Digital readiness in 3D bioprinting: software, governance and hospitals' proto-clinical interfaces

Investigation of Biomaterial Ink Viscosity Properties and Optimization of the Printing Process Based on Pattern Path Planning

Extruded bioprinting is widely used for the biomanufacturing of personalized, complex tissue structures, which requires biomaterial inks with a certain viscosity to enable printing. However, there is still a lack of discussion on the controllable preparation and printability of biomaterial inks with different viscosities. In this paper, biomaterial inks composed of gelatin, sodium alginate, and methylcellulose were utablesed to investigate the feasibility of adjustment of rheological properties, thereby analyzing the effects of different rheological properties on the printing process. Based on the response surface methodology, the relationship between the material components and the rheological properties of biomaterial inks was discussed, followed by the prediction of the rheological properties of biomaterial inks. The prediction accuracies of the power-law index and consistency coefficient could reach 96% and 79%, respectively. The material group can be used to prepare biomaterial inks with different viscosity properties in a wide range. Latin hypercube sampling and computational fluid dynamics were used to analyze the effects of different rheological properties and extrusion pressure on the flow rate at the nozzle. The relationship between the rheological properties of the biomaterial ink and the flow rate was established, and the simulation results showed that the changes in the rheological properties of the biomaterial ink in the high-viscosity region resulted in slight fluctuations in the flow rate, implying that the printing process for high-viscosity biomaterial inks may have better versatility. In addition, based on the characteristics of biomaterial inks, the printing process was optimized from the planning of the print pattern to improve the location accuracy of the starting point, and the length accuracy of filaments can reach 99%. The effect of the overlap between the fill pattern and outer frame on the print quality was investigated to improve the surface quality of complex structures. Furthermore, low- and high-viscosity biomaterial inks were tested, and various printing protocols were discussed for improving printing efficiency or maintaining cell activity. This study provides feasible printing concepts for a wider range of biomaterials to meet the biological requirements of cell culture and tissue engineering.

The regulatory challenge of 3D bioprinting

New developments in additive manufacturing and regenerative medicine have the potential to radically disrupt the traditional pipelines of therapy development and medical device manufacture. These technologies present a challenge for regulators because traditional regulatory frameworks are designed for mass manufactured therapies, rather than bespoke solutions. 3D bioprinting technologies present another dimension of complexity through the inclusion of living cells in the fabrication process. Herein we overview the challenge of regulating 3D bioprinting in comparison to existing cell therapy products as well as custom-made 3D printed medical devices. We consider a range of specific challenges pertaining to 3D bioprinting in regenerative medicine, including classification, risk, standardization and quality control, as well as technical issues related to the manufacturing process and the incorporated materials and cells.

Institutional and infrastructure challenges for hospitals producing advanced therapies in the UK: the concept of 'point-of-care manufacturing readiness'

Aim: To propose the concept of point-of-care manufacturing readiness for analyzing the capacity that a country, a health system or an institution has developed to manufacture therapies in clinical settings (point-of-care manufacture). The focus is on advanced therapies (cell, gene and tissue engineering therapies) in the UK. Materials & methods: Literature review, analysis of quantitative data, and qualitative interviews with professionals and practitioners developing and administering advanced therapies. Results: Three components of point-of-care manufacturing readiness are analyzed staff and institutional procedures, infrastructure, and relations between hospitals and service providers. Conclusion: The technical and regulatory experience that has been gained through manufacturing advanced therapies at small scale in hospitals qualifies the UK for more complex and larger-scale production of therapies in the future.

The Global Care Ecosystems of 3D Printed Assistive Devices

The popularity of 3D printed assistive technology has led to the emergence of new ecosystems of care, where multiple stakeholders (makers, clinicians, and recipients with disabilities) work toward creating new upper limb prosthetic devices. However, despite the increasing growth, we currently know little about the differences between these care ecosystems. Medical regulations and the prevailing culture have greatly impacted how ecosystems are structured and stakeholders work together, including whether clinicians and makers collaborate. To better understand these care ecosystems, we interviewed a range of stakeholders from multiple countries, including Brazil, Chile, Costa Rica, France, India, Mexico, and the U.S. Our broad analysis allowed us to uncover different working examples of how multiple stakeholders collaborate within these care ecosystems and the main challenges they face. Through our study, we were able to uncover that the ecosystems with multi-stakeholder collaborations exist (something prior work had not seen), and these ecosystems showed increased success and impact. We also identified some of the key follow-up practices to reduce device abandonment. Of particular importance are to have ecosystems put in place follow up practices that integrate formal agreements and compensations for participation (which do not need to be just monetary). We identified that these features helped to ensure multi-stakeholder involvement and ecosystem sustainability. We finished the paper with socio-technical recommendations to create vibrant care ecosystems that include multiple stakeholders in the production of 3D printed assistive devices.