Introducing Dr. Geert Schmid-Schoenbein, Chair and Professor of Bioengineering at UC San Diego Jacobs School of Engineering, and a member of the Institute for Public Health Technology Working Group.
|Introducing Dr. Geert Schmid-Schoenbein, Chair and Professor of Bioengineering at UC San Diego Jacobs School of Engineering, and a member of the Institute for Public Health Technology Working Group.|
(Based upon an Interview with Rifaat Malik, June 2017)
TOPIC: Technologies for Improved Reserch, Prevention and Treatment of Disease
Dr. Schmid-Schoenbein’s area of research is molecular and cellular biomechanics, microcirculation and transport in living tissues. What does this have to do with Public Health? Everything.
As he explained during an interview in June 2017, studying the origins of disease and disease processes is vitally important to prevention. Understanding how the body suffers damage in disease processes can shed light on that disease, and potentially many other conditions and diseases.
TECHNOLOGY AS A RESEARCH TOOL. Many of us have heard the term “inflammation,” and know that it is of great interest to medical researchers. That is because patients with a wide range of illnesses show signs of inflammation, which Dr. Schmid-Schoenbein has come to think of as a tissue repair mechanism. In a disease like Diabetes, where inflammation is present, he thinks it logical to question, “Where would the injury come from, that tells my body that it needs to repair tissue?” We know, for example, that overeating calories leads to inflammation. But we don’t yet understand why or how the overeating is damaging one’s own tissue, or increasing risk of developing Diabetes.
However, Technological advances have provided new methods for detecting tissue degradation caused by protease actions (digestion of proteins by an enzyme). Dr. Schmid-Schoenbein’s team found that the powerful digestive enzymes can leak out of the intestine into the blood stream. This can cause splitting of cell membrane receptors, which in turn leads to defective functions in the blood flow of small vessels inside organ tissue (known as microcirculation). This kind of process contributes to inflammation and related damage to bodily functions. For example, cleavage of membrane receptors causes insulin resistance, blood pressure dysregulation, immune suppression, or capillary rarefaction (the loss of microvessels), all of which are detrimental to health.
TECHNOLOGY FOR PREVENTION. In addition to better understanding disease processes and mechanisms, technologies can assist public health and medical professionals in disease prevention efforts. In the case of Diabetes prevention, we know that assisting patients to reduce excess caloric intake is beneficial. Technologies could be of help, but currently fall short. Devices to support increased physical activity (caloric expenditure), like FitBits, are not adopted by large numbers of people, as they are not considered a necessity. (In contrast, cell phones are now considered a necessity by many – and device manufacturers seeking widespread adoption sometimes design technologies to run on/with cell phones, as a result…) Built-in reward mechanisms would also be valuable, but are different for various users and are not generally well incorporated within these products.
TECHNOLOGY FOR INTERVENTION. It should be noted that technologies do not have to be expensive or complicated, in order to be effective. Dr. Schmid-Schoenbein is involved in research on a technologically-supported eating intervention, to decrease over-consumption. It is based upon the premise that when we eat rapidly, we continue consuming excess calories before our body is able to signal the brain that we have eaten enough (satiety). It simply takes time for the intestine to send the message to the hypothalamus, indicating that we are full.
To address this problem, he and colleagues have developed and pilot tested a process with school children and their families, in Mexico. Children are given an hour-glass type of tool that counts 30 second increments. Users are taught to slow down their eating rates, by only taking a bite when it is time to flip the device over again. This slowing of the eating rate allows the children to realize that they are full, prior to consuming significant additional, unnecessary calories. (See Links below, for more information on this research.) The power of this simple technology application is that it supports truly sustainable lifestyle behavior change. Rather than typical “diet” plans, which require radical shifts that are difficult to sustain, this type of lifestyle modification can be readily learned and continued, without great expense.
As Public Health professionals, we need to consider how we can use technologies for disease prevention or treatment that will be widely adopted, to enable health improvement on a population level. Dr. Schmid-Schoenbein recommends that designers ensure that technological approaches include highly motivating incentives, so that they continue to be utilized. From the perspective of manufacturers, large scale device sales must be possible, or the profit margin will be deemed too low and they are unlikely to be manufactured and made available to the public.
MOVING FORWARD. Technologies will be playing a vital and expanding role in Public Health over the coming century. UC San Diego, with its depth of expertise in both Public Health and a variety of engineering and technology expertise, is well-positioned to offer multidisciplinary training the Public Health practitioners and researchers of the 21st century.
Many thanks to Dr. Schmid-Schoenbein, for sharing his expertise and insights!
For more information on Dr. Schoenbein or his work:
About the Institute of Engineering in Medicine:
About the dietary research in Mexico: