Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, April 22, 2024

Computational Modeling as a Tool to Drive the Development of a Novel, Chemical Device for Monitoring the Injured Brain and Body

 If there were ANY FUNCTIONING BRAINS at all in the stroke medical world this would be looked at as a godsend. You could monitor the neuronal cascade of death as it occurs so you could see which interventions work to save neurons from dying! But we have NO STROKE LEADERSHIP! So you'll continue to be screwed until we get survivors in charge! So start screaming at your incompetent doctors and hospital! Everything in stroke is a complete shitshow!

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind?  Survivors would like to know why you are doing nothing to actually solve stroke. NO excuses allowed,  IT IS YOUR FUCKING JOB TO SOLVE STROKE! GET THERE!

Computational Modeling as a Tool to Drive the Development of a Novel, Chemical Device for Monitoring the Injured Brain and Body

  • De-Shaine Murray*
  • Laure Stickel*
  • , and 
  • Martyn Boutelle

Cite this: ACS Chem. Neurosci. 2023, 14, 19, 3599–3608
Publication Date:September 22, 2023
https://doi.org/10.1021/acschemneuro.3c00063

Copyright © 2023 The Authors. Published by American Chemical Society. This publication is licensed under

CC-BY 4.0.
  • Open Access

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Abstract

Real-time measurement of dynamic changes, occurring in the brain and other parts of the body, is useful for the detection and tracked progression of disease and injury. Chemical monitoring of such phenomena exists but is not commonplace, due to the penetrative nature of devices, the lack of continuous measurement, and the inflammatory responses that require pharmacological treatment to alleviate. Soft, flexible devices that more closely match the moduli and shape of monitored tissue and allow for surface microdialysis provide a viable alternative. Here, we show that computational modeling can be used to aid the development of such devices and highlight the considerations when developing a chemical monitoring probe in this way. These models pave the way for the development of a new class of chemical monitoring devices for monitoring neurotrauma, organs, and skin.

This publication is licensed under

CC-BY 4.0.
  • cc licence
  • by licence

 Special Issue

Published as part of the ACS Chemical Neuroscience special issue “Monitoring Molecules in Neuroscience 2023”.

Introduction

ARTICLE SECTIONS

Analytical chemical monitoring devices are an important way of studying diseased and injured tissue. They typically involve a sampling element, often a commercial microdialysis probe, coupled to a microfluidic manifold that incorporates relevant chemical sensors. Devices of this nature are finding increasing utility due to improvements in real-time, continuous, chemical monitoring and advancements in sampling tissue and organs, such as the brain, by less invasive means. This paper describes the design and development, using the aid of computational modeling, of a new class of sampling device that incorporates tissue sampling directly into the sensor-containing manifold.
The successful sampling and monitoring of tissue extracellular fluid (ECF) can provide vital information for clinicians. (1) Chemical levels that deviate from typical values in the blood and ECF can be useful indicators of the proliferation of disease, degeneration, and damage. (2) The accepted standard for chemical monitoring is the sampling of blood, which requires the repeated removal of small samples for offline analysis using high performance liquid chromatography (HPLC) or mass spectrometry (MS). This analysis can be time-consuming and often misses dynamic changes that occur at faster time scales, for example during the acute progression of diseases. (3)
Accurate detection of patient deterioration by quickly elucidating patterns in disease and injury progression can be achieved by online, real-time measurement facilitated by integrated microfluidic channels within analytical chemical devices. (4) Three main approaches can be employed to achieve continuous monitoring: (1) Implanted electrodes with modified surfaces for chemical transduction through biosensing; (5) (2) optical devices that sense in close proximity to the media in question─using light sources; (6,7) and (3) sampling devices such as microdialysis probes which deliver samples representative of ECF for ex-vivo analysis. (5) Of these methods, implanted electrodes often suffer from disturbances of the electrode surface that lead to drift, ultimately reducing the measurement accuracy and precision over time. (8)
Conversely, optical methods, although noninvasive and thus the most desirable, often lack sufficient sensitivity to provide reliable reporting of dynamic changes in chemical concentrations. (9) Therefore, implantable microdialysis probes that act as delivery devices for analytical equipment outside of the body provide a middle ground between the aforementioned methods. (10) When microdialysis is coupled with microfluidics and linked to ex-vivo biosensors, continuous monitoring of dialysate can be achieved. (11) A distinct advantage here is all sensing apparatus is found outside of the body and thus readily accessible and can be easily replaced when performance issues are observed. (12) This has been shown with the development of continuous online microdialysis (coMD) (13,14) which displays data at 200 samples per second, with a slight offset delay.
However, the probes that afford this analysis are concentric in nature and penetrate tissue directly to establish a diffusional concentration gradient. On the order of a few 100 μm, such diameters create penetration injuries, which lead to inflammation and the development of barriers of tissue that can surround and hamper the sampling probe. (15,16) The retrodialysis of dexamethasone, a glucocorticoid anti-inflammatory, has been employed by Varner et al, to alleviate such barriers by reducing the proliferation of abnormal tissue and thus enhancing the level of detection at the sampling zone. (17,18) However, such pharmacological interventions can be completely avoided by designing surface probes that do not have to be inserted into the cortex and as such do not create penetrative injuries upon placement. It is worth noting that such devices can only currently be utilized when a craniectomy or craniotomy has occurred but the “softness” of these prospective technologies means that surface probes could be folded and introduced in minimally invasive ways, such as through a burr hole, before being unraveled. (19,20)
Surface microdialysis (s-μD) is not a new concept. Foundational work from Abrahamsson, Akesson, and colleagues led to the development of a probe that can be sutured to the heart, bowel, liver, and other tissue. (21−23) This device is now commercially available and is known as the OnZurf probe. The devices that follow the general principles described here build on this work but incorporate soft, flat, and flexible materials and a different form factor. Such materials allow for the incorporation of flexible electronics using soft lithography and the possibility of developing new surgical protocols to reduce the risk of surgery on a very fragile region of the body. (20)
By extension, such devices can also make for useful environments to support cell growth, monitoring, and the development of cellular layers into organs, for organ-on-a-chip (OOAC) and organ-in-a-chip (OIAC) applications. The use of semipermeable membranes can allow for the delivery of nutrients to a tissue chamber and the corresponding microfluidics can be used for rapid chemical stimulation. (24,25) Therefore, the development of soft, flexible, near 2-dimensional sampling microdialysis probes solves many immediate issues with chemical monitoring of tissues and has a wide applicability that spans multiple subfields of bioengineering. Such devices open the possibility of monitoring tissues on different scales:
  • In-vivo monitoring could be easily implemented to assess the brain after trauma, with thin, conformal and biocompatible devices being placed directly on the surface of the brain under the dura. Less damage would be sustained to the tissue during implantation, reducing the foreign body response (FBR) and increasing the viability and longevity of the implanted device.

  • Ex-vivo monitoring would benefit from the use of such devices. For example, the chemical state of a kidney could be continually monitored for health and function in transit, without penetrative injuries. (26) As transplant organs are very sensitive, preserving their integrity while getting clear updates about their health (with minimal damage) would be essential to performing successful transplant operations.

  • OOAC and OIAC experiments could be developed using these devices where tissue slices could be placed in close proximity to, or be directly embedded within, the device. Using the microfluidic characteristics of the analytical chemical device, the conditions and delivery of nutrients these tissues would need to survive could be mimicked, in addition to the simulation of disease states. (27−29)

  • Skin monitoring using such noninvasive, conformal devices could monitor the composition of sweat on the surface of the skin. (30) Consumer health, such as fitness monitors or continuous glucose monitoring for diabetes, could benefit from such form factors.

Current fabrication methods offer great freedom of design; therefore, highlighting the critical parameters and design features for effective chemical sampling using microfluidics will greatly aid the development of efficient prototypes. One way of ascertaining these critical parameters is by constructing possible prototypes using computational models. Applying modeling to microfluidic geometries to assess the fluid dynamics and performance of a system is a quick way to home in on feasible, real-world solutions. (31) Such modeling has already been utilized within this field to investigate drug delivery using retrodialysis and tissue damage from low-flow perfusion devices. (32−34) Computational modeling is therefore becoming an increasingly useful tool that allows for the iterative evaluation, development, and optimization of microfluidic and microdialysis systems. (35)
One such computational modeling environment is COMSOL Multiphysics. This is an interactive environment that can be used for solving a range of scientific and engineering questions. COMSOL works on the basis that partial differential equations form the basis of fundamental scientific laws. Within the software, models can be built that simulate physics phenomena by combining these partial differential equations, without the need for an in-depth knowledge of mathematics. A key differentiator of COMSOL is the ability to model and investigate multiple phenomena at the same time, which is more indicative of real-world scenarios, where multiple variables can impact the performance of your system. (36) However, users of such software should be aware that such tools should only be used as a guide for their experimental counterparts and are, more often than not, based on assumptions and simplifications. In addition, although time can be saved by using modeling such as COMSOL, there is a computational cost, and this increases with the complexity of the model that is created. With the increase in computational power available at a low cost, we can also go beyond modeling simple fluidic components as circuit analogies or numerical solutions and generate large data sets without conducting physical experiments. For even more complex systems, where a system cannot be adequately modified from first-principles, machine learning can be utilized to probe complex microfluidic behavior. (37,38)
In this paper, we show how modeling can be implemented, in order to optimize the prototyping of near-2D sampling devices. We consider the separation of consecutive signals, multiple sampling points, and changing the geometry of channels in order to ascertain key considerations for robust chemical sampling with high resolution and minimal time delay, with potential applicability to neuromonitoring.
 
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