Untethered mobile microrobots have the potential to transform medicine radically. Their small size and wireless mobility can enable access to and navigation in confined, small, hard-to-reach, and sensitive inner body sites, where they can provide new ways of minimally invasive interventions and targeted diagnosis and therapy down to the cellular length scales with high precision and repeatability. The exponential recent progress of the field at the preclinical level raises anticipations for their near-future clinical prospects. To pave the way for this transformation to happen, however, the formerly proposed microrobotic system designs need a comprehensive review by including essential aspects that a microrobot needs to function properly and safely in given in vivo conditions of a targeted medical problem. The present review provides a translational perspective on medical microrobotics research with an application-oriented, integrative design approach. The blueprint of a medical microrobot needs to take account of microrobot shape, material composition, manufacturing technique, permeation of biological barriers, deployment strategy, actuation and control methods, medical imaging modality, and the execution of the prescribed medical tasks altogether at the same time. The incorporation of functional information pertaining each such element to the physical design of the microrobot is highly dependent on the specific clinical application scenario. We discuss the complexity of the challenges ahead and the potential directions to overcome them. We also throw light on the potential regulatory aspects of medical microrobots toward their bench-to-bedside translation. Such a multifaceted undertaking entails multidisciplinary involvement of engineers, materials scientists, biologists and medical doctors, and bringing their focus on specific medical problems where microrobots could make a disruptive or radical impact.
Magnetically actuated and controlled mobile micromachines have the potential to be a key enabler for various wireless lab-on-a-chip manipulations and minimally invasive targeted therapies. However, their embodied, or physical, task execution capabilities that rely on magnetic programming and control alone can curtail their projected performance and functional diversity. Integration of stimuli-responsive materials with mobile magnetic micromachines can enhance their design toolbox, enabling independently controlled new functional capabilities to be defined. To this end, here, we show three-dimensional (3D) printed size-controllable hydrogel magnetic microscrews and microrollers that respond to changes in magnetic fields, temperature, pH, and divalent cations. We show two-way size-controllable microscrews that can reversibly swell and shrink with temperature, pH, and divalent cations for multiple cycles. We present the spatial adaptation of these microrollers for penetration through narrow channels and their potential for controlled occlusion of small capillaries (30 μm diameter). We further demonstrate one-way size-controllable microscrews that can swell with temperature up to 65% of their initial length. These hydrogel microscrews, once swollen, however, can only be degraded enzymatically for removal. Our results can inspire future applications of 3D- and 4D-printed multifunctional mobile microrobots for precisely targeted obstructive interventions (e.g., embolization) and lab- and organ-on-a-chip manipulations.
The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is increasing steadily. CKD does not only relate to morbidity and mortality but also has impact on quality of life, depression and malnutrition. Such patients often have significantly decreased physical activity. Recent evidence suggests that low physical activity is associated with morbidity, mortality, muscle atrophy, quality of life impairment, cardiovascular outcomes and depression. Based on this, it is now recommended to regularly improve the physical activity of these patients. Furthermore, studies have shown the beneficial effects of various exercise programs with respect to outcomes such as low physical activity muscle atrophy, quality of life, cardiovascular outcomes and depression. Despite these encouraging findings, the subject is still under debate, with various aspects still unknown. In this review, we tried to critically summarize the existing studies, to explore mechanisms and describe future perspectives regarding physical activity in CKD/ESRD patients.
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