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Engineering the future of biomedicine for Two leading Dutch institutions are joining forces to create the country’s first technical university medical centre to TRANSFORM HEALTH.

A patient undergoes Their management teams are orthopaedic for the jointly planning to bridge the insertion of origami-folded boundaries between biomedical implants, which expand to fit sciences, , technology, her skeleton perfectly, reducing engineering, design and ethics discomfort and optimizing the by creating a technical university surgical procedure. During medical centre. rehabilitation she is monitored intelligence (AI) models to inform in clinical technology began in by motion-capture imaging “WE WILL future and improve 2014, which also includes the techniques to visualize load FACILITATE A clinical outcomes. Roland Kanaar, Leiden University Medical Center on her new joint and ensure ‘PROACTIVE’ head of the Department of and Leiden University. Both her freedom of movement. RATHER THAN Molecular at Erasmus have proven immensely popular Meanwhile, in another ward, a ‘REACTIVE’ MC, says of this development: with students, who will become patient is discharged to return APPROACH.” “It is time to break down the a new generation of ‘hybrid’ to his daily routine. In his body, boundaries between disciplines health professionals: scientists he is carrying a device the size of By joining forces, they will and work together closely to with biomedical knowledge and a blood that will search for address medical challenges create innovative solutions for skills in patient care, supported early signs of cancerous spread, using cutting-edge engineering the future of healthcare.” by technological prowess — an or the development of plaques in techniques and technologies to ability to look on with an his arteries. create, for example, nanoscale A long-held alliance engineer’s eyes. These visions of healthcare devices that monitor disease Erasmus MC and TU Delft “The skills our students gain are among many being explored or cellular-scale models of have a collaborative history. are incredibly valuable for their by engineers at Delft University organs for drug development. With the Erasmus University future careers,” says Claire of Technology (TU Delft), and Researchers will focus on Rotterdam, they have run BA and Wyman, molecular biologist scientists at Erasmus University tailoring treatments and creating MA educational programmes at Erasmus MC and director of Medical Center (Erasmus coherent, digitalized patient in nanobiology since 2012; a the nanobiology programme. MC) in the Netherlands. records that feed into artificial second education programme “A blend of maths, physics and

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Left: A custom-built high-throughput screening microscope for single . Centre top: Printing a liver. Right: WOLBEEK

MICHEL TER MICHEL Claire Wyman leads the nanobiology programme. Bottom: Brain MRIs from the

LEVIEN WILLEMSE LEVIEN Rotterdam Scan Study give insights into changes in normal ageing and disease.

understanding of communication within and between cells, and develop synthetic cells that may one day track and catch diseases in their earliest stages. Wyman’s research focuses on cancer and she hopes that the convergence will enable her department to work alongside engineers to design new ways to monitor real-time molecular processes and cellular interactions. First, however, her team must work out what cellular changes to look for — for example, precursory changes that would warn of metastasis in cancer. They would then design and introduce a sentinel cell with reporter capabilities that could enter the body and search for these signs. “Imagine if we could trace potentially metastatic cancer cells before the damage is done?” says Wyman. medical understanding that can the three universities and two model disease risks across the Another scientist hoping to make a real difference to patient academic medical centres, population. Researchers on advance his research through care.” On the nanobiology building upon the initiative of the Deep Imaging programme working with technical specialists course, students split their time Medical Delta. “It makes sense will improve on existing image is Erasmus MC’s developmental between the hospital at Erasmus to harness this potential and technologies, developing new biologist, Joost Gribnau. Part MC and the campus at TU Delft. combine forces.” tracers, smart devices and of his research is focused on “They are exposed to two very Four initial research analytical platforms. Finally, creating organoids – simplified different working environments programmes will lead the scientists will create smart versions of organs, such as and are therefore comfortable in convergence, stemming from instruments and devices to the kidney or brain, which are both,” she adds. projects that already involve limit the impact of chronic grown on microfluidic chips with “We need professionals researchers from the institutions. illness and mobility disorders electronic , meaning that who can bridge the knowledge The Syn Cells for Health(care) for the Augmenting Humans interactions between cells can and conceptual gaps between programme will improve programme. Over time, new be carefully observed. A brain subjects,” says Jaap Harlaar, understanding of the cellular research priorities will emerge organoid, for example, can be clinical biomechanics expert processes inherent in serious and the centre will work flexibly created using induced pluripotent at TU Delft and director of the diseases, using synthetic cells and quickly to integrate them. stem cells (iPSCs), derived from clinical technology programme. to monitor the body. My Digital He says that the collaboration Twin will develop comprehensive Reporter cells and mini-brains will enhance the success of the digitalized records for every The Syn Cells for Health(care) existing cooperation among patient, and gather data to programme aims to improve

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Left: Jaap Harlaar uses technology to improve physical rehabilitation. Right: Richard Goossens and Régine Steegers-Theunissen explore an immersive data visualization that creates a common language for their different disciplines.

skin cells, which differentiate information about tumours and programme. Researchers will ethical and privacy concerns, and into neurons to create working neurodegenerative diseases, incorporate AI techniques will ensure that patient safety models of different brain for example. into clinical decision-making and security remains key to all conditions. “We must take a holistic and treatment processes. decision-making regarding new Gribnau has a keen interest approach to integrated “Introduction of technology to technologies and strategies. A in Rett syndrome, a rare healthcare, particularly as we are remotely and non-invasively strong health data infrastructure neurological disease that faced with an ageing population,” monitor at the bedside will will be vital to ensure the largely affects girls, resulting in says Wiro Niessen, biomedical improve outcome for patients,” resulting large datasets can be extreme autism, developmental imaging specialist at Erasmus says Diederik Gommers, head of analysed and stored effectively. difficulties, and mobility issues. MC and TU Delft. “We will Intensive Care at Erasmus MC. The management teams at “Brain organoids provide facilitate a ‘proactive’ rather than Smart instruments will both institutions believe that beautiful opportunities to study ‘reactive’ approach to health and play a big part in improving merging branches of the physical neural diseases such as Rett in healthcare.” The new medical the success of both medical sciences, engineering and design detail, including the potential to centre will ensure robust data procedures and rehabilitation. with life sciences, medicine trial new drugs,” says Gribnau. collection, data sharing and “Patients will recover quicker and ethics will fuel pioneering “With the right technology, using integrated analyses so that if surgeons can use very thin innovations for the benefit of a robot to generate the iPSCs doctors and researchers can instruments with advanced patients and those working in the from patient cells, for example, evaluate health status and risks functionality at the tip for healthcare industry. “The state- we could greatly speed up this for individuals over time. of-the-art infrastructure at both discovery process.” The data collected will also “THERE ARE institutions will provide excellent help predict outcomes for HUGE BENEFITS breeding grounds for new ideas Seeing double the treatment of future IN COMBINING and exciting future projects,” Halting diseases before they patients. CROSS-DISCIPLINARY says Lucas van Vliet, Dean of the take hold in the body, or indeed The My Digital Twin EXPERTISE.” Faculty of Applied Sciences at before any symptoms manifest, concept will collate details TU Delft. would transform the costs and about individuals – including minimally invasive treatments,” The benefits of the Erasmus effectiveness of healthcare, as consultation notes, blood test says Jenny Dankelman, a MC – TU Delft convergence well as the clear benefits for and imaging results — giving biomechanical engineer at TU initiative are wide reaching, from patients. Searching for early doctors a quick, simple way of Delft. Harlaar sees scope for generating employment and warning signs will be a key accessing past and present data smart instruments in his field maintaining a vibrant presence part of the My Digital Twin and about their patient’s health and of physical rehabilitation, too. in the local community, to Deep Imaging programmes, wellbeing. Researchers will also “From improving existing motion- national shifts in the quality which will harness the power use these data, in anonymized capture imaging to investigate of healthcare and access to of machine and deep learning form, in large population-wide movement and loading on joints, the latest precision medicine. algorithms to generate predictive studies of specific diseases, to designing prosthetics for the Ultimately, the convergence will models for different diseases using AI algorithms to predict future,” he says, “there are huge fuel the emerging knowledge and clinical outcomes. A key future risks and potential health- benefits in combining cross- economy, and both TU Delft and goal will be the advancement of related challenges. disciplinary expertise.” Erasmus MC hope they will soon high-resolution, high-throughput Applied imaging techniques Throughout the convergence be showing that, when engineers imaging technologies, which will also feature strongly in and beyond, both institutions meet biomedical scientists, could provide detailed the Augmenting Humans will take utmost care over all everyone benefits.n

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