Engineering Research Center for Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP)

慢性疾病如糖尿病和心血管疾病（CVD）是发病率和死亡率的主要原因。每30秒就有一个美国人被诊断出患有糖尿病，另一个人将遭受冠状动脉事件。由于患病率较高和获得护理的机会减少，这些疾病是美国服务不足社区的负担。克服这一人力和经济负担是一个巨大的挑战。NSF-ERC关于服务不足人群的精确先进技术和卫生系统（PATHS-UP）的愿景是通过在护理点开发革命性的，具有成本效益的技术和系统来改变服务不足人群的健康模式。由德克萨斯A M大学的Gerard Coté领导，与洛杉矶的加州大学、赖斯大学和佛罗里达国际大学合作，PATHS-UP带来了杰出的专业知识，以克服POC设备的四个地方性障碍，即：可现场部署、高精度、低复杂性和经济实惠。PATHS-UP的使命由两个首要目标定义：（1）设计变革性的、强大的和负担得起的技术，以改善医疗保健的可及性，提高服务和生活质量，降低医疗成本，以及（2）招募和教育一批多样化的科学家和工程师，他们将领导未来开发使能技术，以改善服务不足社区的健康状况。UP将开发两个变革性的工程系统来监测慢性疾病的关键生物标志物（生物化学，生物物理和行为）：手掌实验室（LiyP）和手腕实验室（LoaW）。LiyP将通过基于纳米工程单分子链反应的新型放大生物芯片与创新的手持式计算成像和模块化光谱仪器相结合来实现。LoaW将通过独特的“条形码”生物化学标记植入物（米粒大小）与新型腕戴式光谱成像仪相结合来实现，以通过组织和创新的传感器来监测生物物理标记（无袖血压，心率）来可视化植入物。PATHS-UP还将开发创新算法来监测行为（饮食、药物摄入）并预测长期并发症。这些使能技术建立在对生物材料、纳米级系统、样品富集、计算成像、多模式数据集成和机器学习的严格研究基础上。试验床包括独一无二的体外模型、受控实验室环境中的人类受试者研究以及服务不足社区的患者。开发这些转型系统并将其整合到社区中需要一个由工程师、医生、公共卫生专家、行业专业人士和社区卫生领导人组成的多学科团队。这种广泛的技术范围和社会影响超出了传统的资金来源，需要成立PATHS-UP紧急救济协调员。该团队将使用参与式设计和社区参与来防止PATHS-UP仅仅向这些社区投掷技术，而是开发无缝集成到他们生活中的技术。在美国每个州，服务不足的社区的患病率较高，获得公平医疗服务的机会较少。因此，这些社区中的许多人未被诊断或诊断较晚，这可能导致严重的后果。为了应对这一挑战，PATHS-UP将开发先进的技术来预防、延迟发病和管理糖尿病和心血管疾病。这既需要发展变革性的保健技术和系统，也需要改变将这些技术纳入社区的模式。除了该中心明显的社会健康影响之外？的系统，学生，博士后，和中心培养的教师？的知识界也将是PATHS-UP的一个重要成果。 该团队有一个热情，以促进有意义的，持久的，与K-学院的学生，特别是代表性不足的少数民族和K-12教师在我们的合作伙伴服务不足的社区参与。 PATHS-UP将为大学生提供体验式学习和新的工程/公共卫生课程，为K-12学生及其教师提供研究经验，以及与关键利益相关者和社区参与的参与式设计机会，以促进丰富的知识环境。该团队也有创业史，曾与学生一起创立生物医学公司，并将建立创新生态系统视为PATHS-UP的重要组成部分。

Chronic diseases such as diabetes and cardiovascular disease (CVD) are a leading cause of morbidity and mortality. Every 30 seconds one American will be diagnosed with diabetes and another will suffer a coronary event. These diseases are a burden in underserved communities across the US due to higher prevalence and reduced access to care. Overcoming this human and economic burden is a grand challenge. The vision for the NSF-ERC on Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP) is to change the paradigm for the health of underserved populations by developing revolutionary, cost-effective technologies and systems at the point-of-care. Led by Gerard Coté at Texas A&M University in partnership with the University of California at Los Angeles, Rice University, and Florida International University, PATHS-UP brings outstanding expertise to overcome four barriers endemic to POC devices, the need to: be field deployable, have high accuracy, have low complexity, and be affordable. The mission of PATHS-UP is defined by two overarching goals: (1) to engineer transformative, robust, and affordable technologies to improve healthcare access, enhance the quality of service and life, and reduce healthcare costs and (2) to recruit and educate a diverse group of scientists and engineers who will lead the future in developing enabling technologies to improve health in underserved communities.PATHS-UP will develop two transformative engineered systems to monitor key biomarkers (biochemical, biophysical, and behavioral) of chronic disease: a Lab-in-your-Palm (LiyP) and a Lab-on-a-Wrist (LoaW). The LiyP will be enabled by novel amplification biochips based on nano-engineered single-molecule chain reactions combined with innovative handheld computational imaging and modular spectroscopic instruments. The LoaW will be enabled by unique, "bar-code like" biochemical marker implants (grain of rice in size) coupled with a novel wrist-worn spectral imager to visualize the implant through tissue and innovative sensors to monitor biophysical markers (cuffless blood pressure, heart rate). PATHS-UP will also develop innovative algorithms that monitor behavior (diet, medication intake) and predict long-term complications. These enabling technologies are founded on rigorous research in biomaterials, nanoscale systems, sample enrichment, computational imaging, multimodal data integration, and machine learning. Testbeds include one-of-a-kind in vitro phantoms, human subject studies in controlled lab environments, and patients in underserved communities. Developing and integrating these transformational systems into communities requires a multidisciplinary team of engineers, medical doctors, public health experts, industry professionals, and community health leaders. Such broad technical scope and societal outreach go beyond traditional funding sources and require the formation of the PATHS-UP ERC. The team will use participatory design and community engagement to prevent PATHS-UP from merely throwing technologies at these communities, and instead develop technologies that seamlessly integrate into their lives.Underserved communities in every US state have higher prevalence and less access to equitable healthcare services. Thus, many people in these communities go undiagnosed or are diagnosed late, which can lead to serious consequences. To address this challenge, PATHS-UP will develop advanced technologies to prevent, delay the onset, and manage diabetes and cardiovascular disease. This requires both the development of transformational health technologies and systems and a paradigm shift in how these technologies are integrated into communities. Beyond the obvious societal health impact of the Center?s systems, the students, post-docs, and faculty nurtured by the Center?s intellectual community will also be a significant outcome of PATHS-UP. The team has a passion to promote meaningful, lasting, engagement with K-College students, especially under-represented minorities and K-12 teachers in our partner underserved communities. PATHS-UP will provide experiential learning and new engineering/public health curriculum for college students, research experiences for K-12 students and their teachers, and opportunities for participatory design with key stakeholders and community engagement, to promote a rich intellectual environment. The team also has a history of entrepreneurship, having spun off biomedical companies with students, and see building the innovation ecosystem as a vital part of PATHS-UP.