Drones for Surgical Inventory Management in Rural Hosptials
The operating room has historically been one of the highest revenue generators for rural hospitals with the operating room often accounting for over half of a hospital’s supply expenditures. Operating room inventory management has been of interest lately as this is also one of the largest contributors of waste and cost for the hospital. Surgeons today are training with more and more tools and supplies that all come with expiration dates. For lower volume operating rooms in rural and community hospitals it is common for surgeons to be limited by their current inventory. By taking inspiration from Zipline, a drone based logistics company, we proposed a hub-and-spoke distribution system for critical access hospitals around larger medical centers or supply depots. These larger medical centers with high volumes can serve as reservoirs for the satellite hospitals. When an unusual case arises in a rural hospital that requires less frequently used medications, supplies, or instruments, these materials can be immediately flown to the smaller location as an alternative to transferring the patient in. Patients benefit by remaining closer to home, rural hospital inventory waste is minimized, and medical risks and costs associated with a transfer are nearly eliminated.
The RAHKit by Austere Surgical
When you're operating in outerspace or the back of a mobile ICU in a combat zone, you've got a few extra challenges to cope with that an earthbound operating room might not encounter. Speed, usability, and organization are some of the first characteristics that a field medic or crew medical officer might care about most. There's no time or stablity to setup a mayo tray and every minute matters. Thats why we created the Rugged Austere Health Kit: a system for invasive medical procedures in extreme, remote environments like Antarctica or the Lunar Surface. It is an efficient system to sterilize, store, and display all the equipment you would need to do surgery on the go, including your first assist.
DiaSense: Preventing Ulcer Progression
Over 34.2M Americans have diabetes and $237B is spent on direct costs of diabetes each year. Of this, $15B is spent on foot ulcer treatment alone as more than half of people with diabetes develop some type of neuropathy, the primary modifiable risk factor of ulcers in this population. Currently, patients with diabetic peripheral neuropathy (DPN) rely on early hotspot identification, padded soles, offloading boots, and diabetic shoes, with compliance being the major issue. Through expert interviews, there is a need for a better method to slow and prevent the progression of hot spots and other complications in patients with DPN. Our team is proposing DiaSense, a wearable device that replaces the lost sensation of pain with a safe and actionable stimulus that modifies gait to offload hotspots. The discrete design was guided by experiences from patients, podiatrists, and vascular surgeons to improve patient compliance, satisfaction, and recovery. Early user-feedback demonstrated useful validation that our device modifies walking behavior in healthy participants, and helps justify a larger study with patients who have diabetic peripheral neuropathy.
A Backountry Ankle Brace for Self Evacuation
On backcountry hiking trips ankle injuries are extremely common and loss of function and weight bearing activity can cause serious complications. The ability to self extricate and walk out after an injury could dictate your chance at survival. Unfortunately hikers are often deciding between a few dollar's worth of tape and a multi-thousand dollar helicopter evacuation. This gap presents an appealing opportunity for a way to triage and treat an ankle injury in a low resource environment to restore an injured individual’s mobility to reach a clinician without exacerbating the injury. Backcountry medical care requires extreme volume and weight minimization while maximizing an object's versatility. We therefore designed a carbon fiber framed first-aid kit that doubles as a first aid kit container and a fully-offloading ankle brace to facilitate self extrication in an emergency.
Preserving Prenatal Care in Rural America through Hybrid Care Packages
In recent years I’ve seen headline after headline announcing the closure of a hospital or Labor & Delivery unit in a rural community. Mothers in rural America are having to travel further and further to find an obstetrician, particularly in high risk pregnancies. The COVID-19 pandemic inspired successful trials of hybrid care models that conduct some pre and post natal visits through telehealth. Unfortunately, some mothers lack the high-speed internet or tools needed to facilitate widespread adoption. We proposed a system for loaning a stand-alone equipment package for short term telehealth access for high-risk mothers requiring long travel distances to an obstetrician. It includes high-speed satellite-based internet access, video conferencing technology, and tools for maternal and fetal monitoring (POC US, vitals, urine, glucose, etc).
Diabetic Peripheral Neuropathies
Diabetes is one of the most prevalent chronic diseases in the world’s population. Neuropathy, a common complication of diabetes, accounts for more hospitalizations than all other complications of diabetes combined. Loss of sensation and muscle control in the legs and feet (Peripheral Neuropathy) is a subset of neuropathy that is particularly relevant to the everyday task of walking. To date, there is a lack of reliable biomarkers that capture the onset and progression of diabetic peripheral neuropathy (DPN). Current work produces subjective measurements with moderate sensitivity, requires invasive and costly nerve conduction measurements, or involves complicated equipment and highly trained personnel. We aim to help maintain quality of life and inform treatment in patients with diabetes by tracking the effects of disease progression on neuromuscular control. We will do this via the Valero Dexterity Test. This test has been shown to quantify an individual’s ability to control dynamic foot-ground interactions with low forces while safely seated. These dynamic foot-ground interactions rely on sensorimotor processing to successfully use the feet while walking. If the data supports our hypothesis, this may serve as a novel biomarker to objectively quantify DPN safely and simply in the outpatient clinic. In particular, such a test is directly relevant to functional gait measures as a biomarker for daily living activities and risk of falls. Additionally, it can guide rehabilitation to avoid wound healing complications after surgical repair of necrotic defects on the legs and feet. This project is currently collecting data at USC.
Neruomuscular control after Stroke
There are many possible explanations for the redundant muscular actuation of our bodies, and the control of this system is currently a hot topic in neuroscience. For example, we have four quadriceps muscles with the singular task of extending our knee. Why four, and not one, two, or eight? Unfortunately, our number of quadriceps is not fully customizable yet, so we are stuck with four. This structure turns our attention to the difficult task of using four muscles to accomplish one task, or in other parts of the body, using two muscles to perform three tasks. Imagine having four gas pedals in your car, each responsible for a separate wheel. Our idea of driving would be much more complicated considering that wheels spin at different speeds on turns. This is the problem our brain has to confront millions of times a day. As expected, the complex neuropathways that drive our muscles are often the most vulnerable to disruption after a stroke. While participating in a team studying this control of the upper extremity, I was amazed by my team’s crude prototype. I first redesigned the system to be sleek, portable, and user-friendly. I am currently using this new device to continue investigating motor control in stroke participants alongside age-matched healthy participants.
Returning to Sports after ACL Surgery
We all know somebody with a bad knee. It might be your elderly neighbor who has been wearing them down for years or even your teenage sister that ruined hers on the soccer field. Soccer has the highest incident of ACL injury, right up there with lacrosse, basketball, and football. Ask any engineer, and they will surely recognize the mechanically unstable structure of the knee. There is ongoing research answering how our bodies stabilize a notoriously unstable joint like the knee. Others are exploring more elusive questions like why female athletes are almost eight times more likely to injure their ACL when compared with the opposite sex. I jumped onto a fascinating project at USC that is attempting to quantify the recovery after ACL surgery. Our goal is to eliminate the subjective, blanket treatment plans for all ACL recoveries. With quantitative data, we hope to eradicate redundant PT appointments for those making speedy recoveries while providing strong support for patients who need the extra sessions that insurance is hesitant to cover. Medical knowledge is exploding, and with it, a new era of personalized, data-driven treatments is on the horizon.
Tendon-Driven Robotics
As the field of robotics advances, the further robots stray from the likeness of humans. Our unique species has evolved over thousands of years, yet we still have four separate quadriceps muscles extending our knee. Most of society glosses over these observations as sources of inspiration, but we wrestle with these ideas every day at the Brain-Body Dynamics Lab. As a young undergraduate, I explored the fascinating world of tendon-driven robotics as a platform for affordable prosthetics and ongoing neuromorphic research. I set out to design the most versatile design of a tendon-driven arm. I defined a versatile arm to mean that it could be as strong as possible in all directions. This process produced what I coined a Multi-Moment Arm (MMA) joint. Through computational optimization, 3D modeling, and some thoughtful tendon routes, I prototyped the most versatile two joint arm possible.