"Global Health is Why I'm an Engineer"

 

October 25, 2018

Through BTB’s global health curriculum and its associated opportunities for research, Jenna discovered the magnitude of the need for simple and cost-effective diagnostics, treatments, and preventive medicine in LMICs. She contributed to the design of a “Diagnostic Lab in a Backpack” aimed for use by medical outreach teams in LMICs to better equip them to provide care for patients in remote locations, and spent eight weeks in Lesotho evaluating the backpack’s efficacy and visiting remote clinics to gather feedback about its design. Jenna’s internship experience in Lesotho propelled her to continue her education in biomedical engineering and global health – “What really struck me is how few resources physicians and health providers had to work with in these remote settings, where so many of the Sesotho people live. I wondered what can I do about this?”

Jenna with the lab-in-a-backpack in 2008.

Photo credit: Rice University.

To gain further expertise in developing biomedical technologies for global health, Jenna pursued a Ph.D. in biomedical engineering at Duke University under the mentorship of Dr. Nimmi Ramanujam. Her graduate work focused on developing optical systems and automated algorithms to imaging breast tumor margins during surgery to ensure that all cancer is successfully removed, such that a woman does not need to come for a re-excision surgery. Since completing her Ph.D. in 2015, Jenna has been working with the Center for Global Women’s Health Technologies (GWHT) to develop low-cost, high-quality technologies to improve cervical cancer management in LMICs. A major bottleneck between screening and treatment is confirmation of disease. The first goal of Jenna’s postdoctoral work was to work with a vertically-integrated team of students, including Christopher Lam, Elizabeth Asma, and Rhea Chitalia to optimize the design of a technology called the Pocket Colposcope to screen women for cervical pre-cancer at the primary care setting to close the gap between screening and treatment. To confirm that the Pocket Colposcope performs comparably to a high-end commercial colposcope, Jenna worked with a team of collaborators to assess the Pocket Colposcope in a clinical study at Duke University Medical Center and at Liga Contra el Cancer in Lima, Perú. This work was recently published in the Journal of Lower Genital Tract Disease and British Journal of Gynecology (BJOG).  In addition, Jenna gave a TEDx style talk at DGHI's 10th symposium where she speaks on her experience, which can be seen here. 

Although low-cost, high-performance Pocket colposcopy can be made accessible at the community level, an equally important challenge is to ensure the availability of effective treatments at the same site. Surgical and ablative approaches are often not available at the community health level due to the relatively high cost, resources, and infrastructure required to offer these treatments. The second focus of Jenna’s postdoctoral research has been to work with a team of graduate students, including Robert Morhard and Corrine Nief, and faculty, including Dr. Nimmi Ramanujam and Dr. David Katz, to develop a “liquid scalpel” that can serve as an effective alternative to current therapies, at a fraction of the cost.

Dr. Jenna Mueller (center), Robert Morhard (left) and Corrine Nief (right) are optimizing ethyl cellulose-ethanol ablation to treat a variety of diseases.

The liquid scalpel leverages ethanol, a widely used ablative agent, in combination with ethyl cellulose to dramatically increase efficacy. Ethyl cellulose dissolves in ethanol; however, when injected into tissue it undergoes a phase transition to form a gel. The gel, which degrades within 24 hours at body temperature, locally sequesters the ethanol, maximizing effectiveness in the target tissue while minimizing leakage into the vasculature. Ethyl cellulose-ethanol ablation could be applied to treat a variety pre-cancers, cancers, and other diseases. Jenna and Rob are currently developing a methodology to optimize delivery parameters for a variety of applications, while Corrine is focused on applying ethyl cellulose-ethanol ablation to treat preclinical models of breast cancer. Last month, Jenna received a K99/R00 Pathway to Independence Award from the National Cancer Institute to develop an optimized procedure to deliver ethyl cellulose-ethanol into cervical pre-cancerous lesions.

Ultimately, Jenna plans to use the K99/R00 mechanism to prepare her for a faculty position in biomedical engineering and global health - “I am passionate about contributing to the betterment of humanity through research and development of new technologies to solve global health challenges, and through teaching, mentoring, and encouraging students to become global scholars that seek to serve their communities.”

Pocket Colposcope study at Duke University Medical Center:

https://www.ncbi.nlm.nih.gov/pubmed/28263237

 

Pocket Colposcope study at Liga Contra el Cancer in Lima, Perú:

https://www.ncbi.nlm.nih.gov/pubmed/29893472

K99 Project Abstract:

https://projectreporter.nih.gov/project_info_description.cfm?aid=9646520&icde=41767627

 

TEDx talk at Duke Global Health Institute’s 10th Anniversary Symposium:

https://www.youtube.com/watch?v=d_Igz6j3Mgw

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