Genomic and Synthetic Biology Digital Biosecurity.

Trends toward automation of synthetic biology and the individualization of biology and medicine raise varied and critical security issues. Digital biosecurity brings together researchers working in secure algorithms, vulnerability assessments, and emerging threat models. The fundamental goal of this digital biosecurity workshop is to identify and present distinct areas of research around making the next generation of biology safer and more secure. The workshop will include a panel overview of the field, including representatives from academia, industry, and non-profits. It will also include novel presentations from the research community. We expect that attendees will leave this workshop with a new appreciation of the research and implementation challenges in maintaining the digital aspects of biosecurity.

Machine Learning Helps Identify New Drug Mechanisms in Triple-Negative Breast Cancer.

This paper demonstrates the ability of mach- ine learning approaches to identify a few genes among the 23,398 genes of the human genome to experiment on in the laboratory to establish new drug mechanisms. As a case study, this paper uses MDA-MB-231 breast cancer single-cells treated with the antidiabetic drug metformin. We show that mixture-model-based unsupervised methods with validation from hierarchical clustering can identify single-cell subpopulations (clusters). These clusters are characterized by a small set of genes (1% of the genome) that have significant differential expression across the clusters and are also highly correlated with pathways with anticancer effects driven by metformin. Among the identified small set of genes associated with reduced breast cancer incidence, laboratory experiments on one of the genes, CDC42, showed that its downregulation by metformin inhibited cancer cell migration and proliferation, thus validating the ability of machine learning approaches to identify biologically relevant candidates for laboratory experiments. Given the large size of the human genome and limitations in cost and skilled resources, the broader impact of this work in identifying a small set of differentially expressed genes after drug treatment lies in augmenting the drug-disease knowledge of pharmacogenomics experts in laboratory investigations, which could help establish novel biological mechanisms associated with drug response in diseases beyond breast cancer.

Prediction of adenocarcinoma development using game theory.

Recent research shows that gene expression changes appear to correlate well with the progression of many types of cancers. Using changes in gene expression as a basis, this paper proposes a data-driven 2-player game-theoretic model to predict the risk of adenocarcinoma based on Nash equilibrium. A key innovation in this work is the pay-off function which is a weighted composite of the expression of a cohort of tumor-suppressor genes (as one player) and an analogous cohort of oncogenes (as the other player). Another novelty of the model is its ability to predict the risk that a healthy sample will develop adenocarcinoma, if its associated gene expression is comparable to that of early-stage tumor samples. The model is validated using two of the largest publicly available adenocarcinoma datasets. The results show that i) the model is able to distinguish between healthy and cancerous samples with an accuracy of 93%, and ii) 95% of the healthy samples said to be at risk had gene expressions comparable to those of samples with stage I or stage II tumors, thereby predicting the imminent onset of adenocarcinoma.

Surgeon Training in Telerobotic Surgery via a Hardware-in-the-Loop Simulator.

This work presents a software and hardware framework for a telerobotic surgery safety and motor skill training simulator. The aims are at providing trainees a comprehensive simulator for acquiring essential skills to perform telerobotic surgery. Existing commercial robotic surgery simulators lack features for safety training and optimal motion planning, which are critical factors in ensuring patient safety and efficiency in operation. In this work, we propose a hardware-in-the-loop simulator directly introducing these two features. The proposed simulator is built upon the Raven-II™ open source surgical robot, integrated with a physics engine and a safety hazard injection engine. Also, a Fast Marching Tree-based motion planning algorithm is used to help trainee learn the optimal instrument motion patterns. The main contributions of this work are (1) reproducing safety hazards events, related to da Vinci™ system, reported to the FDA MAUDE database, with a novel haptic feedback strategy to provide feedback to the operator when the underlying dynamics differ from the real robot's states so that the operator will be aware and can mitigate the negative impact of the safety-critical events, and (2) using motion planner to generate semioptimal path in an interactive robotic surgery training environment.

Adverse Events in Robotic Surgery: A Retrospective Study of 14 Years of FDA Data.

BACKGROUND: Use of robotic systems for minimally invasive surgery has rapidly increased during the last decade. Understanding the causes of adverse events and their impact on patients in robot-assisted surgery will help improve systems and operational practices to avoid incidents in the future. METHODS: By developing an automated natural language processing tool, we performed a comprehensive analysis of the adverse events reported to the publicly available MAUDE database (maintained by the U.S. Food and Drug Administration) from 2000 to 2013. We determined the number of events reported per procedure and per surgical specialty, the most common types of device malfunctions and their impact on patients, and the potential causes for catastrophic events such as patient injuries and deaths. RESULTS: During the study period, 144 deaths (1.4% of the 10,624 reports), 1,391 patient injuries (13.1%), and 8,061 device malfunctions (75.9%) were reported. The numbers of injury and death events per procedure have stayed relatively constant (mean = 83.4, 95% confidence interval (CI), 74.2-92.7 per 100,000 procedures) over the years. Surgical specialties for which robots are extensively used, such as gynecology and urology, had lower numbers of injuries, deaths, and conversions per procedure than more complex surgeries, such as cardiothoracic and head and neck (106.3 vs. 232.9 per 100,000 procedures, Risk Ratio = 2.2, 95% CI, 1.9-2.6). Device and instrument malfunctions, such as falling of burnt/broken pieces of instruments into the patient (14.7%), electrical arcing of instruments (10.5%), unintended operation of instruments (8.6%), system errors (5%), and video/imaging problems (2.6%), constituted a major part of the reports. Device malfunctions impacted patients in terms of injuries or procedure interruptions. In 1,104 (10.4%) of all the events, the procedure was interrupted to restart the system (3.1%), to convert the procedure to non-robotic techniques (7.3%), or to reschedule it (2.5%). CONCLUSIONS: Despite widespread adoption of robotic systems for minimally invasive surgery in the U.S., a non-negligible number of technical difficulties and complications are still being experienced during procedures. Adoption of advanced techniques in design and operation of robotic surgical systems and enhanced mechanisms for adverse event reporting may reduce these preventable incidents in the future.

An embedded reconfigurable architecture for patient-specific multi-paramater medical monitoring.

A robust medical monitoring device should be able to provide intelligent diagnosis based on accurate analysis of physiological parameters in real-time. At the same time, such device must be able to adapt to the characteristics of a specific patient and desired diagnostic needs, and continue to operate even in presence of unexpected artifacts and accidental errors. A reconfigurable architecture is proposed for real-time assessment of individual's health status based on development of a patient-specific health index and online analysis and fusion of multi-parameter physiological signals. This is achieved by static configuration of processing elements and communication blocks in the architecture based on the patient's diagnostic needs. The proposed architecture is prototyped as a single integrated device on an FPGA platform and is evaluated using multi-parameter data from intensive care units (ICUs). Three representative test cases of concurrently analyzing Blood Pressure, Heart Rate, and Electrocardiogram (ECG) data from MIMIC database are presented. The results show the effectiveness of the proposed technique in eliminating false alarms caused by patient movements, monitor noise, or imperfections in the detection schemes.