RESUMO
Personalized medical diagnostics and monitoring have become increasingly important due to inefficient and delayed medical services of traditional centralized healthcare systems. To enhance the comfort and portability, flexible health monitoring systems have been developed in recent years. In particular, smart fiber/textile-based sensing devices show superiority for continuously monitoring personal health and vital physiological parameters owing to their light weight, good flexibility and inherent miniaturization. This review focuses on the recent advances in smart fiber/textile-based sensing devices for wearable electronic applications. First, fabrication strategies of smart sensing fibers/textiles are introduced in detail. In addition, sensing performances, working principles and applications of smart sensing fibers/textiles such as pressure sensing fibers/textiles, stretchable strain sensing fibers/textiles, temperature sensing fibers/textiles, and biofluid, gas and humidity sensing fibers/textiles in health monitoring are also reviewed systematically. Finally, we propose current challenges and future prospects in the area of fiber/textile-based sensors for wearable healthcare monitoring and diagnosis systems. In general, this review aims to give an overall perspective of the promising field by reviewing various fiber/textile-based sensing devices and highlighting the importance for researchers to keep up with the sequential exploration of soft sensing fibers/textiles for applications in wearable smart systems.
Assuntos
Têxteis , Dispositivos Eletrônicos Vestíveis , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Desenho de Equipamento , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodosRESUMO
Flexible self-powered bioelectronics (FSPBs), incorporating flexible electronic features in biomedical applications, have revolutionized the human-machine interface since they hold the potential to offer natural and seamless human interactions while overcoming the limitations of battery-dependent power sources. Furthermore, as biosensors or actuators, FSPBs can dynamically monitor physiological signals to reveal real-time health abnormalities and provide timely and precise treatments. Therefore, FSPBs are increasingly shaping the landscape of health monitoring and disease treatment, weaving a sophisticated and personalized bond between humans and health management. Here, we examine the recent advanced progress of FSPBs in developing working mechanisms, design strategies, and structural configurations toward personalized health management, emphasizing its role in clinical medical scenarios from biophysical/biochemical sensors for sensing diagnosis to robust/biodegradable actuators for intervention therapy. Future perspectives on the challenges and opportunities in emerging multifunctional FSPBs for the next-generation health management systems are also forecasted.
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Técnicas Biossensoriais , Medicina de Precisão , Dispositivos Eletrônicos Vestíveis , Humanos , Medicina de Precisão/métodos , Medicina de Precisão/instrumentação , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Fontes de Energia ElétricaRESUMO
INTRODUCTION: Surgery and biomedical imaging encompass a big share of the medical-device market. The ever-mounting demand for precision surgery has driven the integration of these two into the field of image-guided surgery. A key-question herein is how imaging modalities can guide the surgical decision-making process. Through performance-based design, chemists, engineers, and doctors need to build a bridge between imaging technologies and surgical challenges. AREAS-COVERED: This perspective article highlights the complementary nature between the technological design of an image-guidance modality and the type of procedure performed. The specific roles of the involved professionals, imaging technologies, and surgical indications are addressed. EXPERT-OPINION: Molecular-image-guided surgery has the potential to advance pre-, intra- and post-operative tissue characterization. To achieve this, surgeons need the access to well-designed indication-specific chemical-agents and detection modalities. Hereby, some technologies stimulate exploration ('go'), while others stimulate caution ('stop'). However, failing to adequately address the indication-specific needs rises the risk of incorrect tool employment and sub-optimal surgical performance. Therefore, besides the availability of new technologies, market growth is highly dependent on the practical nature and impact on real-life clinical care. While urology currently takes the lead in the widespread implementation of image-guidance technologies, the topic is generic and its popularity spreads rapidly within surgical oncology.
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Cirurgia Assistida por Computador , Humanos , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos , Diagnóstico por Imagem/métodos , Diagnóstico por Imagem/instrumentação , Medicina de Precisão/métodos , Medicina de Precisão/instrumentação , Equipamentos e ProvisõesRESUMO
Bioelectronic implants delivering electrical stimulation offer an attractive alternative to traditional pharmaceuticals in electrotherapy. However, achieving simple, rapid, and cost-effective personalization of these implants for customized treatment in unique clinical and physical scenarios presents a substantial challenge. This challenge is further compounded by the need to ensure safety and minimal invasiveness, requiring essential attributes such as flexibility, biocompatibility, lightness, biodegradability, and wireless stimulation capability. Here, a flexible, biodegradable bioelectronic paper with homogeneously distributed wireless stimulation functionality for simple personalization of bioelectronic implants is introduced. The bioelectronic paper synergistically combines i) lead-free magnetoelectric nanoparticles (MENs) that facilitate electrical stimulation in response to external magnetic field and ii) flexible and biodegradable nanofibers (NFs) that enable localization of MENs for high-selectivity stimulation, oxygen/nutrient permeation, cell orientation modulation, and biodegradation rate control. The effectiveness of wireless electrical stimulation in vitro through enhanced neuronal differentiation of neuron-like PC12 cells and the controllability of their microstructural orientation are shown. Also, scalability, design flexibility, and rapid customizability of the bioelectronic paper are shown by creating various 3D macrostructures using simple paper crafting techniques such as cutting and folding. This platform holds promise for simple and rapid personalization of temporary bioelectronic implants for minimally invasive wireless stimulation therapies.
Assuntos
Implantes Absorvíveis , Magnetismo , Medicina de Precisão , Tecnologia sem Fio , Papel , Medicina de Precisão/instrumentação , Humanos , Masculino , Animais , Ratos , Encéfalo , Eletrônica Médica/instrumentaçãoRESUMO
Objective To explore the short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures, and explore the quantification of traditional Chinese medicine manual reduction and personalized improvement of splinting. Methods The clinical data of 50 patients with AO type-A distal radius fractures, who received treatment at the outpatient department of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province, were retrospective analyzed. The patient cohort included 22 females and 28 males, with ages ranging from 25 to 75 years old. Among them, 27 cases presented with distal radius fractures on the left side, and 24 cases on the right side. The patients were categorized into two groups: treatment group (n=25) and control group(n=25). There were 13 males and 12 females in the treatment group, with an average age of (56.2±5.5) years old. Treatment approach for this group involved several steps. Initially, Mimics Research software was used to conduct comprehensive analysis of complete CT data from the affected limb, resulting in the creation of a three-dimensional model. Subsequently, 3D models of the bones and skin contours, stored as STL format files, were imported into the Materialise Magics 23.0 software for model processing and repair. This facilitated the simulation of reduction and recording of displacement data, effectively generating a "digital prescription" to guide and quantify traditional Chinese medicine manipulation procedures. Finally, a personalized 3D printed splint was applied for fixation treatment. There were 15 males and 10 females in the control group, with an average age of (53.32±5.28) years old. These patients were treated with manualreduction combined with traditional splinting. The clinical efficacy of the two groups was assessed in terms of fracture reduction quality, fracture healing time, Gartland-Werley wrist joint score and X-ray parameters (palminclination angle, ulnar deviation angle, radius height) at 6 weeks post-operatively. Results The treatment group exhibited a shorter duration for achieving clinical healing compared to the control group (P<0.05). Six weeks post-operatively, the treatment group demonstrated higher wrist joint function scores, and a higher proportion of excellent and good outcomes than the control group(P<0.05). The treatment group was superior to the control group in terms of imaging parameters 6 weeks post-operatively (P<0.05). Conclusion By quantifying skin contours through digital simulation prescription reduction, a personalized 3D printed splint is developed to effectively stabilize fractures, enhancing localized fixation while ensuring greater adherence, stability, and comfort. This innovative approach offers personalized treatment for AO type-A distal radius fractures and presents a novel, precise treatment strategy for consideration.
Assuntos
Manipulação Ortopédica , Medicina Tradicional Chinesa , Impressão Tridimensional , Contenções , Terapia Assistida por Computador , Fraturas do Punho , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População do Leste Asiático , Estudos Retrospectivos , Fraturas do Punho/diagnóstico por imagem , Fraturas do Punho/cirurgia , Fraturas do Punho/terapia , Medicina Tradicional Chinesa/métodos , Terapia Assistida por Computador/instrumentação , Terapia Assistida por Computador/métodos , Manipulação Ortopédica/métodos , Tomografia Computadorizada por Raios X , Medicina de Precisão/instrumentação , Medicina de Precisão/métodosRESUMO
In the past few decades, stem cell-based regenerative engineering has demonstrated its significant potential to repair damaged tissues and to restore their functionalities. Despite such advancement in regenerative engineering, the clinical translation remains a major challenge. In the stance of personalized treatment, the recent progress in bioelectronic medicine likewise evolved as another important research domain of larger significance for human healthcare. Over the last several years, our research group has adopted biomaterials-based regenerative engineering strategies using innovative bioelectronic stimulation protocols based on either electric or magnetic stimuli to direct cellular differentiation on engineered biomaterials with a range of elastic stiffness or functional properties (electroactivity/magnetoactivity). In this article, the role of bioelectronics in stem cell-based regenerative engineering has been critically analyzed to stimulate futuristic research in the treatment of degenerative diseases as well as to address some fundamental questions in stem cell biology. Built on the concepts from two independent biomedical research domains (regenerative engineering and bioelectronic medicine), we propose a converging research theme, 'Regenerative Bioelectronics'. Further, a series of recommendations have been put forward to address the current challenges in bridging the gap in stem cell therapy and bioelectronic medicine. Enacting the strategic blueprint of bioelectronic-based regenerative engineering can potentially deliver the unmet clinical needs for treating incurable degenerative diseases.
Assuntos
Eletrônica Médica , Medicina de Precisão , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Nanoestruturas , Eletrônica Médica/instrumentação , Eletrônica Médica/métodos , Materiais Biocompatíveis/química , MagnetismoRESUMO
Recent developments in the area of resonant dielectric nanostructures have created attractive opportunities for concentrating and manipulating light at the nanoscale and the establishment of the new exciting field of all-dielectric nanophotonics. Transition metal dichalcogenides (TMDCs) with nanopatterned surfaces are especially promising for these tasks. Still, the fabrication of these structures requires sophisticated lithographic processes, drastically complicating application prospects. To bridge this gap and broaden the application scope of TMDC nanomaterials, we report here femtosecond laser-ablative fabrication of water-dispersed spherical TMDC (MoS2 and WS2) nanoparticles (NPs) of variable size (5 to 250 nm). Such NPs demonstrate exciting optical and electronic properties inherited from TMDC crystals, due to preserved crystalline structure, which offers a unique combination of pronounced excitonic response and high refractive index value, making possible a strong concentration of electromagnetic field in the NPs. Furthermore, such NPs offer additional tunability due to hybridization between the Mie and excitonic resonances. Such properties bring to life a number of nontrivial effects, including enhanced photoabsorption and photothermal conversion. As an illustration, we demonstrate that the NPs exhibit a very strong photothermal response, much exceeding that of conventional dielectric nanoresonators based on Si. Being in a mobile colloidal state and exhibiting superior optical properties compared to other dielectric resonant structures, the synthesized TMDC NPs offer opportunities for the development of next-generation nanophotonic and nanotheranostic platforms, including photothermal therapy and multimodal bioimaging.
Assuntos
Nanosferas , Medicina de Precisão , Refratometria , Molibdênio , Nanosferas/uso terapêutico , Medicina de Precisão/instrumentação , ÁguaRESUMO
BACKGROUND: Gallbladder carcinoma (GBC) is a relatively rare but highly aggressive cancer with late clinical detection and a poor prognosis. However, the lack of models with features consistent with human gallbladder tumours has hindered progress in pathogenic mechanisms and therapies. METHODS: We established organoid lines derived from human GBC as well as normal gallbladder and benign gallbladder adenoma (GBA) tissues. The histopathology signatures of organoid cultures were identified by H&E staining, immunohistochemistry and immunofluorescence. The genetic and transcriptional features of organoids were analysed by whole-exome sequencing and RNA sequencing. A set of compounds targeting the most active signalling pathways in GBCs were screened for their ability to suppress GBC organoids. The antitumour effects of candidate compounds, CUDC-101 and CUDC-907, were evaluated in vitro and in vivo. RESULTS: The established organoids were cultured stably for more than 6 months and closely recapitulated the histopathology, genetic and transcriptional features, and intratumour heterogeneity of the primary tissues at the single-cell level. Notably, expression profiling analysis of the organoids revealed a set of genes that varied across the three subtypes and thus may participate in the malignant progression of gallbladder diseases. More importantly, we found that the dual PI3K/HDAC inhibitor CUDC-907 significantly restrained the growth of various GBC organoids with minimal toxicity to normal gallbladder organoids. CONCLUSIONS: Patient-derived organoids are potentially a useful platform to explore molecular pathogenesis of gallbladder tumours and discover personalized drugs.
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Ensaios de Seleção de Medicamentos Antitumorais/métodos , Neoplasias da Vesícula Biliar/diagnóstico , Modelos Biológicos , Organoides/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios de Seleção de Medicamentos Antitumorais/estatística & dados numéricos , Detecção Precoce de Câncer/instrumentação , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Neoplasias da Vesícula Biliar/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Medicina de Precisão/estatística & dados numéricos , Sequenciamento do Exoma/métodos , Sequenciamento do Exoma/estatística & dados numéricosRESUMO
The molecular nanoscale organization of the surfaceome is a fundamental regulator of cellular signaling in health and disease. Technologies for mapping the spatial relationships of cell surface receptors and their extracellular signaling synapses would unlock theranostic opportunities to target protein communities and the possibility to engineer extracellular signaling. Here, we develop an optoproteomic technology termed LUX-MS that enables the targeted elucidation of acute protein interactions on and in between living cells using light-controlled singlet oxygen generators (SOG). By using SOG-coupled antibodies, small molecule drugs, biologics and intact viral particles, we demonstrate the ability of LUX-MS to decode ligand receptor interactions across organisms and to discover surfaceome receptor nanoscale organization with direct implications for drug action. Furthermore, by coupling SOG to antigens we achieved light-controlled molecular mapping of intercellular signaling within functional immune synapses between antigen-presenting cells and CD8+ T cells providing insights into T cell activation with spatiotemporal specificity. LUX-MS based decoding of surfaceome signaling architectures thereby provides a molecular framework for the rational development of theranostic strategies.
Assuntos
Células Apresentadoras de Antígenos/imunologia , Linfócitos T CD8-Positivos/imunologia , Sinapses Imunológicas/metabolismo , Optogenética/métodos , Proteômica/métodos , Receptores de Superfície Celular/imunologia , Anticorpos/química , Células Apresentadoras de Antígenos/citologia , Linfócitos B/imunologia , Linfócitos B/patologia , Produtos Biológicos/química , Linfócitos T CD8-Positivos/citologia , Comunicação Celular , Linhagem Celular Tumoral , Cromatografia Líquida , Expressão Gênica , Células HL-60 , Humanos , Ligantes , Luz , Ativação Linfocitária , Optogenética/instrumentação , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Ligação Proteica , Proteômica/instrumentação , Receptores de Superfície Celular/genética , Transdução de Sinais , Oxigênio Singlete/química , Oxigênio Singlete/metabolismo , Bibliotecas de Moléculas Pequenas/química , Espectrometria de Massas em Tandem , Vírion/químicaAssuntos
Testes Farmacogenômicos/estatística & dados numéricos , China , Clopidogrel/metabolismo , Clopidogrel/farmacologia , Citocromo P-450 CYP2C19/efeitos dos fármacos , Citocromo P-450 CYP2C19/genética , Citocromo P-450 CYP2C9/efeitos dos fármacos , Citocromo P-450 CYP2C9/genética , Humanos , Testes Farmacogenômicos/métodos , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Vitamina K Epóxido Redutases/efeitos dos fármacos , Vitamina K Epóxido Redutases/genética , Varfarina/metabolismo , Varfarina/farmacologiaRESUMO
BACKGROUND: Endoscopic transnasal transclival intradural surgery is limited by a high postoperative cerebrospinal fluid leak rate. The aim of this study was to investigate the role of three-dimensional printing to create a personalized, rigid scaffold for clival reconstruction. METHODS: Two different types of clivectomy were performed in 5 specimens with the aid of neuronavigation, and 11 clival reconstructions were simulated. They were repaired with polylactide, three-dimensional-printed scaffolds that were manually designed in a computer-aided environment based either on the real or on the predicted defect. Scaffolds were printed with a fused filament fabrication technique and different offsets. They were positioned and fixed either following the gasket seal technique or with screws. Postdissection radiological evaluation of scaffold position was performed in all cases. In 3 specimens, the cerebrospinal fluid leak pressure point was measured immediately after reconstruction. RESULTS: The production process took approximately 30 hours. The designed scaffolds were satisfactory when no offset was added. Wings were added during the design to allow for screw positioning, but broke in 30% of cases. Radiological assessment documented maximal accuracy of scaffold positioning when the scaffold was created on the real defect; accuracy was satisfactory when the predicted clivectomy was performed under neuronavigation guidance. The cerebrospinal fluid leak pressure point was significantly higher when the scaffold was fixed with screws compared with the gasket technique. CONCLUSIONS: In this preclinical setting, additive manufacturing allows the creation of customized scaffolds that are effective in reconstructing even large and geometrically complex clival defects.
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Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/cirurgia , Neuroendoscopia/métodos , Procedimentos de Cirurgia Plástica/métodos , Medicina de Precisão/métodos , Estudo de Prova de Conceito , Parafusos Ósseos/efeitos adversos , Vazamento de Líquido Cefalorraquidiano/diagnóstico por imagem , Vazamento de Líquido Cefalorraquidiano/etiologia , Simulação por Computador , Humanos , Imageamento Tridimensional/métodos , Neuroendoscopia/instrumentação , Neuronavegação/instrumentação , Neuronavegação/métodos , Medicina de Precisão/instrumentação , Impressão Tridimensional/instrumentação , Procedimentos de Cirurgia Plástica/instrumentação , Base do Crânio/diagnóstico por imagem , Base do Crânio/cirurgia , Tomografia Computadorizada por Raios X/métodosRESUMO
While the printed circuit board (PCB) has been widely considered as the building block of integrated electronics, the world is switching to pursue new ways of merging integrated electronic circuits with textiles to create flexible and wearable devices. Herein, as an alternative for PCB, we described a non-printed integrated-circuit textile (NIT) for biomedical and theranostic application via a weaving method. All the devices are built as fibers or interlaced nodes and woven into a deformable textile integrated circuit. Built on an electrochemical gating principle, the fiber-woven-type transistors exhibit superior bending or stretching robustness, and were woven as a textile logical computing module to distinguish different emergencies. A fiber-type sweat sensor was woven with strain and light sensors fibers for simultaneously monitoring body health and the environment. With a photo-rechargeable energy textile based on a detailed power consumption analysis, the woven circuit textile is completely self-powered and capable of both wireless biomedical monitoring and early warning. The NIT could be used as a 24/7 private AI "nurse" for routine healthcare, diabetes monitoring, or emergencies such as hypoglycemia, metabolic alkalosis, and even COVID-19 patient care, a potential future on-body AI hardware and possibly a forerunner to fabric-like computers.
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Técnicas Biossensoriais/instrumentação , Medicina de Precisão/instrumentação , Têxteis , Dispositivos Eletrônicos Vestíveis , Tecnologia sem Fio/instrumentação , Técnicas Biossensoriais/métodos , COVID-19/diagnóstico , COVID-19/prevenção & controle , COVID-19/virologia , Desenho de Equipamento , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Medicina de Precisão/métodos , SARS-CoV-2/fisiologia , Suor/fisiologiaRESUMO
How to precisely detect and effectively cure cancer which is defined as precise nanomedicine has drawn great attention worldwide. Polymeric nanoreactors which can in situ catalyze inert species into activated ones, can greatly increase imaging quality and enhance therapeutic effects along with decreased background interference and reduced serious side effects. After a brief introduction, the design and preparation of polymeric nanoreactors are discussed from the following aspects, that is, solvent-switch, pH-tuning, film rehydration, hard template, electrostatic interaction, and polymerization-induced self-assembly (PISA). Subsequently, the biomedical applications of these nanoreactors in the fields of cancer imaging, cancer therapy, and cancer theranostics are highlighted. The last but not least, conclusions and future perspectives about polymeric nanoreactors are given. It is believed that polymeric nanoreactors can bring a great opportunity for future fabrication and clinical translation of precise nanomedicine.
Assuntos
Portadores de Fármacos , Nanoestruturas/química , Neoplasias/terapia , Polímeros/síntese química , Medicina de Precisão/métodos , Nanomedicina Teranóstica/métodos , Células A549 , Animais , Reatores Biológicos , Humanos , Concentração de Íons de Hidrogênio , Membranas Artificiais , Camundongos , Nanoestruturas/administração & dosagem , Nanoestruturas/ultraestrutura , Neoplasias/metabolismo , Neoplasias/patologia , Polímeros/farmacocinética , Medicina de Precisão/instrumentação , Solventes/química , Eletricidade Estática , Tensoativos/química , Tensoativos/farmacocinética , Nanomedicina Teranóstica/instrumentação , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
PURPOSE: Bony resection is the primary step during total knee arthroplasty. The accuracy of bony resection was highly addressed because it was deemed to have a good relationship with mechanical line. Patient-specific instruments (PSI) were invented to copy the bony resection references from the preoperative surgical plan during a total knee arthroplasty (TKA); however, the accuracy still remains controversial. This study was aimed at finding out the accuracy of the bony resection during PSI-assisted TKA. METHODS: Forty-two PSI-assisted TKAs (based on full-length leg CT images) were analyzed retrospectively. Resected bones of every patient were given a CT scan, and three-dimensional radiographs were reconstructed. The thickness of each bony resection was measured with the three-dimensional radiographs and recorded. The saw blade thickness (1.27 mm) was added to the measurements, and the results represented intraoperative bone resection thickness. A comparison between intraoperative bone resection thickness and preoperatively planned thickness was conducted. The differences were calculated, and the outliers were defined as >3 mm. RESULTS: The distal femoral condyle had the most accurate bone cuts with the smallest difference (median, 1.0 mm at the distal medial femoral condyle and 0.8 mm at the distal lateral femoral condyle) and the least outliers (none at the distal medial femoral condyle and 1 (2.4%) at the distal lateral femoral condyle). The tibial plateau came in second (median difference, 0.8 mm at the medial tibial plateau and 1.4 mm at the lateral tibial plateau; outliers, none at the medial tibial plateau and 1 (2.6%) at the lateral tibial plateau). Regardless of whether the threshold was set to >2 mm (14 (17.9%) at the tibial plateau vs. 12 (14.6%) at the distal femoral condyle, p > 0.05) or >3 mm (1 (1.3%) at the tibial plateau vs. 1 (1.2%) at the distal femoral condyle, p > 0.05), the accuracy of tibial plateau osteotomy was similar to that of the distal femoral condyle. Osteotomy accuracy at the posterior femoral condyle and the anterior femoral condyle were the worst. Outliers were up to 6 (15.0%) at the posterior medial femoral condyle, 5 (12.2%) at the posterior lateral femoral condyle, and 6 (15.8%) at the anterior femoral condyle. The percentages of overcut and undercut tended to 50% in most parts except the lateral tibial plateau. At the lateral tibial plateau, the undercut percentage was twice that of the overcut. CONCLUSION: The tibial plateau and the distal femoral condyle share a similar accuracy of osteotomy with PSI. PSI have a generally good accuracy during the femur and tibia bone resection in TKA. PSI could be a kind of user-friendly tool which can simplify TKA with good accuracy. Level of Evidence. This is a Level IV case series with no comparison group.
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Artroplastia do Joelho , Articulação do Joelho/cirurgia , Medicina de Precisão , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/instrumentação , Artroplastia do Joelho/métodos , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Estudos RetrospectivosRESUMO
BACKGROUND: Identifying variants that drive tumor progression (driver variants) and distinguishing these from variants that are a byproduct of the uncontrolled cell growth in cancer (passenger variants) is a crucial step for understanding tumorigenesis and precision oncology. Various bioinformatics methods have attempted to solve this complex task. RESULTS: In this study, we investigate the assumptions on which these methods are based, showing that the different definitions of driver and passenger variants influence the difficulty of the prediction task. More importantly, we prove that the data sets have a construction bias which prevents the machine learning (ML) methods to actually learn variant-level functional effects, despite their excellent performance. This effect results from the fact that in these data sets, the driver variants map to a few driver genes, while the passenger variants spread across thousands of genes, and thus just learning to recognize driver genes provides almost perfect predictions. CONCLUSIONS: To mitigate this issue, we propose a novel data set that minimizes this bias by ensuring that all genes covered by the data contain both driver and passenger variants. As a result, we show that the tested predictors experience a significant drop in performance, which should not be considered as poorer modeling, but rather as correcting unwarranted optimism. Finally, we propose a weighting procedure to completely eliminate the gene effects on such predictions, thus precisely evaluating the ability of predictors to model the functional effects of single variants, and we show that indeed this task is still open.
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Carcinogênese/genética , Progressão da Doença , Aprendizado de Máquina , Oncologia/instrumentação , Neoplasias/genética , Medicina de Precisão/instrumentação , Neoplasias/patologiaRESUMO
Sonodynamic therapy (SDT) is a promising non-invasive therapeutic modality with an extensive application prospect. Due to the engineerable nature of nanotechnology, nanosensitizers with predominant advantages of increased SDT efficacy and targeting specificity have attracted more and more research recently. In this review, we introduce the current investigations of nanosonosensitizers and focus on the potential strategies on nanoparticles-assisted sonosensitizers to enhance SDT efficacy. We extensively discuss the biomedical applications of ultrasound activated nanosonosensitizers in SDT and theranostics.
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Nanomedicina/instrumentação , Nanomedicina/métodos , Nanopartículas/química , Medicina de Precisão/instrumentação , Terapia por Ultrassom/métodos , Animais , Terapia Combinada , Sistemas de Liberação de Medicamentos , Humanos , Lipossomos/química , Camundongos , Neoplasias/terapia , Tamanho da Partícula , Porfirinas/química , Medicina de Precisão/métodos , Espécies Reativas de Oxigênio , Propriedades de Superfície , Titânio/químicaRESUMO
Bipolar disorder (BD) is a complex neurobiological disorder characterized by a pathologic mood swing. Digital phenotyping, defined as the 'moment-by-moment quantification of the individual-level human phenotype in its own environment', represents a new approach aimed at measuring the human behavior and may theoretically enhance clinicians' capability in early identification, diagnosis, and management of any mental health conditions, including BD. Moreover, a digital phenotyping approach may easily introduce and allow clinicians to perform a more personalized and patient-tailored diagnostic and therapeutic approach, in line with the framework of precision psychiatry. The aim of the present paper is to investigate the role of digital phenotyping in BD. Despite scarce literature published so far, extremely heterogeneous methodological strategies, and limitations, digital phenotyping may represent a grounding research and clinical field in BD, by owning the potentialities to quickly identify, diagnose, longitudinally monitor, and evaluating clinical response and remission to psychotropic drugs. Finally, digital phenotyping might potentially constitute a possible predictive marker for mood disorders.
Assuntos
Transtorno Bipolar/genética , Endofenótipos , Telemedicina/métodos , Biomarcadores/metabolismo , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/terapia , Humanos , Aplicativos Móveis , Medicina de Precisão/instrumentação , Medicina de Precisão/métodos , Telemedicina/instrumentaçãoRESUMO
Socially assistive robotics (SAR) has great potential to provide accessible, affordable, and personalized therapeutic interventions for children with autism spectrum disorders (ASD). However, human-robot interaction (HRI) methods are still limited in their ability to autonomously recognize and respond to behavioral cues, especially in atypical users and everyday settings. This work applies supervised machine-learning algorithms to model user engagement in the context of long-term, in-home SAR interventions for children with ASD. Specifically, we present two types of engagement models for each user: (i) generalized models trained on data from different users and (ii) individualized models trained on an early subset of the user's data. The models achieved about 90% accuracy (AUROC) for post hoc binary classification of engagement, despite the high variance in data observed across users, sessions, and engagement states. Moreover, temporal patterns in model predictions could be used to reliably initiate reengagement actions at appropriate times. These results validate the feasibility and challenges of recognition and response to user disengagement in long-term, real-world HRI settings. The contributions of this work also inform the design of engaging and personalized HRI, especially for the ASD community.
Assuntos
Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Robótica/instrumentação , Tecnologia Assistiva , Comportamento Social , Algoritmos , Criança , Comportamento Infantil , Auxiliares de Comunicação para Pessoas com Deficiência , Sinais (Psicologia) , Estudos de Viabilidade , Serviços de Assistência Domiciliar , Humanos , Modelos Psicológicos , Modelos Teóricos , Medicina de Precisão/instrumentação , Medicina de Precisão/estatística & dados numéricos , Robótica/estatística & dados numéricos , Aprendizado de Máquina Supervisionado , Interface Usuário-ComputadorRESUMO
Mobile microrobots offer great promise for minimally invasive targeted medical theranostic applications at hard-to-access regions inside the human body. The circulatory system represents the ideal route for navigation; however, blood flow impairs propulsion of microrobots especially for the ones with overall sizes less than 10 micrometers. Moreover, cell- and tissue-specific targeting is required for efficient recognition of disease sites and long-term preservation of microrobots under dynamic flow conditions. Here, we report cell-sized multifunctional surface microrollers with ~3.0 and ~7.8-micrometer diameters, inspired by leukocytes in the circulatory system, for targeted drug delivery into specific cells and controlled navigation inside blood flow. The leukocyte-inspired spherical microrollers are composed of magnetically responsive Janus microparticles functionalized with targeting antibodies against cancer cells (anti-HER2) and light-cleavable cancer drug molecules (doxorubicin). Magnetic propulsion and steering of the microrollers resulted in translational motion speeds up to 600 micrometers per second, around 76 body lengths per second. Targeting cancer cells among a heterogeneous cell population was demonstrated by active propulsion and steering of the microrollers over the cell monolayers. The multifunctional microrollers were propelled against physiologically relevant blood flow (up to 2.5 dynes per square centimeter) on planar and endothelialized microchannels. Furthermore, the microrollers generated sufficient upstream propulsion to locomote on inclined three-dimensional surfaces in physiologically relevant blood flow. The multifunctional microroller platform described here presents a bioinspired approach toward in vivo controlled propulsion, navigation, and targeted active cargo delivery in the circulatory system.
Assuntos
Sistemas de Liberação de Medicamentos/instrumentação , Robótica/instrumentação , Antineoplásicos/administração & dosagem , Materiais Biomiméticos , Linhagem Celular Tumoral , Doxorrubicina/administração & dosagem , Desenho de Equipamento , Hemodinâmica/fisiologia , Humanos , Magnetismo , Microtecnologia/instrumentação , Movimento (Física) , Nanopartículas Multifuncionais/química , Nanopartículas Multifuncionais/ultraestrutura , Medicina de Precisão/instrumentação , Propriedades de SuperfícieRESUMO
Cancer is a heterogeneous disease that requires a multimodal approach to diagnose, manage and treat. A better understanding of the disease biology can lead to identification of novel diagnostic/prognostic biomarkers and the discovery of the novel therapeutics with the goal of improving patient outcomes. Employing advanced technologies can facilitate this, enabling better diagnostic and treatment for cancer patients. In this regard, microfluidic technology has emerged as a promising tool in the studies of cancer, including single cancer cell analysis, modeling angiogenesis and metastasis, drug screening and liquid biopsy. Microfluidic technologies have opened new ways to study tumors in the preclinical and clinical settings. In this chapter, we highlight novel application of this technology in area of fundamental, translational and clinical cancer research.