Abstract: Compositions and methods are described for detecting enzyme activity in a live organism (e.g., animal) are provided.

Abstract: In a composition aspect of the invention, a nanoparticle coating comprises repeating polyacrylic acid monomers covalently bound together in an aliphatic chain having a plurality of carboxylic acid functional groups and modified carboxylic acid functional groups extending therefrom. A first portion of the modified carboxylic acid functional groups are modified by a PEG oligomer having a terminal methoxy functional group and a second portion of the modified carboxylic acid functional groups are modified by a PEG oligomer having at least one terminal sulfur moiety.

Abstract: In a composition aspect of the invention, a nanoparticle coating comprises repeating polyacrylic acid monomers covalently bound together in an aliphatic chain having a plurality of carboxylic acid functional groups and modified carboxylic acid functional groups extending therefrom. A first portion of the modified carboxylic acid functional groups are modified by a PEG oligomer having a terminal methoxy functional group and a second portion of the modified carboxylic acid functional groups are modified by a PEG oligomer having at least one terminal catechol group.

Abstract: The present invention is directed generally to eukaryotic cells comprising single-celled organisms that are introduced into the eukaryotic cell through human intervention and which transfer to daughter cells of the eukaryotic cell, and methods of introducing such single-celled organisms into eukaryotic cells. The invention provides single-celled organisms that introduce a phenotype to eukaryotic cells that is maintained in daughter cells. The invention additionally provides eukaryotic cells containing magnetic bacteria. The invention further provides eukaryotic cells engineered with single-celled organisms to allow for multimodal observation of the eukaryotic cells. Each imaging method (or modality) allows the visualization of different aspects of anatomy and physiology, and combining these allows the imager to learn more about the subject being imaged.

Abstract: The present invention provides polypeptides, peptide dimer, and multimeric complexes comprising at least one binding moiety for KDR or VEGF/KDR complex, which have a variety of uses wherever treating, detecting, isolating or localizing angiogenesis is advantageous. Particularly disclosed are synthetic, isolated polypeptides capable of binding KDR or VEGF/KDR complex with high affinity (e.g., having a KD<1 ?M), and dimer and multimeric constructs comprising these polypeptides.

Abstract: Image enhancing contrast agents for use in diagnostic and/or therapeutic methods, particularly in the form of gas-filled microvesicles, with enhanced stability. The gas-filled microvesicles are stabilized by a layer of amphiphilic material and comprise from 0.15% to 1.0% by moles of a lipid bearing a hydrophilic polymer. The lipid bearing a hydrophilic polymer is preferably a phospholipid linked to polyethyleneglycol.

Abstract: Compounds as defined herein are provided which are useful in (1) diagnostic methods for detecting and/or identifying cells presenting PSMA; (2) compositions comprising a compound of the invention together with a pharmaceutically acceptable diluent; and (3) methods for imaging prostate cancer cells.

Abstract: A sterilization device (1) with electron beams for thin walled containers (C) comprises a sterilization chamber provided with a first electron cannon (28a) positioned horizontally and a further electron cannon (28c) positioned vertically, to strike the container from different angles.

Abstract: Flow cytometer systems are provided that mitigate aerosols generated during operation of a flow cytometer. A flow cytometer system can include various combinations of: a flow cytometer instrument base, a flow cytometer, and a biosafety hood (BSH). In some embodiments, a subject flow cytometer system includes a flow cytometer instrument base, a flow cytometer, and a BSH. In some embodiments, a subject flow cytometer system includes a flow cytometer instrument base and a flow cytometer. In some cases, a BSH includes an aerosol management system, which provides a redundant air filtration system. Also provided are components of a flow cytometer system (e.g., a BSH configured to attach to a flow cytometer instrument base, a flow cytometer instrument base configured to attach to a BSH, etc.). Also provided are methods, including methods of performing a flow cytometric procedure using a flow cytometer system; and methods of decontaminating a flow cytometer system.

Abstract: A chlorine dioxide gas generator including a frame body which houses a first chemical tank which is filled with a first chemical containing chlorite, a second chemical tank which is filled with a second chemical containing acid, a reactor which causes a reaction between the first chemical containing chlorite and the second chemical containing acid, and a separation tank which separates a chlorine dioxide gas from a chlorine dioxide solution generated in the reactor, the chlorine dioxide gas generator being adapted to disinfect an enclosed space by means of the chlorine dioxide gas.

Abstract: A fragrance composition comprising a low vapor pressure VOC and at least one low vapor pressure VOC potentiator compound, which reduces, or altogether completely obviates the use of HVPVOC solvents in fragrance compositions.

Abstract: A scent delivery system includes first and second scent delivery units and a central controller. The central controller is configured to generate command data capable of affecting operation of at least the first and second units based on one or more scenting schedules. The central controller is also configured to determine a relatedness and an order of priority between the units, and determine whether a desired activation time for the first unit overlaps at least partially with a desired activation time for the second unit. Based upon determination that the first unit is related to the second unit and that a desired activation time for the first unit overlaps at least partially with a desired activation time for the second unit, the central controller is configured to coordinate activity level of each of the first and second delivery units during the overlapping activation time according to the order of priority.

Abstract: A method of manufacturing a nonwoven including the steps of: forming a nonwoven web substantially comprised of continuous fibers; applying a bonding pattern to said nonwoven web using a smooth roll and a calender roll wherein said bonding pattern comprises a pattern having unbonded areas; and subjecting the side of said nonwoven web contacted by said smooth roll to a hydraulic treatment at a pressure of between 25 and 75 bars and a total energy of about 0.01-0.04 kwhr/kg., wherein said continuous fibers are comprised of between 97% and 98.5% by weight of an olefin resin comprising substantially of polypropylene and between 1.5% and 3% by weight of a whitener.

Abstract: Materials and methods for immobilizing bioactive molecules, stem and other precursor cells, and other agents of therapeutic value in surgical sutures and other tissue scaffold devices are described herein. Broadly drawn to the integration and incorporation of bioactive materials into suture constructs, tissue scaffolds and medical devices, the present invention has particular utility in the development of novel systems that enable medical personnel performing surgical and other medical procedures to utilize and subsequently reintroduce bioactive materials extracted from a patient (or their allogenic equivalents) to a wound or target surgical site.

Abstract: Biomedical and tissue engineering devices, such as surgical sutures and microporous scaffolds, respectively, which undergo swelling and increase in dimensions when placed in aqueous environments such as living tissues, are produced by the melt-spinning or electrostatic spinning into strong monofilament and multifilament yarns or microfibrous fabrics, respectively. Such devices are formed from especially high molecular weight crystalline polyether-esters having a minimum inherent viscosity of 0.8 dL/g and heat of fusion of at least 5 J/g, wherein the polyether-esters are made by grafting to a polyester component a polyether glycol component having a minimum molecular weight of about 11 kDa with at least one cyclic monomer.

Abstract: The invention relates to tissue adhesives or sealants, more specifically to fibrinogen based sealants reinforced with particulate material and chemically cross-linked. More particularly, the present invention is directed to tissue sealant, adhesive, hemostat, or scaffolding material containing thrombin, fibrinogen, a biocompatible particulate material having amine functionality, and a biocompatible polymer containing aldehyde groups. The present invention is also directed to methods for the use of such materials.

Abstract: The disclosure relates to a composition that is liquid at a temperature below the body temperature of a mammal and that solidifies at or above the body temperature of the mammal. The composition includes a thermally-desolubilizable polymer interspersed with a polymeric component of extracellular matrix and an encapsulated form of an amine compound (preferably an aminated component of extracellular matrix) that is de-encapsulated in the body of the mammal. The polymeric component is able to form covalent bonds with amine moieties in the aminated component, in one or more tissues in the body of the mammal, or both. Upon injection of a liquid suspension of these components into the body of the mammal, the thermally-desolubilizable polymer condenses, entrapping the polymeric component. The polymeric component binds covalently with a tissue in the body, and the aminated component end-caps the remaining reactive moieties of the polymeric component, forming a matrix at the site of injection.

Abstract: A system is provided, including a plurality of donor cells and a first alginate structure that encapsulates the plurality of donor cells. The first alginate structure has a guluronic acid concentration of between 64% and 74%. The system additionally includes a second alginate structure that surrounds the first alginate structure, the second alginate structure having a mannuronic acid concentration of between 52% and 60%. A selectively-permeable membrane is coupled at least in part to the second alginate structure. Other embodiments are also described.

Abstract: A method for the creation of endothelial parent vessels from human vascular endothelial cells in vitro in a culture perfusion device (CPD) including a collagen chamber, inlet ports, a capillary tube, and an outlet port. A collagen solution is injected into the collagen chamber through a syringe needle until the chamber is filled with collagen. The CPD is perfused by filling the inlet ports and sequentially priming the inlet ports, and the outlet ports. A perfusable channel is created in the collagen chamber and a concentrated suspension of endothelial cells is injected into the inlet ports. The endothelial cells are injected into the at least one perfusable channel and incubated to attach to the walls of the perfusable channel. The cells are distributed within the CPD; and perfused to form a parent vessel having homogeneous monolayers of cells.

Abstract: The invention provides a particulate composition adapted for forming a bone graft substitute cement upon mixing with an aqueous solution, comprising i) a calcium sulfate hemihydrate powder, wherein the calcium sulfate hemihydrate is present at a concentration of at least about 50 weight percent based on the total weight of the particulate composition; ii) a monocalcium phosphate monohydrate powder; iii) a non-porous ?-tricalcium phosphate powder; and iv) a porous ?-tricalcium phosphate powder. Bone graft substitute cements made therefrom, a bone graft substitute kit comprising the particulate composition, methods of making and using the particulate composition, and articles made from the bone graft substitute cement are also provided.

Abstract: An object of the present invention is to provide a tube which can be easily torn and has a large heat-shrinkability at a low temperature. The tube of the present invention is a heat-shrinkable tube having tearability, including a mixture of a fluorine resin and a different kind of resin from the fluorine resin, in which an amount of change in loss energy, ?E loss, with change in temperature from 175° C. to 185° C. is a positive value.

Abstract: Bioabsorbable polymer scaffolds with coatings are disclosed that include immobilized antithrombotic agents on the scaffolds or in or on the coatings. The agents act synergistically with antiproliferative agents released from coatings by providing hemocompatibility during and without interfering with antiproliferative agent release. Methods of modifying scaffolds and coatings with the antithrombotic agents are disclosed.

Abstract: A block copolymer comprising a fluorinated block and a non-fluorinated block and method of making the block copolymer are provided. Also provided herein are a coating on an implantable device comprising the block copolymer and method of using the implantable device.

Abstract: A bioerodible endoprosthesis includes a composite including a matrix comprising a bioerodible magnesium alloy and a plurality of ceramic nanoparticles within the matrix. The bioerodible magnesium alloy has a microstructure including equiaxed Mg-rich solid solution-phase grains having an average grain diameter of less than or equal to 5 microns. The microstructure can be produced by one or more equal-channel high-strain processes.

Abstract: Methods for treating or preventing neointima stenosis are disclosed. The methods generally involve the use of a TGF? inhibitor, a SMAD2 inhibitor, an FGF Receptor agonist, a Let-7 agonist, or a combination thereof, to inhibit endothelial-to-mesenchymal transition (Endo-MT) of vascular endothelial cells into smooth muscle cells (SMC) at sites of endothelial damage. The disclosed methods can therefore be used to prevent or inhibit neointimal stenosis or restenosis, e.g., after angioplasty, vascular graft, or stent. Also disclosed are methods for increasing the patency of biodegradable, synthetic vascular grafts using a composition that inhibits Endo-MT. A cell-free tissue engineered vascular graft (TEVG) produced by this method is also disclosed.

Abstract: Dressings, systems, and methods for treating a tissue site on a patient involve allowing liquids from the tissue site or a priming fluid to evaporate and exit the dressing through a liquid-impermeable, vapor-permeable membrane. The dressing is able to process more liquids than would otherwise be possible without evaporation and potentially to create reduced pressure. Other dressings, systems, and methods are disclosed.

Abstract: In one embodiment of the invention, a robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site. The robotic surgical instrument may include a housing, a flow control system, a hollow tube, and one or more hose fittings. The housing to couple the instrument to a robotic arm. The flow control system mounted in the housing includes one or more controlled valves to control the flow of one or more fluids. The hollow tube has a first end mounted in the housing coupled to the flow control system. A second end of the hollow tube has one or more openings to allow the flow of fluids into and out of the surgical site. The hose fittings have a first end coupled to the flow control system and a second end to couple to hoses.

Abstract: An apparatus for cleansing wounds, in which wound exudate is removed from a wound bed and selectively cleansed and returned to the wound. The cleansing means removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The associated wound dressing and cleansing means are conformable to the wound, and may have irrigant fluid circulated from a reservoir by a device for moving fluid through a flow path which passes through the dressing and a means for fluid cleansing and back to the dressing.

Abstract: In various embodiments, a catheter pump is disclosed herein. The catheter pump can include an elongated catheter body having a distal portion including an expandable cannula having an inlet and an outlet. The expandable cannula can have a delivery profile and an operational profile larger than the delivery profile. An impeller assembly can include an impeller shaft, and an impeller body can include one or more blades. The impeller blades can draw blood into the cannula when rotated. Further, an expandable support can have a mounting portion disposed on the impeller shaft distal of the impeller body and a cannula contact portion for reducing a change in tip gap due to bending of the cannula. The cannula contact portion can be disposed distal of the mounting portion.

Abstract: Methods and apparatus for controlling the operation of, and providing power for and to, implantable ventricular assist devices which include a brushless DC motor-driven blood pump, are disclosed. In one embodiment, a control system for driving an implantable pump is provided. The digital processor is responsive to data associated with the operation of the pump received at the data transfer port, and from the program data stored in memory, (i) to determine therefrom, the identity of the pump, (ii) to determine therefrom, electrical characteristics and features of the identified pump, and (iii) to adaptively generate and apply to the data port, control signals for driving the identified pump. Latch mechanisms, an elongated flexible electrical cable with a strain relief segment, and a lower housing portion that is heavier than an upper housing portion, may also be provided with the control system.

Abstract: A washer press apparatus for washing and dewatering a wide range of solids concentrations of pulp in liquid suspensions includes multiple distinct displacement wash zones about a drum with multiple nips.

Abstract: A filling device of a fluid conducting system of an extracorporeal blood treatment device is disclosed. The filling device includes a spike that is adapted for connection to a single fluid connector of a medical fluid container of the fluid system and a manually operable fluid blocking mechanism that is arranged directly downstream of the spike and is adapted or provided in such a way so as to remain fluidly connected with the spike while the filling device is in operation. The fluid blocking mechanism has at least one fluid outlet connector that is adapted so that a line section or hose of the fluid conducting system, preferably an arterial line section of a blood purification device, can be connected to it in a detachable manner while the filling device is in operation.

Abstract: A cannula for a patient includes an elongate body having a length of at least 70 cm and a channel extending through the body defining a wall. The cannula includes a wire embodied within at least a portion of the wall. The body has a proximal end, a distal end having a tip opening through which the channel extends and a plurality of side holes through the wall in proximity to the tip for unimpeded flow of blood at the distal end. The cannula includes a barbed fitting at the proximal end. The cannula includes a suture wing for securing the elongated body to the patient. A system for assisting a patient's heart. A method for assisting a patient's heart.

Abstract: An object of the present invention is to provide an infusion preparation in which the Maillard reaction between an amino acid and a reducing sugar does not occur during storage and the size of fat particles in the fat emulsion does not increase during storage, and in which various types of vitamins can be incorporated in a stable manner, in spite of the fact that it is a two-chamber infusion preparation. Furthermore, even if only one of the infusions (of the infusion preparation) is administered, the patient is unlikely to develop hyperkalemia, vascular pain, or phlebitis. The present invention provides an infusion preparation containing two chambers separated by a partition that can be communicably opened, wherein a first chamber contains a first-chamber infusion containing a sugar and a fat emulsion, a second chamber contains a second-chamber infusion containing an amino acid and an electrolyte, the first-chamber infusion is substantially free of potassium, and has a relative osmotic pressure of 2.0 to 3.

Abstract: Devices and methods for delivering therapeutic fluid to a patient's body are described. The devices may comprise a dispensing unit having a reservoir, a driving mechanism having a movable member for delivering therapeutic fluid to a patient's body, at least one sensor for sensing a relative position of the movable member and generating a signal, and a processor for controlling the driving mechanism to deliver an amount of therapeutic fluid that compensates for a change in the flow of the therapeutic fluid occurring during fluid delivery. The methods may be implemented by operating the driving mechanism, receiving a signal based on the position of the movable member, determining an amount of therapeutic fluid to deliver, and controlling the driving mechanism to deliver an amount of fluid that compensates for a change in flow occurring during fluid delivery.

Abstract: Some embodiments of an infusion pump system can be configured to provide improved safety monitoring features so that a user receives proper dosage amounts.

Abstract: Some embodiments of an infusion pump system may be configured to detect when at least one component of the pump system is exposed to a moisture level above a threshold level. In particular embodiments, the infusion pump system can be equipped with a moisture level detection system that can sense when a moisture level above the threshold level has occurred to the pump device, which thereby enables the infusion pump system to initiate one or more patient safety countermeasures.

Abstract: An infusion pump assembly includes a locking tab and a pump barrel inside a pump barrel housing, where the pump barrel accommodates a reservoir assembly. The reservoir assembly includes a reservoir and a plunger rod. The infusion pump assembly also includes a locking disc at a terminus of the pump barrel. The locking disc includes a clearance hole for the plunger rod. The locking disc also includes at least one locking tab notch in close proximity with the locking tab. The locking tab is in moveable engagement with the locking tab notch, and the reservoir moves the locking tab from a locked position to an unlocked position when the plunger rod is inserted through clearance hole. The locking disc rotates upon torque being applied to the reservoir assembly, the locking disc rotating from a non-loaded position to a loaded position with respect to the plunger rod and a drive screw.

Abstract: Devices and methods for tissue transfer are described where a cannula may be inserted into the breast of a subject at one of several points of entry. Insertion of the cannula into the breast may be accomplished by using a guidance system to distinguish between tissue types. Once desirably positioned, the cannula may be withdrawn from the breast while automatically (or manually) injecting the fat in multiple deposits of adipose tissue or fat such that the deposited fat remains within the tract formed by the withdrawn cannula. Multiple tracts of the deposited fat may be injected within the breast until the breast has been desirably remodeled and/or augmented.

Abstract: A needle assembly for a hypodermic syringe is disclosed herein. In various aspects, the needle assembly includes a hub and a needle. A bond secures the needle to the hub, and the bond is configured to break allowing the needle to be withdrawn entirely from the hub upon application of a selected axial force to the needle, in various aspects. The axial force may be less than the tensile strength of the needle. Related methods of use of the needle assembly apparatus are disclosed herein. This Abstract is presented to meet requirements of 37 C.F.R. §1.72(b) only. This Abstract is not intended to identify key elements of the apparatus and the related methods disclosed herein or to delineate the scope thereof.

Abstract: A medical pump or the like provides a flow sensor element that may be integrated into the IV tubing assembly. The flow sensor element fits within the medical pump which may provide for capacitive plates sensing changes in the electrical environment within the flow sensor element to deduce flow. For example, the flow sensor element may promote free space liquid drops that cause a periodic change in capacitance across the flow sensor element or the flow sensor element may hold a physical turbine or the like whose movement changes the capacitance across the capacitive plates.

Abstract: An implantable pump includes a base plate and a can that are parts of the pump housing. The base plate bottom divides the housing into a first electronics chamber and a second chamber. A bellows mechanism is connected to the base plate and is disposed within the second chamber. The bellow mechanism has an expandable sidewall and a bottom plate. The bellow mechanism divides the second chamber into a medicament receiving portion and a non-medicament-receiving portion. The bellow mechanism has an intermediate plate disposed within the medicament-receiving portion. A coil is disposed in a recess on the lower surface of the base plate, and the coil is spaced from an internal wall of the recess. The amount of fluid remaining in the implantable pump can be monitored by energizing the coil. A primary magnetic field is generated by the energized coil.

Abstract: A dosing unit for an ambulatory infusion pump device is presented. The dosing unit comprises a cylinder pump with a cylinder and a piston arranged in the cylinder. The piston has a shaft with a first threaded segment interacting with a threaded portion of the cylinder and can be displaced along a longitudinal axis of the cylinder by rotating the piston in regard to the cylinder around the axis. Furthermore, the piston allows for the relative or absolute determination of the longitudinal and/or rotational displacement of the piston in regard to the cylinder. In one embodiment, the piston shaft comprises a second segment provided with optically detectable markings that allow the monitoring of the longitudinal and/or rotational displacement of the piston in regard to the cylinder.

Abstract: Methods and systems for encouraging interactions with a glucose monitoring system include incrementing a score and/or providing a reward based on a variety of different interactions with the glucose monitoring system. The interactions which improve the score may include initiating or changing displays, downloading data, setting operational parameters and other interactions that are independent of a user's glucose measurements. Encouraging these interactions can enhance success in maintaining healthy glucose concentrations.

Abstract: An exemplary embodiment of the present disclosure can provide an injector including a trigger mechanism, an energy source, and a user-operable firing-initiation member. The trigger member can include a trigger member having a retainer portion, and a ram assembly having a ram configured to pressurize a medicament container for expelling a medicament therefrom and a trigger engagement member configured to engage the retainer portion of the trigger member in a pre-firing condition. The energy source can be associated with the ram for powering the ram to expel the medicament, and the user-operable firing-initiation member can be operable for causing an axial rotation between the trigger engagement member and the retainer portion from the pre-firing condition to a firing condition in which the trigger engagement member is released from the retainer portion to allow the energy source to fire the ram.

Abstract: An auto-injector comprises a chassis to contain a syringe with a, needle and a stopper, a needle shroud slideable within the chassis and adapted to rest on the skin of a patient, a plunger adapted to translate the stopper to expel medicament, a coupling shroud slideable within the chassis and releasably coupled to the plunger and a drive means, the drive means driving the coupling shroud proximally from a first position Proximal movement of the coupling shroud translates the syringe exposing the needle, depresses the plunger to expel medicament and advances the needle shroud to a safe position to surround the needle. The needle shroud arranged to prevent decoupling of plunger and coupling shroud when the needle shroud is in a retracted position, whereas the needle shroud is arranged to allow decoupling of plunger and coupling shroud when the needle shroud is moved towards the safe position.

Abstract: Intranasal delivery devices include dosage forms containing medical compositions for use in the intranasal devices, and methods of delivering medical compositions to the nasal mucosa of users. The devices dispense a predetermined quantity of fluid into the nasal passage of a user, in which the predetermined quantity of fluid is contained in, or produced in a dosage form or blister that is crushed by a plunger with sufficient force to drive the dosage form against a piercing mechanism, piercing the dosage form and forcing the liquid contents from the dosage form and through a delivery channel into a spray to be directed into the nasal passage of a user. The plunger is connected to a trigger device by a linkage that confers a mechanical advantage to the trigger mechanism.

Abstract: A medicated module for an injection system to co-deliver at least two medicaments is disclosed where a primary delivery device containing a primary medicament accepts a medicated module containing a single dose of a secondary medicament and where both medicaments are delivered through a hollow needle. The medicated module is initially in a locked state until attached to a drug delivery where a locking plate is moved to a triggering state. The medicated module does not require the user to manually engage a reservoir containing the secondary medicament. Instead, a biasing member automatically activates the reservoir when the needle guard is retracted when the module is in the triggering state. The needle guard prevents accidental needle sticks before and after an injection, and locks after dose delivery.

Abstract: Syringes and methods of using are described which protect the syringe barrel cavity from contaminants. A first syringe is formed with a corrugated sheath which encloses the plunger and space between the rearward end face surface of the syringe barrel handle member and the forward face of the plunger handle member. A second syringe is formed with a syringe barrel having a straight segment and a corrugated segment having the forward face of the plunger handle member molded to the rearward terminus of the corrugated segment of the syringe barrel. A third syringe is formed from mating syringe barrel and plunger member walls. The walls of the mating syringe barrel and plunger member are concentric and slide relative to each other while maintaining an enclosure around the plunger shaft. A fourth syringe is formed from inner and outer concentric syringe barrel walls mating with the walls of a plunger member.

Abstract: A drug delivery device includes a cartridge (211) for storing a medicament and a needle (203) communicating with the cartridge (211) for injecting a medicament dose. A rack (241) is movably disposed in the cartridge (211) and is engageable with a stopper (213) for expelling the medicament dose from the cartridge (211). A lever assembly (231) has a lever arm (233) connected to a lever gear (230). The lever gear (232) is engaged with the rack (241) such that rotation of the lever arm (233) rotates the lever gear (232) during injection of the medicament dose, thereby moving the rack (241) and stopper (213) through the cartridge (211) to deliver the medicament dose.