Toward Development of Novel Remote Ultrasound Robotic System Using Soft Robotics Technology.

This paper reports on the development of a novel soft robotic system for remote ultrasound applications. Direct contact of the ultrasound probe with the patient's body represents a safety risk and therefore control of the probe's positioning and applied force is a crucial task. The proposed robot uses a passive control system that provides safe interaction between the robot and the patient by leveraging soft robotics technology. The soft robot's structure can be considered as a nonlinear spring which can be designed to exert a safe force within the robot's workspace to guarantee the safety of human-robot interaction. The literature suggests that effective ultrasound imaging of both the heart and abdomen requires six degrees-of-freedom. These degrees-of-freedom consist of three translational motions, which are achieved using a novel hybrid soft cable-driven parallel robot, and three wrist motions, which is based on a universal joint design. The experimental results show that the robot can achieve all these six degrees-of-freedom, and its blocking force can be engineered to generate a uniform force within the workspace.

Differential sensitivities to blood pressure variations in internal carotid and intracranial arteries: a numerical approach to stroke prediction.

Stroke remains a global health concern, necessitating early prediction for effective management. Atherosclerosis-induced internal carotid and intra cranial stenosis contributes significantly to stroke risk. This study explores the relationship between blood pressure and stroke prediction, focusing on internal carotid artery (ICA) branches: middle cerebral artery (MCA), anterior cerebral artery (ACA), and their role in hemodynamics. Computational fluid dynamics (CFD) informed by the Windkessel model were employed to simulate patient-specific ICA models with introduced stenosis. Central to our investigation is the impact of stenosis on blood pressure, flow velocity, and flow rate across these branches, incorporating Fractional Flow Reserve (FFR) analysis. Results highlight differential sensitivities to blood pressure variations, with M1 branch showing high sensitivity, ACA moderate, and M2 minimal. Comparing blood pressure fluctuations between ICA and MCA revealed heightened sensitivity to potential reverse flow compared to ICA and ACA comparisons, emphasizing MCA's role. Blood flow adjustments due to stenosis demonstrated intricate compensatory mechanisms. FFR emerged as a robust predictor of stenosis severity, particularly in the M2 branch. In conclusion, this study provides comprehensive insights into hemodynamic complexities within major intracranial arteries, elucidating the significance of blood pressure variations, flow attributes, and FFR in stenosis contexts. Subject-specific data integration enhances model reliability, aiding stroke risk assessment and advancing cerebrovascular disease understanding.

An analytical method informed by clinical imaging data for estimating outlet boundary conditions in computational fluid dynamics analysis of carotid artery blood flow.

Stroke occur mainly due to arterial thrombosis and rupture of cerebral blood vessels. Previous studies showed that blood flow-induced wall shear stress is an essential bio marker for estimating atherogenesis. It is a common practice to use computational fluid dynamics (CFD) simulations to calculate wall shear stress and to quantify blood flow. Reliability of predicted CFD results greatly depends on the accuracy of applied boundary conditions. Previously, the boundary conditions were estimated by varying values so that they matched the clinical data. It is applicable upon the availability of clinical data. Meanwhile, in most cases all that can be accessed are arterial geometry and inflow rate. Consequently, there is a need to devise a tool to estimate boundary values such as resistance and compliance of arteries. This study proposes an analytical framework to estimate the boundary conditions for a carotid artery based on the geometries of the downstream arteries available from clinical images.

A 3D printable dynamic nanocellulose/nanochitin self-healing hydrogel and soft strain sensor.

Presented here is the synthesis of a 3D printable nano-polysaccharide self-healing hydrogel for flexible strain sensors. Consisting of three distinct yet complementary dynamic bonds, the crosslinked network comprises imine, hydrogen, and catecholato-metal coordination bonds. Self-healing of the hydrogel is demonstrated by macroscopic observation, rheological recovery, and compression measurements. The hydrogel was produced via imine formation of carboxyl methyl chitosan, oxidized cellulose nanofibers, and chitin nanofibers followed by two subsequent crosslinking stages: immersion in tannic acid (TA) solution to create hydrogen bonds, followed by soaking in FeIII solution to form catecholato-metal coordination bonds between TA and FeIII. The metal coordination bonds were critical to imparting conductivity to the hydrogel, a requirement for flexible strain sensors. The hydrogel exhibits excellent shear-thinning and dynamic properties with high autonomous self-healing (up to 89%) and self-recovery (up to 100%) at room temperature without external stimuli. Furthermore, it shows good printability, biocompatibility, and strain sensing ability.

A Bioinspired Compliant 3D-Printed Soft Gripper.

A compliant three-dimensional (3D)-printed soft gripper is designed based on the bioinspired spiral spring in this study. The soft gripper is then 3D-printed using a suitable thermoplastic filament material to deliver the desired performance. The sensorless mechanism introduced in this study provides adequate compliance with a single linear actuator for interacting with delicate objects, such as manipulation of human biological materials and fruit picking. The kinematic and dynamic models of the monolithic gripper are derived analytically as well as by means of finite element analysis to synthesize its functionality. The fabricated gripper module is installed on a robot arm to demonstrate the efficacy of design for picking and placing fruits without damaging them. The presented mechanism could be customized and used in the medical and agricultural sectors with diverse geometry objects.

Dynamic Nanohybrid-Polysaccharide Hydrogels for Soft Wearable Strain Sensing.

Electroconductive hydrogels with stimuli-free self-healing and self-recovery (SELF) properties and high mechanical strength for wearable strain sensors is an area of intensive research activity at the moment. Most electroconductive hydrogels, however, consist of static bonds for mechanical strength and dynamic bonds for SELF performance, presenting a challenge to improve both properties into one single hydrogel. An alternative strategy to successfully incorporate both properties into one system is via the use of stiff or rigid, yet dynamic nano-materials. In this work, a nano-hybrid modifier derived from nano-chitin coated with ferric ions and tannic acid (TA/Fe@ChNFs) is blended into a starch/polyvinyl alcohol/polyacrylic acid (St/PVA/PAA) hydrogel. It is hypothesized that the TA/Fe@ChNFs nanohybrid imparts both mechanical strength and stimuli-free SELF properties to the hydrogel via dynamic catecholato-metal coordination bonds. Additionally, the catechol groups of TA provide mussel-inspired adhesion properties to the hydrogel. Due to its electroconductivity, toughness, stimuli-free SELF properties, and self-adhesiveness, a prototype soft wearable strain sensor is created using this hydrogel and subsequently tested.

Patient-specific 3D-printed Splint for Mallet Finger Injury.

Despite the frequency of mallet finger injuries, treatment options can often be costly, time-consuming, and ill-fitted. Three-dimensional (3D) printing allows for the production of highly customized and inexpensive splints, which suggests potential efficacy in the prescription of casts for musculoskeletal injuries. This study explores how the use of engineering concepts such as 3D printing and topology optimization (TO) can improve outcomes for patients. 3D printing enables the direct fabrication of the patient-specific complex shapes while utilizing finite element analysis and TO in the design of the splint allowed for the most efficient distribution of material to achieve mechanical requirements while reducing the amount of material used. The reduction in used material leads to significant improvements in weight reduction and heat dissipation, which would improve breathability and less sweating for the patient, greatly increasing comfort for the duration of their recovery.

Blood Pressure Sensors: Materials, Fabrication Methods, Performance Evaluations and Future Perspectives.

Advancements in materials science and fabrication techniques have contributed to the significant growing attention to a wide variety of sensors for digital healthcare. While the progress in this area is tremendously impressive, few wearable sensors with the capability of real-time blood pressure monitoring are approved for clinical use. One of the key obstacles in the further development of wearable sensors for medical applications is the lack of comprehensive technical evaluation of sensor materials against the expected clinical performance. Here, we present an extensive review and critical analysis of various materials applied in the design and fabrication of wearable sensors. In our unique transdisciplinary approach, we studied the fundamentals of blood pressure and examined its measuring modalities while focusing on their clinical use and sensing principles to identify material functionalities. Then, we carefully reviewed various categories of functional materials utilized in sensor building blocks allowing for comparative analysis of the performance of a wide range of materials throughout the sensor operational-life cycle. Not only this provides essential data to enhance the materials' properties and optimize their performance, but also, it highlights new perspectives and provides suggestions to develop the next generation pressure sensors for clinical use.

In Vitro Validation of a Numerical Simulation of Leaflet Kinematics in a Polymeric Aortic Valve Under Physiological Conditions.

This paper describes a computational method to simulate the non-linear structural deformation of a polymeric aortic valve under physiological conditions. Arbitrary Lagrangian-Eulerian method is incorporated in the fluid-structure interaction simulation, and then validated by comparing the predicted kinematics of the valve's leaflets to in vitro measurements on a custom-made polymeric aortic valve. The predicted kinematics of the valve's leaflets was in good agreement with the experimental results with a maximum error of 15% in a single cardiac cycle. The fluid-structure interaction model presented in this study can simulate structural behaviour of a stented valve with flexible leaflets, providing insight into the haemodynamic performance of a polymeric aortic valve.

Stereolithography for Personalized Left Atrial Appendage Occluders.

Advancements in 3D additive manufacturing have spurred the development of effective patient-specific medical devices. Prior applications are limited to hard materials, however, with few implementations of soft devices that better match the properties of natural tissue. This paper introduces a rapid, low cost, and scalable process for fabricating soft, personalized medical implants via stereolithography of elastomeric polyurethane resin. The effectiveness of this approach is demonstrated by designing and manufacturing patient-specific endocardial implants. These devices occlude the left atrial appendage, a complex structure within the heart prone to blood clot formation in patients with atrial fibrillation. Existing occluders permit residual blood flow and can damage neighboring tissues. Here, the robust mechanical properties of the hollow, printed geometries are characterized and stable device anchoring through in vitro benchtop testing is confirmed. The soft, patient-specific devices outperform non-patient-specific devices in embolism and occlusion experiments, as well as in computational fluid dynamics simulations.

A novel design of a polymeric aortic valve.

INTRODUCTION: In this paper we propose a novel method for developing a polymeric heart valve that could potentially offer an optimum solution for a heart valve substitute. The valve design proposed will provide superior hydrodynamic performance and excellent structural integrity. A full description of the design process is given together with an analysis of the hemodynamic performance using a 2-way strongly coupled Fluid Structure Interaction (FSI). METHOD: A polymeric tri-leaflet heart valve is designed based on a patient's sinus of Valsalva (SOV) geometry. The design strategy aims to improve valve hemodynamic performance as well as valve durability by avoiding stress concentrations in the leaflets and reducing the maximum stress level. The valve dynamics and stress levels are also validated by comparing the predicted data to existing experimental and numerical data. RESULTS: The stress distribution in the valve structure is fully characterized throughout the simulation and Von Mises stress is found to be up to 5.32 Mpa during diastole. The results show that an effective orifice area (EOA) and a pressure drop of 3.22 cm^2, and 3.52 mmHg, respectively, can be achieved using the proposed design. CONCLUSIONS: The optimized valve demonstrates high hemodynamic performance with no sign of damaging stress concentration in the entire cardiac cycle.