2021

Global Health Innovations

  • THE TEAM

    Student Team: Jordan Shuff, Emanuel Wasson, Alejandro Chara, Kaiyan Cai, Deepika Dixit

    Advisors: Dr. Kunal Parikh, Dr. Nakul Shekhawat, Soumyadipta Acharya, Dr. David Friedman, David Green

    Sponsors: Dr. Yadalla Dayakar, Dr. R. Venkatesh

    ABSTRACT

    The goal of our project is to provide accessible vision care to more vulnerable populations in South India. The Aravind Eye Hospital (AEH), located in South India, is the largest provider of vision care in the world, with the mission of eliminating avoidable blindness. Today, 148 million people in rural India suffer from avoidable vision loss and lack access to vision care. Economic, transportation, and cultural barriers limit access to specialized ophthalmic providers in a timely manner. The current pandemic has only exacerbated these barriers. Before the pandemic, AEH would hold periodic, one-day eye camps in select rural villages to diagnose and transport patients to the base hospitals. However, even these eye camps were not accessible to 80% of individuals requiring vision care, and COVID-19 has further limited outreach efforts.

    Our team is developing a community-based, telemedicine-enabled screening program to diagnose the leading causes of vision loss in individuals who have historically lacked access to vision care. Our telemedicine app task-shifts screening to volunteer community health workers (CHWs) by providing adaptive screening protocols and a guided physical examination. Using our app, CHWs can screen rural patients in the community, securely send patient information to AEH for an ophthalmologist to review, after which the patient can be diagnosed and referred. This will enable AEH to expand their outreach by providing continuous access to eye screening in rural communities while eliminating the economic and transportation barriers to diagnosis.

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  • THE TEAM

    Student Team: Mackenzie Hall, Mariana Bendavit Kleinzweig, Kai Zhang, Samuel Weinreb, Izabella Samuel

    Advisors: Nicholas Reed, Soumyadipta Acharya, Carrie Nieman

    Sponsors: Neha Verma, Adler Archer

    ABSTRACT

    Age related hearing loss (ARHL) is the most common sensory deficit in older adults with nearly two thirds of adults over 70 experiencing some form of hearing loss that negatively affects their ability to communicate. However, the majority of these cases go untreated, contributing to negative outcomes including: social isolation, worsening physical and mental health, cognitive decline and even dementia. Education on communication strategies and hearing rehabilitation have been shown to reduce these negative outcomes and improve quality of communication, but despite their proven value, patients rarely receive these services because delivery of this care by skilled practitioners is not covered by insurance and no accessible means of delivering these services without an audiologist has been shown to produce the same quality of outcomes.

    Pidgin is a personalized, adaptable telehealth system which can deliver hearing rehabilitation to patients affected by age related hearing loss (ARHL). Our system is designed to allow users to input their personal hearing struggles, be provided with an individualized lesson plan, teach the lesson plan through information and activities, and evaluate their learning through a platform that will be used by a hard of hearing individual (HoH) and a loved one or caretaker (referred to as a communication partner or CP). The platform will enable the CP to deliver the same quality care that a skilled practitioner could provide by analyzing input data and teaching a clinically proven rehabilitation curriculum. Learning these strategies will enable a hard of hearing individual to communicate better with those around them and live more independently, contributing to a more active engagement with loved ones and better quality of life.

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  • THE TEAM

    Student Team: Lindsay Pierle, Amara Aarif, Rebecca Rosenberg, Robert Breidenstein, Zachary Zarubin

    Advisors: Dr. Soumyadipta Acharya MD, MSE, PhD, Monet Slinowsky, MSE

    ABSTRACT

    Malaria is a vector-borne disease, in which the malaria parasite is transmitted to humans through the bite of a female Anopheles mosquito. Despite investments of $2 billion per year, there were still 228 million cases of malaria in 2018, resulting in over 400,000 deaths. The most effective way to fight malaria is to eliminate malaria-carrying mosquitos. To accomplish this, vector control programs must know exactly what types of mosquitos are in a local area to effectively limit mosquito populations each species has its own behaviors, biting preferences, and insecticide resistance. Vector surveillance involves monitoring the density and distribution of malaria-carrying mosquitoes and is crucial for efficient distribution of limited species-specific control methods.

    Species are currently identified from their discrete morphological characteristics which can take up to 20 minutes for each mosquito. Due to a lack of qualified entomologists, 34-55% of mosquitoes are misidentified. Thus, results are slow and inaccurate. This can prevent decision-makers from having reliable real-time data to inform their vector control decisions.

    Our solution is a handheld field tool that uses a computer vision algorithm to identify mosquito species. The solution consists of two parts: a Cloud-based classification algorithm and a hardware setup to standardize optics and lighting.

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  • THE TEAM

    Student Team: Ignacio Albert Smet, Caterina Esposito, Taylor Holt, Alexis Graham

    Advisors: Youseph Yazdi, Soumyadipta Acharya, Joshua De Souza, Harshad Sanghvi

    ABSTRACT

    Surgically treatable diseases account for 11% of the world’s burden of disease. However only 3.5% of surgeries happen in low-income countries where laparoscopic surgery – which is minimally invasive surgery through a camera – is scarce. In higher income countries, such as the United States, laparoscopic surgery has dominated since the 90s, primarily due to its improved outcomes. However, there is a lack of trained mentors available in LIMCs to train surgeons in laparoscopic surgery. Moreover, for countries such as Kenya, where 85% of the population is employed informally and approximately 62% are farm laborers, the benefits of laparoscopic surgery are even more important, offering a way to improve recovery time and decrease the risk of complications that cause rehospitalization, disability and death. For patients who rely on everyday labor for subsistence, not having access to laparoscopic surgery increases economic loss and poor health outcomes.

    Therefore, our team has developed LaparoscopiX, a novel training paradigm that targets training barriers such as limited mentor availability, expensive training simulators, long learning curves, and inadequate independent training methods. Our proposed paradigm shift in laparoscopic surgical training includes faster skill acquisition with high-frequency, low-dose training exercises. LaparoscopiX contains two main components based on the apprenticeship learning model. The first is an observational component that uses pattern recognition to teach anatomy and surgical planes in real-life situations, and the second is a practical element to gain the skills to perform 3D tasks while referencing a 2D screen. We hypothesize that if surgeons in Kenya have a way to reduce the learning curve associated with going from training to live laparoscopic surgery, they can decrease the number of cases needed with a mentor to gain competency, thus making it possible to train more surgeons and expand access to laparoscopic surgery.

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Healthcare Innovations

  • THE TEAM

    Student Team: Lindsay Pierle, Amara Aarif, Rebecca Rosenberg, Robert Breidenstein, Zachary Zarubin

    Advisors: Dr. C. John Sperati, MD, MHS, Dr. Chirag Parikh, MBBS, PhD, Dr. Derek Fine, MD, Dr. Ashish Nimgaonkar, MBBS, MD, MS, Dr. Soumyadipta Acharya MD, MSE, PhD

    Sponsors: Dr. Peter Kotanko, MD

    ABSTRACT

    About 450,000 Americans currently rely on hemodialysis to manage their end-stage renal disease. Hemodialysis is the medical treatment which replaces the function of the kidneys, filtering a patient’s blood to remove excess fluids and wastes. On average, each patient undergoes hemodialysis three times a week, for a total of 70.2 million dialysis sessions each year in the United States alone. Intradialytic hypotension (IDH) is a drop in systolic blood pressure to less than 90 mmHg during a hemodialysis treatment and occurs in 11-22% of all treatments.

    Under the current standard of care, a patient’s blood pressure is measured every 15-30 minutes using a BP cuff during hemodialysis. However, IDH can occur on the order of 60 seconds. This means that a patient could be hypotensive for up to 29 minutes before blood pressure is recorded with regular monitoring and technicians can intervene. This prolonged drop in blood pressure can result in a decrease in tissue perfusion, causing muscle cramping, abdominal pain, and fatigue. More significantly, IDH can also cause vascular access thrombosis, seizure, stroke, myocardial ischemia, cardiac arrhythmias, and cardiac arrest. As a result, IDH is a significant factor in the high mortality associated with hemodialysis.

    The HypoLERT System is a non-invasive continuous blood pressure device that can detect IDH in real-time. Our device will provide dialysis technicians with high-frequency knowledge of each patient’s condition, improve patient outcomes during hemodialysis, increase patient lifespan, and minimize hospitalizations; therefore keeping patients receiving treatment in the clinic.

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  • THE TEAM
    Student Team: Mackenzie Hall, Izabella Samuel, Kai Zhang, Samuel Weinreb, Mariana Bendavit Kleinzweig

    Advisors: Daniel Laheru, Robert Liddell, Richard Burkhart, Clifford Weiss, Youseph Yazdi

    Sponsors: Bruce Forsyth

    ABSTRACT

    Pancreatic cancer (PC) is the 11th most common cancer in the United States, with an estimated 58,000 new diagnoses a year. This type of cancer has a dismal 5-year survival rate of only about 8%, making it the 3rd leading cause of cancer death and accounting for nearly $1.5 billion dollars a year in healthcare spending for the US. These patients live an average of 3.5 months after their diagnosis if the cancer goes untreated and 8 months if they are able to access good treatment. This meager increase in average survival is a result of the fact that the cancer is often diagnosed at a very late stage and treatment regimens are often ineffective. Treatment for PC includes chemotherapy and/or radiation, but the only potentially curative treatment is surgical resection of the primary tumor. Surgical resectability is based on several factors including the location of the tumor, vascular involvement, and the presence of metastases; based on these factors a tumor may be deemed resectable (20% of patients), metastatic unresectable (50% of patients), or locally advanced (30% of patients). Patients with locally advanced pancreatic cancer (LAPC) are not eligible for surgery due to vascular involvement of pancreatic tumors, and thus, these patients must rely on chemotherapy to downstage their disease. However, both of the first line chemotherapeutics for PC, gemcitabine and FOLFIRINOX, have low efficacies.

    The Plerion One Electrochemotherapy (POET) Catheter is an intravascular catheter designed to enhance the efficacies of these pancreatic cancer chemotherapeutics in the parts of the tumor invading and surrounding an artery. Through the process of reversible electroporation of cell membranes, our device selectively increases the susceptibility of cancer cells to systemic chemotherapy, resulting in tumor regression from a major blood vessel and subsequent downstaging. For patients with locally advanced pancreatic cancer, the POET catheter will increase the chances of receiving potentially curative surgery by reducing tumor involvement with important vessels. Unlike systemic chemotherapy alone, our solution will target perivascular tumor components while limiting unwanted side effects. This intervention, delivered by interventional radiologists, will increase the number of LAPC patients who can receive potentially curative surgery and could increase average survival by around 2 years.

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  • THE TEAM
    Student Team: Deepika Dixit, Kaiyan Cai, Alejandro Chara, Emanuel Wasson, Jordan Shuff

    Advisors: Dr. Sudeep Pramanik, Dr. Kunal Parikh

    Sponsors: Katie Solley

    ABSTRACT

    Worldwide, more than 12.8 million individuals suffer from corneal blindness. Corneal blindness can be devastating and leads to an increased risk of physical harm, mental disorders, social isolation and cognitive deficits, resulting in an over 15 year reduction in life expectancy of patients. Corneal transplants can restore vision; however, current techniques, especially full-thickness corneal transplants are limited by access to donor tissue and high complication rates, including rejection, infection, and glaucoma. Partial thickness corneal transplants, such as deep anterior lamellar keratoplasty (DALK), have the potential to provide improved visual outcomes for patients and have a lower risk of post-operative complications, but they are more difficult to perform and have an increased risk of intraoperative complications.

    In partnership with Eyedea Medical, our mission is to alleviate the global burden of corneal blindness through innovations in cornea transplantation. Our team has worked in collaboration with Eyedea Medical to develop DesceCleave, an assistive device for DALK procedures. DesceCleave enables precise and accurate DALK by providing surgeons with control over the depth at which they remove layers of affected tissue with micro-precision. We believe that enabling safe, standardized, and precise DALK procedures will significantly improve treatment of corneal blindness by driving adoption of a procedure with lower graft rejection rates, shorter recovery times, and decreased reliance on medication. We plan to make this device available to a global market of corneal surgeons so that they can conduct more DALK procedures over unnecessary and less successful full-thickness cornea transplants. With Descecleave, we hope to bring the gift of sight back to many of the 12.8 million individuals who are currently affected.

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  • THE TEAM
    Student Team: Ignacio Albert Smet, Caterina Esposito, Taylor Holt, Alexis Graham

    Advisors: Youseph Yazdi, Joshua De Souza, Danielle Gottlieb-Sen

    Sponsors: Russel Holscher, Sung Kwon

    ABSTRACT

    Congenital heart defects are the most common birth defect in the United States. Children undergoing heart surgery can develop lymphatic leaks that cause immune and nutritional deficiency, which can lead to significant morbidity or death. Current first line therapy requires nutritional deprivation in the hospital that can last on average weeks to months. Unfortunately, children with cardiac disease are already at a nutritional disadvantage due to their increased metabolic demands and a decreased ability to digest large amounts of calories. Because of this, first line therapy leads to clinical decline in these children. If the first line therapy fails, the remaining therapeutic options are highly invasive and often poorly tolerated by an already critically ill child. Based on two weeks of conservative therapy alone, the economic burden of around $63,000 per patient, amounting to a total economic burden of 80-100 million annually to the healthcare system.

    LymphaSeal is a proprietary novel approach that can be applied broadly within the chest to treat hard to find leaks, reducing the patient’s length of stay, preventing the need for surgical intervention, and decreasing morbidity in these critically ill children. This sealant works by leveraging the properties of lymph to form a seal outside of the damaged vessel to stop the leak.

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The Johns Hopkins Center for Bioengineering Innovation & Design