Measurement of Blood Dilution during Lancet-Free Blood Sampling.

In this paper, we report on a fluorescent and colorimetric system for measuring the dilution of capillary blood released by a needle-free jet injector. Jet injection uses a high-speed liquid jet to penetrate tissue, and in the process can release capillary blood that can be collected for performing blood tests. In this way, blood sampling can be performed without the use of a lancet.

Soft Electromagnetic Motor and Soft Magnetic Sensors for Synchronous Rotary Motion.

To create fully-soft robots, fully-soft actuators are needed. Currently, soft rotary actuator topologies described in the literature exhibit low rotational speeds, which limit their applicability. In this work, we describe a novel, fully-soft synchronous rotary electromagnetic actuator and soft magnetic contact switch sensor concept.

Vacuum-Assisted Needle-Free Capillary Blood Sampling.

Background: Poor glycemic management persists among people practicing insulin therapy in relation to type 1 and 2 diabetes despite a clear relationship with negative health outcomes. Skin penetration by jet injection has recently been shown as a viable method for inducing blood release from fingertips. This study examines the use of vacuum to enhance the volume of blood released and quantifies any dilution of the collected blood.

Minimally invasive capillary blood sampling methods.

Introduction: Whole blood samples, including arterial, venous, and capillary blood, are regularly used for disease diagnosis and monitoring. The global Covid-19 pandemic has highlighted the need for a more resilient screening capacity. Minimally invasive sampling techniques, such as capillary blood sampling, are routinely used for point of care testing in the home healthcare setting and clinical settings such as the Intensive Care Unit with less pain and wounding than conventional venepuncture.

Case study of user experience-driven design in a new local anaesthetic dentistry jet injection device.

This case study explored how human-centred design methodologies can improve clinician experience and reduce patient treatment anxiety in the application of a new dental local anaesthetic jet-injection system. An initial embodiment of the prototype injector, dubbed the 'Kiwi' injector, was developed to better understand the user experience during dental-injection procedures. Further design development was undertaken in two distinct phases.

Jet injection needle-free dental anaesthesia: Initial findings.

Objectives: We evaluated patient preference and reported levels of anxiety and discomfort of participants treated with a new needle-free electric motor-driven device vs. conventional local anaesthetic for dental extractions in a proof-of-principle study. Healing and response of gingival tissues to injection were also evaluated at 1, 3- and 7-days post-procedure.

Shoulder Joint Stiffness in a Functional Posture at Various Levels of Muscle Activation.

Objective: In this study, we present a method to quantify the mechanics of the shoulder joint in a functional posture, in two degrees of freedom: internal/external rotation and horizontal abduction/adduction.

Methods: We performed experiments on 15 healthy participants using a custom perturbation robot. Perturbations were applied in internal/external rotation and horizontal abduction/adduction, whilst participants applied varying levels of joint torque.

Jet-Induced Tissue Disruption for Blood Release.

Objective: Needle-free jet injection is a drug delivery technique that uses the momentum of the fluid drug to break through the skin. This technique has recently also been applied to blood release, aiming to collect samples from capillaries in the skin without needing a lancet prick. This work provides new information about the wound geometry and tissue disruption caused by shallow jet injection with circular-shaped and slot-shaped jets.

Jet-Induced Blood Release From Human Fingertips: A Single-Blind, Randomized, Crossover Trial.

Background: Lancet pricks are often poorly received by individuals with diabetes; jet injection may allow lancet-free blood sampling. We examine whether the technique of jet injection can release sufficient blood from the fingertip to enable measurement of blood glucose concentration. In addition, we assess the effect of jet shape and cross-sectional area on fluid release, blood dilution, and perceived pain.

Blood Collection from The Porcine Ear Using a Jet Injector.

We present a new lancet-free method of capillary blood collection for the measurement of blood glucose concentration using a needle-free jet injector. This technique is tested on living animals and directly compared to the current best practice, lancet prick. Shallow jet injection into porcine outer-ear was performed using a portable needle-free jet injector with a slot-shaped nozzle.

System Identification to Characterise Shoulder Joint Dynamics in Two Degrees of Freedom.

In this study, we present a new design of a shoulder perturbation robot that can characterise the dynamics of the shoulder in two degrees of freedom. It uses two linear electric motors to perturb the shoulder joint in internal/external rotation and abduction/adduction, and force and position sensors to measure the corresponding torque and angular displacement about the joint. System identification techniques are used to estimate the dynamics of the muscles around the joint.

Ankle torque forecasting using time-delayed neural networks.

A method for ankle torque prediction ahead of the current time is proposed in this paper. The mean average value of EMG signals from four muscles, alongside the joint angle and angular velocity of the right ankle, were used as input parameters to train a time-delayed artificial neural network. Data collected from five healthy subjects were used to generate the dataset to train and test the model.

Laterally Dispersing Nozzles for Needle-assisted Jet Injection.

Most transdermal drug delivery systems are designed to inject drugs through the skin in a direction normal to the skin surface. However, in some applications, such as local anaesthesia, it is desirable to disperse the drug in a direction parallel to the surface of the skin. In this paper we present nozzles for needle-assisted jet injection that are designed to laterally disperse the fluid drug at a chosen depth in tissue.

Classification of diffuse light emission profiles for distinguishing skin layer penetration of a needle-free jet injection.

In this work, a system is developed for tracking the skin layer to which a needle-free jet injection of fluid has penetrated by incorporating a laser beam into the jet, and measuring the diffuse light emitted from skin tissue. Monitoring the injection in this way offers the ability to improve the reliability of drug delivery with this transdermal delivery method. A laser beam, axially aligned with a jet of fluid, created a distribution of diffuse light around the injection site that varied as the injection progressed.

Spatially resolved diffuse imaging for high-speed depth estimation of jet injection.

We investigate the use of spatially resolved diffuse imaging to track a fluid jet delivered at high speed into skin tissue. A jet injector with a short needle to deliver drugs beneath the dermis, is modified to incorporate a laser beam into the jet, which is ejected into ex vivo porcine tissue. The diffuse light emitted from the side and top of the tissue sample is recorded using high-speed videography.

Subcutaneous nicotine delivery via needle-free jet injection: A porcine model.

Subcutaneous delivery of nicotine was performed using a novel electrically-operated needle-free jet injector, and compared to hypodermic needle delivery in a porcine model. Nicotine was delivered as a single, one-milligram dose into the abdominal skin, formulated as a 50 microliter aqueous solution. Plasma levels of nicotine and cotinine, its main metabolite, were then monitored over 2 h, following which the injection site was excised for histological examination.

Viscous Heating Assists Jet Formation During Needle-Free Jet Injection of Viscous Drugs.

Objective: Jet injectors use a high-pressure liquid jet to pierce the skin and deliver drug into underlying tissues. This jet is formed through a short, narrow orifice; the geometry of the orifice and the properties of the fluid affect the nature of the flow. We aimed to discover information about the turbulent and viscous processes that contribute to pressure loss and flow patterns during jet injection.

Power-efficient controlled jet injection using a compound ampoule.

We present a new mechanism for achieving needle free jet injection that significantly reduces the power required to perform a given injection. Our 'compound ampoule' produces two phases of jet speed under a constant force input by changing the effective piston area part-way through the injection. In this paper we define the benefits associated with a compound ampoule, relative to those of the conventional single piston design, by developing expressions for the power and energy required to perform an injection.

The effect of jet speed on large volume jet injection.

Jet injection presents a promising alternative to needle and syringe injection for transdermal drug delivery. The controllability of recently-developed jet injection devices now allows jet speed to be modulated during delivery, and has enabled efficient and accurate delivery of volumes up to 0.3 mL.

High-speed X-ray analysis of liquid delivery during jet injection.

The effect of varying velocity during jet injection on the dispersion of fluid into tissue is investigated using a custom-built X-ray imaging system. Injections are performed into ex-vivo porcine abdominal tissue using a voice coil actuated injection device. Single velocity and two-phase velocity injections reveal the complex nature of the dispersion of the fluid jet in layered tissue and highlight the effects of changing the jet velocity following the initial penetration of the liquid into the tissue.

Light source depth estimation in porcine skin using spatially resolved diffuse imaging.

We present an inexpensive imaging system for measuring the diffuse surface radiance profile produced by a light source within a turbid medium. The diffusion model of light propagation in multiple scattering media is used to estimate the optical properties of a sample and subsequently approximate the depth of an optical source. The system is shown to accurately estimate the relative changes in source depth in a homogeneous phantom.

A device for controlled jet injection of large volumes of liquid.

We present a needle-free jet injection device controllably actuated by a voice coil and capable of injecting up to 1.3 mL. This device is used to perform jet injections of ~900 μL into porcine tissue.

Characterization of needle-assisted jet injections.

Hypodermic injections have been the standard for transcutaneous drug delivery for many years. However, needle phobia, pain, and risks of needle-stick injuries have manifested in poor patient compliance. Needle-free jet injections (NFJI) have been developed to address these drawbacks but the reliability of dose and depth of delivery have been limited by a lack of control over jet parameters, and by variability in the skin's mechanical properties among individuals.

Four-Dimensional Imaging of Cardiac Trabeculae Contracting In Vitro Using Gated OCT.

Cardiac trabeculae are widely used as experimental muscle preparations for studying heart muscle. However, their geometry (diameter, length, and shape) can vary not only among samples, but also within a sample, leading to inaccuracies in estimating their stress production, volumetric energy output, and/or oxygen consumption. Hence, it is desirable to have a system that can accurately image each trabecula in vitro during an experiment.

Measuring the mechanical efficiency of a working cardiac muscle sample at body temperature using a flow-through calorimeter.

We have developed a new `work-loop calorimeter' that is capable of measuring, simultaneously, the work-done and heat production of isolated cardiac muscle samples at body temperature. Through the innovative use of thermoelectric modules as temperature sensors, the development of a low-noise fluid-flow system, and implementation of precise temperature control, the heat resolution of this device is 10 nW, an improvement by a factor of ten over previous designs. These advances have allowed us to conduct the first flow-through measurements of work output and heat dissipation from cardiac tissue at body temperature.