Look with your hands

The young and the old were invited at an interesting event in Strijp-S Eindhoven during The Dutch Technology Week. This event was organised by The Modelling Association in Eindhoven, Architecture Lessons, and Permanent Future Lab. It presented the 3 months work of 150 children from primary schools (10-12 year old) in Best.

Video 1 . The overall presentation for the elements of the event

Trains are a good theme for a starting point in understanding the science behind this project. It is not as easy as it may seem at the first glance. The oval circuit was split into four sections. Each section was split itself again into four work areas. Each work area was given for setting up to a group of children with an adult supervisor. The work time per week was fixed during school time.

Video 2 . The presentation of a section of the train circuit

They managed to:

• do computer design in 2D and 3D for the scenery;
• find the suitable materials for the scenery and then perform laser cutting;
• design and implement the electronics behind it, using also a microcontroller.

Video 3. The presentation of another section of the train circuit

Personally I wouldn't have been able to participate at such a project at an age of 10-12 years. The children need to comprehend the electronics behind the scenery and the train track. The electronic elements are connected like in a LEGO game with Little Bits. They are color coded, magnetic and reusable. The DIY project also uses the computer of the size of a swipe card, version 2.0, from The Raspberry Pi Foundation The behaviour of each electronic building block in the circuit is checked firstly in the software environment.

Video 4. The hardware has a solid software behind it

The presentation during The Dutch Technology Week showed also a small video with how different hardware parts are put together by children, under supervision.

Video 5. The hardware requires focus on every small detail

The scenery has walking paths with one material, the water with a glassy one, the houses have different material for roof and the walls, and the trees are carefully designed. There are also people featured, in such a small size that one can barely keep the figurines in one's hand. It was a pleasure attending this event.

The animated implantation of the aortic heart valve prosthesis

The transcatheter aortic valve implantation is the non-invasive alternative for the open heart surgery . The percutaneous beating heart interventional procedure for The Medtronic product , The CoreValve Revalving System , is 3D animated by Elite Imaging .

The procedure performed under fluoroscopy in the CathLab lasts for up to 2 - 3 hours . The self expanding multilevel frame containing the tri-leaflet porcine pericardial tissue prosthesis is specifically designed for retrograde percutaneous implantation via the 18Fr catheter .

Video 1 . The presentation of the loading procedure for the bioprosthetic valve
into the delivery catheter

If aortic stenosis is present then a single inflation of the valvuloplasty balloon is performed prior to implantation . The delivery system is advanced retrogradely over the guide wire , from the femoral artery , up to the native failing aortic valve . The catheter circular tip frame is positioned in the aortic valve annulus . The external sheath is progresively retracted . The framed valve is deployed , while pushing aside the native valve leaflets . The new prosthesis is securely anchored by the radial force of the self expanding Nitinol frame . It starts functioning immediately during placement .

Video 2 . The presentaton in detail for the implantation procedure
for the bioprosthetic valve

The side of the frame that expands in the ascending aorta optimises the hemodynamics of the blood flow system . The central level of the frame is calcaved to prevent obstruction of and allow access to the coronary artery ostia . The conforming side of the frame towards the annulus minimises the risk of paravalvular leaks . The tri-level aortic framed bioprosthesis provides secure anchoring , without migration , and with natural valve function , ensuring long term valve durability .

The results for the open heart surgery for aortic valve replacement are compared with the ones for the CoreValve Revalving System , for 795 high risk patients , two years after the clinical procedure . The non-invasive method provides improved outcomes and increased quality of life for the patient .

May the new year bring more research results

Happy winter holiday 2015

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The biggest cardiovascular center in The Netherlands

I worked temporarily at The Catharina hospital in Eindhoven last month . In the first day I had problems finding the main entrance . I parked the bicycle quickly near an entrance with a large building site . After I finished working in that day I asked at the information desk which one is the main entrance . I found out that I entered through it . While unlocking the bicycle , I looked up and read on a panel that I was standing not in front of an ordinary building site , but in front of the one for the biggest cardiovascular center in The Netherlands . I could not resist the temptation to write a post about it .

The Catharina hospital is a modern clinical training hospital , located in Eindhoven , The Netherlands . Although there are many options to find treatment at any hour , in any part of the city , people come at this hospital . I did not encounter any person living in this city that would not check in here , at some point . I found out on their website that it holds the quality mark in healthcare , awarded by The Netherlands Institute for Accreditation in Healthcare ( The NIAZ ) in 2000 . I found out on their LinkedIn group that the hospital has awarded the certificate of " top employers cure and care 2015" .

Figure 1 . The Catherina hospital , in Eindhoven , The Netherlands

The cardiovascular center is the biggest one in The Netherlands . The center already provides diagnosis and treatment for coronary artery disease and stenosis , heart failure , ablation , arrhythmia , valvulopathy , aortic and mitral valve , heart and valve surgery ; high quality research in blood testing , cardiogenetics , cardio - memo , computerised tomography ( CT ) scanning , echocardiogram , fractional flow reserve ( FFR ) measurement , and cardiac catheterisation .

The location of the cardiovascular center is , at the moment , in the main building of the hospital . When the new building section is ready , the centre will move in the new location , giving space to additional rooms for patients in the main hospital building .

Figure 2 . The biggest heart centre from The Netherlands , at The Catharina hospital in Eindhoven

The program Measurable better connects top clinicians and scientists from fourteen cardiovascular centers , and five intervention centers . The cardiovascular centers that joined the program are : The Catharina hospital , The academic medical center Amsterdam , The Amphia hospital , The Erasmus MC , The Hague hospital , Isala , Maastricht UMC + , The medical center Leeuwarden , The medical spectrum Twente , The " Our dear lady " hospital , Radboudumc , The saint Anthonius hospital , The universitary medical center Groningen , and The universitary medical center Utrecht . The five intervention centers that joined the program are : The " Elizabeth two cities " hospital , The Jeroen Bosch hospital , The Maasstad hospital , The medical center Alkmaar , and The Tergooi .

The Catharina hospital provides complex top clinical assistance in the diagnosis and the treatment of cardiac rhythm , in interventional cardiology , and in the cardiothoracic surgery . It is one of the centers that aims to have high quality patient care , with improved transparency . It was an honour working in the hospital .

The microRNA in tissue regeneration

I found a very interesting article that provides a concise literature review with 80 papers about original research in translational medicine .

The polymeric molecules that are the subject of discussion today are the microRNAs ( miRNA ). They are perfect complements to the target messengerRNA ( mRNA ) in plant cells , but they slightly mismatch in base pairing inside animal cells . The gene regulation using the complex micro RNA - m RNA triggers a wide variety of cellular mechanisms .

The cellular mechanisms that achieve organ regeneration , in a spatiotemporally controlled manner , are the differentiation , the dedifferentiation , the transdifferentiation , and the cellular proliferation . They alter the cellular plasticity .

The researchers learn from the invertebrates , the lower vertebrates , and the mammals how to activate the pluripotent stem cells in order to regrow parts or the entire organism . The trigger for the chain of events in the regeneration process is either the under - or the over - expression for the specific microRNA . The article provides a list for the microRNAs that regulate the human mesenchymal , and the human pluripotent ( the human embryonic , the human induced pluripotent ) stem cells .

The modulation of the regeneration process using microRNAs may be done by varying the modulators , the delivery method , or the cellular strategy ( figure 1 ) . The target cells are either the implanted or the endogeneous cells . The scientist may apply a modulation strategy on the endogenous ( stem ) cells , on the implanted cells prior to implantation , or on both the endogenous cells and the implanted cells . The modulators are either the cells themselves , the synthetic oligonucleotides , or the level of expression . The paper presents four delivery methods for the microRNAs : through direct injection , with viruses , with synthetic nanoparticles , and with cells as delivery vehicles .

Figure 1 . The technique variations for the micro - RNA signaling in the process of tissue regeneration .
Copyright ( 2014 ) AlphaMed Press

The heart has a limited potential for endogenous regeneration . The neonatal heart has a different response to myocardial infarction than the adult heart . The underexpressed microRNAs that trigger the proliferation of the cardiomyocytes are the miR - 15 family , the miR - 17 - 92 cluster , the miR - 199a and the miR - 590 families . They may help in the differentiation for the stem cells , for the cellular lineage commitment , and in the direct reprogramming process of the fibroblasts to generate cardiomyocytes . They are critical components in the signalling network for the adult cellular proliferation .

The microRNAs have a complex behaviour that is still not yet fully understood . The modulation strategy varies with the target organ that requires regeneration , and the research application .

References :

Frith J . E . , Porrello E . R . , Cooper - White J . J . ( 2014 )" Concise review : new frontiers in MicroRNA - based tissue regeneration " , Stem Cells Translational Medicine , 3 ( 8 ) , 969 - 976 .