Three babies given 3-D printed custom-designed airway splints found healthy in follow-up study

April 29, 2015

Three babies who received groundbreaking 3-D-printed devices that helped keep their airways open are today healthy, off of ventilators, and no longer need paralytics, narcotics and sedation, say researchers have closely followed their cases to see how well the bioresorable splints implanted in all three patients have worked.

The promising results were published in today’s (April 29) issue of Science Translational Medicine.

Kaiba was just a newborn when he turned blue because his little lungs weren’t getting the oxygen they needed. KurzweilAIreported the splint implant procedure in 2013.

Garrett spent the first year of his life in hospital beds tethered to a ventilator, being fed through his veins because his body was too sick to absorb food. Baby Ian’s heart stopped before he was even six months old.

The three babies all had the same life-threatening condition: a terminal form of tracheobronchomalacia, which causes the windpipe to periodically collapse and prevents normal breathing. There was no cure and life-expectancies were grim.

They became the first in the world to benefit from groundbreaking 3-D-printed devices that helped keep their airways open, restored their breathing, and saved their lives.

UM Health System | How 3D printed devices saved three babies’ lives at Mott

Little chance of surviving previously

“Before this procedure, babies with severe tracheobronchomalacia had little chance of surviving,” said senior authorGlenn Green, M.D., associate professor of pediatric otolaryngology at C.S. Mott Children’s Hospital. “Today, our first patient Kaiba is an active, healthy 3-year-old in preschool with a bright future.

“The device worked better than we could have ever imagined. We have been able to successfully replicate this procedure and have been watching patients closely to see whether the device is doing what it was intended to do. We found that this treatment continues to prove to be a promising option for children facing this life-threatening condition that has no cure.”

Using 3D printing, Green and his colleague Scott Hollister, Ph.D., professor of biomedical engineering and mechanical engineering and associate professor of surgery at U-M, were able to create and implant customized tracheal splints for each patient. The device was created directly from CT scans of their tracheas, integrating an image-based computer model with laser-based 3D printing to produce the splint.

The specially designed splints were placed in the three patients at C.S. Mott Children’s Hospital. The splint was sewn around their airways to expand the trachea and bronchus and give it a skeleton to aid proper growth. The splint is designed to be reabsorbed by the body over time. The growth of the airways were followed with CT and MRI scans, and the device was shown to open up to allow airway growth for all three patients.

No complications

The findings reported today suggest that early treatment of tracheobronchomalacia may prevent complications of conventional treatment such as a tracheostomy, prolonged hospitalization, mechanical ventilation, cardiac and respiratory arrest, food malabsorption and discomfort. None of the devices, which were implanted in then 3-month-old Kaiba, 5-month-old Ian and 16-month-old Garrett have caused any complications.

The findings also show that the patients were able to come off of ventilators and no longer needed paralytics, narcotics and sedation.  Researchers noted improvements in multiple organ systems. Patients were also relieved of immunodeficiency-causing proteins that prevented them from absorbing food, so that they no longer needed intravenous therapy.

Doctors received emergency clearance from the FDA to do the procedures for each child. The authors say the procedure was not designed for device safety and that rare potential complications of the therapy may not yet be evident. However, Richard G. Ohye, M.D., head of pediatric cardiovascular surgery at C.S. Mott, who performed the surgeries, says the cases provide the groundwork to potentially explore a clinical trial that could help other children with less-severe forms of tracheobronchomalacia in the future.

Abstract of Mitigation of tracheobronchomalacia with 3D-printed personalized medical devices in pediatric patients

Three-dimensional (3D) printing offers the potential for rapid customization of medical devices. The advent of 3D-printable biomaterials has created the potential for device control in the fourth dimension: 3D-printed objects that exhibit a designed shape change under tissue growth and resorption conditions over time. Tracheobronchomalacia (TBM) is a condition of excessive collapse of the airways during respiration that can lead to life-threatening cardiopulmonary arrests. We demonstrate the successful application of 3D printing technology to produce a personalized medical device for treatment of TBM, designed to accommodate airway growth while preventing external compression over a predetermined time period before bioresorption. We implanted patient-specific 3D-printed external airway splints in three infants with severe TBM. At the time of publication, these infants no longer exhibited life-threatening airway disease and had demonstrated resolution of both pulmonary and extrapulmonary complications of their TBM. Long-term data show continued growth of the primary airways. This process has broad application for medical manufacturing of patient-specific 3D-printed devices that adjust to tissue growth through designed mechanical and degradation behaviors over time.

New material for creating artificial blood vessels developed by Swiss scientists

Human trials expected in a few years
April 29, 2015

Vienna University of Technology (TU Wien) and Vienna Medical University (MedUni Vienna) researchers have developed artificial blood vessels made from a special elastomer material (thermoplastic polyurethanes) with excellent mechanical properties.

The artificial blood vessels are designed to be broken down by the body and replaced with its own tissue. At the end of this restorative process, a natural, fully functional vessel will be once again in place.

Arteriosclerotic vascular disorder is one of the most common causes of death in industrialized countries. A bypass operation is often the only solution. Normally, blood vessels are taken from another part of the patient’s body and used to replace the damaged vessel.

The artificial materials used so far are not fully compatible with body tissue, and the blood vessel can easily become blocked.

Rat experiments successful

To produce the new vascular prostheses, polymer solutions were spun in an electrical field to form very fine threads and wound onto a spool. “The wall of these artificial blood vessels is very similar to that of natural ones,” says Heinz Schima of the Medical University of Vienna.

The polymer fabric is slightly porous, so it allows a small amount of blood to permeate the material. This enriches the wall with growth factors, encouraging migration of endogenous (body’s own) cells.

The new method has proved successful in experiments with rats. “The rats’ blood vessels were examined six months after insertion of the vascular prostheses,” says Helga Bergmeister of MedUni Vienna.

“We did not find any aneurysms, thromboses, or inflammation. Endogenous cells had colonized the vascular prostheses and turned the artificial constructs into natural body tissue.”

A few more preclinical trials are necessary before the artificial blood vessels can be used in humans, which the researchers expect in a few years.

Abstract of Biodegradable, thermoplastic polyurethane grafts for small diameter vascular replacements

Biodegradable vascular grafts with sufficient in vivo performance would be more advantageous than permanent non-degradable prostheses. These constructs would be continuously replaced by host tissue, leading to an endogenous functional implant which would adapt to the need of the patient and exhibit only limited risk of microbiological graft contamination. Adequate biomechanical strength and a wall structure which promotes rapid host remodeling are prerequisites for biodegradable approaches. Current approaches often reveal limited tensile strength and therefore require thicker or reinforced graft walls. In this study we investigated the in vitro and in vivo biocompatibility of thin host-vessel-matched grafts (n = 34) formed from hard-block biodegradable thermoplastic polyurethane (TPU). Expanded polytetrafluoroethylene (ePTFE) conduits (n = 34) served as control grafts. Grafts were analyzed by various techniques after retrieval at different time points (1 week; 1, 6, 12 months). TPU grafts showed significantly increased endothelial cell proliferation in vitro (P < 0.001). Population by host cells increased significantly in the TPU conduits within 1 month of implantation (P = 0.01). After long-term implantation, TPU implants showed 100% patency (ePTFE: 93%) with no signs of aneurysmal dilatation. Substantial remodeling of the degradable grafts was observed but varied between subjects. Intimal hyperplasia was limited to ePTFE conduits (29%). Thin-walled TPU grafts offer a new and desirable form of biodegradable vascular implant. Degradable grafts showed equivalent long-term performance characteristics compared to the clinically used, non-degradable material with improvements in intimal hyperplasia and ingrowth of host cells.

The most comprehensive 3-D map of the universe

April 29, 2015

Astrophysicists have created a 3D map of the universe that spans nearly two billion light years and is the most complete picture of our cosmic neighborhood to date.

The spherical map of galaxy superclusters will lead to a greater understanding of how matter is distributed in the universe and provide key insights into dark matter, one of physics’ greatest mysteries, the astronomers say.

“The galaxy distribution isn’t uniform and has no definable pattern. It has peaks and valleys much like a mountain range. This is what we expect if the large-scale structure originates from quantum fluctuations in the early universe,” said Professor Mike Hudson of the Department of Physics and Astronomy at the University of Waterloo, who co-created the map. The map appears online in an article in the peer-review journal, Monthly Notices of the Royal Astronomical Society.

The lighter blue and white areas on the map represent greater concentrations of galaxies. The red area is the supercluster called the Shapley Concentration, the largest collection of galaxies in the nearby universe. Unexplored areas appear in medium blue.

Understanding dark matter

Knowing the location and motion of matter in the universe will help astrophysicists predict the universe’s expansion and identify where and how much dark matter exists.

Scientists have observed that galaxies move differently because the universe’s expansion is not even. These differences are called peculiar velocities. Our own Milky Way galaxy and its neighbor Andromeda are moving with a speed of 2 million kilometers per hour.

Previous models haven’t fully accounted for this observed motion. Hudson and his team are interested in discovering what structures are responsible for the peculiar velocities. These deviations in the motion of galaxies are a valuable tool to determine the distribution of matter and dark matter on the largest scales.

Dark matter accounts for a large majority of the mass content in the universe. It is a hypothesized form of matter particle that does not reflect or emit light and as a result it can’t be seen or measured directly. The existence and properties of dark matter can only be inferred indirectly through its gravitational effects on visible matter and light.

“A better understanding of dark matter is central to understanding the formation of galaxies and the structures they live in, such as galaxy clusters, superclusters and voids,” said Hudson.

The next step will involve getting more detailed samples of peculiar velocities to enhance the map, in collaboration with researchers in Australia.

Abstract of Cosmological parameters from the comparison of peculiar velocities with predictions from the 2M++ density field

Peculiar velocity measurements are the only tool available in the low-redshift Universe for mapping the large-scale distribution of matter and can thus be used to constrain cosmology. Using redshifts from the 2M++ redshift compilation, we reconstruct the density of galaxies within 200 h−1 Mpc, allowing for the first time good sampling of important superclusters such as the Shapley Concentration. We compare the predicted peculiar velocities from 2M++ to Tully–Fisher and SNe peculiar velocities. We find a value of β* ≡Ω0.55m/b∗= 0.431 ± 0.021, suggesting Ω0.55mσ8,lin = 0.401 ± 0.024, in good agreement with other probes. The predicted peculiar velocity of the Local Group arising from the 2M++ volume alone is 540 ± 40 km s−1, towards l = 268° ± 4°, b = 38° ± 6°, only 10° out of alignment with the cosmic microwave background dipole. To account for velocity contributions arising from sources outside the 2M++ volume, we fit simultaneously for β* and an external bulk flow in our analysis. We find that an external bulk flow is preferred at the 5.1σ level, and the best fit has a velocity of 159 ± 23  km s− 1 towardsl = 304° ± 11°, b = 6° ± 13°. Finally, the predicted bulk flow of a 50 h−1 Mpc Gaussian-weighted volume centred on the Local Group is 230 ± 30 km s−1, in the direction l = 293° ± 8°, b = 14° ± 10°, in agreement with predictions from Λ cold dark matter.

How to control someone else’s arm with your brain

Greg Gage is a neuroscientist. He started out as an electrical engineer before taking a doctorate in neuroscience. Gage also co-runs a company called Backyard Brains. The aim of the company is to promote education and to entice more people into studying neuroscience. Given that an estimated 20 percent of the world will have a neurological disorder, the company argues such research is of social importance.

This was the theme of Dr. Gage’s recent TED talk (and the second time that Gage had been given the opportunity to appear on the TED channel). TED (Technology, Entertainment and Design) is a nonprofit devoted to spreading ideas, usually in the form of short, powerful talks.

In the presentation, Gage outlines his latest neuroscience equipment. For this he picks out a young woman from the audience and places electrodes onto her arm. Gage then proceeds to play the neuron activity via a speaker as the woman squeezes her arm and generates motor activity.

Gage then calls on a male volunteer and connects him to a “human-to-human interface.” The young woman then uses her brain to control the arm of the man. This is performed through the transmission of electrical impulses. The remarkable feat is shown in the video below.

The educational aspect of Gage’s company involves providing similar neuroscience experiment kits for students of all ages to learn about electrophysiology. The products on offer include kits designed to let people see and hear brain signals from living neurons and devices to allow the robotic control of ordinary cockroaches (termed the “Roboroach.”) With the brain signals, the kit allows students to stimulate neurons in insects and record the resulting electrical signals on a smartphone.

With the Roboroach, those who wish to use the kit can snip the ends of a cockroach’s antennae and thread them with a wire. The wire connects to a battery pack paired with a mobile app. Once this is set up, a finger swipe sends an electrical impulse down the antennae to the insect’s nervous system, steering it left or right. This was a succesful Kickstarter project.

The approach is not without controversy, as Digital Journal reported back in 2013. Here we noted that some people were concerned about cruelty to cockroaches while others, like Michael Allen Fox of Queen’s University in Canada, thinks that the kits trivialize science for they “encourage thinking of complex living organisms as mere machines or tools.”

Read more:

Microsoft Opens Windows 10 to Apple, Android Apps

SAN FRANCISCO — Microsoft hopes to get more people using the next version of its Windows software on all kinds of devices by giving them access to many of the same apps they’re already using on Apple or Android phones.

In a major strategy shift, a top executive told an audience of several thousand software developers Wednesday that Microsoft will release new tools to help them quickly adapt the apps they’ve built for Apple or Android gadgets, so they will work on smartphones, PCs and other devices that use the new Windows 10 operating system coming later this year.

On the first day of the company’s annual software conference, other executives showed off more uses for Microsoft’s holographic “augmented reality” headset, the HoloLens — although it’s not yet for sale. They also announced the official name for a new web browser, called “Edge,” that they promised will be faster and more useful than the Internet Explorer that’s been a Microsoft mainstay for 20 years.

All those initiatives are tied to the impending release of Windows 10, the centerpiece of Microsoft’s ambitions to regain the stature it commanded when Windows-based PCs dominated the computing world. Today, after losing ground to smartphones and tablets that run software from rivals Apple and Google, Microsoft wants to make Windows 10 the universal software for PCs, phones and other Internet-connected gadgets.

“Windows 10 represents a new generation of Windows, built for an era of more personal computing,” CEO Satya Nadella said during a keynote speech, adding that today’s consumers and corporate workers want to have the same experience when they are using a variety of devices.

Although Microsoft has previously shown off some features of Windows 10, it’s hoping to enlist an army of software developers as allies in its campaign to build enthusiasm for the new release. The company is using the three-day conference, called Build, to demonstrate more features and app-building tools, with an emphasis on mobile devices as well as PCs.

“Our goal is to make Windows 10 the most attractive development platform ever,” Vice President Terry Myerson said.

To win over consumers who use competing software, Microsoft needs to persuade outside developers, who create software for consumers and corporate clients, it’s worth their time to create new apps and programs for Windows 10.

“Getting developer buy-in is absolutely the crucial thing,” said J.P. Gownder, a tech industry analyst at Forrester Research. He said Microsoft has struggled with a “chicken-and-egg” problem, in which developers have been reluctant to build mobile apps for Windows because relatively few people use Windows phones and tablets.

Currently, there are more than 1.4 million apps for Android phones and about the same for Apple devices, while there are only a few hundred thousand apps that work on Windows phones and tablets.

Microsoft’s move to help developers adapt their Apple and Android apps for Windows 10 is a major change from the past, when each company maintained rigid differences in their software platforms. Microsoft is also hoping to entice developers by promising that apps for Windows 10 will work equally well on PCs, mobile gadgets, Xbox game consoles and even the HoloLens.

The company has another big carrot to wave in front of those developers: Microsoft has already said it will release Windows 10 as a free upgrade to people who now have PCs or other gadgets running the previous two versions of Windows, provided they upgrade in the coming year. That could help create a huge new audience of Windows 10 users in a relatively short time, Gownder said.

Myerson predicted there will be a billion devices using Windows 10 within the next two to three years. Apps for all those devices will be distributed through a single Windows app store. Myerson also said Microsoft will partner with wireless carriers so consumers who lack credit cards can pay for apps on their phone bill — a popular method in developing nations.

Microsoft has not said exactly when Windows 10 is coming, although some were hoping the company would announce a date on Wednesday.

Since he became CEO last year, Nadella has been presiding over a major overhaul at Microsoft. He has redesigned some of Microsoft’s most popular programs for mobile users and invested in new “cloud-computing” services, in which businesses pay to use software that’s housed in Microsoft’s data centers.

Microsoft announced several new initiatives Wednesday for its Azure cloud-computing service, which has emerged as a fast-growing rival to a popular cloud business operated by Amazon. Microsoft is releasing new programming tools for Azure clients to create programs for computers that run Apple and Linux software, as well as those that run Windows.

Researchers closer to being able to change blood types

Sedimented_red_blood_cells 770

Photo: Wikimedia Commons

What do you do when a patient needs a blood transfusion but you don’t have their blood type in the blood bank? It’s a problem that scientists have been trying to solve for years but haven’t been able to find an economic solution – until now.


University of British Columbia chemists and scientists in the Centre for Blood Research have created an enzyme that could potentially solve this problem. The enzyme works by snipping off the sugars, also known as antigens, found in Type A and Type B blood, making it more like Type O. Type O blood is known as the universal donor and can be given to patients of all blood types.

“We produced a mutant enzyme that is very efficient at cutting off the sugars in A and B blood, and is much more proficient at removing the subtypes of the A-antigen that the parent enzyme struggles with,” said David Kwan, the lead author of the study and a postdoctoral fellow in the Department of Chemistry.

To create this high-powered enzyme capable of snipping off sugars, researchers used a new technology called directed evolution that involves inserting mutations into the gene that codes for the enzyme, and selecting mutants that are more effective at cutting the antigens. In just five generations, the enzyme became 170 times more effective.

With this enzyme, UBC associate professor Jayachandran Kizhakkedathu and colleagues in the Centre for Blood Research were able to remove the wide majority of the antigens in Type A and B blood. But before it can be used in clinical settings, the enzyme used would need to remove all of the antigens. The immune system is highly sensitive to blood groups and even small amounts of residual antigens could trigger an immune response.

Steve Withers

“The concept is not new but until now we needed so much of the enzyme to make it work that it was impractical,” says Steve Withers, a professor in the Department of Chemistry. “Now I’m confident that we can take this a whole lot further.”

The study was published in the Journal of the American Chemical Society and was supported by the Canadian Institutes of Health Research and Canadian Blood Services.


Blood types

The defining difference between A, B and O blood types is the presence of slightly different sugar structures on the outside of the red blood cells of each type. Type A and B blood cells each have a single additional sugar attached to their surface.

edX to Improve Access to MOOCs for People With Disabilities

April 3, 2015

Under a settlement with the U.S. Department of Justice announced on Thursday, edX, the nonprofit MOOC provider created by Harvard University and the Massachusetts Institute of Technology, has agreed to make its offerings more accessible to people with disabilities.

The settlement agreement, which marks the department’s first effort to challenge the accessibility of massive open online courses, affects the colleges that are members of edX as well as the nonprofit consortium itself.

The agreement calls for a number of changes, such as making edX’s website, mobile applications, and learning-management system fully accessible in the next 18 months; providing guidance to course creators on best practices for making online courses fully accessible; hiring a web-accessibility coordinator with specific responsibilities; and developing a web-accessibility policy.

The settlement notes that edX maintains that it was not inaccessible to people with disabilities and that the group did not admit any wrongdoing.

The changes were prompted by a compliance review begun by the Department of Justice.

“We were very aware in 2012 or so about the emergence of MOOCs and the importance, or the potential importance, that they offer to students who have distance barriers and cost barriers to getting good educational content,” said Eve L. Hill, the department’s deputy assistant attorney general for civil rights. “And they offer a potentially really good avenue for students with disabilities.”

But if those platforms are inaccessible, she added, it closes off that opportunity for students with disabilities.

Though Ms. Hill would not share details about the problems with the edX platform, she said they were common website-accessibility problems. She gave examples of those, including videos that lack captions, pop-up windows that aren’t recognized by screen-reader applications used by visually impaired people, and tables of data that lack header information or aren’t organized in a way that screen readers can translate.

The settlement occurred as part of the Justice Department’s broader efforts to make many websites more accessible to people with disabilities. Those efforts have included reaching settlement agreements or filing statements of interest in cases involving Netflix, H&R Block, and Louisiana Tech University, to name a few.

But the agreement with edX, Ms. Hill said, is different because it concerns both platform technology, created by edX, and the content itself, which is largely created by the consortium’s member colleges.

Room for Improvement

The settlement acknowledges that edX has taken steps to make its programs accessible to people with disabilities, but it says there is still room for improvement.

Anant Agarwal, edX’s chief executive, said accessibility had always been a priority for the nonprofit organization.

“Our mission has been to provide learning to anyone, anywhere, including people with disabilities,” Mr. Agarwal said. edX and the Justice Department worked together to develop a “road map” to accessibility that will help edX to “continue to stay on that path.”

Mr. Agarwal said users of edX will see continuous improvements, not sudden, sweeping changes. As an example, he cited an accessible text-annotation tool called Student Notes, which has custom keyboard controls to assist students who are visually impaired. Mr. Agarwal said the program would be released in a few weeks. He also mentioned improvements in edX’s mobile platform.

The settlement also requires edX to appoint a web-accessibility coordinator. Ms. Hill explained that this person would be responsible for monitoring compliance, conducting regular audits, and making sure the settlement agreement was being carried out.

That doesn’t necessarily mean that edX must create a new position — Mr. Agarwal said the nonprofit already employs an accessibility coordinator — but rather it outlines the responsibilities of an accessibility coordinator.

Ms. Hill would not say whether the Justice Department was looking into any other MOOC providers, but she said she hoped that others took note of the settlement with edX, adding that her office “will be watching.”

Peter Blanck, chairman of the Burton Blatt Institute at Syracuse University and author of eQuality: The Struggle for Web Accessibility by Persons With Cognitive Disabilities (Cambridge University Press, 2014), said edX was part of a new generation of services that are essentially content-management services rather than content providers. The settlement acknowledges that, he said.

“It’s reflective of a recognition of the responsibility of these new content-provider management systems to enable a platform that is accessible with content,” said Mr. Blanck.

The settlement also acknowledges “the responsibility of all parties to work together,” he added, in that it holds edX and its member colleges accountable.