Awarded PIHC projects 2015

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Regular PIHC vouchers

Point-of-care test to guide antibody therapy: mAb-on-a-Chip. (UT - MST - ZGT)

Monoclonal antibodies (mAbs) are widely used in the treatment of inflammatory and malignant diseases. Although mAb therapy has shown clinical benefit in many patients, initial response rates vary between 50- 90% and in a majority of patients an initial response is lost over time resulting in disease progression. Lack of response to mAbs has been associated with inadequate mAb serum concentrations. Therapeutic drug monitoring (TDM) of mAbs has the potential to guide to more effective dosing in individual patients. The goal of this project is to develop a point-of-care test platform for measuring mAb concentrations: mAb-on-a- Chip.

Dr. Thijs Oude Munnink (MST), Dr. Kris Movig (MST), Dr. Ron Gill (UT), Dr Ton Vrij (ZGT), Loes Segerink (UT), Dr. Maurice Russel (MST)

A new field for photoacoustic imaging: from validation in healthy feet to critical limb ischemia detection in people with diabetes

People with diabetes are prone to develop chronic foot ulcers that may result in amputation of the leg, having a major impact on patients’ quality of life. Perfusion is crucial in healing and level of amputation determination. Accurate detection of perfusion is the greatest challenge nowadays in diabetic foot disease, with available techniques failing to reach adequate diagnostic and prognostic properties. Photoacoustic imaging (PAI) is a credible candidate for this application. Purpose of this study is to validate this technique in healthy feet, monitoring foot ulcers, and assess whether PAI can be used in the operating room under sterile conditions.

Prof. dr. R.H.J.A. Slart (UT), Prof. dr. W. Steenbergen (UT), Dr. J.J. vn Netten (ZGT), Dr. J. van Baal (ZGT), Dr. R Meerwaldt (MST), Dr. R.H. Geelkerken (MST)

Improves diagnostics on post surgical pain - Altered treatment approach? Prevention of chronic pain? Reduction of high costs? (UT - MST - ZGT)

This project focusses on the role of new technology for pain diagnostics in the prevention and treatment of chronic pain after total knee replacements (TKA). Increased pain sensitivity plays a key role in chronic pain development. Early detection and targeted treatment could prevent chronic pain and save many costs. At UT-BSS, unique technology has been developed for point-of-care monitoring of pain sensitivity. At ZGT-OCON and MST/ZGT-Nocepta, this technology could support decisions on TKA and improved pain management. In a pilot study, the merits of pain sensitivity monitoring are assessed. UT-HTSR will study the relation between chronic pain and healthcare costs.

Dr. ir. J.P. Buitenweg (UT), Dr. C.J.M. Doggen (UT), Dr. R. Huis in 't Velt (ZGT, OCON), Dr. A.Janssen (ZGT), Dr. M Hanje (MST, Nocepta).

Enhanced reality panoramatic user interface for navigation and documentation of endoscopic guided surgeries (Panosurg) (UT - ZGT)

In breast cancer screening, different imaging modalities are used such as mammography, ultrasound and sometimes also MRI because of the high sensitivity for lesions. A lesion may need to be biopsied to determine its malignancy and decide on the right treatment. The lesion then needs to be punctured with a biopsy needle under MRI guidance. The current manual procedure is cumbersome and inaccurate, sometimes the lesion is missed resulting in disadvantages. A robot could perform the procedure more precisely and efficient. A complicating factor in developing such a robot is the strong magnetic field in and around the MRI scanner which may not be distorted, which severily restricts the use of electric motors and metallic materials. Thus it is decided to develop a fully plastic robot, driven by custom pneumatic stepper motors which are controlled by valves outside the MRI room.

Prof. dr. ir. Stefano Stramigioli (UT), Dr. Erik Cornel (ZGT), Ir. Foad Sojoodi Farimani (UT)

Adaptive rebreathing for central sleep apnea treatment (UT - MST - ZGT)

The aim of this research is to develop a device which enables regulation of carbon dioxide levels in the blood during sleep to prevent central sleep apneas. This device should consist of a mask in which exhaled air can be stored and a valve which can regulate the amount of air that is rebreathed. Furthermore, a sensor which can non-invasively measure the amount of carbon dioxide in both the exhaled air and in the blood is needed. Validation studies will be performed by UT master students under combined supervision of technical and medical experts at the MST and ZGT.

Timon Fabius (MST), Frans de Jong (MST/UT), Michiel Wagenaar (MST), Maarten Ruinemans (ZGT), Hans Tragter (UT), Jan Hendrik Crockewit (UT), Niel Tas (UT), Han Gardeniers (UT).

Biomedical sensing and smart coaching in a mobile gaming environment for improving asthma control in children: AIRplay (UT - MST - ZGT)

Self-management is the key in successful treatment of childhood asthma. Current healthcare fails to support in acquiring self-management skills, expressed by a critically low treatment adherence and treatment failure. We need to support beyond the medical environment into daily life. Therefore, we aim to develop an innovative proof-of-concept: AIRplay. AIRplay incorporates sensing and smart coaching strategies in a mobile gaming environment, to improve medication adherence and physical (re-)conditioning, and learn children self-manage their asthma in a fun manner.

Dr. ir. Monique Tabak (UT), Prof. dr. Miriam Vollenbroek (UT), Dr. Marjolein Brusse-Keizer (MST), Dr. Boony Thio (MST), Dr. Ir. Rieks op den Akker (UT), Drs. Ellen van der Gaag (ZGT)

Pressure controlled high-flow therapy for airway infections (UT - MST)

Severe airway infections in infants are increasingly treated by non-invasive high-flow nasal cannula (HFNC) therapy which provides a flow-rate controlled increase of airway pressure and prevents respiratory insufficiency. However, there is a large uncertainty in the generated pressure level which has received world-wide attention over the last decade. To remove this uncertainty we investigate the feasibility of switching from flow rate controlled therapy to pressure controlled therapy. Both in-vivo and in-vitro experiments have been conducted, preliminary results are promising.

Dr. R. Hagmeijer (UT), dr. B.J. Thio (MST), prof. dr. ir. C.H. Venner (UT), drs J.F. Goorhuis (MST)

Multimodal brain monitoring in traumatic brain injury (UT - MST)

Severe traumatic brain injury is one of the leading causes of death and invalidity among young adults. Due to ventilation and sedation, clinical evaluation is often limited, while there is a risk for secondary brain injury in the first days after admission. There is a strong need for new methods to detect this secondary deterioration in an early stage. With the use of multimodal brain monitoring, in which EEG, transcranial doppler and intracerebral pressure measurements are combined with CT perfusion scans and clinical scores, more insight will be obtained in the pathophysiological processes of traumatic brain injury. Thereby, treatment might be improved for future patients.

Dr. M.C. Tjepkema-Cloostermans (MST), Prof. dr. ir. M.J.A.M. van Putten (MST/UT), Dr. A. Beishuizen (MST), Drs. H. Hom (MST), Dr. J. Hofmeijer (UT/Rijnstate)

Menzis PIHC vouchers

E-health in Early cardiac rehabilitation after cardiac surgery

E-health might be a solution to respond to the demand of patients to have more influence on their rehabilitation and start earlier in the postoperative phase after open heart surgery. Aim of the project is to develop and evaluate a personalized intelligent home-based online exercise program, to be used by patients after discharge from the hospital. This application supports the process of therapeutic examination, clinical reasoning and treatment, and offers patients the possibility to participate in a tailored rehabilitation programm at home. By starting the rehabilitation in an earlier phase, we expect patients to start the regular rehabilitation in better physical condition and to gain better health outcomes. Furthermore, an online exercise program increases the possibilities of self management and might increase efficiency of future cardiac rehabilitation.

M. van Dijk (MST), Prof. dr. G.J. Grandjean (MST), Dr. M. Veehof (MST), Prof. dr. M. Vollenbroek-Hutten (UT/RRD), Dr. M. Tabak (UT/RRD)

DiagnOSAS as a screeningtool for obstructive sleep apnea syndrom in the general practice.

In patients with obstructive sleep apnea syndrome (OSAS), breathing stops occur repeatedly during sleep. Untreated OSAS leads to severe health problems and impaired overall functioning during the day. Although OSAS is well treatable, an estimated 250.000 Dutch inhabitants with OSAS are still undiagnosed. In addition, approximately 35% of the patients referred to the hospital for a specialized sleep study do not have OSAS. An important reason for this discrepancy is the lack of a reliable screening test for the general practitioner. In the present study, the diagnostic parameters of ‘DiagnOSAS’ (combination of an online questionnaire combined with overnight pulxeoximetry) will be examined as a novel screening test for OSAS in the general practice.

Drs. M.M.M. Eijsvogel (MST), Dr. E. Koffijberg (UT), Prof. dr. J. van der Palen (UT), Mevr. J.H.M. Mulder (Saxion), Drs. P.H.J.M. van Mechelen (Apneuvereniging), Mevr. L. van Steinvoren-Stamsnijder (Holland Innovative), Dr. R.G. Pleijhuis (MST), Dhr. J.R. Benistant, BSc (student UT), Drs. O. Hertgers (TIM Solutions), Drs. T. Fabius (MST)