Modularized PCA pump design for an ICE-informed medical device coordination framework

Master of ScienceElectrical and Computer EngineeringSteven WarrenMedical device interoperability and re-configurability continue to be important areas of research toward the realization of verifiable medical systems that can be rapidly assembled to meet the needs of specific patients. This thesis addresses the modularized design of a patient-controlled analgesia (PCA) pump to be used within the context of the Medical Device Coordination Framework (MDCF), an open source framework under development by Kansas State University and the University of Pennsylvania that is informed by the Integrated Clinical Environment (ICE) specification managed by the MD PnP program and its collaborators. The thesis illustrates how to set up the MDCF development environment with Eclipse so that a developer can create software for both a remote MDCF console and a local PCA pump, where ICE channels are used for message transmission. Software development on the MDCF console side includes the development of apps that communicate with a local PCA pump through ICE channels and (b) the development of a GUI that can be launched from an MDCF console to configure, control, and monitor a PCA pump. Software development on the PCA pump side includes the creation of (a) ICE channels that can communicate with an MDCF console and (b) multiple threads for corresponding UART ports that support a modularized design. Several hardware modules were implemented to demonstrate the modularized design approach: an alarm module, a patient button module, a pump module, and a control panel module. These modules employ BeagleBone, Arduino, and MSP430 boards. Status information is displayed on an MDCF console GUI, a PCA pump GUI, and a local LCD screen. An enhanced PCA pump or general medical sub-system with more modules can be developed using a similar method by connecting individual modules to UART ports and then creating the corresponding threads to support device-console communication

Complex 3D microfluidic architectures formed by mechanically guided compressive buckling.

Microfluidic technologies have wide-ranging applications in chemical analysis systems, drug delivery platforms, and artificial vascular networks. This latter area is particularly relevant to 3D cell cultures, engineered tissues, and artificial organs, where volumetric capabilities in fluid distribution are essential. Existing schemes for fabricating 3D microfluidic structures are constrained in realizing desired layout designs, producing physiologically relevant microvascular structures, and/or integrating active electronic/optoelectronic/microelectromechanical components for sensing and actuation. This paper presents a guided assembly approach that bypasses these limitations to yield complex 3D microvascular structures from 2D precursors that exploit the full sophistication of 2D fabrication methods. The capabilities extend to feature sizes <5 μm, in extended arrays and with various embedded sensors and actuators, across wide ranges of overall dimensions, in a parallel, high-throughput process. Examples include 3D microvascular networks with sophisticated layouts, deterministically designed and constructed to expand the geometries and operating features of artificial vascular networks

Three-dimensional, multifunctional neural interfaces for cortical spheroids and engineered assembloids.

Three-dimensional (3D), submillimeter-scale constructs of neural cells, known as cortical spheroids, are of rapidly growing importance in biological research because these systems reproduce complex features of the brain in vitro. Despite their great potential for studies of neurodevelopment and neurological disease modeling, 3D living objects cannot be studied easily using conventional approaches to neuromodulation, sensing, and manipulation. Here, we introduce classes of microfabricated 3D frameworks as compliant, multifunctional neural interfaces to spheroids and to assembloids. Electrical, optical, chemical, and thermal interfaces to cortical spheroids demonstrate some of the capabilities. Complex architectures and high-resolution features highlight the design versatility. Detailed studies of the spreading of coordinated bursting events across the surface of an isolated cortical spheroid and of the cascade of processes associated with formation and regrowth of bridging tissues across a pair of such spheroids represent two of the many opportunities in basic neuroscience research enabled by these platforms

Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

Molecular characteristics and pathogenicity of a novel chicken astrovirus variant

Abstract It is well-established that the genetic diversity, regional prevalence, and broad host range of astroviruses significantly impact the poultry industry. In July 2022, a small-scale commercial broiler farm in China reported cases of growth retardation and a 3% mortality rate. From chickens displaying proventriculitis and pancreatitis, three chicken astroviruses (CAstV) isolates were obtained and named SDAU2022-1-3. Complete genomic sequencing and analysis revealed the unique characteristics of these isolates from known CAstV strains in ORF1a, ORF1b, and ORF2 genes, characterized by an unusually high variability. Analysis of amino acid mutations in ORF1a, ORF1b, and ORF2 indicated that the accumulation of these mutations played a pivotal role in the emergence of the variant strain. Inoculation experiments demonstrated that affected chickens exhibited liver and kidney enlargement, localized proventricular hemorrhage, and a dark reddish-brown appearance in about two-thirds of the pancreas. Histopathological examination unveiled hepatic lymphocytic infiltration, renal tubular epithelial cell swelling, along with lymphocytic proventriculitis and pancreatitis. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis indicated viremia and viral shedding at 3 days post-infection (dpi). The proventriculus displayed the highest viral loads, followed by the liver, kidney, duodenum, and pancreas. Liver parameters (AST and ALT) and kidney parameters (UA and UN) demonstrated mild damage consistent with earlier findings. While the possibility of new mutations in the ORF2 gene of CAstV causing proventriculitis and pancreatitis warrants further investigation, these findings deepen our comprehension of CAstV’s pathogenicity in chickens. Additionally, they serve as valuable references for subsequent research endeavors

Three-dimensional electronic scaffolds for monitoring and regulation of multifunctional hybrid tissues

Recently, the integration of electronic elements with cellular scaffolds has brought forth the ability to monitor and control tissue function actively by using flexible free-standing two-dimensional (2D) systems. Capabilities for electrically probing complex, physicochemical and biological three-dimensional (3D) microenvironments demand, however, 3D electronic scaffolds with well-controlled geometries and functional-component distributions. This work presents the development of flexible 3D electronic scaffolds with precisely defined dimensions and microelectrode configurations formed using a process that relies on geometric transformation of 2D precursors by compressive buckling. It demonstrates a capability to fabricate these constructs in diverse 3D architectures and/or electrode distributions aimed at achieving an enhanced level of control and regulation of tissue function relatively to that of other approaches. In addition, this work presents the integration of these 3D electronic scaffolds within engineered 3D cardiac tissues, for monitoring of tissue function, controlling tissue contraction through electrical stimulation, and initiating on-demand, local release of drugs, each through well-defined volumetric spaces. These ideas provide opportunities in fields ranging from in vitro drug development to in vivo tissue repair and many others