2017 Galvanizing Engineering in Medicine (GEM) Awards

UC San Diego Altman Clinical and Translational Research Institute (ACTRI) announces the selection of four physician-engineer teams as the 2017 recipients of the Galvanizing Engineering in Medicine (GEM) awards. GEM, an initiative of ACTRI and UC San Diego Institute of Engineering in Medicine (IEM), supports projects that identify clinical challenges for which engineering solutions can be developed and implemented to improve health care. The GEM recipients and their projects are below.

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Louise Laurent, MD, PhD
Department of Reproductive Medicine
UC San Diego
Drew Hall, PhD
Jacobs School of Engineering
UC San Diego
Yu-Hwa Lo, PhD
Jacobs School of Engineering
UC San Diego

Title: Development of a Magnetic Nanosensor-based Assay for Real-time Non-invasive Quantification of Protein and Nucleic Acid Biomarkers in Preterm Birth—Point-of-care Testing for Early Identification of Patients at Risk for Pregnancy Complications

Preterm birth, preeclampsia, and fetal growth restriction are major causes of fetal and maternal morbidity and mortality. There is increasing evidence that dysregulation of placental function is associated with these disorders, and that the pathologic processes leading to them long precede their clinical manifestations. Therefore, the ability to accurately, rapidly, and safely detect various forms of placental dysfunction early in pregnancy may enable discovery and clinical use of novel biomarkers of pregnancy complications. Currently available strategies for prediction of these adverse pregnancy outcomes suffer from low sensitivity and specificity and/or are unfeasible for broad implementation, due to the need for expensive equipment, specialized expertise, or long turnaround times. This project aims to develop a magnetic nanosensor-based platform for measurement of analytes in the maternal blood that reflect placental function, which can be used to discover novel predictive biomarkers and make them universally available. In this proof-of-concept study, we will develop magnetic immunoassays (MIAs) targeting known protein biomarkers of placental function and two novel analytes from a clinical mass-spectrometry-based assay for prediction of spontaneous preterm birth developed by Sera Prognostics, and validate these MIAs against existing clinical ELISA- and mass spectrometry-based tests. We will also develop, test, and validate magnetic nanosensor-based miRNA assays against a novel set of 21 miRNAs in maternal serum that we have found to be highly predictive of placental dysfunction. If successful, this project will produce a versatile magnetic nanosensor-based platform for sensitive and specific quantification of a variety of analyte types, which will not only enable development of novel strategies for management and treatment of pregnancy complications, but can also be applied to other clinical and biological systems.

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Anna Narezkina, MD
Division of Cardiology
UC San Diego
Elliott R. McVeigh, PhD
Jacobs School of Engineering
UC San Diego

Title: Low-dose CT-based Method for Detection of Subclinical Anthracycline-induced Cardiotoxicity

Early treatment is crucial for successful left ventricular ejection fraction preservation with anthracycline cardiotoxicity. Currently available echocardiographic methods lack accuracy and reproducibility for detection of early subclinical anthracycline-induced myocardial damage. The researcher team believes the increased precision and reproducibility of a fully automated, non-subjective 4D CT-based technique will give physicians the best chance to detect subtle early changes in left ventricular function due to anthracyclines. The aim is to develop a new non-invasive CT-based imaging method for detection of anthracycline-induced myocardial dysfunction at early stages, before a drop in left ventricular ejection fraction is apparent. The team will implement a new 4D CT imaging protocol and analysis method to measure the precise regional left ventricular function in patients treated with anthracyclines. Obtained with minimal human operator interaction, the proposed CT protocol will provide an objective high-resolution local left ventricular function map. The researchers will perform CT in patients before and immediately after anthracycline therapy, and correlate them with echocardiography-based measurements.

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Alexander Norbash, MD
Department of Radiology
Associate Vice Chancellor—Equity Diversity Inclusion
UC San Diego
James Friend, PhD
Jacobs School of Engineering
UC San Diego

Title: Steerable Tip Microcatheter Treatment of Intracranial Aneurysms

This project aims to solve the problem of intervention to treat cerebral aneurysms with minimally invasive methods. The effort includes design engineering of a novel device and its testing in ex vivo and in vivo experiments to obtain sufficient data for rapid adoption of the device in clinical practice. Reducing the time to navigate to an aneurysm improves the success rate and reduces costs of care.

A lack of steerability hinders the treatment of saccular cerebral aneurysms via endovascular coiling. Many minimally invasive surgeries, from biopsies to microsurgery in the eye, are constrained by an absence of useful 100 micrometers to 1 millimeter-sized remote tools. Our aim is to develop sufficient micro-assembly and testing tools to solve the steering problem in neurointervention via our novel technology, an inherently safe and simple (saline-driven) microhydraulic system providing the neurointerventionist complete steering control of the microcatheter’s tip in vivo. We are producing new, inexpensive, and safe surgical devices through novel microprint-and-cast fabrication and new hyperelastic polymers at the challenging scale of 25–500 micrometers. Capillary, viscous, electrostatic, gravity-driven, and adhesive forces are at a similar magnitude, sabotaging traditional fabrication methods useful at larger (machine shop) or smaller (NANO3 clean room) scales. Our approach combines these methods available at the core facilities at UC San Diego by making creative use of wire, 3D printing, casting, fiber optics, multibore capillary tubing, photolithography-produced alignment jigs, and even custom-built hand tools.

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Robert Weinreb, MD
Shiley Eye Institute
UC San Diego
Frank Talke, PhD
Jacobs School of Engineering
UC San Diego

Title: Optical Pressure Sensor for Measuring Intraocular Pressure for Keratoprosthesis Patients and Glaucoma Patients

This project addresses the need for frequent and accurate intraocular pressure (IOP) measurements in glaucoma care. The research team plans to address this need in Keratoprosthesis (K-Pro) patients and cataract patients who are likely to develop glaucoma after surgery. It is not possible to measure IOP in K-Pro patients using standard tonometry techniques due to the rigid back plate of the artificial cornea. In Professor Talke’s lab, a miniaturized sensor has been designed for measuring intraocular pressure (not cornea dependent) using the principle of interferometry. The sensor is passive, does not require an internal power source or battery, is simple in design, and accurate (<1 mmHg resolution). We envision that the sensor will be integrated into a K-Pro artificial cornea or an intraocular lens (IOL) to monitor pressure in K-Pro and cataract patients, respectively. Post-surgery, physicians and possibly patients themselves can measure pressure with ease by capturing images of the sensor in the eye with a handheld reader (or a modified standard slit lamp). Measurement results are readily available after imaging and can be repeated over time. Once implanted, the sensor can remain in the K-Pro or intraocular lens for the lifetime of the implant, i.e., it does not have to be removed post-surgery since the sensor is biocompatible and passive in nature.

The innovation of the technology is in the application of the principle of interferometry into the unique and simple design of the sensor. The hermetically sealed sensor consists of a diaphragm and a PMMA substrate. As pressure increases, the diaphragm deflects, resulting in interference fringes that can be observed when monochromatic light is directed towards the active sensing region. These fringes can be captured and used to determine the intraocular pressure.  The researchers plan to optimize the design of the sensor and the K-Pro to allow integration of the sensor into the K-Pro with minimum obstruction to the patient’s vision.