The University of Southampton

Engineering Replacement body parts 2024-2025

An interdisciplinary module

Neuroprosthetic Devices

Neuroprosthetic devices make use of the nervous system to enhance their ability to efficiently restore function to a part of the body, usually after an injury has occurred [1]. 

Some examples are [2]: 

  • Cochlear implants 
  • Prosthetic limbs
  • Retinal implants

In this particular post I will concentrate on just these examples, explaining what they are and how they work, along with evaluating their risks and any ethical concerns surrounding their use.

Cochlear implants

What are cochlear implants?

Cochlear implants are devices used to allow someone who is deaf or extremely hard-of-hearing to have a sense of sound. Part of the implant is external and sits just behind the ear and the other part is internal and is placed under the skin [3]. The implant picks up sounds using the external part of the device which are then received by the receiver under the skin. These are then converted into electrical signals which can be used to stimulate the cochlear nerve and therefore be understood as sounds by the brain [4]. 

Figure 1: The cochlear implant. Left: The external part of the implant consisting of the transmitter, microphone and speech processor. Right: The internal part of the implant with the receiver under the skin and the electrode in the cochlear [5].

Risks and ethical concerns with cochlear implants

There are many benefits to this type of device which generally improve the patient’s quality of life. Adults tend to benefit from the implant immediately and could have the ability to understand speech without lip-reading, make telephone calls and even perceive different types of sounds [6].

However, there are also some drawbacks to the implant. It is invasive and requires surgery, which comes with various risks such as damage to the facial nerve, infection and leakage of fluids (cerebrospinal and perilymph) [6]. In addition to the surgical risks, there are also some general risks involved: any hearing that was remaining could be lost, the implant could fail and lifestyle changes will need to be made to prevent damage and interference with the implant [6].

There is also an ethical debate involving the use of cochlear implants in deaf/hard-of-hearing children. There was an interesting discussion I found about this topic in an article by Byrd et al. [7]. The article talked about how some people in the Deaf community are sceptical about the devices and feel that they are not worth the risks involved. Additionally, lots of parents in the Deaf community wish to also bring up their children in the community, so that they can share their language, culture and unique experiences. Because of this, some parents will choose to not put their Deaf children through the surgery. However, it has been shown that it’s beneficial for a child to have the implant before 24 months of age to allow better development of speech and language, so in some cases this has raised questions about whether not giving a child the surgery should be considered neglect.

I think that it’s a very complex situation and each case must be looked at individually to determine what’s best for the child in that particular scenario. I also think it’s important that the parents are well informed about the risks and benefits of cochlear implants so that they are able to make the right decision.

Prosthetic limbs

What are neuroprosthetic limbs?

Neuroprosthetic limbs are replacement limbs that are connected to the nervous system allowing the person to control the prosthesis with their brain. For example, in bionic legs, electrodes measure the nerve activity from the person’s intention to move their leg and then a computer in the neuroprosthetic device uses these signals to move the prosthesis [8].

Issues with neuroprosthetic limbs

Due to the type of data collected to train and use these devices, there needs to be an evaluation of the safety of this data to protect it from hacking [9]. Since AI is often involved with these devices, there is bias involved that should be taken into consideration [9].

In my opinion, although there are still some concerns surrounding the use of these devices, the potential benefits by far outweigh the risks, so more research in this area would be beneficial. And as technology improves, as will AI and the ability to protect data, so these concerns could be eliminated in the future.

Retinal implants

What are retinal implants?

Retinal implants are prosthetic devices that aim to restore some vision to those with vision loss by replacing the role of photoreceptors. They can be epiretinal (on the inner surface of the retina), subretinal (behind the retina) or suprachoroidal (between the choroid and the sclera) and they work by using direct electrical stimulation or by using photodiodes [10].

Figure 2: The structure of the retina showing the placement of epiretinal and subretinal implants [11].

Ethical concerns with retinal implants

In the article by Slattery [12], it is mentioned that from observing the data from clinical trials it is clear that visual accuracy cannot be guaranteed from the use of the implants, which can lead to misinterpretations that may affect a patient’s day-to-day life. In conclusion, this type of implant needs to be further researched to give people more confidence in its abilities.

Bibliography 

[1] B. C. Eapen, D. P. Murphy, and D. X. Cifu, “Neuroprosthetics in amputee and brain injury rehabilitation,” Experimental Neurology, vol. 287, pp. 479–485, Jan. 2017, doi: https://doi.org/10.1016/j.expneurol.2016.08.004

[2] D. Infante, “Bionics and Neuroprosthetics: The Future of Functionality with Biomedical Engineering,” News-Medical, Nov. 30, 2023. https://www.news-medical.net/health/Bionics-and-Neuroprosthetics-The-Future-of-Functionality-with-Biomedical-Engineering.aspx (accessed Mar. 09, 2025). 

[3] National Institute on Deafness and Other Communication Disorders, “Cochlear implants,” NIDCD, 2021. https://www.nidcd.nih.gov/health/cochlear-implants (accessed Mar. 10, 2025). 

[4] Mayo Clinic, “Cochlear Implants – Mayo Clinic,” Mayoclinic.org, May 10, 2022. https://www.mayoclinic.org/tests-procedures/cochlear-implants/about/pac-20385021 (accessed Mar. 10, 2025). 

[5]“Cochlear implant in Singapore – Hearing Specialist & Audiologist in Singapore | D&S Audiology,” Dsaudiology.sg, 2022. https://dsaudiology.sg/implantable-devices/ (accessed Mar. 11, 2025).

[6] “Benefits and Risks of Cochlear Implants,” U.S. Food and Drug Administration, Feb. 09, 2021. https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants (accessed Mar. 11, 2025).

[7] S. Byrd, A. G. Shuman, S. Kileny, and P. R. Kileny, “The right not to hear: The ethics of parental refusal of hearing rehabilitation,” The Laryngoscope, vol. 121, no. 8, pp. 1800–1804, Jul. 2011, doi: https://doi.org/10.1002/lary.21886.

[8] S. Ward, “People can move this bionic leg just by thinking about it,” MIT Technology Review, Jul. 2024. https://www.technologyreview.com/2024/07/01/1094459/bionic-leg-neural-prosthetic/ (accessed Mar. 12, 2025).

[9] Marcello Ienca, G. Valle, and Stanisa Raspopovic, “Clinical trials for implantable neural prostheses: understanding the ethical and technical requirements,” The Lancet Digital Health, Jan. 2025, doi: https://doi.org/10.1016/s2589-7500(24)00222-x.[10]

[10] L. N. Ayton et al., “An update on retinal prostheses,” Clinical Neurophysiology, vol. 131, no. 6, pp. 1383–1398, Jun. 2020, doi: https://doi.org/10.1016/j.clinph.2019.11.029.[12]

[11] “File:Retinal implant eyeimplant small.png – Wikimedia Commons,” Wikimedia.org, Jul. 29, 2012. https://commons.wikimedia.org/wiki/File:Retinal_implant_eyeimplant_small.png (accessed Mar. 12, 2025).

[12] M. Slattery, “The ethical future of bionic vision,” Pursuit, Dec. 05, 2017. https://pursuit.unimelb.edu.au/articles/the-ethical-future-of-bionic-vision (accessed Mar. 12, 2025).

Prisoners ‘Donating’ Organs For Sentence Reduction: Should The Punishment Fit The Crime?

In January 2023 two Democratic representatives, Judith Garcia and Carlos
Gonzalez, proposed a bill that would offer prisoners in Massachusetts a new way
to win not less than 60 and not more than 365-day reduction in their sentences by donating their bone marrow or vital organs. The legislators claimed that their proposal would respect the bodily autonomy of prisoners and would address racial disparities by helping to expand the pool of donors.

I must refute this claim. How is this a bill that was passed in TWENTY TWENTY-THREE – a mere two years ago? You’d think politicians would’ve learned by now. Consider the situation in which a prisoner was wrongfully committed and jailed. It is actually estimated that 1 percent of the US prison population, approximately 20,000 people, are falsely convicted. In this case, the punishment does not fit the crime because the crime was never even committed in the first place, and while this is true the bill should have never been passed.

In the instance the crime was committed, it simply doesn’t make sense that the sentence can be modified in anyway. Altering the sentence undermines the idea that it was appropriately determined in the first place which sets a dangerous precedent, suggesting that sentences are flexible rather than fitting the severity of the crime. It also opens the way for future modifications undermining the integrity of the legal system and its ability to deliver justice.

BUT this isn’t even the real problem here. Fundamentally, it does not matter what these prisoners have done – they are still people. Human beings. There will never be real autonomy or true consent in this situation to ask them to give their bodies in exchange for freedom. It’s not a fair trade; it’s a blatant violation of human rights. It’s preying on vulnerable people who have little choice because the alternative – staying locked up for longer – is not really a choice, only the illusion of one.

This punishment will never fit the crime. Furthermore, Garcia and Gonzalez have walked back their proposal and are planning to introduce a version without the promise of a sentence reduction. This bill should never have been passed to allow this change in the first place. Bills passed in future need to focus on real reform—improving rehabilitation, ensuring fair sentencing, and expanding ethical organ donation programs by increasing public awareness and expanding donor registration programs.

Paws to Consider: Ethics Within the Growing World of Animal Prosthetics

Imagine a dragon regaining the ability to fly with a prosthetic tail. Now I’m not just talking about “Toothless” from the movie “How to train your dragon”, but this is a real emerging field in science where real animals in unfortunate situations get the chance to live a better life. As a pet owner myself, should something happen to my cats, I wouldn’t hesitate to provide them with the prostheses that they need to live comfortably again but is this really my choice to make? Are prosthetics for animals justifiable or are we just playing God?

Pivotal Events in Animal Prosthetics

Human prosthetics date back thousands of years but for animals, the idea emerged much more recently, evolving from rudimentary solutions to advanced personalised devices.

Timeline showing the evolution of animal prosthetics

High Profile Cases

“Winter”, a bottlenose dolphin who lost her tail after getting caught in a fishing net received a 3D-printed tail. She slowly regained mobility and could swim again at the Clearwater Marine aquarium (they even made a movie about her! Watch “Dolphin Tale” for her full story).

YouTube video of Winter getting fitted with her new tail

Other notable cases:

  • First reptile to receive a prosthetic limb
  • Lost his tail after being illegally transported
  • Was fitted with a 3D-printed prosthetic one
  • Rescued from a frozen puddle as a puppy
  • Lost his paws and part of his tail due to frostbite
  • Was fitted with 4 prosthetic limbs (first dog to have 4 prosthetic limbs!)
  • Lost her leg by stepping on a landmine
  • Received a prosthetic leg

A Deep Dive into Ethics

All these cases are inspiring, however the question of whether we should be altering an animal’s body remains an ethical dilemma. While I believe for the most part that prosthetics can help improve an animal’s life, some ethical issues are raised:

  • It’s not entirely clear if animals truly benefit from prosthetics long-term or if their suffering is simply prolonged.
  • Often, the need for animal prosthetics may be driven more by the human desire to “fix” things rather than the animal’s genuine needs.
  • In many cases, animals are given prosthetics for cosmetic reasons, to meet human expectations.
  • Animals can’t voice their opinions, so the decision lies in the hands of veterinarians, caretakers and pet owners.

Legal Boundaries of Animal Prosthetics

While there are general veterinary medical guidelines ensuring the safety and well-being of animals undergoing procedures, legal frameworks related to prosthetics are still developing.

  • There are no universal laws that protect animals from unnecessary prosthetic procedures.
  • The cost of the prosthetics can be substantial.
  • Insurance often doesn’t cover the procedures, as they are not always classified as medical necessities.
  • Pet owners are left to bear the financial burden.

A New Era of Compassion

In the past century, society’s perception of disabled animals has drastically shifted. Injured/disabled animals were often euthanised, due to few chances of recovery. Now, thanks to animal advocacy groups, the public has become more sympathetic toward animals with disabilities, many seeing prosthetics as a viable way to provide their furry companions with fuller, happier lives. Rehabilitation has also proven that animals with prosthetics can not only survive but thrive in their environment.

Final Thoughts

Some scepticism still exists about whether animals truly need prosthetics, or if they are merely a human desire. Ultimately, I firmly believe that the decision to fit an animal with a prosthetic should be made in the best interests of the animal and should involve careful consideration of the animal’s needs and physical and emotional state by professionals.

References:

https://watermark.silverchair.com/vcae013.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA0wwggNIBgkqhkiG9w0BBwagggM5MIIDNQIBADCCAy4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMw1-KMyh7YV1719YwAgEQgIIC_0E3oGMRiztUg7f_5QozdIzViH-p3cpz-bvJ7MltSYSC-KZMLgNCpA2yk22KM_XzoSHQCKVLCNqi1LsvCpJkWvixmdqaUTDa3VX_ZEUZUsafL_ID-M0cVdnu_fLMaI_3OBA8N2xmffUY9VisZUvZ2JSZAt3L9CyYXKLPibd-7EgWWaLMo8hvPHqXFhGEENxRaAC-jtRT_TFQ6q4WQeshnLZ-q-ez5Sa92tphkoxJYN2OUduzCzL08oAKaxhihUPPT28dYImGl7SaQwOuVwVteZChAAtWwzdrZgj7m0–WXcpNWKotCEdG6SsZwT3x1S1fAAohrqD5dPG8NCatV3Mc3XMwi7hRYvml7BAW3kogSvEc9ko2sEmXxOI10Rt-CaHzZXsDPziQ8NsxcGu6SfZ4bZm-ddEaASLPsYd0X6GtI6VSDLMJT5gVF11N2tCynj1sdQ5B3Ok7ly-hpx-rqFY6nehTd8TP_eR6ZDhTW1DRL70Z1z2imMSdjmkdAa1tNYqUGLtWvOdMMby-6i6dx9lphDSBzeNkAtDqyPYpJp1s7IQwdi3GV3vnjxjXBlu9KGCbi64XwfOgkGHqG2r0v9SCNkt5tk08W5wh324OqYyJpnjK9etqdR9cLOjyo9DjK5Dl_fs4McupWDe4S3ggs3q2lopuyjkdTt_YNUhkLQVetxzxfODG1f9S89WQnPsgRadv0kEp0_lYIDINM2XOL5oP-R9eh_sykEVpH30JstS7oG1LU7AxzvEGmNXvqOB8n6M2bd195c4ECUoRpeqyf4PyKiG_Eat2uhKWy0kEAe15KiyZiT7ko-LMgCxHZIOngClcknw9DdcAsNkQvXk-ItVxQPPvwPQZhBeENmhVLnwLSmYlImGj3AkmrI3z7QceCMZEyEoumdYoYbfnflEzJTwmw76l65h6SVF6nIhw3RP6Rsa29jMkXhn8sFL7YCp0wqSXzAgw423ivNYQ78tSVZGYgu1b696qriXupmZOAxBnCsousweU-qebbEAgL1K1cto

https://www.cmaquarium.org/animals/dolphins/winter

https://www.mentalfloss.com/article/55866/11-animals-amazing-prosthetics

https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/miscellaneous

https://en.wikipedia.org/wiki/List_of_animal_rights_groups

Cloning: A brief timeline surrounding Dolly

You must know Dolly?! The sensational sheep that was famously cloned in 1996. She’s been heavily reported in near every biology textbook and her story is eagerly recited by millions. She played a significant role in advancing our scientific knowledge. However, most are unaware of the work that led to her being a possibility and in almost three decades we have had major advancements! Did you know Dolly wasn’t even the first cloned animal?

Here is a brief history of cloning from the past and some of the controversial techniques availible today.

Photo of dolly the sheep from the natural history museum in Edinborough

What is cloning?

Cloning is the process of creating a genetically identical individual. Identical twins are natural clones. This concept is widely used as a plot line in media. You must have seen cloning in the movie Jurassic park! Perhaps the book Alex rider? Where an evil scientist creates clones of himself and uses them to try and achieve world domination.

The possibilities of cloning is exciting but clearly potentially problematic! More on that later…

Time line Towards Dolly

  • The early days 1885 – Embryonic cells were separated in the early stages of development of sea urchins.
  • 1928 – The same method was used to clone salamanders but were not viable/fully formed
  • Nuclear transfer – 1950 – The first successful nuclear transfer on a tadpole!

A frog egg nucleus is removed and a the nucleus from another tadpole is added into the empty frog egg.

  • 1958 – Nuclei from differentiated cells were found to result in development.
  • 1970s- The first genetically identical mice was produced by splitting mouse embryos.
  • Dawn of Cloning – 1996 – Dolly the sheep, the first mammal from an adult somatic cell was created.

Cloning after Dolly

  • 2001 -Endangered animals have been cloned.
  • 2013 – Human embryonic stem cells are created using somatic cell nuclear transfer. 

The successful cloning of Dolly led the way for vast improvements in our understanding of stem cells. For the first time it had been shown that a cell could be reprogramed after it had specialised and be used to form an organism. Important ethical issues were raised particularly surrounding human cloning and later the use of human embryos for stem cell research. Would you want your DNA used to create another being the same as you? On one hand it would be kind of amazing to have someone that thinks and acts inherently the same as me but at the same time I don’t think I could stand another one of me! Many had a moral apprehension around cloning and as such human cloning was immediately banned by UNESCO. The use of human embryos is also heavily regulated with the Warnock report restricting research on embryos up to 14 days old.

Nowadays there is a market for Pet cloning, yes you heard me right! Companies are providing the ability to have the DNA of your pet cloned to bring back your lost pup! I am flabbergasted that this is availible for purchase. My first thoughts were that this was pointless as it wouldn’t fully bring back your lost pet but after watching the video I am less sure. it did seem to bring solace to the pet owner, if its a harmless venture, why not?

Watch how cloning has been used to create Marley and Mabel!

Cloning can be hugely beneficial, such as producing live stock with desirable traits and the potential to study genetic diseases and develop cures, including bringing joy back after the loss of a beloved pet. However cloning also raises the concern of autonomy and individuality some argue that its unnatural and could lead to the exploitation and misuse. Additionally the technology required for cloning is expensive unavailable to most third world countries. Is it right to be benefiting from something that others cannot? What do you think?

Bibliography

Books (2023) Anthony Horowitz. Available at: https://anthonyhorowitz.com/books/list/series/alex-rider (Accessed: 11 March 2025).

Häyry, M. (2018) ‘Ethics and cloning’, British Medical Bulletin, 128(1), pp. 15–21. Available at: https://doi.org/10.1093/bmb/ldy031.

Sciences (US), N.A. of et al. (2002) ‘Cloning: Definitions And Applications’, in Scientific and Medical Aspects of Human Reproductive Cloning. National Academies Press (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK223960/ (Accessed: 11 March 2025).

The History of Cloning (no date). Available at: https://learn.genetics.utah.edu/content/cloning/clonezone/ (Accessed: 10 March 2025).





Have BIG toe joint replacements solved BIG problems?

There are many accidents and events that lead to pain and suffering, but none greater than the minutes following stubbing your big toe on the corner of a coffee table (disclaimer – this is not fact, purely for comedic purposes).

However, severe pain in the Hallux (a fancy scientific name for ‘big toe’) is an every day reality for many. 1 in 40 people over the age of 50 suffer from big toe arthritis (Hallux Rigidus) and 16% of those suffering foot pain identified the Hallux as the centre of pain.

Potential treatments

Solutions for Hallux pain date back to the Egyptians, where replacements toes were found from about 1000 BC and in recent years, it has been favourable to fuse the bones at the affected joint, limiting pain and consequentially movement. But, focus has recently shifted, due to revolutionising joint replacement technologies, prioritising the maintenance of as much bone and cartilage as safe and viable.

Cartoon above by Tom Williams, showing a comedic representation of a hammer-toe ‘specialist’ who uses a hammer to treat the Hallux, also known as the hammer toe.

One example of this is Anika – a global joint preservation company, that is leading efforts to help people suffering from Hallux pain, particularly through their ToeMotionÂŽ and Toe HemiCAPÂŽ DF products. The video below providing an explanation of how this technology works (posted by Mason City Clinic).

Video transcript:
Bones joint damage near toes can become debilitating and painful but relief is easier than you think. Osteoarthritis causes the bone and cartilage of the metatarsal the longest bone of the toe to wear down over time this causes pain and limits the toes effective range of motion. In more advanced cases both sides of the toe joint are damaged and a total resurfacing with implants on both sides of the joint may be necessary. The arthro surface toe motion total toe system is a simple procedure that can significantly reduce your pain while providing motion for a more active lifestyle. Here’s how it works. First your surgeon will insert a metal guide wire into the metatarsal bone ensuring that the implant itself will be inserted at exactly the right angle. Next the surgeon inserts a tapered screw designed for maximum strength, durability and fixation. Using a system unique to artho surface, the search and map several data points on your joint surface to figure out the curves of your damaged joint, ensuring that the implant will be a perfect fit. The surgeon then prepares the surface by means of a specialized reamer smoothing out the roughness caused by osteoarthritis and preparing the bone for the implant. Before placing the final implant on the metatarsal side, your surgeon will prepare the opposite side of the joint known as the phalangeal side similar to the technique for the metatarsal bone. The surgeon will begin by placing a metal guide wire, ensuring that the implant is inserted with the correct orientation. After shaping and preparing the bone for the implant, a metal base plate is screwed into place. The appropriate plastic implant is then locked into the base plate with the correct curve in thickness to match your joint. The phalangeal side implant is shaped like a cup and is designed to meet with the rounded metal implant on the metatarsal side. Once the plastic component is secured in place on the phalangeal side of the joint, the final metal implant is then locked into the screw on the metatarsal side, which completes the implantation. The final hem II cap implants are small, unobtrusive, strong and the only implants that have
screw fixation on both sides of the joint. The implants are designed to match variations in patient anatomy so the surgeon can obtain a personalized fit at the time of surgery. With the procedure
completed, the two sides of the joint moved smoothly against one another, simulating the movement of a toe joint. The toe motion procedure can be performed as an outpatient procedure, it’s minimally invasive, restores mobility and lets you enjoy an active lifestyle again.

Arthroplasty over Arthrodesis?

There are many arguments for why Arthroplasty is becoming more favourable than traditional Arthrodesis fusion methods (listed below), all of which are focused towards improving the patients care, recovery and experience with a toe joint replacement.

These arguments are supported by the successes of this medical advancement, which has helped people, at all levels, to get back on their feet. Furthermore, this technology is in line with the NICE joint replacement standards and actually seems to enhance them by giving patients more treatment options, preventing implant errors by removing less bone matter and improving rehabilitation with shorter recovery times.

Anna Lynch’s story: Anna feared she may never be able to walk pain free again, due to debilitating pain in her left big toe, but just months after her operation she trekked 10,000 feet up the Himalayas.

https://www.northeastfootandanklesurgery.co.uk/in-the-news.html

Despite overwhelming success, there is also still some drawbacks to this technology. For example it is fairly modern, so long term survival of the prosthetic cannot yet be disclosed with complete confidence and there is still lasting support for fusion as the more ‘reliable’ method of treatment. However, the benefits greatly outweigh the drawbacks (shown below).

Could this be BIGGER than the BIG toe?

There is also possibility to further this technology. Arthritis is now one of many disorders Hallux Arthroplasty can treat. Others include Hallux Vaglus (bunions), Osteonecrosis and unstable/painful MTP joints – making it a versatile treatment worth investing in.

The practises involved in this treatment have also been expanded to other areas of the body in hopes of achieving the same success, especially in places proven difficult to treat, such as the spine. This makes clear the significance of toe joint replacement technology and how the ideas and structures, e.g. replacement over fusion (shown in the image below), behind it, could revolutionise treatment for more difficult injuries, to allow greater movement and therefore quality of life for patients.

Article on the potential use of total joint replacement of the spine. Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC11265502/pdf/IJSS-18-01-8538.pdf
X-ray images of spinal joint treatment – left image is a lumbar spinal fusion, right image is a artificial disk replacement.
Right image from Mathur S, Jenis LG, An HS: Surgical Management of Chronic Low Back Pain: Arthrodesis, in Jenis LG, ed: Low Back Pain: Monograph Series
Left image from Jenis LG: Surgical Management of Chronic Low Back Pain: Alternatives to Arthrodesis, in Jenis LG, ed: Low Back Pain: Monograph Series. Rosemont, IL, Amer Acad of Orthop Surg, 2005.

My thoughts…

Overall, it could be considered that there is BIG potential for this shift from fusion to joint replacement technology to help improve patient care and quality of life. Starting by improving motion of the BIG toe and hopefully towards future success in more complex regions and functions.

And yours…

Ethics Already Chains Stem Cells – Are Cancer Cells a Step Too Far?

The Return of an Idea –

As a biologist who seeks to uncover the inner-workings of nature to better understand what makes organisms tick and potentially some day cure the seemingly incurable, the lecture I was most excited for in the UOSM2031 Module was that of the stem cell lecture. It’s among my greatest interests in science – a cell that can become any other, a tool to fit any screw, a piece to fit any puzzle, and I’ve been hotly interested in them ever since my biology lessons in my first year of secondary school. It was there that my biology teacher, Mr. Thomas (I wonder where he is now), stood in front of a class of generally apathetic and sleepless teenagers and spoke about a subset of cells called ESCs – Embryonic Stem Cells – which are pluripotent, unspecialized cells arising in the blastocyst (4-5 day old embryo) of a new organism, and have the miraculous ability to differentiate into whatever cell type the body requires, for the purpose of developing a complete body. These could also be cultured ex vivo in labs.

This was all covered in the lecture on the 3rd of February, but was not particularly new to me; what really piqued my interest that day was remembering an idea I had all those years ago. An idea that I took to the equally sleep-deprived Mr. Thomas after class and asked him, “Sir, what if we made hybridoma stem cells?”

A New Frontier of Immunology –

Now the idea was merely that, an idea. Very little deep thought was put into the logic and science of its functionality or practicality, but it was Albert Einstein who was thought to have said, “Innovation is not the product of logical thought, even though the final product is tied to a logical structure”. You have to start somewhere! Just the week prior we had been given a lecture on a type of cell culturing technology called Hybridomas, cell lines that would continually and rapidly produce monoclonal antibodies (mAbs) for the purpose of harvesting the antibodies for treatments, and these cells producing them would ideally never senesce (grow old and stop dividing). The reason for this? They were created from cancer cells. From the fusion of a designated B-lymphocyte immune cell taken from experimental animals and a myeloma (cancerous immune cell), a heterokaryon (cell with multiple nuclei) would be produced capable of unrestricted proliferation and antibody production – key elements of its constituent cells. Practically, it is a useful method of harvesting large amounts of dedicated antibodies towards a specific disease, and as old and low-complexity as it is, being a method originally developed in the 1970s, research is still conducted on it today, simultaneously to assess its viability alongside modern techniques.

Moraes et al., (2021) seek to compare hybridoma and mAb technologies with other emerging approaches, and discuss their benefits and limitations in this research paper.

Moraes JZ, Hamaguchi B, Braggion C, Speciale ER, Cesar FBV, Soares GFDS, Osaki JH, Pereira TM, Aguiar RB. Hybridoma technology: is it still useful? Curr Res Immunol. 2021 Mar 22;2:32-40. doi: 10.1016/j.crimmu.2021.03.002. PMID: 35492397; PMCID: PMC9040095.

To apply this idea to stem cells, what exactly was my approach? While I have done much research into hybridomas and stem cells over the years to better understand them, there is still much to figure out towards it being a working method, but the general concept is simple: combine a pluripotent stem cell with the endless proliferation of a cancer cell to yield a rapidly multiplying source of stem cells for fast and effective treatment. The challenges and difficulty are obvious concerning the use of cancer and ESCs to try and make a new cell line but I feel the benefits outweigh any costs. Almost like an axolotl is able to do, this may allow for the total repair/replacement of entire limbs, organs and tissue all from within the body itself, fully coinciding with the principle purpose of this academic module, Engineering Replacement Body Parts. It can go even further however; replacing neurons which is a most challenging aspect of medicine could be the key to eliminating neurodegenerative disorders like Alzheimer’s and Dementia, which I have experience with in my family and through my mother’s work in the NHS (always an inspiration of mine). So it is clear to see where my motivation for the idea strives from… but will ethics even allow this research?

Axolotls can replace entire limbs by distributing stem cells to the sites of regrowth. They can even do this with parts of their brain using Ependymoglial cells, which are like human neural stem cells. Imagine if we incorporated that? Image property of Julia Moore (2015), obtained from:https://medium.com/quarkmagazine/are-axolotl-the-key-to-everlasting-life-b4b35c9649a5

The Bane of Scientific Advancement? –

The reason for this whole retrospection of my hybridoma stem cell idea in the first place was because I attended a lecture recently that revisited these concepts, and then I had proceeded to have another lecture that revisited yet another aspect of cutting edge scientific development that holds great relevance in the realm of this discussion, only this one I’m slightly less excited about – the ethics of stem cell research. While I call it my least favourite part of the course, it’s not for lack of importance or interest in its discussion, but that it always seems to be the dampening factor on developing a lot of these ideas. On the 3rd of March, we discussed in lesson the ethical arguments surrounding using stem cells for research, and how in 1990, the Human Fertilization and Embryology Authority (HFEA) was set up to establish the guidelines for using them, in response to an enquiry headed by Dame Mary Warnock as to whether scientists should be allowed to freely experiment on the surplus embryos, not only for the reason of harvesting the ESCs from the embryos that would effectively be ‘destroying’ them. They eventually settled on the ‘14-day rule‘, where embryos could only be studied for 14 days at maximum in the lab, or until the ‘primitive streak‘ had appeared on the embryo (a division line of cells).

Dame Mary Warnock, 1924-2019. Photography by Steve Pyke, image obtained from: https://www.nature.com/articles/d41586-019-01277-5

The main reasoning for this and the discussion as a whole is a whole host of moral/ethical arguments as to whether it is ‘inhumane’ to be treating these embryos like mere lab samples and whether stem cell research is effectively the termination of a potential life. Truth be told, I believe these ethical ‘dilemmas’ often get in the way of true scientific breakthrough for the simple reason that people are afraid of what they don’t understand, and things that seem unnatural or are otherwise unexplored frontiers are often viewed as taboo. I have to give Baroness Warnock some credit however, as she claimed the 14-day limit was more to “allay public anxiety” rather than be based on science, indicating the interest in its study was vital, and this was more to keep society ‘happy’. The embryos studied in question are usually excess embryos from fertility clinics that will get destroyed either way if unused, and to not use them for what is potentially life-saving research at the risk of ‘messing with life’ seems silly, and calls into question a very common argument those that are against commonly use: that an embryo is more valuable than a typical culture of cells. If so, would the life of someone with dementia who could greatly benefit from something like hybridoma stem cells be equal to that of an embryo that may very well never develop beyond a certain point? If morals are the standard, what authority decides a human life is any more valuable than any other animal? Obviously, it is an expansive and sensitive discussion that needs exploration well beyond this brief outline, but I only call it into question because it was the very Mr. Thomas himself – my biology teacher – who said “would people really accept the use of cancer and embryonic stem cells as a treatment if it meant ‘people had to die’ for it to work?” He was being metaphorical for the most part and said it mainly to promote thought, but it did make me think. I understand the hesitancy to destroy something as ‘valuable’ as embryos for science, and if this bothers people, what would they think of combining it with cancer, or even then implanting that in someone’s body? I don’t doubt an entirely new discussion and set of guidelines would arise to take control of this approach as well, and as it almost always about control, that is what bothers me. But perhaps I am sometimes too unsentimental and brazen about the issues – I only want to make the world a better place, and in my mind I see the trial and error using these sensitive resources a ‘necessary evil‘ for the betterment of humanity. These ethics are here for a reason after all, and a society without rules will collapse into anarchy, so perhaps this is a large part of my ‘grand’ idea that I have yet to fully explore; maybe research into the method will yield a better way for me to make it a reality, one that makes everyone happy.

References:

Building a Beating Heart : The Role of 3D Bioprinting in Artificial Organ Transplants

Imagine a world where organ transplant waiting lists no longer exist. Where a failing heart, kidney or liver doesn’t lead to a possible death sentence and can be fixed with a simple immediate replacement. According to the World Health Organisation, cardiovascular disease is the leading cause of death worldwide, accounting for almost 15% of all deaths. For patients suffering from end-stage cardiovascular disease, often heart transplantation is the only available option. However, the demand for heart transplants is outweighed by the number of healthy hearts available. 

 Recent and Ongoing Developments in Bio-printing :

There have been multiple breakthroughs and developments recently that all contribute towards bringing us closer to functional bio-printed hearts.

  • Bio-inks: Scientists have been developing advanced bio-inks that better mimic the properties of human heart tissues. Bio-inks are printable materials that can incorporate live cells in 3D and bioactive molecules for bioprinting, allowing for precise 3D placement of cells or molecules within the construct.
  • Scaffolding for Blood Vessels: One of the biggest hurdles is replicating the complex vascular system of the heart. Without a proper network of blood vessels, bioprinted hearts would fail due to a lack of oxygen and nutrients. Researchers are making progress in engineering capillaries and larger vessels to support full organ function. Earlier in 2019, a team of scientists created 3D printed vascular networks that mimic the body’s nature passageways for blood, air, lymph, and other vital fluids. This innovation has cleared a major hurdle in printing functional human tissue and opened the pathway to complete 3D printing heart replacement organs.
  • Miniature 3D-Printed Hearts: In 2019, researchers at Tel Aviv University successfully printed a tiny heart using human cells, complete with chambers and blood vessels. Although it lacked full functionality, this marked an essential step toward printing life-sized, beating hearts.
  • Electrophysiological Control: Bioprinted heart tissue needs to be able to conduct electrical signals properly to enable synchronised contractions. Scientists are experimenting with specialised biomaterials that improve electrical conductivity within printed tissues, enhancing their ability to beat in a coordinated manner.

However, despite all these developments, there are several major obstacles that stand in the way of Bio-printed hearts being transplanted in the near future.

  • Functionality & Longevity: Even though scientists have printed heart tissues, ensuring that these tissues can beat synchronously and sustain long-term function remains a challenge. Hearts must endure years of stress without degradation.
  • Scalability & Precision: Printing a full-sized, fully functional heart that can integrate seamlessly with the human body requires extreme precision, biomimicry, and technological advancements beyond what we currently possess.
  • Vascularisation & Nutrient Delivery: A fully printed heart needs an intricate vascular system that not only delivers oxygen and nutrients but also removes waste efficiently.
  • Regulatory Approval: Like any new medical technology, bioprinted hearts must undergo extensive clinical trials to ensure safety and efficacy before becoming a standard treatment option. Ethical considerations and regulatory hurdles could slow down widespread implementation.

When can we expect the first Bio-printed heart transplant?

Experts predict that within the next 10-20 years, we may see the first clinical trials of bioprinted heart transplants. Initially, printed heart tissues might be used to repair damaged hearts, replace sections of heart muscle, or develop more realistic models for drug testing rather than replacing entire organs. Full organ transplants may take much longer.

While we’re not quite there yet, each scientific breakthrough brings us closer to a future where a patient in need of a heart transplant won’t have to wait—they can have one printed just for them.

References :

  1. Freeman, D. (2019). Israeli scientists create world’s first 3D-printed heart using human cells. [online] NBC News. Available at: https://www.nbcnews.com/mach/science/israeli-scientists-create-world-s-first-3d-printed-heart-using-ncna996031.
  2. ‌Jacobsen, B. (n.d.). We Now Have 3D-Printed Human Hearts. [online] Future Proof. Available at: https://www.futuresplatform.com/blog/3d-printed-human-hearts.

Necrobotics: the future of death

Imagine a tiny robotic gripper, delicate yet powerful, capable of lifting objects many times its weight. Now, picture that this gripper is not made of metal or plastic but the reanimated legs of a dead spider. This is necrobotics, a ground-breaking field intersecting robotics and bioengineering, where deceased organisms are repurposed into functional machines.

Invention of nectrobotics

Necrobotics originated from a study at Rice University, where researchers Daniel Preston, and Te Faye Yap, manipulated a dead wolf spider’s limbs using pressurised air to force extension and contraction. This worked as a spider’s legs rely primarily on a hydraulic pressure system rather than their muscles. However, it’s worth noting a spider’s leg flexor muscles naturally constrict when relaxed meaning it takes no external power to curl their legs. To replicate the spider’s leg extension researchers inserted a syringe into the dead spider’s prosoma (head-chest region) and injected air resulting in the opening of the spider’s legs and vice versa. This process can be seen in the image below:

They tested the lifting capabilities of different species of spider necrobotic grippers and found wolf spiders could lift objects to 130% of their body weight. However, the larger the spider species, the smaller the gripping force relative to body weight.

Upon testing its lifespan functionality, researchers cyclically repeated a series of actions and found it could actuate 700 to 1000 times before cracks formed on the membrane of the leg joints due to dehydration. These degraded joints lead to loss of functionality requiring replacement.

Further description and demonstration of the system are shown in the video below:

Advantages

  • Sustainability and biodegradability – as these are formed from dead biological structures they are sustainable and decompose easily.
  • Fast fabrication and low cost – the time to make a spider gripper can be done in under 30 minutes. These provide an alternative to small mechanical grippers which are costly, complex and difficult to manufacture.
  • Ideal for intricate tasks – necrobotic systems can grip irregularly shaped objects that are larger and heavier than itself, all while maintaining a delicate touch. One potential application is in microelectronics, where these systems could be used for simple pick-and-place actions, handling fragile components with precision.

Disadvantages

  • Necrobotic systems inevitably degrade over time. The joints typically last up to 1,000 cycles, while the tissues, without preservation, begin to degrade after about a week.
  • Greater chance of failure when compared to mechanical systems.
  • Organic inconsistencies – not all spiders are made the same so the gripping force can vary.
  • Ethical concerns surrounding necrobotics are significant. While many, find the concept intriguing, it can also feel disturbing or disrespectful to use deceased bodies for robotic purposes. As Gaurav Dhiman asks, “Does necrobotics violate the dignity and rights of deceased organisms?”

Conclusion

For better or worse, spiders hold the most potential in necrobotics. Fabricating hydraulics, muscles, and joints on such a small scale can be very challenging, if not impossible. Spiders, however, naturally possess these mechanisms, making them ideal for creating eco-friendly, biodegradable robotic systems. However, with such technology comes ethical concerns: Where do we draw the line between technology and nature? Is it ethical to manipulate once-living creatures for human use, even after death? Some may argue that using naturally deceased organisms is no different from utilizing leather or bone in craftmanship. Others may see it as a step towards commodifying life itself reducing once-living beings into mere tools.

References:

From Thought to Movement: The Future of Bionic Limbs

The only way of discovering the limits of the possible is to venture a little way past they into the impossible.” – Arthur C. Clarke


Losing a limb or motor function can be life altering but what if you could regain control through the power of your own mind? Once a concept confined to science fiction, motor neuroprostheses and bionic limbs are now turning fiction into reality. By translating neural signals into motion, these mechanisms are helping individuals with amputations and paralysis regain independence.


Prosthetics have come a long way since their invention in 950 BC [1]. The first designs primarily focused on restoring appearance whilst, modern prosthetics aim to replicate movement and even restore lost sensations.

The video below provides a timeline of key advancements in prosthetic technology; showcasing how innovations have improved both functionality and quality of life for users.


Image source: Nature Biomedical Engineering, A biointegrated and wireless anatomically conformal electronic system for spinal cord neuromodulation
Nature Biomedical Engineering, A biointegrated and wireless anatomically conformal electronic system for spinal cord neuromodulation

At the present day, technology has advanced massively since the first prosthetic; leading to the development of neuroprostheses. Neuroprostheses are bio-hybrid devices that connect electrodes to human tissue to activate neurons or record their activity; in order to regain or amplify lost motor, sensory or cognitive functions [2].

Even after an individual loses a limb or the control of a limb the brain signals responsible for the control of the limb remain in tact. Neuroprostheses takes advantage of this; electrodes are implanted into the area of the brain related to the lost movement, and record electrical activity. These brain signals are then translated to control signals via processing through brain computer interfaces (BCI) or brain machine interfaces (BMI). These control signals can then be used to operate external devices such as robotic arms or they can be used to stimulate the muscle directly to restore lost motor function [3].


Navigating the Ethics of Enhancing Humanity

As promising as neuroprosthetic technology is, it also rases concern to complex ethical dilemmas. How far should we go in enhancing human abilities? What are the consequences of merging biology with advanced technology? How accessible should these life-changing innovations be? These are just a few questions sparking debate as we push the boundaries of what’s possible with bionic limbs and neuroprosthetics. While the potential benefits may be undeniable, it’s important to consider any potential risks and moral implications of integrating technology into the human body.

Image courtesy of The Sun – ‘Children’s Experiences with Bionic Arms.’

One of the most pressing ethical concerns surrounding neuroprosthetics is their accessibility. For example, in a recent article about children receiving bionic arms as life-changing gifts, it’s highlighted that bionic arms can cost up to ÂŁ180,000, making them unattainable for many families unless supported by generous donations. This raises an essential question: should life-changing technologies be available only to those who can afford them?

With cutting edge innovations being financially exclusive, we risk deepening existing inequalities within healthcare; leaving the most vulnerable without access to the help they need. As neuroprosthetics evolve, it’s crucial that we address how to make these life altering devices accessible to everyone, not just those with the means to pay. While the physical and emotional benefits for those who receive them are undeniable, the ethical dilemma of who can access these advancements remain a critical issue.


In conclusion, neuroprosthetics are a powerful example of pushing the boundaries of what’s possible. The future of neuroprosthetics relies not only on innovation but on making these life-changing technologies equitable and accessible.


References:

  1. Admin U. UPMC HealthBeat. 2015 [cited 2025 Mar 11]. Timeline: Prosthetic Limbs Through the Years. Available from: https://share.upmc.com/2015/03/timeline-prosthetic-limbs-years/
  2. Neuroprosthetics – an overview | ScienceDirect Topics [Internet]. [cited 2025 Mar 11]. Available from: https://www.sciencedirect.com/topics/neuroscience/neuroprosthetics
  3. Gupta A, Vardalakis N, Wagner FB. Neuroprosthetics: from sensorimotor to cognitive disorders. Commun Biol. 2023 Jan 6;6(1):1–17.

The Hernia Mesh “Controversy”

Every year, the NHS performs almost 100,000 hernia related surgeries, with 75% of surgeries using a mesh. However during one of our prosthesis lectures, I was surprised to hear about hernia meshes being controversial. So why would such a popular procedure have a negative reputation?

What is a hernia?

Hernias occur when a hole or a weak spot in tissue allows organs or fatty tissue to poke through, the most common hernia in the UK being an inguinal hernia in the groin, but they can also occur in the abdomen. A polypropylene or polyester mesh can be inserted to provide permanent support to the weakened area, which are thin and flexible and don’t react with the body. Absorbable meshes can also be used, where they provide short-term support while new tissue regrows and repairs the area.

What’s wrong with permanent meshes?

Although most of hernia surgeries go well, many people still experience complications. The most common problems with hernia surgeries are pain, adhesion of scar-like tissue, hernia recurrence, infection, bleeding, abnormal connections between organs and obstruction of the large or small intestine. Permanent hernia mesh surgeries have an additional risk of the mesh migrating to a different place, shrinkage of the mesh itself and risk of the mesh reacting with the body and being rejected. There have also been concerns that meshes can cut into tissue and nerves, causing difficulties with walking and every day life.

International guidelines estimate 1 in 10 people who had a mesh repair surgery will experience significant chronic pain. This means every year, roughly 10,000 people in the UK will suffer from chronic pain due to a surgery that should’ve improved their quality of life.

Benefits of hernia meshes.

Hernia recurrences are a major concern, especially with non-mesh surgeries. The use of a mesh, whether it’s permanent or absorbable, significantly reduces the chances of a hernia recurrence. The reduced likeliness of the hernia developing again is one of the main reasons a mesh is preferred, as each subsequent surgery for a hernia has higher chances of complications, such as more scar tissue forming. Using a hernia mesh also allows reduced surgery time and quicker recovery time compared to non-mesh surgeries.

Alternatives

An alternative to classic hernia meshes can be “hybrid” meshes, such as Ovitex made by TELA Bio. This mesh is made of different materials: the main structure is made of polypropylene, and sheep stomach is used to make an absorbable component that’s mainly collagen. Once the collagen is absorbed by the body, there is still a small part of the mesh that’s left behind to provide structural support, but reduces the amount of synthetic mesh present in the body. This has already been used in the ReBAR Technique (Reinforced Biologic Augmented Repair).


References

Lucian Panait (2021). Inguinal Hernia: To Mesh or Not to Mesh? – Minnesota Hernia Center. [online] Minnesota Hernia Center. Available at: https://mnhernia.com/inguinal-hernia-to-mesh-or-not-to-mesh/ [Accessed 11 Mar. 2025].

Pawlak, M., Tulloh, B. and de Beaux, A. (2020). Current trends in hernia surgery in NHS England. The Annals of The Royal College of Surgeons of England, 102(1), pp.25–27. doi: https://doi.org/10.1308/rcsann.2019.0118

Health, C. for D. and R. (2023). Surgical Mesh Used for Hernia Repair. [online] FDA. Available at: https://www.fda.gov/medical-devices/implants-and-prosthetics/surgical-mesh-used-hernia-repair.

Collinson, A. (2020). Hernia mesh implants used ‘with no clinical evidence’. BBC News. [online] 15 Jan. Available at: https://www.bbc.co.uk/news/health-51024974.