The importance of accurately identifying infections and wounds is crucial for correct medical treatment. In serious cases, misidentification of infection can cause delay in the healing process and even result in death. Thus, there is a need to simulate the physiological progression of an infection so that medical trainees are better equipped to respond to a real skin wound/infection. Through UW Medicine’s Center for Research in Education and Simulation Technologies (CREST) lab, the dynamic tissue wound modeling and infection simulation project aims to meet this need. Motivation for this research project is rooted in the lack of acceptable physical simulation models despite the educational benefit they provide. The goal of this research project is to engineer high fidelity models of skin wounds and infections that dynamically alter their appearance to create a more realistic simulation for the trainer/trainee. My specific involvement is to create a model of a skin abscess that not only simulates an infection but, when given correct treatment, changes its physiology to reflect said treatment.

Umbilical vein catheterization (UVC) is a life-saving procedure performed in neonatal intensive care units (NICUs) to provide emergency vascular access for critically ill newborns. The procedure requires accuracy in catheter placement and detailed knowledge of the relevant anatomy. Improper catheter placement can lead to severe complications such as hepatic necrosis, thrombosis, and cardiac tamponade. Current UVC training models lack the anatomical accuracy and tactile realism needed for effective hands-on training. My research aims to develop a realistic UVC training model that improves procedural accuracy and reduces neonatal complications. To address these limitations, I conducted a cognitive task analysis (CTA) with NICU clinicians to evaluate existing training gaps. The CTA revealed difficulties in distinguishing the umbilical vein from the smaller, thicker-walled umbilical arteries, a key factor in accurate catheter placement. The umbilical vein’s thin walls and similar coloration to arteries often lead to misidentification, resulting in incorrect catheterization. Additionally, practitioners reported difficulties in gauging the appropriate insertion depth, which vary based on neonatal size and condition, leading to potential complications if the catheter is advanced too far. Current models lack realistic tactile feedback, making it difficult to differentiate the collapsible umbilical vein from the rigid arterial walls. Without accurate resistance simulation, trainees struggle to develop the necessary sensitivity to detect vein entry and confirm catheter placement effectively. Based on the CTA findings, I am developing a model with depth markers, a simulated blood flashback system, and a suturable outer layer to improve training realism. This research contributes to neonatal care by improving hands-on UVC training, ultimately enhancing practitioner confidence, reducing neonatal morbidity, and raising the standard for UVC procedures. Usability testing with NICU practitioners will evaluate the model's effectiveness and guide refinements for optimal training outcomes. With refinement, this tool could become a vital NICU resource, ensuring high-quality neonatal care everywhere.

Washington state has one of the lowest cardiovascular disease (CVD) mortality rates in the nation, yet significant disparities in CVD burden and access to high-quality cardiovascular care persist and little is known about the effect of socioeconomic and cardiovascular care access factors on CVD burden and outcomes disparity. Here we investigate how the distribution and accessibility of comprehensive cardiovascular care impacts cardiovascular outcomes and burden across the Washington State counties. To assess cardiovascular healthcare accessibility, we catalogued hospitals offering cardiovascular services, determined physician density, and calculated the distance of care types to the county population center. The strength and relationships between these accessibility metrics, selected socioeconomic, and behavioral risk factors were compared against select cardiovascular disease outcomes. Data was obtained from public health records and healthcare datasets and were assessed using linear, logarithmic, and logistic regression models. Area Deprivation Index (ADI), Median Income, and College Education were the top socioeconomic (SES) predictors that positively correlated with improved cardiovascular disease outcomes and burden across counties. While proximity of cath lab and emergency services were not strongly correlated with improved cardiovascular outcomes and mortality, proximity of coronary intervention and cardiothoracic surgery were moderately predictive of cardiovascular disease outcomes and mortality. Surprisingly, the density of primary care, emergency services, critical care, and cardiology physicians was weakly correlated with improved cardiovascular outcomes, while the density of neurologists was moderately correlated with improved cerebrovascular outcomes and the density of cardiothoracic surgeons was moderately correlated with improved cardiovascular outcomes. Cardiovascular outcomes, burden, and healthcare resources vary widely across Washington state counties. Overall, higher SES and immediate accessibility, availability, and proximity of specialized cardiovascular care were most highly associated with improved cardiovascular outcomes and higher median ADI percentiles across counties, highlighting the critical need for targeted and specialized cardiovascular care and expansion of accessible interventional services.

The aorta is the largest blood vessel in the body and is responsible for transporting blood to our organs and extremities. A type A aortic dissection (TAAD) is a tear in the inner and middle layers of the ascending aorta. Given the significant and traumatic nature of such an event, the mortality rate is a major concern as some literature cites up to a 2% increase in mortality rate per hour of an individual suffering from TAAD. Genetic aortopathy, which is an umbrella of genetic diseases, significantly increases the risk of catastrophic aortic events such as TAAD. Patients with genetic aortopathy have been found to have an increased risk of aortic dissections which has already proven to be deadly. However, there is very little research that has been done to show the effect of genetic aortopathy on the short-term outcomes of patients who have undergone surgical repair of TAAD. Our goal is to identify whether differences in outcomes between patients with and without genetic aortopathy truly exist. The dataset we are using is localized to treatment at the UW Medical Center, and contains genetic testing on TAAD patients – something very few centers have previously done. To date, we have completed the database entry of the patients relevant to the study and are beginning the statistical analysis phase which is executed with R programming. The results of this study concern both patients and physicians interested in postoperative outcomes. But, to the patient, this is perhaps the most pressing question moving forward. What is the risk of needing a repeat surgery? What effect does this have on my life expectancy? These are all common yet largely unanswered questions which we provide clarity on.

As the aorta ages, the risk of cardiovascular diseases like high blood pressure, aortic aneurysms, and heart failure increases. Previous research has shown that both mitochondrial dysfunction and cellular aging (senescence) contribute to these problems. However, how these two processes interact is not well understood. We hypothesize that the interactions between mitochondrial dysfunction and senescence in aortic smooth muscle cells (SMCs) can lead to harmful changes that promote disease. To test this, we study SMCs from patients undergoing heart surgery. We will measure mitochondrial function using high-resolution respirometry (Oroboros Oxygraph), assess senescence through gene expression (qPCR) and β-galactosidase staining, and examine cell changes using qPCR and immunofluorescence. Understanding this connection could help identify new ways to prevent or treat age-related aortic diseases. Early data shows significant difference in mitochondrial function and cell expression function in different aging disease groups. We are currently studying the effects of mitochondrial targeted and senescence targeted drugs. 

Extracellular vesicles (EVs) play a crucial role in cell communication and may provide insights into improving care and outcomes for patients with pulmonary diseases. EVs have been studied as potential disease biomarkers to improve diagnosis of lung diseases. This study investigates medium (150-500 nm) and large (500-1000 nm) EVs in patients with Idiopathic Pulmonary Fibrosis (IPF) and Cystic Fibrosis (CF) to determine antibody presence and variation between these two patient groups and between larger sized extracellular vesicles. The characterization of macrophage populations, macrophage subsets, and T Cell phenotypes in IPF and CF patients is done through the analysis of immunophenotypic markers. The experimental findings contribute to understanding immune cell dynamics in IPF and CF patients, potentially informing targeted therapeutic strategies.