Biomechanical comparison of the therapeutic effect of a novel proximal femoral bionic intramedullary nail and traditional inverted triangle hollow screw on femoral neck fracture.

OBJECTIVE: A novel Proximal Femoral Bionic Nail (PFBN) has been developed by a research team for the treatment of femoral neck fractures. This study aims to compare the biomechanical properties of the innovative PFBN with those of the conventional Inverted Triangular Cannulated Screw (ITCS) fixation method through biomechanical testing. METHODS: Sixteen male femoral specimens preserved in formalin were selected, with the donors' age at death averaging 56.1 ± 6.3 years (range 47-64 years), and a mean age of 51.4 years. The femurs showed no visible damage and were examined by X-rays to exclude diseases affecting bone quality such as tumors, severe osteoporosis, and deformities. The 16 femoral specimens were randomly divided into an experimental group (n = 8) and a control group (n = 8). All femurs were prepared with Pauwels type III femoral neck fractures, fixed with PFBN in the experimental group and ITCS in the control group. Displacement and stress limits of each specimen were measured through cyclic compression tests and failure experiments, and vertical displacement and strain values under a 600 N vertical load were measured in all specimens through vertical compression tests. RESULTS: In the vertical compression test, the average displacement at the anterior head region of the femur was 0.362 mm for the PFBN group, significantly less than the 0.480 mm for the ITCS group (p < 0.001). At the fracture line area, the average displacement for the PFBN group was also lower than that of the ITCS group (0.196 mm vs. 0.324 mm, p < 0.001). The difference in displacement in the shaft area was smaller, but the average displacement for the PFBN group (0.049 mm) was still significantly less than that for the ITCS group (0.062 mm, p = 0.016). The situation was similar on the posterior side of the femur. The average displacements in the head area, fracture line area, and shaft area for the PFBN group were 0.300 mm, 0.168 mm, and 0.081 mm, respectively, while those for the ITCS group were 0.558 mm, 0.274 mm, and 0.041 mm, with significant differences in all areas (p < 0.001). The average strain in the anterior head area for the PFBN group was 4947 µm/m, significantly less than the 1540 µm/m for the ITCS group (p < 0.001). Likewise, in the fracture line and shaft areas, the average strains for the PFBN group were significantly less than those for the ITCS group (p < 0.05). In the posterior head area, the average strain for the PFBN group was 4861 µm/m, significantly less than the 1442 µm/m for the ITCS group (p < 0.001). The strain conditions in the fracture line and shaft areas also showed the PFBN group was superior to the ITCS group (p < 0.001). In cyclic loading experiments, the PFBN fixation showed smaller maximum displacement (1.269 mm vs. 1.808 mm, p < 0.001), indicating better stability. In the failure experiments, the maximum failure load that the PFBN-fixated fracture block could withstand was significantly higher than that for the ITCS fixation (1817 N vs. 1116 N, p < 0.001). CONCLUSION: The PFBN can meet the biomechanical requirements for internal fixation of femoral neck fractures. PFBN is superior in biomechanical stability compared to ITCS, particularly showing less displacement and higher failure resistance in cyclic load and failure experiments. While there are differences in strain performance in different regions between the two fixation methods, overall, PFBN provides superior stability.

Photoactive "Bionic Virus" Robustly Elicits the Synergy Anticancer Activity of Immunophotodynamic Therapy.

Coronavirus represents an inspiring model for designing drug delivery systems due to its unique infection machinery mechanism. Herein, we have developed a biomimetic viruslike nanocomplex, termed SDN, for improving cancer theranostics. SDN has a unique core-shell structure consisting of photosensitizer chlorin e6 (Ce6)-loaded nanostructured lipid carrier (CeNLC) (virus core)@poly(allylamine hydrochloride)-functionalized MnO2 nanoparticles (virus spike), generating a virus-mimicking nanocomplex. SDN not only prompted cellular uptake through rough-surface-mediated endocytosis but also achieved mitochondrial accumulation by the interaction of cationic spikes and the anionic mitochondrial surface, leading to mitochondria-specific photodynamic therapy. Meanwhile, SDN could even mediate oxygen generation to relieve tumor hypoxia and, consequently, improve macrophage-associated anticancer immune response. Importantly, SDN served as a robust magnetic resonance imaging (MRI) contrast agent due to the fast release of Mn2+ in the presence of intracellular redox components. We identified that SDN selectively accumulated in tumors and released Mn2+ to generate a 5.71-fold higher T1-MRI signal, allowing for effectively detecting suspected tumors. Particularly, SDN induced synergistic immunophotodynamic effects to eliminate malignant tumors with minimal adverse effects. Therefore, we present a novel biomimetic strategy for improving targeted theranostics, which has a wide range of potential biomedical applications.

From cockroaches to tanks: The same power-mass-speed relation describes both biological and artificial ground-mobile systems.

This paper explores whether artificial ground-mobile systems exhibit a consistent regularity of relation among mass, power, and speed, similar to that which exists for biological organisms. To this end, we investigate an empirical allometric formula proposed in the 1980s for estimating the mechanical power expended by an organism of a given mass to move at a given speed, applicable over several orders of magnitude of mass, for a broad range of species, to determine if a comparable regularity applies to a range of vehicles. We show empirically that not only does a similar regularity apply to a wide variety of mobile systems; moreover, the formula is essentially the same, describing organisms and systems ranging from a roach (1 g) to a battle tank (35,000 kg). We also show that for very heavy vehicles (35,000-100,000,000 kg), the formula takes a qualitatively different form. These findings point to a fundamental similarity between biological and artificial locomotion that transcends great differences in morphology, mechanisms, materials, and behaviors. To illustrate the utility of this allometric relation, we investigate the significant extent to which ground robotic systems exhibit a higher cost of transport than either organisms or conventional vehicles, and discuss ways to overcome inefficiencies.

Automated glycemic control with the bionic pancreas in cystic fibrosis-related diabetes: A pilot study.

Cystic fibrosis-related diabetes (CFRD) is the most common extrapulmonary manifestation of cystic fibrosis. The current standard of care for CFRD involves treatment with insulin, typically via multiple daily injections. We conducted a small pilot study comparing usual care with automated glycemic control using the bihormonal (insulin and glucagon) and insulin-only configurations of the bionic pancreas. Both configurations of the bionic pancreas achieved good glycemic control, with mean glucose levels <150 mg/dl and minimal hypoglycemia. Subjects reported improved treatment satisfaction and reduced burden of diabetes management with the bionic pancreas. Further investigation of automated glycemic control in the treatment of CFRD is warranted.

Differences in the impedance of cochlear implant devices within 24 hours of their implantation.

Cochlear implantation is a surgical procedure, which is performed on severely hearing-impaired patients. Impedance field telemetry is commonly used to determine the integrity of the cochlear implant device during and after surgery. At the Department of Otolaryngology, Cheng Hsin General Hospital (Taipei, Taiwan), the cochlear implant devices are switched on within 24 hours of their implantation. In the present study, the impedance changes of Advanced Bionics™ cochlear implant devices were compared with previous studies and other devices. The aim was to confirm previous hypotheses and to explore other potential associated factors that could influence impedance following cochlear implantation. The current study included 12 patients who underwent cochlear implantation at Cheng Hsin General Hospital with Advanced Bionics cochlear implant devices. The cochlear devices were all switched on within 24 hours of their implantation. The impedance was measured and compared across all contact channels of the electrode, both intra-operatively and post-operatively. The intra-operative impedance was compared with the switch-on impedance (within 24 hours of the cochlear implantation); the impedance was notably increased for all contact channels at switch-on. Of the 16 channels examined, 4 channels had a significant increase in impedance between the intra-operative measurement and the switch-on measurement. To the best of our knowledge, the impedance of a cochlear implant device can be affected by the diameter of the electrode, the position of the electrode arrays in the scala tympani, sheath formation and fibrosis surrounding the electrode after implantation and electrical stimulation during or after surgery. When the results of the current study were compared with previous studies, it was found that the impedance changes were opposite to that of Cochlear™ implant devices. This may be explained by the position of the electrode arrays, sheath formation, the blow-out effect and differences in electrical stimulation.

MnO2 nanosheets as the biomimetic oxidase for rapid and sensitive oxalate detection combining with bionic E-eye.

Urolithiasis commonly occurs in kidney and ureteral, and may cause local organ/tissue damage, even kidney failure. The incidence of this disease is increasing worldwide, in which calcium oxalate is the major composition forming the urinary calculus. Therefore, to monitor this disease for the prevention and treatment, measuring the oxalate in the urine is of great significance. Here, a rapid and sensitive colorimetric method was developed based on 3,3',5,5'-tetramethylbenzidine-manganese dioxide (TMB-MnO2) nanosheets for oxalate detection. MnO2 nanosheets acted as an efficient biomimetic oxidase to catalyze the reaction with TMB and oxalate. Pale yellow TMB can be oxidized to blue oxide TMB catalyzed by BSA-stabilized MnO2 nanosheets, and oxalate can selectively inhibit this reaction by consuming and reacting with MnO2 nanosheets, thus achieving the quantitative detection of oxalate. Moreover, a home-made bionic electronic-eye (E-eye) system was developed as a portable in-situ detection platform to efficiently measure the oxalate concentrations in 10 s by direct photographing. By optimizing experimental conditions, this method shows a wide linear range (7.8 µM to 250 µM) and a low detection limit (0.91 µM) for oxalate detection. Besides, this method exhibits high selectivity even with 80-fold interfering chemicals. Furthermore, the performance of the method was validated by testing the artificial urine samples, indicating its great potential for monitoring and diagnosis of urolithiasis in point-of-care applications.

Fabrication of Tissue-Engineered Bionic Urethra Using Cell Sheet Technology and Labeling By Ultrasmall Superparamagnetic Iron Oxide for Full-Thickness Urethral Reconstruction.

Urethral strictures remain a reconstructive challenge, due to less than satisfactory outcomes and high incidence of stricture recurrence. An "ideal" urethral reconstruction should establish similar architecture and function as the original urethral wall. We fabricated a novel tissue-engineered bionic urethras using cell sheet technology and report their viability in a canine model. Small amounts of oral and adipose tissues were harvested, and adipose-derived stem cells, oral mucosal epithelial cells, and oral mucosal fibroblasts were isolated and used to prepare cell sheets. The cell sheets were hierarchically tubularized to form 3-layer tissue-engineered urethras and labeled by ultrasmall super-paramagnetic iron oxide (USPIO). The constructed tissue-engineered urethras were transplanted subcutaneously for 3 weeks to promote the revascularization and biomechanical strength of the implant. Then, 2 cm length of the tubularized penile urethra was replaced by tissue-engineered bionic urethra. At 3 months of urethral replacement, USPIO-labeled tissue-engineered bionic urethra can be effectively detected by MRI at the transplant site. Histologically, the retrieved bionic urethras still displayed 3 layers, including an epithelial layer, a fibrous layer, and a myoblast layer. Three weeks after subcutaneous transplantation, immunofluorescence analysis showed the density of blood vessels in bionic urethra was significantly increased following the initial establishment of the constructs and was further up-regulated at 3 months after urethral replacement and was close to normal level in urethral tissue. Our study is the first to experimentally demonstrate 3-layer tissue-engineered urethras can be established using cell sheet technology and can promote the regeneration of structural and functional urethras similar to normal urethra.

Nitroaromatic detection and infrared communication from wild-type plants using plant nanobionics.

Plant nanobionics aims to embed non-native functions to plants by interfacing them with specifically designed nanoparticles. Here, we demonstrate that living spinach plants (Spinacia oleracea) can be engineered to serve as self-powered pre-concentrators and autosamplers of analytes in ambient groundwater and as infrared communication platforms that can send information to a smartphone. The plants employ a pair of near-infrared fluorescent nanosensors-single-walled carbon nanotubes (SWCNTs) conjugated to the peptide Bombolitin II to recognize nitroaromatics via infrared fluorescent emission, and polyvinyl-alcohol functionalized SWCNTs that act as an invariant reference signal-embedded within the plant leaf mesophyll. As contaminant nitroaromatics are transported up the roots and stem into leaf tissues, they accumulate in the mesophyll, resulting in relative changes in emission intensity. The real-time monitoring of embedded SWCNT sensors also allows residence times in the roots, stems and leaves to be estimated, calculated to be 8.3 min (combined residence times of root and stem) and 1.9 min mm-1 leaf, respectively. These results demonstrate the ability of living, wild-type plants to function as chemical monitors of groundwater and communication devices to external electronics at standoff distances.

Osteogenic potential and synergistic effects of growth factors delivered from a bionic composite system.

Previous research has raised substantial controversy over the synergistic effects of exogenous growth factors, BMP-2 and bFGF, when used together for the treatment of bony defects. Thus, this study evaluated the effects of BMP-2 and bFGF at specified dose ratio composited with n-HA/PU40, a porous scaffold material, for repairing femoral defect in rats. Four weeks after implantation of this composite system, tissue specimens were collected for histological, immunohistochemical examinations, and µ-CT scanning. The results showed that the group DUAL/BMSCs with both the factors had better effect on repairing bone defects than the other four groups in terms of new bone formation and bone-scaffold bonding, suggesting crosstalk between these growth factors during early bone regeneration. This work demonstrates that provided that there is effective contact between cells and active proteins in the defect area, the controlled release of bFGF and BMP-2 have positive synergistic effects on early bone formation in the defect area. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 659-668, 2016.

Bionic reconstruction to restore hand function after brachial plexus injury: a case series of three patients.

BACKGROUND: Brachial plexus injuries can permanently impair hand function, yet present surgical reconstruction provides only poor results. Here, we present for the first time bionic reconstruction; a combined technique of selective nerve and muscle transfers, elective amputation, and prosthetic rehabilitation to regain hand function. METHODS: Between April 2011, and May 2014, three patients with global brachial plexus injury including lower root avulsions underwent bionic reconstruction. Treatment occurred in two stages; first, to identify and create useful electromyographic signals for prosthetic control, and second, to amputate the hand and replace it with a mechatronic prosthesis. Before amputation, the patients had a specifically tailored rehabilitation programme to enhance electromyographic signals and cognitive control of the prosthesis. Final prosthetic fitting was applied as early as 6 weeks after amputation. FINDINGS: Bionic reconstruction successfully enabled prosthetic hand use in all three patients. After 3 months, mean Action Research Arm Test score increased from 5·3 (SD 4·73) to 30·7 (14·0). Mean Southampton Hand Assessment Procedure score improved from 9·3 (SD 1·5) to 65·3 (SD 19·4). Mean Disabilities of Arm, Shoulder and Hand score improved from 46·5 (SD 18·7) to 11·7 (SD 8·42). INTERPRETATION: For patients with global brachial plexus injury with lower root avulsions, who have no alternative treatment, bionic reconstruction offers a means to restore hand function. FUNDING: Austrian Council for Research and Technology Development, Austrian Federal Ministry of Science, Research & Economy, and European Research Council Advanced Grant DEMOVE.

Results of total hip arthroplasty using a bionic hip stem.

PURPOSE: The trabecular-orientated bionic hip stem was designed to mimic the natural force transmission through the femur in total hip arthroplasty, resulting in supposedly longer prosthesis survivability. The aim of this study was to compare the second-generation bionic hip stem to a standard uncemented hip stem. METHODS: A group of 18 patients (21 hips) who underwent total hip arthroplasty with a bionic stem (bionic group) was compared with a historic group of 12 patients (12 hips) treated with standard anatomic hip stem (control group). During the first year after the procedure, the densitometric measurements of the bone around the prosthesis were taken. Radiographic and clinical assessments were additionally performed preoperatively and at the three month, six month, one year and three year follow-ups in the bionic group. RESULTS: In the bionic group, one patient was revised for aseptic loosening and 16 patients (19 hips) were available to the final follow-up. A significant decrease of bone mineral density was found in Gruen zones 3, 4 and 5 in the bionic group, and in zone 7 in both groups. The bionic group had a significantly higher bone mineral density in Gruen zone 1 at the one year follow-up. At the final follow-up, all prostheses were radiologically stable in both groups. CONCLUSIONS: Provided that a good implant position is achieved, comparable short-term results can be obtained using a bionic stem. Still, a decrease of bone mineral density in Gruen zone 7 occurred in both groups. Further studies are required to determine survivability of the bionic stem.

In vivo electrical conductivity across critical nerve gaps using poly(3,4-ethylenedioxythiophene)-coated neural interfaces.

BACKGROUND: Bionic limbs require sensitive, durable, and physiologically relevant bidirectional control interfaces. Modern central nervous system interfacing is high risk, low fidelity, and failure prone. Peripheral nervous system interfaces will mitigate this risk and increase fidelity by greatly simplifying signal interpretation and delivery. This study evaluates in vivo relevance of a hybrid peripheral nervous system interface consisting of biological acellular muscle scaffolds made electrically conductive using poly(3,4-ethylenedioxythiophene). METHODS: Peripheral nervous system interfaces were tested in vivo using the rat hind-limb conduction-gap model for motor (peroneal) and sensory (sural) nerves. Experimental groups included acellular muscle, iron(III) chloride-treated acellular muscle, and poly(3,4-ethylenedioxythiophene) polymerized on acellular muscle, each compared with intact nerve, autogenous nerve graft, and empty (nonreconstructed) nerve gap controls (n=5 for each). Interface lengths tested included 0, 5, 10, and 20 mm. Immediately following implantation, the interface underwent electrophysiologic characterization in vivo using nerve conduction studies, compound muscle action potentials, and antidromic sensory nerve action potentials. RESULTS: Both efferent and afferent electrophysiology demonstrates acellular muscle-poly(3,4-ethylenedioxythiophene) interfaces conduct physiologic action potentials across nerve conduction gaps of at least 20 mm with amplitude and latency not differing from intact nerve or nerve grafts, with the exception of increased velocity in the acellular muscle-poly(3,4-ethylenedioxythiophene) interfaces. CONCLUSIONS: Nonmetallic, biosynthetic acellular muscle-poly(3,4-ethylenedioxythiophene) peripheral nervous system interfaces both sense and stimulate physiologically relevant efferent and afferent action potentials in vivo. This demonstrates their relevance not only as a nerve-electronic coupling device capable of reaching the long-sought goal of closed-loop neural control of a prosthetic limb, but also in a multitude of other bioelectrical applications.

An approaching genetic algorithm for automatic beam angle selection in IMRT planning.

A method named approaching genetic algorithm (AGA) is introduced to automatically select the beam angles for intensity-modulated radiotherapy (IMRT) planning. In AGA, the best individual of the current population is found at first, and the rest of the normal individuals approach the current best one according to some specially designed rules. In the course of approaching, some better individuals may be obtained. Then, the current best individual is updated to try to approach the real best one. The approaching and updating operations of AGA replace the selection, crossover and mutation operations of the genetic algorithm (GA) completely. Using the specially designed updating strategies, AGA can recover the varieties of the population to a certain extent and retain the powerful ability of evolution, compared to GA. The beam angles are selected using AGA, followed by a beam intensity map optimization using conjugate gradient (CG). A simulated case and a clinical case with nasopharynx cancer are employed to demonstrate the feasibility of AGA. For the case investigated, AGA was feasible for the beam angle optimization (BAO) problem in IMRT planning and converged faster than GA.

Electronic properties of molecular memory circuits on a nanoscale scaffold.

Significant challenges exist in assembling and interconnecting the building blocks of a nanoscale device and being able to electronically address or measure responses at the molecular level. Here we demonstrate the usefulness of engineered proteins as scaffolds for bottom-up self-assembly for building nanoscale devices out of multiple components. Using genetically engineered cowpea mosaic virus, modified to express cysteine residues on the capsid exterior, gold nanoparticles were attached to the viral scaffold in a specific predetermined pattern to produce specific interparticle distances. The nanoparticles were then interconnected using thiol-terminated conjugated organic molecules, resulting in a three-dimensional network. Network properties were engineered by using molecular components with different I-V characteristics. Networks consisting of molecular wires alone were compared with networks containing voltage controlled molecular switches with two stable conductance states. Using such bistable molecules enabled the formation of switchable molecular networks that could be used in nanoscale memory circuits.

Artificial baroreflex: clinical application of a bionic baroreflex system.

BACKGROUND: We proposed a novel therapeutic strategy against central baroreflex failure: implementation of an artificial baroreflex system to automatically regulate sympathetic vasomotor tone, ie, a bionic baroreflex system (BBS), and we tested its efficacy in a model of sudden hypotension during surgery. METHODS AND RESULTS: The BBS consisted of a computer-controlled negative-feedback circuit that sensed arterial pressure (AP) and automatically computed the frequency (STM) of a pulse train required to stimulate sympathetic nerves via an epidural catheter placed at the level of the lower thoracic spinal cord. An operation rule was subsequently designed for the BBS using a feedback correction with proportional and integral gain factors. The transfer function from STM to AP was identified by a white noise system identification method in 12 sevoflurane-anesthetized patients undergoing orthopedic surgery involving the cervical vertebrae, and the feedback correction factors were determined with a numerical simulation to enable the BBS to quickly and stably attenuate an external disturbance on AP. The performance of the designed BBS was then examined in a model of orthostatic hypotension during knee joint surgery (n=21). Without the implementation of the BBS, a sudden deflation of a thigh tourniquet resulted in a 17+/-3 mm Hg decrease in AP within 10 seconds and a 25+/-2 mm Hg decrease in AP within 50 seconds. By contrast, during real-time execution of the BBS, the decrease in AP was 9+/-2 mm Hg at 10 seconds and 1+/-2 mm Hg at 50 seconds after the deflation. CONCLUSIONS: These results suggest the feasibility of a BBS approach for central baroreflex failure.

Methodological and conceptual issues in functional magnetic resonance imaging: applications to schizophrenia research.

Functional magnetic resonance imaging (MRI) is a noninvasive, highly repeatable, and increasingly available method to study disordered brain activity among patients with psychological or neurological disorders. In this chapter the biophysical principles underlying functional MRI are presented, and methodological limitations of the method are discussed. Artifacts related to the biophysical basis of the functional MRI signal or associated with image acquisition methods are presented, as are artifacts related to baseline effects-especially those associated with medication, caffeine, and nicotine use. The difficulties associated with the comparison of groups of subjects differing in performance receive special attention. The limitations of cognitive subtraction designs for functional MRI are also discussed. Functional MRI studies of schizophrenia patients are used to illustrate these points.