2018 Galvanizing Engineering in Medicine (GEM) Awards

UC San Diego Altman Clinical and Translational Research Institute (ACTRI) announces the selection of four physician-engineer teams as the 2018 recipients of the Galvanizing Engineering in Medicine (GEM) awards. GEM, an initiative of ACTRI and the UC San Diego Institute of Engineering in Medicine (IEM), supports projects that identify clinical challenges for which engineering solutions can be developed and implemented to improve health care. Leading this initiative are Gary S. Firestein, MD; Shu Chien, MD, PhD; and Deborah Spector, PhD. The GEM recipients and their projects are below.

DMike Tolley, PhD

Mike Tolley, PhD
Jacobs School of Engineering, Department of Mechanical and Aerospace Engineering

Fred Spada, PhD

Fred Spada, PhD
Center for Magnetic Recording Research

Frank E. Talke, PhD

Frank E. Talke, PhD
Jacobs School of Engineering, Department of Mechanical and Aerospace Engineering

Madhu Alagiri, MD

Madhu Alagiri, MD
School of Medicine Department of Urology

Title: Electricidal Urinary Catheter–Preventing Spread of Infectious Diseases within the Urinary Tract

Catheter-associated urinary tract infections (CAUTIs) affect the largest of all populations at risk for health care-associated infections (Zimlichman 2013). Health care-associated infections are major problems for the medical industry and 75 percent of these are associated with a urinary catheter. To date, the primary treatment method for CAUTIs is antibiotics. Over time, however, these infections have become more difficult to treat due the evolution of more powerful bacteria. As antibiotic-resistant bacteria become more prevalent, doctors need a solution beyond antibiotic mechanisms for prevention of this worsening problem.

An electricidal catheter is a potential solution to substantially mitigate, or completely remove, the risk of catheter-associated urinary tract infection. The utilization of flowing electrical current through a fluidic body to prevent microbial build up has been used in a wide variety of fields. Our proposed solution is to apply this well studied technology to both the outer surface and inner lumen of a urinary catheter. Small currents can be driven by means of a galvanic process using two dissimilar materials or by a small battery. A significant benefit of this sterilization technique is that small currents would not be felt by the patient and should not cause harm to the body. The catheter design can vary and be catered toward ease of insertion and ease of manufacturing. Ringed or multilayered catheters can provide regions of sterilization driven by the electrical currents.


Ryan Orosco, MD

Ryan Orosco, MD
School of Medicine, Department of Surgery – Division of Otolaryngology

Michael Yip, PhD

Michael Yip, PhD
Jacobs School of Engineering, Department of Electrical and Computer Engineering

Title: Developing Methods to Optimize Accuracy, Efficiency, and Safety in Telerobotic Surgery

Telesurgery is a medical force multiplier. It enables surgeons to operate in rural communities, difficult to access areas, and austere environments that may be dangerous. However, technical challenges persist in realizing telesurgery: that remote communications suffer from delay and bandwidth limitations. Without the ability to send sufficient amounts of data, video feeds reduce in resolution or become lower in framerate; furthermore, actions of the surgeon become delayed due to the long-distance travel of information and result in large delays that confuse and disorient the surgeon.

Our aim is to mitigate the deleterious effects of delay. We have already tested two strategies. The first involves scaling down the user input such that the robot acts more conservatively when approaching sensitive tissues; the second measures the focus and care of the user based on the speed of his or her motions, similar to a cursor dynamically slowing as one approaches an icon. Implementing these strategies, the first stage of this project focuses on catering scaling to each clinician. Similar to using a mouse, each person has different capabilities and preferences in scaling that optimize their control. We will investigate the improvements in scaling based on user-tailored dynamic scaling. First, we will allow them to choose a scaling (simply by allowing them to test different scenarios and choose their favorite). Second, we will autonomously select the scaling where we observed optimal performance and minimal errors (simply by performing the same strategies that optometrists use to converge onto the correct pair of lenses – using the “A or B” approach with tests to verify improvements). This approach is a novel strategy that considers the end users carefully and provides the flexibility to adapt to their traits, and is a first of its kind. The second stage of the project is the overlay of non-delayed instrument positions: Roundtrip communication of video is what causes disorientation. Being unable to observe where one's instruments went until a delay happens is the underlying challenge. However, because we measure the instrument commands live, we can instantly overlay the commanded instrument positions on top of the delayed video feedback. The clinician will be able to observe, in real-time, where the instruments have been commanded to adjust accordingly without the effect of delay. Tasks such as suture tying, needle transfer, tissue resection, debridement, and other instrument coordination tasks are expected to reach a level of performance and competency that is statistically insignificant from regular, non-delayed surgery.

Michael Bouvet, MD

Michael Bouvet, MD
School of Medicine, Department of Surgery

Yingxiao Wang, PhD

Yingxiao Wang, PhD
Jacobs School of Engineering, Department of Bioengineering and IEM

Title: Reengineering Monocytes from Peripheral Blood for Immunotherapy Targeting Pancreatic Cancer

This project is to engineer monocytes from peripheral blood samples with rewiring genetic modules for the development of reengineered macrophages to eradicate tumors. Pancreatic cancer is one of the most lethal forms of human cancer, with 90 percent of patient death occurring within one year after diagnosis. Cell-based immunotherapy is becoming a paradigm-shifting therapeutic approach for cancer treatment. Meanwhile, monoclonal antibody (mAb) therapies directly targeting cancer cells have been widely used. Targeting both immune system and cancer, mAb and opsonin-dependent tumor cell phagocytosis mediated by macrophages provides a crucial effector mechanism for mAb-based cancer therapy. Antibody targeting pancreatic cancer antigens, such as mesothelin, can ligate FcγRs on macrophages and trigger pro-phagocytic (“eat me”) signaling for tumor eradications. However, pancreatic cancer cells express high levels of a “don’t eat me” ligand CD47, which can engage its receptor counterpart SIRPa on macrophages to inhibit the pro-phagocytic actions and hence limit therapeutic efficiency. Anti-CD47 antibody to neutralize the “don’t eat me” signaling has recently been demonstrated to promote the tumor eradication. However, red blood cells also express a high level of CD47, which can lead to undesired hemolysis when anti-CD47 antibody is used against tumors for therapeutic purposes. Genetically reengineered macrophages have been developed in our labs to rewire the “don’t eat me” CD47 signaling into an “eat me” action. Our project aims to characterize the phagocytic efficiency against pancreatic cancer cells and the associated FRET signals of reengineered monocytes, and to examine the efficiency of reengineered monocytes in eradicating pancreatic tumors in mouse models.


Joseph Ciacci, MD

Joseph Ciacci, MD
School of Medicine, Department of Surgery – Division of Neurosurgery

Shadi Dayeh, PhD

Shadi Dayeh, PhD
Jacobs School of Engineering, Department of Electronic Materials and Neurotechnology

Vikash Gilja, PhD

Vikash Gilja, PhD
Jacobs School of Engineering, Department of Electrical and Computer Engineering

Eric Halgren, PhD

Eric Halgren, PhD
School of Medicine, Department of Radiology

Martin Marsala, MD

Martin Marsala, MD
School of Medicine, Department of Anesthesiology

Joel Martin, MD

Joel Martin, MD
School of Medicine, Department of Surgery – Division of Neurosurgery

Title: Next-generation Spinal Cord Neuro-electronic Interface Implant for the Potential Treatment of Paralysis

Among the different neuromodulation therapies for spinal cord injury, epidural and intraspinal cord stimulation and recording has shown promising results. This project aims are to develop a next-generation spinal cord neuro-electronic implant to treat paralysis. The implant is an intradural spinal cord stimulation device that includes novel microelectrodes, uses less power and is “smarter” and minimally invasive. The aims are threefold: to investigate the safety and optimal design parameters and device geometries in acute and chronic recording and stimulating in spinal cord injury pig models, with the goal of developing a chronic implant for a human patient; to use chronically implanted flexible electrodes to test the effect of periodic low-power spinal cord stimulation on recovery of function; and to determine the effect of the combined treatment composed of spinal parenchymal delivery of neural stem cells and periodic low power spinal cord stimulation on recovery of function. The innovation will be measured by the flexibility of the surgical implant, and the fidelity and spatial arrangement of the recording and stimulating electrodes. Recorded data from the device will aid in a variety of neuroscience research, ranging from pain, spinal cord injury, and brain-machine-interface engineering research.