Category: Biomedical Engineering Page 1 of 8

Bandaids and pimple patches are the first things we consider when discussing adhesives in medicine. But what if there is more to the story? What if adhesives could not only cover and protect but also diagnose and communicate? It turns out Dr. Wei Gao, assistant professor of medical engineering at the California Institute of Technology, is asking these exact questions. In the field of biomedical adhesives, Gao’s research is revolutionizing our understanding of precision medicine and medical testing accessibility. He visited Duke on Oct. 9 to present his work as part of the MEMS (Mechanical Engineering and Material Science) Seminar Series.

Gao’s research team focuses on material, device, and system innovations that apply molecular research and principles to clinical settings and improve health. Gao focused his talk on the invaluable characteristics and uses of sweat. Sweat can offer doctors a broad spectrum of information, including nutrients, biomarkers, pH levels, electrolytes/salts, and hormones. He leverages this fundamental characteristic of human physiology to design wearable biosensors that can provide early warnings of health issues or diseases. Gao focuses on making biomarker detection more efficient than current methods, such as blood samples, which require hospital testing, involve highly invasive techniques, and lack continuous monitoring.

The first milestone in his research came in 2016 when he introduced a fully printed, wearable, real-time monitoring sensor device. The device allowed them to continuously collect sweat and wirelessly communicate data about these sweat samples from patients onto digital devices. The initial 2016 device focused on resolving four fundamental challenges: since most chemical sensors are not stable over long periods of time, the device had to be (1) low-cost and (2) disposable without sacrificing performance. In addition, the device had to (3) be mass-producible to be accessible to the public and (4) integrate multiple signals that could be real-time transmitted to a digital interface.

Schematic of the sensor array for multiplexed perspiration analysis in Dr. Gao’s 2016 biosensor design

To address the first two of those challenges, Gao and his group turned to printing techniques. The circuit substrate was a thin piece of flexible PET (a plastic), upon which they layered the circuit components. The flexible sensor array was constructed in a similar pattern, with a layer of PET patterned with gold to produce the electrodes, covered with parylene, and then each electrode was tuned to receive a specific chemical stimulus: potassium and sodium ion sensors, with a polyvinyl butyrate reference electrode, and oxidase-based glucose and lactate sensors paired with a silver/silver chloride reference electrode. This design allows the simultaneous monitoring of multiple biomarkers. To transmit the data wirelessly, the circuit board included a Bluetooth transceiver.

The next major step was to devise a way to monitor sweat without relying upon heat or vigorous exercise, neither of which may be feasible in the case of clinically ill patients. In a 2023 paper, Gao and colleagues published a biosensor that could induce localized sweating using an electric circuit. Called iontophoresis, the technique delivers a drug (a cholinergic agonist) that stimulates the sweat glands on demand and only in the area of the sensor.

Another important question was how to power the devices sustainably. Gao’s lab has devised two primary responses to this question: In a 2020 paper, his team powered a similar multiplexed wireless sensor entirely using electricity generated from compounds in sweat. This entailed using lactate biofuel cells to harness the oxidation of lactate to pyruvate (coupled with the reduction of oxygen to water) to provide a stable current. In a 2023 paper, they employed a flexible perovskite solar cell onboard the device to power the monitoring of a suite of biomarkers.

Dr. Gao’s recent publication in February 2024 highlighted a Consolidated AI-Reinforced Electronic Skin (CARES) for stress response monitoring

With these technical hurdles overcome, Gao and his lab have been able to develop sensors targeted to several important medical applications. The work can be directly applied to the monitoring of conditions like cystic fibrosis and gout. More broadly, wearable biosensors can be used to track levels of medically relevant compounds like cortisol (for stress monitoring), C reactive protein (inflammation), and reproductive hormones. The lab has also branched into other kinds of devices that use similar microfluidics approaches, including smart bandages for wound monitoring and smart masks to detect biomarkers in breath.

Through eight years of dedicated investigation, Gao serves as a pioneer in the field of bioelectronic interfaces. Gao continues to widen the possibilities of biosensors not only within the medical sphere but also for the general public. For example, his lab is collaborating with NASA and the U.S. Navy to support the performance and health of astronauts and our military, which is vital as they work in extreme environments. By pushing forward ground-breaking devices such as sweat biosensors, our healthcare systems can pursue preventative care, reducing the need for treatments or health resources by catching these issues early on. Following Gao’s footsteps, we can now build toward a healthier future as we improve the precision of our healthcare approaches and technological advancements.

Duke experts discuss the potential of AI to help prevent, detect and treat disease

By Robin Smith

On October 15, 2024

In Artificial Intelligence, Biomedical Engineering, Engineering, Entrepreneurship, Medicine

Sure, A.I. chatbots can write emails, summarize an article, or come up with a grocery list. But ChatGPT-style artificial intelligence and other machine learning techniques have been making their way into another realm: healthcare.

Imagine using AI to detect early changes in our health before we get sick, or understand what happens in our brains when we feel anxious or depressed — even design new ways to fight hard-to-treat diseases.

These were just a few of the research themes discussed at the Duke Summit on AI for Health Innovation, held October 9 – 11.

Duke assistant professor Pranam Chatterjee is the co-founder of Gameto, Inc. and UbiquiTx, Inc. Credit: Brian Strickland

For assistant professor of biomedical engineering Pranam Chatterjee, the real opportunity for the large language models behind tools like ChatGPT lies not in the language of words, but in the language of biology.

Just like ChatGPT predicts the order of words in a sentence, the language models his lab works on can generate strings of molecules that make up proteins.

His team has trained language models to design new proteins that could one day fight diseases such as Huntington’s or cancer, even grow human eggs from stem cells to help people struggling with infertility.

“We don’t just make any proteins,” Chatterjee said. “We make proteins that can edit any DNA sequence, or proteins that can modify other disease-causing proteins, as well as proteins that can make new cells and tissues from scratch.”

Duke assistant professor Monica Agrawal is the co-founder of Layer Health. Credit: Brian Strickland

New faculty member Monica Agrawal said algorithms that leverage the power of large language models could help with another healthcare challenge: mining the ever-expanding trove of data in a patient’s medical chart.

To choose the best medication for a certain patient, for example, a doctor might first need to know things like: How has their disease progressed over time? What interventions have already been tried? What symptoms and side effects did they have? Do they have other conditions that need to be considered?

“The challenge is, most of these variables are not found cleanly in the electronic health record,” said Agrawal, who joined the departments of computer science and biostatistics and bioinformatics this fall.

Instead, most of the data that could answer these questions is trapped in doctors’ notes. The observations doctors type into a patient’s electronic medical record during a visit, they’re often chock-full of jargon and abbreviations.

The shorthand saves time during patient visits, but it can also lead to confusion among patients and other providers. What’s more, reviewing these records to understand a patient’s healthcare history is time-intensive and costly.

Agrawal is building algorithms that could make these records easier to maintain and analyze, with help from AI.

“Language is really embedded across medicine, from notes to literature to patient communications to trials,” Agrawal said. “And it affects many stakeholders, from clinicians to researchers to patients. The goal of my new lab is to make clinical language work for everyone.”

Duke assistant professor Jessilyn Dunn leads Duke’s BIG IDEAs Lab. Credit: Brian Strickland

Jessilyn Dunn, an assistant professor of biomedical engineering and biostatistics and bioinformatics at Duke, is looking at whether data from smartwatches and other wearable devices could help detect early signs of illness or infection before people start to have symptoms and realize they’re sick.

Using AI and machine learning to analyze data from these devices, she and her team at Duke’s Big Ideas Lab say their research could help people who are at risk of developing diabetes take action to reverse it, or even detect when someone is likely to have RSV, COVID-19 or the flu before they have a chance to spread the infection.

“The benefit of wearables is that we can gather information about a person’s health over time, continuously and at a very low cost,” Dunn said. “Ultimately, the goal is to provide patient empowerment, precision therapies, just-in-time intervention and improve access to care.”

Duke associate professor David Carlson. Credit: Brian Strickland

David Carlson, an associate professor of civil and environmental engineering and biostatistics and bioinformatics, is developing AI techniques that can make sense of brain wave data to better understand different emotions and behaviors.

Using machine learning to analyze the electrical activity of different brain regions in mice, he and his colleagues have been able to track how aggressive a mouse is feeling, and even block the aggression signals to make them more friendly to other mice.

“This might sound like science fiction,” Carlson said. But Carlson said the work will help researchers better understand what happens in the brains of people who struggle with social situations, such as those with autism or social anxiety disorder, and could even lead to new ways to manage and treat psychiatric disorders such as anxiety and depression.

Meet New Blogger Stone Yan

By Stone Yan

On September 23, 2024

In Biomedical Engineering, Students

“Hi, my name is Stone. S-t-o-n-e.”

Since move-in day, I have repeated this introduction hundreds of times. Curiously, I received a lot of “that’s a cool name!” comments in response… enough times to make me pause and think about my name and the history behind it.

“Stone” has not always been a source of pride. Imagine the fun middle schoolers had with it: “ColdStone,” “Stone Cold,” “You Rock,” and other variations. And the name was supposed to be a refuge: my legal name, Shidong, has been so frequently mispronounced by teachers (typically on the first day of school) that I had been convinced that Stone would be a better choice.

The unfortunate nicknames aside, I found explaining the origin of “Stone” to be a hassle. After all, my legal name’s meaning had nothing to do with pebbles or other igneous creations. The Chinese character “shi” meant soldier and the character “dong” translated to scholarship. When I arrive here during some conversations, I find myself often disappointed that the profound meaning behind my name is often thought of in terms of rocks.

Why the lengthy introspection about a few letters? In my few weeks here at Duke, I realized that I am experiencing a rejuvenation in my identity, encouraged by “that’s a cool name!” comments. My name, who I am, what my interests are, and other factors are no longer restricted by previous limitations in the form of high school curriculum, club offerings, or social culture. I am interacting with much more diverse students who, like me, have long and winding life stories and are willing to share them with others.

In short, the personal biography I am about to share with you is dynamic. At Duke, my mission is to explore as much as possible, both in the classroom and beyond, doing things that I would have despised a few short years ago (going against upper class students’ advice on course selection is an egregious sin for young Stone). It is possible that in a semester or two, my academic and extracurricular interests will have shifted so radically that none of what I wrote below is still accurate. Maybe that is my most important trait right now: willingness to experiment and change my mind. This is what led me to this opportunity with the Research Blog and why what you are reading exists in the internet world.

Stone with his parents in Park Güell, Barcelona

Now onto the “traditional” introduction: I am Stone Yan, a first-year student pursuing Biomedical Engineering. I hail from Chicago, Illinois, where the weather is as unpredictable as Durham, but the humidity is never intolerable. I am interested in medicine as my career after graduation, and I hope to study some health policy courses here in addition to my Pratt curriculum. I would describe myself as hard-working, curious, and determined.

Outside of grinding academics, I love to play the piano, play badminton, follow the news, and hang out with friends. Running, drawing, and watching YouTube are also favorite pastimes. My most hated household chore is folding laundry… I can never fold the clothes neat enough. My deepest fear is someone dumping my washed and dried clothes on the ground after I forgot to run to the laundry room… Randolph friends, please do not do this to me.

Hopefully, there were some sentiments shared here that you echoed. My mission as a blogger with the Research Blog is to broadcast tidbits that we do not typically notice and call our attention to amazingness overshadowed by other amazingness (too much of this on campus!). My focus will probably be on the people that make Duke special to all of us: the faculty, staff, students, athletes, alumni, and community members that make us proud to be Blue Devils.

I cannot conclude without giving a shoutout to my parents. As an only child, I was remarkably close to them, and I cannot thank them enough for their boundless support.

Cheers to celebrating Duke’s rich community in future blogs!

Carrying on Dr. King’s Legacy: The Fight for Equity in Obesity Treatment

By Skylar Hughes

On January 22, 2024

In Biomedical Engineering, Faculty, Lecture, Medicine

“Of all the forms of inequality” Dr. Martin Luther King Jr. once said in a 1966 press conference, “injustice in health is the most shocking and the most inhumane.”

In honor of King’s impact on public health, Duke’s dean of Trinity College Dr. Gary G. Bennett delivered a powerful address Jan. 12 at the Trent Semans Center. Entitled ‘You have to Keep Moving Forward: Obesity in High-Risk Populations,’ Bennett discussed America’s Obesity Epidemic, and its disproportionate effects on Black women.

“More than 40% of the American population has obesity,” Bennett began. Incidence rates among Black women are the highest and have been since the epidemic began in 1955. “These disparities have not closed, and in many cases, they’ve widened over the years,” Bennett said.

Type two diabetes, hypertension, and cardiovascular disease are just some of the health risks associated with obesity. Compared to other racial groups, Black women are more likely to suffer from these conditions, as well as die from their effects. Furthermore, it appears that the efficacy of treatment options is significantly lower for patients of African descent.

But why do such disparities exist in the first place? According to Bennett, they can be attributed to a range of internal and external factors. “There certainly are physiological variations that are worth noting here, which is perhaps a challenge in all of obesity research.”

Research published in the journal Nature in 2022 found that, while there are different forms of obesity, that have shared ‘genetic and biological underpinnings.’ Environmental factors are also driving disparities. Black women are “exposed to more obesogenic environments, food desserts,” Bennett explained. With limited access to affordable and nutritious food, options for healthy eating are slim.

But perhaps most interestingly, Black women also have a range of sociocultural factors at play. “There are fewer within-group social pressures to lose weight,” Bennett maintained. Other sociocultural factors include higher body image satisfaction and higher weight misperception. “This is problematic in some ways,” he continued. While it protects against certain eating disorders and low self-esteem, “It does challenge your ability to achieve weight loss.”

For Black women, obesity is a complex public health issue that needs to be addressed.

But how? From medication to surgery, there are myriad potential treatment options. According to Bennett, however, the real key is lifestyle intervention. “It really is the foundation.” Comprised of three parts: reduced calorie diet, physical activity, and self-monitoring, lifestyle intervention is able to reach the widest range of participants.

Like other treatment options, the lifestyle intervention route shows racial disparities in its outcomes. Because of this, Dr. Bennett’s work focuses on developing methods that are designed with Black patients in mind.

At the forefront of his research is a new online intervention called iOTA, which stands for Interactive Obesity Treatment Approach. “This is a digital obesity approach that we designed specifically for high-risk populations.” The platform personalizes weight loss goals and feedback, which assist in program retention.

In addition, participants are equipped with coaching support from trained medical professionals. “This IOTA approach does a bunch of things,” Bennett said. “It promotes weight loss and prevents weight gain, improves cardiometabolics,” along with a host of other physical benefits. Results also show a reduction in depressive symptoms and increased patient engagement. Truly incredible.

Scholars like Bennett have continued the fight for public health equity- a fight advocated for by Dr. King many years ago. For more information on Bennett and his work, you can visit his website here.

Written by Skylar Hughes | Class of 2025

Sharing a Love of Electrical Engineering With Her Students

By Guest Post

On January 11, 2024

In Artificial Intelligence, Biomedical Engineering, Engineering, Faculty, Guest Post

Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the seventh of eight posts.

“As a young girl, I always knew I wanted to be a scientist,” Dr. Tania Roy shares as she sits in her Duke Engineering office located next to state-of-the-art research equipment.

The path to achieving her dream took her to many places and unique research opportunities. After completing her bachelor’s in India, she found herself pursuing further studies at universities in the United States, eventually receiving her Ph.D. from Vanderbilt University.

Throughout these years Roy was able to explore and contribute to a variety of fields within electrical engineering, including energy-efficient electronics, two-dimensional materials, and neuromorphic computing, among others. But her deepest passion and commitment is to engage upcoming generations with electrical engineering research.

As an assistant professor of electrical and computer engineering within Duke’s Pratt School of Engineering, Tania Roy gets to do exactly that. She finds happiness in mentoring her passionate young students. They work on projects focused on various problems in fields such as Biomedical Engineering (BME) and Mechanical Engineering, but her special focus is Electrical Engineering.

Roy walks through the facilities carefully explaining the purpose of each piece of equipment when we run into one of her students. She explains how his project involves developing hardware for artificial intelligence, and the core idea of computer vision.

Roy in her previous lab at the University of Central Florida. (UCF photo)

Through sharing her passion for electrical engineering, Roy hopes to motivate and inspire a new generation.

“The field of electrical engineering is expected to experience immense growth in the future, especially with the recent trends in technological development,” she says, explaining that there needs to be more interest in the field of electrical engineering for the growth to meet demand.

The recent shortage of semiconductor chips for the industrial market is an example of this. It poses a crucial problem to the supply and demand of various products that rely on these fundamental components, Roy says. By increasing the interest of students, and therefore increasing the number of students pursuing electrical engineering, we can build a foundation for the advancement of technologies powering our society today, says Roy.

Coming with a strong background of research herself, she is well equipped for the role of advocate and mentor. She has worked with gallium nitride for high voltage breakdowns. This is when the insulation between two conductors or electrical components fails, allowing electrical current to flow through the insulation. This breakdown usually occurs when the voltage across the insulating material exceeds a certain threshold known as the breakdown voltage.

In electric vehicles, high breakdown voltage is crucial for several reasons related to the safety, performance, and efficiency of the vehicle’s electrical system, and Roy’s work directly impacts this. She has also conducted extensive research on 2D materials and their photovoltaic capabilities, and is currently working on developing brain-inspired computer architectures for machine learning algorithms. Similar to the work of her student, this research utilizes the structure of the human brain to model an architecture for AI, replicating the synapses and neural connections.

As passionate as she is about research, she shares that she used to love to go to art galleries and look at paintings, “I could do it for hours,” Roy says. Currently, if she is not actively pursuing her research, she enjoys spending time with her two young children.

“I hope to share my dream with this new generation,” Roy concludes.

Guest post by Sutharsika Kumar, North Carolina School of Science and Mathematics, Class of 2024

Solving More Medical Device Challenges by Teaching Others How

By Guest Post

On December 28, 2023

In Biomedical Engineering, Faculty, Global Health, Medicine

Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the third of eight posts.

Eric Richardson is a professor of the practice in Biomedical Engineering and founding director of Duke Design Health. His research and teaching centers around medical device design and innovation, with a focus on underserved communities.

Richardson has always had a strong desire to enhance people’s wellbeing. Growing up, he wanted to be a doctor, but during high school, he was drawn towards the creative and problem-solving aspects of engineering. After earning a bachelor’s degree in mechanical engineering, he pivoted to biomedical engineering for graduate work. While pursuing his PhD degree, he developed a profound interest in cardiac devices.

Through technology, Richardson has been able to impact the lives of many. He first worked in industry as a Principal R&D Engineer at Medtronic, where he helped develop transcatheter heart valves that have now helped over a million patients. However, it was his love for teaching that brought him to academia. Over the past decade as a professor, his interests have shifted towards global health and helping underserved communities.

Richardson aims to design technology to fit the needs of people, and bridge the gap of “translation” between research and product development. During his time in industry, Richardson realized that the vast majority of medical device research doesn’t go anywhere in terms of helping patients.

“That point of translation… is really where most technology and research dies, so I really wanted to be at that end of it, trying to figure out that pipeline of getting research, getting technology, all the way into the clinic,” Richardson says. “I would argue that is probably the hardest step of the whole process is actually getting a product together, developing it, doing the clinical trials, and doing the manufacturing and regulatory steps.”

A prototype of Richardson’s latest device.

Through his teaching, Richardson emphasizes product design, interdisciplinary approaches, and industry-academia partnerships to best meet the needs of underserved communities. One of his favorite courses to teach is the Design Health Series, a four-course sequence that he was brought to Duke to develop. In this class, interdisciplinary teams of graduate students, ranging from medicine to business, work together to design medical devices. They learn how to identify problems in medicine, develop a solution, and translate that into an actual product.

Richardson also encourages engineers to look at the broader picture and tackle the right problems. According to Richardson, challenges in global and emerging markets often aren’t due to a particular device, but rather, a multilayered system of care, ranging from a patient’s experience within a clinic to a country’s whole healthcare system. From this vantage point, he believes it’s important for engineers to determine where to intervene in the system, where the need is greatest, and to consider any unintended consequences.

“I think that there is so much great talent in the world, so many exciting problems to go after. I wish and hope that people will think a little more carefully and deliberately about what problems they go after, and the consequences of the problems that they solve,” he says.

Richardson is currently working on an abdominal brace for Postural Tachycardia Syndrome (POTS) patients – people who feel lightheaded after standing up – that is currently in clinical trials. While he is always eager to tackle different projects, as an educator, he believes the most important part of academia is training the next generation of engineers.

“I can only do a couple projects a year, but I can teach a hundred students every year that can then themselves go and do great things.”

Guest Post by Arianna Lee, North Carolina School of Science and Mathematics, Class of 2025.

Pioneering New Treatments in Deep Brain Stimulation for Parkinson’s Disease

By Guest Post

On December 26, 2023

In Biomedical Engineering, Faculty, Guest Post, Medicine, Neuroscience

Meet a star in the realm of academic medicine – Dr. Kyle Todd Mitchell!

A man who wears many hats – a neurologist with a passion for clinical care, an adventurous researcher, and an Assistant Professor of Neurology at Duke – Mitchell finds satisfaction in the variety of work, which keeps him “driven and up to date in all the different areas.”

Dr. Mitchell holds a deep brain stimulation device.

Dr. Mitchell’s educational journey is marked by excellence, including a fellowship at the University of California San Francisco School of Medicine, a Neurology Residency at Washington University School of Medicine, and an M.D. from the Medical College of Georgia. Beyond his professional accolades, he leads an active life, enjoying running, hiking, and family travels for rejuvenation.

Dr. Mitchell’s fascination with neurology ignited during his exposure to the field in medical school and residency. It was a transformative moment when he witnessed a patient struggling with symptoms experience a sudden and remarkable improvement through deep brain stimulation. This therapy involves the implantation of a small electrode in the brain, offering targeted stimulation to control symptoms and bringing relief to individuals grappling with the challenges of Parkinson’s Disease.

“You don’t see that often in medicine, almost like a light switch, things get better and that really hooked me,” he said. The mystery and complexity of the brain further captivated him. “Everything comes in as a bit of a mystery, I liked the challenge of how the brain is so complex that you can never master it.”

Dr. Mitchell’s research is on improving deep brain stimulation to alleviate the symptoms of Parkinson’s disease, the second most prevalent neurodegenerative disorder, which entails a progressive cognitive decline with no cure. Current medications exhibit fluctuations, leading to tremors and stiffness as they wear off. Deep brain stimulation (DBS), FDA-approved for over 20 years, provides a promising alternative.

Dr. Mitchell’s work involves creating adaptive algorithms that allow the device to activate when needed and deactivate so it is almost “like a thermostat.” He envisions a future where biomarkers recorded from stimulators could predict specific neural patterns associated with Parkinson’s symptoms, triggering the device accordingly. Dr. Mitchell is optimistic, stating that the “technology is very investigational but very promising.”

A key aspect of Dr. Mitchell’s work is its interdisciplinary nature, involving engineers, neurosurgeons, and fellow neurologists. Each member of the team brings a unique expertise to the table, contributing to the collaborative effort required for success. Dr. Mitchell emphasizes, “None of us can do this on our own.”

Acknowledging the challenges they face, especially when dealing with human subjects, Dr. Mitchell underscores the importance of ensuring research has a high potential for success. However, the most rewarding aspect, according to him, is being able to improve the quality of life for patients and their families affected by debilitating diseases.

Dr. Mitchell has a mindset of constant improvement, emphasizing the improvement of current technologies and pushing the boundaries of innovation.

“It’s never just one clinical trial — we are always thinking how we can do this better,” he says.

The pursuit of excellence is not without its challenges, particularly when attempting to improve on already effective technologies. Dr. Mitchell juggles his hats of being an educator, caregiver, and researcher daily. So let us tip our own hats and be inspired by Dr. Mitchell’s unwavering dedication to positively impact the lives of those affected by neurological disorders.

Guest post by Amy Lei, North Carolina School of Science and Math, Class of 2025.

Inventors, Assemble: The Newest Gadgets Coming Out of Duke

By Michelle Li

On December 15, 2023

In Biology, Biomedical Engineering, Engineering, Entrepreneurship, Faculty, Medicine, Science Communication & Education

What do a smart toilet, an analog film app, and metamaterial computer chips have in common? They were all invented at Duke!

The Office for Translation & Commercialization—which supports Duke innovators bringing new technologies to market—recently hosted its fifth annual Invented at Duke celebration. With nine featured inventors and 300 attendees, it was an energetic atmosphere to network and learn.

*Attendees mingle in Penn Pavilion. Credit: Brian Mullins Photography.*

When event organizer Fedor Kossakovski was selecting booths, the name of the game was diversity—from medicine to art, from graduate students to faculty. “Hopefully people feel like they see themselves in these [inventors] and it’s representative of Duke overall,” he said. Indeed, as I munched through my second Oreo bar from the snack table and made the rounds, this diversity became apparent. Here are just two of the inventions on display:

Guided Medical Solutions

The first thing you’ll notice at Jacob Peloquin’s booth is a massive rubber torso.

As he replaces a punctured layer of rubber skin with a shiny new one, Peloquin beckons us over to watch. Using his OptiSETT device, he demonstrates easy insertion and placement of a chest tube.

“Currently, the method that’s used is you make an incision, and then place your fingers through, and then take the tube and place that between your fingers,” Peloquin explained. This results in a dangerously large incision that cuts through fascia and muscle; in fact, one-third of these procedures currently end in complications.

Peloquin’s device is a trocar—a thin plastic cylinder with a pointed tip at one end and tubing coming out of the other. It includes a pressure-based feedback system that tells you exactly how deep to cut, avoiding damage to the lungs or liver, and a camera to aid placement. Once the device is inserted, the outer piece can be removed so only the tubing remains.

*Peloquin demonstrates his OptiSETT device. Credit: Brian Mullins Photography.*

Peloquin—a mechanical engineering graduate student—was originally approached by the surgeons behind OptiSETT to assist with 3D printing. “They needed help, so I kind of helped those initial prototypes, then we realized there might be a market for this,” he said. Now, as he finishes his doctorate, he has a plethora of opportunities to continue working on OptiSETT full-time—starting a company, partnering with the Department of Defense, and integrating machine learning to interpret the camera feed.

It’s amazing how much can change in a couple years, and how much good a rubber torso can do.

GRIP Display

This invention is for my fellow molecular biology enthusiasts—for the lovers of cells, genes, and proteins!

The theme of Victoria Goldenshtein’s booth is things that stick together. It features an adorable claw machine that grabs onto its stuffed animal targets, and a lime green plastic molecule that can grab DNA. Although the molecule looks complex, Goldenshtein says its function is straightforward. “This just serves as a glue between protein and the DNA [that encodes it].”

*Goldenshtein—a postdoctoral associate in biomedical engineering—uses her lime green molecular model to demonstrate GRIP’s function. Credit: Brian Mullins Photography.*

Goldenshtein applies this technology to an especially relevant class of proteins—antibodies. Antibodies are produced by the immune system to bind and neutralize foreign substances like disease. They can be leveraged to create drug therapies, but first we need to know which gene corresponds to which antibody and which disease. That’s where GRIP steps in.

“You would display an antibody and you would vary the antibody—a billion different variations—and attach each one to the system. This grabs the DNA,” Goldenshtein said.

Then, you mix these billions of antibody-DNA pairs with disease cells to see which one attaches. Once you’ve found the right one, the DNA is readily available to be amplified, making an army of the same disease-battling antibody. Goldenshtein says this method of high-throughput screening can be used to find a cancer cure.

Although GRIP be but small, its applications are mighty.

Explore Other Booths

Coprata: a smart toilet that tracks your digestive health
inSoma Bio: a polymer that aids soft-tissue reconstruction
Spoolyard: a platform for exploring digital footage with analog film techniques
FaunaLabs: smart watches for our furry friends
G1 Optics: a tonometer to automatically detect eye pressure
TheraSplice: precision RNA splicing to treat cancer
Neurophos: metamaterial photonics for powering ultra-fast AI computation

As I finished my last Oreo bar and prepared for the trek back to East Campus, I was presented with a parting gift—a leather notebook with “Inventor” embossed on the cover. “No pressure,” said the employee who was handing them out with a wink.

I thought about the unique and diverse people I’d met that night—an undergraduate working in the Co-Lab, an ECE graduate student, and even a librarian from UNC—and smiled. As long as we each keep imagining and scribbling in our notebooks, there’s no doubt we can invent something that changes the world.

Post by Michelle Li, Class of 2027

How to be a Global Inventor

By Olivia Ares

On November 29, 2023

In Biomedical Engineering, Business/Economics, Climate/Global Change, Engineering, Entrepreneurship, Faculty, Global Health

Gadgets, devices, doo-dads, oh my! The Duke Global Health Institute (DGHI) recently hosted three of its members to lead a panel on creating medical devices for low- and middle-income countries. The event was called “Global Medical Device Innovation: Three Models for Creation and Commercialization.”

Each sought to decrease costs and increase scalability for medical procedures. In short, they are expert inventors who are doing good in the world.

*Two of the most prominent inventors of our era. Image courtesy of Disney.*

We’ll go step-by-step in a moment, but to start you on your journey to being just like our panelists, here’s a short glossary:

Standard-of-care: a public health term for the way things are usually done.

IRB: institutional review board, a group of people, usually based in universities, that protect human subjects in research studies.

Screening: when doctors look at signs your body might show to determine
whether you need to be tested for certain conditions.

Supply-chain: the movement of materials your product goes through before, during, and after manufacturing. It is a general term for a group of different suppliers, factories, vendors, advertisers, researchers, and others that work separately.

Regulatory pathways: supply-chain for government approvals and other paperwork you need to have before introducing your product to the public.

Step 1: Meet your Mentors

Walter Lee is Chief of Staff of the Department of Head and Neck Surgery & Communication Sciences, Co-Director of the Head and Neck Program, and an affiliate faculty member at the Duke Global Health Institute. He presented ENlyT (pronounced like en-light), a newfangled nasopharyngoscope – a camera that goes down your nose and down your throat to screen for cancer. He wants to expand with partners in Vietnam and Singapore.

Marlee Kreiger helped found the Center for Global Women’s Health Technologies at Duke in 2007. Since then, she has led the Center in many interdisciplinary and international ventures. In fact, the Center for Global Women’s Health Technologies spans both the Pratt School of Engineering and the Trinity College of Arts and Sciences. She presented on the Callascope, a pocket-sized colposcope – a camera device for cervical cancer screening.

Julias Mugaga will soon be a visiting scholar at Duke – until then, he heads Design Cube at Makerere University in Uganda. He presented his KeyScope, a plug-and-play surgical camera with 0.3% of the cost of standard-of-care cameras.

Step 2: Name your Audience

DGHI has “global” in the name, so it is no surprise that these presenters serve communities around the world. Perhaps something that inventors like Dr. Doofenshmirtz often get wrong is that new innovation should come at the benefit of underserved communities, not at the cost of them. For Lee, that focus would be in his collaborations in Vietnam; for Mugaga it was his community in Uganda; and for Kreiger, it was the many studies conducted in Zambia, Tanzania, Kenya, Costa Rica, Honduras, and India.

Each of the presenters could agree that the main strategy is simple: find partners. Community members on the ground. Organizations that can benefit from your presence.

*Another prominent–albeit villainous–inventor, Dr. Doofenshmirtz. Image courtesy of Disney.*

Another notable aspect of your audience will be the certification you vie for. Depending on your location, you may need different permissions to distribute your product, or even begin on the journey to secure funding from certain sources.

In the United States, the most relevant regulatory pathway is FDA clearance, which is notably less restrictive than the CE mark distributed in the European Union. Both certifications are accepted in other countries, but many of the inventors on the panel opted to secure a CE mark to potentially appeal to a wider variety of governments around the world.

ISO is an international organization that is also necessary for certification, particularly if you are looking to test a medical product. No reason to be dragged down by the paperwork, though! When asked about securing Ugandan product certification, Mugaga declared, “This is one of the most exciting journeys I have taken.” His path to clearance was even more wrought with uncertainty – without steady sources of material in the Ugandan economy, it is harder to earn FDA or CE approval, two of the most widely-acknowledged certifications in the world.

Step 3: Test

Now that you have permission, you can start changing lives. Many participants in our panelists’ studies were patients in community health clinics across the globe. Their partners in these clinics also had the opportunity to save tens to hundreds of thousands of dollars in equipment. While it seems like a no-brainer, there are ethical concerns that need to be addressed first. For that, you need to fill out…. You guessed it: more paperwork. IRB approval is usually granted by educational institutions (as you should recall from my handy glossary), and is crucial to secure before any testing with humans is started. In fact, the government (and most private investors) won’t even give you a second glance if you ask them for money without IRB approval.

One big hurdle many of the panelists noted was a distrust of the technology and institution it came from – a foreign entity testing their products on you does not always invoke fear, but it certainly does not always promote trust. Kreiger noted that the work of their community health partners does the heavy lifting on that front; not only are they known community pillars, but they have authority to promote health technology through their existing relationships. If you run into trouble identifying partners in your inventorship journey–never fear. Lee has a message for you: “Ask around. At Duke, there’s always an expert around who’s willing to lend you their time.”

Step 4: Distribute

Now that you are an expert, your invention works, and you’re saving lives, you can attempt to cement your design as standard-of-care. This may look different depending on where in the world you want to distribute, but the next step is to contract a large-scale manufacturer. Your materials have been sourced by now (FDA says they better be) — so finding someone to put them together at an industrial scale should be easy! Your cost may fluctuate at this scale with the increased labor costs, but bulk production and distribution altogether should provide you, your institution, and your clients the best possible chance at changing the world.

Lee did not receive NIH funding until his fourth attempt at applying. Kreiger did not settle on the first manufacturer contracted. Mugaga is still in the process of securing a CE mark. And yet, all of them are success stories. You can see the ENlyT saving lives in hospitals in Vietnam; you can track the reallocation of $18,000 in savings from purchasing a Calloscope; and if you’re lucky, you’ll catch Mulgaga on campus next year as a visiting scholar at Duke!

Post by Olivia Ares, Class of 2025

Only Mostly Dead? The Evolving Ethics of Evaluating Death

By Victoria Wilson

On March 31, 2023

In Behavior/Psychology, Biology, Biomedical Engineering, Cardiology, Lecture, Medicine, Religion, Responsible Conduct

I recently had the pleasure of attending Professor Janet Malek’s lecture: Only Mostly Dead? The Evolving Ethical Evaluation of Death by Neurologic Criteria, a lecture sponsored by the Trent Center for Bioethics, Humanities & History of Medicine.

Dr. Malek is an associate professor in the Duke Initiative for Science & Society, and at the Baylor College of Medicine Center for Medical Ethics and Health Policy.

We don’t often talk about death. On the surface, it seems like it would be a straight-forward concept. You’re either dead, or you’re not dead. Right? It turns out that clinically defining death is not so simple.

Popular media has some grasp on the ambiguity of the definition of death. Remember this scene from the popular movie, The Princess Bride? Suspecting that the protagonist is dead, his friends bring him to a miracle-worker and have the following conversation.

Miracle Max: “Whoo-hoo-hoo, look who knows so much. It just so happens that your friend here is only MOSTLY dead. There’s a big difference between mostly dead and all dead. Mostly dead is slightly alive. With all dead, well, with all dead there’s usually only one thing you can do.

Inigo Montoya: What’s that?

Miracle Max: Go through his clothes and look for loose change.

In real life, death used to be determined by cardiopulmonary criteria – when the heart and lungs stop working. In recent decades the idea that death can be determined using neurologic criteria – when the brain stops working – has gained acceptance. As neuroscience and technology has evolved, so too have our definitions. Now that we know more about how the brain works, we know that there may be some brain activity even after a person has met the criteria for death by neurologic criteria (DNC). This leads to philosophically rich and practically relevant questions of ethics – for example, when do we stop providing life-sustaining care? In the field of bioethics and beyond, there is high demand for discussion on this topic.

There has been controversy over defining death since the 1650’s — when a woman named Anne Greene woke up after being hanged. It wasn’t until the 1980’s that a consensus definition of death was first identified. Here is a brief history:

1950s

Widespread availability of ventilators led to the identification of a state described as death of the neurological system.

1960s

Advances in organ transplantation foster discussion on the ethics of defining death.
A committee at Harvard Medical School examined the definition of Brain Death. They created a definition of “Irreversible Coma,” which focused on loss of neurological function.

1980s

The 1980 Uniform Determination of Death Act (UDDA) provided a legal basis for clinically determining death as: an individual who has sustained either 1) irreversible cessation of circulatory and respiratory functions OR 2) irreversible cessation of functions of the entire brain.
1981: President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research report. Findings are centered on questions of functioning of the organism as a whole and the brain’s role in coordinating it.

1990s-2000s

Clinicians arrive at general agreement that a patient in a state of coma or unresponsiveness, without brainstem reflexes and who fails an apnea test is dead by neurologic criteria. Largely it is accepted that “brain death is death” but there is not complete consensus.

2010-late

2013: Case of Jahi McMath. A 13-year old girl was declared “brain dead” in California, and a death certificate was issued. However, the family fought to have her maintained on life support. They moved to New Jersey, the only state which recognized objections to brain death, and the “brain dead” declaration was reversed. Jahi lived there for 4 years before passing away. This famous case caused people to reconsider the concept of brain death.

2020s:

Recent innovations in heart transplantation technology will likely challenge the acceptance of the Dead Donor Rule (DDR) which requires that an individual is clinically declared dead before vital organs are removed for transplantation.
2021: Assembly of the Determination of Death Committee, tasked with updating the Uniform Determination of Death Act (UDDA). Duke faculty (and founding director of Science & Society) Nita Farahany, is involved with this process.

What ethical issues and practical questions challenging Death by Neurologic Criteria (DNC) today? Dr. Malek shared the following case.

Following a tragic car accident, Ms. Jones, a 20-year-old college student, was brought to the hospital, having suffered significant anoxic brain injury. The medical team determined that she met criteria for DNC. However, her family refused to allow for further testing. Several days passed. Ms. Jones was maintained on life support, during which she did not show signs of improvement. After several difficult conversations, the family consented for assessment and Ms. Jones was declared dead — using the criteria associated with DNC.

What is the proper amount of time to continue life-sustaining treatment if a physician suspects the patient will never recover?

Although this may sound like an uncommon occurrence, nearly half of neurologists have been asked to continue neurologic support for patients that may meet criteria for DNC.

Obligating life support for patients suspected of meeting DNC, either through the family’s refusal for testing or by direct request, would likely result in ethical harms such as violation of the dignity of decedent, unjustly using scarce resources, or causing moral distress in caregivers.

However, it may be permissible to maintain life support in these situations. Dr. Malek says that we do not yet have a good ethical framework for this. Reasonable accommodations that are in line with professional guidelines probably have minimal impact, and might provide some psychosocial benefits to families.

Is consent required to test for DNC? Should it be?

Legal and professional standards favor the idea that testing for DNC likely falls under the category of implied consent, which assumes that a person would want reasonable medical care in the event of unconsciousness. In fact, 80% of neurologists think that getting consent for these evaluations is unnecessary.

These are extremely difficult questions, and there is continuing controversy over what the correct answers should be. Dr. Malek advises medical experts to work with healthcare administrators to develop clear institutional policies.

Post by Victoria Wilson, 2023 MA student in Bioethics & Science Policy

Following the people and events that make up the research community at Duke

Category: Biomedical Engineering Page 1 of 8

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Duke experts discuss the potential of AI to help prevent, detect and treat disease

Meet New Blogger Stone Yan

Carrying on Dr. King’s Legacy: The Fight for Equity in Obesity Treatment

Sharing a Love of Electrical Engineering With Her Students

Solving More Medical Device Challenges by Teaching Others How

Pioneering New Treatments in Deep Brain Stimulation for Parkinson’s Disease

Inventors, Assemble: The Newest Gadgets Coming Out of Duke

How to be a Global Inventor

Only Mostly Dead? The Evolving Ethics of Evaluating Death

What is the proper amount of time to continue life-sustaining treatment if a physician suspects the patient will never recover?

Is consent required to test for DNC? Should it be?