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

糖尿病和心血管疾病等慢性疾病是发病率和死亡率的主要原因。每30秒就会有一名美国人被诊断出患有糖尿病，另一名美国人则会患上冠状动脉疾病。由于更高的流行率和更少的护理机会，这些疾病在美国各地服务不足的社区是一个负担。克服这种人力和经济负担是一项巨大的挑战。NSF-ERC关于服务不足人群的精密先进技术和健康系统(PATH-UP)的愿景是通过开发革命性的、具有成本效益的技术和系统在护理点改变服务不足人群健康的范例。由德克萨斯州农工大学的Gerard Coté与加州大学洛杉矶分校、莱斯大学和佛罗里达国际大学合作领导的Path-Up带来了杰出的专业知识，以克服PoC设备普遍存在的四个障碍，即：可现场部署、高精度、低复杂性和经济实惠。PATHS-UP的使命由两个总体目标定义：(1)设计变革性的、强大的和负担得起的技术，以改善医疗保健服务，提高服务质量和生活质量，并降低医疗成本；(2)招募和培养多样化的科学家和工程师群体，他们将领导未来开发使能技术，以改善服务不足的社区的健康。PATHS-UP将开发两个变革性的工程系统来监测慢性病的关键生物标志物(生化、生物物理和行为)：一个是掌上实验室(LiyP)，另一个是手腕实验室(LoaW)。LiyP将通过基于纳米工程化单分子链式反应的新型放大生物芯片以及创新的手持计算成像和模块化光谱仪器来实现。LoAW将通过独特的“条形码”生化标记植入物(米粒大小)与新型手腕佩戴的光谱成像器相结合，通过组织和创新传感器可视化植入物，以监测生物物理标记(无袖带血压、心率)。Path-Up还将开发创新的算法，监控行为(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、纳米系统、样品浓缩、计算成像、多模式数据集成和机器学习的严格研究的基础上。试验床包括独一无二的体外幻影，受控实验室环境中的人体受试者研究，以及服务不足社区的患者。开发这些变革性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、行业专业人员和社区卫生领导者组成的多学科团队。这种广泛的技术范围和社会影响超出了传统的资金来源，需要形成ERC的路径。该团队将使用参与性设计和社区参与来防止仅仅向这些社区扔技术，而是开发无缝融入他们生活的技术。在美国每个州，未得到充分服务的社区都有更高的普及率和更少的机会获得公平的医疗服务。因此，这些社区中的许多人没有得到诊断或诊断较晚，这可能会导致严重的后果。为了应对这一挑战，Path-Up将开发先进的技术来预防、推迟发病和管理糖尿病和心血管疾病。这既需要开发变革性的卫生技术和系统，也需要改变这些技术融入社区的方式。除了S中心明显的社会健康影响之外，S中心培养的学生、博士后和教职员工也将是一个重要的成果。该团队热衷于促进与K-College学生的有意义、持久的接触，特别是在我们的合作伙伴服务不足的社区中，代表不足的少数族裔和K-12教师。Path-Up将为大学生提供体验式学习和新的工程学/公共卫生课程，为K-12学生及其教师提供研究体验，并提供与关键利益相关者和社区参与的机会，以促进丰富的智力环境。该团队也有创业的历史，曾与学生一起剥离生物医药公司，并将建立创新生态系统视为创业的重要组成部分。

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.