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PAUL:

Welcome to Brainwaves, a podcast about big ideas produced at the 暗网禁区.

I鈥檓 Paul Beique.

This week: the world of accessibility.

How would you watch the next Hollywood hit film if you were visually impaired?

If you鈥檙e missing a leg and live in a remote place in the world, how can you get a prosthesis?

And file this under 鈥渙ut of this world鈥� ideas: How high-tech space suits might help people on Earth.

The world isn鈥檛 a one-size-fits-all place, although the people we talk to today are trying to open up new possibilities for everyone.

If you鈥檙e missing a limb, prosthetics can be expensive, easily running thousands of dollars.

If you live in a remote part of the world, then you also have to factor in a good amount of shipping and handling.

Brainwaves鈥� Lisa Marshall spoke with David Krupa, executive director of ROMP, the Range of Motion Project, based in Denver. He noticed that fewer than 2% of amputees worldwide have access to care.

He decided to do something about it.

LISA:
Can you give me a little background about yourself, and what got you interested in this project?

DAVE:
Sure, so when I was born, I actually had a deformity in my left foot, which about a year-and-a-half after I was born, my parents opted to have my foot amputated. And a few months after that, I started wearing my first prosthesis.

So, I was very interested in the field. I, in my junior year, decided that I wanted to pursue this profession. Early on in my profession, I learned about this incredible global problem that most people living with amputation face, which is the simple fact that the majority of people living with limb loss the world are disabled, not because they're missing a limb, but because they're missing the prosthesis after the amputation.

LISA:
So, can you give me just a snapshot of some of the specific ways that you're doing that?

DAVE:
Yeah, very specifically, for example in the country of Guatemala, we operate the largest prosthetic, nongovernmental prosthetic clinic in the country, where our full-time Guatemalan staff is providing quality care year-round, which involves the actual design and fabrication of prosthetic limbs. And also, the training provided to the amputees so that they can learn how to use those devices to their fullest potential, and along the way then kind of unlock their potential.

LISA:
I know you have teamed up with some folks from our integrative physiology department, Josh Taka, who is a student. Can you talk a little bit about the specific issue you're trying to address with this project in Ecuador?听

DAVE:
So, traditionally what we do to make a prosthesis is we'll actually take a mold and a cast of the person鈥檚 amputated limb, and we work with plaster, and we make positive molds on that plaster, and just shape it. And then we鈥檒l thermoform plastics or other types of composite materials over that mold.

In recent years, there are some new tools within our field that allow us to do that same process but in a much more digital way. So we do a 3-D scan of the person's limb, and in order to create this test prosthesis, so that they can walk on it and see if it's comfortable enough for permanent use, we can print, we can 3-D print the socket, and then attach that to the knee and the foot and all the components that go in between.听

And so, a couple years ago, we started asking the question of, well you know the 3-D printers, they run on filaments and that filament, even though we're doing this down in Ecuador, and we have our 3-D printer lab where we're importing that filament directly from manufacturers in the U.S. So, it's a costly material, it takes time for us to just get it down there, and so the question we had was, well is there a way that we can use plastic bottle waste to create 3-D printer filament that can be used to print these prosthetic test sockets?

And we partnered up with an innovative startup in Ecuador called Takuna, and they actually have been working on making this 3-D printer filament from 100% recycled plastic waste. So taking all these Coke bottles and water bottles, grinding them down and extruding filament that we then use in our printers.听

And so Josh was, this last summer, working with us in Quito to really continue perfecting this system. You know, our vision here is that we could potentially have this endless source of material at a very low cost, which can help us increase our output, and at the same time, reduce waste in the environment.

LISA:
If I were to watch you turn these plastic bottles into this prosthetic sleeve, how does it work?

DAVE:
Yeah, so imagine some plastic bottles go into a grinder, and they get chopped up into little tiny pieces, and then those pieces get fed into basically a heater that melts them down, and then they get extruded through a little tiny nozzle. And what comes out of that nozzle is a thin string of filament. That filament gets spooled onto a large, you know, almost picture like a thread for a sewing machine, but just a larger spool, and then that spool connects right to the 3-D printer.

And the 3-D printer, as it prints, is extruding layer upon layer of this, you know, recycled plastic to create the socket of the prosthesis.

LISA:
How did it go this summer? Did it work?

DAVE:
It does work, and what we did this past summer is we had some people walk on them in some testing. And then, we, we started to send the sockets off for some further materials testing, so that we can try to get a more consistent quality print before we're actually sending people out on them.

LISA:
How does it feel to watch someone slip on one of those prosthetics and be able to move again after they haven't been able to for a while?

DAVE:
Well, it's certainly, for me personally, as a prosthetist, it鈥檚 the thing that, that just keeps me going every day. I am filled with such joy to watch this transformation happen, and I give you a perfect little story. This guy I worked with a few weeks ago weeks ago, right before coming up here, this gentleman in Ecuador, Victor, who imagine this: Five years ago, he suffered electrical burns and lost both of his arms above the elbow, and for the last five years he's lived without arms, without prosthetic care, totally dependent on, on everybody else for everything. Just imagine what that implies. And I was blessed to work with him in our last clinic and fabricate two mechanical prosthetic arms for him, and then help him learn how to feed himself, brush his teeth, you know, drink. And it was just an amazing thing to watch him learn, to watch how excited he was, and how happy he was, and knowing that this is going to completely change, not only his quality of life, but also all of the people, especially his closest family members, that are there to do everything for him. And now he's much more independent. There's a lot of joy and happiness and hope that鈥檚 kind of surrounding that whole transaction. So it鈥檚 a really awesome thing to be a part of.

PAUL:
Question: How much creative content is out there in the world?

The answer: A whole lot.

Since it started, The U.S. Copyright Office says it鈥檚 registered more than 38 million 鈥渃laims of authorship鈥� of creative works.

But not all of it is accessible to people with ability differences.

And as University of Colorado law professor Blake Reid told us, many of the authors don鈥檛 want their work to be accessible.

Brainwaves鈥� Cole Hemstreet has that story.

COLE: 听听
For lovers of books, movies or videogames, today is a golden age, with an almost unlimited universe of content to consume, and tons of new ways to consume it.

But there are some people who can鈥檛 read, watch, or play those titles the way they鈥檙e released.

BLAKE:
Take different kinds of copyrighted works, books, music, movies, video games and so forth, and they might be inaccessible to people with certain kinds of disabilities, for example a book might be inaccessible to somehow who is blind or visually impaired.听

COLE:
That鈥檚 Blake Reid, he teaches intellectual property and disability law at the Colorado Law School.

He and several of his students have been on a mission to help convert media to an accessible format, but there鈥檚 a hitch: copyright law.

BLAKE:
Let鈥檚 say you wanted to make an adaption of a movie, you wanted to make a sequel to a movie. You鈥檝e got to go get a license from the copyright holder. Well, it turns out things like adding closed captions or making a Braille version of a book implicate that same set of rights to the copyright holder.

COLE:
Reid got onto this topic almost by accident.

Years ago, when he was a young lawyer, a file involving copyright law got dropped on his desk.

The more he got into it, the more he recognized these problems around accessibility weren鈥檛 an anomaly.

People worldwide experience the lack of accessible content as early as their school-age years.

BLAKE:
If you鈥檙e a disabilities services office trying to remediate a textbook for a student in a class, you鈥檝e got to in a hurry have the work be accessible so they can go do their studies for the semester and you might not be able to find a copyright holder.

COLE:
Like dealing with any corporation, obtaining those rights is easier said than done, even when it鈥檚 for a wholesome cause.听

BLAKE:
If you find them, you may not be able to get permission, they may ask for a lot of money that sort of thing, and so one of the things we work on is how to get exceptions and limitations in copyright law to allow for these accessible transformations in copyrighted works. 听

COLE:
There are a few systems in place to help.

BLAKE:
The good news is we have a doctrine called 鈥渇air use鈥� in the United States.

COLE:
But it only helps so much.

BLAKE:
Larry Lesig calls fair use the right to hire a lawyer. It鈥檚 a little bit uncertain, you never quite know how it鈥檚 going to work out. So, one of the things we鈥檙e working on is, can you get specific exceptions and limitations in the law that clarify affirmatively? 鈥榊es you can go out and engage in accessibility activities.鈥� We have stuff for books. Not for the other suite of works.

COLE:
Like movies and video games.

They鈥檝e represented clients here in the U.S. and written research on good next steps.

His center is working on the same thing internationally.

BLAKE:
How do we deal with in South America, how do we deal with it in Southeast Asia. There are just so many different circumstances, so many different cultures and so many different approaches to law and policy and culture in all of these countries.

For Brainwaves, I鈥檓 Cole Hemstreet.听

PAUL:
NASA鈥檚 space suits do a lot for the people inside them.

They help you breathe oxygen, drink water, and move around in some of the most inhospitable climates we know of.

And we鈥檙e starting to see some of those designs helping people right here on Earth.

Dirk Martin has that story.

JORDAN DIXON:
鈥淭his is a Microsoft Hololens. It is an augmented reality device. So unlike virtual reality, I still see everything around me, right? I'm living in the world and it is putting holographic information on the real world and this is important, right? Because virtual reality isn't really helpful for astronauts, right? They need to see what they're doing.鈥�
听
DIRK:
Can technologies designed to assist humans in challenging environments like space help people on Earth? One young man thinks so.
听
JORDAN:
My name is Jordan Dixon. This is my fourth year here in the PhD program in aerospace. I'm in the bioastronautics focus area. We kind of work on human health and medicine in space.
听
DIRK:
Dixon is also a member of a team in CU Boulder鈥檚 Aerospace Engineering Sciences program that is using assistive technology to build a better space suit.

It鈥檚 part of NASA鈥檚 design challenge competition called SUITS. Short for 鈥淪pacesuit User Interface Technologies for Students.鈥�
听
JORDAN:
NASA does a few challenges every year. Part of their microgravity university. It鈥檚 their first programming challenge. So, it is toward building heads-up displays for future space suits. If you鈥檝e seen 鈥淚ronman,鈥� kind of like the Jarvis in his spacesuit, which is showing him information on how much fuel is left 鈥� those kinds of things. But for a human in space, it鈥檚 a little different than how we look at assistive technologies on the ground. We're trying to augment a very healthy human in a very dangerous environment to keep them safe. So, we're trying to provide them information like their oxygen pressure, any leaks that might be happening, kind of give them the knowledge that鈥檚 on the ground. That we're in constant communication with flight control 鈥� mission control 鈥� people in the spacecraft, and it's kind of making these crew members more autonomous. We鈥檙e giving them that knowledge on board with a computer.
听
DIRK:
Wearing the Hololens augmented reality device, which really looks more like space-age ski goggles that display information, Jordan can communicate with the computer through hand motions.
听
JORDAN:
We call it kind of a mixed-reality spectrum between pure physical reality and pure virtual reality, where nothing is real and you鈥檙e experiencing everything artificially. 听I鈥檓 manipulating things with my hands and I'm getting presented with some information right now.
听
DIRK:
Or interact with the computer using voice commands.
听
JORDAN:
Enable step readout.
听
DIRK:听
And in this case the computer talks back.

COMPUTER:
Enabling step readout.
听
JORDAN:
Next.
听
COMPUTER:
Locate battery pack and tether-to-tether cable. Undo the battery pack leads from the auxiliary power input.
听
DIRK:
It鈥檚 technology like this that Jordan believes will one day help humans on earth with disabilities lead a better life.
听
JORDAN:
You know, we've been dreaming of 鈥淚ronman鈥� and movies like this for a long time, and we have these grand ideas that right now our tech can accomplish. So, we're working at the level of, you know, what's best for the human.听

And what we've really been focusing on is different modalities and how you interact with computer systems. So, we've had visual and audio communication both back and forth. So you can request the computer to read things out to you.听

And this year we worked on electromyography. So, you essentially measure the muscle activation鈥攖he electrical energy of the muscle activation. And if we do some math, set some thresholds, and I say, when I raise my eyebrow鈥攎y left eyebrow or my right eyebrow鈥攖hat's going to manipulate something on my display.听

So maybe I can鈥檛 use hand gestures, because if you had impairment in your arms, you could activate things with your voice. You could activate things with other muscles that you generally wouldn't use, but you can. So, there are these things.
听
DIRK:
Things like a computer that accepts voice commands. Jordan thinks that will eventually help someone who is blind interact with the internet by having a computer read out information searched from the web, or reading books and more.
听
COMPUTER:
On the right side of the EVA kit, locate and use the panel access key to unlock the panel access door locks. Caution. The keys are on a tension spring cable.

PAUL:
Thanks for listening to this episode of Brainwaves.

We鈥檙e taking next week off for Labor Day, but we鈥檒l be back the following Tuesday.

If you haven鈥檛 already, please like and subscribe wherever you get your podcasts.

I鈥檓 Paul Beique.

Cole Hemstreet, Dirk Martin, Lisa Marshall and I produced today鈥檚 program.

Andrew Sorensen is our executive producer.

Sam Linnerooth is our digital producer.听

Cole and Andres Belton created our introduction.

We鈥檒l catch you next time on Brainwaves.