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Wright DN, Züchner M, Annavini E, Escalona MJ, Hammerlund Teige L, Whist Tvedt LG, Lervik A, Haga HA, Guiho T, Clausen I, Glott T, Boulland JL. From wires to waves, a novel sensor system for in vivo pressure monitoring. Sci Rep 2024; 14:7570. [PMID: 38555360 PMCID: PMC10981663 DOI: 10.1038/s41598-024-58019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Pressure monitoring in various organs of the body is essential for appropriate diagnostic and therapeutic purposes. In almost all situations, monitoring is performed in a hospital setting. Technological advances not only promise to improve clinical pressure monitoring systems, but also engage toward the development of fully implantable systems in ambulatory patients. Such systems would not only provide longitudinal time monitoring to healthcare personnel, but also to the patient who could adjust their way-of-life in response to the measurements. In the past years, we have developed a new type of piezoresistive pressure sensor system. Different bench tests have demonstrated that it delivers precise and reliable pressure measurements in real-time. The potential of this system was confirmed by a continuous recording in a patient that lasted for almost a day. In the present study, we further characterized the functionality of this sensor system by conducting in vivo implantation experiments in nine female farm pigs. To get a step closer to a fully implantable system, we also adapted two different wireless communication solutions to the sensor system. The communication protocols are based on MICS (Medical Implant Communication System) and BLE (Bluetooth Low Energy) communication. As a proof-of-concept, implantation experiments in nine female pigs demonstrated the functionality of both systems, with a notable technical superiority of the BLE.
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Affiliation(s)
| | - Mark Züchner
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0317, Oslo, Norway
| | - Eis Annavini
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0317, Oslo, Norway
| | - Manuel J Escalona
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0317, Oslo, Norway
- Department for Immunology, Clinic for Laboratory Medicine, Oslo University Hospital-Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway
| | - Lena Hammerlund Teige
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0317, Oslo, Norway
- Department for Immunology, Clinic for Laboratory Medicine, Oslo University Hospital-Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway
| | - Lars Geir Whist Tvedt
- Department of Microsystems and Nanotechnology, SINTEF AS, Oslo, Norway
- InVivo Bionics AS, Oslo, Norway
| | - Andreas Lervik
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Ås, Norway
| | - Henning A Haga
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Ås, Norway
| | | | - Ingelin Clausen
- Department of Microsystems and Nanotechnology, SINTEF AS, Oslo, Norway
- InVivo Bionics AS, Oslo, Norway
| | - Thomas Glott
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Jean-Luc Boulland
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0317, Oslo, Norway.
- Department for Immunology, Clinic for Laboratory Medicine, Oslo University Hospital-Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway.
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2
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Alam F, Ashfaq Ahmed M, Jalal AH, Siddiquee I, Adury RZ, Hossain GMM, Pala N. Recent Progress and Challenges of Implantable Biodegradable Biosensors. MICROMACHINES 2024; 15:475. [PMID: 38675286 PMCID: PMC11051912 DOI: 10.3390/mi15040475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
Implantable biosensors have evolved to the cutting-edge technology of personalized health care and provide promise for future directions in precision medicine. This is the reason why these devices stand to revolutionize our approach to health and disease management and offer insights into our bodily functions in ways that have never been possible before. This review article tries to delve into the important developments, new materials, and multifarious applications of these biosensors, along with a frank discussion on the challenges that the devices will face in their clinical deployment. In addition, techniques that have been employed for the improvement of the sensitivity and specificity of the biosensors alike are focused on in this article, like new biomarkers and advanced computational and data communicational models. A significant challenge of miniaturized in situ implants is that they need to be removed after serving their purpose. Surgical expulsion provokes discomfort to patients, potentially leading to post-operative complications. Therefore, the biodegradability of implants is an alternative method for removal through natural biological processes. This includes biocompatible materials to develop sensors that remain in the body over longer periods with a much-reduced immune response and better device longevity. However, the biodegradability of implantable sensors is still in its infancy compared to conventional non-biodegradable ones. Sensor design, morphology, fabrication, power, electronics, and data transmission all play a pivotal role in developing medically approved implantable biodegradable biosensors. Advanced material science and nanotechnology extended the capacity of different research groups to implement novel courses of action to design implantable and biodegradable sensor components. But the actualization of such potential for the transformative nature of the health sector, in the first place, will have to surmount the challenges related to biofouling, managing power, guaranteeing data security, and meeting today's rules and regulations. Solving these problems will, therefore, not only enhance the performance and reliability of implantable biodegradable biosensors but also facilitate the translation of laboratory development into clinics, serving patients worldwide in their better disease management and personalized therapeutic interventions.
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Affiliation(s)
- Fahmida Alam
- Department of Electrical and Computer Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; (A.H.J.); (G.M.M.H.)
| | | | - Ahmed Hasnain Jalal
- Department of Electrical and Computer Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; (A.H.J.); (G.M.M.H.)
| | - Ishrak Siddiquee
- Institute of Microsystems Technology, University of South-Eastern Norway, Horten, 3184 Vestfold, Norway;
| | - Rabeya Zinnat Adury
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL 32611, USA;
| | - G M Mehedi Hossain
- Department of Electrical and Computer Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; (A.H.J.); (G.M.M.H.)
| | - Nezih Pala
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL 33174, USA;
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3
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Kang M, Lee DM, Hyun I, Rubab N, Kim SH, Kim SW. Advances in Bioresorbable Triboelectric Nanogenerators. Chem Rev 2023; 123:11559-11618. [PMID: 37756249 PMCID: PMC10571046 DOI: 10.1021/acs.chemrev.3c00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Indexed: 09/29/2023]
Abstract
With the growing demand for next-generation health care, the integration of electronic components into implantable medical devices (IMDs) has become a vital factor in achieving sophisticated healthcare functionalities such as electrophysiological monitoring and electroceuticals worldwide. However, these devices confront technological challenges concerning a noninvasive power supply and biosafe device removal. Addressing these challenges is crucial to ensure continuous operation and patient comfort and minimize the physical and economic burden on the patient and the healthcare system. This Review highlights the promising capabilities of bioresorbable triboelectric nanogenerators (B-TENGs) as temporary self-clearing power sources and self-powered IMDs. First, we present an overview of and progress in bioresorbable triboelectric energy harvesting devices, focusing on their working principles, materials development, and biodegradation mechanisms. Next, we examine the current state of on-demand transient implants and their biomedical applications. Finally, we address the current challenges and future perspectives of B-TENGs, aimed at expanding their technological scope and developing innovative solutions. This Review discusses advancements in materials science, chemistry, and microfabrication that can advance the scope of energy solutions available for IMDs. These innovations can potentially change the current health paradigm, contribute to enhanced longevity, and reshape the healthcare landscape soon.
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Affiliation(s)
- Minki Kang
- School
of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic
of Korea
| | - Dong-Min Lee
- School
of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic
of Korea
| | - Inah Hyun
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
| | - Najaf Rubab
- Department
of Materials Science and Engineering, Gachon
University, Seongnam 13120, Republic
of Korea
| | - So-Hee Kim
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
| | - Sang-Woo Kim
- Department
of Materials Science and Engineering, Center for Human-oriented Triboelectric
Energy Harvesting, Yonsei University, Seoul 03722, Republic of Korea
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4
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Thevenot C, Rouxel D, Sukumaran S, Rouabah S, Vincent B, Chatbouri S, Ben Zineb T. Plasticized P(
VDF‐TrFE
): A new flexible piezoelectric material with an easier polarization process, promising for biomedical applications. J Appl Polym Sci 2021. [DOI: 10.1002/app.50420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Camille Thevenot
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
| | - Didier Rouxel
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
| | - Sunija Sukumaran
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
- Université de Lorraine CNRS, Arts et Métiers ParisTech, LEM3 Nancy France
| | - Sawsen Rouabah
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
| | - Brice Vincent
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
| | - Samir Chatbouri
- Institut Jean Lamour Université de Lorraine, CNRS, IJL Nancy France
| | - Tarak Ben Zineb
- Université de Lorraine CNRS, Arts et Métiers ParisTech, LEM3 Nancy France
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Hake AE, Zhao C, Ping L, Grosh K. Ultraminiature AlN diaphragm acoustic transducer. APPLIED PHYSICS LETTERS 2020; 117:143504. [PMID: 33060860 PMCID: PMC7538164 DOI: 10.1063/5.0020645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Piezoelectric acoustic transducers consisting of a circular aluminum nitride and silicon nitride unimorph diaphragm and an encapsulated air-filled back cavity are reported. Analytical and finite element analysis models are used to design the transducer to achieve low minimum detectable pressure (MDP) within chosen size restrictions. A series of transducers with varying radii are fabricated using microelectromechanical systems (MEMS) techniques. Experimental results are reported for a transducer with a 175 μm radius on a 400 × 500 × 500 μm3 die exhibiting structural resonances at 552 kHz in air and 133 kHz in water. The low-frequency (10 Hz-50 kHz) sensitivity is 1.87 μV/Pa (-114.5 dB re 1 V/Pa) in both air and water. The sensor has an MDP of 43.7 mPa/ Hz (67 dB SPL) at 100 Hz and 10.9 mPa/ Hz (55 dB SPL) at 1 kHz. This work contributes a set of design rules for MEMS piezoelectric diaphragm transducers that focuses on decreasing the MDP of the sensor through size, material properties, and residual stress considerations.
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Affiliation(s)
- Alison E. Hake
- Mechanical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Chuming Zhao
- Mechanical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Lichuan Ping
- Singular Medical USA, Irvine, California 92614, USA
| | - Karl Grosh
- Author to whom correspondence should be addressed:
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6
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Dogan O, Schierbaum N, Weidenmuller J, Baum M, Schroder T, Wunsch D, Gortz M, Seidl K. Miniaturized Multi Sensor Implant for Monitoring of Hemodynamic Parameters .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3823-3826. [PMID: 31946707 DOI: 10.1109/embc.2019.8856571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
t a novel miniaturized multi sensor implant for monitoring hemodynamic parameters in cardiovascular regions. Pressure measurements are performed with a highly accurate capacitive pressure sensor. An additional acceleration and temperature sensor allows compensating the impact of patient's inclination and temperature variations on the pressure measurement, respectively. A multi-functional transponder application-specific integrated circuit (ASIC) manages sensor signal processing, storage of ID, sensor calibration data, telemetric energy, and data transmission with an extracorporeal reading unit. Each component of the implant is assembled on a low temperature co-fired ceramics (LTCC) circuit board with an integrated antenna coil enabling an inductive near-field coupling at a frequency of 13.56 MHz. For a streamlined shape and reduction of thrombogenicity, the implant is encapsulated by biocompatible polymers.
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7
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Habibzadeh H, Dinesh K, Shishvan OR, Boggio-Dandry A, Sharma G, Soyata T. A Survey of Healthcare Internet-of-Things (HIoT): A Clinical Perspective. IEEE INTERNET OF THINGS JOURNAL 2020; 7:53-71. [PMID: 33748312 PMCID: PMC7970885 DOI: 10.1109/jiot.2019.2946359] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In combination with current sociological trends, the maturing development of IoT devices is projected to revolutionize healthcare. A network of body-worn sensors, each with a unique ID, can collect health data that is orders-of-magnitude richer than what is available today from sporadic observations in clinical/hospital environments. When databased, analyzed, and compared against information from other individuals using data analytics, HIoT data enables the personalization and modernization of care with radical improvements in outcomes and reductions in cost. In this paper, we survey existing and emerging technologies that can enable this vision for the future of healthcare, particularly in the clinical practice of healthcare. Three main technology areas underlie the development of this field: (a) sensing, where there is an increased drive for miniaturization and power efficiency; (b) communications, where the enabling factors are ubiquitous connectivity, standardized protocols, and the wide availability of cloud infrastructure, and (c) data analytics and inference, where the availability of large amounts of data and computational resources is revolutionizing algorithms for individualizing inference and actions in health management. Throughout the paper, we use a case study to concretely illustrate the impact of these trends. We conclude our paper with a discussion of the emerging directions, open issues, and challenges.
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Affiliation(s)
- Hadi Habibzadeh
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627
| | - Omid Rajabi Shishvan
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Andrew Boggio-Dandry
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627
| | - Tolga Soyata
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
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8
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Song Y, Min J, Gao W. Wearable and Implantable Electronics: Moving toward Precision Therapy. ACS NANO 2019; 13:12280-12286. [PMID: 31725255 DOI: 10.1021/acsnano.9b08323] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Soft wearable and implantable electronic systems have attracted tremendous attention due to their flexibility, conformability, and biocompatibility. Such favorable features are critical for reliably monitoring key biomedical and physiological information (including both biophysical and biochemical signals) and effective treatment and management of specific chronic diseases. Miniaturized, fully integrated self-powered bioelectronic devices that can harvest energy from the human body represent promising and emerging solutions for long-term, intimate, and personalized therapies. In this Perspective, we offer a brief overview of recent advances in wearable/implantable soft electronic devices and their therapeutic applications ranging from drug delivery to tissue regeneration. We also discuss the key opportunities, challenges, and future directions in this important area needed to fulfill the vision of personalized medicine.
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Affiliation(s)
- Yu Song
- Andrew and Peggy Cherng Department of Medical Engineering , California Institute of Technology , Pasadena , California 91125 , United States
| | - Jihong Min
- Andrew and Peggy Cherng Department of Medical Engineering , California Institute of Technology , Pasadena , California 91125 , United States
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering , California Institute of Technology , Pasadena , California 91125 , United States
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9
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Schwartz BF. Editorial Comment on: The Impact of Ureteral Deformation and External Ureteral Pressure on Stent Failure in Extrinsic Ureteral Obstruction: An In Vitro Experimental Study by Shilo et al. (From: Shilo Y, Modai J, Leibovici D, et al. J Endourol 2019;34:68-73; DOI: 10.1089/end.2019.0465). J Endourol 2019; 34:74. [PMID: 31583897 DOI: 10.1089/end.2019.0636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bradley F Schwartz
- Division of Urology, Southern Illinois University School of Medicine, Springfield, Illinois
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10
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Li T, Feng ZQ, Qu M, Yan K, Yuan T, Gao B, Wang T, Dong W, Zheng J. Core/Shell Piezoelectric Nanofibers with Spatial Self-Orientated β-Phase Nanocrystals for Real-Time Micropressure Monitoring of Cardiovascular Walls. ACS NANO 2019; 13:10062-10073. [PMID: 31469542 DOI: 10.1021/acsnano.9b02483] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Implantable pressure biosensors show great potential for assessment and diagnostics of pressure-related diseases. Here, we present a structural design strategy to fabricate core/shell polyvinylidene difluoride (PVDF)/hydroxylamine hydrochloride (HHE) organic piezoelectric nanofibers (OPNs) with well-controlled and self-orientated nanocrystals in the spatial uniaxial orientation (SUO) of β-phase-rich fibers, which significantly enhance piezoelectric performance, fatigue resistance, stability, and biocompatibility. Then PVDF/HHE OPNs soft sensors are developed and used to monitor subtle pressure changes in vivo. Upon implanting into pig, PVDF/HHE OPNs sensors demonstrate their ultrahigh detecting sensitivity and accuracy to capture micropressure changes at the outside of cardiovascular walls, and output piezoelectric signals can real-time and synchronously reflect and distinguish changes of cardiovascular elasticity and occurrence of atrioventricular heart-block and formation of thrombus. Such biological information can provide a diagnostic basis for early assessment and diagnosis of thrombosis and atherosclerosis, especially for postoperative recrudescence of thrombus deep within the human body.
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Affiliation(s)
- Tong Li
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Zhang-Qi Feng
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Minghe Qu
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Ke Yan
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Tao Yuan
- Department of Orthopedic , Nanjing Jinling Hospital , Nanjing 210002 , China
| | - Bingbing Gao
- State Key Laboratory of Bioelectronics , Southeast University , Nanjing 210096 , China
| | - Ting Wang
- State Key Laboratory of Bioelectronics , Southeast University , Nanjing 210096 , China
| | - Wei Dong
- School of Chemical Engineering , Nanjing University of Science and Technology , Nanjing 210094 , China
| | - Jie Zheng
- Department of Chemical and Biomolecular Engineering , The University of Akron , Akron , Ohio 44325 , United States
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Basu AS, Majerus S, Ferry L, Makovey I, Zhu H, Damaser MS. Is submucosal bladder pressure monitoring feasible? Proc Inst Mech Eng H 2019; 233:100-113. [PMID: 30799738 PMCID: PMC6391733 DOI: 10.1177/0954411918754925] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There has been recent interest in placing pressure-sensing elements beneath the bladder mucosa to facilitate chronic bladder pressure monitoring. Wired submucosal sensors with the wires passed through detrusor have been demonstrated in vivo, with limited chronic retention, potentially due to the cable tethering the detrusor. Published studies of submucosal implants have shown that high correlation coefficients between submucosal and lumen pressures can be obtained in caprine, feline, and canine models. We have developed a wireless pressure monitor and surgical technique for wireless submucosal implantation and present our initial chronic implantation study here. Pressure monitors were implanted (n = 6) in female calf models (n = 5). Five devices were implanted cystoscopically with a 25-French rigid cystoscope. One device was implanted suprapubically to test device retention with an intact mucosa. Wireless recordings during anesthetized cystometry simultaneous with catheter-based reference vesical pressure measurements during filling and manual bladder compressions were recorded. Individual analysis of normalised data during bladder compressions (n = 12) indicated high correlation (r = 0.85-0.94) between submucosal and reference vesical pressure. The healing response was robust over 4 weeks; however, mucosal erosion occurred 2-4 weeks after implantation, leading to device migration into the bladder lumen and expulsion during urination. Wireless pressure monitors may be successfully placed in a suburothelial position. Submucosal pressures are correlated with vesical pressure, but may differ due to biomechanical forces pressing on an implanted sensor. Fully wireless devices implanted beneath the mucosa have risk of erosion through the mucosa, potentially caused by disruption of blood flow to the urothelium, or an as-yet unstudied mechanism of submucosal regrowth. Further investigation into device miniaturisation, anchoring methods, and understanding of submucosal pressure biomechanics may enable chronic submucosal pressure monitoring. However, the risk of erosion with submucosal implantation highlights the need for investigation of devices designed for chronic intravesical pressure monitoring.
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Affiliation(s)
- Anisha S. Basu
- Dept of Biomedical Engineering, Case Western Reserve University, Cleveland, OH USA
- Dept of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH USA
| | - Steve Majerus
- Dept of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH USA
- Dept of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, OH USA
- Advanced Platform Technology Center, Louis Stokes Cleveland Dept. of Veterans Affairs Medical Center, Cleveland, OH USA
| | - Liz Ferry
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY USA
| | - Iryna Makovey
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH USA
| | - Hui Zhu
- Advanced Platform Technology Center, Louis Stokes Cleveland Dept. of Veterans Affairs Medical Center, Cleveland, OH USA
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH USA
| | - Margot S. Damaser
- Dept of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH USA
- Advanced Platform Technology Center, Louis Stokes Cleveland Dept. of Veterans Affairs Medical Center, Cleveland, OH USA
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH USA
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12
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Measurement of Urinary Bladder Pressure: A Comparison of Methods. SENSORS 2018; 18:s18072128. [PMID: 29970801 PMCID: PMC6068839 DOI: 10.3390/s18072128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 11/17/2022]
Abstract
Pressure is an essential parameter for the normal function of almost all organs in the human body. Measurement of pressure is therefore highly important in clinical practice and medical research. In clinical practice, pressures are often measured indirectly through a fluid line where the pressure is transmitted from the organ of interest to a remote, externally localized transducer. This method has several limitations and is prone to artefacts from movements. Results from an in vitro bench study comparing the characteristics of two different sensor systems for bladder assessment are presented; a new cystometry system using a MEMS-based in-target organ sensor was compared with a conventional system using water-filled lines connected to external transducers. Robustness to measurement errors due to patient movement was investigated through response to forced vibrations. While the new cystometry system detected real changes in applied pressure for excitation frequencies ranging from 5 Hz to 25 Hz, such small and high-frequency stimuli were not transmitted through the water-filled line connected to the external transducer. The new sensor system worked well after a resilient test at frequencies up to 70 Hz. The in-target organ sensor system will offer new possibilities for long-term monitoring of in vivo pressure in general. This opens up the possibility for future personalized medical treatment and renders possible new health services and, thereby, an increased patient empowerment and quality of life.
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13
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Majerus SJA, Fletter PC, Ferry EK, Zhu H, Gustafson KJ, Damaser MS. Suburothelial Bladder Contraction Detection with Implanted Pressure Sensor. PLoS One 2017; 12:e0168375. [PMID: 28060842 PMCID: PMC5218553 DOI: 10.1371/journal.pone.0168375] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/29/2016] [Indexed: 12/31/2022] Open
Abstract
Aims Managing bladder pressure in patients with neurogenic bladders is needed to improve rehabilitation options, avoid upper tract damage, incontinence, and their associated co-morbidities and mortality. Current methods of determining bladder contractions are not amenable to chronic or ambulatory settings. In this study we evaluated detection of bladder contractions using a novel piezoelectric catheter-free pressure sensor placed in a suburothelial bladder location in animals. Methods Wired prototypes of the pressure monitor were implanted into 2 nonsurvival (feline and canine) and one 13-day survival (canine) animal. Vesical pressures were obtained from the device in both suburothelial and intraluminal locations and simultaneously from a pressure sensing catheter in the bladder. Intravesical pressure was monitored in the survival animal over 10 days from the suburothelial location and necropsy was performed to assess migration and erosion. Results In the nonsurvival animals, the average correlation between device and reference catheter data was high during both electrically stimulated bladder contractions and manual compressions (r = 0.93±0.03, r = 0.89±0.03). Measured pressures correlated strongly (r = 0.98±0.02) when the device was placed in the bladder lumen. The survival animal initially recorded physiologic data, but later this deteriorated. However, endstage intraluminal device recordings correlated (r = 0.85±0.13) with the pressure catheter. Significant erosion of the implant through the detrusor was found. Conclusions This study confirms correlation between suburothelial pressure readings and intravesical bladder pressures. Due to device erosion during ambulatory studies, a wireless implant is recommended for clinical rehabilitation applications.
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Affiliation(s)
- Steve J. A. Majerus
- Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Department of Electrical Engineering and Computer Sciences, Case Western Reserve University, Cleveland, OH, United States of America
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America
| | - Paul C. Fletter
- Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America
| | - Elizabeth K. Ferry
- Division of Urology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Urology Institute, University Hospitals, Case Medical Center, Cleveland, OH, United States of America
| | - Hui Zhu
- Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Division of Urology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland OH, United States of America
| | - Kenneth J. Gustafson
- Urology Institute, University Hospitals, Case Medical Center, Cleveland, OH, United States of America
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
- Functional Electrical Stimulation Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
| | - Margot S. Damaser
- Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland OH, United States of America
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
- * E-mail:
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14
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Frequency Splitting Analysis and Compensation Method for Inductive Wireless Powering of Implantable Biosensors. SENSORS 2016; 16:s16081229. [PMID: 27527174 PMCID: PMC5017394 DOI: 10.3390/s16081229] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/19/2016] [Accepted: 07/29/2016] [Indexed: 11/17/2022]
Abstract
Inductive powering for implanted medical devices, such as implantable biosensors, is a safe and effective technique that allows power to be delivered to implants wirelessly, avoiding the use of transcutaneous wires or implanted batteries. Wireless powering is very sensitive to a number of link parameters, including coil distance, alignment, shape, and load conditions. The optimum drive frequency of an inductive link varies depending on the coil spacing and load. This paper presents an optimum frequency tracking (OFT) method, in which an inductive power link is driven at a frequency that is maintained at an optimum value to ensure that the link is working at resonance, and the output voltage is maximised. The method is shown to provide significant improvements in maintained secondary voltage and system efficiency for a range of loads when the link is overcoupled. The OFT method does not require the use of variable capacitors or inductors. When tested at frequencies around a nominal frequency of 5 MHz, the OFT method provides up to a twofold efficiency improvement compared to a fixed frequency drive. The system can be readily interfaced with passive implants or implantable biosensors, and lends itself to interfacing with designs such as distributed implanted sensor networks, where each implant is operating at a different frequency.
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15
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Majerus S, Damaser MS. Automatic Drift Cancellation of Implanted Bladder Pressure Sensor. IEEE BIOMEDICAL CIRCUITS AND SYSTEMS CONFERENCE : HEALTHCARE TECHNOLOGY : [PROCEEDINGS]. IEEE BIOMEDICAL CIRCUITS AND SYSTEMS CONFERENCE 2015; 2015. [PMID: 33899050 DOI: 10.1109/biocas.2015.7348430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Implanted pressure sensors suffer from long-term offset drift due to atmospheric changes, package moisture absorption, and patient factors such as posture, implant shift, and tissue overgrowth. Traditionally, wide dynamic range instrumentation is used to satisfy the full-scale and sensitivity requirements for a given application. Transmission of extra bits greatly increases the power draw of an implanted medical device, and simple AC-coupling cannot monitor static pressures. We present a mixed-signal offset cancellation loop to maximize the AC dynamic range of instrumentation circuitry. A digital implementation allows for designer control of the cancellation system time constant and was specifically designed for power-gated pressure sensors. Pressure offset is calculated by digital integration and a bipolar IDAC with coarse/fine tuning injects an offset-cancelling current into a standard piezoresistive MEMS pressure sensor. Test results showed a dynamic range increase of 2.9 bits using dynamic offset cancellation, for an effective sensing range of 11 bits using 8-bit instrumentation. The measured step response of the system showed an overall highpass response of 2.3 - 3.8 mHz. This approach is therefore relevant for bio-sensing of pressures in organs with a very slow physiologic response, e.g. the bladder.
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Affiliation(s)
- Steve Majerus
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
- Dept. of Electrical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Margot S Damaser
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
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16
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Abstract
The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra into the bladder to measure pressure variations. Unfortunately, this method is inaccurate because measurement is affected by disturbances in catheter lines as well as delays in response time owing to the inertia of urine inside the bladder. Moreover, this technique can cause infection during prolonged use; hence, it is only suitable for short-term measurement. Development of discrete wireless implantable sensors to measure bladder volume/pressure would allow for long-term monitoring within the bladder, while maintaining the patient’s quality of life. With the recent advances in microfabrication, the size of implantable bladder sensors has been significantly reduced. However, microfabricated sensors face hostility from the bladder environment and require surgical intervention for implantation inside the bladder. Here, we explore the various types of implantable bladder sensors and current efforts to solve issues like hermeticity, biocompatibility, drift, telemetry, power, and compatibility issues with popular imaging tools such as computed tomography and magnetic resonance imaging. We also discuss some possible improvements/emerging trends in the design of an implantable bladder sensor.
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17
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Laurenson C, Rivet F, Yuce MR, Redoute JM. A 1.04µW wireless integrated MEMS interface in UMC 0.18µm CMOS. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:889-892. [PMID: 26736405 DOI: 10.1109/embc.2015.7318505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper presents an ultra low-power integrated interface for capacitive and resistive MEMS and sensors, intended for use in biomedical applications. The interface encodes the sensed data in the time between transmitted UWB pulses: this reduces the number of transmitted bits and benefits the power consumption. The interface was designed and fabricated in the UMC 0.18μm CMOS process: the power consumption of the system was measured to be 1.04μW at a sample rate of 37Hz.
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18
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Yu L, Kim BJ, Meng E. Chronically implanted pressure sensors: challenges and state of the field. SENSORS 2014; 14:20620-44. [PMID: 25365461 PMCID: PMC4279503 DOI: 10.3390/s141120620] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 10/14/2014] [Accepted: 10/21/2014] [Indexed: 12/12/2022]
Abstract
Several conditions and diseases are linked to the elevation or depression of internal pressures from a healthy, normal range, motivating the need for chronic implantable pressure sensors. A simple implantable pressure transduction system consists of a pressure-sensing element with a method to transmit the data to an external unit. The biological environment presents a host of engineering issues that must be considered for long term monitoring. Therefore, the design of such systems must carefully consider interactions between the implanted system and the body, including biocompatibility, surgical placement, and patient comfort. Here we review research developments on implantable sensors for chronic pressure monitoring within the body, focusing on general design requirements for implantable pressure sensors as well as specifications for different medical applications. We also discuss recent efforts to address biocompatibility, efficient telemetry, and drift management, and explore emerging trends.
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Affiliation(s)
- Lawrence Yu
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, DRB-140, Los Angeles, CA 90089-1111, USA.
| | - Brian J Kim
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, DRB-140, Los Angeles, CA 90089-1111, USA.
| | - Ellis Meng
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, DRB-140, Los Angeles, CA 90089-1111, USA.
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Juanola-Feliu E, Miribel-Català PL, Páez Avilés C, Colomer-Farrarons J, González-Piñero M, Samitier J. Design of a customized multipurpose nano-enabled implantable system for in-vivo theranostics. SENSORS (BASEL, SWITZERLAND) 2014; 14:19275-306. [PMID: 25325336 PMCID: PMC4239942 DOI: 10.3390/s141019275] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 02/05/2023]
Abstract
The first part of this paper reviews the current development and key issues on implantable multi-sensor devices for in vivo theranostics. Afterwards, the authors propose an innovative biomedical multisensory system for in vivo biomarker monitoring that could be suitable for customized theranostics applications. At this point, findings suggest that cross-cutting Key Enabling Technologies (KETs) could improve the overall performance of the system given that the convergence of technologies in nanotechnology, biotechnology, micro&nanoelectronics and advanced materials permit the development of new medical devices of small dimensions, using biocompatible materials, and embedding reliable and targeted biosensors, high speed data communication, and even energy autonomy. Therefore, this article deals with new research and market challenges of implantable sensor devices, from the point of view of the pervasive system, and time-to-market. The remote clinical monitoring approach introduced in this paper could be based on an array of biosensors to extract information from the patient. A key contribution of the authors is that the general architecture introduced in this paper would require minor modifications for the final customized bio-implantable medical device.
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Affiliation(s)
- Esteve Juanola-Feliu
- Department of Electronics, Bioelectronics and Nanobioengineering Research Group (SIC-BIO), University of Barcelona, Martí i Franquès 1, Barcelona 08028, Spain; E-Mails: (P.L.M.-C.); (C.P.A.); (J.C.-F.); (J.S.)
| | - Pere Ll. Miribel-Català
- Department of Electronics, Bioelectronics and Nanobioengineering Research Group (SIC-BIO), University of Barcelona, Martí i Franquès 1, Barcelona 08028, Spain; E-Mails: (P.L.M.-C.); (C.P.A.); (J.C.-F.); (J.S.)
| | - Cristina Páez Avilés
- Department of Electronics, Bioelectronics and Nanobioengineering Research Group (SIC-BIO), University of Barcelona, Martí i Franquès 1, Barcelona 08028, Spain; E-Mails: (P.L.M.-C.); (C.P.A.); (J.C.-F.); (J.S.)
| | - Jordi Colomer-Farrarons
- Department of Electronics, Bioelectronics and Nanobioengineering Research Group (SIC-BIO), University of Barcelona, Martí i Franquès 1, Barcelona 08028, Spain; E-Mails: (P.L.M.-C.); (C.P.A.); (J.C.-F.); (J.S.)
| | - Manel González-Piñero
- Department of Public Economy, Political Economy and Spanish Economy, University of Barcelona, Av. Diagonal 690-696, Barcelona 08034, Spain; E-Mail:
- CREB-Biomedical Engineering Research Centre, Technical University of Catalonia, Pau Gargallo 5, Barcelona 08028, Spain
| | - Josep Samitier
- Department of Electronics, Bioelectronics and Nanobioengineering Research Group (SIC-BIO), University of Barcelona, Martí i Franquès 1, Barcelona 08028, Spain; E-Mails: (P.L.M.-C.); (C.P.A.); (J.C.-F.); (J.S.)
- IBEC-Institute for Bioengineering of Catalonia, Nanobioengineering Research Group, Baldiri Reixac 10-12, Barcelona 08028, Spain
- CIBER-BBN-Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine, María de Luna 11, Edificio CEEI, Zaragoza 50018, Spain
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20
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Clausen I, Glott T. Development of clinically relevant implantable pressure sensors: perspectives and challenges. SENSORS (BASEL, SWITZERLAND) 2014; 14:17686-702. [PMID: 25248071 PMCID: PMC4208244 DOI: 10.3390/s140917686] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 08/20/2014] [Accepted: 09/10/2014] [Indexed: 11/19/2022]
Abstract
This review describes different aspects to consider when developing implantable pressure sensor systems. Measurement of pressure is in general highly important in clinical practice and medical research. Due to the small size, light weight and low energy consumption Micro Electro Mechanical Systems (MEMS) technology represents new possibilities for monitoring of physiological parameters inside the human body. Development of clinical relevant sensors requires close collaboration between technological experts and medical clinicians. Site of operation, size restrictions, patient safety, and required measurement range and resolution, are only some conditions that must be taken into account. An implantable device has to operate under very hostile conditions. Long-term in vivo pressure measurements are particularly demanding because the pressure sensitive part of the sensor must be in direct or indirect physical contact with the medium for which we want to detect the pressure. New sensor packaging concepts are demanded and must be developed through combined effort between scientists in MEMS technology, material science, and biology. Before launching a new medical device on the market, clinical studies must be performed. Regulatory documents and international standards set the premises for how such studies shall be conducted and reported.
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Affiliation(s)
- Ingelin Clausen
- SINTEF ICT, Department of Microsystems and Nanotechnology, NO-0314 Oslo, Norway.
| | - Thomas Glott
- Sunnaas Rehabilitation Hospital HF, NO-1450 Nesoddtangen, Norway.
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21
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Affiliation(s)
- Chu-Pak Lau
- Cardiology Division, Department of Medicine, Queen Mary Hospital (C.-P.L., C.-W.S., H.-F.T.) and Research Center of Heart, Brain, Hormone and Healthy Ageing, Li Ka Shing Faculty of Medicine (C.-W.S., H.-F.T.), University of Hong Kong, Hong Kong SAR, China
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22
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Cleven NJ, Isfort P, Penzkofer T, Woitok A, Hermanns-Sachweh B, Steinseifer U, Schmitz-Rode T. Wireless blood pressure monitoring with a novel implantable device: long-term in vivo results. Cardiovasc Intervent Radiol 2014; 37:1580-8. [PMID: 24464260 DOI: 10.1007/s00270-014-0842-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/22/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE Devices constantly tracking the blood pressure (BP) of hypertensive patients are highly desired to facilitate effective patient management and to reduce hospitalization. We report on experiences gathered in a pilot study that was designed to evaluate the prototype of a newly developed, minimally invasive implantable sensor system for long-term BP monitoring. METHODS The device was implanted in the femoral artery (FA) of 12 sheep via standard FA catheterization under fluoroscopic control. Accuracy of the recorded blood pressure was determined by comparison with a reference catheter, which was positioned in the contralateral FA immediately after implantation. Regular follow-up included angiography, computed tomography (CT), and control of functionality and position of the BP sensor. Animals were euthanized after 6 months. FA segments with in situ pressure sensor underwent macroscopic and histopathologic examinations. RESULTS All implantations of the novel sensor device in the FA were successful and uneventful. High-quality BP recordings were documented. Bland-Altman plots indicate very good agreement. Comparison with measurements taken from the reference sensor revealed mean differences and standard deviations of -0.56 ± 0.85, 0.29 ± 1.44, and 0.85 ± 2.27 mmHg (diastolic, systolic, and pulse pressure, respectively) after exclusion of one outlier. CT uncovered deficiencies in cable stability that were addressed in a redesign. No thrombus formation, necrosis, or apoptosis were detected. CONCLUSIONS The pilot study proved the technical feasibility of wireless BP measurement in the FA via a novel miniature sensor device.
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Affiliation(s)
- Nina J Cleven
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz-Institute, RWTH Aachen University, Pauwelsstraße 20, 52074, Aachen, Germany,
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23
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Wolbring G, Leopatra V. Sensors: views of staff of a disability service organization. J Pers Med 2013; 3:23-39. [PMID: 25562409 PMCID: PMC4251385 DOI: 10.3390/jpm3010023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/05/2013] [Accepted: 02/07/2013] [Indexed: 11/16/2022] Open
Abstract
Sensors have become ubiquitous in their reach and scope of application. They are a technological cornerstone for various modes of health surveillance and participatory medicine-such as quantifying oneself; they are also employed to track people with certain as impairments perceived ability differences. This paper presents quantitative and qualitative data of an exploratory, non-generalizable study into the perceptions, attitudes and concerns of staff of a disability service organization, that mostly serve people with intellectual disabilities, towards the use of various types of sensor technologies that might be used by and with their clients. In addition, perspectives of various types of privacy issues linked to sensors, as well data regarding the concept of quantified self were obtained. Our results highlight the need to involve disabled people and their support networks in sensor and quantified-self discourses, in order to prevent undue disadvantages.
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Affiliation(s)
- Gregor Wolbring
- Department Community Health Sciences, Faculty of Medicine, Stream of Community Rehabilitation and Disability Studies, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
| | - Verlyn Leopatra
- Bachelor of Health Sciences, Faculty of Medicine, University of Calgary 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
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