Capstone 2012: Innovations in Emergency Medicine, Diagnostic Tools, Physical Therapy, and More

Capstone

A football helmet enhancement designed to prevent concussions, a method of diagnosing burn severity with advanced imaging, and a Microsoft Kinect game console at the heart of an interactive physical therapy system were among the dozen new products on display at the Fischell Department of Bioengineering (BioE) Capstone II finale May 11, where seniors presented the final projects of their undergraduate careers..

This year's event was presented in a new, open format in which the students, mentors, guests and judges were free to move among exhibits to see demonstrations of biomedical device prototypes, interact with Capstone team members, and learn more about each project's goals, challenges, and results.

The annual Capstone Design Awards, created and sponsored by Mrs. Susan Fischell, were also updated to include new categories, including Best In Patent, Best Impact, and Best Business Plan. The department also introduced a Students' Choice Award. (Winners are noted in the project descriptions below.)

This year's panel of judges included:

John W. Karanian of the U.S. Food and Drug Administration's (FDA) Laboratory of Cardiovascular and Interventional Therapeutics at the Center for Devices and Radiological Health;
Brian Lipford, Vice President of medical device prototyping and development firm Key Tech;
Kwame Ulmer, Deputy Director of the FDA's Science and Policy Division of Anesthesiology, General Hospital Infection Control & Dental Devices;
BioE adjunct professor Jafar Vossoughi; and
Jeff Webb, Vice President of KDM Systems, which provides mission engineering and technical support services.

2012 Capstone II Teams, Projects and Awards

Team 1: Real-time Blood Pressure Measurement from Radial Artery Distension in the Wrist Using Self-Mixing Interferometry–A Non-Invasive Wearable Wristband Design
Conrad W. Merkle, Patrick L. Myers, Darnell J. A. Slaughter, Olufemi O. Sokoya, and Ming Zhang

Faculty Advisor: Associate Professor Hubert Montas

Students' Choice Award
Team 1 designed a new way to continuously monitor blood pressure with a wearable device. The minimally-invasive system uses a laser to measure the displacement of the radial artery in the subject's wrist as the heart contracts, translating the tiny movements generated by the human pulse into information about blood pressure. When the laser's light reflects off of the radial artery, a portion of it is returned to the laser cavity. The difference between the emitted and returned light generates a photocurrent that is amplified, converted into a voltage, and interpreted as blood pressure data which can be both displayed and, unlike cuff-based blood pressure readings, tracked over time and stored for analysis. In their demonstration, Team 1 used a smartphone to illustrate how off-the-shelf technology could provide a simple interface for the device.

Team 2: Depth Characterization of the Burn Wound Through Thermal Energy Transfer Analysis
Payam Fathi, Erich Herbermann, Duc Dinh Nguyen, Nicholas J. Prindeze, and Gregory J. Winter

Faculty Advisor: Professor Yang Tao
Mentor: Dr. Jeffrey Shupp (Department of Surgery, Washington Hospital Center)

Best Impact Award
The damaged flesh of deep burn wounds is often surgically removed to improve patient survival and recovery rates. A type of second degree burn known as a deep partial thickness burn, which extends partway though the second layer of skin known as the dermis, could either heal on its own or fully penetrate, developing into a third degree burn requiring surgical intervention. Currently, doctors subjectively characterize burns based on what they see when examining a patient externally, which could lead to unnecessary surgery or skin grafts. Team 2 created the first imaging system capable of consistently measuring, analyzing and interpreting deep burn wounds. The system uses a special imaging technique to measure the ability of an area of skin to dissipate heat after being damaged by a burn. The deeper the burn and more serious the damage, the longer it takes to return to an equilibrium temperature among the different layers of skin. These thermal gradients are translated into a visual map showing doctors exactly where tissue is necrotic (requiring removal), static (damaged, but possibly repairable), or hyperaemic (capable of complete recovery with proper care).

Team 3: Endotracheal Tube Catheter for Controlled Drug Delivery Using Surface Acoustic Waves and Method
Walter Beller-Morales, Esmaeel Paryavi, Stephen T. Robinson, Bernard Pak-Ning Wong, and Kaiyi Xie

Faculty Advisor: Associate Professor Hubert Montas
Mentor: Dr. Jeffrey Hasday (Department of Pulmonology and Critical Care, University of Maryland Medical Center)

First Place and Best In Patent Award
Patients in respiratory distress or under general anesthesia require intubation, the insertion of an endotracheal tube that ensures a clear path for air to reach the lungs. These patients also often require inhaled medication. Drug delivery via an endotracheal tube is inconsistent because the drugs, administered from external inhalers or nebulizers, stick to its inner surface or condense into droplets too large to be absorbed by the lungs. Team 3's endotracheal aerosol generating catheter (ETAG) delivers droplets of liquid drugs to a microchip at the innermost tip of the tube. The chip uses ultrasonic vibrations to precipitate the droplet, nebulizing it into consistently sized particles that travel out and directly into the patient's lungs. An external controller can customize the particle size by altering the amount of power sent to the microchip, which in turn changes the frequency of the acoustic waves. These innovations allow the ETAG to provide correct and predictable dosing to patients who are often in the most dangerous conditions.

Team 4: Integration of Skin Stapler and Forceps for Efficient Surgical Stapling
Joseph D. Hartstein, Kelley M. Heffner, Victoria Stefanelli, and Tina Zhang

Faculty Advisor: Chandra Thamire (Department of Mechanical Engineering)
Mentor: Dr. Chris Rhim (Plastic Surgery, Midatlantic Permanente Medical Group, Va.)

Surgical stapling is a common method of closing wounds. Currently, it is a two-person job: one doctor uses forceps to hold the skin together, while another operates the stapler. Team 4 set out to design and fabricate a new surgical stapler that incorporates the forceps and frees up fingers, allowing a single doctor to quickly and more accurately close a wounds in a variety of situations. The new device fires stables more quickly using a compressed air mechanism, and only requires the push of a button to eject the staple, rather than a thumb-and-finger(s) trigger or clench. The prototype's distinctive design starts with a vertical grip that loops around the hand in a way that keeps the mechanism from obstructing the doctor's view of the wound site. Team 4 also presented computer models showing how, with miniaturized components, a production model would have an even more streamlined design the approximate size and shape of a wide marker.

Team 5: Blood Platelet Contamination Detection Prior to Transfusions Using a Microfluidic Chip and Real-Time PCR
Robert G. Breithaupt, Linda Rassenti, Daniel Dongwon Shin, Robert Spetrini, and Travis W. Wilson

Faculty Advisor: Assistant Professor Ian White

Blood platelet transfusions, which are used to support patients whose own have been reduced by cancer or blood disorders, routinely save lives, but they are not without risk. Because platelet supplies may be stored for up to five days at room temperature and a full transfusion can take up three days, they are at risk of bacterial contamination, which results in life-threatening sepsis (blood poisoning) for the patient. Team 5 designed a fast, accurate, semi-automated system capable of screening platelet supplies in the hours before a transfusion, improving the overall safety of the procedure. The microfluidic device, called the HemaFlow Platelet Plus, uses a filter to collect and destroy bacterial cells and a DNA capture buffer used to identify which bacteria were present, and in what concentration.

Team 6: ReKinect™ Rehabilitation System to Improve Patient-Therapist Interactions for Range of Motion Quantification Using Kinect 3D Motion Sensor
Reginald K. Avery, Jonathan P. Eskin, David Chi Wai Lai, Aman Rahman, and Sruthi Rajarajan

Faculty Advisors: Professor Yang Tao and Associate Professor Jae Kun Shim (Department of Kinesiology)
Mentor: Dr. Michael Collins (Department of Physical Medicine, Holy Cross Hospital, Silver Spring, Md.)

Team 6 harnessed the power of an off-the-shelf Microsoft Kinect motion-sensing gaming console and its software developers' kit (SDK) to create an inexpensive, interactive physical therapy system that shows patients when they are doing their range of motion exercises correctly and tracks their progress over time. The patient's motions are captured by the Kinect's infrared receiver and video camera and interpreted and displayed by the ReKinect software, which can run on an ordinary Windows-based computer. The system offers live video and a skeletal representation of the patient, angular data for a selected joint, calibration for different people and exercises, and data plotting for visual analysis. Unlike other digital physical therapy products, it provides immediate feedback and full-body evaluation, can be used at home, is based on affordable consumer products, and does not require information-gathering leads to be attached to the patient.

Team 7: Smartphone Compatible Spirometer to Assess Lung Functionality
Thomas A. Hulcher, Sumanth S. Kuppalli, Natasha A. Lodha, William A. Plath, and James D. Ponton

Faculty Advisor: Assistant Professor Yu Chen
Mentor: Dr. Nirav Shah (Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center)

The most common threat to a lung transplant patient's survival is the body's rejection of the new organ, which is prevented by a regimen of immunosuppressive antibiotics. Determining the right dosage is crucial: too much, and the patient could suffer infections and illnesses. Too little, and the new lung will be rejected. Team 7 created a portable, smartphone-compatible spirometer—a device used to measure lung function—that the patient can use to easily, efficiently and routinely monitor his or her condition between hospital visits, allowing doctors to fine-tune the immunosuppressive drug dosage on an ongoing basis. Team 7's solution has the user exhale through a disposable, filtered mouthpiece into a flowmeter. A customized mircocontroller records the strength of the airflow and transmits the data wirelessly to a smartphone running SpiromeTERP, an Android application created to log and display patient lung data.

Team 8: Tapered Sphygmomanometer Bladder for Varying Arm Circumferences
Oren I. Feder, Christopher P. Gloth, Ryan Hilaman, Emmarie G. H. Myers, and Mariya M. Sitnova

Advisor: Dr. Martha Connolly (Director, Maryland Industrial Partnerships, Maryland Technology Enterprise Institute)
Mentor: Dr. Sean T. Gloth (Cardiology and Internal Medicine)

Almost everyone is familiar with a sphygmomanometer, though usually by its common name: the blood pressure cuff. The cuffs come in different sizes, each designed for a range of arm circumferences. Using the wrong-sized cuff, either by accident or because the appropriate size is unavailable, results in an inaccurate blood pressure reading, which could lead to a misdiagnosis or improper treatment. In an effort to improve the flexibility and accuracy of the ubiquitous sphygmomanometer, Team 8 redesigned the inflatable bladder of the blood pressure cuff. The prototype's tapered, trapezoidal bladder better accommodates variations in arm size, provides a closer match with patient arm circumference, and more naturally settles on the ideal width required to come into contact with the patient's artery.

Team 9: Incorporating Machine Vision into the Ultrasound-Guided Brachial Plexus Nerve Block from the Interscalene Region
Alison M. Clark, Christopher M. Dupuis, Kelsey M. Harrison, Daniel T. Smith, and Pascal Chunyong Yang

Faculty Advisor: Professor Yang Tao
Mentor: Dr. Paul Bigeleisen (Department of Anesthesiology, University of Maryland Medical Center)

A nerve block is a method of delivering anesthesia to a cluster of nerves prior to a medical procedure or surgery. Anesthesiologists often use ultrasound to help locate the nerves, which may vary widely in size, angle and location from patient to patient. In the absence of an anesthesiologist, particularly in combat or emergency situations, the procedure may be very difficult or impossible to perform, even if the appropriate equipment is available. In an effort to improve the survival rate and comfort level of badly injured soldiers, Team 9's goal was to give military medical technicians the ability to correctly administer ultrasound-guided anesthesia. The team created an algorithm that interprets data in realtime from the ultrasound images. Using measurements relative to anatomical "landmarks," texture recognition, and pattern recognition, the software identifies the targeted nerves and highlights them in bright colors on either a still or motion ultrasound image, making it easier to guide anesthesia to the correct location.

Teams 10 and 12: Football Helmet Attachment To Reduce Concussions and Head Injuries
Team 10: Laith M. Abu-Taleb, Azam A. Ansari, Ryan Haughey, Karan Raje, and Adam L. Zviman; Team 12: Dana A. Hartman, David Kuo, Julie R. Loiland, and Afareen Rezvani

Faculty Advisor: Professor Kenneth Kiger (Department of Mechanical Engineering)
Mentor: Dr. Robert E. Fischell

Teams 10 and 12 collaborated on their final project, which sought to address the growing concern over the thousands of concussions suffered by football players each year. The group created an enhancement for existing football equipment that takes the form of a shock absorber filled with a dilatant fluid, one that thickens under sheer strain, such as produced by the force of a tackle. They fitted a boxing torso with an official Terps Riddell football helmet and shoulder pads, to which they attached a prototype of their device in a position behind the mannequin's head. Analysis of front and side impact tests on the simulated player's head showed the device substantially reduced maximum acceleration, velocity, and displacement across the Z- and Y-axis. The simultaneous absorption and transfer of energy from the impact, and the decreased acceleration of the player's head and neck, should result in a dramatic reduction of concussions.

Team 11: Adaptable Cervical Brace to Maximize Patient Comfort While Maintaining Support
John A. Donovan, Joshua M. Gammon, Alex Huang, Kesshi M. Jordan, Adeline McLaren, and Syeda K. F. Zaidi

Faculty Advisor: Associate Professor Adam Hsieh
Mentor: Dr. Cha-Min Tang (Departments of Neurology and Physiology, University of Maryland School of Medicine)

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Team 13: Implantable Sole for the Monitoring of Diagnostic Foot Brace Techniques Using Pressure Sensing Modules
David H. Blumenstyk, Michael A. Lal, Hassan A. M. Moustafa, and Jiemin Wu

Faculty Advisor: Associate Professor Hubert Montas
Mentors: Dr. Shannon Bowles and Dr. Sally Evans (HSC Pediatric Center, Washington, D.C.)

Each year, millions of people are given foot and leg braces to protect them from re-injury while they heal. These braces also provide support and promote mobility in patients with muscle weakness. Unfortunately, many patients find the braces uncomfortable or do not wear them correctly, resulting in a lack of compliance, longer healing times, and increased treatment costs. Team 13 invented a system designed to help patients use their braces correctly and to help doctors monitor compliance and progress. They created an implantable sole for foot braces, capable of sensing and monitoring pressure, and an accompanying software application for doctors that tracks and displays pressure from different areas of the foot over time, indicating how and when a patient is walking. The prototype sole, which looks very similar to an ordinary insole, contains strain gages encased in gel at important contact points between the foot and brace. Each sensor's output signal is amplified and cleaned, converted from analog to digital, and stored on its own SD memory card. A software application charts high and low pressure points for each sensor over time.

Good Luck, Seniors!

We wish all of our seniors the best! We're sure innovative engineers like these will succeed wherever they go. Left: Team 3, 1st Place and Best In Patent Award, with faculty and judges.

Thank you!

Our seniors would like to thank their professors and mentors (listed with their Capstone teams above); lab staff including Melvin Hill and Gary Seibel for guidance, time, and labor; administrative staff members for help with financial support and purchasing; Professors Yang Tao and William E. Bentley; our 2012 judges; and friends in outside academia and industry for the advice and supplies they donated that helped these projects succeed.

Published May 18, 2012