When implanted medical devices like urinary stents and catheters get clogged with biofilms, the usual solution is to take them out and replace them with new ones. Now, however, researchers at the University of Bern and ETH Zurich, Switzerland have developed an alternative. By incorporating ultrasound-activated moving structures into their prototype “stent-on-a-chip” device, they showed it is possible to remove biofilms without removing the device itself. If translated into clinical practice, the technology could increase the safe lifespan of implants, saving money and avoiding operations that are uncomfortable and sometimes hazardous for patients.

Biofilms are communities of bacterial cells that adhere to natural surfaces in the body as well as artificial structures such as catheters, stents and other implants. Because they are encapsulated by a protective, self-produced extracellular matrix made from polymeric substances, they are mechanically robust and resistant to standard antibacterial measures. If not removed, they can cause infections, obstructions and other complications.

Intense, steady flows push away impurities

The new technology, which was co-developed by Cornel Dillinger, Pedro Amado and other members of Francesco Clavica and Daniel Ahmed’s research teams, takes advantage of recent advances in the fields of robotics and microfluidics. Its main feature is a coating made from microscopic hair-like structures known as cilia. Under the influence of an acoustic field, which is applied externally via a piezoelectric transducer, these cilia begin to move. This movement produces intense, steady fluid flows with velocities of up to 10 mm/s – enough to break apart encrusted deposits (made from calcium carbonate, for example) and flush away biofilms from the inner and outer surfaces of implanted urological devices.

“This is a major advance compared to existing stents and catheters, which require regular replacements to avoid obstruction and infections,” Clavica says.

The technology is also an improvement on previous efforts to clear implants by mechanical means, Ahmed adds. “Our polymeric cilia in fact amplify the effects of ultrasound by allowing for an effect known as acoustic streaming at frequencies of 20 to 100 kHz,” he explains. “This frequency is lower than that possible with previous microresonator devices developed to work in a similar way that had to operate in the MHz-frequency range.”

The lower frequency achieves the desired therapeutic effects while prioritizing patient safety and minimizing the risk of tissue damage, he adds.

Wider applications

In creating their technology, the researchers were inspired by biological cilia, which are a natural feature of physiological systems such as the reproductive and respiratory tracts and the central nervous system. Future versions, they say, could apply the ultrasound probe directly to a patient’s skin, much as handheld probes of ultrasound scanners are currently used for imaging. “This technology has potential applications beyond urology, including fields like visceral surgery and veterinary medicine, where keeping implanted medical devices clean is also essential,” Clavica says.

The researchers now plan to test new coatings that would reduce contact reactions (such as inflammation) in the body. They will also explore ways of improving the device’s responsiveness to ultrasound – for example by depositing thin metal layers. “These modifications could not only improve acoustic streaming performance but could also provide additional antibacterial benefits,” Clavica tells Physics World.

In the longer term, the team hope to translate their technology into clinical applications. Initial tests that used a custom-built ultrasonic probe coupled to artificial tissue have already demonstrated promising results in generating cilia-induced acoustic streaming, Clavica notes. “In vivo animal studies will then be critical to validate safety and efficacy prior to clinical adoption,” he says.

The present study is detailed in PNAS.

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Researchers from four universities in Shanghai, China, are developing a practical visual assistance system to help blind and partially sighted people navigate. The prototype system combines lightweight camera headgear, rapid-response AI-facilitated software and artificial “skins” worn on the wrists and finger that provide physiological sensing. Functionality testing suggests that the integration of visual, audio and haptic senses can create a wearable navigation system that overcomes current designs’ adoptability and usability concerns.

Worldwide, 43 million people are blind, according to 2021 estimates by the International Agency for the Prevention of Blindness. Millions more are so severely visually impaired that they require the use of a cane to navigate.

Visual assistance systems offer huge potential as navigation tools, but current designs have many drawbacks and challenges for potential users. These include limited functionality with respect to the size and weight of headgear, battery life and charging issues, slow real-time processing speeds, audio command overload, high system latency that can create safety concerns, and extensive and sometimes complex learning requirements.

Innovations in miniaturized computer hardware, battery charge longevity, AI-trained software to decrease latency in auditory commands, and the addition of lightweight wearable sensory augmentation material providing near-real-time haptic feedback are expected to make visual navigation assistance viable.

The team’s prototype visual assistance system, described in Nature Machine Intelligence, incorporates an RGB-D (red, green, blue, depth) camera mounted on a 3D-printed glasses frame, ultrathin artificial skins, a commercial lithium-ion battery, a wireless bone-conducting earphone and a virtual reality training platform interfaced via triboelectric smart insoles. The camera is connected to a microcontroller via USB, enabling all computations to be performed locally without the need for a remote server.

When a user sets a target using a voice command, AI algorithms process the RGB-D data to estimate the target’s orientation and determine an obstacle-free direction in real time. As the user begins to walk to the target, bone conduction earphones deliver spatialized cues to guide them, and the system updates the 3D scene in real time.

The system’s real-time visual recognition incorporates changes in distance and perspective, and can compensate for low ambient light and motion blur. To provide robust obstacle avoidance, it combines a global threshold method with a ground interval approach to accurately detect overhead hanging, ground-level and sunken obstacles, as well as sloping or irregular ground surfaces.

First author Jian Tang of Shanghai Jiao Tong University and colleagues tested three audio feedback approaches: spatialized cues, 3D sounds and verbal instructions. They determined that spatialized cues are the most rapid to convey and be understood and provide precise direction perception.

Real-world testing A visually impaired person navigates through a cluttered conference room. (Courtesy: Tang et al. Nature Machine Intelligence)

To complement the audio feedback, the researchers developed stretchable artificial skin – an integrated sensory-motor device that provides near-distance alerting. The core component is a compact time-of-flight sensor that vibrates to stimulate the skin when the distance to an obstacle or object is smaller than a predefined threshold. The actuator is designed as a slim, lightweight polyethylene terephthalate cantilever. A gap between the driving circuit and the skin promotes air circulation to improve skin comfort, breathability and long-term wearability, as well as facilitating actuator vibration.

Users wear the sensor on the back of an index or middle finger, while the actuator and driving circuit are worn on the wrist. When the artificial skin detects a lateral obstacle, it provides haptic feedback in just 18 ms.

The researchers tested the trained system in virtual and real-world environments, with both humanoid robots and 20 visually impaired individuals who had no prior experience of using visual assistance systems. Testing scenarios included walking to a target while avoiding a variety of obstacles and navigating through a maze. Participants’ navigation speed increased with training and proved comparable to walking with a cane. Users were also able to turn more smoothly and were more efficient at pathfinding when using the navigation system than when using a cane.

“The proficient completion of tasks mirroring real-world challenges underscores the system’s effectiveness in meeting real-life challenges,” the researchers write. “Overall, the system stands as a promising research prototype, setting the stage for the future advancement of wearable visual assistance.”

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The world’s smallest pacemaker to date is smaller than a single grain of rice, optically controlled and dissolves after it’s no longer needed. According to researchers involved in the work, the pacemaker could work in human hearts of all sizes that need temporary pacing, including those of newborn babies with congenital heart defects.

“Our major motivation was children,” says Igor Efimov, a professor of medicine and biomedical engineering, in a press release from Northwestern University. Efimov co-led the research with Northwestern bioelectronics pioneer John Rogers.

“About 1% of children are born with congenital heart defects – regardless of whether they live in a low-resource or high-resource country,” Efimov explains. “Now, we can place this tiny pacemaker on a child’s heart and stimulate it with a soft, gentle, wearable device. And no additional surgery is necessary to remove it.”

The current clinical standard-of-care involves sewing pacemaker electrodes directly onto a patient’s heart muscle during surgery. Wires from the electrodes protrude from the patient’s chest and connect to an external pacing box. Placing the pacemakers – and removing them later – does not come without risk. Complications include infection, dislodgment, torn or damaged tissues, bleeding and blood clots.

To minimize these risks, the researchers sought to develop a dissolvable pacemaker, which they introduced in Nature Biotechnology in 2021. By varying the composition and thickness of materials in the devices, Rogers’ lab can control how long the pacemaker functions before dissolving. The dissolvable device also eliminates the need for bulky batteries and wires.

“The heart requires a tiny amount of electrical stimulation,” says Rogers in the Northwestern release. “By minimizing the size, we dramatically simplify the implantation procedures, we reduce trauma and risk to the patient, and, with the dissolvable nature of the device, we eliminate any need for secondary surgical extraction procedures.”

The latest iteration of the device – reported in Nature – advances the technology further. The pacemaker is paired with a small, soft, flexible, wireless device that is mounted onto the patient’s chest. The skin-interfaced device continuously captures electrocardiogram (ECG) data. When it detects an irregular heartbeat, it automatically shines a pulse of infrared light to activate the pacemaker and control the pacing.

“The new device is self-powered and optically controlled – totally different than our previous devices in those two essential aspects of engineering design,” says Rogers. “We moved away from wireless power transfer to enable operation, and we replaced RF wireless control strategies – both to eliminate the need for an antenna (the size-limiting component of the system) and to avoid the need for external RF power supply.”

Measurements demonstrated that the pacemaker – which is 1.8 mm wide, 3.5 mm long and 1 mm thick – delivers as much stimulation as a full-sized pacemaker. Initial studies in animals and in the human hearts of organ donors suggest that the device could work in human infants and adults. The devices are also versatile, the researchers say, and could be used across different regions of the heart or the body. They could also be integrated with other implantable devices for applications in nerve and bone healing, treating wounds and blocking pain.

The next steps for the research (supported by the Querrey Simpson Institute for Bioelectronics, the Leducq Foundation and the National Institutes of Health) include further engineering improvements to the device. “From the translational standpoint, we have put together a very early-stage startup company to work individually and/or in partnerships with larger companies to begin the process of designing the device for regulatory approval,” Rogers says.

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A new retinal stimulation technique called Oz enabled volunteers to see colours that lie beyond the natural range of human vision. Developed by researchers at UC Berkeley, Oz works by stimulating individual cone cells in the retina with targeted microdoses of laser light, while compensating for the eye’s motion.

Colour vision is enabled by cone cells in the retina. Most humans have three types of cone cells, known as L, M and S (long, medium and short), which respond to different wavelengths of visible light. During natural human vision, the spectral distribution of light reaching these cone cells determines the colours that we see.

Some colours, however, simply cannot be seen. The spectral sensitivity curves of the three cone types overlap – in particular, there is no wavelength of light that stimulates only the M cone cells without stimulating nearby L (and sometimes also S) cones as well.

The Oz approach, however, is fundamentally different. Rather than being based on spectral distribution, colour perception is controlled by shaping the spatial distribution of light on the retina.

Describing the technique in Science Advances, Ren Ng and colleagues showed that targeting individual cone cells with a 543 nm laser enabled subjects to see a range of colours in both images and videos. Intriguingly, stimulating only the M cone cells sent a colour signal to the brain that never occurs in natural vision.

The Oz laser system uses a technique called adaptive optics scanning light ophthalmoscopy (AOSLO) to simultaneously image and stimulate the retina with a raster scan of laser light. The device images the retina with infrared light to track eye motion in real time and targets pulses of visible laser light at individual cone cells, at a rate of 10⁵ per second.

In a proof-of-principle experiment, the researchers tested a prototype Oz system on five volunteers. In a preparatory step, they used adaptive optics-based optical coherence tomography (AO-OCT) to classify the LMS spectral type of 1000 to 2000 cone cells in a region of each subject’s retina.

When exclusively targeting M cone cells in these retinal regions, subjects reported seeing a new blue–green colour of unprecedented saturation – which the researchers named “olo”. They could also clearly perceive Oz hues in image and video form, reliably detecting the orientation of a red line and the motion direction of a rotating red dot on olo backgrounds. In colour matching experiments, subjects could only match olo with the closest monochromatic light by desaturating it with white light – demonstrating that olo lies beyond the range of natural vision.

The team also performed control experiments in which the Oz microdoses were intentionally “jittered” by a few microns. With the target locations no longer delivered accurately, the subjects instead perceived the natural colour of the stimulating laser. In the image and video recognition experiments, jittering the microdose target locations reduced the task accuracy to guessing rate.

Ng and colleagues conclude that “Oz represents a new class of experimental platform for vision science and neuroscience [that] will enable diverse new experiments”. They also suggest that the technique could one day help to elicit full colour vision in people with colour blindness.

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