Field-Portable Microplastic Sensing in Aqueous Environments: A Perspective on Emerging Techniques.

Microplastics (MPs) have been found in aqueous environments ranging from rural ponds and lakes to the deep ocean. Despite the ubiquity of MPs, our ability to characterize MPs in the environment is limited by the lack of technologies for rapidly and accurately identifying and quantifying MPs. Although standards exist for MP sample collection and preparation, methods of MP analysis vary considerably and produce data with a broad range of data content and quality. The need for extensive analysis-specific sample preparation in current technology approaches has hindered the emergence of a single technique which can operate on aqueous samples in the field, rather than on dried laboratory preparations. In this perspective, we consider MP measurement technologies with a focus on both their eventual field-deployability and their respective data products (e.g., MP particle count, size, and/or polymer type). We present preliminary demonstrations of several prospective MP measurement techniques, with an eye towards developing a solution or solutions that can transition from the laboratory to the field. Specifically, experimental results are presented from multiple prototype systems that measure various physical properties of MPs: pyrolysis-differential mobility spectroscopy, short-wave infrared imaging, aqueous Nile Red labeling and counting, acoustophoresis, ultrasound, impedance spectroscopy, and dielectrophoresis.

Guiding Elastic Rods With a Robot-Manipulated Magnet for Medical Applications.

Magnet-tipped, elastic rods can be steered by an external magnetic field to perform surgical tasks. Such rods could be useful for a range of new medical applications because they do not require either pull wires or other bulky mechanisms that are problematic in small anatomical regions. However, current magnetic rod steering systems are large and expensive. Here, we describe a method to guide a rod using a robot-manipulated magnet located near a patient. We solve for rod deflections by combining permanent-magnet models with a Kirchhoff elastic rod model and use a resolved-rate approach to compute trajectories. Experiments show that three-dimensional trajectories can be executed accurately without feedback and that the system's redundancy can be exploited to avoid obstacles.

Force Perception Thresholds in Cochlear Implantation Surgery.

Tissue trauma is a frequent complication of cochlear implantation (CI) surgery, but the relationship between intracochlear trauma, electrode insertion forces, and surgeons' ability to perceive these forces is poorly understood. In this study, we simulated CI surgery using a benchtop apparatus to repeatedly apply small forces to the subjects' hands while reducing the variability in their hand movements. We used a psychophysical testing procedure to estimate the force perception thresholds of 10 otologic surgeons and found a median threshold of 20.4 mN. The results suggest that surgeons have the capability to sense at least some insertion forces and are likely to perceive severe trauma such as occurs when the electrode crosses from one scala to the other.

Correction: A high-throughput microfluidic microphysiological system (PREDICT-96) to recapitulate hepatocyte function in dynamic, re-circulating flow conditions.

Correction for 'A high-throughput microfluidic microphysiological system (PREDICT-96) to recapitulate hepatocyte function in dynamic, re-circulating flow conditions' by Kelly Tan et al., Lab Chip, 2019, 19, 1556-1566, DOI: .

Characterization of intracochlear rupture forces in fresh human cadaveric cochleae.

HYPOTHESIS: To develop a method to measure the forces required for a probe to translocate from the scala tympani (ST) to the scala vestibuli (SV) in fresh human cochleae. BACKGROUND: Translocation of cochlear implant electrodes from the ST to the SV may lead to suboptimal audiologic outcomes. Prior work investigating the rupture forces of human intracochlear membranes comes from a single study conducted on isolated ex vivo cadaveric specimens. METHODS: Fresh (postmortem <120 h), nonfixed, never-frozen human temporal bones underwent preparation consisting of surgical isolation of the cochleae and exposure of the osseous spiral lamina, basilar membrane, and Reissner's membrane complex by removing bone covering the ST and the SV. Each isolated cochlea was mounted to a force sensor using an adjustable mounting platform. A 300-µm-diameter ball-tipped probe was attached to a piezoelectric linear motor and advanced at 1 mm/s from the ST to the SV while recording force from the load cell concurrent with video. RESULTS: Ten specimens were successfully exposed and analyzed. The range of rupture forces was 42 to 122 mN, with a mean of 88 mN. Nine of the 10 specimens failed via simple puncture, whereas one failed by being avulsed from its medial attachment. CONCLUSION: Using a novel technique, we report the forces required to translocate a model of an electrode from the ST to the SV. Correlation to human perceptual ability is necessary to determine if a surgeon can detect such translocation during cochlear implant surgery.

An experimental evaluation of the force requirements for robotic mastoidectomy.

HYPOTHESIS: During robotic milling of the temporal bone, forces on the cutting burr may be lowered by choice of cutting parameters. BACKGROUND: Robotic bone removal systems are used in orthopedic procedures, but they are currently not accurate enough for safe use in otologic surgery. We propose the use of a bone-attached milling robot to achieve the required accuracy and speed. To design such a robot and plan its milling trajectories, it is necessary to predict the forces that the robot must exert and withstand under likely cutting conditions. MATERIALS AND METHODS: We measured forces during bone removal for several surgical burr types, drill angles, depths of cut, cutting velocities, and bone types (cortical/surface bone and mastoid) on human temporal bone specimens. RESULTS: Lower forces were observed for 5-mm diameter burrs compared with 3-mm burrs for a given bone removal rate. Higher linear cutting velocities and greater cutting depths independently resulted in higher forces. For combinations of velocities and depths that resulted in the same overall bone removal rate, lower forces were observed in parameter sets that combined higher cutting velocities and shallower depths. Lower mean forces and higher variability were observed in the mastoid compared with cortical/surface bone. CONCLUSION: Forces during robotic milling of the temporal bone can be predicted from the parameter sets tested in this study. This information can be used to guide the design of a sufficiently rigid and powerful bone-attached milling robot and to plan efficient milling trajectories. To reduce the time of the surgical intervention without creating very large forces, high linear cutting velocities may be combined with shallow depths of cut. Faster and deeper cuts may be used in mastoid bone compared with the cortical bone for a chosen force threshold.

A manually operated, advance off-stylet insertion tool for minimally invasive cochlear implantation surgery.

The current technique for cochlear implantation (CI) surgery requires a mastoidectomy to gain access to the cochlea for electrode array insertion. It has been shown that microstereotactic frames can enable an image-guided, minimally invasive approach to CI surgery called percutaneous cochlear implantation (PCI) that uses a single drill hole for electrode array insertion, avoiding a more invasive mastoidectomy. Current clinical methods for electrode array insertion are not compatible with PCI surgery because they require a mastoidectomy to access the cochlea; thus, we have developed a manually operated electrode array insertion tool that can be deployed through a PCI drill hole. The tool can be adjusted using a preoperative CT scan for accurate execution of the advance off-stylet (AOS) insertion technique and requires less skill to operate than is currently required to implant electrode arrays. We performed three cadaver insertion experiments using the AOS technique and determined that all insertions were successful using CT and microdissection.

Design of a bone-attached parallel robot for percutaneous cochlear implantation.

Access to the cochlea requires drilling in close proximity to bone-embedded nerves, blood vessels, and other structures, the violation of which can result in complications for the patient. It has recently been shown that microstereotactic frames can enable an image-guided percutaneous approach, removing reliance on human experience and hand-eye coordination, and reducing trauma. However, constructing current microstereotactic frames disrupts the clinical workflow, requiring multiday intrasurgical manufacturing delays, or an on-call machine shop in or near the hospital. In this paper, we describe a new kind of microsterotactic frame that obviates these delay and infrastructure issues by being repositionable. Inspired by the prior success of bone-attached parallel robots in knee and spinal procedures, we present an automated image-guided microstereotactic frame. Experiments demonstrate a mean accuracy at the cochlea of 0.20 ± 0.07 mm in phantom testing with trajectories taken from a human clinical dataset. We also describe a cadaver experiment evaluating the entire image-guided surgery pipeline, where we achieved an accuracy of 0.38 mm at the cochlea.