Develop an automatic device that removes the epidermis of skin for use in the operating room

Client: Dr. Carol Soteropulos

UWSMPH Student(s): Todd Le

UW-BME Students: Joshua Giarto, Young Kim, Noah Ruh, Colleen Cuncannan, Tatum Rubald, Michael Chiariello

Automatically control intracranial brain pressure by designing a novel valve.

Client: Dr. Joshua Medows

UWSMPH Student(s): Sarah Thornton

UW-BME Students: Yue Mo, Victoria Trantow, Ronnie AlRamahi, Andrew Budde, Amber Rollette, Saketh Challa

Obtain a plasma sample from a patient without depleting hemoglobin

Client: Prof. Jacques Galipeau

UWSMPH Student(s): Momin Mohis

UW-BME Students: Tsani Rogers, Angelica Lopez, Akshay Vankayala, Sandhya Nagarajan, Siva Ramalingam, Addison Dupies

To take clinically useful photographs of the optic disc through a non-dilated pupil from a distance or from another room

Client: Dr. Nick Von Bergen

UWSMPH Student(s): Leah Gruen

UW-BME Students: Mitchell Josvai, Kate Eichstaedt, Russell Heintz, Dominic Dovalis, Connor Link, Melissa Bouharati, Leah Gruen

This project aims to design a lumbar spine model (skin, subcutaneous tissue, bones, ligaments, epidural space, dura, subdural space, etc) that can be utilized in a repeated fashion to help teach learners the interventional techniques required prior to performing injections on real patients.

Client: Dr. Michael Suer

UWSMPH Student(s): Katharine Tippins

UW-BME Students: Ani Srinivasan, Emma Hansen, Kiera Miller, Xu He

To design a microsurgical training tool using a smartphone connected to VR glasses to simulate practice under a surgical microscope

Client: Dr. Ellen Shaffrey

UWSMPH Student(s): Kat Milosavljevic

UW-BME Students: Jason Wang, Xiaoxuan Ren, Martin Janiszewski, Jiong Chen

To develop reliable and quick ways to attach navigation arrays to standard pins and osteotomes

Client: Dr. Ken Noonan

UWSMPH Student(s): Anthony Roberts

UW-BME Students: Nomita Chandra, Shankar Sundaresan, Eric Cimino, Lily Gallagher, Tony Tu, Emma Brower

Create a functional meniscal suture device that can successfully pierce through the tissue, pass a suture through, and selftie a luggage knot stitch all in one step.

Client: Dr. Brian Walczak

UWSMPH Student(s): Ian Kuckelman

UW-BME Students: Hailey Frye, Samantha Barr, Thor Larson, Elizabeth Gunderson, Jack Stamer

Create an attachment to the guide needles that mitigates the risk of an air embolism.

Client: Dr. John McDermott

UWSMPH Student(s): Collin Evenson

UW-BME Students: Nicholas Goetz, Abdel Daoud, Brooke Pernsteiner, Mitchell Korbel

Significantly reduce pain and long-term disability associated with routine sonographic medical imaging.

Client: Dr. Emily Lewis

UWSMPH Student(s): Vanish Jain

UW-BME Students: Aaron Skubal, Everett Cartier, Stephen Foley, Roxi Reuter, Annabel Frake, James Koeper

To develop the prototype and submit a patent for this first of its kind helmet

Client: Dr. Tracy Downs

UWSMPH Student(s): Allison Zinter

UW-BME Students: Anne Wong, Haley Oswald, Lily Jaeger, Kenzie Hurt, Emily Lai, Gabrielle Zuern 

To produce a simulator that medical residents and students can use to learn and practice prostate radiation oncology procedures (e.g. placement of radioactive seeds into the prostate).

Client: Dr. John Floberg

UWSMPH Student(s): Temisan Blagogee

UW-BME Students: Zihan Wang, Yicheng Ma, Francisco O'Neill Rodriguez, Josh Andreatta, Jack Maher, Hannah Nyman

Develop a model of the lungs and blow flow to the lungs that shows how ventilation/perfusion mismatching leads to hypoxemia. A textbook illustration is provided as a sample model.

Client: Dr. Chris Green

UWSMPH Student(s): Remington Finn

UW-BME Students: Brittany Glaeser, Kaitlin Lacy, Zoe Schmanski, Jenna Eizadi

Anaphylaxis is an unpredictable, acute, and potentially life threatening condition. It is caused by an immunoglobulin E (IgE) mediated hypersensitivity reaction to a benign antigen. Upon first exposure to an antigen, for example, peanuts or shellfish, the adaptive immune system generates a large amount of IgE antibodies. Normally, IgE is at a relatively low plasma concentration, so most of the IgE antibodies will bind to mast cells or basophils. Reexposure to the antigen promotes the systemic release of mediators such as histamine, which lead to the experienced symptoms. Immediate treatment is necessary for a positive outcome.

The occurrence of anaphylaxis is increasing across all ages in the U.S. Since children between 5-9 are most commonly affected by anaphylaxis, our team has decided to specifically focus on improving treatment in pediatric patients.

Current treatment involves self-injectable epinephrine intramuscularly in two doses, 0.15 mg and 0.30 mg. Since the recommended epinephrine dose is 0.001mg/kg, these doses are applicable to children weighing 15 kg (33.1 lbs) or 30 kg (66.1 lbs). The dose can be repeated every 5-15 minutes depending on the patient's response to the previous dose. Epinephrine reverses the pathophysiological effects experienced during anaphylaxis by increasing peripheral vascular resistance to increase blood pressure and flow.

The current EpiPen and EpiPen Jr autoinjector pack is very expensive ($650-$700) making it difficult for some families to afford treatment, even though it is necessary. Most of the time, individuals need multiple EpiPens to bring with them to work, school, home, and other significant locations which can lead to families carrying expired EpiPens. In a study evaluating patient's EpiPen or EpiPen Jr autoinjectors, many were past the expiration date, leading to significantly reduced epinephrine bioavailability. EpiPens maintain bioavailability for about a year until a new one must be purchased.

Although epinephrine injections are the only current viable treatment option, families still do not know how to recognize the early signs of anaphylaxis, administer injections to a child correctly or help teach the child to avoid food triggers. Studies have shown that parents of severely food-allergic children and teenagers cannot correctly administer their self-injectable epinephrine or may not have it readily available. Pediatricians are not as familiar with EpiPen usage and may not fully explain the proper placement and use to patients and their families. It was also investigated whether parents are aware of their child's anaphylactic symptoms and able to correctly utilize the EpiPen. Studies showed that the EpiPen device was only used in 29% of recurrent anaphylactic reactions and parents were unaware of anaphylaxis symptoms or EpiPen use. Not only is it difficult for children to use their EpiPen during anaphylaxis, sometimes the EpiPen may be expired or their caregivers may be unaware of its correct use.

A dissolving tablet would be beneficial to not only children, but also their families and caregivers. It would be easy to administer, requiring minimal training, and be able to come in a variety of doses. The increase in dose availability would allow for the child to quickly recover from anaphylaxis without having to repeatedly self-inject epinephrine to achieve proper dosage for their weight. Children may have needle fears and be more comfortable using a self-dissolving tablet. It can be difficult for them to quickly and efficiently administer epinephrine through the EpiPen during anaphylaxis, since they are experiencing a life-threatening reaction. Using a rapidly-disintegrating sublingual tablet (RDST) for epinephrine delivery would be easier to deliver, allow for the proper dosage, be favorable for pediatric patients, and have a longer shelf life.

Our product seeks to combine methodologies to develop a safe and effective alternative to epinephrine auto-injectors for treating symptoms of anaphylaxis. Our proposed approach integrates epinephrine nanoparticles with taste-masking and disintegrant compounds into an RDST tablet.

The proper administrative dose of epinephrine is also a large barrier of the current device. Current auto injectors come in either 2 doses: 0.15 mg or 0.3 mg, however this does not factor in weight and age of the user. If the dose is too low, several auto injections are necessary which can lead to more discomfort with the use of the injection. With RDST, the concentration of the tablet is controlled and increases the amount accessed by the body. The highly vascularized sublingual mucosa helps with drug absorption into the venous circulation. Epinephrine bitartrate, a hydrophilic compound, is absorbed through passive diffusion, which gives the concentration gradient (Fick's Law). The high drug concentration in the sublingual space drives epinephrine through the mucosal epithelium into the interstitial fluid and eventually into the venous circulation. Overall, using RDST over auto injection would allow for a variation in concentration and an increased access to circulation since it would directly enter the bloodstream rather than through muscle.

Reducing particle size increases diffusion and absorption, a critical component in treating anaphylaxis. As shown by Rawas-Qalaji et al, reducing epinephrine crystal particle size from 131.8 - 10.5 micrometers to 2.5 - 0.4 micrometers increased saturation solubility and dissolution rate, leading to an increased concentration gradient and permeation. In a follow-up study, maximum plasma concentration and time of maximum plasma concentration were comparable to those achieved via a 0.3 mg injection of epinephrine into the thigh muscles.

For any sublingual medication, a small particle size is crucial for two reasons: a lack of saliva in the sublingual area reduces dissolution, and discomfort can arise from holding a tablet sublingually for an extended period of time. For a time-critical medication such as epinephrine, these properties become even more important. Thus, we intend to reduce the epinephrine crystal size further, into the nanoscale range. As anaphylaxis can lead to swelling of the oral sublingual mucosa, a physical reduction in tablet size would allow for easier placement. Furthermore, the addition of bitterness-masking, lubricating, disintegrant, and/or flavor-enhancing compounds would inevitably increase the tablet size, so a reduction in crystal size would be necessary to maintain an overall small volume.

A high shear fluid homogenizer can be used to fabricate the nanoparticles. Epinephrine bitartrate suspended in isopropyl alcohol will form nanoparticles when exposed to high pressures (up to 30,000 psi). This process can be repeated if smaller particle sizes are desired. After centrifuging, the nanoparticles undergo lyophilization to improve stability. Various concentrations of epinephrine bitartrate can be used to test uniformity.

There are several excipients that could potentially prove beneficial for the epinephrine tablet. As epinephrine is unpleasantly bitter on its own, a taste-masking compound would improve palatability. Drug taste is a large administrative difficulty confirmed by more than 90% of pediatricians. The problem with current RDST epinephrine is its bitter taste, highlighted even more in children due to their sensitivity. The addition of either sugar, acids or salts significantly reduces the bitterness of pharmaceuticals. Citric acid is an effective taste-masker; one study showed that adding citric acid reduced the perceived bitterness of epinephrine by 85%. If further palatability is desired, mannitol, a sugar alcohol, could also be considered. As a sublingual medication, a disintegrant would be a useful addition to the epinephrine pill. When in contact with water, disintegrants expand and dissolve, which allows the tablets to more easily break apart when placed under the tongue. Options for our product include sodium carboxymethyl cellulose or calcium carboxymethyl cellulose, among others.

This form of epinephrine would be a useful alternative to auto-injectors, particularly for pediatric patients or those with needle phobias. It is inexpensive to develop, can be produced at scale, and is shelf-stable up to three times as long as injectable epinephrine. Currently, the epipen auto injection shelf life is only about 20 months. Children may not need to use the epipen during that time period, which could lead to expired usage and wasted cost. On the other hand, RDSTs may have a shelf life of up to 7 years, which is more realistic and affordable. Our primary clients would be immunologists or primary physicians who prescribe it to patients and pharmaceutical companies who make the product. Increased competition in this niche market would drive down auto-injector prices, making treatment of every variety more affordable to consumers.

Client: Dr. Liliana Hernandez Marin

UWSMPH Student(s): Grigor Simitian, Alyssa Fleischman

UW-BME Students: Marisa Vattendahl Vidal, Sophia Nehs, Katarina Martinet, Gwendolyn Johnson 

Currently, intraventricular drainage systems require consistent nursing assistance and for patients to remain in the same position unless a nurse is there to adjust it. Currently, nurses have to manually adjust and level the height of the collection container which is time-consuming and imprecise. A device is needed that eliminates this leveling process through the precise regulation of fluid flow.

Client: Dr. Joshua Medow

UWSMPH Student(s): Derek Steck, Nicholas Zacharias

UW-BME Students: Ronnie AlRamahi, Amber Rollette, Yue Yang Mo, Drew Budde 

It is crucial that air not be injected during neuroendovascular interventions (percutaneous, transarterial, endovascular procedures). Injection of bubbles results in mini-strokes and may complicate these procedures. Currently, syringes of saline and contrast, often in mixtures, are filled by hand and are "degassed" based on visual inspection. The syringe is then manually connected to the catheter and the contents injected. This process is tedious and often incomplete with small bubbles being inadvertently injected.

A potential solution to this problem could be a manifold with ports for syringes containing saline, contrast, and a 50% mixture which would be connected to the angiography catheter and automatically filled in an air-free manner after each injection.

Client: Dr. Azam Ahmed

UWSMPH Student(s): Katrina Ruedinger

UW-BME Students: Dan Wildner, Jared Piette, Sara Jorgensen, Andrew Kurth 

Central venous catheter (or central lines) are large bore venous access devices that access central veins, veins that feed almost directly into the heart. They are used for high volume trauma resuscitations, dialysis, or administration of powerful intensive care medications.

Placement of a central line typically involves a clinician inserting a needle into a central vein under ultrasound guidance, guiding a wire through the needle, then inserting the line over the wire; this is known as the Seldinger Technique.

However, there are several significant pitfalls to this procedure.

First, central veins are all located next to very, very important structures (major arteries or lungs), and injury to one of these other structures by inaccurate needle guidance can lead to severe injury or death.

Second, operator skill can be a large determinant in the success of placing a line as well as how long it takes. This can be problematic in crashing patients who desperately need central venous access.

Third, present technique has what I perceive as a massive mechanical flaw. Placement of a central line requires keeping constant suction on the needle with a syringe with one hand while operating the ultrasound with the other. When the vein is cannulated by the needle, blood returns due to the suction, so the suction is critical. However, syringes are an awkward device to maintain suction on, made all the more difficult by the need to make fine and accurate movements under ultrasound guidance near many important structures.

Fourth, confirming line placement (that it was not put in an artery) can be difficult, with the most common bedside techniques including assessing cannulated vessel pressure (arteries are high pressure systems, veins low pressure systems, so ensuring a fairly low pressure strongly implies that the proper vein has been cannulated). However, there is presently no easy way to measure pressure.

Fifth, passing the wire through the needle and the central line over it can be awkward and basically requires the operator to have a third hand. Worse, if the clinician ever loses control of the wire, it can be sucked into the patient's venous system requiring further invasive procedures to have it removed at a later time (yes, this actually happens).

My suggestion would be developing an all in one device that solves pitfalls 3-5 to improve outcomes in 1-2. It would:

-Maintain suction with less awkward hand positioning

-Have a fluid pressure sensor built in

-Would automatically pass the wire through the needle and then the central line over the wire

There would be a large market for this product, and I would be enthusiastic about bringing it to patent/production/marketing.

Client: Dr. Christopher Vandivort

UWSMPH Student(s): James Xu, Benjamin Nguyen

UW-BME Students: Sam Crowell, Ali Schulz, Rachel Minehan, Anna Samuelsohn

In both reconstructive and vascular surgery frequent monitoring of vessel patency/sufficiency from the surface of the skin is a critical practice which guides major clinical/surgical decisions. This is typically accomplished via pencil doppler which requires the application of gel and searching for the a doppler signal each time one wishes to evaluate. This project would seek expand on the device already created by a previous BME design team. The previous design was a self-adhesive capsule that could be placed on the patient's skin for multiple days both marking the vessel under evaluation and holding the ultrasound gel for quick and easy assessment.

Ideas: integration of ultrasound into the adhesive device that would only need to be plugged in when assessing doppler signals without even touching the patient.

Client: Dr. Nicholas J Albano

UWSMPH Student(s): Gabe Sobczak, Adati Tarfa 

UW-BME Students: Ben Knudsen, Courtney Lynch, Tarika Patel, Janmesh Patel

The goal of this project would be to develop an automatic device for placement of Intravenous Lines (IVs).

In modern medicine, IVs are critical for medication administration. Placing an IV is easy until it isn't. Whether it's a dehydrated patient, a pediatric patient who is not tolerating the procedure well, a person with brittle veins, placing IVs can be a challenge. In fact, many hospitals actually have Venous Access Teams made up of nurses who are particularly talented in IV placement and essentially perform this task and only this task all day for anyone who might be a hard stick.

I think there is room for innovation in the realm of IV placement, namely that an automated device could be developed which would use ultrasound or some other technology to find a quality vein then automatically deliver a needle and catheter to that site, free of a human tremor or human error.

Client: Dr. Christopher Vandivort

UWSMPH Student(s): David Martin, Ian Wolf

UW-BME Students: Sam Simon, Mark Nyaeme, Tom Geissler, Josiah Wolf, Mitchell Glodowski 

A fluid filled cyst develops in the spinal cord (syringomyelia) in some patients with anomalies of skull development. Half of individuals with Chiari I malformation, a condition with a smaller than normal skull volume and part of the cerebellum extending into the upper spinal canal, develop syringomyelia. Also individuals with smaller than normal skulls lacking the cerebellar displacement also develop syringomyelia. The cysts are most commonly located at the lower end of the cervical spine, about 8 cm from the junction of the cervical spine with the skull (foramen magnum). The cause of the cysts is presumably abnormal cerebrospinal fluid dynamics, although the exact mechanism is not known.

Patients with syringomyelia undergo a specialized surgical treatment to prevent the continued enlargement of the cysts. The surgical procedure. craniovertebral decompression, involves the removal the posterior arch of the uppermost cervical vertebra and of a small amount of the nearby skull bone. This surgery enlarges the cerebrospinal-filled subarachnoid space where the skull joins the spine. About 15,000 craniovertebral decompressions are done each year in the US at a cost of about $300,000 per operation. The operation most commonly causes the spinal cord cyst to collapse over time and the patient's symptoms to resolve. Some patients require re-operation. Some complications and deaths occur because of infection, damage to adjacent arteries, or damage to the spinal cord. The procedure results in slower flow of CSF in the foramen magnum and smaller amplitude of cyclic intracranial pressure oscillations.

In theory, CSF dynamics that results from the arterial pulse in the large intracranial arteries (the so-called Monro-Kelli doctrine) can be modulated without craniovertebral decompression using other means to decrease pressure oscillations in the cranial vault. The goal of this project is to create methods for altering the cyclic pressure oscillation in the cranial vault. With smaller cyclic pressure oscillation in the cranial vault, flow velocities and flow volumes in the foramen magnum that connects the spine with the skull will diminish.

Client: Dr. Victor Haughton

UWSMPH Student(s): Jon Schrope, Nick Arp

UW-BME Students: Jack Metzger, Jack Stamer, Susan Xia, Mitchell Korbell 

Heart disease is currently the number one killer in the US. This is in large part due to elevated cholesterol, and cholesterol related disease. As a medical system we are moving towards more prevention of this disease, and require accurate cholesterol screening techniques. However, the current techniques remain invasive.

I would like to develop a non-invasive means of determining cholesterol levels.

My suggestion: Use data gathered from visualization of the eye vessels to determine cholesterol levelsAims:

1) To do this safely

2) To determine the best method for getting this info. For example, do we shine a light in the eye, measure absorbance and then calculate? Do we take a picture of the eye, and use that image to calculate?

3) To build a basic prototype to do this (mostly the image acquisition tool of the desired information to be measured)

4) Eventually, to see if this can work.

Client: Dr. Nicholas Von Bergen

UWSMPH Student(s): Harjot Uppal, Than Huynh

UW-BME Students: Margaret Edman, Siddhant Jain, David Beedle, Benjamin Ayd, Nicholas Mathew

Tears and avulsion of the posterior meniscus root attachment to the tibia is catastrophic if left untreated. The current standard is arthroscopically-assisted posterior meniscus root repair. This repair is performed by drilling a tunnel through the tibia at the attachment of the posterior meniscus root. This is done using a standard drill guide and guide pin. Sutures are then stitched into the edge of the meniscus using an industry made (Arthrex) multiple use device (Meniscus Scorpion) done through the joint (not through the bone tunnel). Sutures are then retrieved through the tibial tunnel using a suture passing device and then tied over the front of the tibial bone.

However, the medial compartment of the knee and pre-existing arthritic disease associated with posterior meniscus root injury, make suture passage difficult, time consuming, and often associated with iatrogenic cartilage damage. Therefore, I would like to have assistance in final design and building of a working prototype for a device that would be able to go up the tibial tunnel and pass sutures in the meniscus all-together avoiding the cartilage.

Client: Dr. Biran Walczak

UWSMPH Student(s): Jennifer Dietzel, Marina Adrianzen

UW-BME Students: Kirsten Brokish, Samantha Barr, Hailey Frye, Elizabeth Gunderson

interventional radiologists are asked to perform CT guided biopsies on smaller and smaller lung nodules; in addition, the IR physician is asked to send more tissue from smaller and smaller pulmonary nodules for genetic analysis to tailor therapy for the individual patient. Air embolism during percutaneous lung biopsy can be catastrophic and life ending for the patient.

A CT guided lung biopsy often requires a coaxial technique for performing the biopsy; additionally, a coaxial technique allows for multiple biopsies (ie samples to be obtained).

In a coaxial biopsy, either a seventeen gauge or 19 gauge guide needle is advanced under CT guidance to the proximal edge of the pulmonary nodule. Then the inner stylet is removed and the smaller diameter cutting needle is advanced and fired. For instance, a 19 gauge guide needle through which a 20 gauge biopsy gun is fired or similarly a 17 gauge guide needle throught which an 18 gauge gun is fired.

importantly, the pressure within the lung is subatmospheric and during the removal of the stylet of the 19 or 17 gauge guide, air can rapidly enter the guide needle and result in air embolism if the biopsy is performed near an adjacent pulmonary vein. This will result in air embolism to the left atrium, left ventricle, aorta and God forbid the brain.

so the mitigate this risk, I would like to create a guide needle with a hemostasis valve on it; the inner stylet will fit snugly into the guide and allow ease of advancing to the superficial edge of the pulmonary nodule; when the guide needle is in satisfactory location, the inner stylet is removed and the sealing valve will reduce the chance of ambient atmospheric air rapidly entering into the lung. Thus multiple biopsies now may be done with much reduced risk of air embolism.

Client: Dr. John C McDermott

UWSMPH Student(s): George Luong, Serra Crawford

UW-BME Students: Dylan Schuller, Nick Goetz, Noah Nicol, Abdel Daoud 

Development of a home device that can be used by patients to detect the concentration of urine test values so patients can measure the response to therapy. The therapy would be medications or diet changes that would help prevent kidney stones. The urine values I would be interested in include pH, Specific Gravity, Oxalate, Citrate, Calcium, Sodium, and possibly other electrolytes. The project would be to focus on one or more of these. Ideally would be simple for the patient use and also incorporate a cellular device allowing transmission of data.

Client:

UWSMPH Student(s): Bryan Hall

UW-BME Students: Jamison Miller, Cory Van Beek, Janavi Kotamarthi, Yash Gokhale 

Acute compartment syndrome (ACS) impacts many trauma patients and presents medical providers with perplexing dilemmas regarding the diagnosis and treatment of this condition. ACS diagnosis is most frequently based on clinical examination findings,but, clinical scenarios arise where examination is not possible. In these cases objective data are needed to confirm the diagnosis. Intracompartmental (IC) pressure measurement is the current standard of care when clinical evaluation is not possible. The use of IC pressure measurements has three major flaws. First, the recommended pressure threshold for decompression is not clear. Secondly, IC pressure measurements have an alarmingly high false positive rate. Finally, limb positon and acquisition location can significantly alter the results of an IC pressure reading.These issues with IC pressure measurements highlight the possibly of ACS misdiagnosis, resulting in either overtreatment patients with the morbidity of unnecessary fasciotomies or undertreatment of patients resulting in permanent dysfunction.

We hypothesized that biochemical markers are would be more sensitive and specific than pressure readings for determining muscle hypoxia and therefore for diagnosing the critical underlying pathology in acute compartment syndrome. Glucose, lactate, and pyruvate levels can detect muscle ischemia in situations of arterial occlusion, venous hypertension, and hypoperfusion. We have previously published the utility of intracompartmental glucose concentration and partial pressure of O2 and are working on data on pH concentrations on diagnosing compartment syndrome. In all of our animal studies pH and glucose measurements are able to detect compartment syndrome.

The focus of this project would be designing a device that is easy for clinicians to place in muscle compartments and quickly and accurately measure pH concentration.

Client: Dr. Christopher Doro

UWSMPH Student(s): Joshua Choe, Bailey Huser 

UW-BME Students: Syafiqah Saidin, Lucas Ratajczyk, Hunter Huth, Jonah Mudge