Photomodulated Extrusion as a Localized Endovascular Hydrogel Deposition Method.

Minimally invasive endovascular embolization is used to treat a wide range of diseases in neurology, oncology, and trauma where the vascular morphologies and corresponding hemodynamics vary greatly. Current techniques based on metallic coils, flow diverters, liquid embolics, and suspended microspheres are limited in their ability to address a wide variety of vasculature and can be plagued by complications including distal migration, compaction, and inappropriate vascular remodeling. Further, these endovascular devices currently offer limited therapeutic functions beyond flow control such as drug delivery. Herein, a novel in situ microcatheter-based photomodulated extrusion approach capable of dynamically tuning the physical and morphological properties of injectable hydrogels, optimizing for local hemodynamic environment and vascular morphology, is proposed and demonstrated. A shear thinning and photoactivated poly(ethylene glycol diacrylate)-nanosilicate (PEGDA-nSi) hydrogel is used to demonstrate multiple extrusion modes which are controlled by photokinetics and device configurations. Real-time photomodulation of injected hydrogel viscosity and modulus is successfully used for embolization in various vasculatures, including high-flow large vessels and arterial-to-arterial capillary shunts. Furthermore, a generalizable therapeutic delivery platform is proposed by demonstrating a core-shell structured extrusion encapsulating doxorubicin to achieve a more sustained release compared to unencapsulated payload.

Characterization and mitigation of aerosols and spatters from ultrasonic scalers.

BACKGROUND: Dental procedures often produce aerosols and spatter, which have the potential to transmit pathogens such as severe acute respiratory syndrome coronavirus 2. The existing literature is limited. METHODS: Aerosols and spatter were generated from an ultrasonic scaling procedure on a dental manikin and characterized via 2 optical imaging methods: digital inline holography and laser sheet imaging. Capture efficiencies of various aerosol mitigation devices were evaluated and compared. RESULTS: The ultrasonic scaling procedure generated a wide size range of aerosols (up to a few hundred µm) and occasional large spatter, which emit at low velocity (mostly < 3 m/s). Use of a saliva ejector and high-volume evacuator (HVE) resulted in overall reductions of 63% and 88%, respectively, whereas an extraoral local extractor (ELE) resulted in a reduction of 96% at the nominal design flow setting. CONCLUSIONS: The study results showed that the use of ELE or HVE significantly reduced aerosol and spatter emission. The use of HVE generally requires an additional person to assist a dental hygienist, whereas an ELE can be operated hands free when a dental hygienist is performing ultrasonic scaling and other operations. PRACTICAL IMPLICATIONS: An ELE aids in the reduction of aerosols and spatters during ultrasonic scaling procedures, potentially reducing transmission of oral or respiratory pathogens like severe acute respiratory syndrome coronavirus 2. Position and airflow of the device are important to effective aerosol mitigation.

Toward Biodegradable Electronics: Ionic Diodes Based on a Cellulose Nanocrystal-Agarose Hydrogel.

Bioderived cellulose nanocrystals (CNCs) are used to create light, flexible, biocompatible, and biodegradable electronic devices. Herein, surface modification of cellulose nanocrystals was employed to fabricate cationic and anionic CNCs. Subsequently, we demonstrated rectification behavior from a fixed junction between two agarose hydrogels doped with cationic and anionic cellulose nanocrystals. The current rectification ratio reaches 70 reproducibly, which is significantly higher than that for analogous diodes generated with microfibrillated cellulose (∼15) and the first polyelectrolyte gel diode (∼40). The current-voltage characteristics of the CNC-hydrogel diode are influenced by concentration, gel thickness, scanning frequency, and applied voltage. The high surface area of CNC resulted in high charge density after surface modification, which in turn resulted in good rectification behavior from only small amounts of dopant material.

Low-Grade Papillary Schneiderian Carcinoma of the Sinonasal Cavity and Temporal Bone.

OBJECTIVES:: The aim of this study was to further characterize a newly described neoplasm, low-grade papillary Schneiderian carcinoma, occurring simultaneously in the sinonasal cavity and mastoid. Additionally, the authors review the only 2 similar cases within the literature and describe the common clinical features, radiographic findings, and pathologic characteristics of this exceptionally rare disease process. METHODS:: Chart review for single patient, review of literature. RESULTS:: The patient presented with bilateral nasal obstruction. Computed tomography revealed a left sinonasal mass with skull base hyperostosis, and follow-up magnetic resonance imaging showed a concomitant olfactory groove meningioma. Examination showed a bilateral, completely obstructing sinonasal mass with skip areas, and biopsy confirmed inverted papilloma (human papilloma virus strains 16 and 18 indeterminate). The patient underwent bilateral endoscopic sinus surgery, left medial maxillectomy, and left partial nasopharyngectomy. Given her multifocal disease, she was advised that she would require additional excision, but was lost to follow up. One year later she developed acute left facial paralysis. Magnetic resonance imaging demonstrated an enhancing mass in the left mastoid with enhancement along the Eustachian tube in addition to her known recurrent sinonasal disease. Simultaneous endoscopic sinus surgery and mastoidectomy were performed. Polypoid tissue was removed from the nasopharynx, mesotympanum, epitympanum, and retrofacial air cells. Immunohistochemistry showed that cells stained positive for p63 and dermCK and negative for synaptophysin. Morphologically, cells were bland, without classic stromal invasion, retaining their smooth, cystic, and papillary features, despite their increased depth within the tissue. Upon further review and consultation with an outside pathologist, a diagnosis of low-grade papillary Schneiderian carcinoma was made. The patient was referred for radiation therapy and is disease free at 3-month follow-up, with return of her facial function. CONCLUSIONS:: This case represents the first report of concurrent low-grade papillary Schneiderian carcinoma of both the nasal cavity and mastoid. It emphasizes the importance of recognizing this new entity through pathologic analysis and suspecting it when the clinical course does not follow an expected pattern.

High-Performance Supercapacitors from Niobium Nanowire Yarns.

The large-ion-accessible surface area of carbon nanotubes (CNTs) and graphene sheets formed as yarns, forests, and films enables miniature high-performance supercapacitors with power densities exceeding those of electrolytics while achieving energy densities equaling those of batteries. Capacitance and energy density can be enhanced by depositing highly pseudocapacitive materials such as conductive polymers on them. Yarns formed from carbon nanotubes are proposed for use in wearable supercapacitors. In this work, we show that high power, energy density, and capacitance in yarn form are not unique to carbon materials, and we introduce niobium nanowires as an alternative. These yarns show higher capacitance and energy per volume and are stronger and 100 times more conductive than similarly spun carbon multiwalled nanotube (MWNT) and graphene yarns. The long niobium nanowires, formed by repeated extrusion and drawing, achieve device volumetric peak power and energy densities of 55 MW·m(-3) (55 W·cm(-3)) and 25 MJ·m(-3) (7 mWh·cm(-3)), 2 and 5 times higher than that for state-of-the-art CNT yarns, respectively. The capacitance per volume of Nb nanowire yarn is lower than the 158 MF·m(-3) (158 F·cm(-3)) reported for carbon-based materials such as reduced graphene oxide (RGO) and CNT wet-spun yarns, but the peak power and energy densities are 200 and 2 times higher, respectively. Achieving high power in long yarns is made possible by the high conductivity of the metal, and achievement of high energy density is possible thanks to the high internal surface area. No additional metal backing is needed, unlike for CNT yarns and supercapacitors in general, saving substantial space. As the yarn is infiltrated with pseudocapacitive materials such as poly(3,4-ethylenedioxythiophene) (PEDOT), the energy density is further increased to 10 MJ·m(-3) (2.8 mWh·cm(-3)). Similar to CNT yarns, niobium nanowire yarns are highly flexible and show potential for weaving into textiles and use in wearable devices.

Artificial muscles from fishing line and sewing thread.

The high cost of powerful, large-stroke, high-stress artificial muscles has combined with performance limitations such as low cycle life, hysteresis, and low efficiency to restrict applications. We demonstrated that inexpensive high-strength polymer fibers used for fishing line and sewing thread can be easily transformed by twist insertion to provide fast, scalable, nonhysteretic, long-life tensile and torsional muscles. Extreme twisting produces coiled muscles that can contract by 49%, lift loads over 100 times heavier than can human muscle of the same length and weight, and generate 5.3 kilowatts of mechanical work per kilogram of muscle weight, similar to that produced by a jet engine. Woven textiles that change porosity in response to temperature and actuating window shutters that could help conserve energy were also demonstrated. Large-stroke tensile actuation was theoretically and experimentally shown to result from torsional actuation.

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

UNLABELLED: Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. MATERIALS AND METHODS: Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. RESULTS: In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. CONCLUSIONS: A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

Microstructuring of polypyrrole by maskless direct femtosecond laser ablation.

Ultrafast laser micromachining was optimized for microstructuring polypyrrole as a facile new approach towards tailoring electrochemical and mechanical responses desirable for microactuator, sensors, neural probing, and nerve conduit applications. Laser perforation of high-density and high aspect ratio through-holes generated greater than 5-fold increase in surface area. The flexible machining technique offers micron-size resolution and fast prototyping capability for optimizing properties and opening new directions for polypyrrole-based devices.

Conducting polymer based active catheter for minimally invasive interventions inside arteries.

An active catheter intended for controllable intravascular maneuvers is presented and initial experimental results are shown. A commercial catheter is coated with polypyrrole and laser micromachined into electrodes, which are electrochemically activated, leading to bending of the catheter. The catheter's electro-chemo-mechanical properties are theoretically modeled to design the first prototype device, and used to predict an optimal polypyrrole thickness for the desired degree of bending within approximately 30 seconds. We compared the experimental result of catheter bending to the theoretical model with estimated electrochemical strain, showing reasonable agreement. Finally, we used the model to design an encapsulated catheter with polypyrrole actuation for improved intravascular compatibility and performance.