Designing a Reproducible Endothelialized Channel in a 3D Hydrogel to Model Cerebral Cavernomas in Vitro; Healthcare in Rural America: Is it Accessible?

The issue of accessibility to healthcare in America is a constant conversation, and both my technical topic and STS topic address aspects of this issue. Although there are several layers to healthcare in America, my STS topic focuses on the inaccessibility of healthcare in rural areas. My technical topic focuses on constructing a novel device to model the disease Cerebral Cavernous Malformation (CCM) in vitro, to create a marketable product. In a country where rural citizens struggle to have easy access to healthcare, in the case that the product in development in my technical topic goes to market, it is crucial to understand the state of healthcare across the country so that rural citizens have the same access to such treatments as everyone else. The overarching problem observed is how both rural citizens and those affected by CCM are underserved groups, and that it is crucial to include them in healthcare discussions on a larger scale to ensure they don't go overlooked.
My technical topic focuses on the vascular malformation Cerebral Cavernous Malformation, which is an abnormal cluster of small blood vessels (capillaries) in the brain and spinal cord. This disease affects around 1 in every 100-200 people with symptoms including seizures, headaches, speech difficulties, and vision changes. There is currently no in vitro model for CCM, therefore, the disease can only be studied within the human or mouse models, leaving it severely under-researched. My project attempts to create an in vitro model of the disease by constructing a 3D hydrogel that mimics the mechanical properties of brain tissue, where we can create an endothelialized channel to run permeability measurements within. The project incorporates several lab techniques, including hydrogel fabrication, rheology testing, cell culture, and fluorescence microscopy, to create the device and acquire the necessary results. Through rheology testing, we confirmed that our protocol produced a hydrogel that yields the mechanical properties (storage and loss modulus) that most closely resemble brain tissue. We were successfully able to culture cells on a hydrogel slab where they adhered and grew. Additionally, we performed flow experiments within a hydrogel channel to measure the diffusivity of dye into the hydrogel to make permeability estimations about the hydrogel. Although a lot was accomplished, the results of an endothelial monolayer within a hydrogel channel remain inconclusive and require further testing.
The STS topic analyzed in this paper was the accessibility of healthcare in rural areas across America. Rural America comprises approximately 97% of the United States’ land mass, however, there are significant healthcare disparities in those areas compared to urban areas that remain unstudied. My paper examined the state of rural healthcare today and analyzed what factors are contributing to the difference in healthcare with rural areas compared to urban ones. My research found that financial barriers, hospital closures, and physician distribution are all factors that contribute to the inaccessibility of care. Government sources were helpful throughout this paper in determining what constitutes a rural area, statistics on hospitals, insurance information, and overall health statistics.
When reviewing both my technical and STS topics, I feel there were significant accomplishments and room for improvement. I was able to address all aims within my technical topic, however, with limited time and resources, we were unable to conduct the necessary number of trials to confirm the validity of our results. Nevertheless, all protocols and procedures were documented for future groups to make further progress, as we faced several roadblocks ourselves. Future researchers and capstone groups can build upon the research we initiated by fine-tuning our protocols and conducting repeat trials of experiments that can confirm the accuracy, validity, and reproducibility of our results. Regarding my STS problem, an adequate job was done of highlighting and analyzing the factors contributing to the inaccessibility of healthcare in rural areas. However, future researchers can build upon these ideas by analyzing current and possible solutions to determine if they are sufficient and how we can improve on them.
I would like to finish by thanking Autumn Birch, my technical topic partner and Brian Helmke for his mentorship and dedication to aiding us in the completion of our capstone project. I would like to thank Chris Highley for the use of his lab and materials. Finally, Caitlin Wylie for her guidance and feedback through the development of my STS paper.

School of Engineering and Applied Science

Bachelor of Science in Biomedical Engineering

Technical Advisor: Brian Helmke

STS Advisor: Caitlin Wylie

Technical Team Members: Autumn Birch