Number Of Novel Devices Research Articles

Current State of Non-surgical Devices for Female Stress Urinary Incontinence.

The purpose of this review is to summarize and assess the current non-surgical devices for the treatment of stress urinary incontinence (SUI). Devices for SUI can generally be divided into two categories. One category is the augmentation of pelvic floor muscle training (PFMT), wherein devices such as vaginal cones, intravaginal biofeedback, and electrical or magnetic stimulation are used to strength the pelvic floor musculature, though none are more effective than traditional PFMT. The second category of devices mechanically occludes the outlet and includes incontinence pessaries, intravaginal occlusion devices, and urethral plugs and patches. While these are palliative rather than curative, they share similar rates of improvement in leakage. A number of novel devices exist for the treatment and management of SUI. Though no single device has been shown to be more effective than PFMT alone, they may be beneficial for women who have difficulty isolating their pelvic floor muscles, desire accountability, or prefer technology-based engagement. Outlet occlusion devices are less comfortable for the patient, but remain an option for women who do not desire surgery.

Thermal hysteresis controlled reconfigurable MoS2 nanomechanical resonators.

Two-dimensional (2D) structures from layered materials have enabled a number of novel devices including resonant nanoelectromechanical systems (NEMS). 2D NEMS resonators are highly responsive to strain, allowing their resonance frequencies to be efficiently tuned over broad ranges, which is a feature difficult to attain in conventional micromachined resonators. In electrically configured and tuned devices, high external voltages are typically required to set and maintain different frequencies, limiting their applications. Here we experimentally demonstrate molybdenum disulfide (MoS2) nanomechanical resonators that can be reconfigured between different frequency bands with zero maintaining voltage in a non-volatile fashion. By leveraging the thermal hysteresis in these 2D resonators, we use heating and cooling pulses to reconfigure the device frequency, with no external voltage required to maintain each frequency. We further show that the frequency spacing between the bands can be tuned by the thermal pulse strength, offering full control over the programmable operation. Such reconfigurable MoS2 resonators may provide an alternative pathway toward small-form-factor and low-power tunable devices in future reconfigurable radio-frequency circuits with multi-band capability.

Personalising surgical treatments for glaucoma patients.

Surgical treatments for glaucoma have relied for decades on traditional filtering surgery such as trabeculectomy and, in more challenging cases, tubes. Antifibrotics were introduced to improve surgical success in patients at increased risk of failure but have been shown to be linked to a greater incidence of complications, some being potentially vision-threatening. As our understanding of glaucoma and its early diagnosis have improved, a more individualised management has been suggested. Recently the term "precision medicine" has emerged as a new concept of an individualised approach to disease management incorporating a wide range of individual data in the choice of therapeutic modalities. For glaucoma surgery, this involves evaluation of the right timing, individual risk factors, targeting the correct anatomical and functional outflow pathways and appropriate prevention of scarring. As a consequence, there is an obvious need for better knowledge of anatomical and functional pathways and for more individualised surgical approaches with new, less invasive and safer techniques allowing for earlier intervention. With the recent advent of minimally invasive glaucoma surgery (MIGS) a large number of novel devices have been introduced targeting potential new sites of the outflow pathway for lowering intraocular pressure (IOP). Their popularity is growing in view of the relative surgical simplicity and apparent lack of serious side effects. However, these new surgical techniques are still in an era of early experiences, short follow-up and lack of evidence of their superiority in safety and cost-effectiveness over the traditional methods. Each year several new devices are introduced while others are withdrawn from the market. Glaucoma continues to be the primary cause of irreversible blindness worldwide and access to safe and efficacious treatment is a serious problem, particularly in the emerging world where the burden of glaucoma-related blindness is important and concerning. Early diagnosis, individualised treatment and, very importantly, safe surgical management should be the hallmarks of glaucoma treatment. However, there is still need for a better understanding of the disease, its onset and progression, the functional and structural elements of the outflow pathways in relation to the new devices as well as their long-term IOP-lowering efficacy and safety. This review discusses current knowledge and the future need for personalised glaucoma surgery.

PTH-013 Endorings™ In Screening Colonoscopy: Results of A Single Centre Pilot Study

Introduction Colonoscopy remains the gold standard procedure for screening and polyp detection, with adenoma detection rate (ADR) being a widely-accepted key performance indicator (KPI). It has long been recognised that even experienced endoscopists incur an appreciable ‘miss-rate’ and a number of novel devices have been marketed to assist this aspect of practice. The Endorings™ device is a simple soft silicone, single-use device consisting of a series of rings arranged around a central tubular core. As the colonoscope is inserted the rings fold backward to allow intubation and flare on withdrawal to flatten colonic folds and aid inspection. Methods Prospective data was collected during screening colonoscopy (performed by two accredited colonoscopists) when the Endorings™ device was used and compared the KPI results to outcomes from the previous few months, for the same two colonoscopists) when the device was not in use (ie. historical controls). Results The ADR without Endorings™ (n = 85) was 49.4% with a per-procedure detection rate (ppr) of 0.97. With Endorings (n = 66) 66.7% (p = 0.0006) with ppr of 1.625. This represents a 35% increase in ADR and a 68% increase in the number of polyps detected at any given procedure. There were no significant differences in completion rates, withdrawal time, use of sedation or comfort scores. The device was removed in 5/66 procedures due to interference with intubation (in the presence of either an angulated sigmoid or diverticulosis). No complications were recorded. Conclusion Use of the Endorings™ device was associated with a significant increase in ADR. Qualitatively, the three-ring design was felt to interfere with normal intubation such that insertion technique had to be modified. An updated design iteration with two rings in slightly different positions along the central tube, has been produced and appears to offer a significant advantage in this regard. Furthermore, the central tube can be pushed further along the distal end of the colonoscope to allow the terminal ileum to be intubated with the device in place. The Endorings™ may offer an advantage in screening colonoscopy and, in this cohort, further prospective investigation is warranted. Disclosure of Interest None Declared

Advantages of Picosecond Laser Machining for Cutting-Edge Technologies

Abstract The demand to reduce the size, weight and material cost of modern electronic devices results in a requirement for precision micromachining to aid product development. Examples include making smaller and more powerful smartphones with brighter displays, eliminating the requirement for post-process cleaning and machining the latest bio- absorbable medical stents. The pace of innovation in high-tech industries has led to ultrafast (picosecond) industrial lasers becoming an important tool for many applications and the high repetition rates now available help to meet industrial throughput levels. This is due to the unique operating regime (megawatts of peak power) enabling clean cutting and patterning of sensitive materials and thin films used in a number of novel devices and allows micromachining of wide bandgap, “difficult” materials such as glass.

Integrated photonic systems based on transformation optics enabled gradient index devices

Integrated photonics is expected to play an increasingly important role in optical communications, imaging, computing and sensing with the promise for significant reduction in the cost and weight of these systems. Future advancement of this technology is critically dependent on an ability to develop compact and reliable optical components and facilitate their integration on a common substrate. Here we reveal, with the utility of the emerging transformation optics technique, that functional components composed of planar gradient index materials can be designed and readily integrated into photonic circuits. The unprecedented design flexibility of transformation optics allows for the creation of a number of novel devices, such as a light source collimator, waveguide adapters and a waveguide crossing, which have broad applications in integrated photonic chips and are compatible with current fabrication technology. Using the finite-difference time-domain method, we perform full-wave numerical simulations to demonstrate their superior optical performance and efficient integration with other components in an on-chip photonic system. These components only require spatially-varying dielectric materials with no magnetic properties, facilitating low-loss, broadband operation in an integrated photonic environment.

Fabricating Metamaterials Using the Fiber Drawing Method

Metamaterials are man-made composite materials, fabricated by assembling components much smaller than the wavelength at which they operate (1). They owe their electromagnetic properties to the structure of their constituents, instead of the atoms that compose them. For example, sub-wavelength metal wires can be arranged to possess an effective electric permittivity that is either positive or negative at a given frequency, in contrast to the metals themselves (2). This unprecedented control over the behaviour of light can potentially lead to a number of novel devices, such as invisibility cloaks (3), negative refractive index materials (4), and lenses that resolve objects below the diffraction limit (5). However, metamaterials operating at optical, mid-infrared and terahertz frequencies are conventionally made using nano- and micro-fabrication techniques that are expensive and produce samples that are at most a few centimetres in size (6-7). Here we present a fabrication method to produce hundreds of meters of metal wire metamaterials in fiber form, which exhibit a terahertz plasmonic response (8). We combine the stack-and-draw technique used to produce microstructured polymer optical fiber (9) with the Taylor-wire process (10), using indium wires inside polymethylmethacrylate (PMMA) tubes. PMMA is chosen because it is an easy to handle, drawable dielectric with suitable optical properties in the terahertz region; indium because it has a melting temperature of 156.6 °C which is appropriate for codrawing with PMMA. We include an indium wire of 1 mm diameter and 99.99% purity in a PMMA tube with 1 mm inner diameter (ID) and 12 mm outside diameter (OD) which is sealed at one end. The tube is evacuated and drawn down to an outer diameter of 1.2 mm. The resulting fiber is then cut into smaller pieces, and stacked into a larger PMMA tube. This stack is sealed at one end and fed into a furnace while being rapidly drawn, reducing the diameter of the structure by a factor of 10, and increasing the length by a factor of 100. Such fibers possess features on the micro- and nano- scale, are inherently flexible, mass-producible, and can be woven to exhibit electromagnetic properties that are not found in nature. They represent a promising platform for a number of novel devices from terahertz to optical frequencies, such as invisible fibers, woven negative refractive index cloths, and super-resolving lenses.

Modern Device Technologies

Implantable cardiac devices for arrhythmias and related conditions are a rapidly evolving field, with a constant stream of technologies being developed. There are a number of novel devices, other than conventional pacemakers and implantable defibrillators, currently being developed that have the potential to greatly improve patient outcomes. This paper reviews the important recent technologies, the subcutaneous defibrillator, cardiac contraction modulation, the HeartPOD and CardioMEMS heart failure monitors, left atrial appendage closure devices and leadless cardiac pacing. The features of these devices, the results to date, and their possible clinical utility are discussed.

Advances in cardiovascular disease: how far is the summit?

In the last three decades, great achievements have been made in the field of cardiovascular medicine. The rapid development of new drugs, the invention of novel devices and techniques, all of these, have significantly decreased the mortality and morbidity from cardiovascular disease. Mortality and morbidity rates fell by at least 50% from about 1980 to 2000. However, are we winning the war against cardiovascular disease? Cardiovascular diseases are still the major leading cause of global mortality and morbidity. As estimated by the World Health Organization, twenty million people will die from cardiovascular disease by 2015. Coronary artery disease (CAD) is especially increasing rapidly. In China, the incidence is increasing with the changing lifestyle and economic development, and affected by factors such as urbanization, decreased physical activity, increased tobacco use, and dietary changes. More than one million patients die from CAD every year in China. Atrial fibrillation is the most common arrhythmia, which increases the risk of stroke five-fold. Atrial fibrillation will become the new epidemic cardiovascular disease in the 21st century, as estimated by the World Heart Federation. Therefore, prevention of cardiovascular disease has become a key public health issue worldwide. Although therapeutic options for cardiovascular disease are developing rapidly, not all patients receive the standard treatment. For example, changes in CAD treatment have been revolutionary. Percutaneous coronary intervention (PCI) has been increasingly used, and even with more complex lesions. In China, PCI use has increased by 30% to 40% in the last five years. However, many treatments are not applied in a standardized fashion, or according to guidelines, which increases medical risks, and may lead to the waste of medical resources. Standardization and adherence to guidelines will be an ongoing challenge. In the last decade, a number of novel devices and technologies have been developed in cardiovascular medicine. Cardiac cell therapy has caused great excitement. Both clinical trial and basic research have provided evidence that transplantation of stem cells can improve cardiac function through a paracrine effect, angiogenesis, and possibly myogenesis. However, there are still many substantial obstacles and setbacks along the road of successful application of this therapy. For instance, the majority of implanted cells die within one week of transplantation. This and other technical problems will require further research before this therapy is readily applied. Motivated by these issues, we will hold the 4th Qianjiang International Cardiovascular Congress (QICC4) and Annual Scientific Session of the Zhejiang Society of Cardiology in Hangzhou from July 29 to August 1, 2010. The theme for this congress is “Focus on Prevention, Comply with Guidelines, Start from the Beginning, Go to the Summit”. QICC4 will deliver, in an independent forum, up-to-date achievements in new theories, technologies, and guidelines applied to this field, including general cardiology, interventional cardiology, electrophysiology, and basic research. Also, knowledge and skill contests, live case presentations, presentations on difficult cases, and late breaking clinical trials will be popular sessions. Of note, the Hong Kong College of Cardiology (HKCC) and the Taiwan Society of Cardiovascular Interventions (TSCI) are the supporters of QICC4, where a number of overseas academic experts will give lecture and live case demonstrations. In this special issue of QICC, we received many papers from experts at home and abroad, the contents of which include the current status of PCI, stent restenosis, hypertension, pacing technology, case reports of stent implantation, stem cell research, and many other topics of interest. On behalf of the organizing committee and Zhejiang Society of Cardiology, I am honored to invite your participation in this meeting and look forward to seeing you at QICC4 this summer.

Novel Chemical Approach to Achieve Advanced Soft Lithography by Developing New Stiffer, Photocurable PDMS Stamp Materials

AbstractRecent advances in microfabrication technology allow us to develop a number of novel devices with high performance. In microfabrication technology, a new development, ‘soft lithography’, is widely used by making stamps, molding, and microcontact-printing due to the low cost and easy processability. The resolution of soft lithography significantly relies on the performance of stamping materials. However, pattern transfers using commercially available PDMS stamp materials often end up with mechanical failures such as collapse or sag due to their low physical stiffness. Additionally, most of those commercial PDMS materials are thermally curable systems, which results in significant thermal deformations. These limitations have motivated us to start this work, which demonstrates a ‘chemical approach’ to overcome those limits by developing new stiff, photocurable PDMS stamp materials with attached designed functionalities. Molecular modification of PDMS materials results in advanced soft lithography, which produces enhanced physical toughness, lower polymerization shrinkage, and photopatterning capability.

Wafer fusion: materials issues and device results

A large number of novel devices have been recently demonstrated using wafer fusion to integrate materials with different lattice constants. In many cases, devices created using this technique have shown dramatic improvements over those which maintain a single lattice constant. We present device results and characterizations of the fused interface between several groups of materials.