Week in BioE (June 7, 2018)

Vision of the Future

corneal transplantation
A human eye that received a cornea transplant one year postoperatively.

Disorders of or damage to the cornea — the clear covering over the lens of the eye — can be threatening to vision, and for the last century, corneal transplantation has been a cornerstone of treatment for these conditions. However, corneal transplants are complicated by two key facts: first, as with virtually all transplant procedures, donor organs are in short supply; and second, rejection is common, and recipients of transplants face repeated procedures or a lifetime of steroid eyedrops to prevent rejection.

One way of obviating these issues is the use of synthetic materials, which can now be manufactured with three-dimensional printing. In a new study from scientists at the Institute of Genetic Medicine at Newcastle University in the UK, to be published this summer in Experimental Eye Research, synthetic corneal tissue was 3D printed using a bioink loaded with encapsulated keratocytes (corneal cells), in combination with computer modeling based on actual corneas. The study is only proof to show that printing a biological replicate of the cornea is possible, but it lays the groundwork for future studies in animals.

Engineering Brain Recovery

One of the reasons why stroke is such a damaging event is the inability of damaged brain tissue to regenerate. Angiogenesis, the growth of new blood vessels, can help to regenerate brain tissue but properly guiding the process of angiogenesis is rather difficult.

However, a new report in Nature Materials indicates success using an injectable biogel for this purpose. In the report, a team led by Tatiana Segura, PhD, Professor of Biomedical Engineering at Duke with colleagues at UCLA, details its engineering of an injectable gel using nanoparticles consisting of heparin (a blood-thinning agent to prevent unwanted blood clotting) and vascular endothelial growth factor (VEGF) to stimulate brain regeneration. After injecting the gel in a mouse model of stroke, the mice showed a significant improvement in recovery compared to animals not receiving the engineered nanomaterial.

Here at Penn, D. Kacy Cullen, PhD, Research Associate Professor of Neurosurgery in the Perelman School of Medicine, has been investigating the use of implantable tissue-engineered brain pathways to treat and perhaps reverse the effects of neurodegnerative diseases like Parkinson’s disease. Penn Today has the story, with video of Dr. Cullen and photos and quotes from several of our own Bioengineering students.

Streamlining Environmental Bioengineering

Outside of the health sciences, bioengineering has applications in diverse fields, including energy development and environmental protection. Biofuels are one application for bioengineering that received a major boost recently. In an article published in NPJ Systems Biology and Applications, engineers from the US Department of Energy’s Lawrence Berkeley National Laboratory describe how they used machine learning to better predict the ability of engineered microbes to produce biofuel. With this information, they can then better adjust fuel-producing microbial pathways to maximize production. The machine learning model is a significant improvement over earlier, traditionally algorithmic approaches requiring complex differential equations. The time saved could, over generations of adjustments, result in a significant increase in output.

More on Pilots

Last week, we discussed how the cognitive load borne by airline pilots differs between simulated and real flight. Other scientists, it turns out, are looking at ways that pilots — in particular, fighter pilots — can overcome fatigue. With more than $1 million in grants from the US Department of Defense, Merhavan Singh, PhD, Dean of the Graduate School of Biomedical Sciences at the University of North Texas Health Science Center, and  Kai Shen, PhD, Associate Professor in the  Department of Chemistry and Forensic Science at Savannah State University in Georgia, are investigating compounds targeting the sigma 1 receptor, which the scientists believe could combat fatigue and also have neuroprotective effects if activated. This is particularly important among fighter pilots serving in conflict, who are often sleep deprived but must remain alert during missions.

People and Places

Having achieved success in its mission, the University of Alabama at Birmingham’s PREP Scholars Program, which supports underrepresented minority students in pursuing graduate study in bioengineering and biomedical engineering, has received an additional $1.8 million in support from the National Institutes of Health. The money will enable the funding of 40 students over the next five years.

Jeffrey Collins Wolchok, PhD, and Kartik Balachandran, PhD, both associate professors in the Department of Biomedical Engineering at the University of Arkansas, have received a $375,000 grant from the National Science Foundation to study the long-term effects of multiple concussions on the brain. With the increased emphasis in the scientific community and media on traumatic brain injury and chronic traumatic encephalopathy, including among former athletes, the two scientists will develop brain on a chip technology to examine the issue.

Finally, this week, the Best College Reviews website published its Top 10 list of online Master’s programs in biomedical engineering. Purdue University’s program finished in first place, with appearances on the list by Colorado State, UC Riverside, Stevens Tech, and Worcester Tech.

APOC Ghana: Day 12

By Summer Kollie, Health & Societies ’19; Amber Figueroa, Biology ’21; and Bosede Ajiboye, Psychology ‘19

Ghana 2018
(left to right) Penn students Amber Figueroa, Bosede Ajiboye, and Summer Kollie watch a nurse at KATH demonstrate how she teases Kangaroo Mother Care to new mothers.
Ghana 2018
A photo of the Kangaroo Mother Care ward as well as public service posters explaining their benefits.

Today, we made a visit to the premature infants and Kangaroo Mother Care (KMC) wing of Komfo Anokye Teaching Hospital (KATH). Our visit was very informative. The overall goal for premature babies was for mothers to engage in KMC. When talking to the doctor in the premature clinic, she mentioned that, on average, a baby would stay in the clinic, where there are incubators and CPAP machines, for about one week before being referred to the KMC ward. In some cases, babies who have more severe cases might stay for a month or longer. The goal of the premature clinic was to stabilize the baby. An infant was stable when they no longer needed supplied oxygen and IV fluids, they had no more difficulties in breathing, and they were able to take food, as in breastmilk, through their mouths. After the baby was stable, then they were moved to the maternal ward, where the mother could administer KMC.

Kangaroo Mother Care (KMC) is an efficient way to take care of premature infants without using an incubator. With skin-to-skin contact, the baby is placed on the mother’s chest between her breast. Then, two to three blankets are wrapped securely around the baby to keep them warm.

At the KMC ward, a nurse demonstrated on herself how a mother would tie her infant onto her chest. Th nursey emphasize for mothers to be able to perform the process of tying the blanket on their own. In this ward, KMC is administered 24/7. The only time a mother gets a break is if she needs to use the bathroom or to buy food. Fathers and other relatives only assist in this process for short periods when the mother needs a break or when the mother has more than one baby, as in twins or triplets, and cannot physically carry more than one on her chest.

APOC Ghana 2018: Day 11

By Shihan Dong, Biotechnology MS ’19; Xuanjie (Lucas) Gong, Biotechnology MS ’19; and Princess Aghayere, Health & Societies ‘19

Ghana 2018
From left to right: KNUST medical student Kwabena Asoka Sarpong, Penn students Ethan Zhao, Sheldon Amoo-Mitchual, Rebecca Zappala, Yasmina Al Ghadban, and KNUST medical student Muti Agyekum present to Christ Apostolic church on the causes and prevention of cancer.

As usual, today we left for to visit the psychiatric ward of the Komfo Anokye Teaching Hospital (KATH), the biggest hospital in Kumasi and the second biggest in Ghana. However, when we arrived at the KATH it turned out that the clinic wasn’t ready for our visit, because there was a mix-up with the letter sent to inform them of our visit. So, we went back to School of Public Health to access to internet to let everyone research  and work on their projects.

In the evening we returned to Christ Apostolic Church, a church for women who are poorly educated and mostly petty traders. Last Tuesday, we spoke to inform them about nutrition. This time, presentation was delivered by Ethan Zhao, Sheldon Amoo-Mitchual, Rebecca Zappala and Yasmina Al Ghadban, with KNUST medical students Kwabena Asoka Sarpong and Muti Agyekum as translators.

Ghana 2018
The APOC team sings a praise song in Twi for the congregation at Christ Apostolic church

Since last time there was a woman asked us to talk about cervical cancer, we decided talk about that as well as about cancer in general this time. At first, Ethan introduced the cancer was the result of cellular instructions being modified, and that there are ways to either protect those instructions or increase the risk of modification. Next, Sheldon talked about the importance of nutrition in cancer prevention, as introduced in last week, as well as the importance of good habits like exercising regularly and not smoking. Then, Rebecca introduced prevent cervical cancer and how to help prevent it through things like HPV vaccines and diagnosing it at early stages through Pap smear test. Finally, Yasmina covered the breast cancer, another cancer prevalent among women. She introduced that everyone is at risk of it and some certain factors would increase the risk like family breast cancer history. She taught them the self-exam, and recommended that women over 40 get a mammogram annually. During the question section, the audience was really active to ask questions, so much so that the other group that was supposed to present on pregnancy, Amber Figueroa, Bosede Ajiboye, and Summer Kollie had to be rescheduled to present next week. The churchgoers were curious about things like how and how often they should wash genitals area, as well as how to take care of their pre-pubescent daughters. They also wanted to clarify some rumors they were told about the causes of cancer, such as if things like phone vibration, or putting a phone to the left ear could cause cancer.

After the presentation, we sang a simple church song in Twi, Asem papa bia mate ne s3 oye oye, which we had prepared before coming. The churchgoers were delighted and they joined in, creating beautiful harmonies as our voices combined.

Bioengineering Postdoc Yogesh Goyal Receives Two Prestigious Awards

Yogesh Goyal
Yogesh Goyal, PhD

The University of Pennsylvania Department of Bioengineering is proud to announce that Yogesh Goyal, a postdoctoral fellow in the laboratory of Professor Arjun Raj, PhD, has received two pretigious awards. First, has received the Jane Coffin Childs (JCC) Memorial Fund Fellowship, which is a premier fellowship for biomedical studies. The JCC fellowship provides three years of funding at approximately $50,000 per year to top scholars having received the PhD in the previous 18 months. In addition, along with recently minted Bioengineering PhD Jina Ko, Yogesh has been named one of the 14 inaugural Schmidt Science Fellows, each of whom receives $100,000 to cover living expenses while working as a postdoctoral fellow under the auspices of the Rhodes Trust.

“I am thrilled to have the opportunity to work with such a talented scientist in the coming years on quantitative problems related to development and cancer,” Dr. Raj said. “These fellowships are a well-deserved recognition of Yogesh’s scientific vision and dedication.”

Yogesh, a native of Jammu and Kashmir, India, received his undergraduate in chemical engineering at the Indian Institute of Technology. He then came to Princeton University and studied for the PhD in the Department of Chemical and Biological Engineering and the Lewis-Sigler Institute for Integrative Genomics, under the advisement of Stanislav Shvartsman, PhD, and Trudi Schüpbach, PhD. He came to Penn Bioengineering after finishing his doctorate.

“I am very excited to be selected for two prestigious fellowships,” Yoghes says. “I am looking forward to working with Arjun on learning experimental and computational single-cell techniques to understand developmental and invasive systems.”

APOC Ghana 2018: Day 10

By Adam Yablonski, Health & Societies ‘21

Ghana 2018
Penn students Rebecca Zappala (left) and Amber Figueroa (right) teach math to grade 2 students at Kokoben (Photo credit: Eliza Culp)

Another early start to the day and another breakfast later, we were on our way to the KNUST Counseling Center. Our aim was to inquire further into another of the four fields our groups are interested in, today’s visit being geared towards mental health in Ghana (and more specifically, the mental health of university students at KNUST). Our plan for the afternoon was to return to the Kokoben Academy for our final set of lessons for the students there.

Ghana 2018
Penn student Xuanjie (Lucas) Gong teaches English to a grade 4 class at Kokoben
(Photo credit: Eliza Culp)

Upon arriving at KNUST however, we hit an unexpected roadblock (figuratively, that is). There was an unforeseen situation (the details of which remain undisclosed) that resulted in the unavailability of our contact in the facility. Luckily, we are no strangers to scheduling changes. We were able to call an audible, and simply ended up switching the order of our activities for the day – we drove instead first to Kokoben. Once again, the kids were eager to learn anything we would teach, but they seemed most interested in American culture. They inquired about our holidays, demographics, geography, food, and even our government. We ourselves were able to learn from them as well – both introspectively at our own culture as one of immigrants, but also simpler lessons, like the first ten numbers in Twi! Since today marked out final trip to the school, many of us bought candy beforehand to gift to the students. We had to exercise caution however, Ghanaian children are almost as voracious as their American counterparts and will not hesitate to swarm any candy-giving figure in proximity (no matter how tall you are, I found). Though fun, our trip was marked by melancholy; we had to say goodbye to the very real connections that we had formed in just a few short days. The service aspect of APOC will not end though, as we will be teaching at another school in the coming days.

After skipping lunch due to its lateness and our crunch for time, we returned to the University Counseling Center to discuss the state of mental health among the students there. They have low funding and just 10 staff members, and they see 900 new cases each year. We learned about what the Center does, which includes therapy, outreach, and training programs. Since poverty and hunger are unfortunately not rare problems among students at KNUST, the Center will also provide basic food items to students during exam times, and provide free health screenings of all kinds.

Ghana 2018
Penn and KNUST students listen to a member of the University Counseling Center

In speaking with a faculty member there, we uncovered some rather stark cultural differences that surround the issue of mental illness in this country. Firstly, there are no explicit diagnoses made at the Counseling Center, at least not as we would think of them. Instead, patients come in and simply speak with counselors there. The counselor will listen and perhaps will be able to diagnose something, be it GAD, MDD, or another condition. There is a disconnect though – because of Ghanaian society’s attitude towards mental illness, counselors are unlikely to even tell their patients of their condition, for fear that they will not return to counseling. As a result, emphasis is usually placed on what are perceived to be the causes of these conditions – the most commonly cited are relationship and family issues, financial issues, and academic stress (oftentimes, combinations will manifest). Counselors focus on these stressors with patients, rather than the disorders themselves. This stigmatization of mental illness is widespread, structural, and systemic, and will be a real challenge for our mental health group moving forward.

 

APOC Ghana 2018: Days 7-9

By Summer Kollie, Health & Societies ’19; Amber Figueroa, Biology ’21; and Bosede Ajiboye, Psychology ‘19

Ghana 2018
The team posing under a cocoa tree in front of the Center for National Culture, which did not allow photos inside. Left to right: Penn students Sheldon Amoo-Mitchual, Muti Agyekum*, Rebecca Zappala, Kwabena Asoka Sarpong, Yasmina Al Ghadban, Amber Figueroa, Summer Kollie, Sandy Tang, and Ethan Zhao (* second-year KNUST medical students)

Friday

We spent Friday morning learning more and experiencing Ghanaian history and culture. This was after we got the bad news that the scheduled programming to visit the urban high-risk maternal clinic was canceled. Even though we were disappointed because we wanted to learn more about high risk pregnancy in urban areas, we were luckily able to re-plan our day by going to the Center for National Culture Kumasi, a small museum containing objects significant to Ashanti history.

While there, we learned about the history of the kings and warriors of Ashanti culture. We learned about the golden stool and how it fell from the sky. We also visited the shops of several Ghanaian artisans and got the chance to patronize their work. We bought various jewelry, paintings, fabric, bowls, bandanas, and food.

We also had the chance to see a basket weaver weave an elaborate basket from scratch. It took him about 30 minutes to do so while we got an educational talk about the process while he was doing it.

On Friday night, we went to a bar and grill with music, where we ate dinner and danced with the other restaurant-goers. 

Ghana 2018
A basket weaver constructing a basket from rods of straw

Saturday

We spent Saturday morning at the market exploring and getting a taste of the rush of the market. We went to a big market, which had many sections and was bustling. The Ghanaian students helped us to navigate and barter with the sellers. We bought a lot of pretty fabric, like kente cloth. We also bought Ankara fabric, whichis used to make colorful wax-printed clothes that are common in Ghana, in preparation for the tailor, who will come in the following week to measure us and sew nice outfits for us.

On Saturday afternoon, we went home, slept, and later hand washed our laundry. We got a taste of what it was like to do laundry the way the locals do it, without washing machines. It took hard work and elbow grease, but it was fun.

Ghana 2018
Penn student Adam Yablonski navigates his way through the Anakara fabric at the market

Sunday

On Sunday morning, we moved into our new home which is more secluded. We went from having no air conditioning at the last location to having wonderful and cooling AC, along with private bathrooms. In this location, we are able to vibe with new people and get to know the neighborhood and culture more.

We spent Sunday afternoon resting after we enjoyed a delicious homemade lunch. On Sunday evening, we went out to a nice bar called Bar-Nas, where we enjoyed music and traditional Ghanaian dishes.

APOC Ghana 2018: Day 6

By Sandy Tang, Bioengineering ’19; Eliza Culp, Fine Arts ’20; and Jessica Fan, Biotechnology MS ‘18

Ghana 2018
Penn students Rebecca Zappala, Xuanjie (Lucas) Gong, and Eliza Culp observe and interview patients at the Afrancho Health Center

After a delicious breakfast, we headed out to Afrancho Health Center, a rural health center about an hour away that specializes in maternal ante-natal care. There we talked with the head nurse about their internal processes and the general work flow of the center, as well as general practices for maternal healthcare. She showed us several examples of blank paperwork used to register expecting mothers and their medical history, which was very helpful to our understanding of their process. From our conversation, we learned to identify and categorize pregnancies as high risk based on conditions such as anemia, hypertension and preeclampsia, hepatitis, teenage pregnancy, and timing of pregnancy.

The Afrancho Health Center sees all women once a month during pregnancy and weekly during the last month before delivery. Sonograms are done at each visit. Diagnostic tests are also run when the women initially come in to screen for risk factors and conditions. The center also provides educational materials on nutrition, safe delivery practices, and other important information. In addition to speaking with the head nurse, the center kindly arranged for us to speak to patients with their consent to gain a better understanding of each of the high-risk factors identified by the center. Afterwards, we got a glimpse of their delivery rooms, as well as the laboratory spaces where they are able to run several diagnostic tests for the center. They are able to provide these services, but they need more staff, an ambulance system, a reliable power source, bigger facilities, and lab machinery.

Ghana 2018
Penn students Adam Yablonski and Shihan Dong teach a grade 9 class at Kokoben geography and Chinese.

After lunch on the road, we arrived at the Kokoben Municipal Assembly school. We continued to assist with their classroom lessons, including English grammar, math, and physics, and we also introduced some new topics, such as Chinese and art. The kids were wonderful and very active participants. We look forward to working with them again on Monday.

We also look forward to re-visiting the health center in two weeks to follow up on some cases.

Week in BioE (May 29, 2018)

Virtual Biopsy for Melanoma

virtual biopsy
Melanoma cells stained to show cell nuclei (blue), podosomes (yellow), actin (red), and an actin regulator (green).

Melanoma is a common form of skin cancer that is most often successfully treated by removal of the cancerous cells. However,  malignant forms of melanoma can metastasize and become deadly. The significance of malignant melanoma is evident in its incidence – melanoma is the fifth most common cause of deaths from cancer in the US. Treating melanoma relies on using biopsy samples to determine the virulence of the cancer. However, the biopsy process is invasive and painful, and it can even be disfiguring.

Addressing this issue, Jesse Wilson, PhD, Assistant Professor in the Department of Electrical and Computer Engineering and in the School of Biomedical Engineering at Colorado State University (CSU), is developing a virtual biopsy for the disease. Funded by a Young Investigator Award from the Melanoma Research Alliance and a grant from the Colorado Clinical and Translational Sciences Institute, Dr. Wilson’s virtual biopsy uses multiphoton microscopy, which normally requires the use of a costly short-pulse laser for optimal visualization; his research seeks to obviate the need for laser, thus rendering the process more broadly available. 

Dr. Wilson intends to begin testing of his biopsy device on dogs from CSU’s veterinary school. Dogs also develop malignant melanoma, so the device will be used to gather data about each lesion that a dog develops. Once the imaging data are collected, the dogs will undergo normal biopsy and, if needed, treatment. In parallel, Dr. Wilson’s imaging algorithm will process the microscopy data collected prior to the biopsy, score it as malignant or not, and compare the predictions with the actual biopsy results to determine the new technique’s accuracy.

A Clue to Consciousness

Among the great mysteries in neuroscience is the nature of consciousness — that aspect of our psyche that allows us to observe that we are aware. We know that we have consciousness, but we aren’t sure why we do, nor do we fully understand the biological mechanisms that underlie consciousness.

A new study from scientists at Washington University in St. Louis might offer some clues, however. In the study, published in Neuron, the authors used a combination of calcium and hemoglobin imaging in mice to detect infra-slow spatiotemporal trajectories — essentially brain waves that are qualitatively different from other traditional electrical activity waves measured in the brain. These new waveforms were much slower than the activity of other traditional activity waves, and they traveled through different areas of the animals’ brains. The direction of the waves, moreover, changed on the basis of the level of consciousness of the mice.

Closer to home (and to humans), in a new article in Frontiers in Human Neuroscience, Hasan Ayaz, PhD, Associate Research Professor in the
School of Biomedical Engineering, Science and Health Systems at Drexel University, in collaboration with scientists from France, reports that the cognitive load of airline pilots differs significantly between pilots in the actual cockpit, compared to those using flight simulators. Dr. Ayaz and his colleagues used functional near infrared spectroscopy (fNIRS) for their comparisons. A future step for this research will be to integrate flight data recordings with the fNIRS data.

3D Printing Now Sweeter

Three-dimensional printing has become a vital resource in tissue engineering. However, the ability of commercial 3D printing technology to produce water-soluble glass — a key compound used in many tissue engineering processes — has been elusive because of the specific properties of the carbohydrates used to create this glass, which do not work with the technology used in available 3D printers.

However, this issue could be closer to a solution. In a new article in Additive Manufacturing, a team of scientists led by Rohit Bhargava, PhD, Founder Professor of Engineering in the Department of Bioengineering at the University of Illinois in Urbana-Champaign, reports that they have solved some of these problems. Using isomalt, a type of sugar alcohol, for their experiments, the authors were able to determine the characteristics inherent in the material necessary for 3D printing, as well as modeling the type of machinery necessary to use isomalt in a 3D printing process. Work on creating the 3D printing model recently published is still under way, but video of a bridge model has been published online here.

Seeing Like a Bat

Earlier this month, CLEO (the Conference on Lasers and Electro-Optics) held its annual meeting in San Jose, with a bioengineering contingent out in full force. Nader Engheta, PhD, the H. Nedwill Ramsey Professor with appointments in the Departments of Bioengineering, Electrical and Systems Engineering, and Materials Science and Engineering, was there and gave an interview with Optics & Photonics News. In the interview, Dr. Engheta discusses, among other things, bioinspired polarization — a developing field that seeks to enable people to see polarized light, which is visible to some animals, such as bats, but not to the human eye.

People and Places

Elon University in North Carolina will expand its current offerings in engineering in the coming year. In addition to a dual-degree program, Elon will offer for the first time an undergraduate degree program in engineering with an available concentration in biomedical engineering.  Sirena Hargrove-Leak, PhD, has been named director of the new program.

APOC Ghana 2018: Day 5

By Yasmina Al Ghadban, Bioengineering ’20; and Rebecca Zappala, Bioengineering ‘21

Ghana 2018
From left to right: KNUST second-year medical student Muti Agyekum, Penn students Sheldon Amoo-Mitchual, Amber Figueroa, Rebecca Zappala, and Ethan Zhao.

This morning, after a breakfast of eggs, sausage, and toast, we headed to the Maternal and Child Welfare Center (at the Komfo Anokye teaching hospital) to visit the malnutrition ward. We learned about two types of severe acute malnutrition: marasmus, which is characterized by severe wasting due to starvation and a lack of both protein and energy nutrients; and kwashiorkor, which is characterized by swelling of the belly, cheeks, and limbs due to a lack of protein in the diet. We also learned about the process of treatment starting from diagnosis by measuring the mid-upper arm circumference (MUAC), as well as the weight. After the specific case of malnutrition has been diagnosed, healthcare providers look for underlying conditions, such as infection, anemia, HIV, or malaria, by running lab tests. For treatment, depending on the severity of the case and the age of the child, they administer F75 or F100, which are different kinds of ready-to-use therapeutic agents. After learning about the third case that we will be working on, we went to the nutrition center where families are sent for outpatient care and follow-up. This is also the first point of contact between the family and the healthcare system; if the case is severe, the patient is referred to the malnutrition ward that we first visited. At first, we had questions about how the follow-up process works. We discovered that mothers are supposed to come back weekly to collect more food and check the weight and MUAC of their children to track their progress. In cases in which mothers do not come back for their follow-up, they are called and sometimes even visited at their homes by nurses.

Although we had visited this same ward yesterday, it is still so hard to look at the children there. The clinic seems to be doing everything they can; however, it is difficult to ignore that there is a clear lack of resources, funds, and accessibility. For example, the malnutrition center had to move from being a 2-room clinic to a 1-room clinic due to a lack of funds. This resulted in having the waiting area, the food distribution, and the assessment of the child in the same confined space, which then limits the number of patients they can care for at once.

Ghana 2018
Penn student Ethan Zhao teaches a grade 8 class at Kokoben Municipal Assembly School about the importance of a balanced diet and its components.

Later in the afternoon, after a drive through the market and a stop to get coconuts, we headed to Kokoben Municipal Assembly school (kindergarten through grade 9) for service. We were divided into pairs, which each taught a class about something the grade was currently working on or wanted to learn. The experiences ranged from singing with 5-year-olds and struggling to communicate in English, as most children only know Twi, to teaching about heart diseases and the circulatory system. There was a lot of shock at first since it was not easy to stand in front of 40 students and teach an unprepared lesson. Overall, the kids seemed very excited and fascinated by our presence. Although we were glad we were able to spend some time with them and share an (infinitely) small part of knowledge, we were shocked by their fascination and overwhelming joy to see us.

As on our fourth day in Ghana, we feel like we have learned so much — both about the healthcare system and the culture, and we look forward to continuing to learn and grow tomorrow.

APOC Ghana 2018: Day 4

By Xuanjie (Lucas) Gong, Biotechnology MS ’19; Shihan Dong, Biotechnology MS ’19; and Princess Aghayere, Health & Societies ‘19

Ghana 2018
MUAC tape

Today, we all went to the Maternal and Child Health Hospital in Rural Kumasi. The main purpose of the visit was to observe malnutrition cases in children and to interact with doctors and nurses who treat children suffering from malnutrition.

Ghana 2018
RUTF

While visiting the clinic, the nutrition group asked the questions that we prepared yesterday. It turns out that the situations here match up with our research. Doctors and nurses use WHO standards to determine the nutrition status of the kids. Also, they use MUAC tape to determine the severe acute malnutrition. Children who have MUAC less than 11.5 cm will be sorted into a severe acute malnutrition group.

As for solutions or treatments, they do know about and have RUTF (Ready-to-Use Therapeutic Food). We also learned that they have therapeutic milk, F-75 and F-100, to treat malnourished children in different phases. They have F-75 to use at the starting phase of treatment. If F-75 helps to stabilize the children, they move onto F-100, and they use diluted F-100 for children under 6 months.

We had 2 cases that we mainly focused on. The first case was of a 3-year-old girl who suffered from Kwashiorkor, Marasmus, and Marasmic Kwashiorkor. All 3 diseases are signs of severe acute malnutrition. She had been there for 3 weeks for treatment, and her condition was not improving. The doctors attributed her declining condition to poverty and the mother’s psychiatric problems. The patient’s mother has already lost two children to the same condition. The doctors describe the girl’s status as unstable because she often vomits and isn’t gaining weight. The second patient is a child exposed to HIV as a result of her mother being positive for the disease. Because she is only 3 months old, blood cannot be drawn, and testing cannot be done to ensure her HIV status.

Ghana 2018
F-75 therapeutic milk

In the evening, we went to a church to give a presentation to local women with little to no education. We started by asking them what they eat everyday, and luckily we received a lot of responses. From their responses, we could clearly see that their diet lacked components of vegetables and fruits. Then, we delivered a brief speech containing basic nutrition knowledge, mainly based on the six essential nutrients. We explained the function of these nutrients and some local sources to obtain them. Surprisingly, one of the female audience members said that this was her first time hearing about vitamins and minerals.

During the question and answer segment of our presentation, some women asked about the different types of sources for minerals and vitamins. In particular, one woman asked about the foods that she could eat to help with her hypertension. To our surprise, another women asked whether her intake of fruits was excessive. This question made us think about people’s awareness of obesity and other diseases related to overeating. At the end of the presentation, the audience was happy about what we presented today and looked forward to learning more on our next visit.