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1.
Med ; 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38663403

RESUMO

BACKGROUND: Dosing of chemotherapies is often calculated according to the weight and/or height of the patient or equations derived from these, such as body surface area (BSA). Such calculations fail to capture intra- and interindividual pharmacokinetic variation, which can lead to order of magnitude variations in systemic chemotherapy levels and thus under- or overdosing of patients. METHODS: We designed and developed a closed-loop drug delivery system that can dynamically adjust its infusion rate to the patient to reach and maintain the drug's target concentration, regardless of a patient's pharmacokinetics (PK). FINDINGS: We demonstrate that closed-loop automated drug infusion regulator (CLAUDIA) can control the concentration of 5-fluorouracil (5-FU) in rabbits according to a range of concentration-time profiles (which could be useful in chronomodulated chemotherapy) and over a range of PK conditions that mimic the PK variability observed clinically. In one set of experiments, BSA-based dosing resulted in a concentration 7 times above the target range, while CLAUDIA keeps the concentration of 5-FU in or near the targeted range. Further, we demonstrate that CLAUDIA is cost effective compared to BSA-based dosing. CONCLUSIONS: We anticipate that CLAUDIA could be rapidly translated to the clinic to enable physicians to control the plasma concentration of chemotherapy in their patients. FUNDING: This work was supported by MIT's Karl van Tassel (1925) Career Development Professorship and Department of Mechanical Engineering and the Bridge Project, a partnership between the Koch Institute for Integrative Cancer Research at MIT and the Dana-Farber/Harvard Cancer Center.

2.
Cyborg Bionic Syst ; 6: 0077, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38435709

RESUMO

Flexible miniature robots are expected to enter difficult-to-reach areas in vivo to carry out targeted operations, attracting widespread attention. However, it is challenging for the existing soft miniature robots to substantially alter their stable shape once the structure is designed. This limitation leads to a fixed motion mode, which subsequently restricts their operating environment. In this study, we designed a biocompatible flexible miniature robot with a variable stable form that is capable of adapting to complex terrain environments through multiple movement modes. Inspired by the reversible stretching reaction of alginate saline gel stimulated by changes in environmental ion concentration, we manufactured a morphologically changeable super-soft hydrogel miniature robot body. According to the stretch and contraction shapes of the flexible hydrogel miniature robot, we designed magnetic fields for swing and rolling motion modes to realize multi-shape movement. The experimental results demonstrate that the deflection angle of the designed flexible miniature robot is reversible and can reach a maximum of 180°. The flexible miniature robot can complete forward swinging in the bar stretch state and tumbling motion in the spherical state. We anticipate that flexible hydrogel miniature robots with multiple morphologies and multimodal motion have great potential for biomedical applications in complex, unstructured, and enclosed living environments.

3.
Sci Robot ; 9(87): eadh8170, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38416855

RESUMO

Postoperative ileus (POI) is the leading cause of prolonged hospital stay after abdominal surgery and is characterized by a functional paralysis of the digestive tract, leading to symptoms such as constipation, vomiting, and functional obstruction. Current treatments are mainly supportive and inefficacious and yield acute side effects. Although electrical stimulation studies have demonstrated encouraging pacing and entraining of the intestinal slow waves, no devices exist today to enable targeted intestinal reanimation. Here, we developed an ingestible self-propelling device for intestinal reanimation (INSPIRE) capable of restoring peristalsis through luminal electrical stimulation. Optimizing mechanical, material, and electrical design parameters, we validated optimal deployment, intestinal electrical luminal contact, self-propelling capability, safety, and degradation of the device in ex vivo and in vivo swine models. We compared the INSPIRE's effect on motility in models of normal and depressed motility and chemically induced ileus. Intestinal contraction improved by 44% in anesthetized animals and up to 140% in chemically induced ileus cases. In addition, passage time decreased from, on average, 8.6 days in controls to 2.5 days with the INSPIRE device, demonstrating significant improvement in motility. Luminal electrical stimulation of the intestine via the INSPIRE efficaciously restored peristaltic activity. This noninvasive option offers a promising solution for the treatment of ileus and other motility disorders.


Assuntos
Íleus , Robótica , Animais , Suínos , Motilidade Gastrointestinal/fisiologia , Íleus/terapia , Íleus/etiologia , Intestinos , Complicações Pós-Operatórias
4.
Proc IEEE Sens ; 20222022.
Artigo em Inglês | MEDLINE | ID: mdl-36570066

RESUMO

Recent advances in ingestible sensors have enabled in situ detection of gastrointestinal (GI) biomarkers which shows great potential in shifting the paradigm of diagnosing GI and systemic diseases. However, the humid, acidic gastric environment is extremely harsh to electrically powered sensors, which limits their capacity for long term, continuous monitoring. Here, we propose an encapsulation approach for a gas sensor integrated into a nasogastric (NG) tube that overcomes chemical corrosion, electrical short, and mechanical collision in a gastric environment to enable continuous gaseous biomarkers monitoring. The coating effects on the sensitivity, signal latency, and repeatability are investigated. Our long-term continuous monitoring in vitro results show that the proposed coating method enables the gas sensors to function reliably and consistently in the simulated GI environment for more than 1 week. The encapsulation is composed of Polycaprolactone (PCL) to protect against mechanical scratching and Parylene C to prevent a sensor from chemical corrosion and electrical short. The average life-time of the sensor with 10 micrometers Parylene coating is about 3.6 days. Increasing the coating thickness to 20 micrometers results in 10.0 days. In terms of repeatability, 10 micrometers and 20 micrometers Parylene C coated sensors have a standard deviation of 1.30% and 2.10% for its within sensor response, and 5.19% and 3.06% between sensors respectively.

5.
Proc IEEE Sens ; 20222022.
Artigo em Inglês | MEDLINE | ID: mdl-36570065

RESUMO

Recent advances in remote-photoplethysmography (rPPG) have enabled the measurement of heart rate (HR), oxygen saturation (SpO2), and blood pressure (BP) in a fully contactless manner. These techniques are increasingly applied clinically given a desire to minimize exposure to individuals with infectious symptoms. However, accurate rPPG estimation often leads to heavy loading in computation that either limits its real-time capacity or results in a costly setup. Additionally, acquiring rPPG while maintaining protective distance would require high resolution cameras to ensure adequate pixels coverage for the region of interest, increasing computational burden. Here, we propose a cost-effective platform capable of the real-time, continuous, multi-subject monitoring while maintaining social distancing. The platform is composed of a centralized computing unit and multiple low-cost wireless cameras. We demonstrate that the central computing unit is able to simultaneously handle continuous rPPG monitoring of five subjects with social distancing without compromising the frame rate and rPPG accuracy.

6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2491-2494, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36085797

RESUMO

More than two decades ago it was discovered that nitric oxide (NO) concentrations in gas aspirated during colonoscopy were more than 100 times higher in patients diagnosed with Ulcerative Colitis (UC) than controls. While this provides a diagnostic opportunity, it has not been possible to perform in situ detection of NO via a non-invasive manner. This work presents the feasibility of in situ detection of NO by means of a capsule-like electrochemical gas sensor. Our in vivo results in a large animal model of intestinal inflammation show that NO can be directly detected at the site of inflammation and that it quickly dissipates to surrounding tissues, demonstrating the importance of in situ detection.


Assuntos
Inflamação , Óxido Nítrico , Animais , Biomarcadores , Colonoscopia , Modelos Animais de Doenças , Inflamação/diagnóstico
7.
Artigo em Inglês | MEDLINE | ID: mdl-35571871

RESUMO

The COVID-19 pandemic has accelerated methods to facilitate contactless evaluation of patients in hospital settings. By minimizing in-person contact with individuals who may have COVID-19, healthcare workers can prevent disease transmission and conserve personal protective equipment. Obtaining vital signs is a ubiquitous task that is commonly done in person by healthcare workers. To eliminate the need for in-person contact for vital sign measurement in the hospital setting, we developed Dr. Spot, a mobile quadruped robotic system. The system includes IR and RGB cameras for vital sign monitoring and a tablet computer for face-to-face medical interviewing. Dr. Spot is teleoperated by trained clinical staff to simultaneously measure the skin temperature, respiratory rate, and heart rate while maintaining social distancing from patients and without removing their mask. To enable accurate, contactless measurements on a mobile system without a static black body as reference, we propose novel methods for skin temperature compensation and respiratory rate measurement at various distances between the subject and the cameras, up to 5 m. Without compensation, the skin temperature MAE is 1.3°C. Using the proposed compensation method, the skin temperature MAE is reduced to 0.3°C. The respiratory rate method can provide continuous monitoring with a MAE of 1.6 BPM in 30 s or rapid screening with a MAE of 2.1 BPM in 10 s. For the heart rate estimation, our system is able to achieve a MAE less than 8 BPM in 10 s measured in arbitrary indoor light conditions at any distance below 2 m.

8.
J Control Release ; 343: 31-42, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34998917

RESUMO

Glycemic control through titration of insulin dosing remains the mainstay of diabetes mellitus treatment. Insulin therapy is generally divided into dosing with long- and short-acting insulin, where long-acting insulin provides basal coverage and short-acting insulin supports glycemic excursions associated with eating. The dosing of short-acting insulin often involves several steps for the user including blood glucose measurement and integration of potential carbohydrate loads to inform safe and appropriate dosing. The significant burden placed on the user for blood glucose measurement and effective carbohydrate counting can manifest in substantial effects on adherence. Through the application of computer vision, we have developed a smartphone-based system that is able to detect the carbohydrate load of food by simply taking a single image of the food and converting that information into a required insulin dose by incorporating a blood glucose measurement. Moreover, we report the development of comprehensive all-in-one insulin delivery systems that streamline all operations that peripheral devices require for safe insulin administration, which in turn significantly reduces the complexity and time required for titration of insulin. The development of an autonomous system that supports maximum ease and accuracy of insulin dosing will transform our ability to more effectively support patients with diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Insulina , Glicemia , Automonitorização da Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Insulina de Ação Curta/uso terapêutico
9.
BMJ Open ; 12(12): e062707, 2022 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-36600328

RESUMO

OBJECTIVES: Mask adherence continues to be a critical public health measure to prevent transmission of aerosol pathogens, such as SARS-CoV-2. We aimed to develop and deploy a computer vision algorithm to provide real-time feedback of mask wearing among staff in a hospital. DESIGN: Single-site, observational cohort study. SETTING: An urban, academic hospital in Boston, Massachusetts, USA. PARTICIPANTS: We enrolled adult hospital staff entering the hospital at a key ingress point. INTERVENTIONS: Consenting participants entering the hospital were invited to experience the computer vision mask detection system. Key aspects of the detection algorithm and feedback were described to participants, who then completed a quantitative assessment to understand their perceptions and acceptance of interacting with the system to detect their mask adherence. OUTCOME MEASURES: Primary outcomes were willingness to interact with the mask system, and the degree of comfort participants felt in interacting with a public facing computer vision mask algorithm. RESULTS: One hundred and eleven participants with mean age 40 (SD15.5) were enrolled in the study. Males (47.7%) and females (52.3%) were equally represented, and the majority identified as white (N=54, 49%). Most participants (N=97, 87.3%) reported acceptance of the system and most participants (N=84, 75.7%) were accepting of deployment of the system to reinforce mask adherence in public places. One third of participants (N=36) felt that a public facing computer vision system would be an intrusion into personal privacy.Public-facing computer vision software to detect and provide feedback around mask adherence may be acceptable in the hospital setting. Similar systems may be considered for deployment in locations where mask adherence is important.


Assuntos
COVID-19 , SARS-CoV-2 , Adulto , Masculino , Feminino , Humanos , COVID-19/prevenção & controle , Máscaras , Recursos Humanos em Hospital , Computadores , Estudos Observacionais como Assunto
10.
Sci Adv ; 7(48): eabj4624, 2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34826238

RESUMO

Diurnal variation in enzymes, hormones, and other biological mediators has long been recognized in mammalian physiology. Developments in pharmacobiology over the past few decades have shown that timing drug delivery can enhance drug efficacy. Here, we report the development of a battery-free, refillable, subcutaneous, and trocar-compatible implantable system that facilitates chronotherapy by enabling tight control over the timing of drug administration in response to external mechanical actuation. The external wearable system is coupled to a mobile app to facilitate control over dosing time. Using this system, we show the efficacy of bromocriptine on glycemic control in a diabetic rat model. We also demonstrate that antihypertensives can be delivered through this device, which could have clinical applications given the recognized diurnal variation of hypertension-related complications. We anticipate that implants capable of chronotherapy will have a substantial impact on our capacity to enhance treatment effectiveness for a broad range of chronic conditions.

11.
Adv Funct Mater ; 31(44)2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34720792

RESUMO

Implantable and ingestible biomedical electronic devices can be useful tools for detecting physiological and pathophysiological signals, and providing treatments that cannot be done externally. However, one major challenge in the development of these devices is the limited lifetime of their power sources. The state-of-the-art of powering technologies for implantable and ingestible electronics is reviewed here. The structure and power requirements of implantable and ingestible biomedical electronics are described to guide the development of powering technologies. These powering technologies include novel batteries that can be used as both power sources and for energy storage, devices that can harvest energy from the human body, and devices that can receive and operate with energy transferred from exogenous sources. Furthermore, potential sources of mechanical, chemical, and electromagnetic energy present around common target locations of implantable and ingestible electronics are thoroughly analyzed; energy harvesting and transfer methods befitting each energy source are also discussed. Developing power sources that are safe, compact, and have high volumetric energy densities is essential for realizing long-term in-body biomedical electronics and for enabling a new era of personalized healthcare.

12.
Adv Sci (Weinh) ; 8(24): e2102861, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34713599

RESUMO

Continuous monitoring in the intensive care setting has transformed the capacity to rapidly respond with interventions for patients in extremis. Noninvasive monitoring has generally been limited to transdermal or intravascular systems coupled to transducers including oxygen saturation or pressure. Here it is hypothesized that gastric fluid (GF) and gases, accessible through nasogastric (NG) tubes, commonly found in intensive care settings, can provide continuous access to a broad range of biomarkers. A broad characterization of biomarkers in swine GF coupled to time-matched serum is conducted . The relationship and kinetics of GF-derived analyte level dynamics is established by correlating these to serum levels in an acute renal failure and an inducible stress model performed in swine. The ability to monitor ketone levels and an inhaled anaesthetic agent (isoflurane) in vivo is demonstrated with novel NG-compatible sensor systems in swine. Gastric access remains a main stay in the care of the critically ill patient, and here the potential is established to harness this establishes route for analyte evaluation for clinical management.


Assuntos
Injúria Renal Aguda/metabolismo , Anestésicos Inalatórios/metabolismo , Suco Gástrico/metabolismo , Isoflurano/metabolismo , Monitorização Fisiológica/métodos , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Intubação Gastrointestinal , Cetonas/metabolismo , Estômago/metabolismo , Suínos
13.
Adv Drug Deliv Rev ; 177: 113926, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34403749

RESUMO

The delivery of macromolecules via the gastrointestinal (GI) tract remains a significant challenge. A variety of technologies using physical modes of drug delivery have been developed and investigated to overcome the epithelial cell layer of the GI tract for local and systemic delivery. These technologies include direct injection, jetting, ultrasound, and iontophoresis, which have been largely adapted from transdermal drug delivery. Direct injection of agents using needles through endoscopy has been used clinically for over a century. Jetting, a needle-less method of drug delivery where a high-speed stream of fluid medication penetrates tissue, has been evaluated pre-clinically for delivery of agents into the buccal mucosa. Ultrasound has been shown to be beneficial in enhancing delivery of macromolecules, including nucleic acids, in pre-clinical animal models. The application of an electric field gradient to drive drugs into tissues through the technique of iontophoresis has been shown to deliver highly toxic chemotherapies into GI tissues. Here in, we provide an in-depth overview of these physical modes of drug delivery in the GI tract and their clinical and preclinical uses.


Assuntos
Sistemas de Liberação de Medicamentos , Trato Gastrointestinal , Mucosa , Animais , Humanos , Iontoforese , Ondas Ultrassônicas
14.
JAMA Netw Open ; 4(3): e210667, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33662134

RESUMO

Importance: Before the widespread implementation of robotic systems to provide patient care during the COVID-19 pandemic occurs, it is important to understand the acceptability of these systems among patients and the economic consequences associated with the adoption of robotics in health care settings. Objective: To assess the acceptability and feasibility of using a mobile robotic system to facilitate health care tasks. Design, Setting, and Participants: This study included 2 components: a national survey to examine the acceptability of using robotic systems to perform health care tasks in a hospital setting and a single-site cohort study of patient experiences and satisfaction with the use of a mobile robotic system to facilitate triage and telehealth tasks in the emergency department (ED). The national survey comprised individuals living in the US who participated in a sampling-based survey via an online analytic platform. Participants completed the national survey between August 18 and August 21, 2020. The single-site cohort study included patients living in the US who presented to the ED of a large urban academic hospital providing quaternary care in Boston, Massachusetts between April and August 2020. All data were analyzed from August to October 2020. Exposures: Participants in the national survey completed an online survey to measure the acceptability of using a mobile robotic system to perform health care tasks (facilitating telehealth interviews, acquiring vital signs, obtaining nasal or oral swabs, placing an intravenous catheter, performing phlebotomy, and turning a patient in bed) in a hospital setting in the contexts of general interaction and interaction during the COVID-19 pandemic. Patients in the cohort study were exposed to a mobile robotic system, which was controlled by an ED clinician and used to facilitate a triage interview. After exposure, patients completed an assessment to measure their satisfaction with the robotic system. Main Outcomes and Measures: Acceptability of the use of a mobile robotic system to facilitate health care tasks in a hospital setting (national survey) and feasibility and patient satisfaction regarding the use of a mobile robotic system in the ED (cohort study). Results: For the national survey, 1154 participants completed all acceptability questions, representing a participation rate of 35%. After sample matching, a nationally representative sample of 1000 participants (mean [SD] age, 48.7 [17.0] years; 535 women [53.5%]) was included in the analysis. With regard to the usefulness of a robotic system to perform specific health care tasks, the response of "somewhat useful" was selected by 373 participants (37.3%) for facilitating telehealth interviews, 350 participants (35.0%) for acquiring vital signs, 307 participants (30.7%) for obtaining nasal or oral swabs, 228 participants (22.8%) for placing an intravenous catheter, 249 participants (24.9%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed. The response of "extremely useful" was selected by 287 participants (28.7%) for facilitating telehealth interviews, 413 participants (41.3%) for acquiring vital signs, 192 participants (19.2%) for obtaining nasal or oral swabs, 159 participants (15.9%) for placing an intravenous catheter, 167 participants (16.7%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed. In the context of the COVID-19 pandemic, the median number of individuals who perceived the application of robotic systems to be acceptable for completing telehealth interviews, obtaining nasal and oral swabs, placing an intravenous catheter, and performing phlebotomy increased. For the ED cohort study, 51 individuals were invited to participate, and 41 participants (80.4%) enrolled. One participant was unable to complete the study procedures because of a signaling malfunction in the robotic system. Forty patients (mean [SD] age, 45.8 [2.7] years; 29 women [72.5%]) completed the mobile robotic system-facilitated triage interview, and 37 patients (92.5%) reported that the interaction was satisfactory. A total of 33 participants (82.5%) reported that their experience of receiving an interview facilitated by a mobile robotic system was as satisfactory as receiving an in-person interview from a clinician. Conclusions and Relevance: In this study, a mobile robotic system was perceived to be acceptable for use in a broad set of health care tasks among survey respondents across the US. The use of a mobile robotic system enabled the facilitation of contactless triage interviews of patients in the ED and was considered acceptable among participants. Most patients in the ED rated the quality of mobile robotic system-facilitated interaction to be equivalent to in-person interaction with a clinician.


Assuntos
Atenção à Saúde/métodos , Serviço Hospitalar de Emergência , Hospitais , Assistência ao Paciente/métodos , Satisfação do Paciente , Robótica/métodos , Triagem , Adulto , Idoso , Boston , COVID-19 , Cateterismo , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Flebotomia , Exame Físico , Inquéritos e Questionários , Telemedicina
15.
ACS Pharmacol Transl Sci ; 3(6): 1076-1082, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33330837

RESUMO

N95 filtering facepiece respirators (FFR) and surgical masks are essential in reducing airborne disease transmission, particularly during the COVID-19 pandemic. However, currently available FFR's and masks have major limitations, including masking facial features, waste, and integrity after decontamination. In a multi-institutional trial, we evaluated a transparent, elastomeric, adaptable, long-lasting (TEAL) respirator to evaluate success of qualitative fit test with user experience and biometric evaluation of temperature, respiratory rate, and fit of respirator using a novel sensor. There was a 100% successful fit test among participants, with feedback demonstrating excellent or good fit (90% of participants), breathability (77.5%), and filter exchange (95%). Biometric testing demonstrated significant differences between exhalation and inhalation pressures among a poorly fitting respirator, well-fitting respirator, and the occlusion of one filter of the respirator. We have designed and evaluated a transparent elastomeric respirator and a novel biometric feedback system that could be implemented in the hospital setting.

16.
Sci Transl Med ; 12(558)2020 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-32848090

RESUMO

Epithelial tissues line the organs of the body, providing an initial protective barrier as well as a surface for nutrient and drug absorption. Here, we identified enzymatic components present in the gastrointestinal epithelium that can serve as selective means for tissue-directed polymerization. We focused on the small intestine, given its role in drug and nutrient absorption and identified catalase as an essential enzyme with the potential to catalyze polymerization and growth of synthetic biomaterial layers. We demonstrated that the polymerization of dopamine by catalase yields strong tissue adhesion. We characterized the mechanism and specificity of the polymerization in segments of the gastrointestinal tracts of pigs and humans ex vivo. Moreover, we demonstrated proof of concept for application of these gastrointestinal synthetic epithelial linings for drug delivery, enzymatic immobilization for digestive supplementation, and nutritional modulation through transient barrier formation in pigs. This catalase-based approach to in situ biomaterial generation may have broad indications for gastrointestinal applications.


Assuntos
Trato Gastrointestinal , Intestino Delgado , Animais , Epitélio , Suínos
17.
BMJ Open ; 10(7): e039120, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32641368

RESUMO

OBJECTIVE: To develop and test a new reusable, sterilisable N95 filtering facepiece respirator (FFR)-comparable face mask, known as the Injection Molded Autoclavable, Scalable, Conformable (iMASC) system, given the dire need for personal protective equipment within healthcare settings during the COVID-19 pandemic. DESIGN: Single-arm feasibility study. SETTING: Emergency department and outpatient oncology clinic. PARTICIPANTS: Healthcare workers who have previously undergone N95 fit testing. INTERVENTIONS: Fit testing of new iMASC system. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome is success of fit testing using an Occupational Safety and Health Administration (OSHA)-approved testing method, and secondary outcomes are user experience with fit, breathability and filter replacement. RESULTS: Twenty-four subjects were recruited to undergo fit testing, and the average age of subjects was 41 years (range of 21-65 years) with an average body mass index of 26.5 kg/m2. The breakdown of participants by profession was 46% nurses (n=11), 21% attending physicians (n=5), 21% resident physicians (n=5) and 12% technicians (n=3). Of these participants, four did not perform the fit testing due to the inability to detect saccharin solution on premask placement sensitivity test, lack of time and inability to place mask over hair. All participants (n=20) who performed the fit test were successfully fitted for the iMASC system using an OSHA-approved testing method. User experience with the iMASC system, as evaluated using a Likert scale with a score of 1 indicating excellent and a score of 5 indicating very poor, demonstrated an average fit score of 1.75, breathability of 1.6, and ease of replacing the filter on the mask was scored on average as 2.05. CONCLUSIONS: The iMASC system was shown to successfully fit multiple different face sizes and shapes using an OSHA-approved testing method. These data support further certification testing needed for use in the healthcare setting.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desenho de Equipamento , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória , Elastômeros de Silicone , Adulto , Idoso , Pessoal Técnico de Saúde , Betacoronavirus , COVID-19 , Infecções por Coronavirus/transmissão , Reutilização de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Médicos , Pneumonia Viral/transmissão , Estudos Prospectivos , SARS-CoV-2 , Esterilização , Adulto Jovem
18.
Clin Transl Gastroenterol ; 11(12): e00229, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33512801

RESUMO

INTRODUCTION: Bile acids, such as chenodeoxycholic acid, play an important role in digestion but are also involved in intestinal motility, fluid homeostasis, and humoral activity. Colonic delivery of sodium chenodeoxycholate (CDC) has demonstrated clinical efficacy in treating irritable bowel syndrome with constipation but was associated with a high frequency of abdominal pain. We hypothesized that these adverse effects were triggered by local super-physiological CDC levels caused by an unfavorable pharmacokinetic profile of the delayed release formulation. METHODS: We developed novel release matrix systems based on hydroxypropyl methylcellulose (HPMC) for sustained release of CDC. These included standard HPMC formulations as well as bi-layered formulations to account for potential delivery failures due to low colonic fluid in constipated patients. We evaluated CDC release profiles in silico (pharmacokinetic modeling), in vitro and in vivo in swine (pharmacokinetics, rectal manometry). RESULTS: For the delayed release formulation in vitro release studies demonstrated pH triggered dose dumping which was associated with giant colonic contractions in vivo. Release from the bi-layered HPMC systems provided controlled release of CDC while minimizing the frequency of giant contractions and providing enhanced exposure as compared to standard HPMC formulations in vivo. DISCUSSION: Bi-phasic CDC release could help treat constipation while mitigating abdominal pain observed in previous clinical trials. Further studies are necessary to demonstrate the therapeutic potential of these systems in humans.


Assuntos
Ácido Quenodesoxicólico/administração & dosagem , Portadores de Fármacos/química , Derivados da Hipromelose/química , Animais , Ácido Quenodesoxicólico/farmacocinética , Colo/química , Colo/metabolismo , Simulação por Computador , Constipação Intestinal/tratamento farmacológico , Constipação Intestinal/etiologia , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/farmacocinética , Liberação Controlada de Fármacos , Feminino , Humanos , Concentração de Íons de Hidrogênio , Mucosa Intestinal/química , Mucosa Intestinal/metabolismo , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/tratamento farmacológico , Modelos Animais , Modelos Biológicos , Peristaltismo/efeitos dos fármacos , Suínos
19.
Soft Robot ; 6(1): 150-159, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30457929

RESUMO

Stimuli-responsive hydrogels are promising candidates for use in the targeted delivery of drugs using microrobotics. These devices enable the delivery and sustained release of quantities of drugs several times greater than their dry weight and are responsive to external stimuli. However, existing systems have two major drawbacks: (1) severe drug leakage before reaching the targeted areas within the body and (2) impeded locomotion through liquids due to the inherent hydrophilicity of hydrogels. This article outlines an approach to the assembly of hydrogel-based microcapsules in which one device is assembled within another to prevent drug leakage during transport. Inspired by the famous Russian stacking dolls (Matryoshka), the proposed scheme not only improves drug-loading efficiency but also facilitates the movement of hydrogel-based microcapsules driven by an external magnetic field. At room temperature, drug leakage from the hydrogel matrix is 90%. However, at body temperature the device folds up and assembles to encapsulate the drug, thereby reducing leakage to a mere 6%. The Matryoshka-inspired micro-origami capsule (MIMC) can disassemble autonomously when it arrives at a targeted site, where the temperature is slightly above body temperature. Up to 30% of the encapsulated drug was shown to diffuse from the hydrogel matrix within 1 h when it unfolds and disassembles. The MIMC is also shown to enhance the movement of magnetically driven microcapsules while navigating through media with a low Reynolds number. The translational velocity of the proposed MIMC (four hydrogel-based microcapsules) driven by magnetic gradients is more than three times greater than that of a conventional (single) hydrogel-based microcapsule.


Assuntos
Cápsulas/química , Sistemas de Liberação de Medicamentos/métodos , Tecnologia Farmacêutica/métodos , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Hidrogéis/química , Federação Russa , Temperatura
20.
Nat Commun ; 7: 12263, 2016 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-27447088

RESUMO

Nature provides a wide range of inspiration for building mobile micromachines that can navigate through confined heterogenous environments and perform minimally invasive environmental and biomedical operations. For example, microstructures fabricated in the form of bacterial or eukaryotic flagella can act as artificial microswimmers. Due to limitations in their design and material properties, these simple micromachines lack multifunctionality, effective addressability and manoeuvrability in complex environments. Here we develop an origami-inspired rapid prototyping process for building self-folding, magnetically powered micromachines with complex body plans, reconfigurable shape and controllable motility. Selective reprogramming of the mechanical design and magnetic anisotropy of body parts dynamically modulates the swimming characteristics of the micromachines. We find that tail and body morphologies together determine swimming efficiency and, unlike for rigid swimmers, the choice of magnetic field can subtly change the motility of soft microswimmers.


Assuntos
Microtecnologia/métodos , Movimento , Anisotropia , Desenho de Equipamento , Magnetismo , Nanopartículas de Magnetita/química , Microtecnologia/instrumentação
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