STEM Model of Medicine

1. Biomedical Engineering formulation of Anatomy, Physiology, Medicine and Surgery:

Through biomedical engineering science analysis of anatomical structures, physiological and organ systems, medical tests data, and surgical procedures, we have developed new insights in:

(i) Anatomy, in how anatomical structures are intrinsically optimally designed for their functional performance, as for example hyperboloid shape of the vertebral body and ellipsoidal shape of left ventricle.

(ii) Physiology, in quantifying physiological systems and developing indices for their function and dysfunction, leading to precision medical diagnostics, such as cardiac contractility index for risk of heart failure.

(iii) Medicine, by developing biomedical engineering formulation of medical diagnostic and assessment methods and indices, including a new concept of non-dimensional indices in medical assessment, such as diabetic index.

(iv) Surgery, involving customized biomedical engineering analysis of surgical procedures (such as of coronary bypass surgery), and design of prosthetic devices (such as vertebral body cage for fractured vertebral body, to preserve its intrinsic hyperboloid shape).

Together, they can provide a more rigorous and precision formulation of medicine, which can be incorporated into the medical curriculum and then also in clinical care.

2. Medical Education and Research Programs, involving biomedical engineering formulation of medical and surgical systems:

Herein, I am describing some of my Education and Research Programs in (i) Physiology, Medicine, Orthopedics and Surgery, (ii) Sports Biomechanics and Medicine, and (iii) Mind-Body Psychosomatic Medicine.

Cardiovascular Medicine: Left Ventricular Wall Stress and Contractility Index, Vector Cardiogram and ECG Signal Processing, Coronary Blood flow and Myocardial Perfusion, Myocardial Infarct detection and Heart Failure, Intra-Ventricular Blood Flow and Candidacy for bypass surgery, Pulse wave velocity and Detection of Arteriosclerosis, Aortic Pressure Profile and Aortic stiffness determination, Coronary Bypass surgery design for maximal patency, Prosthetic Aortic and Mitral Valve designs.

Pulmonary Medicine: Lung Ventilation modeling for Lung disease detection, Lung Ventilatory Index, Lung Gas Transfer performance analysis, Determination of O2 and CO2 Diffusion coefficients, Non-dimensional Gas-transfer index, Indicators for Extubation of Mechanically ventilated COPD patients.

Diabetic Medicine: Glucose-Insulin Regulatory Control systems, Oral Glucose Tolerance Test modeling and model parameters determination, Non-dimensional indices for glucose and insulin responses, Non-dimensional Diabetic Index for Diabetes detection.

Renal Medicine: Kidney Functional analysis, Countercurrent mechanisms and modelling of urine concentration, Osmolality in the descending and ascending limbs of the Loop of Henle, compartmental model of renal clearance kinetics, Physiological measurement of the Glomerular Filtration Rate (GFR), Relationship between blood creatinine levels and the renal clearance rate, Renal clearance convolution analysis; Renography modelling and determination of normalized urine flow rate index to differentiate between obstructed and normal kidneys.

Orthopedic Biomechanics and Surgery: Osteoporosis Index for osteoporosis detection; Structural analysis of plate-reinforced fractured bone and Optimal design of fixation plate; Osteosynthesis using hemihelical plates for fixation of oblique bone fractures, Finite Element analysis and design of Bone-Plate assemblies and Helical Fixation plate.

Spinal Biomechanics and Surgery: Biomechanical Simulation of Scoliotic Spinal deformity and Correction, Presurgical Finite-element Simulation of Scoliosis Correction, Structural analysis of the Spinal Vertebral body as an intrinsically optimal lightweight and high-strength structure, Fractured Vertebral body fixation techniques and design of a vertebral body cage, Clinical Biomechanics of Spinal Fixation: Anterior, Posterior Fixations; Structural analysis of Intervertebral Disc as an intrinsically optimal minimally deformed structure under spinal loading, Nucleotomized Disc model analysis and solution for disc herniation.

Sports Biomechanics and Medicine: Optimal Walking Modality based on modeling the leg as a Simple-compound pendulum, Optimal Jogging Mode based on Double-compound model of the lower limb; Analysis of Spinning Ball Trajectories of Soccer kicks and Basketball throws, Analysis of high jump and pole vault, Analysis of tennis serves and cricket bowling, Analysis of Ice Hockey Slap shots and Field Hockey Drag flick; Cardiac Fitness Index based on Treadmill test, Evaluation of Hip Joint based on Differential equation model of the Swinging Leg motion, to determine the hip joint damping and stiffness parameters.

Mind-Body Psychosomatic Medicine, Therapy for Psychiatric Disorders, Regenerative Medicine: Mind-body rejuvenation, by boosting cognitive function, increasing gray matter density in the hippocampus, lowering blood pressure and boosting the immune system, reducing depression and easing stress; Triggering of neurohormonal mechanisms that bring about health benefits, as evidenced by increased parasympathetic and reduced sympathetic nerve activity and increased overall HRV, reducing stress and anxiety; Enhanced release of melatonin, which has anti-inflammatory, immune-stimulating, anti-oxidant and regeneration-enhancing properties; Development of non-volitional EEG Biofeedback System Therapy for treating neurological disorders.

Non-dimensional Physiological Indices in Medical Assessment: New Concept of Non-dimensional Physiological Indices (NDPIs) or Physiological Numbers (PHYNs) for analyzing Physiological Systems and Medical Tests’ Data, Sports Fitness index, Cardiac contractility index, Lung ventilation Index to detect lung disorders, Diabetes diagnosis index from oral-glucose-tolerance test, Arterial stiffness or arteriosclerosis index, Mitral Valve Elasticity Index from heart sound and echocardiography data, Bone osteoporosis index, Hospital Departments’ performance-cost indices, and optimizing budget allocation for maximizing patient care with cost-effective hospital operation.

3. What is needed for Medicine, towards precision medicine for the best treatment outcomes:

It is our objective to (i) make medicine more precise in its diagnosis, (ii) improve the outcomes of medical/surgical procedures, and (iii) patency of surgical procedures, implants and prostheses.

For this purpose, we need to make Medical sciences more precise, so that they can be translated into more reliable medical and surgical procedures. Now medical sciences, such as anatomy, physiology, biochemistry, microbiology, molecular biology, pharmacology are also undergoing transformation into more scientific and mathematically oriented disciplines. For example, physiology can be taught as physiological physics, anatomy can be taught as anatomical engineering, biology subjects can be taught as systems biology and mathematical biology.

In other words, we need to incorporate the full scope of STEM subjects into Medicine, into both medical sciences and clinical sciences.

4. Modern Medical Curriculum, to educate scientific and technological doctors to offer the best healthcare to their patients:

Many medical schools have started to develop a new medical curriculum, for the next generation of primary care physicians. This curriculum provides an education that integrates formal classroom-based medical science knowledge with patient-centered and disease-focused medical education. Essentially the new curriculum features foundational medical sciences courses integrated with early engagement with patients and clinical training, involving teaching medical students about the health care system, and how to integrate use of technology into the practice of medicine. The four inter-woven pillars of this new medical curriculum are Health Systems Sciences, Medical Sciences, Healthcare Informatics, and Clinical Sciences. The shift in this new curriculum is to make students more informed about healthcare delivery.

However, this modern curriculum does not make for precision medicine and to educate a new generation of smart medical doctors with the competency to apply all the modern STEM disciplines into clinical practice. In fact, in this modern medical curriculum there has still remained the need for engineering-physics-mathematics incorporation into medical sciences and biomedical engineering incorporation into clinical sciences, in order to cultivate knowledge for more quantitative medical and clinical sciences leading to more precise medical and surgical procedures—which is where medicine is headed in the 21st century.

For this purpose, we are proposing the following MD-PhD (Medical & Surgical Engineering) Program, to be offered in the School of Medicine, in collaboration with the Biomedical Engineering Department.

5. MD-PhD (Medical & Surgical Engineering) Program (to be offered in the School of Medicine):

With the help of the Biomedical Engineering Department, the PhD component of this novel program will consist of Courses in:

1. Physiological Engineering:

• Physics and Engineering formulations of Physiological Systems

2. Medical Diagnostics:

• Signal and Image Processing, Medical Diagnostic Apps.

3. Medical Engineering:

• Cardiological and Cardiac Surgical Engineering, Renal Engineering, Neurological Engineering, Orthopedic and Spinal Surgical Biomechanics, Rehabilitation Engineering.

4. Surgical Engineering:

• Cardiac Surgical Engineering (in coronary stenting and bypass surgery),

• Orthopedic and Spinal Surgical Engineering (of bone fracture fixation, joint replacement, and spinal fracture fixation), involving computerized surgical simulation to analyze and plan patient-specific surgical procedures for obtaining optimal outcomes.

This Program will educate new set of smart medical doctors, who are learned in biomedical engineering formulations of medical systems and surgical procedures, and are able to implement them in clinical care.

6. Promoting significant advances in Medical education, teaching, research and practice, through my textbooks:

I am now providing some insights into my recent textbooks which are designed to be developers and transcribers of new medical knowledge and concepts into medical education and learning. For that purpose, I have attached information on my following three books:

(i) Cardiology Science and Technology (Taylor and Francis) designed as computational format of Cardiology, involving (i) left ventricular wall stress, contractility and vector cardiogram, and (ii) aortic and coronary blood flow and customized coronary bypass surgery.

(ii) Biomedical Science, Engineering and Technology (InTech publishers), integrates biomedical science, biomaterials and implants, biomedical engineering, biotechnology, physiological engineering, and hospital management science and technology. Together, these topics are incorporating STEM into translational medicine.

(iii) Computational and Mathematical Methods in Cardiovascular Physiology (World Scientific), which has transformed cardiovascular physiology into a STEM discipline.

Together, these books are providing a gateway for this new emerging scenario of (i) science and engineering based medical educational curriculum, and (ii) technologically oriented medical and surgical procedures.

I am now also launching a new Book Series on Biomedical Engineering in Translational Medicine, with the Institute of Physics. This book series will provide the textbooks needed for both the Biomedical Engineering Department and this new format of School of Medicine.

7. New Era School of Medicine:

Together, this will help develop a new era school of Medicine.