Mobile phone-based detection of neonatal jaundice
TEAM NAME: MobileMed Enterprises
Christina Baker
Giselle Fontela
Pierce Jones
Brendan Lynch
Sloan Sypher
Chetan Patil, Ph.D.
NCIIA Project Proposal
Abstract:
Neonatal jaundice is a condition that affecting around 60 percent of all newborns and is characterized by a buildup of the yellow pigment, bilirubin, in the blood. While the jaundice condition can recede naturally and may not cause any discomfort or harm, high levels of bilirubin associated with jaundice can cause brain damage or even death if left untreated. In the US, non-invasive screening for jaundice with an optical bilirubinometer is part of the standard of care, however the cost of these devices limits their availability to resource-constrained areas of the world. In designing a low-cost, mobile phone-based bilirubinometer, we aim to:
- prototype a software application that measures skin reflectance at 2 wavelengths from a mobile phone-based camera
- ensure safety via built-in functions to quantify adequate camera performance and detection
- test the software on a range of commonly available phone models and on infants of various skin tones that are afflicted with the condition
Introduction:
Neonatal jaundice, or neonatal hyperbilirubinemia, is a yellowing of the skin, appearing in newborn children with excess amounts of bilirubin in their blood. Bilirubin develops as the byproduct of normal heme catabolism and, thus, can develop in excess for numerous reasons such as increased red blood cell volume, increased bilirubin circulation, or ineffective secretion via bile. For most infants, jaundice develops mostly because of the elevated amounts of unconjugated bilirubin during the first week; this cause is also referred to as physiological jaundice and can be quite common and oftentimes even normal.
Although many infants are born with hyperbilirubinemia due to the normal hemolysis of red blood cells that were necessary for fetal circulation before birth, pathological jaundice can persist in some infants, causing a much more serious diagnosis, resulting in severe and permanent brain damage or even death. To be clinically declared as pathological jaundice, there are four main parameters, only one of which must be met. First, the infant can exhibit jaundice within the first 24 hours or after the first 14 days of life. The second criterion is an increase in bilirubin of more than 8.5 mg/dL per hour. Third, jaundice is diagnosed if the total concentration of bilirubin is greater 19.5 mg/dL at any point in the infant’s life. Finally, the fourth measure is if the direct concentration of bilirubin is greater than 2.0 mg/dL. Because of these four parameters, our experiment will focus on children greater than 14 days to ensure that we are testing for pathological jaundice and not physiological jaundice.
In determining whether or not an infant’s condition can be classified as pathological jaundice or not, most of the conditions listed above require invasive methods. Another, non-invasive option for determining jaundice is with an Ingram icterometers which directly measure the yellowness of the infant’s skin. In the United States, these devices are quite commonplace and are typical in the standard of treatment of newborns. Because of their cost, however, these devices or far less available in low-income resources and remote locations. The prohibitive nature of these devices is especially unfortunate because of how simply jaundice can be treated, infants usually requiring treatment as simple as extra sunlight or changes in breastfeeding.
In order to supply low-income and low-resource areas with a better standard of care for all newborn infants, our team has several aims for our project. First, our main goal is to develop a software application that can determine jaundice within infants using skin reflectance with as few as two different wavelengths via a mobile-phone camera. Second, we want to ensure safety through verifying accurate camera performance and detection. Finally, we aim to carry this study into trial studies, attempting to use the program on several different phone models when looking at infants afflicted with this condition. Through our research, development, and trials, we hope to better guarantee higher quality of care for all newborn infants
Team:
Our team consists of five undergraduate seniors: Christina Baker, Giselle Fontela, Pierce Jones, Brendan Lynch, and Sloan Sypher. All members are majoring in Biomedical Engineering and have acquired extensive knowledge in various physiological processes, signal analysis, and computer programming. In fact, one of our group members, Brendan Lynch, has had experience with mobile phone programming for games and basic applications. He also has a strong background in software development. Another group member, Giselle Fontela, has had three summers worth of experience in various kinds of signal analyses in a research laboratory setting. Christina Baker has also acquired signal analysis skill in a research laboratory setting. Pierce Jones has taken several classes in instrumentation, medical imaging, and human physiology. He has also has research experience on campus, working in a clinical setting. Sloan Sypher has been involved in Searle Systems Biology and Bioengineering Undergraduate Research Experience (SyBBURE) and has had imaging experience using Image J. Two group members, Christina Baker and Sloan Sypher, are minoring in Engineering Management. The knowledge that they have acquired through the required courses for the minor will provide our team with expertise in development and marketing strategies. In addition to her minor, Sloan has internship experience with patent search of analogous technologies and mapping of market environments of competitor products and technologies. It should be noted that as project develops, more specific roles will be assigned to each group member based on their skills. For further background on each group member, reference Appendix A.
Our team will be working under Dr. Chetan Patil, a Research Assistant Professor of Biomedical Engineering. He is a member of the Biomedical Optics Laboratory and has recently been awarded a grant from the Bill & Melinda Gates Foundation to develop this particular project. Mapping of competitive technologies
History and Context:
Previous Work and Current Progress:
On May 9, 2012, Dr. Patil was awarded a $100,000 grant from the Bill & Melinda Gates Foundation to test the ability of an adapted mobile phone to diagnose jaundice in newborns in developing countries.
Dr. Patil is working on testing the flash and detector response of phones commonly available in the developing countries. The phone’s camera and simple applications are used to detect levels of bilirubin through the skin, which allows for a diagnosis to be made so that treatment as simple as increased exposure to sunlight can begin.
Target Market
The target market will depend on the accuracy and sensitivity of the device. Initially the target market is hospitals, clinics, and expecting family members in resource-constrained settings. Although for the purpose of our own research and prototyping we will be introducing our product to the local area, the specific grant from the Gates Foundation, our product will later be introduced to sub-Saharan Africa and is meant for that area. To this extent, all phones, software, and testing will be geared towards this ultimate target market of sub-Saharan Africa.
The device being a software package on commonly available mobile phones means that everyone from the doctors and nurses to the infant’s parents could purchase the software if they have the right phone. Furthermore, if the device can prove to be on the same order of accuracy as the current optical bilirubinometer then the target market will increase to areas outside low-resource settings.
Work Plan and Outcomes:
See Appendix B for Gantt Chart.
First, the team must characterize the response curve of the smartphone camera by conducting a series of tests in the biomedical optics laboratory at Vanderbilt University. Then we will calculate a logarithm, which normalizes the results to a 1:1 ratio to the white light spectrum. If need be, lenses will be utilized to select for the specific wavelengths of interest. Then we will compile data in order to create a Weiner Estimation that will serve as a reference to diagnose pathological jaundice from the smartphone application. After we have compiled this data, we will present it to the team of computer scientists that will program the application to run on the Android platform used on the top smartphones in Sub-Saharan Africa. By the end of the year, the application should be fully functional and field ready.
Evaluation, Sustainability Plan:
This device would be more sustainable if it were programmed to run on a variety of different smartphone platforms (iPhone, Android, HTC, etc) so that patients would be able to use the program on their own device without making the trip to a clinic or physicians office. Additionally, environmental considerations such as the conservation of paper and other naturally derived resources should be considered. One such method of conservation would be to administer diagnoses of positive neonatal jaundice results electronically. Also, it is important that the application has an innate trouble-shooting function that sends error reports in order to analyze bugs in the application before failure occurs.
Budget:
Any necessary funding will be provided for by a $100,000 grant received by Dr. Chetan Patil from the Bill and Melinda Gates Foundation.
Appendices:
A.)Group Member Resumes (see attached pages)
Christina M. Baker
Current Permanent
PMB 352115 7301 Capilla Court
2301 Vanderbilt Place Coral Gables, FL 33143
Nashville, TN 37235-1234 (305)665-7654
(305)775-8574
EducationVanderbilt University Nashville, TN
Bachelor of Engineering, May 2013
Major: Biomedical Engineering; Minor: Engineering Management
Ransom Everglades Upper School Miami, FL
Graduation date: May 2009
RelevantBiomedical Materials, Tissue Engineering, Therapeutic Bioengineering, Biomechanics, Circuits I and II with Lab,
Coursework General Chemistry A and B with Lab, General Physics A and B with Lab, Introduction to Biological Sciences A and B with Lab,
Introductory Programming for Engineers and Scientists, Physiological Transport Phenomena, Differential Equations with Linear Algebra, Systems Physiology 1 and 2, Medical Instrumentation with Lab, Analysis of Biomedical Data, Technology Strategy, Applied Behavioral Science, Engineering Economy, Program and Project Management
Work Jackson Memorial Hospital/University of Miami, Miller School of Medicine
ExperienceMiami, FL
Research Assistant, Department of Anesthesiology June 2012 – August, 2012
Worked under Dr. Bruce Saltzman to develop a pharmacokinetic/pharmacodynamic model for the drug dilaudid
Collaborated with pharmacologist Dr. William Wolowich at Nova Southeastern University to determine dilaudid’s therapeutic range, which led to implementation in Dr. Saltzman’s practice
Utilized software programs AnestAssist and Phoenix to aid in the development of the models
The Miami Project to Cure Paralysis at the University of Miami, Miller School of Medicine
Miami, FL
Research Assistant May 2011 – August 2011
Researched under Dr. Justin C. Sanchez, Head of the Department of Biomedical Engineering at the University of Miami and Director of the Neuroprosthetics Research Group
Participated in a research study concerning Brain-Computer Interfaces and their applications to rehabilitation treatment methods for paralysis patients
Constructed a poster explaining the study and presented it to all researchers and assistants involved in the program
Cinema Equipment and Supplies Miami, FL
Sakes Assistant June 2010 – August 2010
Utilized the accounting software Quickbooks to produce sales orders, purchase orders, and invoices
Provided customer service by answering the phone and greeting potential clients
Organized and filed customer documents
Honors and Biomedical Engineering Society Member
Activities National Spanish Honors Society Member (2008)
Vanderbilt Students Volunteering for Science Member (2009-present)
Teach inquiry-based, hands-on science lessons to middle-school students
Society of Women Engineers Member
Society of Hispanic Professional Engineers Member
Publicity Chair
Increased presence of the Society on campus by making posters, organizing information sessions, and submitting a calendar of the Society’s events to the Engineering School’s email list serve
Kappa Delta Sorority Member – Beta Tau Chapter
Philanthropy Chair
Hosted an event for 300 potential new members to inform them of our four national philanthropies
Organized the decoration of a craft by each potential new member to be donated to the Girl Scouts of America in order to promote confidence in young girls
Ritual Chair
Arranged and set up for first, second, and third degree initiations
Emphasized the importance of our historic rituals with monthly reminders and information during our chapter meetings
SkillsMicrosoft Office Suite, Matlab, Mathematica, LabVIEW, Spanish: working proficiency, FEMA certified Emergency Manager
Giselle Fontela
Current Address: (305) 778-6536Permanent Address:
1016 18th Ave South8825 SW 100 ST
Unit # 505Miami, FL, 33176
Nashville, TN 37212
EducationVanderbilt University, Nashville, TN
Bachelor of Engineering, Biomedical EngineeringAnticipated, May 2013
GPA: 3.58/4.00
CoursesBiomechanics, Biomaterials, Physiological Transport, Systems Physiology, Circuits, Instrumentation, Therapeutic Bioengnineering, Tissue Engineering, Biostatistics, Biology, Organic Chemistry, Physics
Experience The Miami Project to Cure Paralysis, Miami,FL Summer 2011 and Summer 2012
- Worked with Dr. Christine Thomas in the Neuromuscular Physiology Laboratory
- In 2011, conducted research experiments on muscle spasms and effects of passive muscle stretch on lasting H-reflex depression in humans
- In 2012, conducted research on using an FES system to restore sufficient ankle excursion for walking in rats with reinnervated lower leg muscles
- Designed and developed an intramuscular electrode for EMG recordings in rat leg muscles
- After extensive data analysis, summarized research results in an abstract and prepared a poster to present in a poster session at the conclusion of each summer
University of Miami Neurosensory Engineering Lab, Coral Gables, FL, Summer 2010
Lab Intern
- Worked with Dr. Ozdamar and Dr. Bohorquez of the biomedical engineering department
- Worked on individual project, using EEG to record and analyze the auditory middle latency response of the brain to frequency and amplitude modulated auditory signals
The Learning Co-operative, Miami, FL, Summer 2010
- Part time editing/proofreading for SAT and ACT practice problems and tests
LeadershipVanderbilt Students Volunteer for Science, September 2009-Present
Team Leader
- Led a group of Vanderbilt students to volunteer on a weekly basis at middle schools to promote an early interest in science careers, by teaching hands-on science lessons/experiments to middle school students
Alpha Epsilon Delta Society, September 2010-Present
Undergraduate mentor and Service Trip Participant
- Mentored a group of younger undergraduate students interested in pursuing a medical career
- Participated in a medical service trip to Honduras during my 2012 Spring Break
- Trip consisted primarily of one week assisting at clinics and hospitals in Northern Honduras
Vanderbilt Association of Hispanic Students, September 2009-Present
Active Member
- Organize and participate in activities and events to spread knowledge and celebration of Hispanic culture on the Vanderbilt Campus
Pi Beta Phi, January 2010-Present
Philanthropy Round Chair, 2011
- Organize the presentation of the chapter’s philanthropic services for the philanthropy rounds of formal recruitment and volunteer in community service projects organized by the chapter
Scholarship Committee Chair, 2012
- Headed a committee in charge of overseeing GPA/scholarship of potential new members
SkillsFluent in Spanish, Proficient in Microsoft Office (Word, Excel, PowerPoint), Matlab, Labview, Mathematica
B) Gantt Chart