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Adding wisdom to 'smart' bioelectronic systems: a design framework for physiologic control including practical examples. 为 "智能 "生物电子系统增添智慧:包括实例在内的生理控制设计框架。
Pub Date : 2019-03-01 Epub Date: 2019-05-30 DOI: 10.2217/bem-2019-0008
Aysegul Gunduz, Enrico Opri, Ro'ee Gilron, Vaclav Kremen, Gregory Worrell, Phil Starr, Kent Leyde, Timothy Denison

This perspective provides an overview of how risk can be effectively considered in physiological control loops that strive for semi-to-fully automated operation. The perspective first introduces the motivation, user needs and framework for the design of a physiological closed-loop controller. Then, we discuss specific risk areas and use examples from historical medical devices to illustrate the key concepts. Finally, we provide a design overview of an adaptive bidirectional brain-machine interface, currently undergoing human clinical studies, to synthesize the design principles in an exemplar application.

本视角概述了如何在力求实现半自动到全自动操作的生理控制回路中有效考虑风险。本视角首先介绍了设计生理闭环控制器的动机、用户需求和框架。然后,我们讨论了特定的风险领域,并使用历史医疗设备的实例来说明关键概念。最后,我们概述了一个自适应双向脑机接口的设计,该接口目前正在进行人体临床研究,并在示例应用中综合了设计原则。
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引用次数: 0
Vagus nerve stimulation for the treatment of heart failure 迷走神经刺激治疗心力衰竭
Pub Date : 2019-03-01 DOI: 10.2217/BEM-2019-0012
Z. Asad, S. Stavrakis
Heart failure (HF) is one of the most prevalent cardiovascular diseases and is associated with high morbidity and mortality. Mechanistically, HF is characterized by an overactive sympathetic nervous system and parasympathetic withdrawal, and this autonomic imbalance contributes to the progression of the disease. As such, modulation of autonomic nervous system by device-based therapy is an attractive treatment target. In this review, we discuss the role of autonomic nervous system dysfunction in the pathogenesis of HF and present the available evidence regarding vagus nerve stimulation for HF, with special emphasis on optimization of stimulation parameters. Finally, we discuss future avenues of research for neuromodulation in patients with HF.
心力衰竭(HF)是最常见的心血管疾病之一,与高发病率和死亡率有关。从机制上讲,HF的特征是交感神经系统过度活跃和副交感神经退缩,这种自主神经失衡导致了疾病的进展。因此,通过基于设备的治疗来调节自主神经系统是一个有吸引力的治疗目标。在这篇综述中,我们讨论了自主神经系统功能障碍在HF发病机制中的作用,并提出了迷走神经刺激治疗HF的可用证据,特别强调了刺激参数的优化。最后,我们讨论了HF患者神经调控的未来研究途径。
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引用次数: 4
Removing the need for invasive brain surgery: the potential of stent electrodes 消除对侵入性脑外科手术的需求:支架电极的潜力
Pub Date : 2019-03-01 DOI: 10.2217/BEM-2019-0013
N. Opie, T. Oxley
Over the last decade, significant advances in brain–machine interfaces have demonstrated that people with paralysis can control assistive technology such as computers, wheelchairs and bionic arms with their minds. However, due to the invasive surgery required to access the brain and implant electrodes, to date, no device has received commercial US FDA approval, and consequently there is no existing solution to return independence and mobility for the hundreds-of-millions of people paralyzed by stroke, spinal cord injury and motor neuron disease. But there is hope. We have developed a minimally invasive brain–machine interface that can access the brain using cortical vessels which mitigates the risks associated with open brain surgery.
在过去的十年里,脑机接口的重大进步表明,瘫痪的人可以用他们的思想控制辅助技术,如电脑、轮椅和仿生手臂。然而,由于进入大脑和植入电极需要进行侵入性手术,迄今为止,没有任何设备获得美国FDA的商业批准,因此没有现有的解决方案可以为数亿因中风、脊髓损伤和运动神经元疾病而瘫痪的人恢复独立性和活动能力。但还是有希望的。我们已经开发了一种微创脑机接口,可以通过皮质血管进入大脑,从而降低开颅手术的风险。
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引用次数: 3
Welcome to the 2nd Volume of Bioelectronics in Medicine 欢迎收看《医学生物电子学》第二卷
Pub Date : 2019-03-01 DOI: 10.2217/BEM-2018-0013
Alice Bough
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引用次数: 0
Rapid electrochemical device for single-drop point-of-use screening of parathyroid hormone 用于甲状旁腺激素单点使用筛选的快速电化学装置
Pub Date : 2019-03-01 DOI: 10.2217/BEM-2019-0011
Ambalika S Tanak, S. Muthukumar, I. Hashim, S. Prasad
Aim: Novel electrochemical point-of-use biosensing device for rapid assessment of parathyroid hormone (PTH) levels has been developed. Materials & methods: The analytical nanobiosensor was designed by integrating unique high density semiconducting nanostructured arrays on a flexible sensing surface. Surface modification technique was tailored for enhancing the interaction of nanostructure–biological interface to capture the target PTH level. Results & conclusion: We demonstrate a rapid nanobiosensor to detect PTH in human serum, plasma and whole blood with a limit of detection of 1 pg/ml and a clinically relevant dynamic range from 1 to 1000 pg/ml. This is the first demonstration of detecting PTH as a point-of-use device devoid of sample pretreatment suitable in a surgical setting with high specificity to PTH.
目的:开发了一种用于快速评估甲状旁腺激素(PTH)水平的新型电化学使用点生物传感装置。材料与方法:分析型纳米生物传感器是通过在柔性传感表面集成独特的高密度半导体纳米结构阵列而设计的。表面修饰技术旨在增强纳米结构-生物界面的相互作用,以捕获目标PTH水平。结果与结论:我们证明了一种快速的纳米生物传感器可以检测人类血清、血浆和全血中的甲状旁腺激素,检测限为1 pg/ml,临床相关动态范围为1至1000 pg/ml。这是首次证明检测PTH是一种无需样品预处理的使用点设备,适用于对PTH具有高特异性的外科手术环境。
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引用次数: 10
Activation of the sciatic nerve evoked during epidural spinal cord stimulation in rodents. 啮齿动物硬膜外脊髓刺激引起的坐骨神经激活
Pub Date : 2019-01-01 Epub Date: 2019-10-04 DOI: 10.2217/bem-2019-0020
Narendra Bhadra, Tina Vrabec, Kevin Kilgore, Niloy Bhadra

Aim: To validate the use of motor activation thresholds (MoT) to titrate stimulation amplitudes for spinal cord stimulation in rodent models.

Methods: We recorded thresholds for MoT and sciatic compound action potentials in ten Sprague-Dawley rats implanted with epidural electrodes. Strength duration curves were fitted to the threshold values.

Results: Activation thresholds were in the same order for both MoT and sciatic compound action potentials.

Conclusion: Many of the large, myelinated fibers traversing the dorsal columns in the rodent spine are activated at similar current levels to MoT. Epidural stimulation in rodents needs to be applied at amplitudes close to MoT to activate these axons.

目的:验证在啮齿类动物模型中使用运动激活阈值(MoT)来滴定脊髓刺激的刺激幅度。方法:我们记录了10只植入硬膜外电极的Sprague-Dawley大鼠的MoT和坐骨复合动作电位阈值。将强度-持续时间曲线拟合到阈值。结果:MoT和坐骨神经复合动作电位的激活阈值顺序相同。结论:啮齿类动物脊柱中许多穿过背柱的有髓鞘大纤维在与MoT相似的电流水平下被激活。啮齿类动物的硬膜外刺激需要以接近MoT的振幅来激活这些轴突。
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引用次数: 0
Is vagus nerve stimulation effective in the treatment of drug-resistant epilepsy? 迷走神经刺激对治疗耐药癫痫有效吗?
Pub Date : 2018-12-01 DOI: 10.2217/BEM-2019-0004
A. Mertens, P. Boon, K. Vonck
Epilepsy is one of the most prevalent chronic neurological conditions affecting approximately 0.5–2% of the population worldwide [1] . Patients with epilepsy repeatedly and unexpectedly experience sudden changes in behavior and or consciousness. Epileptic discharges can involve only a part of the brain, causing focal seizures, or the entire brain leading to generalized seizures. First-line treatment comprises pharmacotherapy with one or more anti-epileptic drugs. Several anti-epileptic drugs are currently available with distinct mechanisms of action and side effects. However, for an estimated third of epilepsy patients, seizures remain poorly controlled despite optimal medical management. After failure of at least two anti-epileptic drugs, patients suffer from drug-resistant epilepsy. For these patients, dedicated diagnostic workup in a specialized epilepsy center is warranted and other treatment options should be explored. The most effective treatment option for patients with refractory epilepsy is epilepsy surgery. Following a thorough presurgical evaluation, seizure freedom is obtained in approximately two thirds of patients with mesial temporal lobe epilepsy and half of patients with focal neocortical epilepsy [2] . Patients who are considered unsuitable surgery candidates should be considered for neurostimulation. Several types of neurostimulation have been developed including vagus nerve stimulation (VNS), deep brain stimulation and responsive neurostimulation. Availability may differ by region. Noninvasive neurostimulation techniques are also on the rise, aiming to avoid an invasive procedure and accompanying side effects. Invasive VNS is a neurostimulation therapy which activates vagal nerve fibers in the neck region by means of a helical electrode that is wound around the cervical vagus
癫痫是最普遍的慢性神经系统疾病之一,影响全世界约0.5-2%的人口。癫痫患者反复和意外地经历行为和/或意识的突然变化。癫痫放电可能只涉及大脑的一部分,导致局灶性癫痫发作,或整个大脑导致全身性癫痫发作。一线治疗包括用一种或多种抗癫痫药物进行药物治疗。目前几种抗癫痫药物具有不同的作用机制和副作用。然而,估计有三分之一的癫痫患者,尽管有最佳的医疗管理,但癫痫发作仍然控制不佳。在至少两种抗癫痫药物失效后,患者会患上耐药性癫痫。对于这些患者,在专门的癫痫中心进行专门的诊断检查是必要的,并且应该探索其他治疗方案。对难治性癫痫患者最有效的治疗选择是癫痫手术。经过彻底的术前评估,大约三分之二的内侧颞叶癫痫患者和一半的局灶性新皮层癫痫患者获得了癫痫发作自由。认为不适合手术的患者应考虑进行神经刺激。目前已经发展出几种类型的神经刺激,包括迷走神经刺激(VNS)、深部脑刺激和反应性神经刺激。可用性可能因地区而异。非侵入性神经刺激技术也在兴起,旨在避免侵入性手术和伴随的副作用。有创VNS是一种神经刺激疗法,通过缠绕在颈部迷走神经周围的螺旋电极激活颈部区域的迷走神经纤维
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引用次数: 1
Stochastic and periodic vagus nerve stimulation: how do they affect the heart? 随机和周期性迷走神经刺激:它们如何影响心脏?
Pub Date : 2018-12-01 DOI: 10.2217/BEM-2019-0005
Elizabeth M. Annoni, E. Tolkacheva
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引用次数: 1
Comparing pharmacological and bioelectronic approaches for the treatment of gastrointestinal disorders 药理学和生物电子学治疗胃肠道疾病的方法比较
Pub Date : 2018-12-01 DOI: 10.2217/BEM-2019-0009
J. Furness
Professor John Furness speaks to Alice Bough, Commissioning Editor. Professor John Furness leads the Digestive Physiology and Nutrition Laboratory at the Florey Institute of Neuroscience and Mental Health and the University of Melbourne, where he has appointments in the Medical and Veterinary and Agricultural Sciences Faculties. His laboratory has worked for many years on the physiology of digestion, particularly its neuronal and endocrine control. A current emphasis of his work is on the relationships between diet, environment and gut health, and their implications for animal production and for human wellbeing. He is also investigating therapies for the treatment of inflammatory bowel disease and the roles of gut hormones. He has worked closely with the pharmaceutical, medical devices and animal production industries. He is one of the most highly cited Australian scientists. Google Scholar (January 2019) gives his h-index as 107, including 40,400 citations overall.
约翰·弗内斯教授与委托编辑爱丽丝·博夫交谈。John Furness教授领导着墨尔本大学弗洛里神经科学和心理健康研究所的消化生理学和营养实验室,他在墨尔本大学的医学、兽医和农业科学系任职。他的实验室多年来一直致力于消化生理学,特别是其神经和内分泌控制。他目前的工作重点是饮食、环境和肠道健康之间的关系,以及它们对动物生产和人类福祉的影响。他也在研究炎症性肠病的治疗方法和肠道激素的作用。他曾与制药、医疗设备和动物生产行业密切合作。他是被引用次数最多的澳大利亚科学家之一。谷歌Scholar(2019年1月)给出他的h指数为107,总共引用40400次。
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引用次数: 0
The potential of conductive hydrogel electrodes at the neural interface: an interview with Rylie Green 导电性水凝胶电极在神经界面的潜力:采访Rylie Green
Pub Date : 2018-12-01 DOI: 10.2217/BEM-2019-0007
R. Green
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引用次数: 0
期刊
Bioelectronics in medicine
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