Congratulations to Jiamei Hou, M.D., Ph.D., Michael Franklin, D.O., Sanjeev Kumar, M.D., and Isaac Luria, M.D., who have received IHAF 2021 Education Awards from the I. Heermann Anesthesia Foundation (IHAF).
The purpose of IHAF is to encourage and support scholarly pursuits designed to enhance the field of anesthesia through clinical research, laboratory research, publication, the teaching of anesthesia, and the ultimate application of such knowledge to the welfare of the patient.
Jiamei Hou, M.D., Ph.D., assistant scientist, Department of Anesthesiology, and Michael Franklin, D.O., assistant professor of anesthesiology
Project Title: Preclinical Application of Oxygen Therapeutic for Acute Spinal Cord Injury
Investigators: PI: Jiamei Hou, M.D., Ph.D.; Co-Is: Shigeharu Tsuda, Ph.D.; Jiepei Zhu, Ph.D., and Michael Franklin, D.O. Mentors: Prodip Bose, M.D., Ph.D.; Bruce Spiess, M.D.; Cynthia Garvan, Ph.D. All Co-Is and mentors are members of the Department of Anesthesiology.
Spinal cord injury (SCI) is a devastating injury of the central nervous system that can result in a broad range of life-long locomotor and spasticity disabilities. Acute SCI creates a spectrum of tissue damage. Damage results from primary injuries caused by immediate neural cell death and secondary injury resulting from ischemic and inflammatory cascades. Secondary injury contributes to lesion expansion and worsening neurological deficit. Injury and neuron death lead to swelling, reduced perfusion/oxygen delivery, and an expanding penumbra. This ischemic penumbra is an obvious target for therapeutic interventions because rapid reduction of ischemia can have a substantial benefit for neuron salvage and motor function. The work outlined in this proposal will test the preclinical evaluation of the safety and efficacy of a novel patented IV emulsions of perfluorocarbon (PFC) nanoparticles, NanO2, to limit the ischemic penumbra and improve motor disabilities. NanO2 is a pentane-based low-molecular-weight nanodroplet PFC emulsion. This study seeks to determine the efficacy and safety of acute IV NanO2 infusion compared to normal saline controls in a rat model of moderate cervical SCI. The group hypothesizes that the proposed NanO2 therapy in SCI will prevent ischemia-mediated neurological damage and improve motor disabilities. Ultimately, the research could provide a bridge to human trials.
Sanjeev Kumar, M.D., associate professor of anesthesiology, medical director, Springhill Pain Clinic
Project Title: Creation of an Intelligent Alert to Improve Efficacy and Patient Safety in Real Time During Fluoroscopic Guided Lumbar Transforaminal Epidural Steroid Injection
Contributor & Technical Adviser: Ruogu Fang Ph.D., J. Crayton Pruitt Family Department of Biomedical Engineering. Mentor: Patrick Tighe, M.D. M.S.
Fluoroscopic-guided lumbar transforaminal epidural steroid injection (LTFESI) is commonly performed by anesthesiologists. Increasingly, these injections are conducted for acute or chronic pain relief. Degeneration and stenosis of the lumbar spine can make this procedure challenging. Every year there are several case reports of complications associated with LTFESI despite existing safe practice recommendations from the FDA, which were published in 2015. There is also a subset of patients who do not get relief from LTFESI because of oor procedural technique, where the needle tip position is not optimal inside the neuroforamen. The project will use artificial intelligence to analyze several thousand stored images during LTFESI procedures over the past 5 years at UF Health. Researchers will use convolutional neural network, a special form of deep learning, which will use different modules and segmentation of images to identify variations in needle trajectory, tip location, and contrast spread and appropriately map these characterizations as good, acceptable, or unacceptable. The end goal is to create a smart alert, designed to give feedback in real time during LTFESI to ensure patient safety and improve the efficacy of this common procedure.
Isaac Luria, M.D., assistant professor of anesthesiology
Project Title: A Virtual Coach for Learning Foundational Ultrasound Skills
Ultrasonography is an increasingly available and commonly used clinical tool in modern medicine; however, many clinicians did not train with ultrasound guidance for procedures or point-of-care ultrasound for diagnostic needs. Gaining such training after residency can be expensive and time consuming, especially for rural or private practice clinicians. This project plans to develop a foundational skills ultrasonography simulation that combines a physical model, computer software with motion tracking, and a virtual coach to evaluate the progress of users and advise them appropriately. Participants’ baseline visuospatial ability will be evaluated by using well-validated instruments, as will their baseline needle targeting under ultrasound guidance ability. Participants will work with the virtual coach without a human instructor until they are assessed by the software to have achieved mastery and then repeat the assessments. The hypothesis is that participants will demonstrate improvement in visuospatial ability and needle placement under ultrasound guidance with only the virtual coach as their instructor. The goal is to take steps toward solving the problem of medical education after residency, especially in a rapidly changing world where medical knowledge, tools, and techniques expand exponentially.