The Influence of Airway Closure Technique for Right Pneumonectomy on Wall Tension During Positive Pressure Ventilation: An Experimental Study

Bronchopleural fistula (BPF) remains a significant source of morbidity and mortality after right pneumonectomy (RPN). Postoperative mechanical ventilation represents a primary risk factor for BPF. We undertook an experiment to determine the influence of airway diameter on suture line tension during mechanical ventilation after RPN. RPN was performed in 6 fresh human adult cadavers. After initial standard bronchial stump closure (BSC), the airway suture lines were subjected to 5 cm H2O incremental increases in airway pressures beginning at 5–40 cm H2O. To minimize airway diameter, a carinal resection was then performed with trachea to left main bronchial anastomosis and the airway suture lines subjected to similar incremental airway pressures. Wall tension (N/m) at the suture lines was measured using piezoresistive sensors at each pressure point. As delivered airway pressure increased, there was a concomitant increase in wall tension after BSC and carinal resection. At every point of incremental positive pressure, wall tension was however significantly lower after carinal resection when compared to BSC (P < 0.05). Additionally the differences in airway tension became even more significant with higher delivered airway pressure (P < 0.001). Airway diverticulum after BSC leads to significantly increased tension on the bronchial closure with positive airway pressure as compared to a closure which minimize airway diameter after RPN. This supports the role of Laplacian Law where small increases in airway diameter result in significant increases on closure site tension. Techniques which reduce airway diameter at the airway closure will more reliably reduce the incidence of BPF following RPN

Design and Manufacturing of Flexible Optical and Mechanical Metamaterials

Metamaterials are artificially structured materials which attain their unconventional macroscopic properties from their cellular configuration rather than their constituent chemical composition. The judicious design of this cellular structure opens the possibility to program and control the optical, mechanical, acoustic, or thermal responses of metamaterials. This Ph.D. dissertation focuses on scalable design and manufacturing strategies for optical and mechanical metamaterials. The fabrication of optical metamaterials still relies heavily on low-throughput process such as electron beam lithography, which is a serial technique. Thus, there is a growing need for the development of high-throughput, parallel processes to make the fabrication of optical metamaterials more accessible and cost-effective. The first part of this dissertation presents a scalable manufacturing method, termed “roll-to-roll laser induced superplasticity” (R2RLIS), for the production of flexible optical metamaterials, specifically metallic nearperfect absorbers. R2RLIS enables the rapid and inexpensive fabrication of ultra-smooth metallic nanostructures over large areas using conventional CO2engravers or inexpensive diode lasers. Using low-cost metal/epoxy nanomolds, the minimum feature size obtained by R2RLIS was \u3c40 nm, facilitating the rapid fabrication of flexible near-perfect absorbers at visible frequencies with the capability to wrap around non-planar surfaces. The existing approaches for designing mechanical metamaterials are mostly ad hoc, and rely heavily on intuition and trial-and-error. A rational and systematic approach to create functional and programmable mechanical metamaterials is therefore desirable to unlock the vast design space of mechanical properties. The second part of this dissertation introduces a systematic, algorithmic design strategy based on Voronoi tessellation to create architected soft machines (ASMs) and twisting mechanical metamaterials (TMMs) with programmable motion and properties. ASMs are a new class of soft machines that benefit from their 3D-architected structure to expand the range of mechanical properties and behaviors achievable by 3D printed soft robots. On tendon-based actuation, ASMs deform according to the topologically encoded buckling of their structure to produce a wide range of motions such as contraction, twisting, bending, and cyclic motion. TMMs are a new class of chiral mechanical metamaterials which exhibit compression-twist coupling, a property absent in isotropic materials. This property manifests macroscopically and is independent of the flexible material chosen to fabricate the TMM. The nature of this compression-twist coupling can be programmed by simply tuning two design parameters, giving access to distinct twisting regimes and tunable onset of auxetic (negative Poisson’s ratio) behavior. Taking a metamaterial approach toward the design of soft machines substantially increases their number of degrees of freedom in deformation, thus blurring the boundary between materials and machines

Parametric optimization of ultrasonic machining process using gravitational search and fireworks algorithms

Ultrasonic machining (USM) is a mechanical material removal process used to erode holes and cavities in hard or brittle workpieces by using shaped tools, high-frequency mechanical motion and an abrasive slurry. Unlike other non-traditional machining processes, such as laser beam and electrical discharge machining, USM process does not thermally damage the workpiece or introduce significant levels of residual stress, which is important for survival of materials in service. For having enhanced machining performance and better machined job characteristics, it is often required to determine the optimal control parameter settings of an USM process. The earlier mathematical approaches for parametric optimization of USM processes have mostly yielded near optimal or sub-optimal solutions. In this paper, two almost unexplored non-conventional optimization techniques, i.e. gravitational search algorithm (GSA) and fireworks algorithm (FWA) are applied for parametric optimization of USM processes. The optimization performance of these two algorithms is compared with that of other popular population-based algorithms, and the effects of their algorithm parameters on the derived optimal solutions and computational speed are also investigated. It is observed that FWA provides the best optimal results for the considered USM processes

Parametric Optimization of Nd:YAG Laser Beam Machining Process Using Artificial Bee Colony Algorithm

Nd:YAG laser beam machining (LBM) process has a great potential to manufacture intricate shaped microproducts with its unique characteristics. In practical applications, such as drilling, grooving, cutting, or scribing, the optimal combination of Nd:YAG LBM process parameters needs to be sought out to provide the desired machining performance. Several mathematical techniques, like Taguchi method, desirability function, grey relational analysis, and genetic algorithm, have already been applied for parametric optimization of Nd:YAG LBM processes, but in most of the cases, suboptimal or near optimal solutions have been reached. This paper focuses on the application of artificial bee colony (ABC) algorithm to determine the optimal Nd:YAG LBM process parameters while considering both single and multiobjective optimization of the responses. A comparative study with other population-based algorithms, like genetic algorithm, particle swarm optimization, and ant colony optimization algorithm, proves the global applicability and acceptability of ABC algorithm for parametric optimization. In this algorithm, exchange of information amongst the onlooker bees minimizes the search iteration for the global optimal and avoids generation of suboptimal solutions. The results of two sample paired t-tests also demonstrate its superiority over the other optimization algorithms

Rapid Fabrication of Epidermal Paper-Based Electronic Devices Using Razor Printing

This work describes the use of a benchtop razor printer to fabricate epidermal paper-based electronic devices (EPEDs). This fabrication technique is simple, low-cost, and compatible with scalable manufacturing processes. EPEDs are fabricated using paper substrates rendered omniphobic by their cost-effective silanization with fluoroalkyl trichlorosilanes, making them inexpensive, water-resistant, and mechanically compliant with human skin. The highly conductive inks or thin films attached to one of the sides of the omniphobic paper makes EPEDs compatible with wearable applications involving wireless power transfer. The omniphobic cellulose fibers of the EPED provide a moisture-independent mechanical reinforcement to the conductive layer. EPEDs accurately monitor physiological signals such as ECG (electrocardiogram), EMG (electromyogram), and EOG (electro-oculogram) even in high moisture environments. Additionally, EPEDs can be used for the fast mapping of temperature over the skin and to apply localized thermotherapy. Our results demonstrate the merits of EPEDs as a low-cost platform for personalized medicine applications

Design Considerations for Macroencapsulation Devices for Stem Cell Derived Islets for the Treatment of Type 1 Diabetes

Stem cell derived insulin producing cells or islets have shown promise in reversing Type 1 Diabetes (T1D), yet successful transplantation currently necessitates long-term modulation with immunosuppressant drugs. An alternative approach to avoiding this immune response is to utilize an islet macroencapsulation device, where islets are incorporated into a selectively permeable membrane that can protect the transplanted cells from acute host response, whilst enabling delivery of insulin. These macroencapsulation systems have to meet a number of stringent and challenging design criteria in order to achieve the ultimate goal of reversing T1D. In this progress report, the design considerations and functional requirements of macroencapsulation systems are reviewed, specifically for stem-cell derived islets (SC-islets), highlighting distinct design parameters. Additionally, a perspective on the future for macroencapsulation systems is given, and how incorporating continuous sensing and closed-loop feedback can be transformative in advancing toward an autonomous biohybrid artificial pancreas.Juvenile Diabetes Research Fund (Grant 1-PNF-2019-778-S-B

Roll-to-Roll Nanoforming of Metals Using Laser-Induced Superplasticity

This Letter describes a low-cost, scalable nanomanufacturing process that enables the continuous forming of thin metallic layers with nanoscale accuracy using roll-to-roll, laser-induced superplasticity (R2RLIS). R2RLIS uses a laser shock to induce the ultrahigh-strain-rate deformation of metallic films at room temperature into low-cost polymeric nanomolds, independently of the original grain size of the metal. This simple and inexpensive nanoforming method does not require access to cleanrooms and associated facilities, and can be easily implemented on conventional CO₂ lasers, enabling laser systems commonly used for rapid prototyping or industrial cutting and engraving to fabricate uniform and three-dimensional crystalline metallic nanostructures over large areas. Tuning the laser power during the R2RLIS process enables the control of the aspect ratio and the mechanical and optical properties of the fabricated nanostructures. This roll-to-roll technique successfully fabricates mechanically strengthened gold plasmonic nanostructures with aspect ratios as high as 5 that exhibit high oxidation resistance and strong optical field enhancements. The CO₂ laser used in R2RLIS can also integrate the fabricated nanostructures on transparent flexible substrates with robust interfacial contact. The ability to fabricate ultrasmooth metallic nanostructures using roll-to-roll manufacturing enables the large scale production, at a relatively low-cost, of flexible plasmonic devices toward emerging applications

A soft robotic sleeve mimicking the haemodynamics and biomechanics of left ventricular pressure overload and aortic stenosis

Preclinical models of aortic stenosis can induce left ventricular pressure overload and coarsely control the severity of aortic constriction. However, they do not recapitulate the haemodynamics and flow patterns associated with the disease. Here we report the development of a customizable soft robotic aortic sleeve that can mimic the haemodynamics and biomechanics of aortic stenosis. By allowing for the adjustment of actuation patterns and blood-flow dynamics, the robotic sleeve recapitulates clinically relevant haemodynamics in a porcine model of aortic stenosis, as we show via in vivo echocardiography and catheterization studies, and a combination of in vitro and computational analyses. Using in vivo and in vitro magnetic resonance imaging, we also quantified the four-dimensional blood-flow velocity profiles associated with the disease and with bicommissural and unicommissural defects re-created by the robotic sleeve. The design of the sleeve, which can be adjusted on the basis of computed tomography data, allows for the design of patient-specific devices that may guide clinical decisions and improve the management and treatment of patients with aortic stenosis.</p