A Patient-Centered Design Thinking Workshop to Improve Patient-Provider Communication in Cardiovascular Medicine.

Healthcare providers are expected to deliver care improvement solutions that not only provide high quality patient care, but also improve outcomes, reduce costs, ensure safety, and increase patient satisfaction. Human-centered design methodologies, such as design thinking, allow providers to collaboratively ideate solutions with patients and family members. We describe a pilot workshop designed to teach providers the stages of design thinking while working on improving patient-provider communication. Twenty-four providers (physicians, nurses, technical staff, and administrative staff) from multiple cardiovascular units attended the workshop with five former patients and family members from those units. The workshop educated on and guided teams of providers patients and family members through the stages of design thinking (empathy, define, ideate, prototype, test). Pre- and post-event assessments indicated an increase in knowledge of the design thinking methodology and participants' ability to apply it to a clinical problem. We also present recommendations for designing a successful design thinking workshop.

Replication of bone marrow differentiation niche: comparative evaluation of different three-dimensional matrices.

The comparative evaluation of different 3D matrices-Matrigel, Puramatrix, and inverted colloidal crystal (ICC) scaffolds-provides a perspective for studying the pathology and potential cures for many blood and bone marrow diseases, and further proves the significance of 3D cultures with direct cell-cell contacts for in vitro mimicry of the human stem cell niche.

Engineering liver tissue spheroids with inverted colloidal crystal scaffolds.

Multicellular spheroids provide a new three-dimensional (3D) level of control over morphology and function of ex vivo cultured tissues. They also represent a valuable experimental technique for drug discovery and cell biology. Nevertheless, the dependence of many cellular processes on the cluster diameter remains unclear. To provide a tool for the systematic evaluation of such dependences, we introduce here inverted colloidal crystal (ICC) scaffolds. Uniformly sized pores in ICC cell matrixes afford a high yield production of controlled size spheroids in standard 96 well-plates. Transparent hydrogel matrix and ship-in-bottle effect also allows for convenient monitoring of cell processes by traditional optical techniques. Different developmental stages of 46.5-151.6 microm spheroids from HepG2 hepatocytes with vivid morphological similarities to liver tissue (bile canaliculi) were observed. The liver-specific functions of HepG2 cells were systematically investigated and compared for spheroids of different diameters as well as 2D cultures. Clear trends of albumin production and CYP450 activity were observed; diffusion processes and effect of cellular aggregation on metabolic activity were identified to be the primary contributors to the size dependence of the liver functions in HepG2 spheroids in ICC scaffolds. Since the aggregation of cells into clusters is a universal biological process, these findings and scaffolds can be applied to many other relevant cell types.

Poly(lactic-co-glycolic acid) bone scaffolds with inverted colloidal crystal geometry.

Controllability of scaffold architecture is essential to meet specific criteria for bone tissue engineering implants, including adequate porosity, interconnectivity, and mechanical properties to promote bone growth. Many current scaffold manufacturing techniques induce random porosity in bulk materials, requiring high porosities (>95%) to guarantee complete interconnectivity, but the high porosity sacrifices mechanical properties. Additionally, the stochastic arrangement of pores causes scaffold-to-scaffold variation. Here, we introduce a biodegradable poly(lactic-co-glycolic acid) (PLGA) scaffold with an inverted colloidal crystal (ICC) structure that provides a highly ordered arrangement of identical spherical cavities. Colloidal crystals (CCs) were constructed with soda lime beads of 100-, 200-, and 330-mum diameters. After the CCs were annealed, they were infiltrated with 85:15 PLGA. The method of construction and highly ordered structure allowed for ease of control over cavity and interconnecting channel diameters and for full interconnectivity at lower porosities. The scaffolds demonstrated high mechanical properties for PLGA alone (>50 MPa), in vitro biocompatibility, and maintenance of osteoblast phenotype, making them promising for a highly controllable bone tissue engineering scaffold.

Three-dimensional cell culture matrices: state of the art.

Traditional methods of cell growth and manipulation on 2-dimensional (2D) surfaces have been shown to be insufficient for new challenges of cell biology and biochemistry, as well as in pharmaceutical assays. Advances in materials chemistry, materials fabrication and processing technologies, and developmental biology have led to the design of 3D cell culture matrices that better represent the geometry, chemistry, and signaling environment of natural extracellular matrix. In this review, we present the status of state-of-the-art 3D cell-growth techniques and scaffolds and analyze them from the perspective of materials properties, manufacturing, and functionality. Particular emphasis was placed on tissue engineering and in vitro modeling of human organs, where we see exceptionally strong potential for 3D scaffolds and cell-growth methods. We also outline key challenges in this field and most likely directions for future development of 3D cell culture over the period of 5-10 years.