Bioprinting of 3D Convoluted Renal Proximal Tubules on Perfusable Chips

Three-dimensional models of kidney tissue that recapitulate human responses are needed for drug screening, disease modeling, and, ultimately, kidney organ engineering. Here, we report a bioprinting method for creating 3D human renal proximal tubules in vitro that are fully embedded within an extracellular matrix and housed in perfusable tissue chips, allowing them to be maintained for greater than two months. Their convoluted tubular architecture is circumscribed by proximal tubule epithelial cells and actively perfused through the open lumen. These engineered 3D proximal tubules on chip exhibit significantly enhanced epithelial morphology and functional properties relative to the same cells grown on 2D controls with or without perfusion. Upon introducing the nephrotoxin, Cyclosporine A, the epithelial barrier is disrupted in a dose-dependent manner. Our bioprinting method provides a new route for programmably fabricating advanced human kidney tissue models on demand.

Stable propagation of mechanical signals in soft media using stored elastic energy

Soft structures with rationally designed architectures capable of large, nonlinear deformation present opportunities for unprecedented, highly tunable devices and machines. However, the highly dissipative nature of soft materials intrinsically limits or prevents certain functions, such as the propagation of mechanical signals. Here we present an architected soft system composed of elastomeric bistable beam elements connected by elastomeric linear springs. The dissipative nature of the polymer readily damps linear waves, preventing propagation of any mechanical signal beyond a short distance, as expected. However, the unique architecture of the system enables propagation of stable, nonlinear solitary transition waves with constant, controllable velocity and pulse geometry over arbitrary distances. Because the high damping of the material removes all other linear, small-amplitude excitations, the desired pulse propagates with high fidelity and controllability. This phenomenon can be used to control signals, as demonstrated by the design of soft mechanical diodes and logic gates.

Laser-assisted direct ink writing of planar and 3D metal architectures

The ability to pattern planar and freestanding 3D metallic architectures at the microscale would enable myriad applications, including flexible electronics, displays, sensors, and electrically small antennas. A 3D printing method is introduced that combines direct ink writing with a focused laser that locally anneals printed metallic features "on-the-fly." To optimize the nozzle-to-laser separation distance, the heat transfer along the printed silver wire is modeled as a function of printing speed, laser intensity, and pulse duration. Laser-assisted direct ink writing is used to pattern highly conductive, ductile metallic interconnects, springs, and freestanding spiral architectures on flexible and rigid substrates.

Programming Mechanical and Physicochemical Properties of 3D Hydrogel Cellular Microcultures via Direct Ink Writing

3D hydrogel scaffolds are widely used in cellular microcultures and tissue engineering. Using direct ink writing, microperiodic poly(2-hydroxyethyl-methacrylate) (pHEMA) scaffolds are created that are then printed, cured, and modified by absorbing 30 kDa protein poly-l-lysine (PLL) to render them biocompliant in model NIH/3T3 fibroblast and MC3T3-E1 preosteoblast cell cultures. Spatial light interference microscopy (SLIM) live cell imaging studies are carried out to quantify cellular motilities for each cell type, substrate, and surface treatment of interest. 3D scaffold mechanics is investigated using atomic force microscopy (AFM), while their absorption kinetics are determined by confocal fluorescence microscopy (CFM) for a series of hydrated hydrogel films prepared from prepolymers with different homopolymer-to-monomer (Mr ) ratios. The observations reveal that the inks with higher Mr values yield relatively more open-mesh gels due to a lower degree of entanglement. The biocompatibility of printed hydrogel scaffolds can be controlled by both PLL content and hydrogel mesh properties.

Biomimetic 4D printing

Shape-morphing systems can be found in many areas, including smart textiles, autonomous robotics, biomedical devices, drug delivery and tissue engineering. The natural analogues of such systems are exemplified by nastic plant motions, where a variety of organs such as tendrils, bracts, leaves and flowers respond to environmental stimuli (such as humidity, light or touch) by varying internal turgor, which leads to dynamic conformations governed by the tissue composition and microstructural anisotropy of cell walls. Inspired by these botanical systems, we printed composite hydrogel architectures that are encoded with localized, anisotropic swelling behaviour controlled by the alignment of cellulose fibrils along prescribed four-dimensional printing pathways. When combined with a minimal theoretical framework that allows us to solve the inverse problem of designing the alignment patterns for prescribed target shapes, we can programmably fabricate plant-inspired architectures that change shape on immersion in water, yielding complex three-dimensional morphologies.

Design, fabrication, and in vitro testing of novel three-dimensionally printed tympanic membrane grafts

The tympanic membrane (TM) is an exquisite structure that captures and transmits sound from the environment to the ossicular chain of the middle ear. The creation of TM grafts by multi-material three-dimensional (3D) printing may overcome limitations of current graft materials, e.g. temporalis muscle fascia, used for surgical reconstruction of the TM. TM graft scaffolds with either 8 or 16 circumferential and radial filament arrangements were fabricated by 3D printing of polydimethylsiloxane (PDMS), flex-polyactic acid (PLA) and polycaprolactone (PCL) materials followed by uniform infilling with a fibrin-collagen composite hydrogel. Digital opto-electronic holography (DOEH) and laser Doppler vibrometry (LDV) were used to measure acoustic properties including surface motions and velocity of TM grafts in response to sound. Mechanical properties were determined using dynamic mechanical analysis (DMA). Results were compared to fresh cadaveric human TMs and cadaveric temporalis fascia. Similar to the human TM, TM grafts exhibit simple surface motion patterns at lower frequencies (400 Hz), with a limited number of displacement maxima. At higher frequencies (>1000 Hz), their displacement patterns are highly organized with multiple areas of maximal displacement separated by regions of minimal displacement. By contrast, temporalis fascia exhibited asymmetric and less regular holographic patterns. Velocity across frequency sweeps (0.2-10 kHz) measured by LDV demonstrated consistent results for 3D printed grafts, while velocity for human fascia varied greatly between specimens. TM composite grafts of different scaffold print materials and varied filament count (8 or 16) displayed minimal, but measurable differences in DOEH and LDV at tested frequencies. TM graft mechanical load increased with higher filament count and is resilient over time, which differs from temporalis fascia, which loses over 70% of its load bearing properties during mechanical testing. This study demonstrates the design, fabrication and preliminary in vitro acoustic and mechanical evaluation of 3D printed TM grafts. Data illustrate the feasibility of creating TM grafts with acoustic properties that reflect sound induced motion patterns of the human TM; furthermore, 3D printed grafts have mechanical properties that demonstrate increased resistance to deformation compared to temporalis fascia.

Controlling Material Reactivity Using Architecture

3D-printing methods are used to generate reactive material architectures. Several geometric parameters are observed to influence the resultant flame propagation velocity, indicating that the architecture can be utilized to control reactivity. Two different architectures, channels and hurdles, are generated, and thin films of thermite are deposited onto the surface. The architecture offers an additional route to control, at will, the energy release rate in reactive composite materials.

Wettability Contrast Gravure Printing

Silicon gravure patterns are engineered to have cells that are wettable and lands that are not wettable by aqueous inks. This strategy allows excess ink on the lands to be removed without using a doctor blade. Using an aqueous silica ink, continuous lines as narrow as 1.2 μm with 1.5 μm space are gravure printed.

Rapid and Versatile Photonic Annealing of Graphene Inks for Flexible Printed Electronics

Intense pulsed light (IPL) annealing of graphene inks is demonstrated for rapid post-processing of inkjet-printed patterns on various substrates. A conductivity of ≈25,000 S m(-1) is achieved following a single printing pass using a concentrated ink containing 20 mg mL(-1) graphene, establishing this strategy as a practical and effective approach for the versatile and high-performance integration of graphene in printed and flexible electronics.

Topology Optimized Architectures with Programmable Poisson's Ratio over Large Deformations

Topology optimized architectures are designed and printed with programmable Poisson's ratios ranging from -0.8 to 0.8 over large deformations of 20% or more.

Active mixing of complex fluids at the microscale

Mixing of complex fluids at low Reynolds number is fundamental for a broad range of applications, including materials assembly, microfluidics, and biomedical devices. Of these materials, yield stress fluids (and gels) pose the most significant challenges, especially when they must be mixed in low volumes over short timescales. New scaling relationships between mixer dimensions and operating conditions are derived and experimentally verified to create a framework for designing active microfluidic mixers that can efficiently homogenize a wide range of complex fluids. Active mixing printheads are then designed and implemented for multimaterial 3D printing of viscoelastic inks with programmable control of local composition.

Multistable Architected Materials for Trapping Elastic Strain Energy

3D printing and numerical analysis are combined to design a new class of architected materials that contain bistable beam elements and exhibit controlled trapping of elastic energy. The proposed energy-absorbing structures are reusable. Moreover, the mechanism of energy absorption stems solely from the structural geometry of the printed beam elements, and is therefore both material- and loading-rate independent.

Screen Printing of Highly Loaded Silver Inks on Plastic Substrates Using Silicon Stencils

Screen printing is a potential technique for mass-production of printed electronics; however, improvement in printing resolution is needed for high integration and performance. In this study, screen printing of highly loaded silver ink (77 wt %) on polyimide films is studied using fine-scale silicon stencils with openings ranging from 5 to 50 μm wide. This approach enables printing of high-resolution silver lines with widths as small as 22 μm. The printed silver lines on polyimide exhibit good electrical properties with a resistivity of 5.5×10(-6) Ω cm and excellent bending tolerance for bending radii greater than 5 mm (tensile strains less than 0.75%).

Microfluidic Printheads for Multimaterial 3D Printing of Viscoelastic Inks

Multimaterial 3D printing using microfluidic printheads specifically designed for seamless switching between two visco-elastic materials "on-the-fly" during fabrication is demonstrated. This approach opens new avenues for the digital assembly of functional matter with controlled compositional and property gradients at the microscale.

Capacitive soft strain sensors via multicore-shell fiber printing

A new method for fabricating textile integrable capacitive soft strain sensors is reported, based on multicore-shell fiber printing. The fiber sensors consist of four concentric, alternating layers of conductor and dielectric, respectively. These wearable sensors provide accurate and hysteresis-free strain measurements under both static and dynamic conditions.

High-resolution, high-aspect ratio conductive wires embedded in plastic substrates

A novel method is presented to fabricate high-resolution, high-aspect ratio metal wires embedded in a plastic substrate for flexible electronics applications. In a sequential process, high-resolution channels connected to low-resolution reservoirs are first created in a thermosetting polymer by imprint lithography. A reactive Ag ink is then inkjet-printed into the reservoirs and wicked into the channels by capillary forces. These features serve as a seed layer for copper deposition inside the channels via electroless plating. Highly conductive wires (>50% bulk metal) with minimum line width and spacing of 2 and 4 μm, respectively, and an aspect ratio of 0.6 are obtained. The embedded wires exhibit good mechanical flexibility, with minimal degradation in electrical performance after thousands of bending cycles.

Low-Dose CT Lung Cancer Screening Practices and Attitudes among Primary Care Providers at an Academic Medical Center

BACKGROUND

Low-dose computed tomography (LDCT) screening reduces lung cancer-specific and overall mortality. We sought to assess lung cancer screening practices and attitudes among primary care providers (PCPs) in the era of new LDCT screening guidelines.

METHODS

In 2013, we surveyed PCPs at an academic medical center (60% response) and assessed: lung cancer screening use, perceived screening effectiveness, knowledge of screening guidelines, perceived barriers to LDCT use, and interest in LDCT screening education.

RESULTS

Few PCPs (n = 212) reported ordering lung cancer screening: chest X-ray (21%), LDCT (12%), and sputum cytology (3%). Only 47% of providers knew three or more of six guideline components for LDCT screening; 24% did not know any guideline components. In multiple logistic regression analysis, providers who knew three or more guideline components were more likely to order LDCT (OR, 7.1; 95% confidence intervals, 2.0-25.6). Many providers (30%) were unsure of the effectiveness of LDCT. Mammography, colonoscopy, and Pap smear were rated more frequently as effective in reducing cancer mortality compared with LDCT (all P values < 0.0001). Common perceived barriers included patient cost (86.9% major or minor barrier), harm from false positives (82.7%), patients' lack of awareness (81.3%), risk of incidental findings (81.3%), and insurance coverage (80.1%).

CONCLUSIONS

LDCT lung cancer screening is currently an uncommon practice at an academic medical center. PCPs report ordering chest X-ray, a nonrecommended screening test, more often than LDCT. PCPs had a limited understanding of lung cancer screening guidelines and LDCT effectiveness. Provider educational interventions are needed to facilitate shared decision-making with patients.

IMPACT

This study describes some of the first data available about PCPs' use of lung cancer screening tests since the publication of multiple professional guidelines endorsing LDCT. Knowledge gaps were identified that may hinder the uptake of evidence-based lung cancer screening guidelines.

Chromosomal ampC mutations in cefpodoxime-resistant, ESBL-negative uropathogenic Escherichia coli

AmpC β-lactamase is an enzyme commonly produced by Escherichia coli that causes resistance to cephalosporins and penicillins. Enzyme production is controlled by the strength of the promoter encoded by the chromosomal ampC gene, with the level of production affected by the presence of certain mutations in this region. This study sets out to determine the prevalence of ampC promoter mutations present in a group of uropathogenic E. coli strains. A total of 50 clinical strains of E. coli were collected from urine samples between June 2011 and November 2011. Strains were investigated for the presence of mutations in the chromosomal ampC promoter region by amplification and sequencing of a 271 bp product. The presence of ampC-carrying plasmids derived from other species was also determined, to exclude these from further analysis. ampC-carrying plasmids were found in 10 of the 50 strains, all of which were of the CIT-type. Analysis of the chromosomal ampC promoter region in the 40 remaining strains showed mutations at 16 different positions, with 18 different genotype patterns detected overall. The most common ampC chromosomal mutation, present in 25 of 40 strains, was a T --> A transition at position -32. This mutation has been shown by others to increase enzyme production by up to 46-fold. Altogether, three separate mutations (-32, -42 and -13ins) were present in 90% of the 40 non-plasmid strains, indicating a strong association with the resistance observed. It appears, therefore, that the majority of AmpC-mediated resistance in E. coli can be accounted for by just three point mutations in the chromosome.

3D-printing of lightweight cellular composites

A new epoxy-based ink is reported, which enables 3D printing of lightweight cellular composites with controlled alignment of multiscale, high-aspectratio fiber reinforcement to create hierarchical structures inspired by balsa wood. Young's modulus values up to 10 times higher than existing commercially available 3D-printed polymers are attainable, while comparable strength values are maintained.