APOC in Ghana: May 22nd

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

We started the day very early at 7:00 am with a drive to the Suntreso General Hospital where we were to visit Dr. Agyarko-Poku, a venerologist who would help us understand more about mother-to-child transmission of HIV/AIDS to aid in our study of noncommunicable diseases.

We arrived at the hospital, where the in-charge for the STI-OPD unit welcomed us and gave us a general overview of how events are run at the hospital’s HIV clinic which occurs on Wednesdays for adults and on Fridays for children. She gave us also an overview of how viral testing, data collection, and drug dispensary and treatment occur for the confirmed patients in the hospital. We got to see the relevant data points that were collected on each patient visit to help us better understand how well to modify our machine learning system.

We then went to the Disease Control Unit where the professionals there have the job of collating all hospital cases at the end of the week to identify diseases that are on the rise and have the potential to become public health concerns. We also got to understand more about how tuberculosis is diagnosed in the clinics and how treatment occurs for the disease. We found out also that drug-resistant tuberculosis has not been much of a problem for that particular hospital, contrary to what we thought. After this, we split into teams and went to visit the ART center, the counseling center, the dispensary, the data management room, as well as the consulting room where we got to interact more with the health professionals (i.e. nurses and pharmacists) in order to understand the processes that the patients have to go through from entrance into the hospital facility to diagnosis and the reception of their medication.

We left the Suntreso hospital and came back to KNUST where we had lunch before meeting with the civil engineers to discuss writing a report and making possible recommendations for the communities that we visited in order to improve their sanitation and water supply. We arrived at the Komfo Anokye Teaching Hospital’s Nursing Training School at about 2.30pm where we presented our Tuberculosis Triaging system to the students and received their questions which ranged from the usefulness of our algorithm and project to concerns about data contamination and invalidation. From KATH, we made a final run through KFC to grab dinner before making our way back to the guest house to enjoy our meal and conclude the day.

Week in BioE (May 31, 2019)

by Sophie Burkholder

Vector Flow Imaging Helps Visualize Blood Flow in Pediatric Hearts

A group of biomedical engineers at the University of Arkansas used a new ultrasound-based imaging technique called vector flow imaging to help improve the diagnosis of congenital heart disease in pediatric patients. The study, led by associate professor of biomedical engineering Morten Jensen, Ph.D., collaborated with cardiologists at the local Children’s Hospital in Little Rock to produce images of the heart in infants to help potentially diagnose congenital heart defects. Though the use of vector flow imaging has yet to be developed for adult patients, this type of imaging could possibly provide more detail about the direction of blood flow through the heart than traditional techniques like echocardiography do. In the future, the use of both techniques could provide information about both the causes and larger effects of heart defects in patients.

Using Stem Cells to Improve Fertility in Leukemia Survivors

One of the more common side effects of leukemia treatment in female patients is infertility, but researchers at the University of Michigan want to change that. Led by associate professor of biomedical engineering Ariella Shikanov, Ph.D., researchers in her lab found ways of increasing ovarian follicle productivity in mice, which directly relates to the development of mature eggs. The project involves the use of adipose-derived stem cells, that can be found in human fat tissue, to surround the follicles in an ovary-like, three-dimensional scaffold.  Because the radiation treatments for leukemia and some other cancers are harmful to follicles, increasing their survival rate with this stem cell method could reduce the rate of infertility in patients undergoing these treatments. Furthermore, this new approach is innovative in its use of a three-dimensional scaffold as opposed to a two-dimensional one, as it stimulates follicle growth in all directions and thus helps to increase the follicle survival rate.

Penn Engineers Look at How Stretching & Alignment of Collagen Fibers Help Cancer Cells Spread

Cancer has such a massive impact on people’s lives that it might be easy to forget that the disease originates at the cellular level. To spread and cause significant damage, individual cancer cells must navigate the fibrous extracellular environment that cells live in, an environment that Penn Engineer Vivek Shenoy has been investigating for years.

Shenoy is the Eduardo D. Glandt President’s Distinguished Professor with appointments in Materials Science and Engineering, Mechanical Engineering and Applied Mechanics, and Bioengineering. He is also the Director of the Center for Engineering MechanoBiology (CEMB), one of the NSF’s twelve Science and Technology Centers.

Shenoy’s most recent study on cancer’s mechanical environment was led by a postdoctoral researcher in his lab, Ehsan Ban. Paul Janmey, professor in Physiology and Bioengineering, and colleagues at Stanford University also contributed to the study. Shenoy also received the Heilmeier Award this March and delivered the Heilmeier Award Lecture in April.

Read the rest of this story on Penn Engineering’s Medium Blog.

Controlled Electrical Stimulation Can Prevent Joint Replacement Infections

Joint replacements are one of the most common kinds of surgery today, but they still require intense post-operative therapy and have a risk of infection from the replacement implant. These infections are usually due to the inflammatory response that the body has to any foreign object, and can become serious and life-threatening if left untreated. Researchers at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences hope to offer a solution to preventing infections through the use of controlled electrical stimulation. Led by Mark Ehrensberger, Ph.D., Kenneth A. Krackow, M.D., and Anthony A. Campagnari, Ph.D., the treatment system uses the electrical signal to create an antibacterial environment at the interface of the body and the implant. While the signal does not prevent infections completely, these antibacterial properties will prevent infections from worsening to a more serious level. Patented as the Biofilm Disruption Device TM, the final product uses two electrode skin patches and a minimally invasive probe that delivers the electrical signal directly to the joint-body interface. The researchers behind the design hope that it can help create a more standard way of effectively treating joint replacement infections.

People and Places

TBx: Gabriel Koo, Ethan Zhao, Daphne Cheung, and Shelly Teng

For their senior design project, four bioengineering seniors Gabriel Koo, Ethan Zhao, Daphne Cheung, and Shelly Teng created a low-cost tuberculosis diagnostic that they called TBx. Using their knowledge of the photoacoustic effect of certain dyes, the platform the group created can detect the presence of lipoarabinomannan in patient urine. The four seniors presented TBx at the Rice360 Design Competition in Houston, Texas this spring, which annually features student-designed low-cost global health technologies.

APOC in Ghana 2019: May 21st

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

On this beautiful Tuesday, we woke up at our hotel to a lovely breakfast of sausage and pepper omelets. After our meal we loaded up on the bus to drive over to Aprade. On the way to Aprade we picked up our water and sanitation expert of friends: Sophia, Kingsley, and Alfred. We first stopped at Aprade Government School where we met with the entire population of the school to present a demonstration on hand-washing. After the presentation we took a tour of the school to survey their existing water and sanitation systems. We learned about their construction projects and about the school itself, which educates about six hundred students!

Our second stop was to the main village of Aprade. We were taken through the village and observed their rainwater collection systems and boreholes. We discovered the public and private boreholes around the village. Everyone was so hospitable and welcoming. Before continuing we took a quick break to eat lunch on the bus. The food was catered and we had a delicious meal of jollof rice and fried chicken. There was refreshing mango and ginger juice to cool us down from the hot day.

After lunch we drove over to Mmeswam. We were able to make an appointment with the Chief! He brought us into his home with welcoming arms; it was amazing being able to shake the chief’s hand. The chief showed us around Mmeswam and led us to his boreholes and wells. The main borehole pumps water to a large elevated tank. Underneath that tank is a pipe and valve mechanism where villagers come to collect water in large basins. The chief encouraged us to take the basin on our heads and try to carry some of the water. Ellie, Kyler and El were chosen among the group to test their strength.

From the boreholes we walked over to the village’s wells. The oldest well was spoiled and is unusable. The working well in the village was a traditional pulley system well. Several of our students cast the bucket and fished up some water. After our day of water we thanked the chief and hopped back on the bus. We drove back to campus, dropped off the graduate students at campus, and made a stop at the mall. We grabbed dinner at Game and quickly made our way home. It had been a long day so we chowed down on dinner and passed out for the night. A great and very busy day!

APOC in Ghana 2019: May 20th

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Allaire Morgan (Electrical Engineering, ’22)

This wasn’t your typical 8:00 A.M.

The bus came and picked us up just after 8 and took us to the Kwame Nkruma University of Science and Technology (KNUST, for short) for our orientation to the program. We pulled into a small lot guarded by a fence and some old barbed wire to greet Professor Ellis Owusu-Dabo, a charismatic and accomplished professor in public health in Ghana. We were ushered to a board room where we began a meeting with Ghanaian students and professors. They sang their national anthem, and then asked us to sing the Penn fight song—which we learned the words to the night before in the hostel. Throughout the morning, we heard remarks from Professor Ellis as well as his distinguished colleagues regarding the program and introducing us to the university. Then we closed the session with a prayer, as is custom in a Christian nation such as Ghana, and went to have lunch and tour the university some more.

During our lunch break, I got the chance to chat with Kingsley, a Nigerian student at KNUST in the Water Supply Management program (the program gathers students from all over West Africa to train them as young “water professionals” to better combine ideas from across the region). Kingsley was very passionate about the field he worked in, explaining that about 90% of the issues related to public health and electricity in Ghana and the region at large were due to issues with the water supply—whether it be sanitation or accessibility in general.

As we toured the university by bus, I talked to Kingsley some more about water systems currently in place, to which he explained the role of politics in the amount of technology able to be implemented. “Trust me, we have the technology,” he exclaimed. “It’s just the will of the people, and the government, that prevent us from using it.” The government here is peculiar compared to that of the United States: Where we had always been focused on separation of state and church, religion and culture here serve as the two strongest influences on the government and their decision-making, which can serve both as a blessing and a curse in some cases like that of water supply funding.

We wrapped up our tour of the university, which looked verydifferent from Penn with its vast fields and cream-and-orange-colored buildings in all their glory. The afternoon session introduced us to the most prevalent medical problems in Ghana to date, as well as giving us a general idea of what the Ghanaian health system looks like. We were given guidance on our project which we had prepared during the spring, and then promptly sent on our way before the sunset, which abruptly ends each day around 6:30 P.M.

APOC in Ghana 2019: May 19th

In this series of posts, University of Pennsylvania students who took the spring 2019 APOC (Appropriate Point of Care Diagnostics) course write about their experience traveling to Ghana in May-June 2019.

by Ellie Chen (Bioengineering, ’22)

Waking up early to the sound of rooster calls, we washed up, ate, and got ready for our 9:30 am church service. As we drew close to the location, the bus began to rumble to the vibrations of worship—indicative of the amount of passion and volume we were about to experience in the first of many parts of the service. Walking out of the bus, we were engulfed by the music of our open-building communion. The amount of evident love, hope, and faith was overwhelming. The three-hour service in and of itself consisted of worship and thanksgivingin which we celebrated many livesas well as a sermon, all of which held a consistently amplified energy, song, and dance.

By the time we got out of service, our stomachs were once again rumbling and we were ready to eat. We sat down for a traditional Ghanaian meal: jhollof rice and fufu. Careful to not use our left hand, we scooped our fufu in our hands and downed many servings, supplemented by the delicious jhollof rice and protein of our choice. Many salads were left untouched.

Plates emptied and stomachs refilled, we set out to our first football (or, as we know it, soccer) game. Sitting down in the stadium filled with cheering fans, we tried to discern which team to cheer for. We decided upon Allie’s favorite color: yellow. Unfortunately, after consulting a local, we found out that the players in the yellow jerseys were of a team far from here, and the red-jerseyed team was the local—the one we should be cheering for. This was good information to have because the game ended in a 2-0 win for our local team.

Post-football game, we wandered our way into the mall, picking up carelessly forgotten essentials and dinner. For the majority of us, this was curry rice, chicken, and kebabs—which ended up being too spicy for everybody except El. We ate. We planned. We debriefed and went to bed, ready for orientation tomorrow.

Junior Bioengineering Students Complete Their Laboratory Course with Creatively Designed Spectrophotometers

by Sophie Burkholder

To finish the second half of Bioengineering Modeling, Analysis, and Design (BE MAD) Laboratory – the hallmark laboratory course of Penn’s Bioengineering program – instructors Dr. Brian Chow and Dr. David Issadore tasked junior undergraduate students with creating their own spectrophotometers for potential use in detecting water-borne pathogens in a design process that involved rapid prototyping techniques, the use of low-cost optoelectronics, and the incorporation of automation software and a graphical user interface for data acquisition. The final projects were assessed for both the creativity of the structural design of the device, and their abilities to measure optical properties of fluorescein, a chromophore used in clinical diagnostics, to determine each device’s accuracy, sensitivity, precision, and dynamic range.

For the final project of the year, many groups planned adventurous structural innovations to house their spectrophotometer circuits. Some of this year’s highlights included a fish tank complete with flashing lights and goldfish, a motorized arm that could successfully shoot a ball into a miniature basketball hoop with every spectrophotometer reading, a guitar with the ability to actually play music, and a working carousel. “My group decided to make a version of the Easy Bake Oven, using an LED oven light bulb, and a motor to open the door,” said junior Alina Rashid. “Of course, it didn’t actually cook anything because of the spectrophotometer inside, but maybe next time!” All of these designs involved the use of CAD-modeling to create sketches and parts that could then be laser-cut or 3D-printed into physical structures. The Department of Bioengineering also allotted each group with a budget for students to purchase any additional parts they required for their designs that were not already available in the lab.

On Demo Day for the spectrophotometer projects, instructors, lab staff, and friends came to the Stephenson Foundation Bioengineering Educational Laboratory and Bio-MakerSpace to assess final designs and celebrate the end of the semester. Given three solutions of unknown concentrations, students used their completed spectrophotometers to create standard curves using Beer-Lambert’s Law and attempt to determine the concentrations of the provided solutions. “I always love Demo Day because that’s when all separate aspects of the project – the mechanical design, the code, the circuitry – come together to make a device that actually works the way we planned and wanted it to all along,” said junior Jessica Dubuque. After nearly a month of working on the projects, each lab group went into Demo Day with designs they were proud of, and ended the semester on a high note with many new insights and lab skills under their belt for the beginning of their Senior Design projects in the fall.

Graduating BE Seniors Present Their Senior Design Projects

At the end of April, the graduating seniors in the Penn Department of Bioengineering‘s B.S.E. (Bachelor of Science in Engineering) program presented their Senior Design projects. Developed over the course of their final two semesters in the undergraduate program, these projects are developed in teams of three or four as the students are guided through choosing and understanding an impactful biomedical problem, defining the characteristics of a successful design solution to eliminate or mitigate a problem or fulfill a need, identifying constraints, and creatively developing potential design solutions. Over the course of two days, the students then present their projects to faculty and students from across the Penn Engineering community.

Additionally, three groups (BreatheSmart, RIPT, and Proscopy) were selected to represent BE in the 2019 Penn Engineering Senior Design Project Competition.

Congrats to all of our graduating students on their innovative projects. Check out some photos from the 2019 BE Senior Design presentations and read the full list of this year’s abstracts below.

Group A: BreatheSmart

Caroline Atkinson, Sarah Cai, Rebecca Kellner, Harrison Troché

In the United States, more than 51 million people have been diagnosed with either asthma or chronic obstructive pulmonary disorder (COPD) as of 2016. These conditions result in swelling of the airways, making it difficult to breathe, but the symptoms are commonly managed through the use of a pressurized metered dose inhaler (pMDI), which dispenses aerosolized medication to the lungs, and are currently used by 78% of asthma patients in the US. However, a recent study showed up to 90% of pMDI users incorrectly use their inhalers, reducing the efficacy of medication . Our solution guides patients through the proper technique for using inhalers while providing real-time feedback so patients can correct their technique. This was accomplished by tracking flow rate data converted from a pressure sensor and a smartphone app that provides real-time visual feedback to the user. We were successful in our four design goals as the final device is: (1) lightweight and compact (78 grams with inhaler and 2.5”x1.5”x3.5”), (2) accurate in flow rate measurements (±8.7% error), (3) easy-to-use, with 95% of users surveyed able to use the app successfully without assistance (n=20), and (4) low cost, with the total cost being $76. To improve the design, we will improve accuracy and compactness, and reduce cost. Some ways this could be achieved are through the use of a smaller, custom microcontroller, and a more sensitive pressure sensor. Next steps would include a clinical trial to demonstrate the effectiveness of our device.

Group B: RIPT

Toren Arginteanu, Anna Mujica, Justin Mills, Kayla Prezelski

The tourniquet is the gold standard for treating traumatic extremity bleeding in pre-hospital emergency scenarios. Existing pneumatic tourniquets are safer than non-pneumatic alternatives, minimizing nerve damage and loss of limb function. However, current emergency pneumatic tourniquets are costly and delicate and prone to leaking, punture, and abrasion. Therefore, there is need for an emergency pneumatic tourniquet that is low-cost, highly durable, and easily applied by laypeople. Our design, the Rapidly Inflating Pneumatic Tourniquet (RIPT), consists of an internal bladder made of tough rubber, a durable outer covering made of ballistic nylon, and a pneumatic inflation mechanism involving an inflator valve, pressurized CO 2 cartridge, and pressure relief and regulator valves that maintain a safe and sufficient internal pressure of 250 mmHg. RIPT is tightened around the injured limb and secured with a spring-loaded, automatically locking PLA and aluminum clasp. RIPT’s average application time was 20 ± 0.4 s, which is significantly shorter than that of the Combat Application Tourniquet (CAT): 32 ± 2.9 s. RIPT’s internal bladder pressure reached 250 ± 4.8 mmHg. RIPT packs up to 87.5 in 3 and weighs 18.8 oz. RIPT has comparable circumferential pressure distribution to CAT and superior axial pressure gradient. RIPT’s raw material cost is $65.62. In the future, the clasp mechanism will be modified to improve ease-of-use and minimize size and weight. RIPT will be tested with trauma surgeons at Penn Presbyterian Hospital, and user feedback will indicate ease-of-use and pain of application relative to the CAT.

Group C: Proscopy

Abigail Anmuth, John Forde, Sarah Raizen, Rohit Shinde

Robotically-assisted surgery is a rapidly evolving technology that is expanding the capabilities of surgeons and improving patient outcomes in fields ranging from cardiothoracic surgery to urology. However, as this technology becomes more widely used, there are distinct limitations that impact the safety of surgical maneuvers, largely because of the lack of haptic feedback in the robotic arms of these surgical systems. In the case of prostatectomies, this can lead to the unintentional penetration of the rectal wall and cause pervasive infection, a condition known as rectal injury (RI). Proscopy is a novel real-time proximity sensor that monitors the distance between robotic surgical tools and a patient’s rectal wall to reduce the incidence of RI. This two-part preventative solution consists of a Hall Effect sensor-embedded brace at the tip of the surgical arm and a magnetized flexible insert. The Hall Effect sensors convert magnetic field strength to distance from the rectal wall. In lieu of haptic feedback, Proscopy provides visual feedback within the robot control console as the surgical robot arm nears the rectal wall, displaying information that cannot be perceived from the laparoscopic camera itself. Proscopy gives surgeons the ability to detect the rectal wall with a precision of 0.1±.05mm, rendering it a highly effective and streamlined mechanism for RI prevention during robotically-assisted prostatectomies.

Group D: CerviAid

Dana Abulez, Dayo Adetu, Lamis Elsawah, Yueqi Ren

Cervical insufficiency is premature dilation of the cervix in pregnant women without active labor, and if not addressed, can lead to the loss of pregnancy in the second trimester. This condition results in a protrusion of the amniotic sac out of the uterus and into the cervix, which must be pushed back to extend the pregnancy. In the cervical cerclage procedure, the only treatment for this condition, the cervix is sutured shut to prolong pregnancy. If the cerclage is completed after 14 weeks of pregnancy or if the cervix is more than 3 cm dilated, the procedure is termed an emergency cerclage, which has a higher rate of pregnancy loss due to amniotic sac puncture than regular cerclage procedures. Cerclage procedures are dependent on surgeon experience and utilize no standard method to push back the amniotic sac, which makes this procedure even more high risk. To combat this issue, CerviAid is a device that aims to increase the success rate of emergency cerclages, for which no standardized method exists. The device pushes up the amniotic sac gently with a silicone head and can accommodate a variety of cervix diameters found in patients. The head of the device is controlled by a rack and pinion with a locking mechanism to secure the device and firmly support the sac while the surgeon places the suture. Evaluations of CerviAid with a realistic model of the cervix and amniotic sac produced a 96.15% success rate, in which no membranes were ruptured after pushing through a model cervix. Future steps include further stakeholder evaluations and decreasing manufacturing costs.

Group E: ArcAlert

Kelsey Friberg, Weiwei Meng, Vanessa Moody, Malika Shukurova

Risk of surgical fire increases with use of surgical energy like electrocautery, which presents a source of ignition in an operating room setting with elevated percent oxygen saturation in the air and abundant flammable materials. To address this problem, the FDA recommends human factors strategies, such as heightening awareness, and training on use of surgical energy, which is available yet not standardized across the field. ArcAlert offers a real-time risk management solution for data-driven prevention of surgical fires during use of da Vinci robot electrocautery. The system includes an oxygen sensor device that detects percent oxygen saturation at the surgical field, a machine vision algorithm that detects electrical arcing, and a user-friendly web application. ArcAlert consolidates and assesses risk factor information so that if the oxygen sensor device’s reading exceeds a dangerous threshold or the machine vision algorithm detects arcing, an alert appears on the web application describing the risk, which facilitates improvements to equipment usage by operating room personnel. The oxygen sensor device acquires reliable readings over the timespan of a procedure with an accuracy within +/- 1% for 97% of readings. The machine vision algorithm detects approximately 80% of arcing incidences with only 20% falsely labeled, achieves spatial localization on the order of under 1 centimeter, and executes full pipeline implementation in under half a second. The current design is indicated for transoral surgeries, so future generations will diversify the types of procedures with which the system is compatible, in addition to going fully wireless.

Group F: Grip Glove

Kathryn Khaw, Matthew Rosenwasser, Vidula Kopli

Soft robotics offers many advantages over traditional robotics as an assistive and rehabilitative technology due to its cost-effectiveness and ability to mimic physiological movements. Because of the importance of grip on a patient’s quality of life, we leveraged soft robotic technology to create a flexible, exoskeleton glove for both therapy and assisting daily living for patients with hand impairments. Our device targets muscular dystrophy patients because these patients have a limited selection of devices for their needs. Our design consists of soft robotic actuators attached to a glove that mimic finger movement by bending upon inflation and surface electromyography (SEMG) sensors on the arm to predict the user’s intention to grip or release. Our device effectively recapitulates the forces generated during the grip of a healthy individual using three soft robotic actuators, with each actuator generating 2.83 ± 0.44 N (n = 6). The actuation frequency is 0.2 Hz (12 grips/minute) due to delays in deflation. The EMG sensors, MyoWare and OYMotion Analog EMG Sensor, were not sensitive enough to pick up graded changes in muscle activity, meaning we could only replicate an on-off response through a thresholded spike detection of processed EMG signals in two muscle groups that corresponded to grip and release. Going forward, we will use more sensitive EMG sensors, such as the Biosignalsplux Electromyography Muscle Sensor, increase actuation frequency by actively deflating actuators and include a pressure – solenoid feedback system to have controllable grips.

Group G: SpotOn

Julian Mark, Chase Rapine, Jared Rifkin

In this paper, we discuss SpotOn: a novel bioengineering solution to improving anterior cruciate ligament (ACL) tear recovery. ACL tears are very prevalent injuries and typically take 6-9 months to heal [1]. Physical therapy during recovery is costly and time-intensive, and current knee braces for patients do not provide active support to protect the patient. With SpotOn’s dual-faceted smart mirror and dynamic knee brace technology, patients can begin strengthening the ligament and joint sooner after surgery with less risk of re-injury. When the patient exercises with SpotOn, the smart mirror provides feedback on the patient’s exercise form. If the mirror detects an error, it notifies the user and sends a signal to activate the knee brace and straighten the user’s knee. Key specifications for success include latency of knee brace activation, maximum supported load by the brace, and total cost. Latency and cost met specification goals with a delay less than 0.1s (target under 3s) and total cost of $343.25 (target under $600), but maximum torque output of 18.26ft-lbs was short of the 101.25ft-lbs load goal. Future directions for our design include tracking additional metrics besides squat form, increasing maximum torque output of the knee brace, and lastly adding an on-board battery to the brace to improve portability. Our product was not tested clinically, so the next step to implement our solution would be to reach out to clinicians who are treating injured patients and move forward with gathering clinical data.

Group H: TBx

Daphne Cheung, Gabriel Koo, Shelly Teng, Ethan Zhao

Caused by bacterial strain Mycobacterium tuberculosis, tuberculosis (TB) remains one of the world’s deadliest diseases, with over 10 million new cases and 1.3 million deaths in 2017. Currently, the gold standard for TB diagnosis is to sequence a patient sputum sample using a PCR machine called the GeneXpert. Although this method demonstrates high sensitivity and specificity, it is not ideal in low-income developing countries because it is too expensive and inaccessible, priced at $32,000 for equipment, and $17/test. Thus, diagnosis is most widely determined through smear microscopy. However, this method shows low sensitivity and specificity at only 60% and 81%, respectively. Our solution is TBx, a urine-based diagnostic protocol that offers greater diagnostic power than smear microscopy, while maintaining affordability at only a fraction of the price of the GeneXpert. TBx detects the presence of lipoarabinomannan (LAM) in urine, a glycolipid that is specific to active TB cases. Under TBx protocol, LAM is tagged using photoacoustic dye (IR Dye 800CW) and immunoprecipitation beads via anti-LAM antibodies. Samples are then spun down using a centrifuge to wash out excess dye, concentrated by resuspension in only 5mL 1x PBS, and imaged in a 96-well plate. The photoacoustic dye thermally expands and produces photoacoustic signal in response to photoexcitation at λ = 800nm. Compared to smear microscopy, TBx has higher sensitivity (67%, n = 31) and specificity (92%, n = 31). TBx also only costs $1,500 in equipment, and around $12/test. With further refinements to the TBx protocol and point-of-care packaging, TBx shows promise in developing countries to improve the TB diagnosis landscape, especially with its combination of increased sensitivity and specificity, as well as affordability.

Group I: Sensei “The Cast Master”

Carolina Ferrari, Kristen Ho, Blake Thomas, Alfredo Tovar

Acute compartment syndrome (ACS) occurs in 26,500 people in the US each year and is a result of capillary blood flow becoming compromised when tissue pressure exceeds 30 mmHg. The consequences of ACS are extremely severe if it is not immediately diagnosed. ACS can result in permanent muscle damage, nerve damage and/or amputation, and 70% of cases can be traced back to fractures. The current diagnostic method requires invasive pressure measurements if a patient’s primary symptom assessment is inconclusive. Thus, we have designed SENSEI, a non-invasive device that constantly monitors pressure and can diagnose ACS underneath a cast post-fracture. The device interacts with an Android application via bluetooth to let the user know if they are at risk in real time. SENSEI currently measures compartmental pressure of the forearm within a range of 20-40 mmHg with 91% accuracy. In the future, we plan on improving our pressure sensors so that SENSEI can diagnose ACS with 100% confidence. Other potential additions to SENSEI include designing a sleeve for the lower leg and developing an iOS application to capture more market share.

Group J: UrineLuck: Artificial Urinary Sphincter

Jason Grosz, Richard Adamovich-Zeitlin, Teddy Wang, Sally Pennacchi

Urinary incontinence (UI) is a debilitating ailment that impacts the lives of millions of men. Caused by urinary sphincter damage, prostate issues, or overactive bladder muscles, UI can render men homebound and ruin their social and professional lives. The current gold standard intervention for severe UI is the AMS 800, which consists of a pressure regulated cuff surrounding the urethra and a manual pump in the scrotum. The AMS 800 requires an invasive surgery for implantation and is extremely expensive – around $37,000 for the device, surgery, and hospital stay. It also suffers from a high failure rate, around 33% within three years, due to infections, mechanical failures, and tissue atrophy from the cuff blocking perfusion. In this paper, we fabricate and validate a silicone endourethral valve to treat UI in a less expensive, less invasive, and user-friendly way. These valves are inserted into the penile urethra and mimic the mechanics of bite valves commonly found in water bottles, whereby force applied perpendicularly to a slit enables flow. They are cheap, around $0.08 per device in material costs, do not occlude blood perfusion, and can be inserted at home or in an outpatient clinic with a catheter. Through validation in a PDMS model that recapitulates penile mechanics and geometry, we demonstrated that these valves enable strong flow, 4.99 mL/s, minimal leakage, 0.43 drops, and resistance to cyclic stress. With further cytotoxicity and biofilm testing and insertion protocol development, we hope that this design can improve quality-of-life and prognoses for incontinent men.

Group K: Automated Pathology

Olivia Lang, Joseph Maggiore, Prithvi Pendekanti, Olivia Teter

Clinical and laboratory staining protocols are typically an inefficient use of money, resources and manhours. The highly repetitive and standardized nature of this work poses an opportunity for automation. An automated system would allow a physician or clinician the ability to dedicate their time elsewhere, use less staining fluid, and potentially save on thousands of dollars when compared to similar alternatives. Hemauto is an automated diagnostic device as a proof of concept for a lowcost instrument that combines staining, image acquisition, and image analysis capabilities. Hemauto’s first use case is the detection of Malaria. Malaria, despite being highly treatable, is currently an epidemic in African lowresource regions, disproportionately affecting children. The high incidence rate can be attributed to a lack of standardized and effective earlydetection methods. Providing a lowcost, highthroughput device capable of giving a quantitative diagnosis with limited userinput is critical for these regions because current detection methods are either too hightech, not accurate enough, or are too expensive to be administered frequently. Hemauto’s solution synchronizes the actions of motors and computer technology to deliver a diagnosis. It uses two axes of motion controlled by independent stepper motors to follow the standard Giemsa staining protocol. The stained slide is then automatically focused and imaged in front of a 100x objective lens, where the captured images are analyzed to provide a quantified diagnosis. This proof of concept offers incredible promise for future automated pathology devices across many disease areas.

Group L: Preventear

Matt Riley, Jasmine Wang, Mary Zhuo Ke

Adolescent female athletes are at a high risk of Anterior Cruciate Ligament (ACL) tears as a result of improper form and training techniques. ACL tear prevention training programs are designed to reduce one’s future risk of a tear, but these programs are expensive and not available everywhere. PREVENTEAR is our proposed solution. PREVENTEAR is a self-guided jump training system involving a wearable sock and companion mobile app that like a personal trainer, provides instantaneous feedback on your technique, but is inexpensive and portable. The three main parameters important to jump training are knee angle, knee-to-knee distance, and foot landing technique. The ideal form is to have a knee angle between 30 and 90 degrees with respect to the vertical, have a knee-to-knee distance of greater than 60% with respect to hip width, and land on the ball of the foot before the heel. PREVENTEAR uses bluetooth to communicate with the sensors woven into the sock to a phone app and aims to give feedback on the quality of an athlete’s jump as accurately as ACL tear prevention training programs like Sportsmetrics. The app-reported feedback was compared to true values measured by an observer, phone application, and measuring tools to evaluate performance. PREVENTEAR overall provides a means for ACL tear prevention training by being portable and low cost in comparison to Sportsmetrics, and flexible for adolescent female athletes of varying sizes. PREVENTEAR hopes to further improve accuracy and expand to other forms of training important in reducing risk of ACL injury such as strength, flexibility, and plyometric training in the future.

Group M: Autonomous Home Urinalysis

Saumeel Desai, Anand Prabhu, Eshwar Inapuri

Urinalysis is a crucial diagnostic component of managing heart failure, kidney failure, pre-eclampsia and several other medical conditions. Urinalysis currently requires patient willingness, effort, time and money as patients must travel to a lab, wait for results and rely on caregiver support in order to comply with required follow-ups. Current at-home alternatives, such as dipsticks, lack proper controls and cannot reliably be used by physicians to guide therapy. Moreover, patients are opposed to handling urine, leading to low adherence rates. The goal of this design project was to create an autonomous home urinalysis device that greatly reduces the barriers to diagnostic data collection, enabling detection of deterioration and guidance of therapy with higher efficiency. To meet this goal, the proposed design needed to be affordable, fit on top of a toilet tank, take three or fewer simple steps to use and be capable of rapidly and quantitatively measuring urine volume as well as creatinine, sodium, glucose and albumin concentrations in published clinical reference ranges with a coefficient of variance less than 5%. The solution developed can perform urinalysis within two minutes with only three user steps and is quantitative, controlling assay conditions such as light, volume and time. Each of the initial design requirements have been met, but there is still room for improvement in reducing variation, improving usability and design for manufacturing. This work is a successful starting point upon which future iterations can build to successfully meet patient and provider needs in the urinalysis space.

Group N: BubbleBed

Eden Harris, Candace Jasper, Faith Taliaferro, Sandy Tang

Each year, the U.S. healthcare system spends over $11 billion towards the treatment of pressure ulcer. While pressure ulcers commonly occur in long-term care facilities, they are also prevalent in hospitals, with 700,000 patients admitted to U.S. acute care hospitals developing pressure ulcers each year [1]. The current Braden diagnostic questionnaire assesses risk of ulcers development but fails quantify their locations without nurses having to inspect and rotate patients every two hours. Expensive sensing mats exist, but they offer no pressure relief, and smart-feedback beds offer no information about patient bodily pressure. Thus, we combine pressure sensing capabilities with smart feedback technology [2]. We have developed Bubblebed: a mattress-like device capable of visualizing the user’s bodily pressure as well as responding to areas in need of pressure alleviation, as a means of preventing pressure ulcer development. This device increases or decreases pressure in a specified air cushion (or air cell) based on pressure readings received every ten minutes, actuating until all air cells are restored to safe values, the latter of which was drawn from empirical studies [3]. Our final prototype consists of four air cells controlled by an Arduino algorithm that reads in pressure values within the air cell and opens the corresponding valve to either inflate or deflate a given cell. This prototype serves as a proof-of-concept, demonstrating the efficacy of our pressure-sensing feedback loop and workflow. Future clinical applications would necessitate expanding this to a full hospital bed-size mattress overlay with an associated monitor to visualize pressure ulcer risk.

BE Sophomore wins 2019 Barry Goldwater Scholarship

Chloe Cho, BSE ’21

Congratulations to BE sophomore Chloe Cho (BSE ’21), recipient of the 2019 Goldwater Scholarship!

Three juniors and one sophomore (Cho) at the University of Pennsylvania have been selected as Goldwater Scholars by the Barry Goldwater Scholarship and Excellence in Education Foundation, which provides scholarships of as much as $7,500 to undergraduate students interested in research careers in the natural sciences, math, or engineering.

They are among 496 recipients chosen this year from across the United States from out of more than 5,000 applicants. To date, 43 Penn students have received the award since Congress established the foundation in 1986 to honor the work of U.S. Sen. Barry Goldwater.

Chloe, a sophomore from Moorestown, New Jersey, majors in bioengineering in the School of Engineering and Applied Sciences. She works with Jason Mills and Jean Bennett at the Center for Advanced Retinal and Ocular Therapeutics on engineering novel treatments for retinal degenerative disorders. She intends to pursue a MD/PhD in bioengineering.

Continue reading about Penn’s Goldwater Scholars at Penn Today.

A Record 12 BE Students Receive 2019 NSF Graduate Research Fellowships

In a record year for the BE graduate program, twelve current and future students from the Department of Bioengineering were selected for the 2019 National Science Foundation (NSF) Graduate Research Fellowship Program (GRFP). In addition, four more students were selected for honorable mention. This prestigious program recognizes and supports outstanding graduate students in NSF-supported fields. BE is thrilled to congratulate our excellent students on these well-deserved accolades! Continue reading below for a list of winning students and descriptions of their research.

Further information about the program can be found on the NSF website.

2019 NSF GRFP Recipients:

Tala Azar

Tala Azar is a PhD student in the Liu lab. During pregnancy and lactation, the maternal skeleton mobilizes to provide calcium for the developing fetus and breastfeeding, respectively. Tala’s current work seeks to isolate individual effects of pregnancy and lactation on the biology and structure of maternal bone in a rat and mouse model, which is important for understanding the mechanisms behind postmenopausal osteoporosis development.

 

Sarah Cai

Shuting (Sarah) Cai  is a current Bioengineering senior (BSE ’19).  She previously worked in Dr. Lloyd Miller’s Dermatology and Immunology Lab at Hopkins during the summer of her freshman year, and she has since been working in Dr. Andrew Tsourkas’s lab here at Penn on various projects involving development of nanoparticles for multimodal imaging and cancer theranostics.

 

Brandon Hayes

Brandon Hayes is a PhD student in the Discher lab. He is currently working on manipulating the macrophage immune checkpoint to exploit the mechanisms of phagocytosis for immunoengineering. The goal of this manipulation is to develop a new cell therapy and engineer new gene therapy and protein delivery approaches to target both immune cells and tumors.

 

Travis Kotzur

Travis Kotzur is a PhD student in the Winkelstein lab. His project revolves around better understanding the mechanisms of neuronally transduced pain from an injury within his lab’s models of the spine and the ligaments within.

 

 

Victoria Muir

Victoria Muir is a PhD student in the Burdick lab. She is studying injectable hyaluronic acid hydrogels for musculoskeletal tissue regeneration and repair.

 

 

 

Margaret Schroeder

Margaret Schroeder graduated with a BSE in 2018 and is currently completing her MSE, both in BE. She works in the Meaney lab. She studies astrocytic modulation of mesoscale neural populations in vitro, in the context of traumatic brain injury. She images the calcium activity of neurons and astrocytes to examine how astrocytes affect population response to single-cell mechanical injury.

 

Olivia Teter

Olivia Teter is a current Bioengineering senior (BSE ’19). She works in the Meaney lab which focuses on traumatic brain injury. Olivia’s work has been dedicated to understanding how injury propagates in neuronal networks. She uses a combination of in vitro experiments and computational analyzes to identify and evaluate possible mechanisms describing how the neuronal network changes after injury.

 

Tanniel Winner graduated with her BSE from Penn BE in the fall of 2015 and is now a PhD candidate in the Neuromechanics Lab at Georgia Tech and Emory University. She is working on machine learning models to classify and predict gait cycle states.

 

Honorable Mentions:

  • Margaret Billingsley – PhD student in the Mitchell lab
  • Dennis Andrew Huang – BSE 2018, now at the University of Texas at Austin
  • Brianna Marie Karpowicz – current BE senior (BSE ’19) and MSE student in Data Science
  • Hannah Zlotnick – PhD student in the Mauck lab

In addition to her honorable mention, Margaret Billingsley was also awarded the Tau Beta Pi Fellowship,  a selective program which provides a year of financial support for graduate study.

Finally, several honorees at other institutions will be joining our department in the fall of 2019. We congratulate them as well and look forward to welcoming them to Penn:

Congrats once again to everyone on another year of outstanding research!

Building Literacy and Leadership Through Basketball

by Gwyneth K. Shaw

Bioengineering student Oladunni Alomaja, who goes by the nickname Ola, moved to the United States six years ago.

Princess Aghayere, Summer Kollie, and Oladunni Alomaja met for the first time before they even started college, at Penn’s Pre-Freshman Program. Drawn together by their common ties to West Africa, they became fast friends and, eventually, roommates. Kollie is originally from Liberia, and Aghayere and Alomaja were born in Nigeria.

Although all three moved to the United States as children or teenagers, each felt compelled to give back to Africa. As winners of one of the 2019 President’s Engagement Prizes (PEP), they will.

Their project, Rebound Liberia, aims to give young women a platform to develop their voices and, ultimately, to position them to create a new, more positive narrative about the country. It involves building a basketball court in Monrovia, the capital, and pairing it with literacy programs and a resource center.

The initial goal is to serve about 60 girls between the ages of 8 and 18, to complement what the young women are learning in school, and to build on those skills during the summer break. The PEP gives their project a $100,000 award, as well as a $50,000 living stiped for each of them.

All three women said the ability to begin their post-Penn lives giving back is hugely significant.

“We have always had that passion, that drive to want to work with youth in West Africa, to give back and just kind of help the youth in the way we have been helped along the way of our journey,” Kollie says.

“In Africa, West Africa especially, it’s very patriarchal,” says Alomaja, who goes by the nickname Ola. “We’re giving girls a voice. We’re empowering them, teaching them leadership skills. And we’re teaching them so many things that their society might have taken away from them or has not given them the opportunity to learn.

“For me, being involved in this project means I will be able to see that through and to have a close, interactive relationship with these girls for a long time, to help reach their own goals. I want to help them realize they’re more than what their society tells them they can be.”

Aghayere, a standout forward on Penn’s women’s basketball team, began playing basketball not long after she and her family moved to Virginia when she was 8. She’s driven by research showing the power of sports to teach leadership, and she can’t wait to expand the sport’s reach in Liberia.

“Basketball is definitely on the rise in Liberia. If we can build this program to a world-class program and really sort of help redefine Liberia in a new way, it will help. We’ve talked a lot about the negative narratives about Liberia,” Aghayere says. “We want to see this not only be self-sustainable but be something that people from all across West Africa come to and know Liberia for.”

The genesis of the project lies in Penn Engineering’s global and local-service program. Aghayere and Kollie had both been involved in summer projects in Africa and in 2018 won a grant from the Davis Projects for Peace Program.

Their project, Promoting Education and Cultivating Empowerment (PEACE) through Girls Basketball, renovated a basketball court in Monrovia and hosted a basketball clinic for girls twice a week. Each participant received a jersey, shoes, and a basketball, all donated by the Penn women’s basketball team.

Kollie and Aghayere also put together weekly workshops for the girls, discussing everything from sexual and reproductive health to goal-setting. They took the girls to Monrovia’s Coca-Cola plant and the nation’s Senate, two places where women are scarce.

After that success, the duo wanted to reach higher and began thinking about entering the annual contest for the PEP. Alomaja suggested adding in the literacy component to round out the program.

The trio approached Ocek Eke, the director of global and local-service learning programs in the School of Engineering and Applied Science. He knew all three women, since Alomaja is majoring in bioengineering and Kollie and Aghayere had worked on programs with him, and he agreed to be their faculty mentor for the project.

Read the full story at Penn Today.