The partnership between USF Health Morsani College of Medicine and the College of Engineering can help spur new technologies, devices and processes to improve health care and reduce costs

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A rare joint program between the USF College of Engineering and USF Health Morsani College of Medicine is celebrating its success, made possible by funding from the State of Florida’s preeminence program.

The newly created Department of Medical Engineering is preparing to open a wet lab that allows students and faculty to conduct tissue engineering, regenerative medicine and biomedicine experiments. Students recently started working with electronic equipment to design and build medical devices. Biomedical engineering graduate students have also been observing surgeries performed by USF Health physicians at Tampa General Hospital.

“The new medical engineering facility houses a unique, interdisciplinary program and is a shining example of the things that happen when we combine our strengths and work together,” USF System President Judy Genshaft said during a ribbon-cutting to officially launch the department’s new academic home in the Interdisciplinary Sciences Building. “This new department is already making an impressive impact, and it shows what we can achieve through preeminence.”

“This innovative partnership between medicine and engineering embodies interprofessional learning and research, which will allow us to advance patient safety and care,” said Charles J. Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine (MCOM).  “Medical engineering can play a vital role in improving health outcomes while lowering costs.”

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The Florida Board of Governors designated USF as a Preeminent State Research University in 2018, allocating more than $6 million in new funding this year, which can also be used to enhance research or student success activities in other strategic areas and attract nationally regarded faculty members.

“We wouldn’t have a new department. We wouldn’t have an undergraduate biomedical engineering major without preeminence funding,” said Robert Frisina, PhD, chair of the Department of Medical Engineering.

Professor Huabei Jiang was recruited from the University of Florida, where he served as the endowed professor of biomedical engineering. Professor George Spirou comes to USF from West Virginia University, where he was director and endowed professor of neuroscience. Together, they brought with them more than $5 million in grants from the National Institutes of Health, adding to the portfolio that helps USF rank as one of the nation’s top 25 public research universities, according to the National Science Foundation.

Samuel Wickline, MD, (left), professor of cardiology and director of the USF Health Heart Institute, is a faculty member in the Department of Medical Engineering. He is pictured here with colleague Hua Pan, PhD, a biomedical engineer.

The department’s faculty members consist of physician-scientists as well as engineers, including Stephen Liggett, MD, professor of internal medicine, molecular pharmacology and physiology and vice dean for research at MCOM, and Samuel Wickline, MD, professor of cardiology and director of the USF Health Heart Institute.

USF is one of very few universities to have a medical engineering department and just one of four in Florida to offer a Bachelor of Science degree in biomedical engineering. Currently, 105 undergraduate students are enrolled, 45 are pursuing their master’s degree and 20 are working towards their PhD.

USF System President Judy Genshaft (center), USF Provost Ralph Wilcox; Robert Bishop, dean of the College of Engineering; Robert Frisina, chair of the Department of Medical Engineering; and Dr. Charles Lockwood, senior vice president of USF Health and MCOM dean; joined College of Engineering faculty and students to cut a ribbon to celebrating the new academic home of the medical engineering department.

“Biomedical engineering is the fastest growing area of engineering and one of the top job fields in the United States if you look at over the next 10 years. So, we were able to fill a critical gap in Florida’s State University System for training biomedical engineers,” said Frisina.

There are many career options for graduates, such as in drug development and creating medical devices. Demand is especially high due to our aging population and changes needed within the health care system.

The launch of the Department of Medical Engineering comes at an important time as the USF Health Morsani College of Medicine and Heart Institute is slated to open in downtown Tampa in late 2019. This will allow for better synergy between biomedical engineers and their colleagues at USF Health and Tampa General Hospital.

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-Ribbon-cutting photo by Ryan Wakefield, College of Engineering

A new device created at the University of South Florida – and including a cross-disciplinary team of experts from USF engineering, physical therapy and neurology – is showing early promise for helping correct the signature limp experienced by many stroke survivors.

Called the Gait Enhancing Mobile Shoe (GEMS), the shoe attachment is the result of multidisciplinary work and expertise in USF’s engineering, physical therapy, and neurology programs.

In addition to offering stroke patients good outcomes for improving their gait and balance, a preliminary study is showing the shoe also provides several advantages over a current stroke rehabilitation tool – the split-belt treadmill – including lower cost, greater convenience, and mobility.

“This is early in the process but we’re seeing the benefits we expected so it’s very promising,” said Kyle Reed, PhD, associate professor in the Department of Mechanical Engineering in the USF College of Engineering and principal investigator for the preliminary study on GEMS.

“We really want to help people who are limited in their walking ability to improve enough so they can return to the activities of their daily lives. The long-term hope is that this shoe attachment could be less expensive and safe enough that, once trained on how to use it, patients could take the GEMS home for therapy.”

Dr. Kim helps a patient try the GEMS shoe attachment.

Reed developed the GEMS shoe along with Seok Hun Kim, PT, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences in the USF Health Morsani College of Medicine and co-principal investigator for the GEMS study. In 2010, Dr. Reed received funding from the National Institutes of Health to conduct a clinical trial of a small group of stroke survivors trying the GEMS; the study is not for severe stroke survivors, but mild to moderate stroke survivors.

The study also includes USF Health stroke expert David Z. Rose, MD, associate professor in the Department of Neurology in the USF Health Morsani College of Medicine, who said he sees the GEMS as a great potential option for stroke patients to improve their mobility.

“Many stroke patients are devastated that their ability to walk on their own can be so limited, even around their own homes,” Dr. Rose said. “Early data for the GEMS is very promising and the next phases of study will really help us see its true potential.”

Many stroke patients develop an asymmetric gait because of damage to their central nervous system, resulting in difficulty moving their affected leg – they can’t extend their foot backward enough, which prevents natural pushing off into the swing phase experienced in an unaffected walk.

Typical stroke rehabilitation to improve gait symmetry involves using a split-belt treadmill that offers two independent belts operating at different speeds to exaggerate the asymmetry of the patient’s gait.

But an odd yet natural thing happens when patients leave the treadmill – their brain returns to a fixed-floor state and they regress, with many finding it difficult to recreate the gait correction on solid ground, a regression that is called an after effect.

While generally successful for improving stroke patients’ gaits, the split-belt treadmill is expensive, requires a dedicated space to house and a qualified staff to monitor sessions and, because of after effect, can require more time for patients to master the correction, said Seok Hun Kim, PT, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences in the USF Health Morsani College of Medicine.

“The GEMS allows movement across any safe surface, thus ‘rewiring’ the brain to learn the new compensation technique for everyday walking, not just for when they are on the treadmill,” Dr. Kim said.

“The GEMS is generally worn on the unaffected side, helping the patient use their affected side to compensate for the irregular footing.”

While early results of this preliminary study are showing strong support for a successful approach to improving the gait of stroke patients, more detailed study with more patients will be necessary. Dr. Kim said a full study, one that compares to the current approach with the split-belt treadmill, is critical before clinicians adjust their approach.

Dr. Kyle Reed demonstrates the GEMS shoe.

Story by Sarah Worth, photos and video by Sandra C. Roa, USF Communications

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Interprofessional collaborations between health professionals and engineers can help improve patient care.

That’s what’s happening at USF. A nurse scientist and an engineer worked together to develop a smartphone application for patients with heart failure.

HeartMapp, created at USF, is an Android-based application for patients with congestive heart failure (CHF).

Ponrathi Athilingam, PhD, assistant professor at the USF College of Nursing, and Miguel Labrador, PhD, professor in the Department of Computer Science and Engineering at the USF College of Engineering, created HeartMapp, an Android-based application to help older adults with congestive heart failure (CHF) improve their self-care and reduce costly hospital readmissions.

“As a cardiology nurse of 25 years, I know that patients with heart failure, who must follow an intricate medication regimen and self-management practices at home to stay healthy and prevent getting admitted to the hospital, struggle with self-care,” Dr. Athilingam said. “After patients leave the hospital, they are alone. However, they do have a phone as a companion. So, we developed this easy-to-use, patient-centered technology to help them keep their heart health on track.”

Ponrathi Athilingam, PhD, assistant professor at the USF College of Nursing, and Miguel Labrador, PhD, professor in the Department of Computer Science and Engineering at the USF College of Engineering.

HeartMapp is a non-invasive mobile application that serves as a health coach for patients. The app has six modules allowing patients to assess their heart condition daily, monitor vital signs, perform breathing and walking exercises, take their medication, read educational information on heart health and review statistics in graphs that show their performance. The app also reminds patients every morning to check their weight, blood pressure and answer questions about their symptoms, thinking ability and mood.

“The app puts patients in green, yellow and red zones based on the status of their heart failure symptoms,” Dr. Athilingam said. “The green zone means their symptoms are under control. The red zone means they’re gravely ill and need to immediately go to the hospital. The goal is to identify patients when their symptoms decline to the ‘yellow zone’ to provide appropriate, early treatment and prevent hospital admissions.”

HeartMapp, now copyrighted by USF, also provides patients with a web interface to access historical and real-time information about their physical condition using the Microsoft Wrist Band – to help with their physical activity and heart rate.

“HeartMapp is more than just a smartphone application, it’s a mobile information system,” Dr. Labrador said. “Besides the typical application technology, the system has different machines in the background receiving data from sensors and mobile devices, processing it with computer science algorithms and saving it in databases for patients, doctors, nurses and caregivers.”

Heart failure is a serious public health issue in the United States. According to Center for Disease Control and Prevention, more than five million people live with the condition. Heart failure occurs when the heart is not able to pump enough blood and oxygen to support other organs. Some symptoms include shortness of breath, weight gain, swelling and body weakness.

Supported by grants from the Florida High Tech Corridor and Draper Laboratory, the researchers have published several studies on HeartMapp in Wireless Health, Applied Nursing Research and Computers, Informatics, Nursing.

HeartMapp was also accepted into the National Science Foundation’s Innovation Corps (I-Corps) program, where researchers spent six months receiving real-world, hands-on experience that could help transition the mobile app out of the laboratory and into a commercially feasible product.

Dr. Athilingam and Dr. Labrador are currently working on a pilot study testing HeartMapp with nine patients from the USF Health Cardiology clinic. The patients, who are participating in the pilot study, find the app useful. A patient, who wishes to remain anonymous, thinks HeartMapp is a great tool that constantly keeps her informed about the state of her health.

“HeartMapp makes me self-aware,” the patient said. “It also allows me to keep track of my symptoms and be attentive of changes – pushing me to take action or check with my doctor regularly.”

Dr. Athilingam and Dr. Labrador are constantly updating HeartMapp with new features based on patients’ feedback. Their goal is to develop an efficient app that helps patients improve their overall health and well-being and reduce expensive hospital readmission rates.

“We’re hoping to get more funding to test the efficacy of HeartMapp to demonstrate that the app can improve patients’ condition and reduce hospital readmissions penalty fees,” Dr. Athilingam said. “When we show its efficacy, we could then potentially implement the product into cardiology clinics, commercialize it to companies and expand to iPhone and Microsoft operating systems.”

Both researchers are committed to HeartMapp. They will continue to work together as a team to improve the quality of life for patients with heart failure using the power of technology.

“In this day in age, there are difficult problems to solve,” Dr. Labrador said. “These problems need the knowledge and expertise of many different disciplines. If we don’t bring these disciplines together, we won’t be able to solve these complex problems.”

Story by Vjollca Hysenlika, video and photos by Sandra C. Roa, USF Health Office of Communications

The new department will be home to USF’s growing biomedical engineering program

TAMPA, Fla. (Jan. 4, 2017) —  The University of South Florida College of Engineering and the USF Health Morsani College of Medicine have established the Department of Medical Engineering, a unique transdisciplinary concept that will combine the related aspects of engineering and medicine while providing access to real-world health care environments for education and research.

The faculty will consist of both physicians and engineers specializing in chemical and mechanical engineering, biomedicine and nanotechnology with initial concentrations in a broad range of biomedical engineering areas such as nanotechnology for drug delivery, orthopedics, and cardiology, neurology and cancer.

“The new program will focus on how best to help patients and improve medical care,” said Robert H. Bishop, dean of the USF College of Engineering.  “We are creating an environment where intellectual collisions can readily occur between engineering professors, medical doctors, researchers, and students leading to innovative solutions that save lives and improve the quality of health care. In addition, occupations in biomedical engineering are typically high paying and are showing above average growth in the United States.”

Robert H. Bishop, PhD (left), dean of the USF College of Engineering, and Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine.

While most biomedical engineering programs are based only within engineering, medical engineering at USF will offer a unique concept that pairs engineers with doctors and medical residents in a clinical setting.  Graduate students will spend time at Tampa General Hospital meeting with surgeons and going into the operating room as observers.  In addition to completing a thesis, graduate students will be encouraged to obtain a patent and publish an article in a peer-reviewed journal.

“This medical engineering department will enhance opportunities for doctors and engineers to learn from one another in real-world clinical environments,” said Dr. Charles J. Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine. “It will facilitate joint work on applied research, including drug discovery and delivery and the development of medical devices and imaging to solve health care problems and improve patient care.”

The success of the USF biomedical engineering (BME) graduate program, which has grown more than 50 percent over the last five years and is currently the largest BME graduate program in Florida, is expected to lead to the launch of a bachelor’s degree program in biomedical engineering at USF in the near future.

Robert Frisina, director of the biomedical engineering program, will serve as interim chair of the Department of Medical Engineering.  An advisory group of National Academy members is being formed to help attract world class faculty to the new program.

About USF
The University of South Florida is a high-impact, global research university dedicated to student success. USF is a Top 25 research university among public institutions nationwide in total research expenditures, according to the National Science Foundation. Serving over 48,000 students, the USF System has an annual budget of $1.6 billion and an annual economic impact of $4.4 billion. USF is a member of the American Athletic Conference.

About USF Health
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and the USF Physicians Group. USF Health is an integral part of the University of South Florida, a high-impact, global research university dedicated to student success. For more information, visit www.health.usf.edu.

News release by Janet Gillis, Communications and Marketing Officer, USF College of Engineering

Media contact:
Anne DeLotto Baier, USF Health Communications
abaier@health.usf.edu, or (813) 974-3303

USF recently acquired the CAREN virtual reality system, a powerful tool that helps people with disabilities increase their independence and reintegrate into the community

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When you see the Computer Assisted Rehabilitation Environment system (CAREN) in action, the room-sized simulator resembles a giant video game, complete with avatars. Scenes projected on its 180-degree screen range from walking through a forest to driving past cityscapes to riding on a wave-tossed boat.

The three-dimensional virtual reality system engages and entertains – but its purpose is serious.

The system’s immersive environment and interactive gaming elements safely challenge people to learn new strategies for coping with changes in their balance, coordination or mobility caused by disability, traumatic injury or aging.  The advanced technology also gives researchers the scientific tools they need to advance the diagnosis and treatment of musculoskeletal and neurological disorders.

Watch time-lapse video of CAREN’s installation:

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Supported by a $450,000 National Science Foundation (NSF) grant, the University of South Florida recently became the first non-Department of Defense institution in the United States to obtain the CAREN extended model for research and rehabilitation, said William S. Quillen, DPT, PhD, associate dean of the USF Health Morsani College of Medicine and director of the School of Physical Therapy & Rehabilitation Sciences. Additional matching funds from colleges and schools across USF also helped purchase the approximately $1 million simulator

“The CAREN system will be a critical part of the university’s neuromusculoskeletal, traumatic brain injury and post-traumatic stress disorder research initiatives involving wounded warriors, warfighters and student veterans,” Dr. Quillen said. “The system will greatly facilitate our ongoing interdisciplinary research to analyze human mobility and function and to improve the quality of life for people with disabilities by increasing their independence and community reintegration.”

USF purchased the CAREN system with the support of grant from the National Science Foundation.

Integrated technologies add research and rehabilitation value

“This system integrates a lot of technologies typically used individually — like a split belt treadmill with force-sensing plates, a moveable base and motion capture analysis — to really help us better understand how an individual walks and moves in different terrains and environments,” said Kyle Reed, PhD, assistant professor of mechanical engineering in the College of Engineering.

The CAREN project will bring together more than 20 investigators with expertise in rehabilitation engineering and science from the colleges of Engineering, Medicine’s School Physical Therapy & Rehabilitation Sciences, Arts and Sciences, Behavioral and Community Sciences, Nursing, and Virtual and Performing Arts.  They will collaborate with researchers from James A. Haley Veterans’ Hospital and Draper Laboratories.

L to R: Seok Hun Kim, PT, PhD, of the USF School of Physical Therapay & Rehabilitation Sciences, with Kyle Reed, PhD, and Stephanie Carey, PhD, of the College of Engineering, look at the incoming information instantaneously displayed on CAREN’s control panel.

The system bridges the gap between the controlled environment of a laboratory or clinical rehabilitation setting and the uncontrolled community environments experienced in daily life.

“CAREN gives us a lot of opportunities to create variable scenarios that are closest to real-life environments,” said Seok Hun Kim, PT, PhD, assistant professor in the School of Physical Therapy & Rehabilitation Sciences.

Dr. Kim works with patients living with stroke, ataxia and other neurological disorders that significantly increase the risk for falls. “We can gradually increase the level of difficulty of the exercises based on patients’ performance using the CAREN system.  This allows patients to safely push their limits while working to regain balance control,” he said.

Dr. Carey secures the safety harness attached to Gordon Beadle before he begins a simulation exercise to try out his new prosthetic leg.

Gait analysis demo:  Strolling down a virtual path

During a recent demonstration in the USF Center for Assistive, Rehabilitation & Robotics Technology, Gordon “Skip” Beadle stood on CAREN’s platform safely secured in a harness suspended from a rigid frame attached to the platform.

The 71-year-old Vietnam veteran was there to try out a simulation exercise wearing his new prosthetic leg with a microprocessor-controlled knee and ankle, designed to more closely mimic natural gait.  Beadle lost his right leg in 1965 while his Marine infantry was clearing landmines as the unit advanced toward Chu Lai airbase north of South Vietnam.

Stephanie Carey, PhD, assistant research professor of mechanical engineering, leaned toward the simulator’s control panel, preparing to adjust settings and monitor the incoming data as Beadle began walking.  Jason Highsmith, DPT, PhD, CPO, associate professor in the USF School of Physical Therapy & Rehabilitation Sciences, watched from the side as the treadmill began.

The simulator’s integrated techologies, including the split-belt treadmill and motion capture system, provide real-time information to analyze gait.

As birds chirped through the surround-sound system, Beadle began his simulated stroll along a winding cobblestone path through the forest at a slow, steady pace.  Some bumps in the terrain were introduced by CAREN’s motion platform, and the treadmill’s speed gradually increased as Beadle picked up his pace when a cottage, the finish line, came into view ahead on the screen.

Dozens of reflective sensors on Beadle’s lower body detected by high-speed, infrared cameras tracked his every step and instantaneously relayed the information to the computer software overseen by Dr. Carey.

The CAREN project investigators eventually hope to work with virtual designers to recreate the terrain of the USF Tampa campus or downtown Tampa.

Engineering and scientific methods improve functional recovery

The immersive system precisely measures and integrates a variety of data valuable to researchers and therapists — including which muscles are working at any given time, length of stride, weight bearing distribution, and how an individual’s joints move and the amount of force placed on them.

The information can be used, for instance, to analyze and correct the asymmetric gait of patients recovering from stroke, to test and improve prosthetics for lower-limb amputees, and to design assistive devices such as orthotic shoes, crutches or canes that help users walk more efficiently without tiring easily.

The system, working in concert with a therapist, could also help desensitize those suffering from post-traumatic stress disorder by having them virtually re-experience situations that provoke anxiety in carefully controlled stages.

Beadle said the system’s safety harness significantly reduced his fear of falling.

The CAREN project investigators eventually hope to work with virtual designers to recreate the terrain of the USF campus or downtown Tampa for study participants or patients, Dr. Reed said.

“We’re just beginning to use the system for studies,” he said. “We expect in the next year or two we will have lots of results that can both help researchers at other universities and make life better for people with strokes, amputations, spinal cord injuries and other physical limitations.”

Pushing limits helps increase confidence, physical abilities

One of CAREN’s advantages is that patients feel protected by the safety harness that will quickly catch them if they begin to fall, so they become more comfortable stepping up their performance when challenged with new or more complex tasks – like negotiating a steeper incline, walking on an increasingly uneven surface, or maintaining balance while the ground beneath tilts to the right and left.

L to R: Jason Highsmith, DPT, PhD, School of Physical Therapy & Rehabilitation Sciences; Kyle Reed, PhD, College of Engineering; Dimitrios Menychtas, biomedical engineering doctoral student; Seok Hun Kim, PT, PhD; Physical Therapy & Rehabilitation Sciences; and Stephanie Carey, PhD, College of Engineering.

The safety feature definitely lessened his fear of falling, Beadle said when he finished the forest path exercise. “I can see where this type of therapy for someone just beginning to use a prosthesis would be beneficial in teaching balance and building confidence at the same time.”

CAREN allows therapists working with the system operators to gradually introduce obstacles that may be even more difficult than what patients would encounter in everyday life, Dr. Reed said.  “So, when they do face some small stairs or a street curb in a real-life situation, they can potentially say ‘I can handle that.  I’ve seen much bigger ones in the simulator system.’”

The NSF-funded project for USF’s CAREN virtual reality system is directed by principal investigators Rajiv Dubey, PhD, Sudeep Sakar, PhD, and Dr. Reed, College of Engineering; Dr. Quillen, School of Physical Therapy & Rehabilitation Sciences; and  David Diamond, PhD, College of Arts and Sciences and James A. Haley Veterans’ Hospital.

The simulation system mimics real-life environments. So, for instance, if the boat on video screen tilts left the ground beneath the person tilts left.

Video and photos by Eric Younghans, USF Health Communications

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