Project Selection

Student List

  Level Team Members Project Title Keyword Engineering Specialty Medical Specialty
1 200/300 5 RaDistance safety meter radiation_meter Bioinstrumentation Radiology
2 200/300 5 CO2 prevents sleep apnea sleep_apnea Bioinstrumentation Medicine
3 400 4 Gastroesophageal reflux (GERD) preventer GERD_preventer Biomechanics Gastroenterology
4 200/300 5 Smartphone speech analytics speech_analytics Bioinstrumentation Medicine
5 200/300 5 Optimizing filtration and preservation of epithelial cells from urine stem_cell_collector Tissue Engineering, Biomaterials Neurology, Urology
6 200/300 5 Shoulder intraosseous humeral task trainer task_trainer Biomechanics, Biomaterials Orthopedic Surgery
9 200/300 5 An endo-pouch for selective targeted ovarian drug delivery in cancer patients ovarian_pouch Biomechanics, Biomaterials Obstetrics/Gynecology
10 200/300 5 Expandable bone graft bone_graft Biomechanics, Biomaterials Neurosurgery
11 200/300 5 Inflatable vertebral body distractor vertebral_body_distractor Biomechanics Neurosurgery
12 200/300 5 Impact wrench for orthopedics orthopedic_wrench Biomechanics Orthopedic Surgery
13 400 4 Collective cell migration and the perpetual wound perpetual_wound_device Biomaterials, Tissue Engineering Medicine
14 400 5 Hemorheological-based microfluidic chip platform for measuring blood viscosity blood_viscosity_chip Biomaterials, Bioinstrumentation Medicine
15 400 4 Infant delivery device for vaginal delivery delivery_device Biomechanics Obstetrics/Gynecology
16 400 2 Electronic voice output for children with verbal apraxia voice_output Bioinstrumentation Rehabilitation
17 400 4 Sensor-enabled simulations for the clinical breast exam breast_exam Bioinstrumentation, Biomaterials Surgery
18 200/300 5 A device to inflict traumatic brain injury in flies brain_injury_device Bioinstrumentation, Biomechanics Neurology
19 400 4 Pelvic floor muscle biofeedback computer games biofeedback_games Bioinstrumentation Urology
20 200/300 5 Auto-levelling ventriculostomy drain IVD_drain_leveller Bioinstrumentation, Biomechanics Neurosurgery
21 400 5 Cataract surgery manual cortex aspiration pressure sensor, display, and regulator cataract_surgery Bioinstrumentation, Biomaterials Ophthalmology
23 400 4 Modified inkjet printer for multi-channel bioprinting bioprinting Bioinstrumentation, Biomaterials, Cellular Engineering, Tissue Engineering Surgery
24 400 5 Microfluidic device to study biofilm infection on a vascular catheter microfluidic_catheter_model Biomaterials, Cellular Engineering, Tissue Engineering Cardiology
25 400 4 Bladder cancer resectoscope: The Badger Bladder Tumor Removal Device badger_resectoscope Bioinstrumentation, Biomechanics, Biomaterials Urology
26 400 4 Pulsatile pump for in vitro patient specific cardiovascular flow experiments cardiovascular_model Bioinstrumentation, Biomechanics, Medical Imaging Simulation
27 200/300 5 Stethoscope sound recorder stethoscope_recorder Bioinstrumentation Cardiology, Medicine
28 200/300 5 Ergonomic keyboard for pregnant women on bedrest ergonomic_keyboard Bioinstrumentation, Human Factors Obstetrics/Gynecology
32 200/300 5 Spider cage to support cerebral palsy patient spider_cage Biomechanics, Human Factors Pediatrics
33 200/300 5 Wireless ECG tank top ecg_tank_top Bioinstrumentation Cardiology
34 200/300 5 Ergonomic toolbox with decision support ergonomic_toolbox Human Factors, Biomechanics Physical Therapy
35 200/300 5 Mite traps for model organism incubators mite_traps Biomechanics, Bioinstrumentation Research
36 200/300 5 Development of an anti-crouch, dynamic leg brace dynamic_leg_brace Biomechanics Physical Therapy
37 200/300 5 Individualized functional finger prosthesis finger_prosthesis Biomechanics, Biomaterials Plastic Surgery
38 200/300 5 Temporary pacemaker training simulator heart_simulator Bioinstrumentation Cardiology, Medical Simulation
39 400 4 Ventilation recording tank top Ventilation_recording Bioinstrumentation Pulmonology
40 200/300 5 Functional grasp and release brace grasp_release_brace Biomechanics Physical Therapy
41 400 4 Emergency medicine – simulation of a difficult pediatric airway pediatric_airway Biomechanics, Biomaterials, Bioinstrumentation Medical Simulation
42 200/300 5 Standardization of hapten delivery in the diagnosis of allergic contact dermatitis hapten_delivery Biomechanics, Biomaterials Pharmacy
43 400 4 Lipoma extraction device lipoma_extraction Bioinstrumentation, Biomechanics, Biomaterials Surgery
44 200/300 5 Fluid control system for a phantom used to study aneurysm hemodynamics and wall motion aneurysm_model Biomechanics Cardiology
45 200/300 5 Metered dose inhaler (MDI) drug delivery system for rats metered_inhaler Biomechanics Pharmacy
46 200/300 5 SLIP project (Solution for Leakage through an Innovative Pessary) innovative_pessary Biomaterials, Biomechanics, Human Factors Geriatrics
47 200/300 5 Hip aspirate model to teach physicians hip_model Biomechanics, Biomaterials, Bioinstrumentation Medical Simulation, Orthopedic Surgery
48 200/300 5 System to monitor and correct posture and lower extremity movement during vibration exercise training posture_monitor Bioinstrumentation, Biomechanics, Human Factors Physical Therapy, Geriatrics
49 400 4 Smartphone anemia detection application and device smartphone_anemia Bioinstrumentation, Medical Imaging, Global Health Engineering, Cellular Engineering Medical Imaging, Pathology, Rural/Global Medicine
50 200/300 5 User programmable haptic injection simulator injection_simulator Bioinstrumentation, Biomechanics, Biomaterials Simulation
51 400 4 Smartphone cardio-auscultation stethescope smartphone_stethescope Bioinstrumentation Cardiology
52 400 5 Peripheral nerve stimulator tester nerve_stimulator_tester Bioinstrumentation Anesthesiology
54 200/300 5 Measurement of muscle function and balance to assess risk of falling balance_measurement Bioinstrumentation, Human Factors, Biomechanics Geriatrics, Physical Therapy
55 200/300 5 Sensor-enabled intubation trainer intubation_trainer Bioinstrumentation, Biomechanics, Biomaterials Medical Simulation
56 400 4 GE Healthcare: Uniform definition and management of contact surface biological hazards GE_bological_hazards Biomaterials, Biomechanics Radiology
57 200/300 5 GE Healthcare: Anthropometric analyses for MR coil and system development GE_MR_coil Human Factors, Biomechanics Medical Imaging
58 200/300 5 GE Healthcare: MR phantom development GE_MR_phantom Biomaterials, Biomechanics, Bioinstrumentation Medical Imaging
59 200/300 5 Atrial fibrillation screener afib_screener Bioinstrumentation Medicine


1. RaDistance safety meter

radiation_meter

BME 200/300
Students assigned: Joseph Benthein, Keith Dodd, Nicholas Gilling, Alexander Mccunn, Michael Wolff
Advisor: Wally Block

Engineering Specialty: Bioinstrumentation
Medical Specialty: Radiology
Skills: Electronics, Software

Summary
The therapeutic doses of radioactive iodine (I-131) can be potentially harmful to family members, individuals close to the patient as well as health workers and the environment. The International Commission on Radiation Protection (ICRP) recommends that radioactive iodine patients receive thorough instructions to avoid direct and indirect contact with infants and young children following the treatment. Design a device/multiple devices that would help radioactive iodine patients interact normally with family members in their home settings post hospital discharge. A possibility is a cap with both distance and heat sensors. If a patient gets within 1 m of a human, the patient could be alerted by acoustic, optical or vibratory feedback.

Fall 2013 a BME design team made a device that looks only ahead described at http://bmedesign.engr.wisc.edu/projects/f13/radiation_meter/ Now we need this expanded to look in all directions.

Materials
Develop multiple home pyroelectric intruder sensors and a time-of-flight ultrasonic camera focus sensors.

References
Barrington S , O'Doherty M, Kettle A, Thomson W, Mountford P, Burrell D, et al. 1999. Radiation exposure of the families of outpatients treated with radioiodine (iodine-131) for hyperthyroidism, Eur. J. Nucl. Med., vol. 26,pp. 686-692.
Barrington S, Anderson P, Kettle A, Gadd R, Thomson W, et al. 2008. Measurement of the internal dose to families of outpatients treated with 131I for hyperthyroidism. Eur J Nucl Med Mol Imaging. 2008 Nov;35(11):2097-104.
Directorate-General: Environment, Nuclear Safety and Civil Protection 1998, Radiation Protection following Iodine-131 Therapy (Exposures due to out-patients or discharged in-patients), European Commission.
Fraden, J., Handbook of modern sensors: physics, designs, and applications, 2nd ed., American Institute of Physics, Woodbury NY, 1997. Pages 267, 280.
Greaves, C. and Tindale, W. 1999, Dose rate measurements from radiopharmaceuticals: Implications for nuclear medicine staff and for children with radioactive parents, Nucl. Med. Commun., vol 20, pp. 179-187.
International Commission on Radiological Protection 1996, Radiological Protection and Safety in Medicine, ICRP Publication 73, Annals of the ICRP vol. 26 No. 2.
Matheoud R, Reschini E, Canzi C, Voltini F, Gerundini P. 2004. Potential third-party radiation exposure from outpatients treated with 131I for hyperthyroidism. Med Phys.;31(12):3194-200.
Mathieu I, Caussin J, Smeesters P, Wambersie A, Beckers C. 1999, Recommended restrictions after 131I therapy: measured doses in family members, Health Phys., vol. 76, pp. 129-136.
National Council on Radiation Protection and Measurements 1995, Dose limits for individuals who receive exposure from radionuclide therapy patients, NCRP Commentary No. 11.
Rémy H, Coulot J, Borget I, 2012. Thyroid cancer patients treated with 131I: radiation dose to relatives after discharge from the hospital. Thyroid. Jan;22(1):59-63.

Client:
Prof. John Webster
Biomedical Engineering
University of Wisconsin
(608) 263-1574
webster@engr.wisc.edu

Alternate Contact:
Prof. Sarah Hagi
Director of Medical Equipment Planning & Development
Medical Physics Unit, Radiology Dept., King Abdulaziz University Hospital Jeddah, Saudi Arabia
sarahhagi@gmail.com


2. CO2 prevents sleep apnea

sleep_apnea

BME 200/300
Students assigned: Madison Boston, Eric Howell, Jacob Levin, Christopher Nguyen, Christopher Schreiber
Advisor: Beth Meyerand

Engineering Specialty: Bioinstrumentation
Medical Specialty: Medicine
Skills: Electronics, Human Subjects, Mechanics

Summary
About 3% of the population has sleep apnea. During sleep the throat relaxes and closes. The CO2 increases, the subject wakes up, breathes again and this repeats. A therapy is to use continuous positive airway pressure (CPAP), and a blower raises the throat pressure to keep it open. However some apnea is central. The subject breathes too rapidly, the CO2 decreases, and breathing stops. Research has shown that increasing the inspired CO2 prevents apnea. Design a system for determining how much to increase CO2. The simplest system would use a nasal mask with extended tubes to increase the airway dead space. Measure the increase in CO2 for different dead spaces. Design a simple system for home use.

BME graduate students Mehdi Shokouei and Fa Wang have started work but need lots of help.

Materials
Spirometer in BME310 lab, CO2 sensor, plastic tubing, prototype device

References
J Appl Physiol 115:22-33, 2013.
Sleep. 2005 Jan;28(1):69-77.
Chest. 2003 May;123(5):1551-60.
J Appl Physiol. 1997 Mar;82(3):918-26.
Am J Respir Crit Care Med. 1999 May;159(5 Pt 1):1490-8.

Client:
Prof. John Webster
Biomedical Engineering
Engineering
(608) 263-1574
webster@engr.wisc.edu

Alternate Contact:
Prof. Jerome Dempsey
(608) 263-1732
jdempsey@wisc.edu


3. Gastroesophageal reflux (GERD) preventer

GERD_preventer

BME 400
Students assigned: Christopher Beglinger, Matthew Bradfish, Hannah Frank, William Greisch
Advisor: Tracy Puccinelli

Engineering Specialty: Biomechanics
Medical Specialty: Gastroenterology
Skills: Biomaterials, Mechanics

Summary
Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus.

GERD is usually caused by changes in the barrier between the stomach and the esophagus, including abnormal relaxation of the lower esophageal sphincter, which normally holds the top of the stomach closed, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. These changes may be permanent or temporary. In the Western world, between 10 and 20% of the population is affected.

Design a permanently implantable one-way valve that will permit food to easily pass to the stomach, yet prevent low stomach pressures from causing GERD. Add a parallel one-way valve that for high stomach pressures will permit burping or vomiting.

Materials must withstand the high acididity of the stomach fluids.

References
http://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease
http://en.wikipedia.org/wiki/Gastric_acid
Cobb, W. S., Burns, J. M., Kercher, K. W., Matthews, B. D., James Norton, H., & Todd Heniford, B. (2005). Normal intraabdominal pressure in healthy adults. Journal of Surgical Research, 129(2), 231-235.
Esophageal Dilation (2004). EndoNurse. Accessed October 29, 2013. From http://www.endonurse.com/articles/2004/12/esophageal-dilation.aspx, A., Haider, M., Stadlhuber, R. J., Karu, A., Corkill, S., & Filipi, C. J. (2008). A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting. Surgical endoscopy, 22(12), 2571-2575.
Material Properties (2008). ThermoPore Materials Corporation. http://www.thermoporecorp.com/PorousPlasticProperties.html
7/7 Metapor Porous Mold Material (n.d.). Tooling Technology. http://www.segen-online.com/pdfs/metapor.pdf
Waśko-Czopnik, D., Jóźków, P., Dunajska, K., Mędraś, M., & Paradowski, L. (2012). Associations between the lower esophageal sphincter function and the level of physical activity. Advances in clinical and experimental medicine: official organ Wroclaw Medical University, 22(2), 185-185

Client:
Prof. John Webster
Biomedical Engineering
University of Wisconsin
(608) 263-1574
webster@engr.wisc.edu


4. Smartphone speech analytics

speech_analytics

BME 200/300
Students assigned: Ashley Hermanns, Yifan Li, Austin Scholp, Fritz Wells, Trevor Zarecki
Advisor: Wally Block

Engineering Specialty: Bioinstrumentation
Medical Specialty: Medicine
Skills: Electronics, Human Subjects, Software, Mobile Health

Summary
In both children and adults with neurological diseases, cognitive dysfunction frequently is accompanied by motor dysfunction. One accessible method to assay motor dysfunction is through analyzing speech. Voice-based tests for some diseases like Parkinson's can be as accurate as clinical tests. Performing these tests through smartphones opens up an opportunity to administer such tests remotely, without requiring a visit to the clinic. A successful smartphone app to track cognitive function/dysfunction could be high speed, ultra low cost and massively scalable.

Materials
Patient speech data

References
Parkinson's Voice Initiative

Sterling, A., Mailick, M.R., Greenberg, J.S., Warren, S.F., & Brady, N. (2013) Language dysfluencies in females with the FMR1 premutation. Brain and Cognition. 82(1):84-9.

Client:
Prof. Krishanu Saha
Biomedical Engineering
Engineering
(608) 316-4313
ksaha@wisc.edu


5. Optimizing filtration and preservation of epithelial cells from urine

stem_cell_collector

BME 200/300
Students assigned: Nathan Bressler, Kiersten Haffey, Michelle Tong, Joseph Vecchi, Jesse Wang
Advisor: Randy Ashton

Engineering Specialty: Tissue Engineering, Biomaterials
Medical Specialty: Neurology, Urology
Skills: Software, Animal Experiments, Human Subjects, Imaging, Cell Biology, Tissue Engineering, Reactor design

Summary
Collection of patient specific cells is a task that often involves painful blood draw, skin puncture, or other clinical techniques. In order to streamline the process of cell collection from patient to laboratories, it is necessary to create a method for easily collection of epithelial cells. The goal for this project is to fabricate an easy-to-use, at home urine collection device that serves to separate renal epithelial cells from urine. In addition to filtrating epithelial cells from urine, the must be kept viable for at least 24 hours. The cells will then be used for reprogramming to create embryonic-like stem cells, called induced pluripotent stem cells (iPSCs). Patient-specific iPSCs are thought to hold unlimited potential in regenerative medicine and disease modeling applications.

Materials
\"Secondary\" human and mouse cells that harbor the inducible reprogramming factors Oct4, Sox2, Klf4 and cMyc
Reprogramming and differentiation cell culture media
Antibodies to stain for cell fate

References
Fluri, D. A. et al. Derivation, expansion and differentiation of induced pluripotent stem cells in continuous suspension cultures. Nat Meth – (2012).doi:10.1038/nmeth.1939

Shafa, M. et al. Derivation of iPSCs in stirred suspension bioreactors. Nat Meth (2012).doi:10.1038/nmeth.1973

Client:
Prof. Krishanu Saha
Biomedical Engineering
Engineering
(510) 541-6900
ksaha@wisc.edu


6. Shoulder intraosseous humeral task trainer

task_trainer

BME 200/300
Students assigned: Jehad Al-Ramahi, My An-Adirekkun, Catherine Finedore, Aude Lefranc, Cassandra Thomas
Advisor: Randy Ashton

Engineering Specialty: Biomechanics, Biomaterials
Medical Specialty: Orthopedic Surgery
Skills: Mechanics, Tissue Engineering, Educational models

Summary
The goal of this project is to develop a task trainer to be used for the training of medical personnel in the placement of intraosseous needle into the human humeral bone.

The trainer must simulate a human torso and shoulder and arm. In order to provide a realistic feel for insertion of the needle, the trainer must include skin, muscle and bone layers. Joint mobility and the ability to provide blood flow through the bone is required.

The skin and bone should have easy replaceable skin and bone tissues.

Features requested:
1) Realistic palpation of shoulder and humerus
2) Moveable shoulder joint
3) Realistic release of pressure through bone and arriving in marrow
4) Realistic blood return from marrow (bone could be hollow to contain blood solution).
5) Bone and skin should be self healing so 1 needle stick is not visible to next student.
6) Task Trainer will have at least 100 learners per year.
7) Bone and skin should be replaceable after X number of needle sticks.

Materials
The team will be provided with smooth-on materials for skin and muscle tissue and with simulated bone from other task trainers for the tibia. The team will be able to see the Intraosseous drill (this drill cannot be removed from our department).

A mold may be made from other task trainers designed for other procedures.

References
http://californiaacep.org/wp-content/uploads/LifelineMagazine_JUNE2013_v4.pdf (See pp. 12-13.)
https://www.armstrongmedical.com/index.cfm/go/product.detail/sec/2/ssec/11/cat/46/fam/2446
https://www.armstrongmedical.com/index.cfm/go/product.detail/sec/2/ssec/11/cat/46/fam/95
http://www.simulaids.eu.com/acatalog/lifeform-adult-sternal-intraosseous-infusion-simulator.html
http://www.jems.com/article/intraosseus/using-humerus-bone-io-access
http://www.smooth-on.com
http://www.enasco.com/healthcare/
http://www.vidacare.com/

Client:
Ms. Susan K. Olson
UW Health Clinical Simulation Program
UW Hospital & Clinics
(608) 265-1047
solson3@uwhealth.org


9. An endo-pouch for selective targeted ovarian drug delivery in cancer patients

ovarian_pouch

BME 200/300
Students assigned: Matthew Anderson, Nicolaas Angenent-Mari, Montserrat Calixto, Lazura Krasteva, Veronica Porubsky
Advisor: Randy Ashton

Engineering Specialty: Biomechanics, Biomaterials
Medical Specialty: Obstetrics/Gynecology
Skills: Software, Mechanics, Animal Experiments, Biomaterials

Summary
Project description:
Oftentimes female patients lose their reproductive capabilities as a consequence of having cancer or from undergoing cancer chemotherapy. Our research has discovered that dexrazoxane shields the ovaries from DNA damage caused by doxorubicin chemotherapy [1]. However, to translate our protection strategy to young girls and women, we need to be able to selectively deliver Dexra to the ovary to prevent non-targeted toxicity. Selective ovarian drug delivery can be done via establishing a novel endo-bag for drug delivery.

Establishing an ovarian pouch to administer chemo-protective agents to the ovary. Utilizing a suitable biomaterial, the students will make an endo-bag (pouch) that is connected to a port with a suitable valve. The initial phase of the project will include making the endo-bag and test it in ovaries obtained from research mice, or from slaughterhouse pigs or cows. The pouch will eventually be introduced in a suitable animal model and tested to infuse drugs through the port around the ovary. This ovarian drug delivery route will be similar to picc lines that are currently used to administer chemotherapy in blood vessels. They will ensure targeted drug delivery to the ovary and limit drug toxicity. Important parameters will include the longevity of the pouch and durability to withstand repeated use.

Materials
Students will have access to mouse ovaries and ovarian tissue that can be used to test the system. Alternatively, students can obtain pig or cow ovaries from slaughterhouses. Currently there is no specific synthetic material designated for this project. Students will need to select material for the pouch and the port.

References
Recent publication:
Protection from doxorubicin toxicity: Roti Rot, E.C. and Salih, S.M. Dexrazoxane Ameliorates Doxorubicin-Induced Injury in Mouse Ovarian Cells. Biology of Reproduction, 2012. 86(3): p. 1-11.

Website: http://www.obgyn.wisc.edu/research/salih-lab.aspx

Client:
Dr. Sana M. Salih, MD, MMS.
Obstetrics and Gynecology
School of Medicine and Public Health
(409) 771-1966
salih@wisc.edu


10. Expandable bone graft

bone_graft

BME 200/300
Students assigned: Reed Bjork, Samantha Bremner, Alexandria Craig, Sarah Dicker, Brendan Drackley
Advisor: Bill Murphy

Engineering Specialty: Biomechanics, Biomaterials
Medical Specialty: Neurosurgery
Skills: Biomaterials, Mechanics

Summary
In some cases in spine surgery it is necessary to perform a bone fusion in the intervertebral space (the space between the 2 vertebral bodies). This is done by removing the intervertebral disc and then placing bone graft. Traditional bone grafts are rectangular or cresent shaped. The graft is placed through a small surgical corridor. The graft needs to be large enough to support the vertebral bodies but not so large that it injures the surrounding nerves. It would be easier and safer to develop an expandable bone graft that could be inserted in a collapsed form and then expanded to fill the disk interspace. The goal of this project would be to develop an expanding interbody bone graft. This has already been done using a mechanical jack design. However, I would like to develop an expandable graft that is similar to a balloon but would be filled with bone graft material. This should be made out of a biomaterial that would allow bone fusion to occur but also would be strong enough to support the biomechanical forces of the spine as healing occurs.

Client:
Dr. Nathaniel Brooks
Neurological Surgery
UW School of Medicine and Public Health
(608) 469-3136
n.brooks@neurosurgery.wisc.edu


11. Inflatable vertebral body distractor

vertebral_body_distractor

BME 200/300
Students assigned: Gabrielle Laures, Michael Lohr, Ryan Serbin, Bridget Smith, Christina Sorenson
Advisor: Bill Murphy

Engineering Specialty: Biomechanics
Medical Specialty: Neurosurgery
Skills: Mechanics

Summary
In some cases of spine surgery the intervertebral disc is removed and the vertebral bodies are distraction to help with alignment of the spine. This is often done with metal spatula shaped tools or with mechanical jacks. Both of these tools have two problems. One, they have a narrow surface area so they can easily fracture the bone with the distractive forces. Two, they work along a linear trajectory so they cannot be manipulated easily to different regions of the intervertebral space to allow working space for graft placement. The goal of this project would be to develop an inflatable vertebral body distractor.

Client:
Dr. Nathaniel Brooks
Neurological Surgery
UW School of Medicine and Public Health
(608) 469-3136
n.brooks@neurosurgery.wisc.edu


12. Impact wrench for orthopedics

orthopedic_wrench

BME 200/300
Students assigned: Nicholas Hoppe, Evan Jellings, Andrew Siedschlag, Joseph Ulbrich, Alison Walter
Advisor: John Puccinelli

Engineering Specialty: Biomechanics
Medical Specialty: Orthopedic Surgery
Skills: Mechanics

Summary
Hardware removal is a required part of orthopedics and can be challenging. Screws have often been implanted for over a year when we remove them and can be in quite tight. When a screw gets stripped during removal it becomes much harder to remove.
Impact wrenches for automotive applications exist, but they are too large for the hardware we use in orthopedics. I would be interested in an impact wrench that could be used with the orthopedic screws we use to prevent stripping. It would also have to be sterilizable so it could be used in the operating room.

Materials
I can supply samples of the screws. We would also need \"sawbones\" which are fake bones that we use to practice placing hardware and would be useful for testing the wrench. This can be ordered on line. Ultimately, testing could be done on cadaveric bones, which can be obtained through the department.

Client:
Dr. John Wollaeger
Orthopedics
Meriter and UW School of Medicine
(608) 287-2219
john.wollaeger@uwmf.wisc.edu


13. Collective cell migration and the perpetual wound

perpetual_wound_device

BME 400
Students assigned: Ryan Lane, Michael Martinez, Matthew Reagan, Ryan Rinehart
Advisor: Tracy Puccinelli

Engineering Specialty: Biomaterials, Tissue Engineering
Medical Specialty: Medicine
Skills: Biomaterials, Cell Biology, Mechanics

Summary
The collective migration of epithelial cells is a fundamental phenomenon that occurs in a diversity of physiological processes, from early embryonic development to homeostasis in the adult intestine. One of the main ways in which collective migration is studied in vitro, is through a wound healing assay. In a wound healing assay, a monolayer of epithelial cells is grown on a coverslip, and then physically scratched, or wounded. The wound removes a strip of cells from coverslip, creates free space, and the cells that remain migrate collectively to close the space. An alternative to this experiment, is a microfluidic wound healing assay. In this assay, a monolayer of cells is grown inside of a microfluidic channel. Instead of scratching the monolayer, laminar fluid flows within the microfluidic channel are used to deliver a stream of trypsin, an enzyme which cleaves cell adhesions. The trypsin stream is thinner than the width of the channel (or the width of the cell population), and thus selectively cleaves a strip of cells from the chip, and washes them away, leaving behind free space. The trypsin is then removed, and replaced by cell culture media. Like the wound healing assay, the cells will migrate to close the gap. The microfluidic method has significant advantages over the physical scratch. First, there is never physical abrasion or cell death associated with removing the strip of cells. Thus, the effect of physical abrasion can be isolated from the effect of free space on the induction of cell migration. Second, the microfluidic method may be automated. My goal is to develop an automated system for trypsinzing and culturing the cells within the microfluidic chip for very long time in order to observe how the migration of cells changes with age. Thus, roughly every 24 hrs (or 1 generation), the monolayer will be trypsinized, the cells will migrate, reproduce and repopulate the channel, and then this process will repeat for many generations, thus creating a perpetual wound.

References
http://go.wisc.edu/5zzlj0

Client:
Prof. Michael Murrell
Biomedical Engineering
COE
mmurrell2@wisc.edu


14. Hemorheological-based microfluidic chip platform for measuring blood viscosity

blood_viscosity_chip

BME 400
Students assigned: Tyler Lieberthal, Christopher Patterson, Ross Paulson, Anthony Prostrollo, Jared Warczytowa
Advisor: Paul Thompson

Engineering Specialty: Biomaterials, Bioinstrumentation
Medical Specialty: Medicine
Skills: Animal Experiments, Biomaterials, Electronics, Mechanics

Summary
Blood viscosity has been shown to have significant implications in a clinical setting. Changes in blood viscosity can be related to inflammation, tissue injuries, cardiovascular and neoplastic disease. Current methods to characterize blood viscosity involve centrifuging the blood plasma out of whole blood and measuring the viscosity of the plasma alone using capillary or falling-sphere viscometers. Blood plasma by itself is considered a Newtonian fluid, with its viscosity remaining independent of shear-rate and temperature. Measuring changes in blood plasma viscosity can give physicians further insight into the presence or progression of diseases that lead to changes in clotting cascade activation, immunoglobulin concentration, inflammatory biomarkers. However, while highly sensitive to multiple diseases, plasma viscosity is lacking in disease specificity, leading to its underutilization in the clinical workflow in a hospital.

The measurement of whole blood viscosity, on the other hand, incorporates the highly-compressible and aggregating element of red blood cells (RBCs). As a result, whole blood is considered a shear-thinning, non-Newtonian fluid, with viscosities that change with temperature and velocity. Measuring the response of whole blood viscosity across different temperatures and velocities can potentially offer more discriminating information about certain disease process, leading to increased specificity in disease diagnosis or progression.

Arranging and measuring multiple combinations of velocity and temperature of blood can be labor-intensive and prohibitively time consuming due to the rapid onset of coagulation once blood is removed from the patient. Our proposal is to overcome this challenge by leveraging advances in microfluidic technology to make temperature adjustments and viscosity measurements within seconds of leaving the blood vessel. Microfluidic devices are small and inexpensive, necessitating only minimal sample volumes and can be multiplexed in a manner that can run multiple studies simultaneously. The high surface-area to volume ratio associated with using microfluidics allows for near instantaneous heating of blood samples and associated viscosity measurements. The rapid execution of the viscosity measurements will ensure that the viscosity changes are derived exclusively from flow and temperature, and not platelet activation from oxygen exposure.

The successful completion of this project will lead to a novel diagnostic platform that can uniquely characterize the progression of a wide variety of diseases using whole blood viscosity. The microfluidic platform lends itself well to being scaled up and modified for immediate clinical applications.

Materials
Animal surgery lab and access to fresh in-vivo porcine blood

Microfabrication/instrumentation lab supplies

Microwave/radiofrequency heating technology

References
[1] E. Y. Yang Jun Kang, A microfluidic device for simultaneous measurement of viscosity and flow rate of blood in a complex fluidic network, Biomicrofluidics, vol. 7, 2013.
[2] K. F. Lei, K.-H. Chen, P.-H. Tsui, and N.-M. Tsang, Real-Time Electrical Impedimetric Monitoring of Blood Coagulation Process under Temperature and Hematocrit Variations Conducted in a Microfluidic Chip, PLoS ONE, vol. 8, no. 10, p. e76243, Oct. 2013.
[3] G. Késmárky, P. Kenyeres, M. Rábai, and K. Tóth, Plasma viscosity: a forgotten variable, Clin. Hemorheol. Microcirc., vol. 39, no. 1-4, pp. 243-246, 2008.
[4] E. W. MERRILL, E. R. GILLILAND, G. COKELET, H. SHIN, A. BRITTEN, and R. E. WELLS Jr, Rheology of human blood, near and at zero flow. Effects of temperature and hematocrit level, Biophys. J., vol. 3, pp. 199-213, May 1963.

*Merrill has around 20 articles on blood viscosity theory and practice. They're easy to find on PubMed.

Client:
Prof. Christopher Brace
Biomedical Engineering
Engineering
(608) 265-9051
clbrace@wisc.edu

Alternate Contact:
Jason Chiang
(310) 923-1577
cjchiang@wisc.edu


15. Infant delivery device for vaginal delivery

delivery_device

BME 400
Students assigned: Alenna Beroza, Kimberly Buchanan, Emily Junger, Ana Lara Santiago
Advisor: Joseph Towles

Engineering Specialty: Biomechanics
Medical Specialty: Obstetrics/Gynecology
Skills: Mechanics, Software

Summary
A cylindicrical, helically wound, braided device would be designed which could be placed into the birth canal around the fetal head.

Pulling on the braid would lenghthen and narrow it. This would reduce the radial distance between opposite sides (ie. the fetal head and the operator providing traction) and the overall circumference around the fetal head.

By placing traction in the plane of the birth canal, the fetal head should be delivered without trauma. (this cannot always be accomplised by traditional devices in use now such as vacuums and forceps).

This device would allow for a much safer delivery than traditional forceps or vacuum.

Design would be similar to devices used in orthopedics to fix Bennet\'s fractures or designs of Chinese finger traps.

The overall goal would be to reduce birth injury, reduce cesearean section rate, and design a device that would require minimal training in use.

I am very confindent that this idea would work well and would be a cost effective tool to manufacture.

Materials
open

References
See design for Kellem\'s grip
See design for Chinese Finger Trap

Client:
Dr. Jay Lick
Ob/Gyn
The University of Wisconsin School of Medicine
(608) 576-6977
jclick@wisc.edu


16. Electronic voice output for children with verbal apraxia

voice_output

BME 400
Students assigned: Kaitlyn Laning, Samantha Mccarthy
Advisor: Mitch Tyler

Engineering Specialty: Bioinstrumentation
Medical Specialty: Rehabilitation
Skills: Electronics, Human Subjects

Summary
Children with congenital verbal apraxia may often understand spoken and written language and may be socially motivated to communicate, but are physically unable to speak. Because there are few, if any, treatments for this condition, children with this disorder are occasionally taught to communicate by using touch-activated voice output devices, which produce spoken words elicited by pressing buttons or touchscreens. However, for toddlers with severe verbal apraxia, commercially available touch-activated voice output systems present several logistical drawbacks. This project is to equip a wearable arm band with electronics to emit spoken words on demand. The client for this project is a toddler who presently communicates by selectively tapping on a list of 30 words printed on an armband that currently has no voice-output functions. The toddler would benefit from having his communication armband design equipped with voice-output capability. This will act as a wearable, fixed display voice-output communication device. The weight and bulk of the design solution must be low enough for the toddler to tolerate as a wearable item.

Materials
Armbands with printed keypads are available. All materials needed for creating modified wearable armbands and modified printed keypads are also available. Pre-recorded voice messages in childrens\\\' voices are available. The design team must determine, procure, or assemble the necessary electronics.

References
More details about this project, including video of prototypes in action, are available upon request. An introduction to this area is:
Speech generating device

Client:
Mrs. Tiffany Glass
(651) 343-6048
glass@surgery.wisc.edu


17. Sensor-enabled simulations for the clinical breast exam

breast_exam

BME 400
Students assigned: Timothy Abbott, Clair Kurzynski, Kristen Rasske, Lauren Stopfer
Advisor: Mitch Tyler

Engineering Specialty: Bioinstrumentation, Biomaterials
Medical Specialty: Surgery
Skills: Biomaterials, Electronics

Summary
The clinical breast examination (CBE) is intended to detect palpable lesions and guide further diagnostic workup and treatment. Despite the widespread practice of this examination, there is little standardization in the way that it is performed [1,2]. In addition, evidence regarding the actual technique performed in the clinical setting and how it relates to the ability of a practitioner to detect a breast lesion is lacking.

In our lab, we have developed a large range of sensored silicone breast models. We embedded force sensitive resistors (FSR) at the base of the models. Using these FSRs we can recode and track the performance of the CBE. Since these FSRs are made of plastic and are soldered and wired we are limited to placing them on the bottom of the model relatively far from the surface, otherwise they would be felt by the practitioner preforming the exam.
During the last few years, a broad range of new materials has been developed. These include conductive cloth, piezoresistive fabrics, conductive paint and more. These new materials provide an opportunity to develop a new sensor that is smaller, soft and more flexible. The goal of this project is to develop these sensors and embed them in our breast models in a way that won’t be felt by the examiner. The project includes the development and fabrication of the sensors, measurement and categorization of their performance and embedding them in our models. This project will be part of our ongoing CBE research and successful models will be used in our future data collection sessions (by now we have collected more than 250 exams and we expect to collect hundreds more).

Materials
We have a variety of silicone breast models that can be used. We have a sample of different materials and more can be purchased if needed. We have the electronic equipment for measuring the resistivity both NI based and Arduino based. We have just started our research regarding these new materials and we are open to student’s suggestions.

References
[1] Pugh, C.M., Domont, Z.B., Salud, L.H., & Blossfield, K.M. (2008), A simulation-based assessment of clinical breast examination technique: Do patient and clinician factors affect clinical approach? The American Journal of Surgery, 195, 874-880.
[2] Salud, L.H., & Pugh, C.M. (2011). Use of sensor technology to explore the science of touch. Studies in Health Technology and Informatics, 163, 542-548.

Usage of these materials by other groups:
http://www.kobakant.at/DIY/?cat=24
http://hlt.media.mit.edu/

Client:
Dr. Shlomi Laufer
Surgery
SMPH
(608) 556-1026
slaufer2@wisc.edu


18. A device to inflict traumatic brain injury in flies

brain_injury_device

BME 200/300
Students assigned: Katherine Barlow, Brady Lundin, David Neuser, Katrina Ruedinger, Stephen Schwartz
Advisor: Kris Saha

Engineering Specialty: Bioinstrumentation, Biomechanics
Medical Specialty: Neurology
Skills: Animal Experiments, Electronics, Mechanics

Summary
We have recently developed a device to inflict traumatic brain injury (TBI) in fruit flies (Drosophila melanogaster). Our published paper provides a detailed description of the device (Figures 1 and S1) and how we are using it to understand the cellular and molecular events that occur as a result of TBI. The reference for the paper is provided below.

We would like to redesign the device to make it more reproducible and expandable, i.e., higher throughput. Another goal would be to calibrate the device so that it produces an impact of a given force.

If these goals are achieved, then we will be able to use the device to carry out high throughput screens to identify drugs to treat TBI and to study the effects of different impact forces on TBI outcomes.

Reference:
Katzenberger, R. J., Loewen, C. A., Wassarman, D. R., Petersen, A. J., Ganetzky, B., and Wassarman, D. A. (2013) A Drosophila model of closed head traumatic brain injury. Proc. Natl. Acad. Sci. 110, E4152-E4159.

Materials
We can supply the current device and money to purchase materials for the redesign.

References
Our paper:
Katzenberger, R. J., Loewen, C. A., Wassarman, D. R., Petersen, A. J., Ganetzky, B., and Wassarman, D. A. (2013) A Drosophila model of closed head traumatic brain injury. Proc. Natl. Acad. Sci. 110, E4152-E4159.

An article about devices used to inflict TBI in mice and rats:
Xiong, Y. Mahmood, A., and Chopp, M. (2013) Animal models of traumatic brain injury. Nature Rev. Neurosci. 14, 128-142.

An article written by UW Communications about our work on TBI:
UW article about our work

An article written by the LA Times about our work on TBI:
LA Times article about our work

Client:
Dr. David Wassarman
Cell and Regenerative Biology
School of Medicine and Public Health
(608) 262-6648
dawassarman@wisc.edu

Alternate Contact:
Dr. Barry Ganetzky
(608) 263-2404
ganetzky@wisc.edu


19. Pelvic floor muscle biofeedback computer games

biofeedback_games

BME 400
Students assigned: Samual Lines, Shawn Patel, Michael Simonson, Andrew Vamos
Advisor: Amit Nimunkar

Engineering Specialty: Bioinstrumentation
Medical Specialty: Urology
Skills: Electronics, Human Subjects, Software

Summary
Dr. Patrick McKenna joined the UW Department of Urology in September 2012 as the Chief of Pediatric Urology. He brought a new clinical program to our center, whereby children learn to control their pelvic floor muscles using biofeedback. The aspect of his program that is unique nationally is that he utilizes video games in the pelvic floor training. Biofeedback "leads" attached to the patient's pelvic floor muscles connect to an electronic interface that is about 2"x5"x7" in size and connects to a computer that runs the video games. Currently we have two of the electronic interfaces, one in use and one backup. The backup unit will be soon be deployed in a satellite clinic location. The devices have a history of "burning up" after a few years.
Our initial goal is the creation of extra interfaces that can be used if the existing ones fail because the devices are no longer commercially available. A more ambitious goal is the creation of a new interface and video games that run on a modern operating system with high resolution graphics.

Materials
Access to current biofeedback set-up outside normal clinic hours.
Access to a broken interface.
Funds for equipment and supplies with pre-approval.

Client:
Mr. Patrick H. McKenna, MD, FACS, FAAP
Urology
School of Medicine and Public Health
(608) 262-0475
mckenna@urology.wisc.edu

Alternate Contacts:
Stephen Hall, Department Administrator
(608) 263-9032
hall@urology.wisc.edu

Sarah Novinsie, Medical Staff Assistant to Pediatric Urology Division
(608) 262-0475
novinskie@urology.wisc.edu


20. Auto-levelling ventriculostomy drain

IVD_drain_leveller

BME 200/300
Students assigned: Anupama Bhattacharya, Jason Brunkow, Steven Gock, John Kegel, David VanVeen
Advisor: John Puccinelli

Engineering Specialty: Bioinstrumentation, Biomechanics
Medical Specialty: Neurosurgery
Skills: Electronics, Mechanics, Software

Summary
Current intraventricular drain (IVD) systems consist of a closed drainage system that is hung by a string from a pole. In order to function properly, the IVD collection container must be kept at a constant, consistent level relative to the ventricles of the patient. Since patients rarely stay completely immobile for any length of time, keeping the IVD properly leveled is a time-consuming, imprecise, almost sisyphysean nursing intervention. I have a general design for a device that would keep the IVD continually and consistently leveled at the correct height. In simple terms, a small sensor/transmitter/something of that nature would be attached to the patients temple. The collection systems buretrol would be mounted on a small motorized carriage. The system would raise or lower the carriage to keep the buretrol at the proper level. Furthermore, the envisioned device would also include an important safety feature-when sudden changes in height are detected, the system would automatically clamp the drainage system. Additional features are possible.

Materials
I have nothing but my ideas and a few sketches. The device is fairly simple-it would require a few motors, switches, sensors and so on using existing technology. I can arrange for whatever sheetmetal housings/boxes, etc. to be fabricated if need be.

Client:
Mr. David M Longseth
Nursing Operations
UWHC
(608) 843-6588
dlongseth@uwhealth.org


21. Cataract surgery manual cortex aspiration pressure sensor, display, and regulator

cataract_surgery

BME 400
Students assigned: Mohammed Hayat, Dalton Hess, Alice Huang, Brandon Jonen, Scott Schulz
Advisor: Paul Thompson

Engineering Specialty: Bioinstrumentation, Biomaterials
Medical Specialty: Ophthalmology
Skills: Animal Experiments, Biomaterials, Electronics, Mechanics, Software

Summary
BACKGROUND:
Cataract surgery involves removing a patient's diseased lens. After the hard lens nucleus has been removed using an ultrasound handpiece, the softer lens cortex is aspirated using a vacuum-based handpiece. The ultrasound and aspiration systems are paired to an irrigation system to ensure balanced fluid exchange and intraocular stability within the closed system of the eyeball. Total volume of the system is approximately 2.5 cc.


Automated cortex aspiration may be performed using a handpiece attached to a low-compliance, small-diameter (<3mm), long length (approx 1.5 m) flexible silicone tube attached to a machine governed by a proprietary microprocessor that generates vacuum levels ranging from 0-650 mmHg. Minimum and maximum vacuum levels may be defined and set by the user and actual vacuum levels are displayed instantaneously and continuously in real-time.

Manual cortex aspiration may be performed using a handpiece attached to a high-compliance, small-diameter (<3mm), short length (approx 25 cm) flexible silicone tube attached to a handheld 10 cc syringe. We do not have a mechanism to measure, display or limit the vacuum levels using this system.

PROJECT:
1a. Design a pressure sensor to measure vacuum levels within a high-compliance, small-diameter (<3 mm) variable vacuum (0-500 mmHg) flexible silicone tubing system of approximately 25 cm in length.
1b. Design a remote digital vacuum level display unit for this system to display vacuum levels instantaneously and continuously in real-time.
1c. Design a pressure-release valve for this system with user-adjustable upper limit (up to 500 mmHg).

Materials
Will provide access to:
- cataract surgery instruments
- cataract surgery videos
- cataract surgery wetlab
- porcine and human eyes
- disposables for project

Client:
Dr. Stephen Sauer
Ophthalmology
UWSMPH
(608) 263-4758
sksauer@wisc.edu


23. Modified inkjet printer for multi-channel bioprinting

bioprinting

BME 400
Students assigned: Jack Goss, Karl Kabarowski, Evan Lange, Tyler Max
Advisor: Paul Thompson

Engineering Specialty: Bioinstrumentation, Biomaterials, Cellular Engineering, Tissue Engineering
Medical Specialty: Surgery
Skills: Biomaterials, Electronics, Mechanics, Software, Tissue Engineering

Summary
Bio-printing or the process of depositing living cells using the printer technology brings the dream of creating an artificial organ through tissue-engineering closer to reality. Several printer technologies including the laser-jet, bubble-jet, and ink-jet methods have been explored for bio-printing. Of these, the ink-jet technology where the ink is pressure-ejected by a piezo-electric device appears to be least damaging to live cells. Much advance has been made but the ability to eject a precise mixture of different bio-ink (e.g. different cells or growth factors) to create an optimal environment for cell growth has been under utilized.

The goal of this project is to modify a readily available inexpensive commercial ink-jet printer with the following design goals: 1. create a mechanical interface for translating the paper-advance information delivered to the printer to translate a plate for receiving the deposited cells (y-axis translation), 2. modify the ink-jet printer head to accommodate "bio-ink" while providing the x-axis translation for depositing the bio-ink, 3. control the duration of bio-ink ejection to accommodate bio-ink of different viscosity, 4. allow a controlled mixture of different "color" (i.e. growth factors or different cells) bio-ink, and 5. develop a user friendly software interface (Visual Basic preferred)for controlling the bio-printer. An additional capacity for z-axis translation will enhance the printer to allow 3D printing of biomaterials.

Design and development of this bio-printing device and making it available to a larger scientific audience will advance the field of tissue engineering.

Materials
Cell culture hood, various primary cells and cell lines, and a fully-equipped lab located in WIMR for conducting biomedical research. Various electro-mechanical translation devices previously used as part of an electrophysiology set up are also available.

References
Reviews on bio-printing.

Boland et al. Application of inkjet printing to tissue engineering. Biotechnol J 2006, 1:910-917.

Ringeisen et al. Jet-based methods to print living cells. Biotech J 2006 1: 930-948.

Ozbolat and Yu. Bioprinting toward organ fabrication: Challenges and future trends. IEEE Biomed Engng 60: 691-699.

Client:
Dr. Jay Yang
Anesthesiology
SMPH
(608) 265-6710
jyang75@wisc.edu


24. Microfluidic device to study biofilm infection on a vascular catheter

microfluidic_catheter_model

BME 400
Students assigned: Jacob Hindt, Amy Kim, Stephanie O'leary, Xiyu Wang, Yue Yin
Advisor: Tracy Puccinelli

Engineering Specialty: Biomaterials, Cellular Engineering, Tissue Engineering
Medical Specialty: Cardiology
Skills: Biomaterials, Cell Biology, Imaging

Summary
The goal of the project is to develop a microfluidic device that mimics a vascular catheter infection in a patient and can be used for microscopy experiments examining the immune response. The device would have an outer endothelial layer and an inner “catheter”. The areas would have an interface at the tip of the catheter. The lumen of the catheter would be able to be inoculated to produce a biofilm. Some of the future applications for this device may include examining how neutrophils migrate to biofilms in the presence and absence of an endothelial cell lining, comparing immune recognition of biofilm and free floating cells, measuring the cytokine responses, and examining the impact of disrupting genetic pathways in either the microorganism or immune cells.

Patients with indwelling medical devices, such as venous catheters, are at risk for serious infection. Bacteria and fungi can adhere to the surface of the medical device and proliferate as a biofilm, a resilient community of cells encased in an extracellular matrix. The host immune response and anti-infective therapies are frequently ineffective against this process and these infections can have devastating consequences. Much of how transitioning to the biofilm lifestyle protects organisms from immune clearance remains a mystery.

The goal of our laboratory is to identify the mechanisms of immune evasion for biofilms formed by Candida albicans, one of the most common fungal pathogens. We currently use a combination of rodent models and in vitro models. The focus of our in vitro models is examining the neutrophil response to biofilms infections. Development of this microfluidic device would allow us to examine the role of the endothelial lining in biofilm pathogenesis in vitro.

Materials
Through our laboratory, the students would have access to neutrophils or neutrophil-like cells, biofilm producing organisms, an endothelial cell line, and a microscope for confocal microscopy. We have media, incubators, and supplies to maintain the cell lines and microorganisms. We have fluorescent stains to visualize both microorganisms and neutrophils. We have two full time research scientists who maintain the cell lines. They would be able to assist students with biological aspects of the project and/or provide these cells and reagents as needed. We have funds to purchase engineering supplies and materials.

References
For a review of Candida biofilms:

Ramage G1, Martínez JP, López-Ribot JL.2006. Candida biofilms on implanted biomaterials: a clinically significant problem.FEMS Yeast Res. 979-86.

I can provide additional references regarding microfluidic devices, endothelial cells, or patient catheters.

Client:
Dr. Jeniel Nett
Medicine-Infectious Disease, Medical Microbiology & Immunology
Medicine and Public Health
(608) 262-7494
jenett@medicine.wisc.edu


25. Bladder cancer resectoscope: The Badger Bladder Tumor Removal Device

badger_resectoscope

BME 400
Students assigned: Katherine Baldwin, Alyssa Mitchell, Tyler Moon, Ryan Reynebeau
Advisor: Mitch Tyler

Engineering Specialty: Bioinstrumentation, Biomechanics, Biomaterials
Medical Specialty: Urology
Skills: Human Subjects, Mechanics, Software

Summary
The goal of this project is to design a new and novel equipment to aid in the removal of bladder tumors.

My name is Tracy Downs, I am an associate professor of urology at UW SMPH. I have been in clinical practice for 11 years. In the past decade it has become very clear to me that we need a different way to remove bladder tumors. Traditionally, we pass a long instrument called a cystoscope through a patient’s urethra (male - penis and female - shorter urethra). This provides us access into the bladder where we "cut" the tumor 4-5 cm or smaller ones 1-2 cm into small pieces to facilitate tumor removal. The problem with this approach is that we have to violate the tumor by cutting through it, which can lead to tumor spillage leading to "seeding" and frequent recurrences of these bladder tumors.

Materials
Access to currently used bladder cystoscopies and resectoscopes
Access to observe live surgery to understand how contemporary equipment is used and their limitations to aid in novel redesign.

References
Non muscle invasive bladder cancer (NMIBC) Early stage urothelial carcinoma of the bladder (UCB) is the fourth most common site of new human cancer diagnoses (1). It is estimated that there are 585,390 urinary bladder cancer survivors living in the United States and an additional 73,510 new cases will be diagnosed in 2012, with an estimated 14,880 deaths occurring in the United States as a result of this disease (1). The two most well established risk factors for bladder tumors are cigarette smoking and occupational exposure to urothelial carcinogens. Cigarette smoking is the most important risk factor, accounting for 50% of cases in men and 35% in women (2). Most new bladder cancer cases (≈ 50,000 patients) are diagnosed early with disease limited to the mucosal epithelium (Ta/Tis, Stage 0) and immediate connective tissue layer beneath the mucosa (T1, Stage I). Collectively these tumor stages (Ta, Tis, T1) are referred to as non-muscle invasive bladder cancer (NMIBC) or superficial bladder cancer. The clinical course of early stage Urothelial carcinoma of the bladder (UCB), is dominated by frequent recurrences and surveillance testing (cystoscopy, bladder biopsy, urine cytology, etc.) (3). The need for long-term invasive monitoring and treatment has significant cost and morbidity consequences for UCB patients. In fact, 53% of patients diagnosed with superficial bladder cancer will experience a recurrence within 2 years of diagnosis (4). Compared to other malignancies, UCB ranks highest in lifetime per patient costs, between $96,000 to $187,000 with total costs at a population level estimated at $3.7 billion annually (5).

1.Siegel R, DeSantis C, Virgo K et al. Caner treatment and survivorship statistics 2012. CA Cancer J Clin: 62 (5): 232, 2012.

2.Zeegers MP; Tan, FE; Dorant, E; Van Den Brandt, PA (2000). "The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies". Cancer 89 (3): 630–9.

3.Foresman WH, Messing EM. Bladder cancer: natural history, tumor markers, and early detection strategies. Semin Surg Oncol. 13:299-306, 1997.

4.Tolley DA et al. The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of followup. J Urol 1996;155:1233-1238

5.Botteman MF, et a.l, The health economics of bladder cancer: a comprehensive review of the literature. Pharmacoeconomics, 12;1315-1330, 2003.

Websites to view:
http://acmicorp.com/acmi/user/display.cfm?display=product&pid=9233&catid=109&maincat=Urology&catname=Rotating ResectoscopesACMI Urology

http://www.olympus.co.uk/medical/en/medical_systems/applications/urology/urology_2.html

http://www.bcan.org

http://www.urology.wisc.edu and bladder cancer

http://www.bupa.co.uk/individuals/health-information/directory/t/turbt

Client:
Dr. Tracy Downs
Department of Urology
University of Wisconsin School of Medicine and Public Health
(608) 263-9534
downs@urology.wisc.edu


26. Pulsatile pump for in vitro patient specific cardiovascular flow experiments

cardiovascular_model

BME 400
Students assigned: Maria Maza, Jaime Mortier, Shaun Pomerenke, Adam Strebel
Advisor: Mitch Tyler

Engineering Specialty: Bioinstrumentation, Biomechanics, Medical Imaging
Medical Specialty: Simulation
Skills: Electronics, Imaging, Software

Summary
The multidirectional nature of flow within the cardiovascular system makes the comprehensive non-invasive characterization and quantification of normal and pathological blood flow difficult and challenging. Standard imaging techniques such as Doppler ultrasound or magnetic resonance imaging (MRI) are still limited in their ability to fully characterize this complex flow. 4D Flow MRI, with its ability to assess multidirectional volumetric flow, offers the opportunity to non-invasively assess the performance and efficiency of the cardiovascular system, both in vivo in patients and in vitro using patient-specific models. Currently we use data acquired from in vivo MRI evaluations to create patient-specific in vitro models using additive manufacturing techniques. Physical models are subjected to different inflow and resistance conditions during MRI in vitro experiments using a bypass non-pulsatile perfusion pump. The goal of this project would be to design a system that in series with the perfusion pump can convert the continuous flow in pulsatile flow that reproduces patient-specific flow waves as inputs for the in vitro model.

Materials
Perfusion pump, tubbing, Software

Client:
Mr. Alejandro
Radiology
School of Medicine
(608) 262-1780
roldan@wisc.edu


27. Stethoscope sound recorder

stethoscope_recorder

BME 200/300
Students assigned: Matthew Knoespel, Lucas Lato, Anneka Littler, Philip Terrien, Anna Zebzda
Advisor: John Webster

Engineering Specialty: Bioinstrumentation
Medical Specialty: Cardiology, Medicine
Skills: Electronics, Software

Summary
The goal of the project is to design a device that can record the acoustic signal from a stethoscope.
The recording should be played with a stopwatch to identify (by time) the precise moment auscultation changes.

Materials
Stethoscope

Client:
Dr. Juan Boriosi
Pediatrics
Univ of WI-Madison
(608) 320-3556
jpboriosi@pediatrics.wisc.edu


28. Ergonomic keyboard for pregnant women on bedrest

ergonomic_keyboard

BME 200/300
Students assigned: Christopher Blanchard, Justin Faanes, Andrew Hajek, Elliott Janssen Saldivar, Randal Mills
Advisor: Jeremy Rogers

Engineering Specialty: Bioinstrumentation, Human Factors
Medical Specialty: Obstetrics/Gynecology
Skills: Electronics, Mechanics

Summary
Although it has not been proven to be especially effective, bedrest is frequently prescribed for pregnant women at risk of pregnancy loss or preterm labor (including women with pre-eclampsia, premature contractions, weakened cervix, or multiples). The length and strictness of bedrest varies, but in nearly all cases women are advised to lay on their sides (not their backs and stomachs), with a preference for laying on the left side to promote circulation for the fetus. When in this position it is difficult to work on existing computing devices (laptops, tablets) for extended periods of time due to the poor ergonomics (particularly for the wrists) with existing keyboards.

It would be ideal to develop a new interface that works with existing computing devices- either an adjustable stand to position an existing keyboard (and tablet/laptop) or a bluetooth keyboard that would work with existing devices but be adjustable for the patient to find a comfortable position. Additional constraints are that the device can not interfere with or rest on the patients belly as fetuses may be sensitive to the heat/waves emitted by the device. As women come in all sizes and the pregnant belly can vary widely (both between patients and over time), careful consideration must be given to how to make this device accommodate those different situations.

Materials
Should be able to use the student's own laptops/tablets to get a sense of existing materials. Through SWAP the client can procure a few keyboards to take apart and reconstruct.

The client is currently pregnant and willing to serve as a model for measurements as well as provide contacts with local ObGYN/MFMs who may provide background on the position preferences.

References
To get a sense of the issues involved with bedrest (namely boredom and being uncomfortable), look at online groups on websites such as babycenter.com

Client:
Prof. Pamela Kreeger
BME
Engineering
kreeger@wisc.edu


32. Spider cage to support cerebral palsy patient

spider_cage

BME 200/300
Students assigned: Jonathan Elicson, Austin Gehrke, Jonathon Leja, Taylor Marohl, Samantha Mesanovic
Advisor: Beth Meyerand

Engineering Specialty: Biomechanics, Human Factors
Medical Specialty: Pediatrics
Skills: Human Subjects, Mechanics

Summary
A spider cage is a device used by therapists to work with people (usually kids) who have cerebral palsy. It supports their weight with bungy cords connected to a custom suit so the person can work on building leg and arm strength. This is something that is available commercially, but is very expensive. We are looking for a design that is relatively inexpensive, is collapsible and able to fit in a car, and has custom features that meet the need of one particular person.

Materials
Amanda Miller, OT from Wisconsin Therapists has agreed to help with project specifics and can meet during the semester to evaluate your design.

References
Here is a basic design:
http://www.suittherapy.com/ueu.htm

Client:
Mr. Matt Jahnke
United Cerebral Palsy
(608) 279-5897
mattjahnke@ucpdane.org


33. Wireless ECG tank top

ecg_tank_top

BME 200/300
Students assigned: Zachary Burmeister, Lucas Hurtley, Andrew McMenomy, David Mott, Ian Wolf
Advisor: Kris Saha

Engineering Specialty: Bioinstrumentation
Medical Specialty: Cardiology
Skills: Electronics, Human Subjects, Software

Summary
To monitor the ECG continuously, most patients are not willing to apply new gel electrodes daily. We have tested reusable dry electrodes in an elastic tank top and for the next step require (1) a low power ECG amplifier and battery, (2) wireless connection to smart phone, (3) transmission to hospital computer, (4) algorithm to alarm and display when arrhythmia occurs.

Materials
Elastic tank top with dry electrodes

References
Meziane, N., J. G. Webster, M. Attari and A. J. Nimunkar, Dry electrodes for electrocardiography, Physiol. Meas. 34, R47–R69, 2013.

Client:
Prof. John G. Webster
Biomedical Engineering
COE
(608) 263-1574
webster@engr.wisc.edu


34. Ergonomic toolbox with decision support

ergonomic_toolbox

BME 200/300
Students assigned: Mensah Amuzu, Zachary Katsulis, Ian Kinsella, Ryan Sepehr, Aaron Sonderman
Advisor: Thomas Yen

Engineering Specialty: Human Factors, Biomechanics
Medical Specialty: Physical Therapy
Skills: Electronics, Mechanics, Software

Summary
Design of an application for i-Pad/i-phone that takes accepted ergonomic tools and applies appropriately for inputed job critical demands. The output would give ergonomic risk-low, med, high by body part. This tool would allow for ergonomic recommendations, based on objective data, to be given specific to job tasks suspected to be risk areas for musculoskeletal disorders.

Note requester is guest lecturer for U.W. Physical Therapy program, Faculty in U.W. Orthopedic physical therapy residency. Steering committee member for U.W. Orthopedic residency.

The project is being requested in cooperation with Dr. Mary Sesto PT, PHD

Materials
i-pad if needed. Other support as needed.

References
NIOSH lifting index - single and multi-tasks
RULA (rapid upper limb assessment)
Washington Checklists (Hazard and caution zone checklists)
Strain Index Metabolic/Physiological Energy Expenditure Prediction Snook tables for carrying
Vibration calculators

http://www.lni.wa.gov/safety/SprainsStrains/tools/default.asp
http://www.rula.co.uk/
http://www.cdc.gov/niosh/docs/94-110/
http://www.cdc.gov/niosh/topics/ergonomics/

Client:
Mr. Matthew VanderKooi
NewLife 4Work
(608) 698-2304
mattv@newlifept.com


35. Mite traps for model organism incubators

mite_traps

BME 200/300
Students assigned: Herman Feller, Joaquin Herrera, Tej Patel, David Schmidt, Greg Zilberg
Advisor: Kris Saha

Engineering Specialty: Biomechanics, Bioinstrumentation
Medical Specialty: Research
Skills: Biomaterials, Electronics

Summary
Mites are a virulent pest that pose significant problems for model organism researchers. In Drosophila labs such as ours, hundreds of fly stocks are maintained in trays of vials in temperature and humidity controlled incubators. Unfortunately, any introduction of mites into incubators can rapidly lead to a significant mite problem due to contamination of fan housings. Solutions currently available rely on the use of toxic mitocides. We would like you to design a non-toxic mechanism for preventing mite contamination of lab stocks in incubators, possibly through the use of traps constructed using 3D printing and microfluidic fabrication techniques.

Materials
Model organisms, trays, vials, incubators, 3D printing supplies, electronics for sensing and monitoring.

References
http://www.gen.cam.ac.uk/department/flylab/mites-quarantine

http://flystocks.bio.indiana.edu/Fly_Work/culturing.htm#mites

https://www.youtube.com/watch?v=PfSAAsrVANc

Client:
Dr. Kate O'Connor-Giles
Laboratories of Genetics & Cell and Molecular Biology
CALS, Graduate School
(608) 265-4813
oconnorgiles@wisc.edu

Alternate Contact:
Kevin Eliceiri
(608) 263-6288
eliceiri@wisc.edu


36. Development of an anti-crouch, dynamic leg brace

dynamic_leg_brace

BME 200/300
Students assigned: Joshua Bensen, Aaron Bishop, Alex Ehlers, Nathan Leppert, David Piotrowski
Advisor: Thomas Yen

Engineering Specialty: Biomechanics
Medical Specialty: Physical Therapy
Skills: Biomechanics

Summary
People with cerebral palsy frequently have a crouched stance and gait due to muscle weakness and spasticity. Ankle foot orthotics are often used to improve the biomechanics of gait, however a limitation of this type of brace is that they are not dynamic. They are either fixed, allowing for no significant dorsi/plantar flexion, or they are articulated which allows for too much crouch during times of high fatigue or weakness. We are interested in having an anti crouch, dynamic brace developed. This would be a leg brace that would allow dorsi flexion when needed functionally, but would spring load back to keeping the tibia in line with the ankle during stance. this could be a brace that is a dynamic postural training device that could, ideally, work in combination with a foot orthotic.

Materials
We have articulated and fixed braces that were previously used and some access to an orthotics specialist.

References
To be discussed with team

Client:
Dr. Donita Croft
Medicine
Medical School
(608) 445-1536
dc2@medicine.wisc.edu

Alternate Contact:
Wendy Stewart, PT
(608) 263-8412


37. Individualized functional finger prosthesis

finger_prosthesis

BME 200/300
Students assigned: Crystal Jimenez, Lane Van Epern, Brittany Warnell, Annie Yang, Linda Yang
Advisor: Ed Bersu

Engineering Specialty: Biomechanics, Biomaterials
Medical Specialty: Plastic Surgery
Skills: Biomaterials, Human Subjects, Mechanics, 3D printing

Summary
Finger prostheses have been provided to individuals who have sustained amputation of their fingers. Due to the inherent difficulty of retaining finger prostheses securely to restore grip strength and function many efforts to restore the finger have shifted focus toward cosmesis. These aesthetic silicone prostheses can be detailed and tinted to look very natural, and the restored length does restore passive function.

This project will focus on the development of a mechanical unit that is actuated by flexion/extension in the residual finger and that is adaptable to patient-specific finger sockets created by the prosthetist.

Materials
Polymers - silicones, polyurethanes, epoxies, PMMA, etc. Additional resources and budget available to purchase hardware. Access to scanning/3D printing process on UW campus. Access to laboratory for experimentation with materials,fabrication and assembly of prototypes.

References
www.didrickmedical.com, www.NakedProsthetics.com
www.MedicalArtProsthetics.com, www.HandProsthesis.com
www.FingerProsthesis.com

Client:
Mr. Gregory Gion
Medical Art Prosthetics, LLC
(608) 833-7002
g.g.gion@sbcglobal.net


38. Temporary pacemaker training simulator

heart_simulator

BME 200/300
Students assigned: Samuel Brenny, Haley Knapp, Katherine Peterson, Madeline Rutherford, Laura Xu
Advisor: John Webster

Engineering Specialty: Bioinstrumentation
Medical Specialty: Cardiology, Medical Simulation
Skills: Electronics, Software

Summary
Problem: There is no available training device for temporary pacemakers (pacers). The training device would have to essentially replace of the patient’s heart and interface with the monitor and the pacer. This would allow trainees (students, nurses, residents, fellows) to learn how the pacer works without using a real patient.

Background: Temporary pacemakers are commonly used after cardiac surgery because patients are at high risk for developing abnormal cardiac rhythms in the post-operative period and a pacer can provide therapy for some of the abnormal rhythms. In addition, continuous electrocardiogram (ECG) monitoring is used in the post-operative period to monitor the patient’s electrical cardiac activity and also to monitor the patients response to the pacer, if the pacer is used. I will provide a diagram of the input and output relationship of the three systems: monitor, patient's heart, and pacemaker.

Requested submission: Develop an interface (simulated heart) between the pacemaker and the monitor that replaces the electrical conduction system of the heart, specifically the hearts electrical output and its electrical response to the pacemaker. It would need six inputs from the operator (instructor):

1. Adjustable heart rate
2. Heart rhythm (In addition to a normal rhythm, I would recommend the most common 5-6 rhythms we expect post-operatively and that we can treat with a pacer)
3. Atrial output (mV) to the pacer
4. Atrial sensitivity (mA), response to the pacers output
5. Ventricular output (mV) to the pacer
6. Ventricular sensitivity (mA), response to the pacers output

The simulated heart would have to respond with an electrical heartbeat when the pacer output (mA) exceeds the atrial and/or ventricular sensitivity of the simulated heart.

There are “rhythm generators” on the market that can produce a waveform on a monitor (see Simulaids and Laerdal websites below for examples). However, there are no simulators that interface between the monitor and a pacer, which is our request.

Materials
Temporary Pacemaker, cables and wires (There is a very small chance we may only be able to provide the pacemaker on an intermittent basis, depending on the number of heart surgeries that are done in a week. However, in the past we have always had at least one that is not in use.)

Electrocardiogram monitor, cables and leads

References
No pubmed articles found related to temporary pacemaker, training, and/or simulation were found except the following:
Ahlfeldt H, et al. Computer simulation of cardiac pacing. Pacing Clin Electrophysiol. 1988 Feb;11(2):174-84.

The temporary pacemaker we use is the Medtronic Dual Chamber External Pacemaker Model 5388 and is at the following website:
http://www.medtronic.com/for-healthcare-professionals/products-therapies/cardiac-rhythm/pacemakers/external-pacemakers/index.htm

Examples of ECG can be found at the following website:
http://www.scribd.com/doc/2155828/EKG-Examples

Rhythms we would be interested in include normal sinus rhythm, junctional rhythm, third degree AV block and supraventricular tachycardia. We would want to be able to vary the rate of these rhythms.

There are many companies that have created rhythm generators including Laerdal and Simulaids. We have both available to us at UWHC and AFCH.
http://www.laerdal.com/us/doc/177/HeartSim-200#/Webshop
http://www.simulaids.com/102.htm

Schematic provided by client (contact Dr.P)

Client:
Dr. Scott A. Hagen, MD
Division of Critical Care Medicine, Department of Pediatrics
UW School of Medicine and Public Health
(608) 263-8552
shagen@pediatrics.wisc.edu

Alternate Contact:
Glenda Zemlicka
(608) 263-8552
gczemlicka@pediatrics.wisc.edu


39. Ventilation recording tank top

Ventilation_recording

BME 400
Students assigned: Kelsie Harris, Danielle Horn, Samuel Jensen, Mustafa Khan
Advisor: Paul Thompson

Engineering Specialty: Bioinstrumentation
Medical Specialty: Pulmonology
Skills: Electronics, Human Subjects, Software

Summary
We would like to continuously record lung ventilation. Presently to record lung ventilation for 8 h in a sleep lab the respiratory inductive plethsmograph (RIP) is used. We have already developed an ECG tank top to continuously record the ECG. We would like to take an elastic tank top, add an RIP or other method of recording lung ventilation, add a battery driven microcontroller to record data for a week and process algorithms to identify abnormalities in ventilation. Eventually we would like to wi-fi data to a smart phone, then to a hospital computer that provides physician access.

Materials
Elastic tank top

References
Luo, S., V. X. Afonso, J. G. Webster, and W. J. Tompkins, The electrode system in impedance-based ventilation measurement, IEEE Trans. Biomed. Eng., 39, 1130–1141, 1992.
Cohen, K. P., D. Panescu, J. H. Booske, J. G. Webster, and W. J. Tompkins, Design of an inductive plethysmograph for ventilation measurement, Physiol. Meas., 15, 217–229, 1994.
Rosell, J., K. P. Cohen, and J. G. Webster, Reduction of motion artifacts using a two-frequency impedance plethysmograph and adaptive filtering, IEEE Trans. Biomed. Eng., 42, 1044-1048, 1995.
Cohen, K. P.,W. M. Ladd, D. M. Beams, W. S. Sheers, R. G. Radwin, W. J. Tompkins, and J. G. Webster, Comparison of impedance and inductance ventilation sensors on adults during breathing, motion and simulated airway obstruction, IEEE Trans. Biomed. Eng., 44, 555-566, 1997.
Weinberg, G. M., and J. G. Webster, Measuring human ventilation for apnoea detection using an optical encoder, Physiol. Meas., 19, 441-446, 1998.
Meziane, N., J. G. Webster, M. Attari and A. J. Nimunkar, Dry electrodes for electrocardiography, Physiol. Meas. 34, R47–R69, 2013.

Client:
Prof. John G. Webster
Biomedical Engineering
COE
(608) 263-1574
webster@engr.wisc.edu


40. Functional grasp and release brace

grasp_release_brace

BME 200/300
Students assigned: Frederico Barrionuevo, Kristen Driscoll, Micaella Poehler, Alexander Yueh, Eric Zeman
Advisor: Thomas Yen

Engineering Specialty: Biomechanics
Medical Specialty: Physical Therapy
Skills: Human Subjects, Mechanics

Summary
This brace will allow anyone, but specifically children to easily close their hand (grasp) and release. This will need to be lightweight, comfortable, easy to don/doff and will easily allow the wearer to grasp and release.
What is envisioned is a moldable brace not unlike ones used for fractures with a glove at the end with something like the boa lacing system that will cause a grasp. When the cords are released it would allow the hand to relax and open. The easier to tighten and loosen the better. If the person's hand is always in a fisted position then the lacing system could be used to extend the hand to open and when released the hand would then close. If need be both could be applied to the same brace.

Materials
None immediately available potential for some casting supplies.

References
No Journal articles.

Website: http://www.djoglobal.com/products/exos/pediatric-short-arm-fracture-brace
This will show the brace and boa lacing system, but no ability to open or close hand as it is used for stability not function.

Client:
Mr. Michael V. Hoeper, PT
Physical Therapy
Monroe Clinic
(608) 324-1736
michael.hoeper@monroeclinic.org


41. Emergency medicine – simulation of a difficult pediatric airway

pediatric_airway

BME 400
Students assigned: Zachary Balsiger, Jonathan Luedtke, Scott Mawer, Malachi Willey
Advisor: Joseph Towles

Engineering Specialty: Biomechanics, Biomaterials, Bioinstrumentation
Medical Specialty: Medical Simulation
Skills: Biomaterials, Mechanics

Summary
Intubation is a critical to the recovery of a compromised airway. Recovery of an adult airway requires visualization the glottis and placement of a tube to provide unobstructed ventilation. However, the skills and tools used in adult airways do not transfer to smaller pediatric patients. Due to the infrequency and complexity of pediatric intubation, there is a critical need for training and development of performance standards. [1,2,3].

In our lab, clinical simulators are developed to capture clinical skills and define expert performance. Our fabricate process utilizes a range of silicon casting and molding material, but are not limited to them. We are open to suggestions for different materials.

We outfit simulators with sensors and data acquisition systems to capture expert motion and performance characteristics.
We developed and purchased adult airway simulations, however there is a lack of quality models for patients age 0 – 2 years.

The goal of this project is to develop an airway representative of a 10 month old pediatric patient. In particular, the simulated airway will need to mimic the stiffness and dimensions of a 10 month old and be durable. Relevant intubation skills in this simulated model include airway navigation, tube insertion, direct and indirect laryngoscope tool expertise.

The project includes the development and fabrication of the pediatric airway and their clinical scenarios, performance measurement using force-sensitive resistors, and the development of expert/novice performance metrics. This project will

Materials
We have a variety of silicone materials for model fabrication and molding. We have a sample of different materials and more can be purchased. We have just started our research regarding these new materials and we are open to student’s suggestions. Service for the 3D printing at the engineering student shop can be utilized if needed. We have electronic equipment for measuring sensor resistivity using NI based or Arduino based systems.

References
[1] Stewart, Charles, MD, FAAEM, FACEP. "Managing The Pediatric Airway In The ED." Pediatric Emergency Medicine Practice 3.1 (2006). EBmedicine. Web. 18 Aug. 2014. .

[2] Graham, C A. "Advanced Airway Management in the Emergency Department: What Are the Training and Skills Maintenance Needs for UK Emergency Physicians?" Emergency Medicine Journal (2004): 14-19. Print.

[3] Walls, Ron M. "Approach to the Pediatric Airway." Manual of Emergency Airway Management. Revised/Expanded ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008. 263-302. Print.

Commonly used silicones for fabrication:
http://www.smooth-on.com/Silicone-Rubber-an/c2_1115/index.html

Client:
Dr. Carla Pugh
Department of Surgery
UW School of Medicine and Public Health
(608) 263-7502
pugh@surgery.wisc.edu

Alternate Contact:
Calvin Kwan
(608) 262-5241
kwan@surgery.wisc.edu


42. Standardization of hapten delivery in the diagnosis of allergic contact dermatitis

hapten_delivery

BME 200/300
Students assigned: Andrea Doll, Alexandra Picard, Kari Stauss, Katrina Strobush, Lauren Taylor
Advisor: Randy Ashton

Engineering Specialty: Biomechanics, Biomaterials
Medical Specialty: Pharmacy
Skills: Chemistry, Human Subjects, Mechanics

Summary
Allergic contact dermatitis is a T-cell mediated allergic reaction that typically manifests as dermatitis when patients come in direct contact with a hapten (or allergen) to which they have previously been sensitized. Patch testing is a clinical test used to diagnosed delayed type hypersensitivity reactions to a variety of allergens such as preservatives, fragrance, rubber, surfactants, oils, metals, and other ingredients. Haptens for allergy testing are and supplied to the clinic in a dilute concentration by a commercial supplier. The vehicle for haptens is usually petrolatum, but some are available in aqueous solutions, either in ethanol or purified water. Haptens are stored in either a syringe (petrolatum vehicle), or a dropper bottle (aqueous vehicle).

Haptens are loaded onto aluminum (finn) chambers by hand and applied to patients in a standardized fashion. Instructions for amount of allergen for patch testing recommend a 5 mm ribbon for petrolatum based haptens and 1 liquid drop (about 25 micro-liters) for haptens in aqueous solutions. Given that the haptens are loaded onto the chambers by hand, there is variation in the volume of allergen to which that each patient is exposed. The detection of allergic contact dermatitis is a dose depended process and lack of a method to reproducible exposure patients to the same amount of allergen brings into question the validity and reproducibility of the test.

The project aim would be to develop a device to reliably and reproducible deliver the same volume of hapten to the finn chamber in preparation for patch testing. This volume would be the same based on the vehicle, meaning that all haptens with a petrolatum vehicle would deliver the same volume to the finn chamber. Such a device would need to be used with multiple different haptens without cross contamination. It would also need to be able to load haptens with petrolatum or aqueous vehicles.

The development of a tool to standardize the volume of hapten delivery for patch testing would a significant step forward for quality assurance and reproducibility in the diagnosis of contact allergy. It would also increase the reliability of the test between institutions and limit human variations in the loading of haptens for testing. Both the American Contact Dermatitis Society and the European Society for Contact Dermatitis would have interest in the development and untilization of a hapten loading device.

Materials
Supplied materials include haptens, finn chambers, and other supplies for patch testing. Training in clinic to demonstrate the technique of patch testing including hapten storage, preparation, and loading of trays for application.

References
http://www.contactderm.org (American Society for Contact Dermatitis)

1.Dosage considerations in patch testing with liquid allergens.
Shaw DW, Zhai H, Maibach HI, Niklasson B.
Contact Dermatitis. 2002 Aug;47(2):86-90.
PMID: 12423405

2.A contemporary Fischer-Maibach investigation: variations in patch test delivery systems and implications for standardization.
Hamann D, Hamann CR, Hamann C.
Dermatitis. 2013 Nov-Dec;24(6):302-12.
PMID: 24201463

3.Towards a perfect vehicle(s) for diagnostic patch testing: an overview.
Chiang A, Maibach HI.
Cutan Ocul Toxicol. 2013 Mar;32(1):60-6. doi: 10.3109/15569527.2012.684418. Epub 2012 Jun 6. Review.
PMID: 22667342

4.The role of vehicles in diagnostic patch testing. A reappraisal.
Tanglertsampan C, Maibach HI.
Contact Dermatitis. 1993 Oct;29(4):169-74. Review.
PMID: 8281777

5.Variations in the quantities of petrolatum applied in patch testing.
Antoine JL, Lachapelle JM.
Derm Beruf Umwelt. 1988 Nov-Dec;36(6):191-4.
PMID: 3234271

6.Recommendation of appropriate amounts of petrolatum preparation to be applied at patch testing.
Bruze M, Isaksson M, Gruvberger B, Frick-Engfeldt M.
Contact Dermatitis. 2007 May;56(5):281-5.
PMID: 17441852

7.Variation in the amount of petrolatum preparation applied at patch testing.
Bruze M, Frick-Engfeldt M, Gruvberger B, Isaksson M.
Contact Dermatitis. 2007 Jan;56(1):38-42.
PMID: 17177708

8.Audit of Finn Chamber patch test preparation.
Moffitt DL, Sharp LA, Sansom JE.
Contact Dermatitis. 2002 Dec;47(6):334-6.
PMID: 12581278

9. Prevalence of patch testing and methodology of dermatologists in the US: results of a cross-sectional survey.
Warshaw EM, Nelson D.
Am J Contact Dermat. 2002 Jun;13(2):53-8.
PMID: 12022120

Client:
Dr. Margo Reeder
Dermatology
UW School of Medicine and Public Health
(608) 287-2620
mreeder@dermatology.wisc.edu


43. Lipoma extraction device

lipoma_extraction

BME 400
Students assigned: Matthew Boyer, Stephen Monette, Alexander Nguyen, Thomas Zipp
Advisor: Amit Nimunkar

Engineering Specialty: Bioinstrumentation, Biomechanics, Biomaterials
Medical Specialty: Surgery
Skills: Human Subjects, Mechanics

Summary
Lipomas are benign growths of fatty tissue beneath the skin. They are visible masses on the skin surface and may be asymptomatic or painful. Surgical excision may be complicated by bleeding and difficulty breaking fibrous bands that run through the lesion leading to prominent scarring. Patients and physicians would benefit from a lighted device that could be introduced from a small incision in the skin, break any fibrous tissue and micronize the fat lobules to facilitate extraction.

Client:
Dr. William Aughenbaugh
Dermatology
UW School of Medicine and Public Health
(608) 287-2620
waughenbaugh@dermatology.wisc.edu


44. Fluid control system for a phantom used to study aneurysm hemodynamics and wall motion

aneurysm_model

BME 200/300
Students assigned: Ross Barker, Ellis Cohen, Peter Hartig, Timothy Tyrrell, Benjamin Vander Loop
Advisor: Naomi Chesler

Engineering Specialty: Biomechanics
Medical Specialty: Cardiology
Skills: Imaging, Fluid Mechanics

Summary
We are interested in understanding the flow characteristics of intracranial aneurysms. To help us better understand these patterns we use patient specific models (phantoms) and explants of surgically created aneurysms in canines. Creation of realistic flow conditions in these models as well as optimization of injection protocols for 2D and 3D angiography requires that the fluid used mimic the viscosity and density of blood. In order to visualize flow we acquire x-ray angiographic images after injection of an iodine containing contrast medium. Since the viscosity and density of the contrast medium is quite different from that of blood mixing of this contrast medium with our blood mimic fluid will cause its viscosity and density to change significantly during an experiment.

We would like assistance in designing a bypass circuit for our human specific phantom and the apparatus that we use to study the explanted canine aneurysms. The design should be one such that a bolus of fluid containing contrast medium can be diverted along a path such that it does not contaminate the bulk of the fluid in the system. Design of the bypass loop must be such that the outflow resistance matches that of the experimental circuit i.e. flow rates in the 2 systems must be matched so that there are no changes in flow patterns during opening of the bypass loop. It would also be useful if a way to automatically monitor the viscosity and density of the blood mimic fluid during an experiment could be incorporated into the design.

Materials
1. State of the art Siemens bi-plane angiographic system with capability of obtaining 2D, 3D and 4D (time-resolved 3D) angiographic acquisitions at frame rates up to 30fps.
2. Pulsatile and steady flow pumps with ability to input patient or animal specific waveforms
3. Patient specific models of intracranial aneurysms with appropriate upstream and downstream vasculature
4. Explanted aneurysms of various geometry with an apparatus to study these in an environment that will maintain tissue viability
5. Expertise and experience with computational studies of intracranial aneurysms

Client:
Dr. Alejandro Roldan
Radiology
School of Medicine
(608) 262-1780
roldan@wisc.edu


45. Metered dose inhaler (MDI) drug delivery system for rats

metered_inhaler

BME 200/300
Students assigned: Nicholas Difranco, Yitong He, Claire Hintz, Kathryn Schwarz, Jason Wan
Advisor: Jeremy Rogers

Engineering Specialty: Biomechanics
Medical Specialty: Pharmacy
Skills: Animal Experiments, Fabrication of custom pieces from plastic

Summary
Our research looks at the side effects of inhaled corticosteroid medications (such as Flovent or Symbicort) that people often take for lung disease. In particular, we want to investigate the effects on the musculature of the tongue and upper airway, because atrophy of those muscles can lead to sleep apnea. For the purposes of this research, we need to be able to deliver the medication to rats the same way it is delivered to humans - by a controlled puff of medication into the oral cavity. The design problems we currently face are:
- The mouthpiece of an MDI inhaler used for humans is too big for a rat's mouth and needs to be modified accordingly (i.e. fitted with a custom nozzle to convert it to a rat-sized mouthpiece).
- We need a way to train the animal to put it's mouth around the nozzle voluntarily. This is a challenge because rats tend to feed by either licking or gnawing an object with their front teeth.

Materials
MDI cartridges (Advair, Fluticasone, others)
Research Animals
Treats for training (fruit loops, peanut butter, e.t.c.)
PE tubing of various diameters
General purpose tools and hardware

References
http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=9192

(To see what a metered dose inhaler looks like and how it works).

Client:
Dr. Mihaela Teodorescu
Medicine
UW Madison School of Medicine and Public Health
(608) 395-4645
mt3@medicine.wisc.edu

Alternate Contact:
Oleg Broytman
(608) 469-7460
obroytma@medicine.wisc.edu


46. SLIP project (Solution for Leakage through an Innovative Pessary)

innovative_pessary

BME 200/300
Students assigned: Thomas Feustel, Ping Hu, Mufaddal Lakdawala, Jack Mcginnity, Joshua Plantz
Advisor: Naomi Chesler

Engineering Specialty: Biomaterials, Biomechanics, Human Factors
Medical Specialty: Geriatrics
Skills: Biomaterials, Human Subjects, Mechanics

Summary
Urinary leakage affects more than half of independent US women aged 65 and older (Gorina), and its direct health care costs exceed $25 billion annually (Miner). Stress urinary incontinence, the leakage of urine associated with activities that increase intra-abdominal pressure such as coughing, sneezing, and lifting, can be treated with surgery, pelvic floor muscle strengthening, or the use of an intra-vaginal silicone support device called a pessary.

Pessaries are traditionally used to treat relaxation of the vaginal walls (pelvic organ prolapse) and thus sit between the apex of the vagina and the back of the pubic bone, supporting the vaginal apex and anterior wall. Historically, it was believed that loss of support of the bladder neck (the junction between the bladder and the urethra, tube through which urine leaves the bladder) contributed to stress incontinence. Therefore, two pessaries were designed specifically to treat stress incontinence: an incontinence ring and an incontinence dish. These pessaries sit between the apex of the vagina and the pubic bone and each has a knob to support the bladder neck, but neither incorporates a mechanism to prevent rotation of the knob from midline, and they improve symptoms for about 50% of women who try them. In contrast, mid-urethral sling surgery to treat stress incontinence results in improvement or cure in over 90% of women who undergo the procedure.

Over the last twenty years, our understanding about the underlying pathophysiology of stress incontinence has evolved, so that we now recognize the importance of support not just of the bladder neck but also of the urethra itself (Delancey). The two incontinence pessaries that currently exist do not provide urethral support at all, and are limited in their ability to support the bladder neck by the ease with which their knob can rotate.

The purpose of this project is to build an innovative pessary that provides urethral support, which means it will be situated more distally than existing ones, and will have to be supported laterally. This innovative pessary will provide a minimally invasive and more effective alternative to surgery for the treatment of stress urinary incontinence

Materials
None

Will have to purchase medical grade silicone

References
Delancey JO1, Ashton-Miller JA. Pathophysiology of adult urinary incontinence. Gastroenterology. 2004 Jan;126(1 Suppl 1):S23-32.
Abstract
The anatomic structures that prevent stress incontinence, urinary incontinence during elevations in abdominal pressure, can be divided into 2 systems: a sphincteric system and a supportive system. The action of the vesical neck and urethral sphincteric mechanisms at rest constrict the urethral lumen and keep urethral closure pressure higher than bladder pressure. The striated urogenital sphincter, the smooth muscle sphincter in the vesical neck, and the circular and longitudinal smooth muscle of the urethra all contribute to closure pressure. The mucosal and vascular tissues that surround the lumen provide a hermetic seal, and the connective tissues in the urethral wall also aid coaptation. Decreases in striated muscle sphincter fibers occur with age and parity, but the other tissues are not well understood. The supportive hammock under the urethra and vesical neck provides a firm backstop against which the urethra is compressed during increases in abdominal pressure to maintain urethral closure pressures above rapidly increasing bladder pressure. The stiffness of this supportive layer is presumed to be important to the degree to which compression occurs. This supporting layer consists of the anterior vaginal wall and the connective tissue that attaches it to the pelvic bones through the pubovaginal portion of the levator ani muscle and also the tendinous arch of the pelvic fascia. Activation of the levator muscle during abdominal pressurization is important to this stabilization process. The integrity of the connection between the vaginal wall and tendinous arch also plays an important role.

Miner, P.B., Jr., Economic and personal impact of fecal and urinary incontinence. Gastroenterology, 2004. 126(1 Suppl 1): p. S8-13.

Prevalence of Incontinence Among Older Americans Yelena Gorina, et al NHANES 2007-2010 series 3, No.36 pp1-15

The treatment of female stress urinary incontinence: evidence-based review Cameron and Haraway Open Access Journal of Urology 2011:3 109-120

The history and usage of the vaginal pessary: a review Reeba Oliver et al European Journal of Obstetrics & Gynecology and Reproductive Biology 2011 156:125-130

www.coopersurgical.com/Milex

Client:
Dr. Gloria E. Sarto
Obstetrics and Gynecology
UW School of Medicine and Public Health
(608) 262-7573
gsarto@wisc.edu

Alternate Contact:
Dr. Heidi W. Brown
(608) 265-5654
lwbrown2@wisc.edu


47. Hip aspirate model to teach physicians

hip_model

BME 200/300
Students assigned: Alyssa Acker, Brandon Li, Emily Olszewski, Molly Scott, Conor Sullivan
Advisor: Ed Bersu

Engineering Specialty: Biomechanics, Biomaterials, Bioinstrumentation
Medical Specialty: Medical Simulation, Orthopedic Surgery
Skills: Biomaterials, Electronics, Imaging, Mechanics, Software, Anatomy

Summary
1) OVERVIEW
Septic arthritis of the hip is a pediatric orthopedic emergency. Failure to accurately diagnose the condition in a timely manner can lead to life long sequelae. Fortunately septic arthritis is a relatively uncommon childhood disorder occurring in about (3-12.5/100,000). Most commonly this infection involves children under the age of 2 years old. It is generally felt that the intra-articular infection occurs when bacteria are transmitted hematogenously from other common sites of childhood infection (ears, nose, throat, cuts, scrapes etc.) to the proximal femur. Because the proximal femoral growth plate resides within the hip joint capsule, the bacterial can spread from the bone into the joint space itself. Once in the joint, the bacteria and the ensuing immune response, with its cytotxic chemicals, can cause destruction of the hip joint cartilage. As the infection continues, increased pressure builds within the hip joint that can eventually decrease the vascular perfusion of the femoral head and lead to avascular necrosis. Avascular necrosis in these young children can result in lifelong disability and pain.

The optimal care for these children involves timely diagnosis and treatment, including appropriate antibiotic coverage and surgical debridement. While vital signs, clinical exam, and blood tests can aid in making an accurate diagnosis, joint fluid obtained from X-ray or ultrasound (US) guidance, is critical in confirming the diagnosis. At many centers, hip aspiration relies on the availability of fellowship trained MSK or pediatric radiologists to aspirate fluid from the hip joint. When they are unavailable, the child often has ideal treatment delayed, until the diagnostic procedure can be performed. This often occurs despite “hip joint aspiration and debridement” being one of the required ACGME surgical skills necessary to document orthopedic resident proficiency. Due to the relatively low frequency of this disorder, and yet the high clinical importance of accurate diagnosis, orthopedic and radiology residents get very little hands-on experience practicing and performing these procedures, despite the ACGME requirement. Currently there are no commercially available simulation models that would allow residents to practice X-ray and US guided hip aspiration in the infant.

The long-term goal of this proposal is to develop an infant hip model and OSATS that will allow residents to practice and document proficiency at X-Ray and US guided hip aspiration as well as the anterior surgical approach to the hip joint. Once completed, this would ideally be available for use at multiple training centers. We will accomplish this by the development of a base infant model. An aspiration insert and an anatomic insert will be developed. These inserts will be easily replaceable for use and reuse of the model. While the model will be able to address both aspiration and debridement, the focus of this grant will be joint aspiration.

Client:
Dr. Matthew Halanski
Orthopedics and rehabilitation
AFCH
(608) 265-4086
halanski@ortho.wisc.edu


48. System to monitor and correct posture and lower extremity movement during vibration exercise training

posture_monitor

BME 200/300
Students assigned: Michal Adamski, Cameron Hays, James Hermus, Hannah Lider, Jennifer Westlund
Advisor: John Webster

Engineering Specialty: Bioinstrumentation, Biomechanics, Human Factors
Medical Specialty: Physical Therapy, Geriatrics
Skills: Electronics, Human Subjects, Imaging, Mechanics, Software

Summary
Whole body vibration is a promising exercise modality that effectively improves muscle function and balance in older adults. Vibration exercise activates skeletal muscle through vertical accelerations transmitted by the vibration device into the musculoskeletal system. These stimuli not only increase muscle function but might also be beneficial for bone health and balance. Vibration exercise requires less time than other exercise regimens, and can be performed by older adults with comorbidities that often limit the ability to perform conventional exercise. Despite this, vibration training is currently rarely performed in older adults often due to safety concerns of devices that operate at vibration amplitudes and frequencies that could be harmful if the training is not performed correctly. The main concern of improperly done vibration exercise is that harmful vibration can be transmitted through the body and damage vital structures such as the spine and the head. Studies have shown that vibration gets transmitted cranially easier if participants train with completely extended (straight) knees and also and extended (straight) back.

To reduce the risk of injury vibration device manufacturers provide instructions to trainers and those who exercise how to best use these devices. They emphasize that during training knees and back/hips should be flexed to a certain degree. There are currently several limitations to this approach
- It is unclear which joint positions (hip, knee, ankle) are optimal to reduce transmission of vibration to the head during training
- Individuals will likely differ in the way the transmit vibration and the range of safe joint angles needs to be individualized
- Individuals do not get feedback whether they are training in a safe range until it’s too late (they get pain etc.)

As such we are hoping to develop a system that can 1) monitor transmitted vibration at the level of the head/shoulders/spine using accelerometers or similar devices and 2) monitor joint angles during training and then provide feedback to the individuals to change their posture/movement so they train in a safe position / movement based on an acceptable level of transmitted vibration.

The first part will be designed and built by the group. The sensor needs to be able to be worn during training and measure transmitted vibration at head/shoulders/spine. For the second part, we want to use the Microsoft Kinect system to monitor body position and joint angles. We then need a program to integrate the information from the vibration sensors (e.g. accelerometers) and the Microsoft Kinect in order to provide the training individuals feedback on whether they train in a safe range and instruct them to change their posture / movements in case they are in a not-safe range.

Materials
Microsoft Kinect System (version 1 and version 2)

References
- Rittweger, Eur J Appl Physiol (2010) 108:877–904: Vibration as an exercise modality: how it may work, and what its potential might be

http://blogs.msdn.com/b/kinectforwindows/

Client:
Dr. Bjoern Buehring
Department of Medicine
School of Medicine and Public Health
(608) 265-6410
bbuehring@medicine.wisc.edu


49. Smartphone anemia detection application and device

smartphone_anemia

BME 400
Students assigned: Michelle Chiang, Nyna Choi, Jolene Enge, Russell Little
Advisor: Amit Nimunkar

Engineering Specialty: Bioinstrumentation, Medical Imaging, Global Health Engineering, Cellular Engineering
Medical Specialty: Medical Imaging, Pathology, Rural/Global Medicine
Skills: Cell Biology, Electronics, Human Subjects, Imaging, Software

Summary
Anemia is a very common condition worldwide causing significant morbidity and mortality. Many causes of anemia in developing countries are amenable to treatment. Point of care testing in clinics is usually lacking. Cell phones are very common worldwide even in developing countries. I would propose that we develop a machine based neural network software program that could diagnose various forms of treatable anemias. We would need a microscope (google foldscope for 1 low cost option) an image capture device (google Skylight image capture device) or a smartphone equipped with a microscope attachment and the software program.

Materials
As above.
Also slides and lancets.

References
Folscope
Skylight
Life lens project ( similar project for malaria diagnosis)

Client:
Dr. Philip A. Bain
Community Medicine
Dean Clinic
(608) 438-7719
philip.bain@deancare.com


50. User programmable haptic injection simulator

injection_simulator

BME 200/300
Students assigned: Brian Frino, Isabella Griffay, Brenda McIntire, Madeline Meier, Zachary Petersen
Advisor: Kris Saha

Engineering Specialty: Bioinstrumentation, Biomechanics, Biomaterials
Medical Specialty: Simulation
Skills: Electronics, Human Subjects, Mechanics, Software

Summary
Background
The injection of different approved "fillers" for cosmetic applications in Plastic Surgery can be a delicate and very difficult process to learn.

One of the challenges for the Resident in training and the Attending appears to be the variability of what is required to accurately control the delivery of the filler to the right location within the anatomical structures via the syringe.

These injectables have different viscosities, are injected from different size syringes with different bore and length needles. The physical properties of the liquid will also vary with ambient temperature.

Problem
Broad variability of tactile effort occurs when manually injecting fluids into tissue. This is also compounded by the size of the clinicians hand and strength. Too much pressure can cause over delivery and potentially cause asymmetry in the anatomy as the result. Conversely the under delivery because of over cautions syringe pressure is problematic to the cosmetic outcome.

How might Residents readily gain haptic simulation experience of such injections when differing syringe, needle, fluid viscosity and temperature conditions are present?

Solution Concept
In a limited search there appears to be all manner of anatomical models that allow users to experience needle placement practice.
In the realm of anesthesia simulators exist for the correct anatomical placement of needles for regional blocks.

However there does not appear to be any injection simulators that allow Faculty and Residents to gain experience and understanding of fine motor hand control required for the injection of materials with differing viscosity and mechanical design.

Needs Assessment Questions
1. Is there a need to help Residents and Physician experience the range of difference (physics) in injection technique?
2. Would a simulation device that did this be of interest to a Residency training program?

Concept
The concept comprises of a computer controlled device with a simple user interface that would allow a user to select common variables that represent a normal range of injection applications.
Selectable variables would include:
a. syringe type/size,
b. needle bore and length,
c. different generic injectable products.

The device would then have various hardware sets to represent different size syringes. This syringe hardware would be configured with haptic feedback components. The device would then measure ambient temperature and barometric pressure and compute the forces of injection resistance and apply this solution to the syringe device via the haptic components. The control section of the device would display the simulated syringe, needle and injectable type on a display.

The user would then be able to compress the syringe to get the feel of the mechanical effort required for the different combinations of injection. Once the syringe has been partly or fully compressed a re-set control would allow the syringe to return to a full or ready position.

Author note: This idea needs more clinician feedback and refinement and may have intellectual property potential. I can provide a UW Invention Disclosure report if you think this is viable.

Materials
Materials/ supplies have not been listed or assembled at this point.
Currently there are no computers or development tools for this project.

References
Anesthesia Simulator - describes a simple injection simulator.
http://bja.oxfordjournals.org/content/103/4/594.full

Epidural Simulator - mainly focused on needle placement.
http://epimedpain.com/productdetails.php?productid=118&categoryid=3&subcategoryid=47

Client:
Mr. Russ
Dept of Plastic Surgery
UW Hospital
(608) 263-2376
ward@surgery.wisc.edu


51. Smartphone cardio-auscultation stethescope

smartphone_stethescope

BME 400
Students assigned: Keum Chun, Alexander Eaton, Ruby Phung, Kevin Wreksoatmodjo
Advisor: Amit Nimunkar

Engineering Specialty: Bioinstrumentation
Medical Specialty: Cardiology
Skills: Electronics, Human Subjects, Software

Summary
Set up a microphone and associated app which can discriminate various cardiac anomalies, valve abnormalities, etc., based upon the sound patterns. I would set up baseline, database references for e.g. aortic stenosis, regurgitation, mitral regurg, mitral stenosis, ventricular septal defect, atrial septal defect for example, and perhaps even a rhythm analysis. A timer could indicate a specified pattern of 'listening locations' along the precordium and the sound patterns could be compared to database with resultant most likely diagnoses.

Materials
iPhone or similar
stethescope-like microphone adapter

References
not applicable // though New England Journal of Medicine and some others have some waveform guidelines for lung auscultation

Client:
Dr. Derek Clevidence
Family Medicine
Meriter Medical Group/ UW Clinical Assistant Prof Fam Med
(608) 228-5404
declevidence@gmail.com


52. Peripheral nerve stimulator tester

nerve_stimulator_tester

BME 400
Students assigned: Allison Berman, Colin Korlesky, Michael Quirk, Katherine Swift, Curtis Weber
Advisor: Mitch Tyler

Engineering Specialty: Bioinstrumentation
Medical Specialty: Anesthesiology
Skills: Electronics, Packing design

Summary
Anesthesiologists and ICU personnel use peripheral nerve stimulators (PNS) to measure the amount of temporary muscle paralysis produced by certain drugs during general anesthesia or during mechanical ventilation in the ICU. It is critical that the nerve stimulator devices are functioning correctly, in order that the paralyzing drugs are administered in the correct dose over time. Since these (relatively simple) hand-held PNSs are subject to daily physical abuse, they often malfunction. However, it is not readily apparent that they are malfunctioning.

I propose that students develop a simple "tester" small enough to be kept in the drawer of each anesthesia machine or at an ICU patient's bedside. It would have two snap buttons to attach the PNS wire leads. The tester would detect/validate several stimulation outputs by the PNS. The tester could have 5 LEDs. One could confirm proper operation of the tester. Once the two snap electrodes are connected to the PNS & the PNS is activated, one LED would confirm a stimulator output of approximately 20 milliamps, two LEDs with 40, three with 60 ma, and four LEDs with 80 ma. No lights indicate that the nerve stimulator is broken or that its leadwires are open.

We would like to have an initial design that would allow off-the-shelf components to be assembled in-house, for actual testing if PNS.

Materials
Sample PNS

Client:
Dr. Scott Springman
Anesthesiology
Medicine
(608) 263-8100
srspring@wisc.edu


54. Measurement of muscle function and balance to assess risk of falling

balance_measurement

BME 200/300
Students assigned: Lida Acuna Huete, Patrick Barrett, Patrick Cummings, Kieran Paddock, Kaitlyn Reichl
Advisor: Thomas Yen

Engineering Specialty: Bioinstrumentation, Human Factors, Biomechanics
Medical Specialty: Geriatrics, Physical Therapy
Skills: Electronics, Human Subjects, Imaging, Software

Summary
Muscle and physical function are predictors for adverse health outcomes such as falls, fractures and mortality. Parameters such as gait speed, the timed-up and go test, repeated chair rises or a test battery such as the “short physical performance battery” (SPPB) are well validated as indicators of potential risk for falls both clinically and in research. Parameters such as blood pressure, pulse and weight are being assessed during the annual visit to a primary health provider (or even more often) but muscle function is not. The UW hospital and clinics health system is currently looking into implementing protocols that would require muscle function testing with every patient at increased risk for falls. Unfortunately these tests have limitations that have prevented them from being integrated in routine medical care so far. These limitations include that the health care providers and other clinical staff are not familiar with the tests and feel uncomfortable doing them, that they are unfamiliar with the interpretations of the results and that there no easy way of integrating this information in current medical records.

This project aims to design a tool that will perform and record several different muscle function tests and then analyze and integrate the results into an electronic medical record using the Microsoft Kinect system. Standard motion analysis systems are too expensive, too large and too complicated to be used as a tool in routine clinical care. However with the development of motion analysis systems for the gaming industry, such as the Microsoft Kinect, now is affordable, small and fairly easy to use. Some data already exists that the Microsoft Kinect version 1 can be used to record gait and body posture. No system exists that would be able to use the Microsoft Kinect in a clinical system.

The tool / software we need should be able to:
- Instruct patients how to do a gait speed test, timed up and go test, repeated chair rise test and the short physical performance battery correctly
- Record these different tests with a click of a button
- Analyze the recorded data and calculate gait speed, time to perform the timed up and go, time for of the repeated chair rise test and the SPPB score
- Estimate risk of adverse outcomes (such as falls) based on available evidence (using cut-off values for the different tests)
- Integrate the results and the estimated risk for adverse outcome into a medical record system such as EPIC or the VA’s CPRS

If this project is successful we are hoping to propose a larger trial within the UW hospital and clinics system and the Madison VA to see whether it can be clinically implemented.

Materials
Microsoft Kinect System (version 1 and version 2)

References
Clark J Biomech. 2013 Oct 18;46(15):2722-5.
Clark Gait Posture. 2012 Jul;36(3):372-7
J Foot Ankle Res. 2013 Apr 8;6(1):14.

http://blogs.msdn.com/b/kinectforwindows/

Client:
Dr. Bjoern Buehring
Department of Medicine
School of Medicine and Publich Health
(608) 265-6410
bbuehring@medicine.wisc.edu


55. Sensor-enabled intubation trainer

intubation_trainer

BME 200/300
Students assigned: Bailey Flanigan, Kevin Knapp, Madalyn Pechmann, Tasnia Tabassum, Olivia Velazquez
Advisor: John Webster

Engineering Specialty: Bioinstrumentation, Biomechanics, Biomaterials
Medical Specialty: Medical Simulation
Skills: Electronics, Software

Summary
Direct laryngoscopy is an important lifesaving intervention that is considered a core skill for anesthesiologists and emergency medicine practitioners. In addition, direct laryngoscopy is commonly taught to medical students and residents across many specialties. The goal for direct laryngoscopy is to insert a breathing tube through the vocal cords without injuring surrounding structures such as the teeth or the posterior wall of the pharynx. Injuries are not uncommon and major complications do occur. Formal assessment of intubation skills is necessary for a number of reasons: 1) training programs either desire or are required to document competency [1]; 2) in several states, emergency medics are required to show maintenance of competency after training [2]; and 3) formal assessments allow development of criterion performance measures that are useful benchmarks for early training [3][4].
The use of sensor technology will allow testing and feedback for healthcare professionals learning intubation. Develop an improved sensor-enabled intubation trainer. Assess several, commercially available mannequins to determine if they are suitable for the proposed sensor technology.
Determine the pro’s and con’s of a variety of sensor technologies. Determine optimal sensor location for performance assessment. Review single and matrix pressure sensors. The sensors will provide real time feedback to the users. Develop the necessary amplifier electronics and display [5].

Materials
Intubation mannequins
Sensors

References
[1] Falck AJ, Escobedo MB, Baillargeon JG, et al. Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics 2003;112:1242.
[2] Texas Department of State Health Services. Skills Proficiency Form. EMS Certification & Licensing Group. Available at:
http://www.dshs.state.tx.us/emstraumasystems/SkillsProficiencyFormforLateRenewal.pdf.
[3] Sayre MR, Sakles JC, Mistler AF, et al. Field trial of endotracheal intubation by basic EMTs. Ann Emerg Med 1998;31:228.
[4] Kovacs G, Bullock G, Ackroyd-Stolarz S, et al. A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance. Ann Emerg Med 2000;36:301.
[5] Pugh CM, Clinical assessment and training system, US patent 8764450, 2014

Client:
Dr. Carla Pugh
Surgery
UW School of Medicine and Public Health
(608) 263-7502
pugh@surgery.wisc.edu

Alternate Contact:
Calvin Kwan
(608) 262-5241
kwan@surgery.wisc.edu


56. GE Healthcare: Uniform definition and management of contact surface biological hazards

GE_bological_hazards

BME 400
Students assigned: Hinnah Abid, Angela Beltrame, Susanna Kwok, Todd Zimmerman
Advisor: Tracy Puccinelli

Engineering Specialty: Biomaterials, Biomechanics
Medical Specialty: Radiology
Skills: Biomaterials, Chemistry, Imaging, Mechanics, Materials Science

Summary
The Magnetic Resonance Imaging industry continues to have an increased focus on controlling the potential for the spread of biological hazards due to contamination of system surfaces during patient scanning. The selection of materials, surface finishes and cleaning agents that facilitates appropriate surface cleaning without a negative impact on imaging quality or equipment durability continues to be a challenge. The main objectives of this project will be to:

1. Analyze the current approach to managing contact / surface hazards in MR scanners and associated environments.
2. Recommend uniform guidelines, approaches, new techniques and materials.
3. Provide performance specifications and test results for recommended materials, and cleaning agents. Document material durability under use conditions, and any negative impacts to material performance when exposed to cleaning agents. Confirm effectiveness of ability to sufficiently clean surfaces consisting of various combinations of material types and surface finishes.

Materials
Samples of typical patient/clinician contact materials and cleaning agents used on these materials can be provided. We can also provide tours of MR systems and demonstrate typical scanning workflows. Typical mechanical loading and durability requirements will be provided. Scanning of study materials to determine any negative impact on image quality.

Client:
Mr. Thomas E. Moran
GE Healthcare
(262) 521-6297
thomas.moran@ge.com


57. GE Healthcare: Anthropometric analyses for MR coil and system development

GE_MR_coil

BME 200/300
Students assigned: Charlie Andrew, Matthew Grondin, Alexander Letourneau, Shakher Sijapati, Emily Yachinich
Advisor: Wally Block

Engineering Specialty: Human Factors, Biomechanics
Medical Specialty: Medical Imaging
Skills: Human Subjects, Mechanics

Summary
MR Systems and Coils are used across an array of patient populations. Standard models and percentiles cover most, but regional, geographic, pediatric differences pose unique challenges for coil ergonomics and application. Many products are designed based on “95th percentile” male or female models, but rising rates of obesity, various disease states, aged populations, and even the need to diagnose cases exceeding the 100th percentile (e.g. football, basketball players) stress the design constraints of devices. Potentially conflicting objectives of MRI coil elements close to the anatomy of interest, and large anatomical variation often drive compromises.

This project will review current ergonomic and anthropometric data sources and models to assess the match of these models to different demographic groups.

The project will define an updated database and design rules for patient fitment in various anatomical regions associated with MR scanners and coils: e.g. Head, Neck, Spine, Chest/Abdomen, Upper Extremities, Lower Extremities, Whole-Body-Imaging, etc. for male and female across a range of pediatric to geriatric is desired. Additional data in the chest region will help with coil and scanner designs which accommodate transitions from head to neck to chest to abdomen to hips.

A statistical model is expected, and the model output should provide means to assess “goodness of fit” for a given coil/scanner design to the population. CAD models from the data are also desired.

Materials
GE can point to some of the existing references, such as “The Measure of Man & Woman, Revised Edition,” Henry Dreyfuss Associates, and “ Anthropometric Reference Data for Children and Adults: United States, 2003–2006,” Margaret A. McDowell, Ph.D., M.P.H., R.D.; Cheryl D. Fryar, M.S.P.H.; Cynthia L. Ogden, Ph.D.; and Katherine M. Flegal, Ph.D.

Client:
Mr. Andrew Formella
GE Healthcare, Magnetic Resonance
(262) 521-6372
andrew.formella@ge.com


58. GE Healthcare: MR phantom development

GE_MR_phantom

BME 200/300
Students assigned: Emily Carroll, Caius Castro, Austin Evans, Jacob Kanack, Laura Wierschke
Advisor: Wally Block

Engineering Specialty: Biomaterials, Biomechanics, Bioinstrumentation
Medical Specialty: Medical Imaging
Skills: Chemistry, Imaging, Mechanics, Software

Summary
Today's MR system and applications development relies heavily on invivo scans to evaluate and assess the system quality and capability, this method is no longer effective for a systems that are targeted for patient/subject population that is not readily accessible, such as the neonate population.

This project is to define and build the MR Phantom sets that will reflect the physiological and anatomical characters of the neonate population, for MR system evaluation and testing.

The project involves: 1). the project leader to work with GE MR system engineers to define the phantom set that is needed, including the key physiological and anatomical characteristics, 2). then translate into chemical and mechanical design of the phantom 3). procure the materials and build the phantom 4). evaluate and use the phantom in MR system environment.

Digital phantom (or idea dataset creation)is also desired for simulating the MR effects if they can be properly constructed.

Materials
GE can provide a modest budget to procure reference materials and tools to facilitate this project work. The project leader should submit the proposal and amount requested.

References
GE can provide technical guidance/reference on MR phantom construction knowledge.

Other example of references:

1.http://wiki.ismrm.org/twiki/bin/view/QuantitativeMR/QuantitativeMRWhitePaper2007

2. Steps toward a Simulator for Magnetic Resonance Images of the Neonatal Brain. K Kazemi 1, R Grebe 1, H Abrishami Moghaddam 1, 2, C Gondry-Jouet 3, F Wallois 1, 3

Client:
Dr. Zhu Li
GE HealthCare
(262) 442-3142
zhu.li@med.ge.com


59. Atrial fibrillation screener

afib_screener

BME 200/300
Students assigned: Justin Alt, Samuel Esch, Daniel Grieshop, Todd Le, Rocio Riillo
Advisor: Jeremy Rogers

Engineering Specialty: Bioinstrumentation
Medical Specialty: Medicine
Skills: Electronics, Human Subjects, Imaging, Software

Summary
Afib is a common, vastly under diagnosed condition. It is diagnosed by a telemetry strip, an ECG or clinically. There is a smartphone app that can diagnose it as well.

What woudl be even more useful is to develop a small device that could attach to a stethoscope that could be placed over the patient's chest and immedicately identify the rhythm.

It would have to be cheap, durable, accurate and easy to use.

Materials
telemetry device.
Display

References
BARCELONA, SPAIN — Incidentally detected atrial fibrillation (AF) in asymptomatic and ambulatory patients is associated with a significantly increased risk of stroke, MI, and all-cause mortality, but treating the detected arrhythmia with oral anticoagulants can significantly improve the prognosis of these patients, according to the results of a new study.

The new data suggest that it would be worthwhile to initiate a communitywide screening program to detect and treat AF in these asymptomatic patients. Such a screening program would even be cost-effective, say researchers.

Dr Ben Freedman (Concord Hospital, University of Sydney, Australia) told heartwire that the prevalence of AF worldwide is only going to increase with the aging baby boomers. "This epidemic is looming," he said. "In the next 10 or 20 years, we're going to see this enormous increase in atrial fibrillation. It's going to be asymptomatic and silent."

And unfortunately, the first manifestation of AF can be devastating. "Often, in patients, the first time you learn they have atrial fibrillation is when they present with a stroke," said Freedman. In fact, he said that AF is responsible for 20% to 33% of all strokes and that 20% to 45% of individuals who have an AF-related stroke did not have a prior diagnosis of AF.

Freedman, along with colleagues Dr Carlos Martinez (Institute for Epidemiology, Statistics, and Informatics, Frankfurt, Germany) and Dr Nicole Lowres (University of Sydney), published the new data on the prognosis of incidentally detected ambulatory AF in the August 2014 issue of Thrombosis and Haemostasis[1] and also presented more research on the topic here at this week's European Society of Cardiology (ESC) 2014 Congress.

Client:
Dr. Phil Bain
Dean Clinic
Dean
(608) 438-7719
philip.bain@deancare.com

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