics and self-assessed visual function. RESULTS: About 75% of farmworkers reported never having had a vision screening. Based on binocular screening, 1.7% (distance vision) and 6.9% (near vision) had moderate to severe visual impairment (>20/40). Farmworkers self-reported poorer visual function, compared with screening results; only 36.4% reported good or very good vision. Sensitivity of distance and near vision self-reports were 60 and 20%, respectively, but specificity was high. CONCLUSIONS: This study confirms past reports of little vision screening among farmworkers. Visual impairment for distance is comparable to other studies of Latinos in the US, though these studies have not reported near vision. Self-reports of vision problems are not a sensitive measure of visual acuity among farmworkers. Screening is needed to identify visual impairment that can create occupational safety risks in this health disparate population.

A Spray-On Carbon Nanotube Artificial Neuron Strain Sensor for Composite Structural Health Monitoring.

We present a nanocomposite strain sensor (NCSS) to develop a novel structural health monitoring (SHM) sensor that can be easily installed in a composite structure. An NCSS made of a multi-walled carbon nanotubes (MWCNT)/epoxy composite was installed on a target structure with facile processing. We attempted to evaluate the NCSS sensing characteristics and benchmark compared to those of a conventional foil strain gauge. The response of the NCSS was fairly good and the result was nearly identical to the strain gauge. A neuron, which is a biomimetic long continuous NCSS, was also developed, and its vibration response was investigated for structural damage detection of a composite cantilever. The vibration response for damage detection was measured by tracking the first natural frequency, which demonstrated good result that matched the finite element (FE) analysis.

Discovery of a Novel 2,6-Disubstituted Glucosamine Series of Potent and Selective Hexokinase 2 Inhibitors.

A novel series of potent and selective hexokinase 2 (HK2) inhibitors, 2,6-disubstituted glucosamines, has been identified based on HTS hits, exemplified by compound 1. Inhibitor-bound crystal structures revealed that the HK2 enzyme could adopt an "induced-fit" conformation. The SAR study led to the identification of potent HK2 inhibitors, such as compound 34 with greater than 100-fold selectivity over HK1. Compound 25 inhibits in situ glycolysis in a UM-UC-3 bladder tumor cell line via (13)CNMR measurement of [3-(13)C]lactate produced from [1,6-(13)C2]glucose added to the cell culture.

Gold-coated carbon nanotube electrode arrays: Immunosensors for impedimetric detection of bone biomarkers.

C-terminal telopeptide (cTx), a fragment generated during collagen degradation, is a key biomarker of bone resorption during the bone remodeling process. The presence of varying levels of cTx in the bloodstream can hence be indicative of abnormal bone metabolism. This study focuses on the development of an immunosensor utilizing carbon nanotube (CNT) electrodes coated with gold nanoparticles for the detection of cTx, which could ultimately lead to the development of an inexpensive and rapid point-of-care (POC) tool for bone metabolism detection and prognostics. Electrochemical impedance spectroscopy (EIS) was implemented to monitor and detect the antigen-antibody binding events occurring on the surface of the gold-deposited CNT electrode. Type I cTx was used as the model protein to test the developed sensor. The sensor was accordingly characterized at various stages of development for evaluation of the optimal sensor performance. The biosensor could detect cTx levels as low as 0.05 ng/mL. The feasibility of the sensor for point-of-care (POC) applications was further demonstrated by determining the single frequency showing maximum changes in impedance, which was determined to be 18.75 Hz.

Prevalence and predictors of bicycle helmet use in a southeastern, US city.

Fatalities and head injuries from bicycle-related crashes remain a concern in the United States. Despite legislation in many states, helmet use remains low. This observational study examined the helmet use and related factors in a North Carolina city. The sample consisted of 2088 observations of bicyclists. The objectives were to (1) determine helmet use; (2) describe other safe bicycling practices; and (3) examine the relationship of demographic variables and safe riding practices with helmet use. Helmet use was observed for 25% of the sample. Demographic factors related to helmet use were being female (OR = 1.32), 26 years old or older (OR = 4.94), and White (OR = 2.17). Bicyclists riding on the road with traffic were more likely to wear a helmet than bicyclists riding on the sidewalk (OR = 2.04). Findings indicate that helmet use remains low in the city. Research to monitor, better understand, and promote helmet use is needed.

Mechanical Strength Improvements of Carbon Nanotube Threads through Epoxy Cross-Linking.

Individual Carbon Nanotubes (CNTs) have a great mechanical strength that needs to be transferred into macroscopic fiber assemblies. One approach to improve the mechanical strength of the CNT assemblies is by creating covalent bonding among their individual CNT building blocks. Chemical cross-linking of multiwall CNTs (MWCNTs) within the fiber has significantly improved the strength of MWCNT thread. Results reported in this work show that the cross-linked thread had a tensile strength six times greater than the strength of its control counterpart, a pristine MWCNT thread (1192 MPa and 194 MPa, respectively). Additionally, electrical conductivity changes were observed, revealing 2123.40 S·cm-1 for cross-linked thread, and 3984.26 S·cm-1 for pristine CNT thread. Characterization suggests that the obtained high tensile strength is due to the cross-linking reaction of amine groups from ethylenediamine plasma-functionalized CNT with the epoxy groups of the cross-linking agent, 4,4-methylenebis(N,N-diglycidylaniline).

Comparison of Estimations Versus Measured Oxygen Consumption at Rest in Patients With Heart Failure and Reduced Ejection Fraction Who Underwent Right-Sided Heart Catheterization.

Cardiac output during right-sided heart catheterization is an important variable for patient selection of advanced therapies (cardiac transplantation and left ventricular assist device implantation). The Fick method to determine cardiac output is commonly used and typically uses estimated oxygen consumption (VO2) from 1 of 3 published empirical formulas. However, these estimation equations have not been validated in patients with heart failure and reduced ejection fraction (HFrEF). The objectives of the present study were to determine the accuracy of 3 equations for estimating VO2 compared with direct measurement of VO2 and determine the extent clinically significant error occurred in calculating cardiac output of patients with HFrEF. Breath-by-breath measurements of VO2 from 44 patients who underwent cardiac catheterization (66% men; age, 65 ± 11 years, left ventricular ejection fraction, 22 ± 6%) were compared with the derived estimations of LaFarge and Miettinen, Dehmer et al, and Bergstra et al. Single-sample t tests found only the mean difference between the estimation of LaFarge and Miettinen and the measured VO2 to be nonsignificant (-10.3 ml/min ± 6.2 SE, p = 0.053). Bland-Altman plots demonstrated unacceptably large limits of agreement for all equations. The rate of ≥25% error in the equations by LaFarge and Miettinen, Dehmer et al, and Bergstra et al occurred in 11%, 23%, and 45% of patients, respectively. Misclassification of cardiac index derived from each equation for 2 clinically important classifications: cardiogenic shock-21%, 23%, and 32% and hypoperfusion-16%, 16%, and 25%; respectively. In conclusion, these findings do not support the use of these empiric formulas to estimate the VO2 at rest in patients with HFrEF who underwent right-sided heart catheterization.

Inverse-Ordered Fabrication of Free-Standing CNT Sheets for Supercapacitor.

Free-standing thin carbon nanotube (CNT) sheets are challenging to handle and control for device fabrication. In this paper, we report on the inverse-ordered fabrication method from thick CNT sheets to thin free-standing CNT sheets. As proof of the concept, thin CNT sheets for a supercapacitor were fabricated from 200 thick layers. The results show that the thin CNT sheet was electrochemically stable and had enhanced capacitive performance. The smaller the number of layers is, the larger the specific capacitances we have (from 10.10 F g(-1) to 51.37 F g(-1)). Energy and power density were increased from 0.50 to 2.57 Wh kg(-1) and from 0.33 to 2.31 kW kg(-1), respectively. This simple and scalable inverse-ordered method is capable to fabricate CNT sheets in various forms, allowing fast trials on various applications.

American-Indian diabetes mortality in the Great Plains Region 2002-2010.

OBJECTIVE: To compare American-Indian and Caucasian mortality rates from diabetes among tribal Contract Health Service Delivery Areas (CHSDAs) in the Great Plains Region (GPR) and describe the disparities observed. RESEARCH DESIGN AND METHODS: Mortality data from the National Center for Vital Statistics and Seer*STAT were used to identify diabetes as the underlying cause of death for each decedent in the GPR from 2002 to 2010. Mortality data were abstracted and aggregated for American-Indians and Caucasians for 25 reservation CHSDAs in the GPR. Rate ratios (RR) with 95% CIs were used and SEER*Stat V.8.0.4 software calculated age-adjusted diabetes mortality rates. RESULTS: Age-adjusted mortality rates for American-Indians were significantly higher than those for Caucasians during the 8-year period. In the GPR, American-Indians were 3.44 times more likely to die from diabetes than Caucasians. South Dakota had the highest RR (5.47 times that of Caucasians), and Iowa had the lowest RR, (1.1). Reservation CHSDA RR ranged from 1.78 to 10.25. CONCLUSIONS: American-Indians in the GPR have higher diabetes mortality rates than Caucasians in the GPR. Mortality rates among American-Indians persist despite special programs and initiatives aimed at reducing diabetes in these populations. Effective and immediate efforts are needed to address premature diabetes mortality among American-Indians in the GPR.

Free-standing carbon nanotube-titania photoactive sheets.

We report on the development of a new photoactive material via titania (TiO2) nanoparticle deposition on free-standing aligned carbon nanotube (CNT) sheets. Controlling homogeneous dispersion of negatively charged TiO2 nanoparticles, achieved by adjusting pH higher than the point of zero charge (PZC), influenced electrochemical deposition of TiO2 on CNT sheets substrate. Varying deposition time with constant voltage, 5 V allowed different thickness of TiO2 to be deposited layer on the CNT sheets. The thickness and morphology of CNT-TiO2 sheets was verified by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD). Electrochemical experiments show that diffusion coefficient of Fe(CN)6(3-) was 5.56×10(-6) cm(2) s(-1) at pristine CNT sheets and 2.19×10(-6) cm(2) s(-1) at the CNT-TiO2 sheets. Photocatalytic activity for CNT-TiO2 sheets exhibits high photocurrent density (when deposition time=30 min, 4.3 µA cm(-2) in N2, 13.4 µA cm(-2) in CO2). This paper proved a possibility to use CNT-TiO2 sheets based on highly-aligned CNT sheets substrate as new photoactive material.