A medical device designed by a UH professor will close the loop with high frequency brain waves to prevent seizures from occurring. Photo via uh.edu

A professor at the University of Houston has received a federal grant aimed at helping stop epileptic seizures before they start.

The BRAIN Initiative at the National Institute of Neurological Disorders and Stroke awarded the $3.7 million grant to Nuri Firat Ince, an associate professor of biomedical engineering at UH. The grant will go toward Ince's work to create a seizure-halting device based on his research.

According to UH, Ince has reduced by weeks the time it takes to locate the seizure onset zone (SOZ), the part of the brain that causes seizures in patients with epilepsy. He's done this by detecting high-frequency oscillations (HFO) forming "repetitive waveform patterns" that identify their location in the SOZ.

Ince plans to use those HFOs to help control seizures. But he first must determine whether the HFOs can be detected with an implantable closed-loop device, enabling delivery of electrical stimulation that can control seizures. The device is called a brain interchange system. A closed-loop system supplies stimulation only when it detects the onset of a seizure.

Ince's neurotechnology partner, Cortec GMBH of Freiburg, Germany, is supplying the brain interchange system. Houston's Baylor College of Medicine eventually will be the site where medical professionals implant the device in pediatric and adult epilepsy patients.

"If the outcomes of our research in acute settings become successful, we will execute a clinical trial and run our methods with the implanted … system in a chronic ambulatory setting," Ince says in a UH news release.

Research published recently in the journal AJOB Neuroscience found that a closed-loop brain implant being used to treat refractory epilepsy does not alter patients' personalities or self-perception.

Nuri Firat Ince associate professor of biomedical engineering. Photo via uh.edu

"Next-generation brain stimulation devices can modulate brain activity without human intervention, which raises new ethical and policy questions," lead author Tobias Haeusermann of the University of California, San Francisco, says in a news release. "But while there is a great deal of speculation about the potential consequences of these innovative treatments, very little is currently known about patients' experiences of any device approved for clinical use."

The study, however, found no evidence that the device Haeusermann and his colleagues studied had changed patients' personalities or self-perception.

Haeusermann and his fellow researchers based their study on a closed-loop device that's currently available. In 2013, the U.S. Food and Drug Administration (FDA) approved this brain stimulation system for treatment of refractory epilepsy. It's the first clinically approved and commercially available closed-loop brain stimulation device for epilepsy patients. Refractory epilepsy occurs when medication no longer controls seizures.

According to a research article published in 2018, epilepsy ranks among the most common neurological disorders, affecting about 1% of the global population. For patients who suffer seizures that cannot be treated with drugs, a frequent treatment is surgical removal of the SOZ.

In this country, about 3 million adults and 470,000 children have epilepsy, according to the U.S. Centers for Disease Control and Prevention, including nearly 293,000 Texans. In the U.S., epilepsy is the fourth most common neurological disorder, preceded by migraine, stroke and Alzheimer's disease, the Epilepsy Foundation of Michigan says.

About 150,000 Americans are diagnosed each year with epilepsy.

Epilepsy is prevalent among people with autism, cerebral palsy, Down syndrome, and intellectual disabilities.

About 30 types of seizure occur among the more than 60 types of epilepsy, the Michigan foundation says. A seizure briefly disturbs electrical activity in the braining, causing temporary changes in movement, awareness, feelings, behavior, and other bodily functions.

Daily medication is the standard treatment for epilepsy, according to the Michigan foundation. Still, 30 percent to 40 percent of people with epilepsy continue to experience seizures.

Each year, U.S. health care costs associated with epilepsy add up to roughly $28 billion, according to the American Journal of Managed Care.

"Most people with epilepsy are able to lead productive and fulfilling lives, but for many, epilepsy can be a devastating condition," the foundation says.

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Houston-based health tech startup is revolutionizing patient selection for clinical trials

working smarter

On many occasions in her early career, Dr. Arti Bhosale, co-founder and CEO of Sieve Health, found herself frustrated with having to manually sift through thousands of digital files.

The documents, each containing the medical records of a patient seeking advanced treatment through a clinical trial, were always there to review — and there were always more to read.

Despite the tediousness of prescreening, which could take years, the idea of missing a patient and not giving them the opportunity to go through a potentially life-altering trial is what kept her going. The one she didn’t read could have slipped through the cracks and potentially not given someone care they needed.

“Those stories have stayed with me,” she says. “That’s why we developed Sieve.”

When standard health care is not an option, advances in medical treatment could be offered through clinical trials. But matching patients to those trials is one of the longest standing problems in the health care industry. Now with the use of new technology as of 2018, the solution to the bottleneck may be a new automated approach.

“Across the globe, more than 30 percent of clinical trials shut down as a result of not enrolling enough patients,” says Bhosale. “The remaining 80 percent never end up reaching their target enrollment and are shut down by the FDA.”

In 2020, Bhosale and her team developed Sieve Health, an AI cloud-based SaaS platform designed to automate and accelerate matching patients with clinical trials and increase access to clinical trials.

Sieve’s main goal is to reduce the administrative burden involved in matching enrollments, which in turn will accelerate the trial execution. They provide the matching for physicians, study sponsors and research sites to enhance operations for faster enrollment of the trials.

The technology mimics but automates the traditional enrollment process — reading medical notes and reviewing in the same way a human would.

“I would have loved to use something like this when I was on the front lines,” Bhosale says, who worked in clinical research for over 12 years. “Can you imagine going through 10,000 records manually? Some of the bigger hospitals have upwards of 100,000 records and you still have to manually review those charts to make sure that the patient is eligible for the trial. That process is called prescreening. It is painful.”

Because physicians wear many hats and have many clinical efforts on their plates, research tends to fall to the bottom of the to-do list. Finding 10-20 patients can take the research team on average 15-20 months to find those people — five of which end up unenrolling, she says.

“We have designed the platform so that the magic can happen in the background, and it allows the physician and research team to get a jumpstart,” she says.” They don’t have to worry about reviewing 10,000 records — they know what their efforts are going to be and will ensure that the entire database has been scanned.”

With Sieve, the team was able to help some commercial pilot programs have a curated data pool for their trials – cutting the administrative burden and time spent searching to less than a week.

Sieve is in early-stage start up mode and the commercial platform has been rolled out. Currently, the team is conducting commercial projects with different research sites and hospitals.

“Our focus now is seeing how many providers we can connect into this,” she says. “There’s a bigger pool out there who want to participate in research but don’t know where to start. That’s where Sieve is stepping in and enabling them to do this — partnering with those and other groups in the ecosystem to bring trials to wherever the physicians and the patients are.”

Arti Bhosale is the co-founder and CEO of Sieve Health. Photo courtesy of Sieve

Houston nonprofit unveils new and improved bayou cleaning vessel

litter free

For over 20 years, a nonprofit organization has hired people to clean 14 miles of bayou in Houston. And with a newly updated innovative boat, keeping Buffalo Bayou clean just got a lot more efficient.

Buffalo Bayou Partnership unveils its newest version of the Bayou-Vac this week, and it's expected to be fully operational this month. BBP Board Member Mike Garver designed both the initial model of the custom-designed and fabricated boat as well as the 2022 version. BBP's Clean & Green team — using Garver's boat — has removed around 2,000 cubic yards of trash annually, which is the equivalent of about 167 commercial dump trucks. The new and improved version is expected to make an even bigger impact.

“The Bayou-Vac is a game changer for our program,” says BBP field operations manager, Robby Robinson, in a news release. “Once up and running, we foresee being able to gain an entire workday worth of time for every offload, making us twice as efficient at clearing trash from the bayou.”

Keeping the bayou clean is important, since the water — and whatever trash its carrying — runs off into Galveston Bay, and ultimately, the Gulf of Mexico. The improvements made to the Bayou-Vac include removable dumpsters that can be easily swapped out, slid off, and attached to a dump truck. The older model included workers having to manually handle trash and debris and a secondary, land-based vacuum used to suck out the trash from onboard.

Additionally, the Bayou-Vac now has a moveable, hydraulic arm attached to the bow of the vessel that can support the weight of the 16-foot vacuum hose. Again, this task was something done manually on the previous model of the Bayou-Vac.

“BBP deeply appreciates the ingenuity of our board member Mike Garver and the generosity of Sis and Hasty Johnson and the Kinder Foundation, the funders of the new Bayou-Vac,” BBP President Anne Olson says in the release. “We also thank the Harris County Flood Control District and Port Houston for their longtime support of BBP’s Clean & Green Program.”