Implantation Technology Research Articles

Assessing the Acceptance of Cyborg Technology with a Hedonic Technology Acceptance Model

Medical implantable technologies, such as cochlear implants or joint prostheses, have been commonly used since the late 20th century. By contrast, the market for this type of technology is expanding when the purpose is not medical, even though it is more marginal. This study tests a technology acceptance model for the latter type of insideable technology based on an extension of the technology acceptance models TAM and TAM2 proposed for hedonic technologies by van del Heijden. So, the behavioral intention of insertables is explained by the perceived usefulness and perceived ease of use, as well as social influence, as proposed in the TAM2 by Venkatesh and Davis. Additionally, the perceived enjoyment, included in the extension by Van der Heijden, is added as an explanatory factor. We applied structural equation modeling to the theoretical scheme provided by the modified TAM and performed a necessary condition analysis. Statistical analysis showed that all variables considered in the model have a significantly positive influence on behavioral intention. Likewise, the model has good properties both from the point of view of the fit obtained, since it predicts 70% of behavioral intention, and from the predictive point of view. The necessary condition analysis allows us to analyze whether the presence of some of the latent variables postulated to explain the attitude toward implantables is necessary to produce the said acceptance. Therefore, its absence is a critical aspect of expansion. We observed that perceived usefulness manifests itself as a necessary condition for behavioral intention with a medium size. Perceived ease of use and enjoyment also present a significant necessity effect size, but their strength is smaller. By contrast, the subjective norm does not have the status of a necessary variable.

Embodiment and regenerative implants: a proposal for entanglement.

Regenerative Medicine promises to develop treatments to regrow healthy tissues and cure the physical body. One of the emerging developments within this field is regenerative implants, such as jawbone or heart valve implants, that can be broken down by the body and are gradually replaced with living tissue. Yet challenges for embodiment are to be expected, given that the implants are designed to integrate deeply into the tissue of the living body, so that implant and body become one. In this paper, we explore how regenerative implants may affect the embodied experience of implant recipients. To this end, we take a phenomenological approach. First, we explore what insights the existing phenomenological and empirical literature on embodiment offers regarding the experience of illness and of living with regular (non-regenerative) implants and organ transplants. Second, we apply these insights to better understand how future implant recipients might experience living with regenerative implants. Third, we conclude that concepts and considerations from the existing phenomenological literature do not sufficiently address what it might be like to live with an implantable technology that, over time, becomes one with the living body. We argue that the interwovenness and intimate relationship of people living with regenerative implants should be understood in terms of 'entanglement'. Entanglement allows us to explore the complexities of human-technology relations, acknowledging the inseparability of humans and implantable technologies. Our theoretical foundations regarding the role of embodiment may be tested empirically once more people will be living with regenerative implants.

Defining the Shape of the Mylohyoid Muscle: A Morphometric Imaging Study.

Implantable hypoglossal nerve stimulation (HNS) therapy is an evolving therapeutic alternative for patients with refractory obstructive sleep apnea (OSA). The muscular anatomy of this region has implications for surgical access through this zone as well as positioning and anchoring of hardware in this area. The purpose of this study was to radiologically describe the topography of the mylohyoid muscle and adjacent structures across a wide age spectrum. We retrospectively evaluated computed tomography scans of the neck in 102 patients who were imaged for reasons unrelated to the floor of mouth or submental space. Patients with prior surgery or pathology in the area of interest were excluded. Fourteen relevant muscle measurements were made on a midline sagittal image and a coronal image positioned at the midpoint between the hyoid bone and the mandible. We included 49 men and 53 women with an average age of 44 years (range 19-70). The average mylohyoid length was 42 mm; the average distance between the anterior digastric bellies was 17 mm. The average angle of the central mylohyoid was 174° in the sagittal plane and 164° in the coronal plane. Several measurements were significantly correlated with patient age, including the angle measurements and the distance between the digastric muscles. Aberrant digastric anatomy was common. The mylohyoid muscle has multiple radiologically distinct segments with predictable curvatures. An understanding of submental muscular anatomy, along with its variability between patients, may be beneficial to the development of bilateral implantable neurostimulation technology for the treatment of refractory OSA. N/A Laryngoscope, 134:2970-2975, 2024.

Digital health and cardiovascular healthcare professionals in Portugal: Current status, expectations and barriers to implementation

Introduction and ObjectivesDigital health (DH) is a broad concept, bringing together technology and healthcare, that is playing an increasingly important role in the daily routine of healthcare professionals (HCPs) and promises to contribute to the prevention and treatment of cardiovascular disease. There are no solid data on the position of Portuguese HCPs toward the implementation of DH in cardiovascular medicine. This national cross-sectional study aims to provide a snapshot of DH implementation in Portuguese cardiovascular HCP routines and to identify both expectations and barriers to its adoption. MethodsAn 18-question survey was created specifically for this study and distributed to 1174 individuals on the Portuguese Society of Cardiology mailing list. ResultsWe collected 117 valid responses (response rate 10%). Almost all participants had smartphones and laptops, and two-thirds had tablets. Electronic medical information systems were the most used DH tool (84% of respondents) and were considered the most important for improving cardiovascular care. Implantable technologies (sensors and devices), telemedicine and social media were used by more than two out of three respondents and considered «very important» or «extremely important» by most of them. Most participants showed positive expectations regarding the impact of DH in cardiovascular medicine: 78% agreed that DH could improve health outcomes, 64% that it promotes health literacy and 63% that it could decrease healthcare costs. The top-rated barriers were patients’ inability to use smartphones, limited access to electronic devices, and lack of legal regulation of DH. ConclusionMost Portuguese cardiovascular HCPs had at least three electronic devices (mainly smartphones, laptops and tablets) and showed positive expectations regarding DH's current and future impact on cardiovascular medicine. Patient DH literacy, technology adoption, and DH regulation were identified as the most important barriers to increasing the adoption of DH tools in cardiovascular medicine.

Influencing factors and evaluation methods for early stability of immediate implant.

At present, implant restoration has become a hot research topic in the field of prosthodontics. The in-depth studies of new materials and new technologies enable immediate implantation, immediate and early loading to be realized, which meets the needs of patients for shortening the course of implant restoration and obtaining better aesthetic effects. However, compared with the traditional delayed implantation technology, it is equally challenging for clinicians how to achieve and even improve the initial and long-term stability of implants in order to raise the success rate of implant restoration. The initial stability of the implant is influenced by a combination of factors, including the implant, the patient's condition, and the surgical procedure. Recently, there have been a lot of studies on the influencing factors and common research methods for immediate implant stability and bone healing. Summarizing and analyzing them can provide reference for preoperative evaluation, surgical plan and loading timing of immediate implant restoration in the later stage.

Neural rehabilitation based on brain computer interface

BCI is a newly developed technology that can be used for neurological rehabilitation of brain injuries and paralysis. This article first reviews the history of BCI, and then introduces two major neurorehabilitation BCI technologies for neurorecording and neuromodulation, invasive and non-invasive. For each technology, we describe the challenges of each technology, analyzing the current state and future development trends. In terms of non-invasive technology, the most mature and extensive EEG brain signal analysis methods and two brain regulation technologies, transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES), as well as the application of brain signal analysis techniques such as functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy fNIRS) were also discussed. In terms of invasive technology, the implantable neural interface technology focuses on implantable neural interface technology, which collects cortical electrical brain signals (ECoG), which can obtain more original neural information and has high temporal and spatial resolution characteristics. In recent years, with the development of microelectronics technology and material technology, invasive BCI technology has made a lot of cutting-edge progress, which is an important future development direction of neurorehabilitation technology.

Chicken Muscle-Derived ACE2-Upregulating Peptide VVHPKESF Reduces Blood Pressure Associated with the ACE2/Ang (1-7)/MasR Axis in Spontaneously Hypertensive Rats.

This study aims to investigate the antihypertensive effect of four chicken muscle-derived angiotensin (Ang)-converting enzymes (ACE)-regulating peptides: Val-Arg-Pro (VRP, ACE inhibition), Leu-Lys-Tyr and Val-Arg-Tyr (LKY and VRY, ACE inhibition and ACE2 upregulation), and Val-Val-His-Pro-Lys-Glu-Ser-Phe (VVHPKESF [V-F], ACE2 upregulation) in spontaneously hypertensive rats. Rats (12-14 weeks old) are grouped: 1) untreated, 2) VRP, 3) LKY, 4) VRY, and 5) V-F. Blood pressure (BP) is monitored using implantable telemetry technology. Over 18-day oral administration of 15mgkg-1 body weight (BW) per day, only peptide V-F significantly (p < 0.05) reduces BP, decreases circulating Ang II, and increases ACE2 and Ang (1-7) levels, and enhances aortic expressions of ACE2 and Mas receptor (MasR). Peptide V-F also attenuates vascular inflammation (TNFα, MCP-1, IL-1α, IL-15, and cyclooxygenase 2 [COX2]) and vascular oxidative stress (nitrotyrosine). The gastrointestinal (GI)-degraded fragment of peptide V-F, Val-Val-His-Pro-Lys (VVHPK), is also an ACE2-upregulating peptide. Peptides VRP, LKY, and VRY do not reduce BP, possibly due to low bioavailability or other unknown reasons. Peptide V-F is the first ACE2-upregulating peptide, purified and fractionated from food proteins based on in vitro ACE2 upregulation, that reduces BP associated with the activation of ACE2/Ang (1-7)/MasR axis; the N-terminal moiety VVHPK may be responsible for the antihypertensive effect of V-F.

Biomedical engineering advances: A review of innovations in healthcare and patient outcomes

Engineering has emerged as a dynamic and transformative field, driving revolutionary changes in healthcare and significantly impacting patient outcomes. This review explores recent advances in biomedical engineering, highlighting key innovations that have reshaped the landscape of medical care. The convergence of engineering principles with biological sciences has led to the development of cutting-edge technologies and novel solutions, ushering in a new era of personalized and precision medicine. The review begins by examining breakthroughs in medical imaging, focusing on advancements in high-resolution imaging modalities, such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET). These innovations enable clinicians to obtain detailed anatomical and functional information, facilitating early disease detection and accurate diagnosis. The integration of artificial intelligence (AI) and machine learning (ML) into biomedical engineering has played a pivotal role in enhancing diagnostic accuracy, treatment planning, and prognosis prediction. Smart algorithms analyze vast datasets, aiding in the identification of patterns and correlations that may go unnoticed by human observers. This synergy between AI and biomedical engineering has expedited decision-making processes, leading to more efficient and personalized healthcare interventions. In the realm of medical devices, significant strides have been made in the development of implantable and wearable technologies. Miniaturized sensors and biocompatible materials have paved the way for the creation of smart devices capable of monitoring physiological parameters in real-time. These devices not only provide continuous health monitoring but also empower patients to actively participate in their care, promoting preventive measures and lifestyle modifications. Advancements in regenerative medicine and tissue engineering have opened new avenues for the treatment of degenerative diseases and organ failure. Scaffold-based and cell-based therapies hold promise for repairing and regenerating damaged tissues, offering hope for patients with conditions that were once considered untreatable.

Efficacy of lysostaphin-coated titanium plates on implant-associated MRSA osteitis in minipigs

PurposeThe growing incidence of implant-associated infections (IAIs) caused by biofilm-forming Staphylococcus aureus in combination with an increasing resistance to antibiotics requires new therapeutic strategies. Lysostaphin has been shown to eliminate this biofilm. Own studies confirm the effectiveness in a murine model. The current study characterizes the effects of lysostaphin-coated plates in an IAI minipig model.MethodsThe femur of 30 minipigs was stabilized with a five-hole plate, a bone defect was created, and in 20 cases methicillin-resistant Staphylococcus aureus was applied. Ten animals served as control group. After 14 days, local debridement, lavage, and plate exchange (seven-hole plate) were performed. Ten of the infected minipigs received an uncoated plate and 10 a lysostaphin-coated plate. On day 84, the minipigs were again lavaged, followed by euthanasia. Bacterial load was quantified by colony-forming units (CFU). Immunological response was determined by neutrophils, as well as interleukins. Fracture healing was assessed radiologically.ResultsCFU showed significant difference between infected minipigs with an uncoated plate and minipigs with a lysostaphin-coated plate (p = 0.0411). The infection-related excessive callus formation and calcification was significantly greater in the infected animals with an uncoated plate than in animals with a lysostaphin-coated plate (p = 0.0164/p = 0.0033). The analysis of polymorphonuclear neutrophils and interleukins did not reveal any pioneering findings.ConclusionThis study confirms the minipig model for examining IAI. Furthermore, coating of plates using lysostaphin could be a promising tool in the therapeutic strategies of IAI. Future studies should focus on coating technology of implants and on translation into a clinical model.

Results of twelve years of experience in carrying out medical and social measures to restore dental health using dental implantation technologies «Quality of life for our veterans»

Since 2009, a group of enthusiastic doctors in Russia has initiated a professional movement for gratuitous implantation for people, mostly elderly, «Quality of life for our parents» for war veterans. Currently, charity events with a slightly modified slogan «Quality of life for our veterans» are held for participants in military operations and local conflicts, widows and mothers of soldiers. For more than 12 years, gratuitous implantation and dental prosthetics of socially dependent groups of the population has been practiced in several subjects of the Russian Federation. Many of the patients were medical indications implantation with immediate loading. The implantation protocol with intraoperative immediate prosthetics reduces the duration of treatment and is most in demand among patients. Patients start using prostheses immediately after implantation surgery. For some patients of the older age group, with facial injuries and cancer patients, this factor was the most decisive in improving their quality of life. Over the years of the campaign, methods and clinical protocols have been developed and optimized. As a result, a charitable program of dental rehabilitation of patients using dental implants «Quality of life for our veterans» was created.

Exploring therapy transport from implantable medical devices using experimentally informed computational methods.

Implantable medical devices that can facilitate therapy transport to localized sites are being developed for a number of diverse applications, including the treatment of diseases such as diabetes and cancer, and tissue regeneration after myocardial infraction. These implants can take the form of an encapsulation device which encases therapy in the form of drugs, proteins, cells, and bioactive agents, in semi-permeable membranes. Such implants have shown some success but the nature of these devices pose a barrier to the diffusion of vital factors, which is further exacerbated upon implantation due to the foreign body response (FBR). The FBR results in the formation of a dense hypo-permeable fibrous capsule around devices and is a leading cause of failure in many implantable technologies. One potential method for overcoming this diffusion barrier and enhancing therapy transport from the device is to incorporate local fluid flow. In this work, we used experimentally informed inputs to characterize the change in the fibrous capsule over time and quantified how this impacts therapy release from a device using computational methods. Insulin was used as a representative therapy as encapsulation devices for Type 1 diabetes are among the most-well characterised. We then explored how local fluid flow may be used to counteract these diffusion barriers, as well as how a more practical pulsatile flow regimen could be implemented to achieve similar results to continuous fluid flow. The generated model is a versatile tool toward informing future device design through its ability to capture the expected decrease in insulin release over time resulting from the FBR and investigate potential methods to overcome these effects.

The influence of biomedical engineering in India

This comprehensive analysis delves into various crucial facets of biomedical engineering, covering cutting-edge technologies, creative methodologies, and ethical dilemmas. Quality Management Systems (QMS) play a pivotal role in maintaining precision, safety, and efficacy in lab experiments and biomedical product development, ensuring adherence to strict quality standards through guidelines like Good Laboratory Practice (GLP) and Good Manufacturing Practice (GMP). Advancements in medical imaging, from X-ray CT to molecular imaging, are revolutionizing disease diagnosis and treatment across multiple medical fields. Biomaterials and tissue engineering hold immense potential in regenerative medicine, addressing challenges like immune rejection and implant wear to meet diverse healthcare needs. Biomechanics and rehabilitation engineering merge biomechanical principles with assistive technologies to empower individuals with disabilities and improve their daily autonomy. Biomedical sensors, devices, and nanotechnology are driving personalized healthcare solutions, enhancing disease management through wearable and implantable technologies. Regulatory policies in India underscore the importance of strict regulations for medical devices and therapeutics to ensure safety and efficacy. Overall, this review highlights the transformative impact of biomedical engineering on healthcare advancements and societal well-being through responsible innovation and ethical practices.

Improving the accuracy of ion implantation simulations through the use of DFT-MD methodology

Ion implantation is a crucial process in the fabrication of semiconductor devices, but accurately predicting the impurities distribution in the low energy range is still challenging. The widely used method to simulate this process is molecular dynamics with recoil interaction approximation (RIA-MD), which uses the translational method to replace traditional periodic boundary conditions. However, this approach leads to accuracy loss due to the simplification of atom-atom interactions and bulk crystal properties. Our study presents a method to simulate the impurity distribution after ion implantation at low energy, which combines all-electron density-functional theory (DFT) and full molecular dynamics (MD). Unlike the RIA-MD method, DFT-MD method calculates the movements of all energetic ions and simulates the whole bulk crystal properties. Thus, it provides a more realistic representation of atom-atom interactions. We used not only the experimental values reported by references but also the experimental value measured by actual ion implantation technology samples. This enabled us to make a more accurate comparison between the DFT-MD and RIA-MD methods. Specifically, the dopant profiles and amorphous thickness obtained using the DFT-MD method were found to be in good agreement with experimental data. These findings demonstrate the effectiveness of our method and highlight its potential to advance the field of ion implantation simulation. Moreover, our method has the potential to be useful in developing atomic-scale technology computer-aided design (TCAD) tools, as well as in other fields of research that require accurate ion implantation simulations.

(Invited) Benchmarking of Beyond the State-of-the-Art Vertical GaN Devices

In this paper theoretical benchmarking of semi-vertical and vertical gallium nitride (GaN) MOSFETs with rated voltage of 1.2 kV to 3.3 kV is performed against corresponding silicon carbide (SiC) devices. Specific design features and technology requirements for realization of high voltage vertical GaN MOSFETs are discussed and implemented in simulated structures. The main findings are that a) specific on-resistance of vertical GaN devices is expected to be 75% and 40% of that for 1.2 kV and 3.3 kV SiC MOSFETs, respectively, b) semi-vertical GaN do not offer any advantage over SiC MOSFETs for medium and high voltage devices (>1.0 kV), and c) vertical GaN has largest potential advantage for high and ultra-high voltage devices (>2.0 kV).Gallium nitride (GaN) devices experience an explosive and rapid development with new device providers entering the market at an impressive speed. However, the devices are HEMT (High Electron Mobility Transistor) type lateral devices utilizing the two-dimensional electron gas (2DEG) properties of the GaN/AlGaN interface. The required GaN layers in the devices are grown epitaxially on hetero substrates like Si, SiC, sapphire and poly-AlN using buffer layers to control the strain caused by lattice mismatch which prevents the vertical current flow. For power applications the lateral current flow close to the surface leads to thermal limitations and complicates thermal management in packaging. Furthermore, it leads to large footprint of the devices for large currents. The devices also lack the robust avalanche breakdown characteristics. At present the HEMT power devices are limited to operational voltages of less than 650V with some first devices from VisIC and iGaNPower demonstrating 1200V capability. For these reasons there is an interest in the development of vertical GaN devices opening the possibilities of small footprint and thus lower cost due to smaller chip sizes, high power densities and robust avalanche breakdown characteristics with large avalanche energy capability [1]. The development of vertical devices has been hindered by the lack of large area freestanding GaN substrates facilitating homoepitaxial growth of drift layers. An alternative are semi-vertical structures grown on Si which are the subject of this study along with true vertical structures on GaN. In addition to the material issues there are technological issues that require further attention like dopant compensation and activation and Mg implantation technology for junction termination. This paper focuses on prospective benchmarking of semi-vertical and vertical GaN MOSFETs against SiC devices. A beyond the state-of-the-art benchmarking, in wide voltage range, is missing in the literature. Most of the benchmarking publications report results of experimental structures based on state-of-the-art technology and simple junction termination [2], [3], [4].The main objective of the work has been to design competitive semi-vertical and vertical GaN structures and perform benchmarking against SiC devices in the voltage range 1.2 kV to 3.3 kV. The structures have been characterized by calculating the output, transfer and voltage blocking characteristics using default Sentaurus models. In the next step, the structures have been modified based on the experience and know-how from SiC devices. The electric field crowding occurring at the trench gate corners must be mitigated both with respect to the breakdown voltage in the bulk material and the reliability of the gate dielectric [5]. Efficient junction termination (JT) is also necessary for both types of structures. This is especially important in the semi-vertical structures where junction termination is an integral part of each device segment and has a significant impact on the resulting on-state resistance. The structure design was optimized by reducing the cell pitch and introducing a multi-cell-per-device-segment design in semi-vertical structures to improve the on-resistance. Removal of the performance limitations in the structures based on the state-of-the-art GaN technology and device cell optimization was done to make benchmarking with more mature SiC devices based on the prediction of what may become feasible beyond the state-of-the-art.1. Matteo Meneghini et al., Journal of Applied Physics, vol. 130, p. 181101, 2021.2. Oka, T. Ina, Y. Ueno and J. Nishii, 2019 31st International Symposium on Power Semiconductor Devices and ICs (ISPSD), pp. 303-306, 2021.3. A. Khadar, C. Liu, R. Soleimanzadeh and E. Matioli, IEEE Electron Device Letters, vol. 40, no. 3, pp. 443-446, 2019.4. Wei He et al., Nanoscale Research Letters, 17:14, 2022.5. Nakamura et al., 2011 International Electron Devices Meeting, pp. 26.5.1-26.5.3, 2011.

Crack resistance of carbonized layer of multilayer polyurethane with nanofillers. Combination of casting, solution, carbonization by ion implantation technologies

The paper describes the results of an experimental study of a polyurethane material treated by ion implantation technology. The problems of crack growth in the near-surface layer carbonized by ion treatment were investigated using digital optical microscopy. The methods of atomic force microscopy allowed studying the possibility of carbonized layers delamination from the substrate. As a result, the technology for the production of a multilayer polyurethane material with nanofillers (nanotubes, nanodiamonds, fullerenes, graphenes) and its optimal modification by ion implantation treatment was developed, which makes it possible to improve the biocompatibility of polyurethane implants with human tissues.

Antimicrobial approaches for medical implants coating to prevent implants associated infections: Insights to develop durable antimicrobial implants

Advances in implantable technologies results from the rapid improvements in research in the fields of biomedical engineering, biomaterial science, and chemistry. No doubt, implantable technologies have provided greater comfort against several illnesses and diseases; however, pathogens adherence and biofilm formation are still the issues that need to be taken into consideration for further implant modifications. Pathogens colonize implants in a surface-dependent manner, so chances of pathogens' adhesion can be minimized by creating anti-adhesive and antimicrobial surfaces. The ongoing research is focused on the design of appropriate multifunctional coatings with a broad antimicrobial spectrum and high biocompatibility. Antimicrobial peptides in conjugation with polymers, nanoparticles, and other biocompatible agents can be potentially used to develop multifunctional coatings. Antibiotics-based coatings are the ultimate approach; however, optimizing the controlled release of antibiotics will be a breakthrough in this decade. Polymers unveil the extraordinary potential in implant coatings by increasing biocompatibility of coatings, offering the possibility for a triggered release of antimicrobial agents. An in-depth review of effective and biocompatible antimicrobial implant coatings is provided herein. We thoroughly discuss the remarkable antimicrobial agents and their compatibility with the host, including seemingly underexplored stability issues and providing an overlook on different methods of fabrication. The ever-growing materials research field can use this review's highlights to develop multifunctional implant coatings to reduce implant-associated infections.

Research progress of metal-based additive manufacturing in medical implants

Abstract Metal-based additive manufacturing has gained significant attention in the field of medical implants over the past decade. The application of 3D-printing technology in medical implants offers several advantages over traditional manufacturing methods, including increased design flexibility for implant customization, reduced lead time for emergency cases, and the ability to create complex geometry shapes for patient-specific implants. In this review study, the working principles and conditions of metal 3D-printing technologies such as selective laser sintering, selective laser melting, and electron beam melting, as well as their applications and advantages in the medical field, are investigated in detail. The application scenarios and research status of non-degradable metals including titanium alloy, medical stainless steel, etc., and degradable metals like magnesium alloy are introduced as printing materials. We discuss the improvement of mechanical properties and biocompatibility of implants through surface modification, porous structure design, and the optimization of molding processes. Finally, the biocompatibility issues and challenges caused by the accuracy of CT imaging, fabrication, implant placement, and other aspects are summarized.

Practical Considerations for Cardiac Electronic Devices Reimplantation Following Transvenous Lead Extraction Due to Related Endocarditis.

Despite progress in implantation technology and prophylactic measures, infection complications related to cardiac implantable electronic devices (CIED) are still a major concern with negative impacts on patient outcomes and the health system's resources. Infective endocarditis (IE) represents one of the most threatening CIED-related infections associated with high mortality rates and requires prompt diagnosis and management. Transvenous lead extraction (TLE), combined with prolonged antibiotic therapy, has been validated as an effective approach to treat patients with CIED-related IE. Though early complete removal is undoubtedly recommended for CIED-related IE or systemic infection, device reimplantation still represents a clinical challenge in these patients at high risk of reinfection, with many gaps in the current knowledge and international guidelines. Based on the available literature data and authors' experience, this review aims to address the practical and clinical considerations regarding CIED reimplantation following lead extraction for related IE, focusing on the reassessment of CIED indication, procedure timing, and the reimplanted CIED type and site. A tailored, multidisciplinary approach involving clinical cardiologists, electrophysiologists, cardiac imaging experts, cardiac surgeons, and infectious disease specialists is crucial to optimize these patients' management and clinical outcomes.

Incorporating zinc ion into titanium surface promotes osteogenesis and osteointegration in implantation early phase

The objective of this study is to further investigate the feasibility of Zinc–Titanium implant as a potential implantable material in oral application in aspects of osteoblast biocompatibility, osteogenesis and osseointegration ability. First, we used plasma immersion ion implantation and deposition (PIIID) technology to introduce Zinc ion into pure Titanium surface, then we used X-ray photoelectron spectroscopy to analyze the chemical composition of modified surface layer; next, we used in vitro studies including immunological fluorescence assay and western blotting to determine responses between MG-63 osteoblast-like cell and implant. In vivo studies adopted pig model to check the feasibility of Zn–Ti implant. Results showed that in vitro and in vivo were consistent, showing that Zn ion was successfully introduced into Ti surface by PIIID technique. The chemical and physical change on modified plant resulted in the more active expressions of mRNA and protein of Type I collagen in MG-63 cells compared with non-treated implant, and the better integration ability of bones with modified implant. We confirmed the Zn–Ti implant owns the ability in promoting osteogenesis and osteointegration in early phase of implantation and is a qualified candidate in dentistry. The overview of our study can be depicted as follows.Graphical

P-type conductive Ga2O3 epilayers grown on sapphire substrate by phosphorus-ion implantation technology

This study utilized various phosphorus-ion implantation techniques, incorporating low, medium, and high doses, to investigate the electrical properties of unintentionally doped β-Ga2O3 epilayers. These epilayers were grown on sapphire substrates by metalorganic chemical vapor deposition.Specifically, the low-dose implantation involved phosphorus ions at concentrations of 1.6✕1013, 1✕1012 and 2.5✕1012 atoms/cm2, administered at implantation energies of 100, 50, and 40 keV, respectively. The medium-dose implantation utilized phosphorus ions at concentrations of 1.6✕1014, 1✕1013 and 2.5✕1013 atoms/cm2, at the same implantation energies. Finally, the high-dose implantation employed phosphorus ions at concentrations of 1.6✕1015, 1✕1014 and 2.5✕1014 atoms/cm2, with implantation energies of 100, 50, and 40 keV, respectively. The implantation parameters were also simulated using the Stopping and Range of Ions in Matter software, while the actual concentration of phosphorus ions was measured via secondary ion mass spectrometry. Subsequently, Ni and Au were deposited on the annealed phosphorus-implanted β-Ga2O3 epilayers, followed by rapid thermal annealing at 600 °C in a nitrogen environment for 1 min, for Hall measurement. The electrical properties of the phosphorus-implanted β-Ga2O3 epilayers were assessed through Hall measurements. Notably, the β-Ga2O3 epilayers implanted with middle and high doses displayed p-type behavior. The resistivity of the p-type β-Ga2O3 epilayers with middle and high doses measured 9.699 and 6.439 Ω cm, respectively, as determined by Hall measurements. Additionally, the hole carrier concentrations for these doses were measured as 1.612 × 1018 and 6.428 × 1017, respectively. Consequently, the phosphorus ion implantations using middle and high doses were proven effective in obtaining p-type Ga2O3. To further explore the defect formation energies and Fermi energies of substitutional phosphorus defects within the β-Ga2O3 lattices, first-principles density-functional simulations were employed.