A drive to engineer solutions to global health problems compelled recent UW BioE Ph.D. graduate Joshua Buser, ’16, to pursue bioengineering. Now a postdoctoral fellow in Professor Paul Yager’s lab, Joshua aims to bring crucial diagnostic testing to low-resource settings – and to make care more affordable and accessible closer to home.

As part of the Yager lab’s MAD-NAAT project, Joshua’s work integrates the fields of bioengineering, chemistry, mechanical engineering and physics. With MAD-NAAT, the lab is creating an affordable, simple platform that anyone, anywhere can use to diagnose a variety of infectious diseases, from MRSA to the flu, and emerging diseases like Zika virus.

Lab-based nucleic acid amplification PCR tests are commonly used to diagnose diseases in developed countries like the United States. However, they are impractical for use in the developing world, combat environments and other low-resource settings. They are expensive, and require costly lab equipment, trained personnel, access to electricity and clean water. The tests also produce results relatively slowly, which can delay treatment and promote disease progression, especially in epidemic situations.

The MAD-NAAT device is designed for environments where lab-based testing is out of reach. In as little as 50 minutes, the device uses chemical processes on paper to emulate the capabilities of lab-based tests. A user inserts a swab with a nasal sample into the device, which breaks apart cells in the sample to extract DNA or RNA. The sample is heated using batteries or the chemicals used in hand warmers to create lots of copies of the nucleic acid strands with a one-temperature version of PCR. The device identifies pathogen DNA or RNA which have been amplified from the sample, capturing them on the test line of a paper test strip. The easy-to-read results can then be photographed and sent to a physician for diagnosis and follow-up care.

Requiring neither electricity nor running water, and enabling a patient to receive treatment advice remotely, MAD-NAAT and similar devices are ideal for use in the developing world where people often live far from medical help. They could also be used in developed countries to make diagnosing disease as easy as a trip to the drugstore. “If there’s a flu epidemic, and you wanted to test people at CVS, having these portable diagnostics would be useful,” Joshua explains.

Beyond improving health worldwide, the devices being developed in the Yager lab could reduce the cost of health care – especially in the United States. “Better diagnostics mean more effective treatment for less money,” he says. If people receive the right diagnosis the first time they are tested, they won’t get as sick, which translates to savings, Joshua explains. “It could cost a lot less money for the health care system.”

Discovering a path to bioengineering, UW

Joshua’s path to engineering began early in life. He grew up on a small dairy farm, an experience where he “got a lot of early mentorship in how to fix things.” This interest led to his work as an auto mechanic in high school and to his undergraduate studies in mechanical engineering at the University of Wisconsin-Madison. “I wanted to design cars,” he explains. “That’s what got me interested in engineering in the first place.”

Following graduation, he worked in industry as a mechanical design engineer. However, he eventually questioned whether industry was the right fit for him. “It was a lot of fun,” he explains. “But I was having a hard time connecting my work to making the world a better place.”

He decided to switch career paths when a friend told him about a job opportunity at Oregon Health & Science University in Portland, Ore., in a developmental neuroscience lab. He made the move and began working on image analysis tools for brain imaging systems. He also took classes at Portland State University.

Joshua found that the gap between his academic background and working in a neuroscience lab was not as drastic as it initially seemed. “On paper, it seemed like I didn’t belong as a mechanical engineer,” he says. “But when I got there, I realized that there were so many low hanging fruit and engineering problems to solve.”

He found working alongside neuroscience experts while contributing his own expertise empowering, and the experience motivated him to apply to graduate school. To him, bioengineering was a natural next step. “I came from mechanical engineering, and I worked in a neuroscience lab,” he explains. “Bioengineering was halfway between. I wanted to apply engineering to medical problems.”

Joshua chose UW due to its strong focus on clinical applications, and BioE’s close connections to the School of Medicine. The Yager lab’s emphasis on solutions for global health particularly stood out to him. “I could really see how the research would have a wide impact. It could expand lower cost options for health care.” Seattle’s reputation as a global health hub was also a factor in his decision to attend UW.

Once he arrived at BioE, he found the department to be strongly supportive of student research. In the Yager lab, he discovered low barriers to getting projects started, and to producing and validating results, quickly. “A lot of the day-to-day work is fast. We use a lot of rapid prototyping – we can build a device with the tools we have in the lab and test it out that afternoon.”

Collaborations within the Seattle research community also help advance the Yager lab’s research. Working with Seattle-based global health nonprofit PATH has been particularly rewarding, Joshua says. “The people we’re working with there can help guide our research to really have an impact.” At Seattle Children’s, the lab is working with pediatric clinician-researcher Jan Englund’s Infectious Disease Clinic to test prototypes of their devices. “We’re able to take some of the devices to the clinic, test them and get really valuable feedback.”

Along with fostering a culture of collaboration, Joshua thinks Seattle’s environment, from its strong arts and music scenes to endless opportunities to enjoy the outdoors, inspires research success. “I think it’s really helpful for getting away from research for a moment. And that’s when I have my best research ideas.”

Future directions

When Joshua decided to apply to graduate school, he wasn’t sure whether to pursue a master’s or a Ph.D. However, as he taught a Linux class at a nonprofit while applying to graduate school, he realized that he wanted to pursue a Ph.D. and teach at the college level.

BioE’s dedication to teaching and mentorship has provided Joshua many opportunities to advance his skills, from TA’ing a class on computational modeling to mentoring eight undergraduates in the Yager lab over the course of his Ph.D. “It’s obvious that the department really cares about teaching, and fosters the development of great teachers,” he explains. He especially enjoys helping younger students develop their research skills. “It’s been really great since it’s an opportunity to help them form their own projects, and understand what makes a good project.”

Now that Joshua has earned his Ph.D., he’s excited to follow his interest in teaching into a career in academia. As he applies for faculty jobs, he looks forward to educating future generations of bioengineers and empowering the future of health care. “I feel like I am making the world a better place, that’s more equitable and where health care will cost less and be better.”