Data show that healthcare disparities plague the Black community in America, making it harder to receive adequate treatment and care. But rather than just accepting the status quo, Ruby Washington, senior in the Department of Bioengineering, is dedicated to leveraging her interest in biomedicine to change outcomes and systems.
“I feel that I have a duty to help my community and make the healthcare system better for people who look like me,” she says.
That’s a challenge well suited to a woman who is both fascinated by the intersection of materials science and biology and dedicated to representing and leading a community of Black engineers.
The Penn Bioengineering student spotlight series continues with David Alanis Garza. David is a senior from Monterrey, Mexico finishing his dual degree in Bioengineering in the School of Engineering and Applied Sciences and Health Care Management at the Wharton School, with minors in Chemistry and Math. He currently serves as the Captain of the Medical Emergency Response Team (MERT), managing clinical operations and the organization’s response to COVID-19. He is also a Penn tour guide and a member of the Sigma Phi Epsilon fraternity. In his free time, he enjoys mountain climbing, camping, and playing guitar.
What drew you to the field of Bioengineering?
I first became interested in BE during my high school physics class, in which my teacher motivated our lesson in electromagnetism by explaining the basics behind an MRI machine and how defibrillators are basically glorified capacitors. I realized that my lifelong dream to be a surgeon would best be served if I armed myself with a scalpel and screwdriver alike. With the fast paced advances in the medical field, the best physicians must not only understand the underlying pathophysiology of disease, but also how to interact with and keep up with innovations in the biomedical engineering field. At Penn, I have enjoyed discovering that BE is much more wide than what I initially appreciated.
Have you ever done research with a professor on campus? What did you like, and what didn’t you like about it?
I have had the opportunity to work in the Center for Resuscitation Science on a research project investigating diagnostic patterns in the electrocardiogram of Pulseless Electrical Activity (PEA). I truly enjoyed the opportunity to take on more responsibility as the first author of the manuscript we are currently working on, and learned so much about communication in science when presenting the research during American Heart Association’s Resuscitation Science Symposium this last weekend. What I learned in Bioengineering, especially in BE 309/310 (Lab) and BE 301 (Signals and Systems), has been incredibly useful for my research. I am also currently completing a Wharton senior thesis exploring how financial derivative securities could be used to hedge risk in emergency departments. Penn is incredibly supportive of students seeking to gain more research experience, offering an abundance of opportunities for guided and independent projects. I truly enjoyed the opportunity of finding answers to very specific questions in my fields, as well as the valuable relationships with my mentors I formed along the way.
What have been some of your favorite courses and/or projects in Bioengineering so far?
BE 305 (Engineering Principles of Human Physiology) has been my favorite course at Penn. In this class, we were able to understand, quantify, and hack the body’s physiology through an engineering lens. From building a pulseoximeter with our phone cameras, to determining the blood volume of the left ventricle over time with MRI images, this class was very much hands on. A close second is BE 301 (Bioengineering Signals and Systems). I hadn’t previously grasped how this discipline was relevant to medicine until this class, but now I find myself applying what I learned in my research. Lastly, as many other BE students will tell you, the human-cockroach machine interface project in BE lab has been one of my most challenging and rewarding undertakings at Penn. Our team linked a wearable device that measured the forearms position and muscle contractions, so that when the wearer painted a picture, a cockroach leg would be moved and stimulated to paint an imitation of the image. Overcoming my phobia of cockroaches and the countless hours of trial and error were all worth it, for I can now brag about how my team made an artist out of a cockroach leg.
What advice would you give to your freshman self?
It is a great idea to identify which area of BE research you are interested in, and plan your academics so that you can take the closely related courses early on. This will empower you to conduct research with greater responsibilities or give you marketable skills that employers may look for when hiring for internships of your interest. BE upperclassmen are always willing to help, so feel free to reach out to us for any advice.
What do you hope to pursue after obtaining your undergraduate degree?
I will be taking a gap year in which I will be working in the area of hospital administration and clinical engineering before I begin my medical school journey. As of right now, I am interested in specializing in emergency medicine or surgery, but I know my interests may change as my understanding of medicine grows throughout the next years.
Have you done or learned anything new or interesting during quarantine?
The COVID pandemic gave me a unique opportunity to manage the clinical operations of MERT’s emergency medical services during an unprecedented challenge. As a result, I learned a lot about how different hospitals and health care systems are managing their response, not to mention the standard protocols to ensure the safety and wellness of our patients and providers. On a less professional note, I have been able to get a bit better at chess and guitar.
Chlorine gas is a commonly used industrial chemical. It is also highly toxic and potentially deadly; it was used as a chemical weapon in both World War I and the Syrian Civil War and has led to multiple deaths from industrial accidents. Mixing certain household cleaners can also produce the toxic gas, leading to lasting lung injuries for which there are currently no effective treatments.
Now, researchers at Penn Engineering and Penn’s Perelman School of Medicine are collaborating with BARDA, the U.S. Office of Health and Human Services’ Biomedical Advanced Research and Development Authority, to address this need using their lung-on-a-chip technology.
The laboratory of Dan Huh, associate professor in the Department of Bioengineering, has developed a series of organ-on-a-chip platforms. These devices incorporate human cells into precisely engineered microfluidic channels that mimic an organ’s natural environment, providing a way to conduct experiments that would not otherwise be feasible.
Huh’s previous research has involved using a placenta-on-a-chip to study which drugs are able to reach a developing fetus; investigating microgravity’s effect on the immune system by sending one of his chips to the International Space Station; and testing treatments for dry eye disease using an eye-on-a-chip, complete with a mechanical blinking eyelid.
The Perelman School of Medicine has announced the winners of the 2020 Penn Medicine Awards of Excellence. The Office of the Dean says:
“These awardees exemplify our profession’s highest values of scholarship, teaching, innovation, commitment to service, leadership, professionalism and dedication to patient care. They epitomize the preeminence and impact we all strive to achieve. The awardees range from those at the beginning of their highly promising careers to those whose distinguished work has spanned decades.
Each recipient was chosen by a committee of distinguished faculty from the Perelman School of Medicine or the University of Pennsylvania. The contributions of these clinicians and scientists exemplify the outstanding quality of patient care, mentoring, research, and teaching of our world-class faculty.”
Two faculty members affiliated with Penn Bioengineering are among this year’s recipients.
Yale Cohen, PhD, Professor of Otorhinolaryngology with secondary appointments in Neuroscience and Bioengineering, is the recipient of the Jane M. Glick Graduate Student Teaching Award. Cohen is an alumnus of the Penn Bioengineering doctoral program and is currently the department’s Graduate Chair.
“Dr. Cohen’s commitment to educating and training the next generation of scientists exemplifies the type of scientist and educator that Jane Glick represented. His students value his highly engaging and supportive approach to teaching, praising his enthusiasm, energy, honesty, and compassion.”
“Dr. Smith is the foremost authority on diffuse axonal injury (DAI) as the unifying hypothesis behind the short- and long-term consequences of concussion. After realizing early in his career that concussion, or mild traumatic brain injury (TBI), was a much more serious event than broadly appreciated, Dr. Smith and his team have used computer biomechanical modeling, in vitro and in vivo testing in parallel with seminal human studies to elucidate mechanisms of concussion.”
Speaker: Audrey Bowden, Ph.D.
Dorothy J. Wingfield Phillips Chancellor’s Faculty Fellow and Associate Professor of Biomedical Engineering and Electrical Engineering & Computer Science
Date: Thursday, November 19, 2020
Time: 3:00-4:00 PM EST
Zoom – check email for link or contact email@example.com
Title: “Emerging Technologies for Detection of Early Stage Bladder Cancer”
Bladder cancer (BC) — the 4th most common cancer in men and the most expensive cancer to treat over a patient’s lifetime — is a lifelong burden to BC patients and a significant economic burden to the U.S. healthcare system. The high cost of BC stems largely from its high recurrence rate (>50%); hence, BC management involves frequent surveillance. Unfortunately, the current in-office standard-of-care tool for BC surveillance, white light cystoscopy (WLC), is limited by low sensitivity and specificity for carcinoma in situ (CIS), a high-grade carcinoma with high potential to metastasize. Early detection and complete eradication of CIS are critical to improve treatment outcomes and to minimize recurrence. The most promising macroscopic technique to improve sensitivity to CIS detection, blue light cystoscopy (BLC), is costly, time-intensive, has low availability and a high false-positive rate. Given the limitations of WLC, we aim to change the paradigm around how BC surveillance is performed by validating new tools with high sensitivity and specificity for CIS that are appropriate for in-office use. In this seminar, I discuss our innovative solutions to improve mapping the bladder for longitudinal tracking of suspicious lesions and to create miniature tools for optical detection based on optical coherence tomography (OCT). OCT and its functional variant, cross-polarized OCT, can detect early-stage BC with better sensitivity and specificity than WLC. We discuss the critical technical innovations necessary to make OCT and CP-OCT a practical tool for in-office use, and new results from recent explorations of human bladder samples that speak to the promise of this approach to change the management of patient care.
Audrey K. Bowden is the Dorothy J. Wingfield Phillips Chancellor Faculty Fellow and Associate Professor of Biomedical Engineering (BME) and of Electrical Engineering and Computer Science (EECS) at Vanderbilt University. Prior to this, she served as Assistant and later Associate Professor of Electrical Engineering and Bioengineering at Stanford University. Dr. Bowden received her BSE in Electrical Engineering from Princeton University, her PhD in BME from Duke University and completed her postdoctoral training in Chemistry and Chemical Biology at Harvard University. During her career, Dr. Bowden served as an International Fellow at Ngee Ann Polytechnic in Singapore. From 2007-2008, she was the Arthur H. Guenther Congressional Fellow sponsored by the OSA and SPIE and served as a Legislative Assistant in the United States Senate through the AAAS Science and Technology Policy Fellows Program. Dr. Bowden is a Fellow of SPIE, a Fellow of AIMBE and is the recipient of numerous awards, including the Air Force Young Investigator Award, the NSF Career Award, the Hellman Faculty Scholars Award, the Phi Beta Kappa Teaching Award, Ford Foundation Postdoctoral Fellowship, and the NSBE Golden Torch Award. She is a former Associate Editor of IEEE Photonics Journal, former Lead Guest Editor of a Biomedical Optics Express Special Issue and is a member of numerous professional committees. Her research interests include biomedical optics – particularly optical coherence tomography and near infrared spectroscopy – microfluidics, and point of care diagnostics.
Using a magnetic field and hydrogels, a team of researchers in the Perelman School of Medicine have demonstrated a new possible way to rebuild complex body tissues, which could result in more lasting fixes to common injuries, such as cartilage degeneration. This research was published in Advanced Materials.
“We found that we were able to arrange objects, such as cells, in ways that could generate new, complex tissues without having to alter the cells themselves,” says the study’s first author, Hannah Zlotnick, a graduate student in bioengineering who works in the McKay Orthopaedic Research Laboratory at Penn Medicine. “Others have had to add magnetic particles to the cells so that they respond to a magnetic field, but that approach can have unwanted long-term effects on cell health. Instead, we manipulated the magnetic character of the environment surrounding the cells, allowing us to arrange the objects with magnets.”
In humans, tissues like cartilage can often break down, causing joint instability or pain. Often, the breakdown isn’t in total, but covers an area, forming a hole. Current fixes are to fill those holes in with synthetic or biologic materials, which can work but often wear away because they are not the same exact material as what was there before. It’s similar to fixing a pothole in a road by filling it with gravel and making a tar patch: The hole will be smoothed out but eventually wear away with use because it’s not the same material and can’t bond the same way.
What complicates fixing cartilage or other similar tissues is that their makeup is complex.
“There is a natural gradient from the top of cartilage to the bottom, where it contacts the bone,” Zlotnick explains. “Superficially, or at the surface, cartilage has a high cellularity, meaning there is a higher number of cells. But where cartilage attaches to the bone, deeper inside, its cellularity is low.”
So the researchers, which included senior author Robert Mauck, PhD, director of the McKay Lab and a professor of Orthopaedic Surgery and Bioengineering, sought to find a way to fix the potholes by repaving them instead of filling them in. With that in mind, the research team found that if they added a magnetic liquid to a three-dimensional hydrogel solution, cells, and other non-magnetic objects including drug delivery microcapsules, could be arranged into specific patterns that mimicked natural tissue through the use of an external magnetic field.
And while innovation in health care usually brings to mind new treatments and medicines, the efforts of clinicians, engineers, and IT specialists demonstrate the importance technological infrastructure for rapidly deployable, tech-based solutions so clinicians can provide the best care to patients amid social distancing and coronavirus restrictions.
The telemedicine revolution
In late March, telemedicine was key for allowing Penn Medicine clinicians to deliver care while avoiding potentially risky in-person interactions. Chief Medical Information Officer C. William Hanson III and his team helped set up the IT infrastructure for scaling up telemedicine capabilities and provided guidance to clinicians. Thanks to the quick pivot, Penn Medicine went from 300 telemedicine visits in February to more than 7,500 visits per day in a matter of weeks.
But far from seeing telemedicine as a temporary solution during the pandemic, Hanson has been a long-time advocate for this approach to health care. In his role as liaison between clinicians and the IT community in the past 10 years Hanson, helped establish remote ICU monitoring protocols and broadened opportunities for televisits with specialists. Now, with the pandemic removing many of the previous barriers to entry, be they technical, insurance-based, or simply a lack of familiarity, Hanson believes that telemedicine is here to stay.
“As the pandemic evolved, people were aware that telemedicine could help the health care system, as well as doctors and patients, during this crisis,” he says. “Now, there are definitely places where telemedicine makes good sense, and we will continue to use that as part of our way of handling a problem.” Other benefits include removing geographic barriers to entry for new patients, reduced appointment times, increased patient satisfaction, and reduced health care provider burnout.
Simple solutions for COVID-19 challenges
As the director of Penn’s Telestroke Program, neurologist Michael Mullen has experience diagnosing from a distance. This spring, telemedicine carts his group uses were repurposed in COVID ICUs. At the same time, Mullen and group wanted to expand their ability to assess stroke patients remotely, so he reached out to Brian Litt, faculty director of Penn Health-Tech, to see how he could collaborate to create an analogous telemedicine station using readily available, cost-effective components.
Rapid and simple solutions are at the heart of Penn’s ModLab, a subgroup of the GRASP lab focused on robots made of configurable individual components. As part of a COVID-19 rapid response initiative, engineers worked with Mullen to figure out a viable solution in record time. “The idea was to make it as simple and as fast as possible,” says graduate student Caio Mucchiani. “With robotics, usually you want to make things more sophisticated, however, given the situation, we needed to know how we could use off-the-shelf components to make something.”
Fellow graduate student Ken Chaney, postdoc Bernd Pfrommer, and Mucchiani came up with a plan that replicated the required specs of the existing telemedicine carts, including state-of-the-art cameras for detailed imaging as well as a reliable, easily rechargeable battery. The team then put together 10 telemedicine carts, assembling the prototypes with social distancing and masks at the GRASP lab in early April.
While changes to treatment approaches mean that these carts still require additional field testing, Mullen is still eager to expand the program, be it for diagnosing patients safely or educating medical students in an era of social distancing. “In the setting of COVID, when everything was getting crazy, it was remarkable to see the energy that GRASP brought to help,” adds Mullen. “Everyone was really busy, and it was amazing to see this group of people who wanted to use their expertise to help.”
Brian Litt, professor in Engineering’s Department of Bioengineering and the Perelman School of Medicine’s departments of Neurology and Neurosurgery, has received a five-year, $5.6 million Pioneer Award from the National Institutes of Health, which will support his research on implantable devices for monitoring, recording and responding to neural activity.
The Pioneer Award is part of the agency’s High-Risk, High-Reward Research Program honoring exceptionally creative scientists. It challenges investigators to pursue new research directions and develop groundbreaking, high-impact approaches to a broad area of biomedical or behavioral science. Litt’s neurodevice research represents a new frontier in addressing a wide variety of neurological conditions.
In epilepsy, for example, these devices would predict and prevent seizures; in Parkinson’s patients, implants will measure and communicate with patients to improve mobility, reduce tremor and enhance responsiveness. Other implants might improve hearing or psychiatric symptoms by querying patient perceptions, feelings, and altering stimulation patterns algorithmically to improve them
Single cell sequencing aided researchers in identifying a previously undiscovered molecule in the brain.
Chimeric antigen receptor (CAR) T cell therapy has revolutionized treatment of leukemia, lymphoma, and multiple myeloma. But some people who have received this treatment experience neurotoxicity, or damage to the brain or nervous system.
New research from a team led by Avery Posey, an assistant professor of systems pharmacology and translational therapeutics in the Perelman School of Medicine, provides evidence that this side effect may owe to a molecule in the brain that scientists previously didn’t know was there.
The work, published in the journal Cell, revealed that the protein CD19 is present in brain cells that protect the blood-brain barrier. Prior to the finding, scientists believed CD19 was only expressed on B cells, and the protein served as a target for certain forms of CAR-T therapy. The discovery may chart a path forward for new strategies to effectively treat cancer while sparing the brain.
“The next question is,” says Posey, “can we identify a better target for eliminating B cell related malignancies other than CD19, or can we engineer around this brain cell expression of CD19 and build a CAR T cell that makes decisions based on the type of cell it encounters—for instance, CAR T cells that kill the B cells they encounter, but spare the CD19 positive brain cells?”
The Penn Bioengineering virtual seminar series continues on September 24th.
Speaker: Kevin Johnson, M.D., M.S.
Cornelius Vanderbilt Professor and Chair
Department of Biomedical Informatics
Vanderbilt University Medical Center
Date: Thursday, September 24, 2020
Time: 3:00-4:00 pm
Zoom – check email for link or contact firstname.lastname@example.org
Title: “Patients, Providers and Data: How the EMR and Data Science are Changing Clinical Care”
The electronic health record (EHR) is a powerful application of Systems Engineering to healthcare. It is a byproduct of a host of pressures including cost, consolidation of providers into networks, uniform drivers of quality, and the need for timely care across disparate socioeconomic and geographic landscapes within health systems. The EHR is also a fulcrum for innovation and one of the most tangible examples of how data science affects our health and health care. In this talk I will showcase projects from my lab that demonstrate the multi-disciplinary nature of biomedical informatics/data science research and translation using the EHR, and our current understanding of its potential from my perspective as a pediatrician, a researcher in biomedical informatics, a Chief Information Officer, an educator, and an advisor to local and international policy. I will describe advances in applying human factors engineering to support medical documentation and generic prescribing, approaches to improve medication safety, and innovations to support precision medicine and interoperability. I will present our efforts to integrate EHR-enabled data science into the Vanderbilt health system and provide a vision for what this could mean for our future.
Kevin B. Johnson, M.D., M.S. is Informatician-in-Chief, Cornelius Vanderbilt Professor and Chair of Biomedical Informatics, and Professor Pediatrics at Vanderbilt University Medical Center. He received his M.D. from Johns Hopkins Hospital in Baltimore and his M.S. in Medical Informatics from Stanford University. In 1992 he returned to Johns Hopkins where he served as a Pediatric Chief Resident. He was a member of the faculty in both Pediatrics and Biomedical Information Sciences at Johns Hopkins until 2002, when he was recruited to Vanderbilt University. He also is a Board-Certified Pediatrician.
Dr. Johnson is an internationally respected developer and evaluator of clinical information technology. His research interests have been related to developing and encouraging the adoption of clinical information systems to improve patient safety and compliance with practice guidelines; the uses of advanced computer technologies, including the Worldwide Web, personal digital assistants, and pen-based computers in medicine; and the development of computer-based documentation systems for the point of care. In the early phases of his career, he directed the development and evaluation of evidence-based pediatric care guidelines for the Johns Hopkins Hospital. He has been principal investigator on numerous grants and has been an invited speaker at most major medical informatics and pediatrics conferences. He also was the Chief Informatics Officer at Vanderbilt University Medical Center from 2015-2019.
See the full list of upcoming Penn Bioengineering fall seminars here.