Evaluation of friction enhancement through soft polymer micro-patterns in active capsule endoscopy

Capsule endoscopy is an emerging field in medical technology. Despite very promising innovations, some critical issues are yet to be addressed, such as the management and possible exploitation of the friction in the gastrointestinal environment in order to control capsule locomotion more actively. This paper presents the fabrication and testing of bio-inspired polymeric micro-patterns, which are arrays of cylindrical pillars fabricated via soft lithography. The aim of the work is to develop structures that enhance the grip between an artificial device and the intestinal tissue, without injuring the mucosa. In fact, the patterns are intended to be mounted on microfabricated legs of a capsule robot that is able to move actively in the gastrointestinal tract, thus improving the robot’s traction ability. The effect of micro-patterned surfaces on the leg-slipping behaviour on colon walls was investigated by considering both different pillar dimensions and the influence of tissue morphology. Several in vitro tests on biological samples demonstrated that micro-patterns of pillars made from a soft polymer with an aspect ratio close to 1 enhanced friction by 41.7% with regard to flat surfaces. This work presents preliminary modelling of the friction and adhesion forces in the gastrointestinal environment and some design guidelines for endoscopic devices

A magnetic internal mechanism for precise orientation of the camera in wireless endoluminal applications

Background and study aims: The use of magnetic fields to control operative devices has been recently described in endoluminal and transluminal surgical applications. The exponential decrease of magnetic field strength with distance has major implications for precision of the remote control. We aimed to assess the feasibility and functionality of a novel wireless miniaturized mechanism, based on magnetic forces, for precise orientation of the camera. Materials and methods: A remotely controllable endoscopic capsule was developed as proof of concept. Two intracapsular moveable permanent magnets allow fine positioning, and an externally applied magnetic field permits gross movement and stabilization. Performance was assessed in ex vivo and in vivo bench tests, using porcine upper and lower gastrointestinal tracts. Results: Fine control of capsule navigation and rotation was achieved in all tests with an external magnet held steadily about 15 cm from the capsule. The camera could be rotated in steps of 1.8°. This was confirmed by ex vivo tests; the mechanism could adjust the capsule view at 40 different locations in a gastrointestinal tract phantom model. Full 360° viewing was possible in the gastric cavity, while the maximal steering in the colonwas 45° in total. In vivo, a similar performance was verified, where the mechanism was successfully operated every 5 cm for 40 cm in the colon, visually sweeping from side to side of the lumen; 360° views were obtained in the gastric fundus and body, while antrally the luminal walls prevented full rotation. Conclusions: We report the feasibility and effectiveness of the combined use of external static magnetic fields and internal actuation to move small permanent intracapsular magnets to achieve wirelessly controllable and precise camera steering. The concept is applicable to capsule endoscopy as to other instrumentation for laparoscopic, endoluminal, or transluminal procedures

Acute effects of whole-body vibrations on the fatigue induced by multiple repeated sprint ability test in soccer players

Background: We tested the hypothesis that whole-body vibration (WBV) positively affects the fatigue process ensuing from repeated bouts of maximal efforts, as induced by repeated sprints' ability (RSA). Eleven male soccer players performed three sets of six repeated shuttle sprints (40 meters). Methods: Eleven male soccer players (age 23.6±4.5 years) were cross-randomized to perform WBW before RSA and during the recovery between sets (WBV-with) or to warm-up and passive recovery between sets (WBV-without). The effects of WBV were quantified by sprint time (ST) and blood lactate concentration (LA), collected up to 15 min after completion of tests. Results: ST during RSA showed a better maintenance of performance in the WBV-with compared to WBV-without condition in all three sets, reaching a statistical significance between-groups during the 2nd and 3rd set (P<0.05). No significant differences in ST over the sets were detected in WBV-with, whereas a significant decrease was observed in the WBV-without condition (P<0.001). LA recovered significantly faster from the 9th to 15th minute of recovery in WBV-with as compared to WBV-without (P<0.05). Conclusions: These findings would indicate that WBV performed during recovery between RSA sets can delay the onset of muscle fatigue resulting in a better maintenance of sprint performance

Effectiveness evaluation of an integrated automatic termomechanic massage system (SMATH® system) in non-specific sub-acute and chronic low back pain - a randomized double-blinded controlled trial, comparing SMATH therapy versus sham therapy: study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Low back pain (LBP) is a major health problem in modern society, with 70-85% of the population experiencing LBP at some time in their lives. Each year, 5-10% of the workforce misses work due to LBP, most for less than 7 days. Almost 10% of all patients are at risk of developing chronic pain and disability. Little clinical evidence is available for the majority of treatments used in LBP therapy. However, moderate evidence exists for interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation, and cognitive behavioral therapy for subacute and chronic LBP. The SMATH^®system (system for automatic thermomechanic massage in health) is a new medical device (MD) that combines basic principles of mechanical massage, thermotherapy, acupressure, infrared therapy, and moxibustion. SMATH^®is suitable for automatic multidisciplinary treatment on patients with non-specific sub-acute and chronic LBP.</p> <p>Methods/design</p> <p>This paper describes the protocol for a double-blinded, sham-controlled, randomized, single-center short term clinical trial in patients with non-specific sub-acute and chronic LBP aged 18 to 70 years. The primary outcome will be the effectiveness of SMATH^®versus sham therapy (medical device without active principles) determined by evaluating self perceived physical function with Roland Morris Disability Questionnaire (RMDQ) scores after 4 weeks of treatment (end of treatment). Major secondary outcome will be effectiveness of SMATH^®determined by evaluating self perceived physical function comparing RMDQ scores between end of treatment and baseline. The trial part of the study will take 7 months while observational follow-up will take 11 months. The sample size will be 72 participants (36 for each arm). The project has been approved by the Ethical Committee of Cremona Hospital, Italy on 29 November 2010.</p> <p>Discussion</p> <p>Compared to other medical specialties, physical and rehabilitation medicine (PRM) has not yet received the deserved recognition from clinicians and researchers in the scientific community, especially for medical devices. The best way to change this disadvantage is through well-conducted clinical research in sham-controlled randomized trials. Sham treatment groups are essential for improving the level of evidence-based practice in PRM. The present trial will counter the general lack of evidence concerning medical devices used in LBP therapy.</p> <p>Trial Registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN08714168">ISRCTN08714168</a></p

Aggiornamenti in tema di tutela della salute occupazionale dei lavoratori della sanità

The board of the Thematic Section on Preventive Medicine for Health Care Workers of the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII) programmed a national conference on occupational risks of health care workers to be held in late 2009. Main topics will be: a) biohazards; b) biomechanical risk; c) psychosocial factors. Three different working groups were established to tackle critical aspects and suggest practical recommendations to occupational health professionals. Preliminary issues are presented while final results will be presented at the conference on September 2009. © PI-ME, 2008

Genome Analysis of Cytochrome P450s and Their Expression Profiles in Insecticide Resistant Mosquitoes, Culex quinquefasciatus

Here we report a study of the 204 P450 genes in the whole genome sequence of larvae and adult Culex quinquefasciatus mosquitoes. The expression profiles of the P450 genes were compared for susceptible (S-Lab) and resistant mosquito populations, two different field populations of mosquitoes (HAmCq and MAmCq), and field parental mosquitoes (HAmCq G0 and MAmCqG0) and their permethrin selected offspring (HAmCq G8 and MAmCqG6). While the majority of the P450 genes were expressed at a similar level between the field parental strains and their permethrin selected offspring, an up- or down-regulation feature in the P450 gene expression was observed following permethrin selection. Compared to their parental strains and the susceptible S-Lab strain, HAmCqG8 and MAmCqG6 were found to up-regulate 11 and 6% of total P450 genes in larvae and 7 and 4% in adults, respectively, while 5 and 11% were down-regulated in larvae and 4 and 2% in adults. Although the majority of these up- and down-regulated P450 genes appeared to be developmentally controlled, a few were either up- or down-regulated in both the larvae and adult stages. Interestingly, a different gene set was found to be up- or down-regulated in the HAmCqG8 and MAmCqG6 mosquito populations in response to insecticide selection. Several genes were identified as being up- or down-regulated in either the larvae or adults for both HAmCqG8 and MAmCqG6; of these, CYP6AA7 and CYP4C52v1 were up-regulated and CYP6BY3 was down-regulated across the life stages and populations of mosquitoes, suggesting a link with the permethrin selection in these mosquitoes. Taken together, the findings from this study indicate that not only are multiple P450 genes involved in insecticide resistance but up- or down-regulation of P450 genes may also be co-responsible for detoxification of insecticides, insecticide selection, and the homeostatic response of mosquitoes to changes in cellular environment

Microfluidic actuators for micro analysis systems in bioaffinity assays

This work focuses on the realization of three different micro-actuators that will be integrated in a lab-on- chip for bioaffinity assays. The aim is to create a microfluidic network to control the sample and reagent delivery as well as the washing cycles for a complete analysis. The three micropumps have different working principles (electromagnetic, electrolytic and peristaltic actuation methods), but they share the same fabrication process. The reason for adopting three different actuation modes is mainly related to the different functionalities that have to be managed at microfluidic level. In particular the electrolytic one-shot micropump will be used for sample and reagents delivery, while the peristaltic and the electromagnetic micropumps are both good candidates for the washing cycles

Design and fabrication of microfluidic actuators towards microanalysis systems for bioaffinity assays

This work focuses on the realization of three different micro-actuators that will be integrated in a lab-onchip for bioaffinity assays. The aim is to create a microfluidic network to control the sample and reagent delivery as well as the washing cycles for a complete analysis. The three micropumps have different working principles (electromagnetic, electrolytic and peristaltic actuation methods), but they share the same fabrication process. The reason for adopting three different actuation modes is mainly related to the different functionalities that have to be managed at microfluidic level. In particular the electrolytic one-shot micropump will be used for sample and reagents delivery, while the peristaltic and the electromagnetic micropumps are both good candidates for the washing cycle