Author: Nancy Fliesler

Three child-focused products to compete at Boston Children’s Hospital Innovation Tank

The creators of a powered arm brace, a device to aid newborn resuscitation and a platform for virtual nutritional consults have been chosen to present at Boston Children’s Hospital’s second annual pitch competition—otherwise known as the Innovation Tank—during the hospital’s Global Pediatric Innovation Summit + Awards 2015.

Augmented Infant Resuscitator Myomo Kindrdfood

Presented by the health care company Philips, the November 9 competition will be hosted by Troy Carter, founder and CEO of the entertainment company Atom Factory (managing Lady Gaga, among others) and newly named guest shark on ABC’s Shark Tank.

A la Shark Tank, each team will pitch its health care innovation to a panel of venture capitalists, clinicians and industry leaders, who will decide how to award $30,000 in sponsored prize money and offer advice on how to advance projects to market.

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Brain stimulation for status epilepticus?

Seizure-storm concept-Linda Bucklin-shutterstock_172455803Status epilepticus, a state of prolonged seizures, is a life-threatening medical emergency. The average mortality rate is 20 percent, and people who survive sustain lasting neurologic damage. Aborting the seizures is of the essence, but about 30 to 40 percent of patients don’t respond to lorazepam, the first-line drug usually given, and the drug itself can cause respiratory depression.

A study in rat model of status epilepticus, led by Alexander Rotenberg, MD, PhD, of Boston Children’s Hospital’s Department of Neurology, is the first to test an emerging approach known as transcranial direct-current stimulation (tDCS) as a way of halting acute seizures. tDCS applies a weak, direct current to the brain via scalp electrodes, to either increase or—more relevant for seizures—decrease excitability in selected areas. In the study, tDCS reduced the duration of acute seizures in the rats. When it was used together with lorazepam, the combination appeared to have a synergistic effect, also preventing new seizures from starting.

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From napkin sketch to new product: Rapid prototyping service speeds medical device development

rapid 3D prototyping services at hospitals
These custom devices hold fiber optic probes used to measure blood oxygenation in newborns. (Courtesy Noah Schulz, SIMPeds)

Some people bring data and completed designs. Others just bring simple sketches. “We have this idea for this device,” they begin. “It may only help 15 kids a year, but it could really improve their quality of life.”

Other people bring only a clinical need: “We need something to keep babies lying still after their procedure, without having to medicate them.”

To make these ideas more tangible and help launch them down a formal development path, the Boston Children’s Hospital Simulator Program, SIMPeds, has begun making its 3D printing and engineering service available to help hospital staff rapidly prototype new devices.

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Strengthening the brain’s executive function in autism

gaming autism executive function
Thomas Ryan with Susan Faja during a baseline assessment

Thomas is feeding virtual bananas to virtual monkeys. If the banana is yellow, he presses the computer’s arrow key to feed it to the monkey. If it’s brown, he’s supposed to just wait for the next banana. “Good job, you really watched carefully,” says Susan Faja, PhD, who’s coaching him through the task.

In the next round, Thomas has to throw bananas in the trash—but only the brown ones. “Oops, I threw a good banana away!” Thomas exclaims. “No worries,” Faja reassures him, “let’s try and remember the new rule on the next one.”

Being able to inhibit impulses—even small ones—is one aspect of what’s called executive function, a set of cognitive skills that allow us to manage complex or conflicting information, solve more nuanced problems and fine-tune our behavior. Executive function also includes the ability to plan, hold information in mind, and shift flexibly between different rules in different situations. And Faja thinks that strengthening executive function could help children with autism spectrum disorder (ASD) function better socially.

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A banquet of tools for health tech innovators

Tools-Shutterstock-donatas1205-croppedWant to hack something in medicine? Vendors are increasingly eager to contribute their tools to problem-solving teams, like those who will gather November 14 for Boston Children’s Hospital’s Hacking Pediatrics. Seeing an array of tools presented at a showcase at Boston Children’s last week, I felt excited about the possibilities ahead.

Here are a few tools that can help innovators improve health care for patients, caregivers and providers.

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Surgical 3-D printing: 300 prints, 16 specialties and counting

3-D printing is rapidly becoming a part of surgical planning. Since July 2013, Boston Children’s Hospital’s 3-D printing service, part of the Simulator Program, has received about 200 requests from 16 departments around the hospital. It’s generated a total of about 300 prints, most of them replicating parts of the body to be operated on.

Most prints take between 4 and 28 hours to produce. The largest to date—an entire malformed rib cage—took 105 hours and 35 minutes to create and weighed 8.9 pounds. The smallest—a tiny tangle of blood vessels in the brain—took 4 hours and 21 minutes and weighed 1.34 ounces. Here is sampling of what’s been coming off the production line.

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Rescuing intestinal stem cells from attack in diabetes

diabetic enteropathy and colonic stem cells
Blood levels of the hormone IGFBP3 (enterostaminine), shown here in green, are markedly elevated in people with longstanding type 1 diabetes and launch a lethal attack on intestinal stem cells. Adding a protein that soaks up the excess hormone restores normal stem cell function and could help prevent or treat diabetic enteropathy. (All images by Riseon)

Up to 80 percent of people with long-standing type 1 diabetes develop gastrointestinal symptoms—abdominal pain, bloating, nausea, vomiting, diarrhea, constipation and fecal incontinence—that severely diminish quality of life. Recent evidence suggests that this condition, known as diabetic enteropathy, results from damage to the intestinal lining, but the details beyond that have been unclear.

A study in this week’s Cell Stem Cell, led by Paolo Fiorina, MD, PhD, now provides some answers. It demonstrates how diabetes can lead to destruction of the stem cells that maintain the intestinal lining, and identifies a potential drug that could protect these stem cells and prevent or treat diabetic enteropathy.

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Maternal-infant health research will bring placenta into view

placental health
A pre-1858 schematic of the placental circulation from Gray’s Anatomy (Wikimedia Commons).

The afterbirth has generally been an afterthought, but that’s about to change.

This week, 19 research centers were awarded grants from NIH’s Human Placenta Project, which is seeking to learn more about the intricate organ that sustained us in the womb, the interface between us and our mothers.

A robust placenta is key to a healthy pregnancy and baby, but strangely, not much is actually known about it. “It’s a fascinating but very poorly understood structure,” says P. Ellen Grant, MD, who directs the Fetal-Neonatal Neuroimaging and Developmental Science Center at Boston Children’s Hospital and is leading one of the projects.

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Beth Stevens: A transformative thinker in neuroscience

When 2015 MacArthur “genius” grant winner Beth Stevens, PhD, began studying the role of glia in the brain in the 1990s, these cells—“glue” from the Greek—weren’t given much thought. Traditionally, glia were thought to merely protect and support neurons, the brain’s real players.

But Stevens, from the Department of Neurology and the F.M. Kirby Neurobiology Center at Boston Children’s Hospital, has made the case that glia are key actors in the brain, not just caretakers. Her work—at the interface between the nervous and immune systems—is helping transform how neurologic disorders like autism, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease and schizophrenia are viewed.

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Stress-induced stem cells debunked: The final word on STAP

In early 2014, controversy erupted when two papers in Nature indicated that exposing ordinary cells to stress—an acid bath or mechanical stress—could quickly and efficiently turn them into pluripotent stem cells, capable of developing into virtually all the tissues in the body.

The technique, called “stimulus-triggered acquisition of pluripotency,” or STAP, was lauded for its simplicity compared to other methods like nuclear transfer into egg cells or cellular reprogramming with a set of transcription factors.

Not so fast.

Six months later, the papers were retracted. And this week in Nature, a team led by George Q. Daley, MD, PhD, director of the Stem Cell Transplantation Program at Boston Children’s Hospital, and Peter Park, PhD, head of the Computational Genomics Group at Harvard Medical School (HMS) details what went wrong. In a companion paper, the Daley Lab provides a roadmap for verifying a cell’s pluripotent status.

Read the full story on the HMS website.

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