Back in Time? How standardization outlines the point of technological innovation. Act 2.
June 4, 2022
Kate M. Serralde
At first pass, 3D printing is underscored with a point of entry problem. There are many reasons for this, but the main difficulty stems from a 3D-printer’s capacity for customization, complexity, and versatility. When thinking about how to use 3D printing in healthcare, it can simply be really hard to know where to start. Despite the fact that we know that a 3D printer is a tool that offers a broad range of uses and applications, it can be really difficult to identify a particular use, especially in the case of everyday healthcare practices. Thus, for students to use 3D printing productively, each student needs a place to work, materials and means to develop practical skills, along with the development of a certain kind of thinking. In other words, you need a methodology for generating practices and applications for new technology, because you are not seeking just any ideas, you are looking for relevant ideas for 3D printing to be applied in medicine. To put this another way, throughout your healthcare career, understanding how to adopt a new technology, like 3D printing, is becoming essential job function. The potential in a technology will be obvious, but at some point, someone is going to look at you and say:
'That's great but what are you going to do with it.'
And you are going to need a plan. A plan that includes allowing for ambiguity and drawing from a diverse range of ideas and practices. A plan that begins and follows the mindset:
“Is this possible?”
“I don’t know, but let’s find out.”
Being aware that ambiguity is inherent to the process of developing new and relevant ideas is important, because a state of mind framed by 'not knowing' generates questions that can lead to specific answers. As a result, allowing for exploration and open-ended problem solving sets the stage for finding relevant ideas, because discovering new practices or applications is not dependent on identifying true or false values, that comes later. In the early stages of creating, what matters is learning from experience and creating a interdisciplinary knowledge-base. So when the thought: "I have no idea what I am doing" floats to the top of your mind, remember that you are right where you are supposed to be.
October 24, 2021
By Kate M. Serralde
One of the important aspects of introducing the concept of 3D printing and medical imaging is to provide a basic understanding of the framework that allows for the conversion of a medical image into a 3D model. To be honest, this is a complex topic that is mired in technical jargon. In the interest of retaining your attention, I have spent a great deal of time trying to figure out the best way to relate this information to you. As I was reviewing the mechanics behind digital graphics, medical imaging, and 3D-printing a funny thing happened, I discovered that there was a common approach to the process of translating what we see in the real world into a digital image and 3D model. An approach that relies on the simplification of visual information into standardized elements like outlines, points, and layers. This simplification allows us to translate what we see and perhaps imagine in a different format. In other words, outlines, points, and layers provide us with a way to retain structural integrity. These elements allow for an image to be divided into parts then reconstructed into different formats like a digital graphic formed from colored dots or a 3D printed object constructed by tracing and layering outlines. Essentially points, outlines, and layers allow us to, with high accuracy, translate what we “see” into physical materials and formats. Moreover, this reliance on standardized elements is a common theme in the history of visualization and technological advancement. As you shall see in the below entry, humans have relied on standardization to express ideas and intentions in a wide range of ways.
Back in Time? How standardization outlines the point of technological innovation.
November 11, 2021
Kate M. Serralde
We have seen how a reliance on standardized elements is a framework for the conversion of digital medical imaging into a 3D printed model. In this entry, we are going to explore how this simplification and standardization of form is a common theme in the history of visualization and technological advancement. In the timeline below, I have sketched a historical continuum illustrating how outlines, points, and layers support the translation of visual information and ideas into different formats and materials. As you shall see here and in forthcoming entries, 3D printing evolved from the interlacing and automation of methods that rely on the use of standardized elements. But how did the interplay between standardization and expression begin?
Perhaps we could start when early humans looked up to see the stars. There, in the night sky, early humans detected patterns and imagined forms within these points of light. Over time, the stars became a standardized element of star charts and constellations, which allowed early humans to establish order not only in ideological ways like expressing belief systems but also technological ways like tools for tracking the passage of time and location. What's more, the constellations were formed by 'connecting the dots', so to speak. This outlining of form from points is a common practice in visual representation, which allows for the delineation of edges and shapes on a two-dimensional surface. Nowadays, points or what we know as the pixel, are a standardized element in digital graphics. Here, a point of color functions as a foundational element in the translation of images into digital graphics and setting coordinate locations for 3D-printing.
Echos of these constellations reverberate on cave walls as outlines of lions, rhinos, and deer. The images found in Chavet Cave were created thirty-two thousand years ago by early humans. Images that demonstrate a similar reliance on standardized elements. Here, outlines and layers are techniques that create an illusion of three dimensional form, space, and depth on a two-dimensional surface. Interestingly, it was thought that perspective as a drawing technique was discovered during the Renaissance era, but the Chavet Cave paintings demonstrate how we have been relying on outlines and layers to create depth and space for thousands of years. This outlining and layering foreshadows techniques formalized in geometry and technical drawing that produce the illusion of depth, generate space within space, or grids to plot and track location. Centuries later, this technique was formalized in the treaty De Pictura (1504), dubbed to be linear perspective. Linear perspective would give rise to the Cartesian grid system which is used in digital imaging to generate depth and assign location to pixels. Just as the echos of constellations harken the dark recesses of Chavet Cave illuminating a world known only to early man, so do the outlines and layers etched on the walls of Chavet Cave allude to the future expression of digital images on screens around the world.
UNWANTED ADVICE: What is 3D printing and what do I need to know?
June 9, 2021
Kate M. Serralde
3D printing is the common term for Additive Manufacturing (AM). The term manufacturing and additive indicates two important parameters of 3D printing. First, manufacturing is about making objects. Second, additive highlights a kind of process that adds materials to create an object. What this means is that 3D printing makes objects by binding or adding materials together. Thus, AM is different from subtractive manufacturing which removes materials to create forms. There are many different kinds of AM processes, but the approach is the same: you lay down fine layers of material, figure out how to get it to stick together, and you have an object!
And on the surface, it is that simple. But each AM process has a unique way of binding materials together. For example, stereolithography uses a light-source to cure photo-polymer resins, while fused filament fabrication extrudes plastic filament by manipulating melting temperatures to create cohesion between layers. Because each AM process has unique manufacturing features, certain processes are better suited for certain projects. For medical practices, in particular, to fully benefit from 3D printing would require the ability to print with materials that simulate real tissue. However, some printers only print with types of thermoplastics that when cooled they become inflexible. While other processes are adept with printing in flexible materials, but the build area for these kinds of printers tend to be on the small side and this kind of material can be limited in terms of replicating fine detail.
What does this mean?
It means, that the way you envision your object may not correlate with what the 3D printer actually produces. For example, you may envision an object with a smooth surface, but some AM processes result in visible layers. Or you might assume that the 3D printed parts for your lightsaber will fit together perfectly right after printing. But most of the time, parts require sanding before assembling. Thus, it is important to understand that material properties can affect design parameters because some materials expand or contract during printing.
In addition, there are also sizing limitations, all printers are limited by the size of the machine's build area. A small build area can limit the size of the object you want to print. That being said, there are ways to work around size, but that requires dividing your object into parts, printing, and finally, figuring out how to assemble the final model. Furthermore, 3D printing is not necessarily intended for mass production. The true benefit of 3D printing is the ability to customize objects and print complex internal structures. For example, an airplane engine can be printed all at one time using AM rather than manufacturing all the parts separately. In the end, additive manufacturing is an amazing resource, but keeping these factors in mind will help you be successful in the actualization of your idea.
March 24, 2019
Disclaimer: We do not print with stem cells. This is purely research for academic purposes.
Since the birth of 3D printing and the promise of this outstanding technology, scientists have dreamt of producing a fully-functional 3D printed organ. While the scientific community has made a lot of progress towards that goal, current projections estimate that this feat will be achieved within the next 5 years. Think of what that could mean for the medical community!
Naturally, we at the Methodology Lab are curious beings. When we found out about bioprinting and all it will be capable of offering in the future, we had to know more. This lead us to Changxue Xu, Assistant Professor of Industrial, Manufacturing & Systems Engineering in the Edward E. Whitacre Jr. College of Engineering at Texas Tech University. Changxue Xu was able to help us understand the theoretical process of 3D tissue fabrication. He explained how the computer-aided, layer-by-layer additive biofabrication of functional human tissue and organs, and went in depth about how it should be constructed using self-assembling tissue spheroids as building blocks for the piece. Changxue Xu has been working diligently to understand this process, and has even been named as one of 18 Outstanding Young Manufacturing Engineers in the world by the Society of Manufacturing Engineers (congratulations from us at the Methodology Lab, Changxue Xu!).
Check out his notes and more information about what he taught us here.
*Ventola, C. (2014). Medical Applications for 3D Printing: Current and Projected Uses. P & T : A Peer-reviewed Journal for Formulary Management, 39(10), 704-11.
**Bertassoni, L., Cecconi, M., Manoharan, V., Nikkhah, M., Hjortnaes, J., Cristino, A., . . . Khademhosseini, A. (2014). Hydrogel bioprinted microchannel networks for vascularization of tissue engineering constructs. Lab on a Chip, 14(13), 2202-2211.
***Ozbolat IT, Yu Y. Bioprinting toward organ fabrication: challenges and future trends. IEEE Trans Biomed Eng 2013;60(3):691–699.
What does Karl Marx have to do 3D Printing and Medical Applications?
Kate M. Serralde
The flexible nature of additive manufacturing means the potential range for 3D printed medical applications will be broad, to say the least. Current applications range from prosthetics to surgical models. It is easy to understand how a 3D printed prosthetic hand or surgical model of a patient’s skull can fit into the practice of medicine. However, when I think about how to apply 3D printing within everyday medical practice, I draw a blank. So today, I want to focus on that blank. How we move from drawing a blank to the generation of new medical applications for 3D printing.
In order to answer that question, we must explore the nature of innovation and creativity. There are many views on what fuels innovation and creativity. In terms of 3D printing, any idea is constrained, in part, by how the printer works. Theories like Technological Determinism, a view held by Karl Marx, argue that technology is the best source for creative practice and innovation. If Karl Marx were here right now he would say:
Comrades, the way you develop new practices for 3D printing is to let the technology define it for you.
And on a surface level, this seems true. When it comes to finding ways to apply 3D printing within everyday medical practice, we are limited by what the technology can do. So, I think we can safely conclude that understanding how a technology works is the first step in generating new applications.
Yet, we have a problem (Karl Marx was wrong, sorry Karl). Tools like 3D printers can shape the scaffolding for our ideas, but they are not the ideas themselves. Defining sources of innovation by only 3D printing’s technological limitations doesn’t seem to accurately describe how we generate new ideas. Moreover, if innovation is constrained by function, then how do we develop new applications beyond the scope of the technology? There seems to be other factors influencing our choices on how to apply the technology. For example, the foundations for certain methods of bio-printing were influenced by candy manufacturing . By drawing connections between cell development and candy production, we see an adaptation of additive manufacturing methods. The innovation is found by discovering a relevant connection between seemingly disparate ideas: growing organs, making candy, and 3D printing.
But how were these connections made? These connections can occur in many ways. One way is to consider how we try to find relevant relationships between ideas.. For example, consider the following:
Why this person is eating cotton candy in a lab is beyond me. Nonetheless, we do seem to think like this at times; we indirectly seek relevance with disparate sources of information. Thus this reflexive search for relevance is what defines innovation, because it forces us to find new ways to connect ideas together. We take tools like a 3D printer into consideration but then apply it to a larger purpose. 3D printing is not the purpose itself.
What does this mean?
It means that we must be careful not to conflate the generation of ideas with only technological function. In other words, the 3D printer is not going to tell you how to apply it to the practice of medicine. But the starting point for innovation is understanding how 3D printing works. And here is my main point: it is our ability to think and reason that enables us to generate ideas that transcends the limitations of the technology. That is where the innovation lies, not in layers of plastic laid down by a 3D printer, but in our ability to see how that process of building an object can be applied to a diverse range of settings.
If we return to our original question: How do we generate medical applications with new technology? First, we must recognize our role in defining the function of the technology. Second, we need to understand and effectively implement the current practices of the technology. By learning the process of 3D printing, you will learn how to control the materials. From that control, you will start to make connections and understand the nature of the technology. At this point the 3D printer will become a blank slate upon which to draw a sweeter connection.
 Technological Determinism explains the rise and fall of governments based on their tendency to advance or restrict technology. See Jon Elster, An Introduction to Karl Marx (New York: Press Syndicate of the University of Cambridge, 1986), 105-106.
 Karl’s definition of the relationship between innovation and technology is deeply embedded in how production forces influence economic and individual development. See Jon Elster, An Introduction to Karl Marx (New York: Press Syndicate of the University of Cambridge, 1986).
 http://news.vumc.org/2016/02/08/cotton-candy-machines-may-hold-key-for-making-artificial-organs/ Accessed May 21, 2019.
 Lee, Jung Bok, Xintong Wang, Shannon Faley, Bradly Baer, Daniel A. Balikov, Hak‐Joon Sung, and Leon M. Bellan. "Development of 3D Microvascular Networks Within Gelatin Hydrogels Using Thermoresponsive Sacrificial Microfibers." Advanced Healthcare Materials 5.7 (2016): 781-85. Web.
 Gelber, Hurst, Comi, and Bhargava. "Model-guided Design and Characterization of a High-precision 3D Printing Process for Carbohydrate Glass." Additive Manufacturing 22 (2018): 38-50. Web.
 Relevance Theory is based on a theory of cognition by Sperber and Wilson that views cognitive information processing as significance driven: the classification of sensory input as relevant or non-relevant. In terms of communication, the exchange assumes that the mind relates new information to existing beliefs and represents this information in the most ‘readily available way.’ The theory focuses on the way the mind processes information through inferences made from a series of contextual assumptions and effects made by two communicators. Pilkington, Adrian. Poetic Effects : A Relevance Theory Perspective. J. Benjamins Pub., 2000. Print. Pragmatics & beyond New Ser. 75.
 The factors in the above twin earth scenario are completely fictitious and are not based on actual events.
Kate M. Serralde
Aesthetic or design principles are used to not only create a composition, but also express the artist’s intention, ideas, or feelings. The way these principles are used will determine how the composition will be interpreted.
First, the way you isolate the anatomy will tell a story. Think of the difference between a model of a heart and model that includes the skeletal frame. What is the relevant information in each image? The way the information is presented in the images delivers a fundamentally different message. The inclusion or exclusion of specific anatomical features changes how the viewer will interpret and interact with the images. The image below and to the right, the heart, directs your attention only to the organ. The other model directs your attention to spatial relationship between the rib cage and heart, moreover, the skeletal frame represents the physicality of a human being. Looking at the only heart, without the suggestion of human form, makes us think of only the heart as an organ. It could be the case, that the absence of human form might make heart image less emotionally charged, because it’s not associated directly with an actual person. However, introducing the skeletal frame suggests human form which allows the viewer to make different associations.
Second, aesthetic principles will help you during the creative process. As you start to make your 3D models, you might a have a very specific message you want to convey. Taking into consideration the interplay between balance and contrast, shape and form, unity versus disunity will help you structure the idea. Even if you think of your 3D printed model as an educational tool or for surgical preparation, the information you include in the model and how that information is structured is vital to it being understood.