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Engineering in Medicine and Biology Society

Calendar Year 2016 Presentations

Novel Long Lasting and Biocompatible Hyalyuronic Acid (HA) for Large Volume Body Augmentation
Phi Nguyen, MD
Founder and CEO
MIBA Medical, Inc.

MIBA Medical, Inc., a medical aesthetic company, is working on products for restoring youthfulness and enhancing patient's natural beauty, all without the need for surgery and scars. Our products offer patients a superior alternative to rejuvenate facial wrinkles and to enhance the natural beauty of their breasts and/or buttocks. Our patent-pending Adaptive Volume Restoration™ (AVR™) technology uniquely™ enables our products to provide a smooth and natural tissue feeling that is safe and long lasting, yet cost-effective for patients. MIBA's AVR technology specifically addresses four long-felt, yet unsatisfied needs by the aesthetic volume augmentation market: (1) A “truly” biocompatible filler. A filler that will not cause granulomas or hard nodules, (2) a natural feel that is similar to surrounding native tissue, (3) greater volume longevity, and (4) complete reversibility without the need for additional surgery or scars.

A graduate of Rice University, Dr. Nguyen went on to medical school in the world renowned Texas Medical Center where he obtained his medical degree from University of Texas Medical School at Houston in 1991. Dr. Nguyen began his training in General Surgery and then Plastic Surgery fellowship at St. Joseph Hospital in Houston, Texas. He completed his formal fellowship training in Plastic Surgery under the guidance and wisdom of the legendary Thomas Cronin, M.D., Raymond Brauer, M.D., and Thomas Biggs, M.D. plastic surgery group in Houston, Texas. This group is credited with many contributions and breakthroughs in plastic surgery including the invention and introduction of the breast implant, advances in cosmetic surgery, breast reconstruction, cleft lip and palate surgery, and hand reconstruction. He began private practice in 1997 and co-founded River Oaks Plastic Surgery Center. This center is dedicated to excellence in plastic surgery and offers the latest in surgery and skin care to their patients. Dr. Nguyen also served as the Medical Director of the Microsurgery Program at St. Joseph Hospital in Houston from 2003-2004. He is currently the Medical Director of Victoria Cosmetic Surgery Center since 2005 and has a large Asian clientele and is well known and respected internationally in the Asian community for his talent in plastic surgery. Dr. Nguyen is also a member of numerous medical and surgical societies and he sits on the board of the Vietnam Forum Foundation, which is a non-profit organization with the purpose to aid in education for those in need in his homeland of Vietnam.

mHealth Physiologic Monitoring Solutions with Ultra Wideband RF Radar
Steve Stephansen
LifeWave Biomedical

LifeWave Biomedical, Inc. is an mHealth company that is developing groundbreaking mHealth monitoring products that are capable of improving health and improving care in home, remote and medical care settings. LifeWave is a leader in a new class of wireless and wearable physiologic sensors using a novel, very safe, low energy RF technology for both consumer and clinical markets. The technology enables internal organ tissue assessments and real-time monitoring that is unmatched by any other wearable technology. A key differentiator of the company is the ability to provide products that bridge health and wellness monitoring with clinical monitoring, enabling continuums of care across settings and health states.

Steve is the CEO of LifeWave Biomedical and is responsible for its general management and execution. He is a 30 year veteran of the high tech industry and has a strong record of achievement in the global commercialization of highly innovative technology products. His domain experience includes semiconductor solutions for high speed computing and signal processing, Internet video capture systems, and mobile application software. His functional experience has spanned marketing, sales, business development, and general management roles in technology companies.

He was previously CEO of WebV2, Inc. and Agoura Technologies, both venture backed technology copies. He previously held the position of VP of Marketing & Sales at Information Storage Devices, a semiconductor company, which he grew from product launch to a public company. He also served in several senior marketing and sales positions at Advanced Micro Devices (AMD) early in his career and later as VP of Strategic Marketing.

He holds an MS in Management from the Stanford GSB, an MBA from Santa Clara University, an MSEE from Rensselaer Polytechnic Institute, and a BSEE from Lehigh University. While pursing his MS in Management at Stanford, he studied medical device development in the BioDesign program.

The Evolution and Future of Mechanical Circulatory Support for Congestive Heart Failure
Dr. J. Donald Hill, MD

The modern era of mechanical circulatory support (MCS) for chronic congestive heart failure (CHF) began circa 1964. Michael Debakey in 1963 ushered it in. He convinced fellow Texan and then President of the United States Lyndon Johnson that the world needed an artificial heart. A small amount of contract funding was provided. It was not a moment to early. The therapy for CHF was based on very rudimentary drug therapy. In the last 5 decades that has improved substantially but is not a significant deterrent for the increasing morbidity and mortality of CHF. Heart transplantation, introduced in 1967, and leaping forward in the early '80s with the introduction of cyclosporine immunosuppressive therapy is an excellent therapy. Its weakness, as a public health solution for CHF, is the stubborn limited availability of donor hearts being at stuck at 2000-2200/yr. for two decades. That falls far short of the 40,000-50,000 hearts/year needed. The number of patients at risk is increasing every year as the baby boomers reach 65 years of age. Now approximately 5-6 million people have some stage of CHF at any one time.

The National Institute of Health (NIH) managed the Artificial Heart Program (AHP). There were four research pathways that included energy, a control system, biomaterials, and the pump. This original AHP was the seed that drove much of the applied science that fortified private companies to get into the sector later.

Nature's very successful biological heart was the model adapted to reproduce. Aggressive specs were adapted. Total implanted heart replacement, pulsatile flow > 10/min, and tether-less power supply. This meant valve pusher plate pumps that were attached to the atrial remnant after the heart was removed.

The holy grail of chronic MCS is conquering the blood-foreign surface interface that leads to thrombus and patient embolic strokes. Much progress has been made but it remains today the single most troublesome property of Mother Nature to tame. The design and management act of balancing anti-thrombogenic surfaces and anticoagulation vs. thrombo-embolism and/or bleeding has never gone away.

Dr. J. Donald Hill was born and raised in Halifax, Nova Scotia, Canada. He graduated from Dalhousie Medical School in Halifax in 1960. He received his general and thoracic surgical training at Cincinnati General Hospital, Victoria General Hospital in Canada, and California Pacific Medical Center in San Francisco. Dr. Hill also spent one and a half years doing animal based cardiac device research at the Thoracic Clinic of the Karolinski Hospital in Stockholm, Sweden from 1961-1963. Dr. Hill was a practicing cardiovascular surgeon from 1966 - 2009. He served as Chairman of the Department of Cardiac Surgery at California Pacific Medical Center (“CPMC”) in San Francisco from 1979 to 1999. He served as Director of the Heart Failure, Transplant, Artificial Heart and Circulatory Support Program at California Pacific Medical Center in San Francisco from 1984 to 2003.

Dr. Hill also served as Surgical Director of the Artificial Heart Program at the University of California in San Francisco from February 2004 to November 2007. Dr. Hill is a founder of Thoratec and a director since its inception. He is a pioneer in the development and use of ventricular assist devices and played a major role at Thoratec throughout the history of the company.

Dr. Hill served as Chairman of the Board at Thoratec Corp. from January 1995 to June 2007 and became an Independent Director and Vice Chairman of Thoratec Corp. from June 2007 until May 2009.

In September 2009 he retired from clinical practice and transitioned from his role on the Board to full time Sr. Medical and Clinical Advisor within Thoratec. Dr. Hill works primarily in Technical Operations and R&D, Scientific Affairs and Research, and Business Development. He currently has more than 25 patents of his own in various cardiac surgical areas and other patents associated with Thoratec.

A History of Robotic Surgery, Controversy and Future Developments
Jonathan Sorger
Intuitive Surgical, Inc.

Intuitive Surgical was founded about 3 miles from Stanford in 1995 and helped usher in an era in which computer-assistance brought minimally invasive surgery to millions of patients.
Today, Intuitive is the global technology leader in minimally invasive robotic-assisted surgery, is headquartered in Sunnyvale, and employs over 3000 people. The company designs, engineers and manufactures the da Vinci® Surgical System, which enables surgeons to operate through a few small incisions or the belly button from a nearby console. The System features a 3D, fluorescence-capable vision system and tiny wristed instruments with greater precision and dexterity than the human hand. Released in 2014, the da Vinci Xi System is the latest iteration of the System, and over 3500 da Vinci's are used to perform approximately 1800 surgeries per day around the world. During this presentation, Jonathan Sorger will talk about the history of the company, some of the challenges it has faced and how it views technology development.

Jonathan Sorger grew up in the South Bay, graduating from Leland High School in 1992. He went on to study bioengineering at the University of California, San Diego and obtained his PhD and MBA degrees from Johns Hopkins University while working at the National Heart Lung and Blood Institute on cardiovascular MRI and stem cell biology. Jonathan returned to the Bay Area in 2003, helping to develop the first-year PhD curriculum for the newly-formed Bioengineering department at Stanford, where he taught until 2006. With his first child on the way and a startup not progressing very quickly, Sorger moved a whopping 3 miles away to work at Varian Medical Systems, where he helped manage Varian's biology research as it related to radiation oncology. In 2010 Jonathan started at Intuitive Surgical, where he focused on bringing alternative imaging modalities into the surgical scene. Today he works in research, helping to evaluate and adapt new technologies for use with robotic systems in order to improve patient outcomes during surgical interventions. Jonathan enjoys running, flying planes and being in the water.

Digital Medicines Provide Physicians With Insights into Patient Medication-taking Patterns and Physiologic Response, Enabling Efficient Therapy Optimization
Mark J. Zdeblick, Ph.D.
Co-Founder, Chief Technology Officer
Proteus Digital Health, Inc.

Proteus Digital Health is a company with an innovative solution for activating patients and helping improve medication adherence. This novel digital Medicines as a Service (MaaS) offering is called Discover. Discover utilizes sensor-enabled pills and small wearable patch that unlocks comprehensive data about medication adherence and clinical effectiveness, empowers more meaningful conversations between patients and caregivers, and delivers actionable insights about entire healthcare populations. Discover and patient and physician reaction will be described in detail. The talk will conclude with highlights from recently announced (ACC, April 2016) cluster randomized trial that revealed that patients with uncontrolled hypertension and diabetes who used Proteus Discover achieved statistically significant reduction in blood pressure (BP) and low-density lipoprotein-cholesterol (LDL) and were more likely to achieve their BP goal than usual care.

Prior to co-founding Proteus Digital Health, Mark Zdeblick served as the chief technology officer for the optical switch group at K2 Optronics. Dr. Zdeblick is also founder, director and past chief technical officer of Redwood Microsystems, developer of the world's highest performance microfabricated valves and electro-fluidic integrated circuits. While working in Professor Calvin Quate's engineering group at Stanford, Dr. Zdeblick invented the microfabricated cantilever beam with an atomically sharp tip that enabled atomic force microscopy. He holds a B.S. in civil engineering (Tau Beta Pi, Phi Eta Sigma) and a B.A. in architecture, both from the University of Illinois, and an M.S. in aeronautics and astronautics and Ph.D. in electrical engineering from Stanford University. He is named as an inventor on over 300 issued patents and is an advisor and/or lecturer to engineering programs at Rice University, Stanford University, and UC San Diego.

Scuba Diving at the Nanoscale: Novel Probes for Reliable Scanning Probe Microscopy in Liquids
Dominik Ziegler
Scuba Probe Technologies

Better understanding of biological processes at the molecular level requires the ability to image soft matter at high resolution. Using scanning probe force microscopy it remains challenging to visualize how proteins work together in native membranes. Mostly, this is because of the high viscous damping, which increases the interaction forces and results in deformation or even damaging of soft samples. The invention of encased cantilevers overcomes these limitations. Encased cantilevers trap a bubble around the cantilever and thus experience significantly less damping and gentle, non-invasive forces can be applied. As the encasement is optically transparent the devices are compatible with all existing commercial instruments using optical beam deflection detection. Superior performance is demonstrated on correct height measurements of soft matter such as lipid bilayers. Furthermore, self-assembly of collagen was observed in-situ and lattice resolution of mica could be achieved repeatedly. Using force spectroscopy we revealed multiple hydration layers demonstrating the low-noise characteristics of encased cantilevers. Beyond gentler imaging, encased cantilevers enable electrostatic excitation, interferometric detection, and quantitative mass sensing as entirely novel applications. Adding a conductive layer to the encasement the cantilever can be electrostatically driven without requiring any electrode alignment. In contrast to the commonly used piezo based excitation, such electrostatic actuation solely shakes the cantilever resulting in a clean resonance free from artifacts and spurious peaks. This enables quantitative studies of tip sample interaction. Adding a metal film enables to use the encasement for interferometric detection. The cantilever and the encasement form a Fabry-Pérot optical cavity. For specific gap size the light reflected from the encasement destructively interferes with light exiting the cavity. A first prototype achieved deflection noise densities that outperform commercially available instruments. Measuring intensity of the reflected light rather than its position also only requires crude alignment and enables high bandwidth position detection using a single photodiode. Another application beyond imaging is cantilever based mass sensing. Conventionally mass is measured indirectly over the induced stress resulting in a static bending of the cantilever. Unknown binding location and low Q-factors have limited use dynamic detection methods in liquid so far. Using encased cantilevers, however, the binding of a specific analyte only occurs at the exposed tip. Hence, the mass of the analyte can be quantitative extracted from the frequency shift, which can be easily tracked due to the high quality factor. We detected single binding events of nanoparticles with a detection limit of 80¬†attograms/√Hz. Improving cantilever geometries and/or using higher eigenmodes has the potential to extend this frontier of mass sensing in liquids down to few zeptograms. This corresponds to the mass of a single small protein.

Dominik Ziegler graduated from EPFL in Lausanne and received his Ph.D. from ETH Zurich. His research on MEMS includes implantable sensors, medical devices, and high precision instrumentation such as scanning probe microscopes. He has extensive experience with scanning probe techniques and ultra low-noise equipment in general. His various inventions related to Kelvin Probe Force Microscopy have improved the ability to measure charge distributions at the nanometer scale and helped studying charges in electret films, organic field effect transistors, and work function of few layers graphene devices. As a postdoc at the Lawrence Berkeley National Laboratory he focused on high-speed scanning probe techniques using non-raster scan patterns. Moreover, he combined his expertise in MEMS and scanning probe microscopy to develop encased cantilever. As co-founder of Scuba Probe Technologies LLC, he currently aims to market these innovative new sensors to provide a solution for more reliable and sensitive exploration of nanoscale science in liquids.

7:30pm, Wednesday, OCTOBER 19th, 2016
Room M114 of the Stanford Medical School

Surgical Robotics Development - From Research Lab to Commercialization
Jian Zhang, Ph.D.
Co-Founder and former CEO

The talk will primarily focus on the development of a surgical robotics prototype for cochlear implant surgery. Key design considerations and development process will be discussed. Challenges in existing manual cochlear implant surgery will be addressed. Iterations of engineering design and validations further improve the results in dry lab and in vitro study. Key findings in the robot-assisted cochlear implant experiments will also be presented. A comparison between research lab engineering development and corporate or start-up engineering development will also addressed. Different design considerations and procedures need to be followed and taken care of in order to later prepare the system for animal or human studies.

Dr. Jian Zhang was the CEO and co-founder of RobotPhoenix, a venture backed startup in China. During his tenure, the company developed a delta robot for packaging, from prototype to production. The company raised 4 million dollars venture capital. In 2015, the company's revenue reached about 2 million dollars. Previously, he was the director of system engineering and research at Auris Surgical Robotics, where he was part of the founding engineering team (employee #2) and lead the early system development which was used in First in Human studies. Auris has developed two generations of surgical robotics systems and closed a total of 190 million dollars venture capital. The system also received FDA clearance in 2016. Before joining Auris Surgical, he was part of the core engineering team developing the da Vinci Xi Surgical System. Dr. Zhang received his M.S. M.Phil., and Ph.D. degrees with distinction from Columbia University. His doctoral research "Robotic Assistance to Cochlear Implant Surgery" was funded by the United States National Science Foundation. His second research project on "High throughput automated minimally-invasive radiation biodosimetry" was supported by the United States National Institute of Health. His research has been reported by the Associated Press, New York Times, and Nature website. Dr. Zhang co-authored one book chapter and more than 20 peer-reviewed journal and conference papers. He's been technical reviewer for IEEE Transaction on Robotics (IEEE TRO), the International Conference on Robotics and Automation (ICRA), and the International Conference on Intelligent Robots and Systems (IROS). He also owns two US patents, two international patents, seven Chinese patents, with nine other US patents and two Chinese patents pending. He also won the MICCAI 2006 Young Scientist Award. As an entrepreneur, he was awarded as the Thousand Talents Plan in China.

7:30pm, Wednesday, NOVEMBER 16th, 2016
Room M114 of the Stanford Medical School

Progress in the Development of an Artificial Pancreas
Dr. Bruce Buckingham, MD
Pediatric Endocrinologist
Stanford Medical School and Hospital

Closed loop systems, also known as the "artificial pancreas", have the potential to greatly improve the health and quality of life for people with diabetes who use insulin. I will discuss progress in closed-loop systems for people with type 1 diabetes. I will discuss the 670G pump which recently received FDA approval, and also discuss our work with some of the other systems included the Bionic Pancreas, Bigfoot Biomedical, Insulet, the University of Virginia, Type 0, and others.

Dr. Buckingham received his medical degree from University of California at San Diego. He completed his internship, residency, and fellowship at Children's Hospital of Los Angeles. He is currently a Professor in the Department of Pediatric Endocrinology at Stanford Medical Center and the Stanford Children's Hospital. His research focuses on continuous glucose monitoring in children and closed-loop (artificial pancreas) systems. He has collaborated on various overnight and 24-hour closed-loop platforms in development and has helped to develop algorithms for detecting infusion set and sensor failures and to improve infusion set wear duration.

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