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      A 3D Printed Implantable Device for Voiding the Bladder Using Shape Memory Alloy (SMA) Actuators

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          Abstract

          Underactive bladder or detrusor underactivity (DU) is defined as a reduction of contraction strength or duration of the bladder wall. Despite the serious healthcare implications of DU, there are limited solutions for affected individuals. A flexible 3D printed implantable device driven by shape memory alloys (SMA) actuators is presented here for the first time to physically contract the bladder to restore voluntary control of the bladder for individuals suffering from DU. This approach is used initially in benchtop experiments with a rubber balloon acting as a model for the rat bladder to verify its potential for voiding, and that the operating temperatures are safe for the eventual implantation of the device in a rat. The device is then implanted and tested on an anesthetized rat, and a voiding volume of more than 8% is successfully achieved for the SMA‐based device without any surgical intervention or drug injection to relax the external sphincter.

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          Most cited references41

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          Dissolvable films of silk fibroin for ultrathin conformal bio-integrated electronics.

          Electronics that are capable of intimate, non-invasive integration with the soft, curvilinear surfaces of biological tissues offer important opportunities for diagnosing and treating disease and for improving brain/machine interfaces. This article describes a material strategy for a type of bio-interfaced system that relies on ultrathin electronics supported by bioresorbable substrates of silk fibroin. Mounting such devices on tissue and then allowing the silk to dissolve and resorb initiates a spontaneous, conformal wrapping process driven by capillary forces at the biotic/abiotic interface. Specialized mesh designs and ultrathin forms for the electronics ensure minimal stresses on the tissue and highly conformal coverage, even for complex curvilinear surfaces, as confirmed by experimental and theoretical studies. In vivo, neural mapping experiments on feline animal models illustrate one mode of use for this class of technology. These concepts provide new capabilities for implantable and surgical devices.
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            Urinary bladder contraction and relaxation: physiology and pathophysiology.

            The detrusor smooth muscle is the main muscle component of the urinary bladder wall. Its ability to contract over a large length interval and to relax determines the bladder function during filling and micturition. These processes are regulated by several external nervous and hormonal control systems, and the detrusor contains multiple receptors and signaling pathways. Functional changes of the detrusor can be found in several clinically important conditions, e.g., lower urinary tract symptoms (LUTS) and bladder outlet obstruction. The aim of this review is to summarize and synthesize basic information and recent advances in the understanding of the properties of the detrusor smooth muscle, its contractile system, cellular signaling, membrane properties, and cellular receptors. Alterations in these systems in pathological conditions of the bladder wall are described, and some areas for future research are suggested.
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              A review of organic and inorganic biomaterials for neural interfaces.

              Recent advances in nanotechnology have generated wide interest in applying nanomaterials for neural prostheses. An ideal neural interface should create seamless integration into the nervous system and performs reliably for long periods of time. As a result, many nanoscale materials not originally developed for neural interfaces become attractive candidates to detect neural signals and stimulate neurons. In this comprehensive review, an overview of state-of-the-art microelectrode technologies provided fi rst, with focus on the material properties of these microdevices. The advancements in electro active nanomaterials are then reviewed, including conducting polymers, carbon nanotubes, graphene, silicon nanowires, and hybrid organic-inorganic nanomaterials, for neural recording, stimulation, and growth. Finally, technical and scientific challenges are discussed regarding biocompatibility, mechanical mismatch, and electrical properties faced by these nanomaterials for the development of long-lasting functional neural interfaces.
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                Author and article information

                Contributors
                shihcheng@nus.edu.sg
                elelc@nus.edu.sg
                Journal
                Adv Sci (Weinh)
                Adv Sci (Weinh)
                10.1002/(ISSN)2198-3844
                ADVS
                Advanced Science
                John Wiley and Sons Inc. (Hoboken )
                2198-3844
                26 July 2017
                November 2017
                : 4
                : 11 ( doiID: 10.1002/advs.v4.11 )
                : 1700143
                Affiliations
                [ 1 ] Department of Electrical and Computer Engineering Faculty of Engineering National University of Singapore 4 Engineering Drive 3, #05‐45 Singapore 117583 Singapore
                [ 2 ] Singapore Institute for Neurotechnology National University of Singapore 28 Medical Dr. #05‐COR Singapore 117456 Singapore
                [ 3 ] Center for Intelligent Sensors and MEMS National University of Singapore 4 Engineering Drive 3 Singapore 117576 Singapore
                [ 4 ] Biomedical Institute for Global Health Research and Technology (BIGHEART) Yong Loo Lin School of Medicine National University of Singapore 14 Medical Drive #14‐01 Singapore 117599 Singapore
                [ 5 ] Raffles Hospital 585 North Bridge Road Singapore 188770 Singapore
                [ 6 ] Singapore General Hospital Outram Road Singapore 169608 Singapore
                Author notes
                Author information
                http://orcid.org/0000-0003-4425-6289
                Article
                ADVS366
                10.1002/advs.201700143
                5700638
                29201606
                6853f254-8967-4b52-9545-3b885b44971e
                © 2017 The Authors. Published by WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 March 2017
                : 09 May 2017
                Page count
                Figures: 9, Tables: 0, Pages: 10, Words: 7111
                Funding
                Funded by: Peripheral Nerve Prostheses: A Paradigm Shift in Restoring Dexterous Limb Function
                Award ID: NRF‐CRP8‐2011‐01
                Funded by: National Research Foundation
                Funded by: Faculty Research Committee
                Funded by: Thermoelectric Power Generator
                Funded by: National University of Singapore
                Categories
                Full Paper
                Full Papers
                Custom metadata
                2.0
                advs366
                November 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.6.1 mode:remove_FC converted:23.11.2017

                3d printing,actuators,flexible electronics,shape memory alloy,under active bladder

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