This is what it looks like when researchers push beyond band-aid solutions and design better answers to pressing medical and mental-health issues.
The Patapsco Valley might not bring to mind the disruption of the technology industry the way Silicon Valley has defined itself, but UMBC student and faculty researchers are aggressively tackling disparities related to health care and changing the way people around the world access health technologies.
As a public university, UMBC’s scientific community is actively researching ways to alleviate public-health problems. In some labs this means changing the focus of research to address a more pressing medical issue, like Ph.D. student Mustafa Al-Adhami did when he veered away from studying water purification to address sepsis, a life-threatening condition that strikes over a million Americans each year.
Another example is UMBC faculty member Govind Rao, who feels a sense of urgency in addressing critical challenges that are impacting people’s quality of life. Rao, a professor of chemical, biochemical, and environmental engineering, and director of UMBC’s Center for Advanced Sensor Technology (CAST), sees UMBC students and professors using their skills and interests to make health technologies more equitable, more affordable, and more sustainable. A central focus of Rao’s collaborative work is creating health-care solutions that are not restrained by cost or geography, like an award-winning cardboard incubator his lab produced, accessible for communities with limited resources.
Rao refers to his research and the technologies he’s developed as “disruptive innovations,” and he’s not the only UMBC researcher who is working to help people change how they approach and access medical care. These developments offer novel solutions to challenges facing the world, and faculty and staff at UMBC are changing the way people receive medical care and support from medical providers.
“If I can empower students to think and come up with solutions that have a green footprint and are lower cost and sustainable, I think we can bend the curve,” explains Rao.
Treating sepsis with more accuracy
Mustafa Al-Adhami, M.S ’15, Ph.D. ’19, mechanical engineering, credits a conversation with his wife Stephanie Al-Adhami, a nurse, in changing the focus of his research. At the time Al-Adhami was working to develop a device to determine whether water was safe to consume, but after discovering devices on the market that could already filter most water to make it potable, he shifted his work to address another prevalent challenge that people around the world are facing. “We just pivoted from water to actual blood with this specific application,” he says.
Sepsis is a serious blood infection that, if not treated properly and promptly, can lead to serious complications and even death in mere days. Those at highest risk are the most vulnerable: infants, children, the elderly, and those already facing severe medical problems. According to the Centers for Disease Control and Prevention, more than one million people fight sepsis each year and about a quarter of these cases are fatal. Discouragingly, the number of sepsis cases each year is also on the rise. Al-Adhami and others are working to reverse the trend.
The challenge for physicians isn’t determining whether a person has sepsis, explains Al-Adhami, but rather identifying which antibiotics to administer to the patient. “With every one hour without proper treatment, there is a 7% less chance of survival,” he says.
Working with faculty and student researchers in CAST, Al-Adhami developed a rapid bacterial-detection test that can determine whether a patient has an infection within an hour and helps physicians determine which specific antibiotics should be administered to help fight the infection. Al-Adhami’s device, ASTEK, costs a fraction of the price of the current antibiotic susceptibility test, can reduce the duration of hospital stays, and can prevent antibiotic resistance by avoiding unnecessary antibiotic use.
In addition to its cost effectiveness, ASTEK only requires one milliliter of blood to be run. This is a breakthrough in detecting sepsis in young children. “For [traditional] blood cultures, they take four bottles of blood. Each one is eight milliliters,” explains Al-Adhami. “Because we don’t need this much blood, it could be used for newborns…the concentration of bacteria is much higher in infants.”
The device has successfully been tested in mice, and Al-Adhami hopes that it will be ready for human testing in the next couple of years. If the device is approved for human use, it has the potential to save thousands of patients each year by speeding up the process of diagnosing and administering the correct antibiotics.
Understanding behavior through social media analytics
According to the U.S. Department of Health and Human Services, more than 130 people die from opioid-related overdoses each day, and there are over 14,000 substance abuse facilities across the U.S. that treat people facing these addictions. The opioid epidemic affects every region of the country, and those watching loved ones go through the cycle of substance abuse are seeking any new ways to halt this disease in its tracks.
Shimei Pan, assistant professor of information systems, is studying human behavior in the context of monitoring, preventing, and treating substance-abuse by analyzing how people with substance use disorders behave on social media. “On social media, there is a lot of information about each individual. Some are related to substance use, like drinking, smoking, and illicit drug use,” she says.
Pan and her collaborator Warren Bickel, a well-known behavior scientist at the Virginia Tech Addiction Treatment Center, are employing large-scale social media analytics to better understand addiction and help medical professionals provide personalized treatment to people facing addiction and substance abuse.
The clues Pan and Bickel are looking for in social media data are subtle, but have the potential to alter the way substance abuse is identified and subsequently treated. “Sometimes, people explicitly mention substance use in their social media posts,” she shares. “These are useful signals. But there are other signals in social media, sometimes even stronger than explicit mentions of substances. Substance abuse is frequently linked to mental disorders such as depression, anxiety and impulsivity. As a result, social media behavior signals related to depression, anxiety and impulsivity can also be very useful in helping us detect and understand substance abuse”
Since substance abuse could be explained by both genetic and environmental factors, with large-scale social media analytics it is possible to identify distinct patterns in its manifestation on social media, says Pan. “We want to see whether we can find those behavioral markers of addiction on social media. By identifying these markers, we can understand substance abuse a little bit better.”
Pan and her collaborators plan to continue conducting basic research, and hope to help develop new screening, diagnostic, and intervention tools in the future—another way of building a bridge to proper health care access for all.
Studying stigma and pain
Another UMBC faculty member studying human behavior is Shawn Bediako, associate professor of psychology, who focuses on the psychosocial impact of sickle cell disease. Bediako is using new technologies to assess sickle cell patients’ pain and experiences.
Previously, Bediako and his collaborators collected data using paper surveys that were sent to patients and required that patients mail them back each week. “We didn’t know when they filled [the surveys] out,” he says. “All we knew is that they would send us a packet back.”
The development of a new app-based tool, however, lessened the lag in survey responses. This new approach gives researchers a more accurate picture by providing data with integrity. Bediako explains that the app allows patients to submit their experiences directly and enables researchers like him to pose bold, new questions to patients. Each night at 7 p.m., the patients automatically receive a survey to fill out by midnight. The rapid turnaround and ease of completing the survey also “cut down on data contamination,” he says.
“Now that data analytics has expanded the range of online behaviors that we can examine, researchers like me can think about the links between health care and health outcomes in a different way,” Bediako explains.
Bediako, who is also the facilitator for UMBC’s Collaborative for the Interdisciplinary Promotion of Health Equity Research (CIPHER), hopes that his work bridges the gap between people who are doing research on sickle cell disease and people who are studying how innovative technologies can be utilized to help people with the disease. “I’m currently integrating information from history, policy, sociology, psychology, and medicine to better understand the genetics of sickle cell pain,” he says, adding this requires some “out-of-the-box type thinking.”
Like Pan, Bediako is interested in how people’s social media use differs depending on whether they are in pain versus not in pain. “Now that data analytics has expanded the range of online behaviors that we can examine, researchers like me can think about the links between health care and health outcomes in a different way,” he explains.
Supporting first responders
In a broad collaboration to understand how the stressful situations first responders encounter in their jobs can lead to anxiety and other mental health issues, UMBC faculty in emergency health services (EHS) and information systems are using existing technologies to tackle the task. Principal investigator Andrea Kleinsmith, assistant professor of information systems, is collaborating with J. Lee Jenkins, associate professor and chair of emergency health services; Helena Mentis, associate professor of information systems and associate dean in the College of Engineering and Information Technology; and Gary Williams, acting paramedic director in emergency health services.
Trainees and first responders on the job may experience an array of physiological responses when they are in a situation that is tense or challenging. UMBC students in their third and fourth years of the emergency health services program move through a series of often intense scenarios in the simulation lab in Sherman Hall to prepare them for a range of situations they may encounter on the job. Involuntary bodily reactions such as increased heart rates or perspiration are tracked by wearable devices, and allow the instructors and trainees the opportunity to assess and manage stress and improve the preparedness for future emergency scenarios.
Working with student researchers, the faculty members design, develop, and evaluate the system to assess how discussions and intentional in-class reflections on stressful situations can help trainees implement stress management strategies during their work. The team is studying how a Team Stress Reflection system can be used by paramedic trainees to “understand the events that trigger stress increases and their ability to mitigate that stress,” according to the grant proposal. This technology allows the students to identify and better understand the correlations between stressful situations and their physiological responses.
Stress, explains Kleinsmith, can lead to errors during care and long-term health concerns for medical personnel, including emergency health professionals. Williams says that it’s important for students to debrief and reflect on the simulation to make sure that they can address any stressors or points that caused them to have strong physiological responses.
“The ability to monitor and manage stress in medical personnel has the potential to improve medical care provided in stressful situations,” explains Kleinsmith.
Understanding the physiological responses during training exercises is important for trainees, explains Williams, because it allows them to improve how they cope with stress in situations that they may encounter on the job. This research is being funded by a three-year grant from the National Science Foundation, which supports the faculty in collecting data from the EHS students and developing the interface to help the students come to their own conclusions about the correlation between physiological measurements and stress to understand their stress triggers. The interface also helps facilitate the team’s discussion about stress.
Motion sensors to inform treatment
Helena Mentis is also using activity trackers and other motion sensors to assess movement and inform treatment for patients with Parkinson’s disease. In collaboration with faculty at the University of Maryland Parkinson Disease and Movement Disorders Center, Mentis designed and developed a sensor using Leap Motion devices to track and assess the movement of patients with Parkinson’s disease during deep brain stimulation.
One observation that Mentis and her collaborators made was that the presentation of data collected from the sensors impacted how the data was interpreted and used to develop customized treatment plans for patients. In 2017, Mentis presented a paper at the Association for Computing Machinery Special Interest Group on Computer-Human Interaction Conference. The paper explains that the data collected by the patients’ activity trackers led to more informed conversations between the patient with Parkinson’s and their physician.
In a well-researched disease like Parkinson’s, there’s still always room for improvements in care and access to care. Researchers have been studying Parkinson’s disease and treatment options for people with Parkinson’s since the 1960s, but there is still work to be done. Every advancement leads to better outcomes and an increased quality of life for Parkinson’s patients. Mentis and her collaborators are now using self-tracking technologies to help physicians customize treatment plans and advocate for patients.
“Determining how sensor data can be incorporated in shared decision-making is fundamental to effective patient-centered care,” explains Mentis. “Even more so for low-resource and marginalized communities, where sensor data could easily be used by medical caregivers to argue for diagnoses or treatments that are based on assumptions and biases. The sensor data in itself does not embody truth and instead should be taken into account alongside a holistic understanding of the patient and their circumstances.”
Doing good through “disruptive innovations”
Through his work, Rao focuses on addressing critical challenges by answering the fundamental question: “How can we help them?”
“These are real lives, real people who are living in desperate conditions,” Rao says, noting that he aims to empower his students to think about how they can make positive changes through their work. Rao explains that his multidisciplinary approach to research has allowed him and his colleagues and students to make tremendous impacts related to health technology. CAST allows him to work with faculty and students from a range of disciplines, and he believes it is important for engineers, scientists, sociologists and psychologists, and policymakers to have a seat at the table, because each perspective is so valuable.
“Disruptive innovation” refers to technologies and other developments that offer novel solutions to challenges facing the world. Like Bediako and other colleagues at UMBC, Rao challenges his students to consider new approaches to addressing challenges and needs in the health technologies space.
While Rao leads this research, he is quick to point out that the collaborative nature of the work and the contributions of his students are crucial to its success. “It’s not about me,” he says. “I’m just privileged enough to have such an amazing team across several disciplines and backgrounds. It’s just a blast.”
With funding and support from federal agencies, including the Defense Advanced Research Projects Agency, Rao has developed a bioreactor or “biomod” that fits inside a suitcase and allows pharmaceuticals to be produced on demand and with limited resources and time. The device was developed with soldiers in conflict zones in mind because it allows them to quickly create customized medicines to save lives based on the needs of the patient.
Additionally, Rao and his colleagues have developed low-cost incubators to support premature babies in communities with limited resources and in areas that do not have access to robust medical facilities. His research team was presented with the 2019 Global Health Research Award at the Pediatric Academic Societies Meeting in Baltimore.
The question “What have you done for others?” is the driving force behind Rao’s lab. He says that many of the health technologies that are currently available are only affordable to a small group of people, and are only helping the people who can afford them. “Just spending five to 10 minutes a day thinking about what they [students] can do with their skill set to improve the lives of others, that’s all it takes to change the world,” Rao says.
All illustrations by Brucie Rosch.