PROVIDENCE – As Dr. James Padbury, chief of pediatrics at Women & Infants Hospital, grabbed a cup of coffee in the small common kitchen area, a colleague walked in and said: “Feel this.”

The colleague held out a 3-D printed simulation model of an infant’s heart, a small, reddish-orange plastic orb, created the previous evening at a monthly geek’s meeting of 3-D printer enthusiasts.

“Now, squeeze it,” the colleague told Padbury, who expressed surprise and delight at the printed heart’s texture and response.

The 3-D printed model of an infant’s heart, Padbury explained during a one-on-one interview with ConvergenceRI, will be used as a training device in treating pericardial effusion, when the area around the heart is filled with fluid and interferes with the heart’s ability to pump blood.

At the heart of the innovation ecosystem
The story behind how the 3-D printed heart model was created revealed the way in which Padbury and his colleagues have come to serve as a nodal point within Rhode Island’s innovation ecosystem, connecting the geek, clinical and research networks in a shared working environment.

“There’s an emergency condition called pericardial effusion,” Padbury began. “Pericardial – surrounding the heart, and effusion – a collection of fluid. Pericardial effusion interferes with the heart’s ability to fill and contract.”

The condition, Padbury continued, can be life threatening. “It’s a rare occurrence; we have 1,200 admissions a year at the Neonatal Intensive Care Unit [NICU], and we might have a pericardial effusion once every three years. When it does occur, it can be evacuated with a needle,” he said.

But hitting the small sac around the heart of a critically ill small infant with a needle is not an easy task, Padbury explained. What has evolved in the last decade is the use of simulation high fidelity models, very realistic models for rare medical procedures, in order to create and maintain skills in training at all levels. “Including the chief’s and senior faculty,” he added. “It’s good for everyone.”

“One of my faculty, myself and two of the senior fellows came up with an idea that we should build a model for this,” Padbury said, telling the story of the device’s creation. “So, we secured some initial intellectual property around our design, to create a life-like texture that you can pass the needle in. And, also to create a doll with this simulated heart in it that we can image with ultrasound and practice [the procedure].”

The latest version of the simulated infant’s heart had been printed at a geek’s meeting of 3-D printing people the night before, Padbury continued, explaining that it was “not the geek meeting that Jack Templin hosts, but another one, a 3-D printing consortium that meets monthly.”

Getting off the island
Padbury said he often goes to the Geek’s dinner hosted by Jack Templin at AS220 to listen in on what’s going on in the tech world, in the design world. “I have a voracious appetite for that.”

“I tell the fellows who are trying to work on their research careers,” he said, warning that he was about to demonstrate the humorous side of his bedside manner in the NIC unit, “Don’t hang out with neonatalists; don’t talk with them, and don’t go to their meetings, because they’re so highly [specialized] you won’t hear any new ideas or learn any new things.”

All life, Padbury continued, is a metaphor for yacht racing. “I tell them: get off of the island. Go to cancer seminars, go to immunology seminars, try to connect the dots with doctors from other [disciplines].

In Padbury’s view of Rhode Island’s emerging knowledge economy and converging innovation ecosystem, he describes his role as a node in the networks. “I’m not the only node, I’m not the biggest node; I’m a node for the clinical and basic science networks.”

Big Data is the big buzzword these days, Padbury continued. “What comes out of Big Data science – what people working in Big Data have recognized – is that the world is not random, it is connected by networks.”

“The web is not random, neural networks are not random,” he said, things seek each other. “In yacht racing, boats seek one another. There are rules to prevent collisions.”

Breaking out of the shell
Padbury deftly changed metaphors to describe how he saw evolution of Rhode Island’s innovation ecosystem.

“It’s like a young amphibian trying to break out of a shell,” he said. “We’ve seen those movies on Nature and National Geographic, where these young amphibians are trying to break out of their shells; that’s what it feels like to me right now.”

Padbury continued, switching metaphors again. “We have a nascent biomedical industry; we’ve had some blips. There is a critical mass that’s required for successes to jump from the top of one wave to another. Rich Horan [the senior managing director at the Slater Technology Fund] was talking about that at the meeting with Congressman Langevin at ProThera Biologics.”

Padbury explained further: “There are peaks and valleys in science, in opportunity, in the clinical world as well. Companies hit bumps, a company recedes, apoptosis [programmed cell death in biology] sets in, and then another company emerges.”

Apoptosis, he continued, “is a very programmed form of death. It doesn’t cause destruction around itself. It’s really a good word to describe ecosystems that are healthy. There’s a critical mass required to jump from wave to wave and have an upward trajectory.”

Padbury expressed hope that the local companies and people in the research community are in that trajectory upward.

A Rhode Island recipe for growth
A critical mass, in Padbury’s vision, needs for there be enough opportunities being pursued – with transparent partnerships between academic researchers and industry.

“It shouldn’t all be in Cambridge and San Francisco; it should be here in Providence, too,” he said. “The things that we would want to take advantage of are here – integrating the design community, the technical community, the biomedical community and the academic communities. What’s needed is enough success for it to become self-sustaining.”

Different companies, Padbury continued, “are going to have their surges, and then a bit of apoptosis. That is true in Cambridge and San Francisco.”

Incubator commercial lab space for academic spinouts – such as the one at the former Fuji Film building in East Providence being managed by Slater – can serve as a critical component in helping companies catch the waves, Padbury said.

The secrets of mentoring
For Padbury, the success in mentoring is finding good, bright, hard-working, motivated young people – “Did I mention hard-working?” repeating it as a point of emphasis – and giving them the opportunity to explore good ideas.

“This enterprise is not a social service agency,” Padbury said, talking about the difficulties of the research enterprise and the persistence it required. But, he continued, “Success is a rising tide that lifts all boats, for mentors and mentees.”

The mentor, he added, needs to think about all the eggs in the basket, and which ones are most likely to hatch, and make strategic and tactical decisions about investments in time and resources. “This is an enterprise that we’re always looking out over the horizon, keeping our eyes and our head out of the boat."

Sometimes it’s important to lead by example – telling the story about how he assisted on a transport to a young infant from Women & Infants to St. Luke’s Hospital, and because it was a very busy time, he rode with the ambulance, to the amazement of the EMT technicians.

“A mentor offers good ideas and opportunities to trainees; they are gifts, concrete choices, investments,” Padbury said, who said that sometimes, there are mentors who become jealous of the success of the mentee and not willing to let go of the scientific or academic enterprise that’s been created. Padbury said he is not like that. “My philosophy is that ideas are cheap and projects are hard."

Convergence with ProThera Biologics
Padbury said his involvement with ProThera Biologics was the outcome of many things he had stressed in his conversation with ConvergenceRI – attending seminars outside his specialty, making connections to different networks, sharing good ideas with young trainees.

Padbury was attending a cancer pathology research seminar led by a faculty member of the adult cancer program at Rhode Island Hospital. He listened while the researcher described a new analytical technique to create a biomarker, the InterAlpha Inhibitor, and its role in adult humans and some animal models for adult sepsis.

“So, I raised my hand and asked: what about newborns? Developmental cancers and aging cancers are not cousins, they are siblings. It’s a highly productive line of investigation to work off advances in one research area to help downstream advances in another area,” he said.

Padbury continued: “Oncogenes shouldn’t be called oncogenes, they should be called oncofetal proteins, because most of them are expressed during development, and they regulate developments normally. If they are mutated, they lead to abnormal developments, which is cancer.”

Padbury shared what he learned from the seminar with a visiting research scientist, and by collecting samples from the NICU, was able to demonstrate that the InterAlpha Inhibitor might be the biomarker to identify sepsis in newborns. Further research undertaken by another trainee showed that it might not only serve as a biomarker, but as a therapeutic agent.

Then three different research mentees look at the potential of the biomarker to identify inflammatory bowel disease in young infants known as necrotizing enterocolitis. It turned out to be one of the best biomarkers yet developed. Another trainee, following up on that work, won the award for the best clinical science presentation at the National Pediatric Research meeting.

The next stage for Padbury’s research team, working in collaboration with ProThera Biologics, is to move to Phase I and Phase II clinical trials in humans, which will require FDA approval and the ability to have done work in two different animal species, which is now underway.

“I can save mice; I want to save children,” Padbury said.