Wayfinding: RFID

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Telemedical Retinal Imaging of : Diabetic Retinopathy, Glaucoma, Macular Degeneration

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Hearing and Tinnitus

Developing new devices to expand diagnostic opportunities

Development of Tinnitus Management Program

From inception through implementation

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Spinal Cord Injury Translational Collaborative Consortium for Regenerative Research• Goal : Develop and translate novel therapies bench to bedside

• Focus: Restoration of upper limb function with 2 research teams

• Discover genes responsible for axon growth and inhibition of growth in the adult spinal cord

• Testing of combination therapies in non-human primate (NHP) models

(cells, growth factors and drugs)

• Long-term, chronic effects cell-based therapies on functional recovery in NHP models

• Determining best approach overcome formation of glial scar (body’s attempt repair injured cord)• Use cells and biologics already used for other clinical indications • Speed up regulatory process towards “investigational new drug” indication by FDA

•Built-in replication criterion :Teams must reproduce results

•Use rodent & NHP contusion & hemisection models for scale-up, feasibility of therapy• Must overcome obstacle translating animal to human

West Haven: Human Oligodendrocyte Precursor for Myelination of Axons

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• Testing safety and ability of GERON cells used in clinical trials to form myelin around injured axons after lesion in NHP spinal cord

• Cells are safe: survival studies up to 3 years post-transplantation with no tumor formation or adverse side effects

• GERON cells form myelin and are superior to “self-repair”

Self – repair 1 year after lesion Geron OPC 7 wks after lesion

San Diego: Human Neural Progenitor Cells (NeuralStem™) Form Functional Axon Bridges with Host Spinal Cord• Identified genetic signaling molecules involved in promoting and retarding

growth of axons post-SCI

• Studies blocking genetic signals that retard axon growth demonstrate increase in growth post-injury in rodents. Removing inhibition results in growth

• Transplantation of NeuralStem™ result in clinically relevant growth – up to 20 segments in rats, equivalent to inches in humans

• Now being tested in NHP

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Neural Prostheses:Functional Electrical Stimulation (FES)

Don Crago, U.S. Army Veteran injured while on active duty Fort Carson, CO

Result of car accident he is paralyzed from chest down uses FES system for exercise and limited walking at home

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Traumatic Brain Injury (TBI):Intensive Multimodal Rehabilitation

Advanced Rehab Devices

Recreation Therapy

Physical Therapy

Assistive Devices

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Rehabilitation Robotics: Physical Therapy

Clinical Trial of Robot-Assisted Physical Therapy

http//www.nejm.org/doi/full/10.1056/NEJMoa0911341

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DEKA arm: Research Plan Past and Future

• Congressional Hearing 2004

• DARPA’s “Revolutionizing Prosthetics 2007/2009” Programs began 2005

• VA Prosthetic Arm Optimization Study 2008-2012 (3 VA, 1 DoD site)

• “Take-Home” Study to begin 2012

• Transition to Additional Applications

• Collaborations with other agencies (DoD/DARPA)

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Artificial Limbs:Ankle-Foot Prosthesis

Dr. Hugh Herr

Powered Electronic Ankle-Foot Prosthesis

May Improve Mobility of Veteran Amputees to Walk

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Osseointegration

• Biohybrid limb combining living tissue with external prosthetic device consisting of a titanium rod

• Device is of the leg stump fused into bone • Problem has been infection• Salt Lake City VA made progress by using

porous disc placed under the skin – animal studies

• 1-year infection free without antibiotics• Recently received FDA approval for human

trial • Photo from work in Europe

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Brain-Computer Interface

http://www.nature.com/nature/journal/v485/n7398/full/nature11076.html

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Journal of Rehabilitation Research & Development: JRRD

http://www.rehab.research.va.gov/jour/jourindx.html

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• JRRD sponsored by RR&D

• Scientific peer reviewed journal

• Fully accessible online: sign up today!

ORD/RR&D Supported Research:Available to the Public

• Search on NIH RePORTER website• Merit, Pilot, Career Development (recent

addition)

• Other award types to follow as forms are generated for use in eRA

• Search on Clinical Trials website

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