Multiple sclerosis treatments a review of current biomedical engineering approaches.

Multiple Sclerosis (MS) is an autoimmune condition targeting the central nervous system (CNS) characterized by focal demyelination with inflammation, causing neurodegeneration and gliosis. This is accompanied by a refractory period in relapsing MS or chronic progression in primary progressive MS. Current MS treatments target disease relapses and aim to reduce further demyelination and disability. These include the treatment of acute exacerbations through global immunomodulation upon corticosteroid administration, which are accompanied by adverse reactions. Disease modifying therapies (DMTs) which provide targeted immunosuppression of T and B cells, and sequestration of leukocytes out of CNS, have led to further improvements in demyelination prevention and disease burden reduction. Despite their efficacy, DMTs are ineffective in remyelination, pathology reversal and have minimal effects in progressive MS. The advent of modern biomedical engineering approaches in combination with a better understanding of MS pathology, has led to the development of novel, regenerative approaches to treatment. Such treatments utilize neural stem cells (NSCs) and can reduce disease relapses and reverse damage caused by the disease through localized tissue regeneration. While at initial stages, pre-clinical and clinical studies utilizing NSCs and immune modulation have shown promising outcomes in tissue regeneration, creating a potential new era in MS therapy.

Engineering with Biomedical Sciences Changing the Horizon of Healthcare-A Review.

In the dynamic realm of healthcare, the convergence of engineering and biomedical sciences has emerged as a pivotal frontier. In this review we go into specific areas of innovation, including medical imaging and diagnosis, developments in biomedical sensors, and drug delivery systems. Wearable biosensors, non-wearable biosensors, and biochips, which include gene chips, protein chips, and cell chips, are all included in the scope of the topic that pertains to biomedical sensors. Extensive research is conducted on drug delivery systems, spanning topics such as the integration of computer modeling, the optimization of drug formulations, and the design of delivery devices. Furthermore, the paper investigates intelligent drug delivery methods, which encompass stimuli-responsive systems such as temperature, redox, pH, light, enzyme, and magnetic responsive systems. In addition to that, the review goes into topics such as tissue engineering, regenerative medicine, biomedical robotics, automation, biomechanics, and the utilization of green biomaterials. The purpose of this analysis is to provide insights that will enhance continuing research and development efforts in engineering-driven biomedical breakthroughs, ultimately contributing to the improvement of healthcare. These insights will be provided by addressing difficulties and highlighting future prospects.

• Integration of engineering into diagnostics leads to early disease detection through medical imaging.• Biosensors offer cost-effective, simple, and reliable early detection of abnormal health parameters. A smart drug delivery system requires fewer drugs compared to conventional methods.• Use of natural materials will enhance the biocompatibility of nanomaterials.• Nanomaterial enhanced tissue regeneration.

Synergistic integration of MXene nanostructures into electrospun fibers for advanced biomedical engineering applications.

MXene-based architectures have paved the way in various fields, particularly in healthcare area, owing to their remarkable physiochemical and electromagnetic characteristics. Moreover, the modification of MXene structures and their combination with polymeric networks have gained considerable prominence to further develop their features. The combination of electrospun fibers with MXenes would be promising in this regard since electrospinning is a well-established technique that is now being directed toward commercial biomedical applications. The introduction of MXenes into electrospun fibrous frameworks has highlighted outcomes in various biomedical applications, including cancer therapy, controlled drug delivery, antimicrobial targets, sensors, and tissue engineering. Correspondingly, this review describes the employed strategies for the preparation of electrospun configurations in tandem with MXene nanostructures with remarkable characteristics. Next, the advantages of MXene-decorated electrospun fibers for use in biomedical applications are comprehensively discussed. According to the investigations, rich surface functional groups, hydrophilicity, large surface area, photothermal features, and antimicrobial and antibacterial activities of MXenes could synergize the performance of electrospun layers to engineer versatile biomedical targets. Moreover, the future of this path is clarified to combat the challenges related to the electrospun fibers decorated with MXene nanosheets.

Bioactive silk fibroin hydrogels: Unraveling the potential for biomedical engineering.

Silk fibroin (SF) has received special attention from the scientific community due to its noteworthy properties. Its unique chemical structure results in an uncommon combination of macroscopically useful properties, yielding a strong, fine and flexible material which, in addition, presents good biodegradability and better biocompatibility. Therefore, silk fibroin in various formats, appears as an ideal candidate for supporting biomedical applications. In this review, we will focus on the hydrogels obtained from silk fibroin or in combination with it, paying special attention to the synthesis procedures, characterization methodologies and biomedical applications. Tissue engineering and drug-delivery systems are, undoubtedly, the two main areas where silk fibroin hydrogels find their place.

DNA hydrogels and their derivatives in biomedical engineering applications.

Deoxyribonucleotide (DNA) is uniquely programmable and biocompatible, and exhibits unique appeal as a biomaterial as it can be precisely designed and programmed to construct arbitrary shapes. DNA hydrogels are polymer networks comprising cross-linked DNA strands. As DNA hydrogels present programmability, biocompatibility, and stimulus responsiveness, they are extensively explored in the field of biomedicine. In this study, we provide an overview of recent advancements in DNA hydrogel technology. We outline the different design philosophies and methods of DNA hydrogel preparation, discuss its special physicochemical characteristics, and highlight the various uses of DNA hydrogels in biomedical domains, such as drug delivery, biosensing, tissue engineering, and cell culture. Finally, we discuss the current difficulties facing DNA hydrogels and their potential future development.

A review of recent advances of piezoelectric poly-L-lactic acid for biomedical applications.

Poly-L-lactic acid (PLLA), recognized as a piezoelectric material, not only demonstrates exceptional piezoelectric properties but also exhibits commendable biocompatibility and biodegradability. These properties render PLLA highly promising for diverse applications, including sensors, wearable devices, biomedical engineering, and related domains. This review offers a comprehensive overview of the distinctive piezoelectric effect of PLLA-based material and delves into the latest advancements in its preparation strategies as a piezoelectric material. It further presents recent research progress in PLLA-based piezoelectric materials, particularly in the realms of health monitoring, skin repair, nerve regeneration, and tissue repair. The discourse extends to providing insights into potential future trajectories for the development of PLLA-based piezoelectric materials.

Trends in sustainable chitosan-based hydrogel technology for circular biomedical engineering: A review.

Eco-friendly materials have emerged in biomedical engineering, driving major advances in chitosan-based hydrogels. These hydrogels offer a promising green alternative to conventional polymers due to their non-toxicity, biodegradability, biocompatibility, environmental friendliness, affordability, and easy accessibility. Known for their remarkable properties such as drug encapsulation, delivery capabilities, biosensing, functional scaffolding, and antimicrobial behavior, chitosan hydrogels are at the forefront of biomedical research. This paper explores the fabrication and modification methods of chitosan hydrogels for diverse applications, highlighting their role in advancing climate-neutral healthcare technologies. It reviews significant scientific advancements and trends chitosan hydrogels focusing on cancer diagnosis, drug delivery, and wound care. Additionally, it addresses current challenges and green synthesis practices that support a circular economy, enhancing biomedical sustainability. By providing an in-depth analysis of the latest evidence on climate-neutral management, this review aims to facilitate informed decision-making and foster the development of sustainable strategies leveraging chitosan hydrogel technology. The insights from this comprehensive examination are pivotal for steering future research and applications in sustainable biomedical solutions.

Biofabrication of Living Actuators.

The impact of tissue engineering has extended beyond a traditional focus in medicine to the rapidly growing realm of biohybrid robotics. Leveraging living actuators as functional components in machines has been a central focus of this field, generating a range of compelling demonstrations of robots capable of muscle-powered swimming, walking, pumping, gripping, and even computation. In this review, we highlight key advances in fabricating tissue-scale cardiac and skeletal muscle actuators for a range of functional applications. We discuss areas for future growth including scalable manufacturing, integrated feedback control, and predictive modeling and also propose methods for ensuring inclusive and bioethics-focused pedagogy in this emerging discipline. We hope this review motivates the next generation of biomedical engineers to advance rational design and practical use of living machines for applications ranging from telesurgery to manufacturing to on- and off-world exploration.

Electronic Skin: Opportunities and Challenges in Convergence with Machine Learning.

Recent advancements in soft electronic skin (e-skin) have led to the development of human-like devices that reproduce the skin's functions and physical attributes. These devices are being explored for applications in robotic prostheses as well as for collecting biopotentials for disease diagnosis and treatment, as exemplified by biomedical e-skins. More recently, machine learning (ML) has been utilized to enhance device control accuracy and data processing efficiency. The convergence of e-skin technologies with ML is promoting their translation into clinical practice, especially in healthcare. This review highlights the latest developments in ML-reinforced e-skin devices for robotic prostheses and biomedical instrumentations. We first describe technological breakthroughs in state-of-the-art e-skin devices, emphasizing technologies that achieve skin-like properties. We then introduce ML methods adopted for control optimization and pattern recognition, followed by practical applications that converge the two technologies. Lastly, we briefly discuss the challenges this interdisciplinary research encounters in its clinical and industrial transition.

Engineering focusing on cancer.

While cancer research and care have benefited from revolutionary advances in the ability to manipulate and study living systems, the field is limited by a lack of synergy to leverage the power of engineering approaches. Cancer engineering is an emerging subfield of biomedical engineering that unifies engineering and cancer biology to better understand, diagnose, and treat cancer. We highlight cancer engineering's unique challenges, the importance of creating dedicated centers and departments that enable translational collaboration, and educational approaches to arm a new generation of scientists with engineering expertise and a fundamental understanding of cancer biology to transform clinical cancer care.

Engineering cancer's end: An interdisciplinary approach to confront the complexities of cancer.

Cancer engineering is an interdisciplinary approach that promises to confront the complexities of cancer and accelerate transformative discoveries by integrating innovative fields across engineering and the physical sciences with a focus on cancer. We offer a conceptual framework for the hallmarks of cancer engineering, integrating 12 fields: system dynamics; imaging, radiation, and spectroscopy; robotics and controls; solid mechanics; fluid mechanics; chemistry and nanomaterials; mathematics and simulation; cellular and protein engineering; kinetics and thermodynamics; materials science; manufacturing and biofabrication; and microsystems.

The use of supramolecular systems in biomedical applications for antimicrobial properties, biocompatibility, and drug delivery.

Supramolecular chemistry is versatile for developing stimuli-responsive, dynamic and multifunctional structures. In the context of biomedical engineering applications, supramolecular assemblies are particularly useful as coatings for they can closely mimic the natural structure and organisation of the extracellular matrix (ECM), they can also fabricate other complex systems like drug delivery systems and bioinks. In the current context of growing medical device-associated complications and the developments in the controlled drug delivery and regenerative medicine fields, supramolecular assemblies are becoming an indispensable part of the biomedical engineering arsenal. This review covers the different supramolecular assemblies in different biomedical applications with a specific focus on antimicrobial coatings, coatings that enhance biocompatibility, surface modifications on implantable medical devices, systems that promote therapeutic efficiency in cancer therapy, and the development of bioinks. The introduced supramolecular systems include multilayer coating by polyelectrolytes, polymers incorporated with nanoparticles, coating simulation of ECM, and drug delivery systems. A perspective on the application of supramolecular systems is also included.

Innovations in bio-engineering and cell-based approaches to address immunological challenges in islet transplantation.

Human allogeneic pancreatic islet transplantation is a life-changing treatment for patients with severe Type 1 Diabetes (T1D) who suffer from hypoglycemia unawareness and high risk of severe hypoglycemia. However, intensive immunosuppression is required to prevent immune rejection of the graft, that may in turn lead to undesirable side effects such as toxicity to the islet cells, kidney toxicity, occurrence of opportunistic infections, and malignancies. The shortage of cadaveric human islet donors further limits islet transplantation as a treatment option for widespread adoption. Alternatively, porcine islets have been considered as another source of insulin-secreting cells for transplantation in T1D patients, though xeno-transplants raise concerns over the risk of endogenous retrovirus transmission and immunological incompatibility. As a result, technological advancements have been made to protect transplanted islets from immune rejection and inflammation, ideally in the absence of chronic immunosuppression, to improve the outcomes and accessibility of allogeneic islet cell replacement therapies. These include the use of microencapsulation or macroencapsulation devices designed to provide an immunoprotective environment using a cell-impermeable layer, preventing immune cell attack of the transplanted cells. Other up and coming advancements are based on the use of stem cells as the starting source material for generating islet cells 'on-demand'. These starting stem cell sources include human induced pluripotent stem cells (hiPSCs) that have been genetically engineered to avoid the host immune response, curated HLA-selected donor hiPSCs that can be matched with recipients within a given population, and multipotent stem cells with natural immune privilege properties. These strategies are developed to provide an immune-evasive cell resource for allogeneic cell therapy. This review will summarize the immunological challenges facing islet transplantation and highlight recent bio-engineering and cell-based approaches aimed at avoiding immune rejection, to improve the accessibility of islet cell therapy and enhance treatment outcomes. Better understanding of the different approaches and their limitations can guide future research endeavors towards developing more comprehensive and targeted strategies for creating a more tolerogenic microenvironment, and improve the effectiveness and sustainability of islet transplantation to benefit more patients.

Medical Microrobots.

Scientists around the world have long aimed to produce miniature robots that can be controlled inside the human body to aid doctors in identifying and treating diseases. Such microrobots hold the potential to access hard-to-reach areas of the body through the natural lumina. Wireless access has the potential to overcome drawbacks of systemic therapy, as well as to enable completely new minimally invasive procedures. The aim of this review is fourfold: first, to provide a collection of valuable anatomical and physiological information on the target working environments together with engineering tools for the design of medical microrobots; second, to provide a comprehensive updated survey of the technological state of the art in relevant classes of medical microrobots; third, to analyze currently available tracking and closed-loop control strategies compatible with the in-body environment; and fourth, to explore the challenges still in place, to steer and inspire future research.

Integrating Upper-Limb Prostheses with the Human Body: Technology Advances, Readiness, and Roles in Human-Prosthesis Interaction.

Significant advances in bionic prosthetics have occurred in the past two decades. The field's rapid expansion has yielded many exciting technologies that can enhance the physical, functional, and cognitive integration of a prosthetic limb with a human. We review advances in the engineering of prosthetic devices and their interfaces with the human nervous system, as well as various surgical techniques for altering human neuromusculoskeletal systems for seamless human-prosthesis integration. We discuss significant advancements in research and clinical translation, focusing on upper limbprosthetics since they heavily rely on user intent for daily operation, although many discussed technologies have been extended to lower limb prostheses as well. In addition, our review emphasizes the roles of advanced prosthetics technologies in complex interactions with humans and the technology readiness levels (TRLs) of individual research advances. Finally, we discuss current gaps and controversies in the field and point out future research directions, guided by TRLs.

Direct Electron Transfer-Type Oxidoreductases for Biomedical Applications.

Among the various types of enzyme-based biosensors, sensors utilizing enzymes capable of direct electron transfer (DET) are recognized as the most ideal. However, only a limited number of redox enzymes are capable of DET with electrodes, that is, dehydrogenases harboring a subunit or domain that functions specifically to accept electrons from the redox cofactor of the catalytic site and transfer the electrons to the external electron acceptor. Such subunits or domains act as built-in mediators for electron transfer between enzymes and electrodes; consequently, such enzymes enable direct electron transfer to electrodes and are designated as DET-type enzymes. DET-type enzymes fall into several categories, including redox cofactors of catalytic reactions, built-in mediators for DET with electrodes and by their protein hierarchic structures, DET-type oxidoreductases with oligomeric structures harboring electron transfer subunits, and monomeric DET-type oxidoreductases harboring electron transfer domains. In this review, we cover the science of DET-type oxidoreductases and their biomedical applications. First, we introduce the structural biology and current understanding of DET-type enzyme reactions. Next, we describe recent technological developments based on DET-type enzymes for biomedical applications, such as biosensors and biochemical energy harvesting for self-powered medical devices. Finally, after discussing how to further engineer and create DET-type enzymes, we address the future prospects for DET-type enzymes in biomedical engineering.

Biomedical Approach of Nanotechnology and Biological Risks: A Mini-Review.

Nanotechnology has played a prominent role in biomedical engineering, offering innovative approaches to numerous treatments. Notable advances have been observed in the development of medical devices, contributing to the advancement of modern medicine. This article briefly discusses key applications of nanotechnology in tissue engineering, controlled drug release systems, biosensors and monitoring, and imaging and diagnosis. The particular emphasis on this theme will result in a better understanding, selection, and technical approach to nanomaterials for biomedical purposes, including biological risks, security, and biocompatibility criteria.

Review: Auxetic Polymer-Based Mechanical Metamaterials for Biomedical Applications.

Over the last three decades but more particularly during the last 5 years, auxetic mechanical metamaterials constructed from precisely architected polymer-based materials have attracted considerable attention due to their fascinating mechanical properties. These materials present a negative Poisson's ratio and therefore unusual mechanical behavior, which has resulted in enhanced static modulus, energy adsorption, and shear resistance, as compared with the bulk properties of polymers. Novel advanced polymer processing and fabrication techniques, and in particular additive manufacturing, allow one to design complex and customizable polymer architectures that are particularly relevant to fabricate auxetic mechanical metamaterials. Although these metamaterials exhibit exotic mechanical properties with potential applications in several engineering fields, biomedical applications seem to be one of the most relevant with a growing number of articles published over recent years. As a result, special focus is needed to understand the potential of these structures and foster theoretical and experimental investigations on the potential benefits of the unusual mechanical properties of these materials on the way to high performance biomedical applications. The present Review provides up to date information on the recent progress of polymer-based auxetic mechanical metamaterials mainly fabricated using additive manufacturing methods with a special focus toward biomedical applications including tissue engineering as well as medical devices including stents and sensors.

Application of a robotics path planning algorithm to assess the risk of mobile bearing dislocation in lateral unicompartmental knee replacement.

Due to ligament laxity, bearing dislocation occurs in 1-6% of Oxford Domed Lateral (ODL) replacements with most dislocations occurring medially. Dislocations were studied using a previously built mechanical rig, however testing using the rig was inefficient. The aim of this study was to develop a better tool that was more reliable and efficient. An established robotics software package, the Open Motion Planning Library, was modified to accept the ODL components. Using a robotics path planning algorithm, the mobile bearing was allowed to find a way out from between the femoral and tibial components i.e. to dislocate. Testing assessed a range of clinically relevant positions of the femoral component relative to the tibial component. Dislocations were labelled as medial, lateral, anterior or posterior depending on the dislocation direction. The Distraction to Dislocation (DD) measured the minimum vertical distraction of the femoral component from the tibial component for a dislocation to occur. Results were validated against the mechanical rig. Statistical analysis of medial dislocation showed excellent agreement with an intraclass correlation value of 0.993 (95% CI 0.982-0.998). All DDs from the dislocation analysis tool were within 1 mm of the mechanical rig DDs with results sharing a remarkably similar trend. The robotics dislocation analysis tool output DDs which were marginally higher than the manual mechanical rig: 0.50 mm anteriorly, 0.25 mm posteriorly and 0.50 mm laterally. Medially, the computational DD differed on average by 0.09 mm (stand deviation: 0.2026 mm). Our study describes the development and validation of a novel robotics dislocation analysis tool, which allows mobile bearing dislocation risk quantification. The tool may also be used to improve surgical implantation parameters and to assess new implant designs that aim to reduce the medial dislocation risk to an acceptable level.