Project types: GH indicates Global Health | MT indicates MedTech
Student Team: Anastasia Borok, Adam Clark, Luke Jungles, Nathaniel Moller
Clinical Advisors: Harshad Sanghvi, MD and Kusum Thapa, MD
Sponsor: Jhpiego and Laerdal Global Health
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. There are over 14 million cases of PPH every year, and approximately 125,000 of these end in death. The majority of these deaths occur in resource-constrained settings, with half occurring in sub-Saharan Africa and one third in South Asia. Additionally, there are over 20 million women living with chronic illnesses (such as anemia) resulting from PPH. Tragically, a child is 10 times more likely to die before their second birthday if their mother dies from PPH. PPH is largely manageable with access to adequate resources, but these are often unavailable in remote locations. We have developed two separate solutions that will buy time for a woman to get to a care facility to receive appropriate treatment.
The Automatically-Deflating Air Postpartum Tamponade (ADAPT) is the first air-inflated tamponade and is equipped with a custom designed balloon which is inserted into the uterus and inflated to provide uniform pressure along the uterine wall. Additionally, the ADAPT automatically releases pressure, which allows the uterus to contract to its normal state while maintaining pressure against the uterine walls. The ADAPT incorporates the safety and performance of devices used in the developed world, at a cost of less than $10.
Legloves are one-size-fits-all elastic devices that are placed over the toes of a woman and rolled up the leg to her upper thigh. The compressive force along the length of the leg shunts blood away from the extremities to critical organs in the same way an anti-shock garment does. Studies have shown that shunting blood from the lower extremities to critical organs provides the equivalent of a self-transfusion of one pint of blood.
Student Team: Creighton Petty, Brian Rayburn, Geoffrey Russell, Lauren Smith
Clinical Advisors: Jean Anderson, MD, and Jeff Smith, MD, Department of Gynecology and Obstetrics; Cherrie Evans, D.PH, CNM, Jhpiego
Sponsor: Jhpiego and Laerdal Global Health
Every year, there are approximately 2 million stillbirths and neonatal deaths related to intrapartum causes. Nearly 99% of these mortalities occur in developing countries. One contributor to this disparity in global neonatal death rates is a lack of monitoring the fetal status during labor in developing countries. Though fetal heart rate is a widely accepted indicator of fetal wellbeing, it is rarely accomplished in low-resource facilities due to the lack of efficient equipment for monitoring, the low staff-to-patient ratios, the minimal staff training, and the insufficient time for finding and counting fetal heart beats. Our BabyBeats fetal monitor is a hand-held device that processes heart sounds using low-cost microphone technology and outputs heart rate on a digital display. It includes a speaker to play heart sounds that are frequency-shifted to make them easier to hear. It also uses a rechargeable cell phone battery to avoid power dependence and has durable housing to withstand harsh environments. Preliminary testing shows promise the device will enable health workers to find the fetal heart rate more quickly and reliably, without specialized training, and at a cost that enables widespread distribution.
Student Team: Marton Varady, Shuja Dawood, John Sidhom
Cervical cancer is the third most common cancer in the world where 88% of all cases occur in the developing world. With approximately 600,000 new cases every year, this silent killer is responsible for over 250,000 deaths per year, making it the second leading cause of female cancer deaths in developing countries. While cervical cancer has largely been eradicated in the developed world with the incorporation of regular screening and new opportunities for vaccinations, it remains a large burden in the developing world due to inadequate healthcare infrastructure, high costs, and the lack of an appropriate technology for treatment. Momo Scientific is a social venture medical device company dedicated to the prevention of cervical cancer. The CryoPop is a patent-pending low-cost medical device which uses dry ice for the treatment of cervical pre-cancerous lesions in low-resource settings. The CryoPop relies only on carbon dioxide tanks, readily available in developing countries because of soda companies, and is ten times cheaper, 30 times more efficient, and more effective and reliable than current technology.
Student Team: Divya Maxwell, Luccie Wo, Luis Soenksen, James Barger, Omid Akhavan
Clinical Advisors: Stefan Riedel, MD PhD and Robert Hamilton, PhD, Department of Pathology, JHU
Globally, malaria and bacterial pneumonia claim the lives of 3 million children under the age of five. Patients suffering from these diseases present with several symptoms, fever being the most common. Other causes of fever include influenza, dengue, and typhoid. However, healthcare providers often lack diagnostic tools to determine the underlying cause of fever, leading to misdiagnosis and over-prescription of antibiotics and other drugs. Unfortunately, 90% of these unnecessary antibiotic prescriptions occur in the developing world. Our team is developing the FeverPoint™, a lateral-flow immunoassay test to differentiate between bacterial, viral and malarial infection. Using an ultra-low-cost microfluidics platform, our test can provide results with a single drop of blood, requiring no electricity, water, or sample preparation. Our goal is to provide accurate diagnosis and to save millions of lives around the globe.
Student Team: James Barger, Divya Maxwell, Brian Rayburn, and Luccie Wo
Clinical Advisors: Clifford Weiss, MD, CBID Clinical Director; Mark Lessne, MD, Department of Radiology, JHU; Robert Liddell, MD, Interventional Radiology, Mercy Hospital, Baltimore
Over 2 million stents are placed annually to preserve blood flow in a vessel or shunt blood to an alternative path. Current stents fail because they are static and unresponsive to physiological changes in the body, compromising the outcome of stent therapy. NeoPersona has created the novel NeoStent that adapts to the body’s demands. Similar to a pacemaker, a physician can “fine-tune” the flow within the stent during clinic visits, adapting the stent to best suit the patient’s needs. This is a platform technology that can be applied to an assortment of stents placed today, including TIPS (Transjugular Intrahepatic Portosystemic Shunt) stents, biliary stents, pediatric stents, pulmonary stents, peripheral venous stents, and cardiac stents.
The NeoStent, consists of two components: (1) Implantable — the implantable portion of the Neostent includes any commercially available stent and a nylon band which can constrict and expand the stent with the use of a piezoelectric motor; (2) External Control Box — the external control of the piezoelectric motor will be achieved with the generation of a high frequency electric field. A very specific frequency will be generated to resonate with the motor.
Student Team: Anastasia Borok, Creighton Petty, Lauren Smith, Marton Varady
Clinical Advisor: Andrew Lane, MD, Department of Otolaryngology, JHU
Approximately 10 million Americans suffer from chronic sinusitis, the persistent inflammation of the sinus lining. The disease results in facial pressure, fatigue, and headaches that severely impair quality of life. Patients attempt to manage sinus inflammation with steroid sprays and irrigations, but current solutions are inadequate because they fail to reach the diseased areas. Each year, approximately 500,000 patients resort to surgery, and up to one third experience recurrent symptoms post-surgery. The SinuGlide is a novel drug delivery device that will improve post-surgical outcomes and could ultimately prevent the majority of chronic sinusitis surgeries. The SinuGlide overcomes the inadequacies of existing treatments by ensuring that medication is distributed to the affected sinus surfaces daily. The device consists of a small, specialized catheter that is inserted in the nasal cavity by the physician. The patient uses a separate external device for daily medication delivery via the catheter. A novel magnetic interface between the inserted tube and external device allows the inserted device to be placed far into the nasal passage where it cannot be seen or felt. Initial testing to date has largely mitigated the technical risks of the device and shown promise that the SinuGlide will achieve drug coverage to the majority of diseased sinus tissue.
Student Team: Adam Clark, Shuja Dawood, Luis Soenksen, Nathaniel Moller
Clinical Advisors: Clifford Weiss, MD, and Steven Hsu, MD, Department of Radiology, JHU
Every year, more than 90,000 patients die unnecessary deaths due to complications of a life-sustaining medical device called a central venous catheter (CVC). Bacteria are prone to growing on CVC surfaces, causing blockages and infections, which cost hospitals $56K per case, and US healthcare $2.3 billion every year. Current solutions are expensive and only address infections or blockages, never both. With leading physicians at Johns Hopkins Hospital, Salveo Vascular has invented the Sonicade, a medical device that attaches to any CVC and prevents bacterial formation using high-frequency vibrations. Our platform technology is the first to reduce both infections and blockages in the growing $780 million dollar CVC market. The Sonicade will reach the market in 3 years and begin saving the lives of healthcare’s most vulnerable patients.
Student Team: Omid Akhavan, Luke Jungles, Geoffrey Russell, John-William Sidhom
Clinical Advisor: Daniel Valaik, MD, Department of Orthopaedics, JHU
Artificial knee joints suffer from a well-acknowledged problem of long-term wear resulting in osteolysis, implant loosening, and revision surgery. With revision surgery being a costly and painful procedure, there is a need for longer-lasting knee replacement technology. Additionally, with the limited lifetime of current artificial knee joints, there is an unaddressed portion of individuals suffering from osteoarthritis who are not candidates for total knee replacement. Rogue Orthopedics has developed the SpringSert, a medical device that will be capable of incorporation into a standard artificial knee joint and provide a passive unloading mechanism to reduce stress in the implant and extend its lifetime. Our technology will allows individuals suffering from knee osteoarthritis to receive earlier joint replacement and thus, obtain early, effective, and lasting pain relief.
Student Team: Samrie Beshah, John J. Kim, Simon Ammanuel, Kalyna Apkarian, Winston Aw, Nathan Buchbinder, Robert Kim, Erika Moore, Neil O’Donnell, and Melissa Sajnani
Clinical Advisors: Michael Johnston, MD, and Ryan Lee, MD, Kennedy Krieger, Jhpiego
Lack of oxygen to the brain during birth leads to Hypoxic-Ischemic Encephalopathy (HIE), which can cause death in up to 60% of affected infants and disability in at least 25% of survivors. The Cooling Cure aims to reduce the impact of HIE on newborns via whole body cooling or therapeutic hypothermia. A specific procedure for hypothermia treatment includes the following crucial steps: lowering the neonate’s core body temperature to 33.5 ̊C within the first 6 hours following birth, maintaining the 33.5 ̊C for 72 hours, and then gradually rewarming to 37 ̊C at a maximum rate of 0.5 ̊C/hr. To cool the infant, the “pot-on-pot” refrigeration method is employed through the use of clay pots. The larger clay pot will be filled uniformly with a 2 cm layer of sand. A smaller pot will be placed on top of the sand layer inside the larger pot. By wetting the sand with water, the device will maintain the inner pot temperature at 17 ̊C and thus the neonate’s body will be cooled. To initiate warming, water is no longer added to the sand. The baby will be wrapped in a cotton blanket and either elevated within the inner pot or held by the mother in the Kangaroo Mother Care (KMC) hold. By combining well-known techniques with the hypothermia treatment, the device will be more easily adapted in the global health setting.
Student Team: Stephanie D’Souza, Henry Ma, Conan So, Stephanie Valarezo, Andrew Wang, Xindi Ai, Lindsay Bauer, Rodolfo Finocchi, Calvin Zhao
Conventional disposable syringes used for injections in developing countries pose a significant risk of needle-stick injury and associated infectious diseases, and create large volumes of infectious medical waste. The EcoJect–an affordable, biodegradable hypodermic syringe with a nonmetal needle is made of a Poly(L-Lactic Acid) (PLLA), an inexpensive, light-weight plastic that burns cleanly and degrades in the presence of water. Our design includes a nitrile O-ring seal that maintains a vacuum and can degrade mechanically, as well as a locking mechanism that prevents reuse and allows safe disposal. After using the syringe, the plunger is locked into a part – the needle attachment member–which holds the needle. The entire needle system can then be withdrawn into the barrel and safely disposed. A water-resistant packaging system indicates (with a color-changing dot) whether or not the device has been exposed to water. The EcoJect is a platform technology that can be applied to a variety of syringe sizes and needle gauges.
Student Team: Noah Young, Rohan Soman, Steffi Liu, Elisa No, Jack Aguilar, Stephen Chen, Peter Nelson, Margo Heston
Clinical Advisor: Robert G. Hamilton, PhD, D.AMBLI, JHU
In developing countries, diagnostic testing for HIV, Hepatitis B (HBV), and Hepatitis C (HCV) is expensive and time-consuming, resulting in spread of disease by uninformed carriers, and contamination in the supply of donated blood. We have designed a paper-based point-of-care microfluidic device that performs a gold nanoparticle-linked immunosorbant assay to diagnose viral infection. Our device is made of mylar-wrapped nitrocellulose paper and is smaller than a business card, approximately 70 mm x 12 mm. We use a wax printing and wax transfer process to embed hydrophobic barriers in the nitrocellulose, which we use to control the routing of fluid reagents on the strip. This control allows us to create an assay that is more sensitive than contemporary lateral flow devices, yet requires less attention from an operator to run. Test results can be seen with the naked eye within minutes and interpreted by a minimally-trained healthcare worker. Our device is robust to changes in temperature and humidity, and we expect it can be manufactured in facilities in the country of use and sold for under $0.20/test.
Student Team: Rohit Dasgupta, Vikram Rajan, Joy Ukaigwe, RJ Powers, Hannah Jiam, Uma Mohan, Renu Kondragunta, Jordan Mandel, Pranay Rao, Martin Kang
Clinical Advisors: Graham Simpson, PhD, Michelle Staben Wobker, PhD, Anne Le, MD, MS
Tafenoquine is a new anti-malarial drug being developed by GlaxoSmithKline (GSK), in partnership with Medicines for Malaria Venture (MMV), for treatment of P. vivax malaria. It is believed to be superior to existing treatments (such as primaquine) due to its single‐dose formulation and ability to prevent relapse. A drawback with primaquine and tafenoquine is potential toxicity in patients with a hereditary condition known as glucose‐6‐phosphate dehydrogenase (G6PD) deficiency. Approximately 400 million people are estimated to have some degree of G6PD deficiency, most of these people living in areas having a history of endemic malaria. In these patients, primaquine and tafenoquine can cause hemolysis of red blood cells and, in extreme cases, could be fatal. There is thus a need for a sensitive point‐of‐care (POC) diagnostic which can be used to screen patients’ suitability to receive tafenoquine or primaquine. We have developed a simple POC diagnostic for detection of G6PD deficiency based on a color change proportional to the activity of G6PD in red blood cells. The chemical reaction for our diagnostic test is based on a previously published enzymatic reaction that produces an orange color dye derived from WST-8, one of the reagents in the reaction. We have designed a unique filter device used to transform the measurement reading of the WST-8 test from a qualitative color gradient to a binary measurement. The filters are preset at certain wavelengths corresponding to the color that specific quantities of G6PD activity produce through the chemical reaction. Our current prototype also uses a stamp device to apply reagents to the testing material before the application of blood. This test can be used on whole blood and the result can be read in under 30 minutes. Our methods demonstrate a path for the development of simple and inexpensive diagnostic assays that may be useful for detecting G6PD deficiency in remote settings.
Student Team: Frank Yao, Adam Xiao, Kelsey Humphries, Shida Li, Michael Chen, Amanda Ojeda, Riley Howard
Clinical Advisor: Jacek Mostwin, MD, PhD, Department of Urology, JHU
One in three adult women suffers from stress urinary incontinence (SUI), the involuntary leakage of urine during movement. Normally, the underlying pelvic muscles compress the urethra against the pubic bone, keeping it shut. SUI is often caused by a weakening of these muscles, which allows the urethra to sink down and open under pressure. The current standard of care is the trans-vaginal sling, a surgical device that supports those muscles and prevents the urethra from leaking. However, despite a high rate of preventing SUI, the sling has been associated with several severe complications, resulting in a hostile litigation environment and prompting the FDA to issue multiple warnings. The Gyneguide is a small, porous polycaprolactone shock-absorber that is implanted transvaginally under the mid-urethra, pushing the urethra against the pubic bone. Its unique shape disperses pressure on the pelvic floor, thereby restricting urethral mobility. Additionally, the device is designed to degrade away within six months and while inducing the growth of permanent fibrous tissue, which will provide a long-term cure while reducing complications such as pain, voiding dysfunction, and tissue erosion.
Student Team: Guilherme Barros, George Chen, William Chen, Judy Doong, Noah Greenbaum, Phillip Oh, David Yin
Clinical Advisor: Robert G. Hamilton, PhD, D.AMBLI, JHU
Faculty Advisor: Soumyadipta Acharya, MD, PhD, Department of Biomedical Engineering
Anemia is a global health problem affecting millions of mothers and infants, contributing to 100,000 maternal and 600,000 newborn deaths annually. Our device, HemoGlobe, is a small, low-cost tool that transforms rural health workers’ cellphones into noninvasive, completely prick-free hemoglobinometers, resembling a standard pulse oximeter in form and function. Hemoglobin levels are pictorially displayed on the cellphone screen for easy, actionable interpretation. Concurrently, the information is transmitted to a central server via automatic SMS, which contributes data to a real-time geographical map of anemia prevalence and severity that can be used for higher-level public health policy decisions. This tool will enable (1) community-based, noninvasive screening of maternal anemia to detect those at highest risk; (2) better targeting of public health resources such as prevention campaigns, blood transfusion facilities, and parenteral iron programs to areas with a high prevalence of severe maternal anemia; and (3) health system accountability, especially for helping individuals in rural and remote areas
Student Team: Nishant Ganesh Kumar, Abhilash Guduru, Kailun Che, Makoto Tanigawa, Sebastian Kwon, Tomas Gaigalas, Bofeng Zhang
Clinical Advisors: Timothy Wang, MD, and Sewon Kang, MD, Department of Dermatology, JHU
When faced with an abnormal skin lesion, physicians often perform a biopsy to obtain a sample of the tissue for pathological examination. In 2006, dermatologists performed approximately 91,000 skin biopsies daily in the US and two thirds ultimately proved to be cancerous. Punch biopsies are the primary technique used to acquire full-thickness skin specimens because they obtain the epidermis, the dermis and the subcutaneous tissue and are quicker and easier to perform than excisional biopsies.
In addition to the cost of the device, the gauze, suture, forceps, scalpel blade, needle holders and scissors needed to perform the procedure, culminate in more than $50 material and autoclaving cost per procedure. Two aspects that can affect the quality of the sample include its thickness (dictated by the depth of the punch) and the mechanical handling of the specimen. Inadequate sample depth or mechanically induced crush artifact can prevent pathologists from making accurate diagnoses. Our solution incorporates the use of a wire that runs down the shaft of the device and encircles the blade of the punch tool. By using a rotating mechanism, the wire constricts and shears the sample to sever it from the underlying tissue. The blade is designed to collect the sample when the punch tool is removed. To close the wound, we propose the use of a steristrip with an adhesive. In this way, our solution addresses the problems of the current standard of care and significantly decreases the need for additional instruments reducing cost by an estimated 80%, improving safety and reproducibility.
Student Team: Marib Akanda, Ahmed Aly, Tara Berglund, Kay Gregory, Joon Seok Oh, Piyush Poddar, Sandya Subramanian, and Sai Vangala
Clinical Advisor: Robert G. Hamilton, PhD, D.AMBLI, JHU
While pregnancy tests are inexpensive to manufacture, supply chain inefficiencies and high mark-up rates in the developing world make the purchase price for the rural healthcare clinics far too expensive to afford, leaving them without this simple and highly useful diagnostic. We created a reusable pregnancy test that minimizes the frequency of reordering tests and thus lower the overall cost to the clinic. Our solution consists of a modified lateral flow immunoassay for pregnancy which can be reused through a simple regeneration process where solutions wash the urine and the results of the previous test off the strip. A new set of pads (supplied with the kit) are then added to the cleaned strip to replace the reagents that were washed away, and a new sample can then be tested. Our reusable device can reduce costs to the clinic by 60-80% per use, hitting the desired price identified by clinicians in the field as being affordable for clinic budgets.
Student Team: Stephen Dria, Zack Chaffin, Megan Hodgson, Meera Ramakrishnan, Saurabh Vyas, Nick Clyde, Austin Jordan, Taylor Lam
Clinical Advisors: Janine Bullard, MD, Department of Pediatrics; Jean Anderson, MD, Department of Gynecology and Obstetrics; Sheena Currie, RM, Jhpiego
Sponsors: Laerdal Global Health and Jhpiego
Approximately one million newborns die each year due to improper resuscitation. This challenge is exacerbated in low-resource settings due to poor airway positioning, lack of frequency feedback, an inadequate seal of the resuscitation mask, and difficulties in skill retention and lack of confidence. The bag-valve-mask (BVM) is the gold standard in these settings, but falls short due to these problems. NeoInspire, a set of three technologies, addresses these issues. First we include a collapsible plastic mat which is dimensioned based on normal term-infant head sizes to properly extend the newborn’s head into the “sniffing position”, opening the trachea to allow ventilation of the lungs. The second element replaces the current mask with a redesigned funnel-shaped mouthpiece which is inserted into the baby’s mouth, rather than over the mouth, and stretches the lips to form a tight seal around the device in order to reduce leakage. The final element is a small flashing LED which paces the rate at which a resuscitator should squeeze the BVM bag. This allows resuscitators to focus on the infant rather than on timing of the procedure.
Student Team: Sohail Zahid, Andy Tu, Daniel Peng, Stephen Van Kooten, Leslie Myint, Anvesh Annadanam, Haley Huang, Luis Herrera
Clinical Advisor: Hien Nguyen, MD, FACS, Department of Surgery, JHU
Approximately 9-19% of nearly five million open abdominal surgeries result in herniation, infection, evisceration, and other postoperative patient complications. One important issue is improper fascial closure, which can be caused by improper approximation of suture placement and bowel laceration. To solve this issue, we have designed QuickStitch – an inexpensive, mechanical suturing device that will better uphold the integrity of the fascia layer. QuickStitch improves fascial reapproximation with a visual guide to place sutures at regular intervals and minimizes bowel injury with an in-built receptacle that minimizes needle exposure. With this device, surgeons can close fascia more safely, easily, and consistently.
Student Team: Qing Xiang Yee, David Shin, Alex Yue, Merrie Zhang, Lucy Gao, Nicholas Blair, Albert Feeny, Hansin Kim
Clinical Advisor: Scott Paul, PhD, National Institutes of Health
In the US hundreds of thousands of children suffer from diseases like cerebral palsy and severe scoliosis and require long-term use of wheelchairs for mobility. As they are physically or neurologically unable to maintain their own posture, they require custom seating solutions to remain upright in a wheelchair. Current solutions, like machined-foam cushions, are expensive, inconvenient and do not account for patient growth. We have developed the ShapeShifter, a re-moldable, environmentally-friendly cushion based on a polycaprolactone and paper composite sheet overlaid with a layer of memory foam. A patient is placed onto a fitting chair, and a negative impression of the body shape is taken. A positive impression is then made using quick-expanding foam, and the heated (and pliable) sheet is then overlaid onto the impression and allowed to solidify. The layer of memory foam is attached to the sheet by velcro, and the whole assembly is attached to the wheelchair. If re-molding is necessary, the memory foam is removed, and the plastic sheet is heated and re-molded to a new impression of the patient’s body shape. The ShapeShifter reduces the cost of healthcare significantly due to its re-usability and affordable materials. It improves clinical outcomes by allowing patients to have the best-fitting cushions possible during all stages of growth, providing better pressure distribution and reducing secondary deformities and complications. It is also more convenient for patients as molding only requires minutes in a single visit.
Student Team: Emmalynn Connor, Rohit Dayal, Cecilia Furlong, Frances Zappone, Christopher Corbett, Linda Yue, Parisa Moghaddam-Taaheri, Mary Banoub, Carly Loveland
Clinical Advisor: Andrew Lane, MD, Department of Otolaryngology, JHU
Faculty Advisor: Hai-Quan Mao, PhD, Department of Material Science, JHU
To improve current management and treatment of chronic rhinosinusitis (CRS), SinuSoothe will topically deliver corticosteroids more effectively to the paranasal sinuses. Delivering steroid over a prolonged period of time to cavities unreachable by current methods and without undesirable systemic side effects will reduce inflammation in those cavities, resulting in decreased rate of recurrence and need for repeated surgeries. Our current design comprises of a biodegradable, biocompatible, thermoresponsive hydrogel and a disposable tubing system for delivery. The hydrogel is a copolymer of polyethylene glycol (PEG) and poly lactide-co-glycolide (PLGA), which will elute the topical corticosteroid mometasone furoate for a period of thirty days. The hydrogel will be injected at room temperature as a solution and will set into a gel at body temperature within a few minutes. The applicator consists of a disposable syringe and malleable tubing system with an inflatable balloon at the distal tip. The end of the delivery tube will be inserted into a sinus cavity where the inflated balloon will prevent drug from escaping out through the ostium and thus ensure the cavity is entirely filled. A clinician will apply this treatment within 30 minutes using an endoscope to observe on-site application. The prototype consists of a catheter delivery system and the drug loaded hydrogel. The team is performing bench testing in the Materials Science Department and full prototype testing on a cadaverous head at the University of Maryland. We expect our solution to benefit 500,000 sufferers of CRS each year in the US.