Search results for: bioinspired fingertip
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 34

Search results for: bioinspired fingertip

34 Roughness Discrimination Using Bioinspired Tactile Sensors

Authors: Zhengkun Yi

Abstract:

Surface texture discrimination using artificial tactile sensors has attracted increasing attentions in the past decade as it can endow technical and robot systems with a key missing ability. However, as a major component of texture, roughness has rarely been explored. This paper presents an approach for tactile surface roughness discrimination, which includes two parts: (1) design and fabrication of a bioinspired artificial fingertip, and (2) tactile signal processing for tactile surface roughness discrimination. The bioinspired fingertip is comprised of two polydimethylsiloxane (PDMS) layers, a polymethyl methacrylate (PMMA) bar, and two perpendicular polyvinylidene difluoride (PVDF) film sensors. This artificial fingertip mimics human fingertips in three aspects: (1) Elastic properties of epidermis and dermis in human skin are replicated by the two PDMS layers with different stiffness, (2) The PMMA bar serves the role analogous to that of a bone, and (3) PVDF film sensors emulate Meissner’s corpuscles in terms of both location and response to the vibratory stimuli. Various extracted features and classification algorithms including support vector machines (SVM) and k-nearest neighbors (kNN) are examined for tactile surface roughness discrimination. Eight standard rough surfaces with roughness values (Ra) of 50 μm, 25 μm, 12.5 μm, 6.3 μm 3.2 μm, 1.6 μm, 0.8 μm, and 0.4 μm are explored. The highest classification accuracy of (82.6 ± 10.8) % can be achieved using solely one PVDF film sensor with kNN (k = 9) classifier and the standard deviation feature.

Keywords: bioinspired fingertip, classifier, feature extraction, roughness discrimination

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33 Analysis of Tactile Perception of Textiles by Fingertip Skin Model

Authors: Izabela L. Ciesielska-Wrόbel

Abstract:

This paper presents finite element models of the fingertip skin which have been created to simulate the contact of textile objects with the skin to gain a better understanding of the perception of textiles through the skin, so-called Hand of Textiles (HoT). Many objective and subjective techniques have been developed to analyze HoT, however none of them provide exact overall information concerning the sensation of textiles through the skin. As the human skin is a complex heterogeneous hyperelastic body composed of many particles, some simplifications had to be made at the stage of building the models. The same concerns models of woven structures, however their utilitarian value was maintained. The models reflect only friction between skin and woven textiles, deformation of the skin and fabrics when “touching” textiles and heat transfer from the surface of the skin into direction of textiles.

Keywords: fingertip skin models, finite element models, modelling of textiles, sensation of textiles through the skin

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32 Analysis of a Single Motor Finger Mechanism for a Prosthetic Hand

Authors: Shaukat Ali, Kanber Sedef, Mustafa Yilmaz

Abstract:

This work analyzes a finger mechanism for a prosthetic hand that will help in improving the living standards of people who have lost their hands for a variety of reasons. The finger mechanism is single degree of freedom and hence has advantages such as compact size, reduced mass and less energy consumption. The proposed finger mechanism is a six bar linkage actuated by a single motor. The kinematic, static and dynamic analyses have been done by using the conventional methods of mechanism analysis. The kinematic results present the motion of the proposed finger mechanism and location of the fingertip. The static and dynamic analyses provide the useful information about the gripping force at the fingertip for various configurations and the selection of motor that will move the finger over its range of configuration. This single motor finger mechanism is simple and resembles the human finger’s motion suitable for grasping operation. This study can be used in the optimization of geometrical parameters of the proposed mechanism to obtain the desired configurations with minimum torque and enhanced griping.

Keywords: dynamics, finger mechanism, grasping, kinematics

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31 Design, Modelling, and Fabrication of Bioinspired Frog Robot for Synchronous and Asynchronous Swimming

Authors: Afaque Manzoor Soomro, Faheem Ahmed, Fida Hussain Memon, Kyung Hyun Choi

Abstract:

This paper proposes the bioinspired soft frog robot. All printing technology was used for the fabrication of the robot. Polyjet printing was used to print the front and back limbs, while ultrathin filament was used to print the body of the robot, which makes it a complete soft swimming robot. The dual thrust generation approach has been proposed by embedding the main muscle and antagonistic muscle in all the limbs, which enables it to attain high speed (18 mm/s), and significant control of swimming in dual modes (synchronous and asynchronous modes). To achieve the swimming motion of the frog, the design, motivated by the rigorous modelling and real frog dynamics analysis, enabled the as-developed frog robot (FROBOT) to swim at a significant level of consistency with the real frog. The FROBOT (weighing 65 g) can swim at different controllable frequencies (0.5–2Hz) and can turn in any direction by following custom-made LabVIEW software’s commands which enables it to swim at speed up to 18 mm/s on the surface of deep water (100 cm) with excellent weight balance.

Keywords: soft robotics, soft actuator, frog robot, 3D printing

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30 Development of Optimized Eye Mascara Packages with Bioinspired Spiral Methodology

Authors: Daniela Brioschi, Rovilson Mafalda, Silvia Titotto

Abstract:

In the present days, packages are considered a fundamental element in the commercialization of products and services. A good package is capable of helping to attract new customers and also increasing a product’s purchase intent. In this scenario, packaging design emerges as an important tool, since products and design of their packaging are so interconnected that they are no longer seen as separate elements. Packaging design is, in fact, capable of generating desire for a product. The packaging market for cosmetics, especially makeup market, has also been experiencing an increasing level of sophistication and requirements. Considering packaging represents an important link of communication with the final user and plays a significant role on the sales process, it is of great importance that packages accomplish not only with functional requirements but also with the visual appeal. One of the possibilities for the design of packages and, in this context, packages for make-up, is the bioinspired design – or biomimicry. The bio-inspired design presents a promising paradigm for innovation in both design and sustainable design, by using biological system analogies to develop solutions. It has gained importance as a widely diffused movement in design for environmentally conscious development and is also responsible for several useful and innovative designs. As eye mascara packages are also part of the constant evolution on the design for cosmetics area and the traditional packages present the disadvantage of product drying along time, this project aims to develop a new and innovative package for this product, by using a selected bioinspired design methodology during the development process and also suitable computational tools. In order to guide the development process of the package, it was chosen the spiral methodology, conceived by The Biomimicry Institut, which consists of a reliable tool, since it was based on traditional design methodologies. The spiral design comprises identification, translation, discovery, abstraction, emulation and evaluation steps, that can work iteratively as the process develops as a spiral. As support tool for packaging, 3D modelling is being used by the software Inventor Autodesk Inventor 2018. Although this is an ongoing research, first results showed that spiral methodology design, together with Autodesk Inventor, consist of suitable instruments for the bio-inspired design process, and also nature proved itself to be an amazing and inexhaustible source of inspiration.

Keywords: bio-inspired design, design methodology, packaging, cosmetics

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29 Characterization, Replication and Testing of Designed Micro-Textures, Inspired by the Brill Fish, Scophthalmus rhombus, for the Development of Bioinspired Antifouling Materials

Authors: Chloe Richards, Adrian Delgado Ollero, Yan Delaure, Fiona Regan

Abstract:

Growing concern about the natural environment has accelerated the search for non-toxic, but at the same time, economically reasonable, antifouling materials. Bioinspired surfaces, due to their nano and micro topographical antifouling capabilities, provide a hopeful approach to the design of novel antifouling surfaces. Biological organisms are known to have highly evolved and complex topographies, demonstrating antifouling potential, i.e. shark skin. Previous studies have examined the antifouling ability of topographic patterns, textures and roughness scales found on natural organisms. One of the mechanisms used to explain the adhesion of cells to a substrate is called attachment point theory. Here, the fouling organism experiences increased attachment where there are multiple attachment points and reduced attachment, where the number of attachment points are decreased. In this study, an attempt to characterize the microtopography of the common brill fish, Scophthalmus rhombus, was undertaken. Scophthalmus rhombus is a small flatfish of the family Scophthalmidae, inhabiting regions from Norway to the Mediterranean and the Black Sea. They reside in shallow sandy and muddy coastal areas at depths of around 70 – 80 meters. Six engineered surfaces (inspired by the Brill fish scale) produced by a 2-photon polymerization (2PP) process were evaluated for their potential as an antifouling solution for incorporation onto tidal energy blades. The micro-textures were analyzed for their AF potential under both static and dynamic laboratory conditions using two laboratory grown diatom species, Amphora coffeaeformis and Nitzschia ovalis. The incorporation of a surface topography was observed to cause a disruption in the growth of A. coffeaeformis and N. ovalis cells on the surface in comparison to control surfaces. This work has demonstrated the importance of understanding cell-surface interaction, in particular, topography for the design of novel antifouling technology. The study concluded that biofouling can be controlled by physical modification, and has contributed significant knowledge to the use of a successful novel bioinspired AF technology, based on Brill, for the first time.

Keywords: attachment point theory, biofouling, Scophthalmus rhombus, topography

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28 Cost-Effective Mechatronic Gaming Device for Post-Stroke Hand Rehabilitation

Authors: A. Raj Kumar, S. Bilaloglu

Abstract:

Stroke is a leading cause of adult disability worldwide. We depend on our hands for our activities of daily living(ADL). Although many patients regain the ability to walk, they continue to experience long-term hand motor impairments. As the number of individuals with young stroke is increasing, there is a critical need for effective approaches for rehabilitation of hand function post-stroke. Motor relearning for dexterity requires task-specific kinesthetic, tactile and visual feedback. However, when a stroke results in both sensory and motor impairment, it becomes difficult to ascertain when and what type of sensory substitutions can facilitate motor relearning. In an ideal situation, real-time task-specific data on the ability to learn and data-driven feedback to assist such learning will greatly assist rehabilitation for dexterity. We have found that kinesthetic and tactile information from the unaffected hand can assist patients re-learn the use of optimal fingertip forces during a grasp and lift task. Measurement of fingertip grip force (GF), load forces (LF), their corresponding rates (GFR and LFR), and other metrics can be used to gauge the impairment level and progress during learning. Currently ATI mini force-torque sensors are used in research settings to measure and compute the LF, GF, and their rates while grasping objects of different weights and textures. Use of the ATI sensor is cost prohibitive for deployment in clinical or at-home rehabilitation. A cost effective mechatronic device is developed to quantify GF, LF, and their rates for stroke rehabilitation purposes using off-the-shelf components such as load cells, flexi-force sensors, and an Arduino UNO microcontroller. A salient feature of the device is its integration with an interactive gaming environment to render a highly engaging user experience. This paper elaborates the integration of kinesthetic and tactile sensing through computation of LF, GF and their corresponding rates in real time, information processing, and interactive interfacing through augmented reality for visual feedback.

Keywords: feedback, gaming, kinesthetic, rehabilitation, tactile

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27 A Bioinspired Anti-Fouling Coating for Implantable Medical Devices

Authors: Natalie Riley, Anita Quigley, Robert M. I. Kapsa, George W. Greene

Abstract:

As the fields of medicine and bionics grow rapidly in technological advancement, the future and success of it depends on the ability to effectively interface between the artificial and the biological worlds. The biggest obstacle when it comes to implantable, electronic medical devices, is maintaining a ‘clean’, low noise electrical connection that allows for efficient sharing of electrical information between the artificial and biological systems. Implant fouling occurs with the adhesion and accumulation of proteins and various cell types as a result of the immune response to protect itself from the foreign object, essentially forming an electrical insulation barrier that often leads to implant failure over time. Lubricin (LUB) functions as a major boundary lubricant in articular joints, a unique glycoprotein with impressive anti-adhesive properties that self-assembles to virtually any substrate to form a highly ordered, ‘telechelic’ polymer brush. LUB does not passivate electroactive surfaces which makes it ideal, along with its innate biocompatibility, as a coating for implantable bionic electrodes. It is the aim of the study to investigate LUB’s anti-fouling properties and its potential as a safe, bioinspired material for coating applications to enhance the performance and longevity of implantable medical devices as well as reducing the frequency of implant replacement surgeries. Native, bovine-derived LUB (N-LUB) and recombinant LUB (R-LUB) were applied to gold-coated mylar surfaces. Fibroblast, chondrocyte and neural cell types were cultured and grown on the coatings under both passive and electrically stimulated conditions to test the stability and anti-adhesive property of the LUB coating in the presence of an electric field. Lactate dehydrogenase (LDH) assays were conducted as a directly proportional cell population count on each surface along with immunofluorescent microscopy to visualize cells. One-way analysis of variance (ANOVA) with post-hoc Tukey’s test was used to test for statistical significance. Under both passive and electrically stimulated conditions, LUB significantly reduced cell attachment compared to bare gold. Comparing the two coating types, R-LUB reduced cell attachment significantly compared to its native counterpart. Immunofluorescent micrographs visually confirmed LUB’s antiadhesive property, R-LUB consistently demonstrating significantly less attached cells for both fibroblasts and chondrocytes. Preliminary results investigating neural cells have so far demonstrated that R-LUB has little effect on reducing neural cell attachment; the study is ongoing. Recombinant LUB coatings demonstrated impressive anti-adhesive properties, reducing cell attachment in fibroblasts and chondrocytes. These findings and the availability of recombinant LUB brings into question the results of previous experiments conducted using native-derived LUB, its potential not adequately represented nor realized due to unknown factors and impurities that warrant further study. R-LUB is stable and maintains its anti-fouling property under electrical stimulation, making it suitable for electroactive surfaces.

Keywords: anti-fouling, bioinspired, cell attachment, lubricin

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26 The Size Effects of Keyboards (Keycaps) on Computer Typing Tasks

Authors: Chih-Chun Lai, Jun-Yu Wang

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The keyboard is the most important equipment for computer tasks. However, improper design of keyboard would cause some symptoms like ulnar and/or radial deviations. The research goal of this study was to investigate the optimal size(s) of keycaps to increase efficiency. As shown in the questionnaire pre-study with 49 participants aged from 20 to 44, the most commonly used keyboards were 101-key standard keyboards. Most of the keycap sizes (W × L) were 1.3 × 1.5 cm and 1.5 × 1.5 cm. The fingertip breadths of most participants were 1.2 cm. Therefore, in the main study with 18 participants, a standard keyboard with each set of the 3-sized (1.2 × 1.4 cm, 1.3 × 1.5 cm, and 1.5 × 1.5 cm) keycaps was used to investigate their typing efficiency, respectively. The results revealed that the differences between the operating times for using 1.3 × 1.5 cm and 1.2 × 1.4 cm keycaps were insignificant while operating times for using 1.5 × 1.5 cm keycaps were significantly longer than for using 1.2 × 1.4 cm or 1.3 × 1.5 cm, respectively. As for the typing error rate, there was no significant difference.

Keywords: keyboard, keycap size, typing efficiency, computer tasks

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25 Design and Analysis of an Electro Thermally Symmetrical Actuated Microgripper

Authors: Sh. Foroughi, V. Karamzadeh, M. Packirisamy

Abstract:

This paper presents design and analysis of an electrothermally symmetrical actuated microgripper applicable for performing micro assembly or biological cell manipulation. Integration of micro-optics with microdevice leads to achieve extremely precise control over the operation of the device. Geometry, material, actuation, control, accuracy in measurement and temperature distribution are important factors which have to be taken into account for designing the efficient microgripper device. In this work, analyses of four different geometries are performed by means of COMSOL Multiphysics 5.2 with implementing Finite Element Methods. Then, temperature distribution along the fingertip, displacement of gripper site as well as optical efficiency vs. displacement and electrical potential are illustrated. Results show in addition to the industrial application of this device, the usage of that as a cell manipulator is possible.

Keywords: electro thermal actuator, MEMS, microgripper, MOEMS

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24 Development of Anti-Fouling Surface Features Bioinspired by the Patterned Micro-Textures of the Scophthalmus rhombus (Brill)

Authors: Ivan Maguire, Alan Barrett, Alex Forte, Sandra Kwiatkowska, Rohit Mishra, Jens Ducrèe, Fiona Regan

Abstract:

Biofouling is defined as the gradual accumulation of Biomimetics refers to the use and imitation of principles copied from nature. Biomimetics has found interest across many commercial disciplines. Among many biological objects and their functions, aquatic animals deserve a special attention due to their antimicrobial capabilities resulting from chemical composition, surface topography or other behavioural defences, which can be used as an inspiration for antifouling technology. Marine biofouling has detrimental effects on seagoing vessels, both commercial and leisure, as well as on oceanographic sensors, offshore drilling rigs, and aquaculture installations. Sensor optics, membranes, housings and platforms can become fouled leading to problems with sensor performance and data integrity. While many anti-fouling solutions are currently being investigated as a cost-cutting measure, biofouling settlement may also be prevented by creating a surface that does not satisfy the settlement conditions. Brill (Scophthalmus rhombus) is a small flatfish occurring in marine waters of Mediterranean as well as Norway and Iceland. It inhabits sandy and muddy coastal waters from 5 to 80 meters. Its skin colour changes depending on environment, but generally is brownish with light and dark freckles, with creamy underside. Brill is oval in shape and its flesh is white. The aim of this study is to translate the unique micro-topography of the brill scale, to design marine inspired biomimetic surface coating and test it against a typical fouling organism. Following extensive study of scale topography of the brill fish (Scophthalmus rhombus) and the settlement behaviour of the diatom species Psammodictyon sp. via SEM, two state-of-the-art antifouling surface solutions were designed and investigated; A brill fish scale bioinspired surface pattern platform (BFD), and generic and uniformly-arrayed, circular micropillar platform (MPD), with offsets based on diatom species settlement behaviour. The BFD approach consists of different ~5 μm by ~90 μm Brill-replica patterns, grown to a 5 μm height, in a linear array pattern. The MPD approach utilises hexagonal-packed cylindrical pillars 10.6 μm in diameter, grown to a height of 5 μm, with vertical offset of 15 μm and horizontal offset of 26.6 μm. Photolithography was employed for microstructure growth, with a polydimethylsiloxane (PDMS) chip-based used as a testbed for diatom adhesion on both platforms. Settlement and adhesion tests were performed using this PDMS microfluidic chip through subjugation to centrifugal force via an in-house developed ‘spin-stand’ which features a motor, in combination with a high-resolution camera, for real-time observing diatom release from PDMS material. Diatom adhesion strength can therefore be determined based on the centrifugal force generated at varying rotational speeds. It is hoped that both the replica and bio-inspired solutions will give comparable anti-fouling results to these synthetic surfaces, whilst also assisting in determining whether anti-fouling solutions should predominantly be investigating either fully bioreplica-based, or a bioinspired, synthetically-based design.

Keywords: anti-fouling applications, bio-inspired microstructures, centrifugal microfluidics, surface modification

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23 A Portable Device for Pulse Wave Velocity Measurements

Authors: Chien-Lin Wang, Cha-Ling Ko, Tainsong Chen

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Pulse wave velocity (PWV) of blood flow provides important information of vessel property and blood pressure which can be used to assess cardiovascular disease. However, the above measurements need expensive equipment, such as Doppler ultrasound, MRI, angiography etc. The photoplethysmograph (PPG) signals are commonly utilized to detect blood volume changes. In this study, two infrared (IR) probes are designed and placed at a fixed distance from finger base and fingertip. An analog circuit with automatic gain adjustment is implemented to get the stable original PPG signals from above two IR probes. In order to obtain the time delay precisely between two PPG signals, we obtain the pulse transit time from the second derivative of the original PPG signals. To get a portable, wireless and low power consumption PWV measurement device, the low energy Bluetooth 4.0 (BLE) and the microprocessor (Cortex™-M3) are used in this study. The PWV is highly correlated with blood pressure. This portable device has potential to be used for continuous blood pressure monitoring.

Keywords: pulse wave velocity, photoplethysmography, portable device, biomedical engineering

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22 Noninvasive Continuous Glucose Monitoring Device Using a Photon-Assisted Tunneling Photodetector Based on a Quantum Metal-Oxide-Semiconductor

Authors: Wannakorn Sangthongngam, Melissa Huerta, Jaewoo Kim, Doyeon Kim

Abstract:

Continuous glucose monitoring systems are essential for diabetics to avoid health complications but come at a costly price, especially when insurance does not fully cover the diabetic testing kits needed. This paper proposes a noninvasive continuous glucose monitoring system to provide an accessible, low-cost, and painless alternative method of accurate glucose measurements to help improve quality of life. Using a light source with a wavelength of 850nm illuminates the fingertip for the photodetector to detect the transmitted light. Utilizing SeeDevice’s photon-assisted tunneling photodetector (PAT-PD)-based QMOS™ sensor, fluctuations of voltage based on photon absorption in blood cells are comparable to traditional glucose measurements. The performance of the proposed method was validated using 4 test participants’ transmitted voltage readings compared with measurements obtained from the Accu-Chek glucometer. The proposed method was able to successfully measure concentrations from linear regression calculations.

Keywords: continuous glucose monitoring, non-invasive continuous glucose monitoring, NIR, photon-assisted tunneling photodetector, QMOS™, wearable device

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21 Preliminary Study on Analysis of Pinching Motion Actuated by Electro-Active Polymers

Authors: Doo W. Lee, Soo J. Lee, Bye R. Yoon, Jae Y. Jho, Kyehan Rhee

Abstract:

Hand exoskeletons have been developed in order to assist daily activities for disabled and elder people. A figure exoskeleton was developed using ionic polymer metal composite (IPMC) actuators, and the performance of it was evaluated in this study. In order to study dynamic performance of a finger dummy performing pinching motion, force generating characteristics of an IPMC actuator and pinching motion of a thumb and index finger dummy actuated by IMPC actuators were analyzed. The blocking force of 1.54 N was achieved under 4 V of DC. A thumb and index finger dummy, which has one degree of freedom at the proximal joint of each figure, was manufactured by a three dimensional rapid prototyping. Each figure was actuated by an IPMC actuator, and the maximum fingertip force was 1.18 N. Pinching motion of a dummy was analyzed by two video cameras in vertical top and horizontal left end view planes. A figure dummy powered by IPMC actuators could perform flexion and extension motion of an index figure and a thumb.

Keywords: finger exoskeleton, ionic polymer metal composite, flexion and extension, motion analysis

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20 Study of Dermatoglyphics Pattern in Patient with Hypertension

Authors: Ajeevan Gautam, Gulam Anwer Khan, Pratibha Pokhrel

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Introduction: Dermatoglyphics is the science which deals with the study of dermal ridge configuration on the digits, palms and soles. It is grooved by ridges and forms variety of configurations. The aim of the study was to identify dermal ridge patterns on fingertip of hypertensive patients and in normal population and to compare patterns among them. Methods: The subjects of the study were 130 hypertensives and 130 non-hypertensives cases of Kathmandu Valley aged between 40 to 80 years. Case history was recorded after consent finger prints were taken. Different parameters as whorl, loop, arch and composite patterns were studied and analysed. Result: It revealed, increased whorl pattern in hypertensive. It showed 65.69% whorl, 29.23% loop and 5.07% arch patterns in right hand of hypertensive people. In control, it was found to be 34.46% whorl, 58.15% loop and 5.38% arch patterns respectively. Similarly in left hand 63.69% whorl, 32% loop and 4.30% arch in hypertensive group. In control group it was 60.15% as loop, 35.69% as whorl and 15% as arch. Discussion: Based on findings of the result, it was concluded that the whorl, loop and arch patterns observed as 65.69%, 29.23% and 5.07% respectively in hypertensive cases in right hand. Similarly in left hand, it was found to be 4.30% as arch, 32% as loop and 63.69% as whorl patterns, but in normotensive subjects these patterns were recorded as 36.43%, 58.15%, 5.38% in right hand and 35.69%, 60.15%, 4.15% in left hand as whorl, loop and arch respectively.

Keywords: arch, dermatoglyphics, hypertension, loop, whorl

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19 Quantum Dots Incorporated in Biomembrane Models for Cancer Marker

Authors: Thiago E. Goto, Carla C. Lopes, Helena B. Nader, Anielle C. A. Silva, Noelio O. Dantas, José R. Siqueira Jr., Luciano Caseli

Abstract:

Quantum dots (QD) are semiconductor nanocrystals that can be employed in biological research as a tool for fluorescence imagings, having the potential to expand in vivo and in vitro analysis as cancerous cell biomarkers. Particularly, cadmium selenide (CdSe) magic-sized quantum dots (MSQDs) exhibit stable luminescence that is feasible for biological applications, especially for imaging of tumor cells. For these facts, it is interesting to know the mechanisms of action of how such QDs mark biological cells. For that, simplified models are a suitable strategy. Among these models, Langmuir films of lipids formed at the air-water interface seem to be adequate since they can mimic half a membrane. They are monomolecular films formed at liquid-gas interfaces that can spontaneously form when organic solutions of amphiphilic compounds are spread on the liquid-gas interface. After solvent evaporation, the monomolecular film is formed, and a variety of techniques, including tensiometric, spectroscopic and optic can be applied. When the monolayer is formed by membrane lipids at the air-water interface, a model for half a membrane can be inferred where the aqueous subphase serve as a model for external or internal compartment of the cell. These films can be transferred to solid supports forming the so-called Langmuir-Blodgett (LB) films, and an ampler variety of techniques can be additionally used to characterize the film, allowing for the formation of devices and sensors. With these ideas in mind, the objective of this work was to investigate the specific interactions of CdSe MSQDs with tumorigenic and non-tumorigenic cells using Langmuir monolayers and LB films of lipids and specific cell extracts as membrane models for diagnosis of cancerous cells. Surface pressure-area isotherms and polarization modulation reflection-absorption spectroscopy (PM-IRRAS) showed an intrinsic interaction between the quantum dots, inserted in the aqueous subphase, and Langmuir monolayers, constructed either of selected lipids or of non-tumorigenic and tumorigenic cells extracts. The quantum dots expanded the monolayers and changed the PM-IRRAS spectra for the lipid monolayers. The mixed films were then compressed to high surface pressures and transferred from the floating monolayer to solid supports by using the LB technique. Images of the films were then obtained with atomic force microscopy (AFM) and confocal microscopy, which provided information about the morphology of the films. Similarities and differences between films with different composition representing cell membranes, with or without CdSe MSQDs, was analyzed. The results indicated that the interaction of quantum dots with the bioinspired films is modulated by the lipid composition. The properties of the normal cell monolayer were not significantly altered, whereas for the tumorigenic cell monolayer models, the films presented significant alteration. The images therefore exhibited a stronger effect of CdSe MSQDs on the models representing cancerous cells. As important implication of these findings, one may envisage for new bioinspired surfaces based on molecular recognition for biomedical applications.

Keywords: biomembrane, langmuir monolayers, quantum dots, surfaces

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18 Graphene-Based Nanocomposites as Ecofriendly Antifouling Surfaces

Authors: Mohamed S. Selim, Nesreen A. Fatthallah, Shimaa A. Higazy, Zhifeng Hao, Xiang Chen

Abstract:

After the prohibition of tin-based fouling-prevention coatings in 2003, the researchers were directed toward eco-friendly coatings. Because of their nonstick, environmental, and economic benefits, foul-release nanocoatings have received a lot of attention. They use physical anti-adhesion terminology to deter any fouling attachment.Natural bioinspired surfaces have micro/nano-roughness and low surface free energy features, which may inspire the design of dynamic antifouling coatings. Graphene-based nanocomposite surfaces were designed to combat marine-fouling adhesion with ecological as well as eco-friendly effects rather than biocidal solutions. Polymer–graphenenanofiller hybrids are a novel class of composite materials in fouling-prevention applications. The controlled preparation of nanoscale orientation, arrangement, and direction along the composite building blocks would result in superior fouling prohibition. This work representsfoul-release nanocomposite top coats for marine coating applications with superhydrophobicity, surface inertness against fouling adherence, cost-effectiveness, and increased lifetime.

Keywords: foul-release nanocoatings, graphene-based nanocomposite, polymer, nanofillers

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17 Duality of Leagility and Governance: A New Normal Demand Network Management Paradigm under Pandemic

Authors: Jacky Hau

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The prevalence of emerging technologies disrupts various industries as well as consumer behavior. Data collection has been in the fingertip and inherited through enabled Internet-of-things (IOT) devices. Big data analytics (BDA) becomes possible and allows real-time demand network management (DNM) through leagile supply chain. To enhance further on its resilience and predictability, governance is going to be examined to promote supply chain transparency and trust in an efficient manner. Leagility combines lean thinking and agile techniques in supply chain management. It aims at reducing costs and waste, as well as maintaining responsiveness to any volatile consumer demand by means of adjusting the decoupling point where the product flow changes from push to pull. Leagility would only be successful when collaborative planning, forecasting, and replenishment (CPFR) process or alike is in place throughout the supply chain business entities. Governance and procurement of the supply chain, however, is crucial and challenging for the execution of CPFR as every entity has to walk-the-talk generously for the sake of overall benefits of supply chain performance, not to mention the complexity of exercising the polices at both of within across various supply chain business entities on account of organizational behavior and mutual trust. Empirical survey results showed that the effective timespan on demand forecasting had been drastically shortening in the magnitude of months to weeks planning horizon, thus agility shall come first and preferably following by lean approach in a timely manner.

Keywords: governance, leagility, procure-to-pay, source-to-contract

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16 Bioinspired Green Synthesis of Magnetite Nanoparticles Using Room-Temperature Co-Precipitation: A Study of the Effect of Amine Additives on Particle Morphology in Fluidic Systems

Authors: Laura Norfolk, Georgina Zimbitas, Jan Sefcik, Sarah Staniland

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Magnetite nanoparticles (MNP) have been an area of increasing research interest due to their extensive applications in industry, such as in carbon capture, water purification, and crucially, the biomedical industry. The use of MNP in the biomedical industry is rising, with studies on their effect as Magnetic resonance imaging contrast agents, drug delivery systems, and as hyperthermic cancer treatments becoming prevalent in the nanomaterial research community. Particles used for biomedical purposes must meet stringent criteria; the particles must have consistent shape and size between particles. Variation between particle morphology can drastically alter the effective surface area of the material, making it difficult to correctly dose particles that are not homogeneous. Particles of defined shape such as octahedral and cubic have been shown to outperform irregular shaped particles in some applications, leading to the need to synthesize particles of defined shape. In nature, highly homogeneous MNP are found within magnetotactic bacteria, a unique bacteria capable of producing magnetite nanoparticles internally under ambient conditions. Biomineralisation proteins control the properties of the MNPs, enhancing their homogeneity. One of these proteins, Mms6, has been successfully isolated and used in vitro as an additive in room-temperature co-precipitation reactions (RTCP) to produce particles of defined mono-dispersed size & morphology. When considering future industrial scale-up it is crucial to consider the costs and feasibility of an additive, as an additive that is not readily available or easily synthesized at a competitive price will not be sustainable. As such, additives selected for this research are inspired by the functional groups of biomineralisation proteins, but cost-effective, environmentally friendly, and compatible with scale-up. Diethylenetriamine (DETA), triethylenetetramine (TETA), tetraethylenepentamine (TEPA), and pentaethylenehexamine (PEHA) have been successfully used in RTCP to modulate the properties of particles synthesized, leading to the formation of octahedral nanoparticles with no use of organic solvents, heating, or toxic precursors. By extending this principle to a fluidic system, ongoing research will reveal whether the amine additives can also exert morphological control in an environment which is suited toward higher particle yield. Two fluidic systems have been employed; a peristaltic turbulent flow mixing system suitable for the rapid production of MNP, and a macrofluidic system for the synthesis of tailored nanomaterials under a laminar flow regime. The presence of the amine additives in the turbulent flow system in initial results appears to offer similar morphological control as observed under RTCP conditions, with higher proportions of octahedral particles formed. This is a proof of concept which may pave the way to green synthesis of tailored MNP on an industrial scale. Mms6 and amine additives have been used in the macrofluidic system, with Mms6 allowing magnetite to be synthesized at unfavourable ferric ratios, but no longer influencing particle size. This suggests this synthetic technique while still benefiting from the addition of additives, may not allow additives to fully influence the particles formed due to the faster timescale of reaction. The amine additives have been tested at various concentrations, the results of which will be discussed in this paper.

Keywords: bioinspired, green synthesis, fluidic, magnetite, morphological control, scale-up

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15 Copper (II) Complex of New Tetradentate Asymmetrical Schiff Base Ligand: Synthesis, Characterization, and Catecholase-Mimetic Activity

Authors: Cahit Demetgul, Sahin Bayraktar, Neslihan Beyazit

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Metalloenzymes are enzyme proteins containing metal ions, which are directly bound to the protein or to enzyme-bound nonprotein components. One of the major metalloenzymes that play a key role in oxidation reactions is catechol oxidase, which shows catecholase activity i.e. oxidation of a broad range of catechols to quinones through the four-electron reduction of molecular oxygen to water. Studies on the model compounds mimicking the catecholase activity are very useful and promising for the development of new, more efficient bioinspired catalysts, for in vitro oxidation reactions. In this study, a new tetradentate asymmetrical Schiff-base and its Cu(II) complex were synthesized by condensation of 4-nitro-1,2-phenylenediamine with 6-formyl-7-hydroxy-5-methoxy-2-methylbenzopyran-4-one and by using an appropriate Cu(II) salt, respectively. The prepared compounds were characterized by elemental analysis, FT-IR, NMR, UV-Vis and magnetic susceptibility. The catecholase-mimicking activity of the new Schiff Base Cu(II) complex was performed for the oxidation of 3,5-di-tert-butylcatechol (3,5-DTBC) in methanol at 25 °C, where the electronic spectra were recorded at different time intervals. The yield of the quinone (3,5-DTBQ) was determined from the measured absorbance at 400 nm of the resulting solution. The compatibility of catalytic reaction with Michaelis-Menten kinetics was also investigated. In conclusion, we have found that our new Schiff Base Cu(II) complex presents a significant capacity to catalyze the oxidation reaction of the catechol to o-quinone.

Keywords: catecholase activity, Michaelis-Menten kinetics, Schiff base, transition metals

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14 The Factors Associated with Health Status among Community Health Volunteers in Thailand

Authors: Lapatrada Numkham, Saowaluk Khakhong, Jeeraporn Kummabutr

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Non-communicable diseases (NCDs) are the leading cause of death in worldwide. Thailand also concerns and focuses on reduction a new case of these diseases. Community Health Volunteers (CHV) is important health personnel in primary health care and performs as a health leader in the community. If the health of CHV changes, it would impact on the performance to promote health of families and community. This cross-sectional study aimed to 1) describe the health status of community health volunteers and 2) examine the factors associated with health status among community health volunteers. The sample included 360 community health volunteers in a province in central Thailand during September-December 2014. Data were collected using questionnaires on health information, knowledge of health behaviors, and health behaviors. Body weight, height, waist circumference (WC), blood pressure (BP), and blood glucose (BS) (fingertip) were assessed. Data were analyzed using descriptive statistics and chi-square test. There were three hundred and sixty participants with 82.5% being women. The mean age was 54 + 8.9 years. Forty-seven percent of the participants had co-morbidities. Hypertension was the most common co-morbidity (26.7%). The results revealed that the health status of the volunteers included: no underlying disease, having risk of hypertension (HT) & diabetes mellitus (DM), and having HT&DM at 38.3%, 30.0%, and 31.7% respectively. The chi-square test revealed that the factors associated with health status among the volunteers were gender, age, WC and body mass index (BMI). The results suggested that community health nurses should; 1) implement interventions to decrease waist circumference and lose weight through education programs, especially females; 2) monitor people that have a risk of HT&DM and that have HT&DM by meeting and recording BP level, BS level, WC and BMI; and 3) collaborate with a district public health officer to initiate a campaign to raise awareness of the risks of chronic diseases among community health volunteers.

Keywords: community health volunteers, health status, risk of non-communicable disease, Thailand

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13 Body Armours in Amazonian Fish

Authors: Fernando G. Torres, Donna M. Ebenstein, Monica Merino

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Most fish are covered by a protective external armour. The characteristics of these armours depend on the individual elements that form them, such as scales, scutes or dermal plates. In this work, we assess the properties of two different types of protective elements: scales from A. gigas and dermal plates from P. pardalis. A. Gigas and P. Pardalis are two Amazonian fish with a rather prehistoric aspect. They have large scales and dermal plates that form two different types of protective body armours. Although both scales and dermal plates are formed by collagen and hydroxyapatite, their structures display remarkable differences. The structure and composition of the samples were assessed by means of X-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR) and Differential Scanning Calorimetry (DSC). Morphology studies were carried out using a Scanning Electron Microscopy (SEM). Nanoindentation tests were performed to measure the reduced moduli in A. gigas scales and P. pardalis plates. The similarities and differences between scales and dermal plates are discussed based on the experimental results. Both protective armours are designed to be lightweight, flexible and tough. A. Gigas scales are are light laminated composites, while P. pardalis dermal plates show a sandwich like structure with dense outer layers and a porous inner matrix. It seems that the armour of P. pardalis is more suited for a bottom-dwelling fish and allows for protection against predators. The scales from A. Gigas are more adapted to give protection to a swimming fish. The information obtained from these studies is also important for the development of bioinspired nanocomposites, with potential applications in the biomedical field.

Keywords: pterygoplichthys pardalis, dermal plates arapaima gigas, fish scales

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12 The Relevance of Bioinspired Architecture and Programmable Materials for Development of 4D Printing

Authors: Daniela Ribeiro, Silvia Lenyra Meirelles Campos Titotto

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Nature has long served as inspiration for humans, since various technologies present in society are a mirror of the natural world. This is due to the fact that nature has adapted for millions of years to possess the characteristics they have today. In this sense, man takes advantage of this situation and uses it to produce his own objects and solve his problems. This concept, which is known as biomimetics, is something relatively new, once it was only denominated in 1957. Nature, in turn, responds directly and consistently to environmental conditions. For example, plants that have touch sensitivity contract with this stimulus. Such a situation resembles a technology that has been gaining ground in the contemporary world of scientific innovation: 4D printing. 4D printing technology emerged in 2012 as a complement to 3D printing and presents numerous benefits since it provides a deficiency in the second kind of printing mentioned. This type of technology reaches several areas, since it is capable of producing materials that change over time, be it in its composition, form or properties and is such a characteristic that determines the additional dimension of the material. Precisely because of these factors, this type of impression resembles nature and is related to biomimetics. However, only certain types of ‘intelligent’ materials are generally employed in this type of impression, since only they will respond well to such stimuli, one of which is the hydrogel. The hydrogel is a biocompatible polymer that presents several applications, these in turn will be briefly mentioned in this article to exemplify its importance and the reason for choosing this material as object of study. In addition, aspects that configure 4D printing will be treated here, such as the importance of architecture, programming language and the reversibility of printed materials.

Keywords: 4D printing, biomimetic, hydrogel, materials

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11 Comparative Study of Skeletonization and Radial Distance Methods for Automated Finger Enumeration

Authors: Mohammad Hossain Mohammadi, Saif Al Ameri, Sana Ziaei, Jinane Mounsef

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Automated enumeration of the number of hand fingers is widely used in several motion gaming and distance control applications, and is discussed in several published papers as a starting block for hand recognition systems. The automated finger enumeration technique should not only be accurate, but also must have a fast response for a moving-picture input. The high performance of video in motion games or distance control will inhibit the program’s overall speed, for image processing software such as Matlab need to produce results at high computation speeds. Since an automated finger enumeration with minimum error and processing time is desired, a comparative study between two finger enumeration techniques is presented and analyzed in this paper. In the pre-processing stage, various image processing functions were applied on a real-time video input to obtain the final cleaned auto-cropped image of the hand to be used for the two techniques. The first technique uses the known morphological tool of skeletonization to count the number of skeleton’s endpoints for fingers. The second technique uses a radial distance method to enumerate the number of fingers in order to obtain a one dimensional hand representation. For both discussed methods, the different steps of the algorithms are explained. Then, a comparative study analyzes the accuracy and speed of both techniques. Through experimental testing in different background conditions, it was observed that the radial distance method was more accurate and responsive to a real-time video input compared to the skeletonization method. All test results were generated in Matlab and were based on displaying a human hand for three different orientations on top of a plain color background. Finally, the limitations surrounding the enumeration techniques are presented.

Keywords: comparative study, hand recognition, fingertip detection, skeletonization, radial distance, Matlab

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10 Novel Bioinspired Design to Capture Smoky CO2 by Reactive Absorption with Aqueous Scrubber

Authors: J. E. O. Hernandez

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In the next 20 years, energy production by burning fuels will increase and so will the atmospheric concentration of CO2 and its well-known threats to life on Earth. The technologies available for capturing CO2 are still dubious and this keeps fostering an interest in bio-inspired approaches. The leading one is the application of carbonic anhydrase (CA) –a superfast biocatalyst able to convert up to one million molecules of CO2 into carbonates in water. However, natural CA underperforms when applied to real smoky CO2 in chimneys and, so far, the efforts to create superior CAs in the lab rely on screening methods running under pristine conditions at the micro level, which are far from resembling those in chimneys. For the evolution of man-made enzymes, selection rather than screening would be ideal but this is challenging because of the need for a suitable artificial environment that is also sustainable for our society. Herein we present the stepwise design and construction of a bioprocess (from bench-scale to semi-pilot) for evolutionary selection experiments. In this bioprocess, reaction and adsorption took place simultaneously at atmospheric pressure in a spray tower. The scrubbing solution was fed countercurrently by reusing municipal pressure and it was mainly prepared with water, carbonic anhydrase and calcium chloride. This bioprocess allowed for the enzymatic carbonation of smoky CO2; the reuse of process water and the recovery of solid carbonates without cooling of smoke, pretreatments, solvent amines and compression of CO2. The average yield of solid carbonates was 0.54 g min-1 or 12-fold the amount produced in serum bottles at lab bench scale. This bioprocess could be used as a tailor-made environment for driving the selection of superior CAs. The bioprocess and its match CA could be sustainably used to reduce global warming by CO2 emissions from exhausts.

Keywords: biological carbon capture and sequestration, carbonic anhydrase, directed evolution, global warming

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9 Fused Deposition Modeling Printing of Bioinspired Triply Periodic Minimal Surfaces Based Polyvinylidene Fluoride Materials for Scaffold Development in Biomedical Application

Authors: Farusil Najeeb Mullaveettil, Rolanas Dauksevicius

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Cellular structures produced by additive manufacturing have earned wide research attention due to their unique specific strength and energy absorption potentiality. The literature review concludes that pattern type and density are vital parameters that affect the mechanical properties of parts formed by additive manufacturing techniques and have an influence on printing time and material consumption. Fused deposition modeling technique (FDM) is used here to produce Polyvinylidene fluoride (PVDF) parts. In this work, patterns are based on triply periodic minimal surfaces (TPMS) produced by PVDF-based filaments using the FDM technique. PVDF homopolymer filament Fluorinar-H™ and PVDF copolymer filament Fluorinar-C™ are printed with three types of TPMS patterns. The patterns printed are Gyroid, Schwartz diamond, and Schwartz primitive. Tensile, flexural, and compression tests under quasi-static loading conditions are performed in compliance with ISO standards. The investigation elucidates the deformation mechanisms and a study that establishes a relationship between the printed and nominal specimens' dimensional accuracy. In comparison to the examined TPMS pattern, Schwartz diamond showed a higher relative elastic modulus and strength than the other patterns in tensile loading, and the Gyroid pattern showed the highest mechanical characteristics in flexural loading. The concluded results could be utilized to produce informed cellular designs for biomedical and mechanical applications.

Keywords: additive manufacturing, FDM, PVDF, gyroid, schwartz primitive, schwartz diamond, TPMS, tensile, flexural

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8 Dynamic Behavior of the Nanostructure of Load-Bearing Biological Materials

Authors: Mahan Qwamizadeh, Kun Zhou, Zuoqi Zhang, Yong Wei Zhang

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Typical load-bearing biological materials like bone, mineralized tendon and shell, are biocomposites made from both organic (collagen) and inorganic (biomineral) materials. This amazing class of materials with intrinsic internally designed hierarchical structures show superior mechanical properties with regard to their weak components from which they are formed. Extensive investigations concentrating on static loading conditions have been done to study the biological materials failure. However, most of the damage and failure mechanisms in load-bearing biological materials will occur whenever their structures are exposed to dynamic loading conditions. The main question needed to be answered here is: What is the relation between the layout and architecture of the load-bearing biological materials and their dynamic behavior? In this work, a staggered model has been developed based on the structure of natural materials at nanoscale and Finite Element Analysis (FEA) has been used to study the dynamic behavior of the structure of load-bearing biological materials to answer why the staggered arrangement has been selected by nature to make the nanocomposite structure of most of the biological materials. The results showed that the staggered structures will efficiently attenuate the stress wave rather than the layered structure. Furthermore, such staggered architecture is effectively in charge of utilizing the capacity of the biostructure to resist both normal and shear loads. In this work, the geometrical parameters of the model like the thickness and aspect ratio of the mineral inclusions selected from the typical range of the experimentally observed feature sizes and layout dimensions of the biological materials such as bone and mineralized tendon. Furthermore, the numerical results validated with existing theoretical solutions. Findings of the present work emphasize on the significant effects of dynamic behavior on the natural evolution of load-bearing biological materials and can help scientists to design bioinspired materials in the laboratories.

Keywords: load-bearing biological materials, nanostructure, staggered structure, stress wave decay

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7 Redox-Mediated Supramolecular Radical Gel

Authors: Sonam Chorol, Sharvan Kumar, Pritam Mukhopadhyay

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In biology, supramolecular systems require the use of chemical fuels to stay in sustained nonequilibrium steady states termed dissipative self-assembly in contrast to synthetic self-assembly. Biomimicking these natural dynamic systems, some studies have demonstrated artificial self-assembly under nonequilibrium utilizing various forms of energies (fuel) such as chemical, redox, and pH. Naphthalene diimides (NDIs) are well-known organic molecules in supramolecular architectures with high electron affinity and have applications in controlled electron transfer (ET) reactions, etc. Herein, we report the endergonic ET from tetraphenylborate to highly electron-deficient phosphonium NDI²+ dication to generate NDI•+ radical. The formation of radicals was confirmed by UV-Vis-NIR absorption spectroscopy. Electron-donor and electron-acceptor energy levels were calculated from experimental electrochemistry and theoretical DFT analysis. The HOMO of the electron donor locates below the LUMO of the electro-acceptor. This indicates that electron transfer is endergonic (ΔE°ET = negative). The endergonic ET from NaBPh₄ to NDI²+ dication was achieved thermodynamically by the formation of coupled biphenyl product confirmed by GC-MS analysis. NDI molecule bearing octyl phosphonium at the core and H-bond forming imide moieties at the axial position forms a gel. The rheological properties of purified radical ion NDI⦁+ gels were evaluated. The atomic force microscopy studies reveal the formation of large branching-type networks with a maximum height of 70-80 nm. The endergonic ET from NaBPh₄ to NDI²+ dication was used to design the assembly and disassembly redox reaction cycle using reducing (NaBPh₄) and oxidizing agents (Br₂) as chemical fuels. A part of NaBPh₄ is used to drive assembly, while a fraction of the NaBPh₄ is dissipated by forming a useful product. The system goes back to the disassembled NDI²+ dication state with the addition of Br₂. We think bioinspired dissipative self-assembly is the best approach to developing future lifelike materials with autonomous behavior.

Keywords: Ionic-gel, redox-cycle, self-assembly, useful product

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6 Investigation of the Effects of 10-Week Nordic Hamstring Exercise Training and Subsequent Detraining on Plasma Viscosity and Oxidative Stress Levels in Healthy Young Men

Authors: H. C. Ozdamar , O. Kilic-Erkek, H. E. Akkaya, E. Kilic-Toprak, M. Bor-Kucukatay

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Nordic hamstring exercise (NHE) is used to increase hamstring muscle strength, prevent injuries. The aim of this study was to reveal the acute, long-term effects of 10-week NHE, followed by 5, 10-week detraining on anthropometric measurements, flexibility, anaerobic power, muscle architecture, damage, fatigue, oxidative stress, plasma viscosity (PV), blood lactate levels. 40 sedentary, healthy male volunteers underwent 10 weeks of progressive NHE followed by 5, 10 weeks of detraining. Muscle architecture was determined by ultrasonography, stiffness by strain elastography. Anaerobic power was assessed by double-foot standing, long jump, vertical jump, flexibility by sit-lie, hamstring flexibility tests. Creatine kinase activity, oxidant/antioxidant parameters were measured from venous blood by a commercial kit, whereas PV was determined using a cone-plate viscometer. The blood lactate level was measured from the fingertip. NHE allowed subjects to lose weight, this effect was reversed by detraining for 5 weeks. Exercise caused an increase in knee angles measured by a goniometer, which wasn’t affected by detraining. 10-week NHE caused a partially reversed increase in anaerobic performance upon detraining. NHE resulted in increment of biceps femoris long head (BFub) area, pennation angle, which was reversed by detraining of 10-weeks. Blood lactate levels, muscle pain, fatigue were increased after each exercise session. NHE didn’t change oxidant/antioxidant parameters; 5-week detraining resulted in an increase in total oxidant capacity (TOC) and oxidative stress index (OSI). Detraining of 10 weeks caused a reduction of these parameters. Acute exercise caused a reduction in PV at 1 to 10 weeks. Pre-exercise PV measured on the 10th week was lower than the basal value. Detraining caused the increment of PV. The results may guide the selection of the exercise type to increase performance and muscle strength. Knowing how much of the gains will be lost after a period of detraining can contribute to raising awareness of the continuity of the exercise. This work was supported by PAU Scientific Research Projects Coordination Unit (Project number: 2018SABE034)

Keywords: anaerobic power, detraining, Nordic hamstring exercise, oxidative stress, plasma viscosity

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5 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

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First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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