After creating a list of various commercial equipment for the diabetic peripheral neuropathy project, the next step was to further solidify the experimental plan. Dr. Lucas planned to purchase some of the commercial equipment so that we could finally begin a mock experiment. Additionally, in order to do so, my following task was to map out the experimental workflow and create figures that describe details of the proposed prototype. One of these figures included an illustration of the sole of a foot to specify where the three sensors would be placed within a Cam-boot. I proposed two sensors would be placed across the area where the ball of the foot comes into contact with the shoe and the last sensor would be in the heel area. Most pressure would be applied in these areas, making them the optimal choice to obtain pressure information from the force sensors. Another figure illustrated a person’s side view with how and where the different prototype parts (vibrating actuator, controller, etc.) would be placed. This was to show all these parts all connected with each other. Related to this, in terms of experimental workflow, I had to detail how these parts connected (e.g. how sensors would connect to the microcontroller in the boot). Additionally, I considered how the experimental trials would be set up. I suggested that the subject wearing the boot with sensors would walk at various speeds and then compare the data to force plate data. Performing these mock experiments would allow us to next try the prototype with patients from the diabetes clinic. Results from this will be used to design and develop an implantable model of the prototype. Technological advancements in this aspect will benefit patients as the implantable sensors will recognize plantar pressure for them and stimulate the peripheral nerves. This provides patients with another solution than having to undergo amputation.

In the next steps of the diabetic peripheral neuropathy project I am helping Dr. Lucas with, I was given the task to construct an experimental design to test the prototype – foot sensors housed inside of a rigid shoe. Some of the necessary components to this prototype are pressure sensors, a controller, a power source, and a vibrating device. I was also tasked with identifying commercially-available equipment that can be used in this design. I started with searching up various types and brands of sensors that could be placed on the insoles of the boot with the Arduino Uno as the controller. Based on Dr. Lucas’s original experimental design, he planned to compare data from the foot sensors to results acquired from force plates, so I looked at different brands of plates as well. This is needed to ensure the sensors can properly convey plantar pressure since only 2-3 sensors would be used in both the prototype and the intended product. After making a list of potential commercially-available equipment, I focused on the experimental procedure. Due to the fewer number of sensors that were going to be used, I had to consider their specific placement inside the boot, so that the most amount of information could be obtained. The overall objective of the procedure I designed was to test plantar pressures at various speeds of walking and validate it with force plate values. Additionally, outside of this project, Dr. Lucas is also working on getting my partner and I a chance to observe one of his patient’s brain surgeries. This would be a very intriguing opportunity as we would be able to see how he works with the brain up-close. It would be a much different experience than simply watching a video on it, so I am excited for the chance!

In the last week of my preceptorship experience, I have finalized the project topic I will be working on and have begun to search for literature. The project I am working on revolves around diabetic peripheral neuropathy where damage occurs to long nerves, such as those in the foot [1]. Due to this damage, patients undergo severe neuropathic pain and can eventually lead to amputation [1]. To prevent the need of amputation which can be burdensome to the patient and their financial situation, Dr. Lucas intends on developing an implantable system that utilizes minimally invasive and wireless sensors to recognize plantar pressure and supply peripheral nerve stimulation. I was able to learn more about the long-term direction of this project from his Specific Aims page and the specific objectives he plans to complete. As this project will continue on even after my time with Dr. Lucas, my main task from this experience is to help develop an alpha prototype of an external foot sensor for beta testing. I am excited to learn more about technology development and the different testing phases that occur in this process, as well as gaining hands-on experience. To start out, I am performing literature searches and getting used to understanding and identifying relevant literature. Some scientific papers I have read discussed the background of diabetic peripheral neuropathy, the effectiveness of spinal cord stimulation for chronic spinal pain, the engineering behind brain-controlled bionic hands, and methods of restoring somatosensation using integrated sensor-brain-machine interfaces. I found the paper about bionic hand engineering to be very interesting as it explained the neural basis of somatosensation and the relevant brain structures. The purpose of these literature searches is to gain a better understanding in order to propose equipment and experimental approaches for this project’s objective in our next meeting. In the upcoming week, we will establish a more specific research plan.

[1] Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology, 7(12), 938–948. https://doi.org/10.1016/s2213-8587(19)30081-6

My preceptorship is with Dr. Timothy Lucas, a neurosurgeon who is also the CEO of the NeuroTech Institute and works to develop novel technologies to treat conditions relating to neuroscience. As of now, we have met virtually twice over Zoom to go over the applications of biomedical engineering within neuroscience and the potential projects students could be working on for the remainder of the semester. The first project involves diabetic neuropathy which is a condition where the nerves are damaged due to high blood glucose levels. Symptoms of this condition include numbness, pain, and loss of sensation in their lower legs or feet. In an effort to restore communication from the nerves in the feet to the brain, Dr. Lucas intends to implant very small sensors on the sole of the patient’s foot which sends signals to a device higher up on the leg and interacts with the spinal cord. There will be multiple sensors spread out on the foot and due to their very small size, there is little risk of it moving around on its own and causing any unwanted disruption. Unlike with larger implanted devices that have a risk of moving around within the body due to the patient playing or fiddling with it, Dr. Lucas does not see any of this happening with the sensors he will be utilizing. Additionally, there poses no problems with its removal from the body if it does in case become damaged and it would be a relatively simple procedure to do. Dr. Lucas discussed he is currently testing the alpha prototype of the device where the sensor is placed at the bottom of a CAM boot. Patients would then wear the boot and spend time walking in it, doing everyday tasks. The purpose of this is to gauge the patient’s comfort levels and to understand whether they like the device or not. The second project focuses on understanding various human conscious states. Dr. Lucas aims to determine the key differences between each state (e.g. what makes someone awake). He mentioned how looking at alpha or beta waves is not enough information to actually describe a conscious state as brain waves is more surface-level information. By next week, I will be actively participating in one of these projects.

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