Faculty Bibliography

Solid-state nanopores are an emerging biosensor for nucleic acid and protein characterization. For use in a clinical setting, solid-state nanopore sensing requires sample preparation and purification, fluid handling, a heating element, electrical noise insulators, and an electrical readout detector, all of which hamper its translation to a point-of-care diagnostic device. A stand-alone microfluidic-based nanopore device is described that combines a bioassay reaction/purification chamber with a solid-state nanopore sensor. The microfluidic device is composed of the high-temperature/solvent resistance Zeonex plastic, formed via micro-machining and heat bonding, enabling the use of both a heat regulator and a magnetic controller. Fluid control through the microfluidic channels and chambers is controlled via fluid port selector valves and allows up-to eight different solutions. Electrical noise measurements and DNA translocation experiments demonstrate the integrity of the device, with performance comparable to a conventional stand-alone nanopore setup. However, the microfluidic-nanopore setup is superior in terms of ease of use. To showcase the utility of the device, single molecule detection of a DNA PCR product, after magnetic bead DNA separation, is accomplished on chip.

Introduction Esophageal cancer is one of the leading causes of death in males in the United States (US). Previous studies have analyzed incidence rates of esophageal cancer in the US using the data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program. However, given its limited patient population, certain groups and regions in the US are underrepresented. Our study utilizes the United States Cancer Statistics (USCS) database, which combines the SEER database with the Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR) to cover all 50 states to examine the incidence of esophageal cancer. Methods The USCS registry was used to obtain data for esophageal cancer from 2001 to 2015. Incidence analysis was stratified based on sex, race, stage, histology, and US regional location/histology. Results The overall incidence of esophageal cancer from 2001-2015 was 4.7 per 100,000 people per year. Overall incidence rates were greatest for each stratification in males, blacks, distant disease, adenocarcinoma, and those in the Midwest with adenocarcinoma. Blacks, compared to other races, had the greatest statistically significant decrease in incidence between 2001-2015 (annual percent change (APC) -4.55). The incidence rate is also increasing the most rapidly in those with adenocarcinoma in the Northeast from 2011 to 2015 (APC 2.16). Conclusion In our study, we were able to determine the incidence of esophageal cancer using data from all 50 states in the US. Our findings of decreasing incidence in blacks and increasing incidence of adenocarcinoma in the Midwest and Northeast help elucidate the at-risk populations. Moreover, our findings help bring to light risk factors that may be contributing to the development of esophageal cancer and how diagnosis and surveillance can be improved based on these risk factors.

We integrated and optimized patient-reported outcome measures into the electronic health record to provide quantitative, objective data regarding patients' health status, which is important for patient care, payer contracts, and research. With a multidisciplinary team from information technology, clinical informatics, population health, and physician champions, we used formal human-computer interaction techniques and user-centered design to integrate several technology platforms and computerized adaptive testing for the National Institutes of Health Patient-Reported Outcomes Measurement Information System. The patient-reported outcome measure system leverages software frequently used by health systems and provides data for research and clinical care via a mobile-responsive web application using Symfony, with REDCap for configuring assessments and de-identified data storage. The system incorporates Oracle databases and Epic flowsheets. Patients complete patient-reported outcome measures, with data viewable in MyChart and Epic Synopsis Reports. Researchers can access data portals. The highly usable, successful patient-reported outcome measures platform is acceptable to patients and clinicians and achieved 73 percent overall completion rates.