Stories about: Devices

“Shapeshifter” that regulates blood clotting is visually captured for the first time

GIF of VWF, which regulates blood clotting, elongating and relaxing on loop
A single molecule of von Willebrand factor is visually captured, as it elongates and relaxes in response to blood flow conditions, for the very first time. Credit: Springer/Wong labs (Boston Children’s Hospital and Harvard Medical School)

We are normally born with a highly sophisticated array of molecules that act as “sentries,” constantly scanning our bodies for injuries such as cuts and bruises. One such molecular sentry, known as von Willebrand factor (VWF), plays a critical role in our body’s ability to stop bleeding.

To prevent hemorrhage or life-threatening blood clots, VWF must strike a delicate balance between clotting too little or too much. Researchers have long suspected that the mechanical forces and shear stress of blood flow could be closely-related to VWF’s function.

“In some ways, like in the movie Star Wars, VWF may be considered a Jedi knight in our body that can use ‘the force’ to guard the bloodstream,” says Timothy Springer, PhD, of Boston Children’s Hospital and Harvard Medical School (HMS).

It has not been possible to witness exactly how VWF senses and harnesses these mechanical forces — until now.

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Pediatric heart surgeons eye sticky, stretchy, slug-inspired adhesive

Arion subfiscus, whose sticky mucus inspired the new surgical adhesive (H. Crisp/Wikimedia Commons)

It’s been a challenge to develop a surgical adhesive that sticks to wet surfaces and isn’t toxic. But it turns out a certain kind of slug is very good at secreting a sticky mucus that glues fast, apparently as a defense mechanism.

That provided the inspiration for a hydrogel “super” adhesive that could supplant surgical sutures, at least for some operations, and help medical devices stay in place. Researchers at the Wyss Institute for Biologically Inspired Engineering and Harvard’s School of Engineering and Applied Sciences (SEAS), led by David Mooney, PhD, report that the adhesive bound strongly to a variety of animal tissues, including skin, cartilage, artery, liver and heart.

Nikolay Vasilyev, MD, a coauthor on the paper, is interested in the adhesive’s potential for young patients with congenital heart disease. He is is a research scientist in Cardiac Surgery at Boston Children’s Hospital, and led cardiac studies in pig models. 

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Building emotional strength with Mighteor: Will’s story

MIghteor

Will, a 13-year-old from Wisconsin, lives with high-functioning Asperger’s and faces difficulties recognizing and managing his emotions. He doesn’t like to talk about emotions he perceives as negative, and becomes upset when he doesn’t meet the high standards he sets for himself. These oachhallenges have made it difficult for Will to thrive in social situations.

Karen immediately began researching strategies, as many as she could find, to help Will manage his emotions. She found a Social Thinking program, as well as ABA therapy, both of them important opportunities for Will to increase his “social batting average,” as Karen puts it.

However, Will soon became resistant to using the strategies offered by these programs. Cues to calm down through deep breathing, for example, tended to create more frustration and anger and did not decrease his swearing, frustration or oppositional behaviors. Despite his ongoing work with an ABA therapist and the Social Thinking program, his academics started to suffer and he sometimes had to leave the classroom. “He would miss class, and then miss homework, and it would circle out of control,” says Karen.

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Robot-enhanced neurosurgery for nimbler seizure mapping

implanting electrodes for seizure monitoring, with robotic assistance
Scellig Stone and Joseph Madsen in surgery with the robot.

Head shaved, a little boy rests on the operating table, deep under anesthesia. His parents have brought him to Boston Children’s Hospital in hopes of determining the cause of his seizures. Now, neurosurgeons Scellig Stone, MD, PhD, Joseph Madsen, MD, and their colleagues in the Epilepsy Center are performing a procedure designed to monitor seizure activity in the 3-year-old’s brain.

But as the team members crowd around the table, they’re not alone. With the push of a button, a large robotic arm rotates and lowers right next to the boy’s head, helping the physicians pinpoint the precise location to drill. “This is a real game-changer,” murmurs one of the clinicians observing the surgery. “It’s going to transform the way we practice.”

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Training neurosurgeons in a rare hydrocephalus procedure, with a little help from Hollywood

ETV trainer

A 4-year-old has a progressively enlarging head and loss of developmental milestones: a clear case of hydrocephalus. He undergoes a minimally invasive endoscopic third ventriculostomy (ETV) to drain off the trapped cerebrospinal fluid.

This requires puncturing the floor of the brain’s third ventricle (fluid-filled cavity) with an endoscope — while avoiding a lethal tear in the basilar artery, which lies perilously close.

There are no good neurosurgical training models for this rare and scary operation.

“We semi-blindly poke a hole through the ventricle floor,” says Benjamin Warf, MD, director of Neonatal and Congenital Anomaly Neurosurgery at Boston Children’s Hospital. “To make the technique safer and to be able to train more people, it would be very helpful to make that hole in a way that’s less anxiety-provoking.”

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Predicting influenza outbreaks faster with a digitally-empowered wearable device

Influenza viruses. Outbreaks can be predicted using digital health tools like Thermia.The Thermia online health educational tool, developed at Boston Children’s Hospital, has enabled one-month-faster prediction of seasonal influenza outbreaks in China, via its digital integration with a commercially-available wearable thermometer. The findings appear in a new study published in the American Journal of Public Health.

 “The fact that we were able to predict influenza outbreaks faster than China’s national surveillance programs really shows the capacity for everyday, wearable digital health devices to track the spread of disease at the population level,” says the study’s lead author Yulin Hswen, who is a research fellow in Boston Children’s Computational Epidemiology Group and a doctoral candidate at the Harvard T. H. Chan School of Public Health.

China has 620 million mobile internet users who can theoretically access the standalone Thermia application from any computer, smartphone or even the Amazon Alexa assistant.

Although the Boston Children’s team has previously demonstrated that social media can be used to track disease, this is the first time they’ve shown that outbreaks can be predicted through an integrated wearable device and online tool.

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Preparing patients and families to manage ventricular assist devices

Beth Hawkins ventricular assist devices

Children in severe heart failure sometimes have a ventricular assist device (VAD) implanted in their chest. VADs are electrically-powered heart pumps that can tide children over while they wait for a heart transplant. They can also be implanted long term if a child is ineligible for transplant, or simply buy children time to recover their own heart function.

Because problems with VADs can be life-threatening, families need extensive training in managing the device and its external controller at home. Nurse practitioner Beth Hawkins RN, MSN, FNP-C, and her colleagues in the Boston Children’s VAD Program begin the training at the child’s hospital bedside while they are still in the cardiac ICU. But despite lectures, demos and practice opportunities, the prospect of maintaining a VAD remains terrifying for many parents and children.

“A lot of families feel their child is attached to a ticking time bomb that could go off at any time,” says Hawkins. “Many say taking a child home on a VAD feels like having a newborn baby again.”

Hawkins realized that families needed more support.

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GALLERY: Custom-built ‘trainers’ help clinicians master procedures

medical mannequins manikins trainers medical simulation
Andrew Hosmer (left) and Noah Schulz at the bench, building parts for medical trainers.

Walking into the SIMPeds Engineering Studio, a few blocks from Boston Children’s Hospital, the first thing you notice is body parts — high-fidelity replicas of human anatomy in various sizes. Some are in a glass display case, while others are laid out in various states of assembly, from a lone finger to the complete abdominal cavity of a newborn, packed with diminutive organs. Six newborn-sized, hollow duodenums, cast in rubber over a plastic mold, hang ready near a workbench.

These aren’t your usual medical mannequins.

In the adjoining InventorSpace, three 3D printers stand ready to fabricate additional custom parts. Some will be used by surgeons to rehearse an upcoming complex operation. Others are used for general training and preparedness purposes.

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Can virtual reality headsets save vision in people with lazy eye?

Luminopia amblyopia virtual reality
IDHA’s Matt Murphy tries out Luminopia’s VR headset with Dean Travers (photo: Greb Weintraub)

Three to five percent of the population has amblyopia, a.k.a. lazy eye, in which a healthy eye never “learns” to see because isn’t used. This usually happens because of a focusing problem or subtle misalignment of that eye. The brain learns to ignore input from that eye, and unless this is noticed early, it weakens and can slowly go blind.

“When I can diagnose amblyopia early enough, I can treat it with an eye patch or eye drops to block the ‘good’ eye,” says David Hunter, MD, PhD, chief of ophthalmology at Boston Children’s Hospital. “This gives the eye with amblyopia time to catch up.”

Unfortunately, eye patching doesn’t work well at older ages, and kids hate the socially stigmatizing patches, which often need to be worn for more than a year. As Dean Travers, cofounder of Luminopia, put it at Boston Children’s Hospital’s Innovators’ Showcase last week, “Being a pirate isn’t cool for very long.”

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2017 Innovators’ Showcase spotlights healthcare decision support

2017 Innovator's Showcase Boston Children's Hospital

Healthcare innovations will be on display next week — April 12 — at Boston Children’s Hospital’s Innovation & Digital Health Accelerator’s annual showcase. The event, from 3:30 to 5:30 p.m., will be kicked off by a discussion on clinical decision support with Doug Perrin, a bioengineer/computer scientist in Cardiac Surgery at Boston Children’s and Garry Steil, who is developing a glucose control technology for diabetes patients at the hospital.

Exhibits, demos and mingling will take place in the Patient Entertainment Center off the main hospital lobby (300 Longwood Avenue, Boston).

Among the roughly 20 apps, ventures and technologies on display:

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