An artificial right heart atrium that could save the lives of children with a rare disease. An AI-powered method to prevent blindness from glaucoma. These are early-stage innovations that were awarded the NEMO Prize through USC’s Office of Health Affairs.

Launched in 2023 through a gift from Shelly and Ofer Nemirovsky, the annual NEMO Prize competition supports collaborations between researchers at the USC Viterbi School of Engineering and the university’s constellation of health sciences schools. In particular, this prize focuses on projects that do not yet qualify for support by federal agencies and are not yet mature enough for private investment.

“A lot of things get funded by the National Institutes of Health when they already know it’s going to work,” said Shelly Nemirovsky, a USC trustee and 1985 graduate of the university. “But I think if you get in at the early stages of research and you gain some traction, you can really move the needle.”

“I love the technology that we’ve seen,” added Ofer Nemirovsky, who has a business and engineering degree from the University of Pennsylvania, where he started the original NEMO Prize. “These proposals represent solutions for both ailments that affect a very specific number of people and broader conditions that affect many more people.”

Each prize-winning partnership exemplifies a multidisciplinary effort to tackle a complex medical issue with creative thinking and execution from experts in the engineering, science, medical and computer science fields.

To help prevent blindness, the ATLAS (AI + Teleophthalmology in Los Angeles) Initiative collaborators Benjamin Xu, chief of the glaucoma division and associate professor of clinical ophthalmology at the USC Roski Eye Institute; Carl Kesselman, director of the informatics systems research division at the USC Information Sciences Institute; and Jose-Luis Ambite, an associate research professor of computer science at USC Viterbi, partnered with Lauren Daskivich, director of ophthalmic services and eye health programs for the L.A. County Department of Health Services, to use artificial intelligence to develop a more efficient system to detect glaucoma.

To tackle a rare, life-threatening heart defect, Aerospace and Mechanical Engineering Assistant Professor Niema Pahlevan of USC Viterbi; Andrew Cheng, an associate professor of clinical pediatrics at the Keck School of Medicine of USC; and cardiac surgeon Cynthia Herrington, the Ryan Winston Family Chair in Transplant Cardiology at Children’s Hospital Los Angeles, teamed up to design an innovative device that could give young patients their best chances at survival.

Using artificial intelligence to diagnose glaucoma

When researchers Kesselman, Xu, Ambite and Daskivich joined forces for the ATLAS project, they first had to learn how to speak the same language. “With multidisciplinary collaboration, it’s not about sticking a bunch of people in the room,” said Kesselman, a William M. Keck Professor of Engineering at USC Viterbi. “It’s about learning culture. It’s about learning the way a computer scientist looks at this problem and the way an engineer looks at this problem and coming to a level of understanding.”

With the NEMO Prize and other support and funding from USC, the ATLAS project is combining disparate disciplines for the shared goal of an innovative solution to diagnosing and treating a common ailment.

Glaucoma is the leading cause of irreversible blindness worldwide — it’s also one of the major drivers of preventable blindness, Xu said.  Unfortunately, glaucoma detection usually requires specialized equipment and the expertise of a trained ophthalmologist or optometrist — and they’re in limited and decreasing supply. An aging population and an increase in the prevalence of glaucoma has also led to a growing demand for better methods of detection, especially in underserved populations. As a result, the team says more than half of glaucoma cases in the United States go undetected and untreated.

An innovative solution for a common problem

Ophthalmologists can use a fundus camera to examine the back of the eye when screening for eye diseases such as glaucoma. Because fundus photography of the retina is considered the standard of care for diabetes patients, the ATLAS team leveraged the large volume of eye images from Daskivich’s L.A. County diabetic retinopathy screening program. With the addition of eye images from the USC Roski Eye Institute, the ATLAS team had access to a robust dataset to address the central question of their project: How do you harness artificial intelligence to identify the growing number of people who are likely to have glaucoma and connect them with a limited number of specialists for diagnosis and treatment?

“There’s a high degree of variability in glaucoma screenings, and you need considerable skill to do this,” said Daskivich, who emphasized the limited number of ophthalmologists available to patients. “So, the question became: Can you actually create AI algorithms that will look at these pictures and make a recommendation as to whether somebody should come in and get looked at in more detail?”

The way forward came in 2022, in the form of a collaboration that leveraged Xu’s clinical knowledge of glaucoma, Ambite’s expertise in leading-edge AI technology, Daskivich’s expertise in healthcare implementation and Kesselman’s computing platform that allows the team to organize its huge dataset.

“This is a real team effort in that each member of the ATLAS Initiative brings a different domain of expertise,” Xu said. “It required getting many people in the same room who don’t normally talk to each other. This is a huge barrier to implementation science that we’ve been able to overcome with this multidisciplinary group.”

With support from the NEMO Prize and future funding, the team hopes to evaluate algorithm effectiveness and equity; demonstrate the feasibility of integrating AI algorithms into existing screening workflows; and develop multimodal AI algorithms that can detect glaucoma while accounting for multiple factors such as age, race and family history.

A rare opportunity to save young lives

Pahlevan and Cheng met each other earlier in their careers at Caltech in Pasadena. A joint research project directed their attention to young patients who had received the Fontan procedure, a palliative surgery for hypoplastic left heart syndrome, a rare and life-threatening congenital defect where the left side of the heart is underdeveloped. With this surgery, young patients can function with only one ventricle of the heart, instead of two. Unfortunately, that single-ventricle circulation eventually fails, leaving the patient in need of a heart transplant.

A colleague at CHLA connected Pahlevan and Cheng with Herrington, who was seeking a collaboration with engineers and mechanicians to create an artificial right atrium (ARA) to improve mechanical circulatory support for patients with failing Fontan circulation. Nine years into this collaboration, the trio is closer than ever to developing an ARA that could transform the lives of their young patients — with help from the NEMO Prize.

The Fontan surgery was first proposed by surgeons in 1968; by the 1990s, practitioners considered the procedure a routine line of treatment for young patients with single-valve heart defects, giving many children the opportunity to reach adulthood. Due to advancements to the Fontan procedure and improvements in peri- and post-operative care, the team projects that the population of patients with Fontan circulation will double in the next 20 years.

Despite these advances, most Fontan patients will eventually experience myriad health challenges as the circulation begins to fail, including issues with the brain, kidneys, liver, lungs and lymphatic system. Without a heart transplant — a solution where demand far exceeds supply — Fontan patients face a progressively higher risk of heart failure and premature death.

Typically, ventricular assist devices (VADs) are used for heart failure patients, who number roughly 26 million worldwide, allowing them to survive in the hopes of an eventual heart transplant. For the 70,000 people around the world living with the inevitable decline in Fontan circulation, VADs are rarely an option due to their unique heart anatomy — but an ARA could change that.

According to the team, no other group of researchers and engineers has successfully tried to create an ARA. Others have attempted to build a customized VAD from scratch, which Cheng said takes far too much time to be a practical solution. By creating an ARA device that hospitals can use to augment existing VADs, Cheng, Herrington and Pahlevan seek to decrease the time it takes for their product to have real-life implications for their young patients hoping to live long enough to receive a heart transplant.

The team says the NEMO Prize funding will be instrumental in helping them finalize the design of their device and move toward production and testing with conventional VADs.

For Pahlevan, the project represents an opportunity he didn’t think he would experience in his field of study. “It’s rare for engineers to be in the position to make a real contribution to patient well-being,” he said. “For me, that was very important.”

For Cheng, this project is impactful on two fronts. As an electrical engineering major who decided to go to medical school, he has always wanted the opportunity to solve a medical problem with an engineering lens. “From another perspective, these families are patients that I take care of all the time,” said Cheng, who is the director of CHLA’s Fontan clinic. “To be able to offer something tangible to them that will greatly increase the likelihood of a good outcome is really important to me.”

“Winning the NEMO Prize makes all the difference in the world at a very pivotal point in this device’s creation,” Herrington said. “My colleagues in the transplant world are excited that this thing could be hitting the shelf sometime in their career and lifetime. I can’t thank the team from NEMO enough.”

For the Nemirovskys, their support for collaborations like ARA and ATLAS is endlessly rewarding.

“I am so excited to see what next year’s slate holds, because I feel like since the first prize launched, and the word has gotten out there, we’ve received more applicants, more stories, more everything,” Shelly Nemirovsky said. “The potential is limitless.”

---

The Request for Applications for this year’s NEMO Prize will be released in March.

Jennifer* had obesity, diabetes, severe acne and excess facial hair — the result of a hormonal disorder called polycystic ovary syndrome, or PCOS. PCOS is linked to infertility and a host of other issues.

Her doctor, Katie Page, an endocrinologist and associate professor of medicine at the Keck School of Medicine of USC, knew that typical treatment — insulin, daily exercise and dietary changes — offered modest improvement, at best. For Jennifer, Page wanted to try something else: the anti-diabetes drug Ozempic.

In just six months, Jennifer lost 70 pounds. Her diabetes went into remission, and problems with acne and excess facial hair disappeared.

“Patients love it because it’s only administered once a week and the effects are just amazing,” Page says. “It has been so great just to have something that works.”

Thanks to its use by celebrities and its ability to cause rapid weight loss, Ozempic and similar drugs like Wegovy, Zepbound and Mounjaro are a pop culture phenomenon — the subject of tabloid speculation, podcasts and late-night TV jokes.

But behind the hype is a medication that could catalyze profound changes in public health. With 75% of Americans now classified as overweight or obese, according to a recent study in The Lancet, obesity is one of the biggest health challenges facing the country.

“These medications not only benefit patients in terms of the weight loss itself but also clearly improve metabolic function and either ameliorate or even eliminate diabetes,” says Pinchas Cohen, dean of the USC Leonard Davis School of Gerontology. “We are now in a completely new era of managing these conditions.”

The economic toll of obesity

By lowering the nation’s staggering obesity burden — as well as rates of associated illness that increase disability and reduce the quality of life — anti-obesity drugs have the potential to reduce future health care spending significantly.

“Obesity is a complicated issue, and one that we, as a society, need to address,” says Anne Peters, a professor of medicine at the Keck School of Medicine and one of the world’s leading diabetes expert and advocates for new care guidelines for the disease. “It can lead to many illnesses in addition to diabetes, such as increases in cancer and heart disease, sleep apnea, joint disease, back pain and huge numbers of other problems. Our bodies aren’t meant to carry that much weight.”

A USC Schaeffer Center for Health Policy & Economics white paper that chief scientific officer Darius Lakdawalla and colleagues contributed to estimates that Medicare coverage for new obesity treatments could save $175 billion in health care costs in the first 10 years alone. A Goldman Sachs forecast predicts widespread use of the drugs in the United States could boost gross domestic product by 1% as lower obesity-related complications increase workplace efficiency.

“Obesity is a leading risk factor for mortality in the U.S.,” Lakdawalla says. “Our modeling shows that new treatments generate substantial benefits to Medicare and its beneficiaries. Developing strategies for unlocking that value should be a priority for policymakers.”

Experience for patients

Semaglutide, the active ingredient in Ozempic and Wegovy, mimics a hormone, GLP-1, released in the gastrointestinal tract in response to eating. Tirzepatide, the active ingredient in Zepbound and Mounjaro, also mimics GLP-1 plus another gut hormone known as GIP. They help lower blood sugar by helping the pancreas make more insulin. Patients say the drugs reduce cravings and quiet the brain’s constant “chatter” about food and eating.

Peters says she initially starts patients off with a low dose of weight-loss drugs before increasing slowly because patients tend to experience gastrointestinal side effects early on, such as nausea, diarrhea, vomiting and constipation.

Weight loss is slow, she says, but patients start feeling full long before they’ve actually lost a lot of weight. Peters advises them to not only eat less but also healthier, with high-quality protein to avoid a loss of muscle mass. She gave an example of a patient who, despite loss of appetite and eating significantly less, maintained the same weight and blood sugar due to an unchanged, unhealthy diet.

“I work with people on healthy nutrition to go along with the fact that they’re not going to feel like eating as much,” Peters says. “It’s all about watching your body, listening to your response and then talking to your health care provider.”

Broad access to the drugs is essential

Christopher Scannell, a physician and postdoctoral researcher at the USC Schaeffer Center for Health Policy & Economics, says that the intense focus on semaglutide’s anti-obesity effect obscures that the drug is also hugely important for treating diabetes.

“It’s the reason why I’ve been able to get some of my patients off insulin,” Scannell says.

In 2024, Scannell and Dima Qato, an associate professor at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences and senior scholar at the USC Schaeffer Center for Health Policy & Economics, published research about potential inequities in access to the drugs.

Their study, which examined prescription data, found that the vast majority of Ozempic and Wegovy prescriptions were going to people with private insurance — and far fewer going to people on Medicaid or Medicare Part D. Obesity disproportionately affects lower-income communities of color.

“If only certain patient populations get access to these medications — those primarily with private insurance, more generous health plans — then a huge percentage of the U.S. population isn’t getting access to these medications,” Scannell says. “That brings up a very significant equity issue.”

Big-picture solutions

 Kayla de la Haye, director of the Institute for Food System Equity at USC Dornsife Center for Economic and Social Research, sees immense promise in Ozempic and other drugs like it. But it’s still important to address underlying problems fueling the obesity epidemic.

“For people living in unhealthy food environments — where unhealthy foods are cheap, convenient and accessible, while healthy options are not — their food environment is stacked against them,” says de la Haye, who studies the impact of low-quality food environments on overall health. “We need strong investment to make our food environments healthier.

“These drugs are expensive, and most people will transition off from them at some point. So, we also need to ramp up our investment in big-picture solutions that make it easier for people to start and sustain healthy eating habits.”

*not her real name

 

 

As Angelenos — many still displaced or facing the ongoing threat of new blazes — return to neighborhoods scarred by wildfires, parents shoulder the task of guiding their children through the emotional, physical and social challenges that come with recovering from catastrophe.

Recent fires in the Castaic area in northern Los Angeles County and in parts of San Diego County have only added to the devastation. The destruction of schools and other vital community spaces has left families without the support systems they rely on. Meanwhile, smoke and ash from the fires continue to spread, compounding concerns about children’s physical health and safety.

“When families with children experience disaster-induced community loss and displacement, they are not only in need of a place to sleep at night, but also a place that becomes the center of the full ecosystem of informal support and formal institutions on which parents and children are dependent,” said Emily Smith-Greenaway, a professor of sociology and spatial sciences at the USC Dornsife College of Letters, Arts and Sciences.

“Anyone who lives in a community is rooted in it, but kids have a way of creating a deeper, more complex root system, making the uprooting of it all and the need to replant one’s family elsewhere an especially daunting task.”

Understanding responses to trauma

There are hallmark signs of post-traumatic stress in both children and adults, USC experts say.

“After a scary event, both kids and adults may be especially sensitive to danger cues or reminders of the threatening event. They might experience flashbacks, bad dreams, a hair-trigger startle response or a desire to avoid cues — like certain places, people or even sensory experiences, like the smell of smoke — that remind them of the trauma,” said Darby Saxbe, a professor of psychology and principal investigator of the NeuroEndocrinology of Social Ties (NEST) Lab at USC Dornsife.

“It’s also very normal for trauma survivors to feel irritable, sad or burned out. Importantly, even vicarious trauma — like seeing images of the fire on the news — can affect our sense of safety and well-being,” she said.

Children’s responses to traumatic events like the recent wildfires can vary widely. While some may show immediate signs of distress, others might not display any noticeable signs of trauma until much later, according to USC experts.

“For some, there may have been an immediate fear during the event. This is a typical response, particularly as children watch how much distress their parents might have been experiencing during the events,” said Julie Cederbaum, an associate professor at the USC Suzanne Dworak-Peck School of Social Work. “For others, the impact of the fires, even if one’s home was not directly impacted, may be more long-lasting.”

Children show their worries and fears differently based on their age and development, she added. Toddlers, who often use play to process emotions, might act out fire-related scenarios. Younger children may also regress, returning to behaviors they showed at earlier ages, Cederbaum explained.

“Allowing space for children to process their thoughts and feelings and being patient with children displaying regressive behaviors is important. For school-age children, providing space for them to talk about what they have heard and to explain things to them using age-appropriate language helps them know it is OK to talk about their thoughts and feelings with you,” she said.

The role of schools in recovery

As parents turn their attention to rebuilding their homes and communities, schools become a critical partner in ensuring children’s well-being.

“Schools play such a vital role in providing a safe space and reestablishing stability,” said Vivien Villaverde, an associate professor at the USC Suzanne Dworak-Peck School of Social Work, who specializes in helping school communities recover from traumatic events. She is currently providing psychological first aid training to school staff as they prepare to support students affected by the recent fires.

“Parents are going to rely heavily on schools in terms of creating a safe space, a routine and predictability, so they don’t have to worry about the kids as they attend to the priorities of rebuilding,” said Villaverde, who also co-founded the Center for Safe & Resilient Schools and Workplaces.

Addressing physical health: Respiratory health in children is top of mind for doctors

In addition to the emotional toll, the physical health risks posed by wildfire smoke are a significant concern, especially for children with asthma or other respiratory conditions. Veronica Vasquez-Montez, associate chief medical director and medical director of the emergency department at USC Arcadia Hospital, said she has seen an uptick in cases of asthma-related issues among children in her hospital’s emergency department.

“Exposure to wildfire smoke and other toxins in the air can be detrimental to children with asthma and other underlying respiratory conditions,” she said. “Environmental irritants such as these can trigger an asthma exacerbation, including wheezing, coughing, shortness of breath and chest tightness.”

Parents and guardians with children in areas affected by wildfire smoke should be especially vigilant to avoid strenuous exercise outdoors. If the air quality is especially poor, using an N95 or KN95 mask is recommended, advises Carl Chudnofsky, an emergency medicine physician with Keck Medicine of USC and chair of the Department of Emergency Medicine with the Keck School of Medicine of USC.

“Children are particularly vulnerable because they breathe more air relative to their body size and are often outdoors,” said Michelle Chu, an assistant professor at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences.

Chu recommends creating a clean air room by using air conditioning with a high-efficiency filter and sealing windows and doors to prevent outdoor air from entering.

“If asthma symptoms worsen, refer to the personalized asthma action plan. Ensure sufficient medication is on hand and review proper inhaler techniques with your child,” she said. “Consult a health care provider during routine checkups to adjust the plan as needed for wildfire season.”

Access to resources ‘color every dimension’ of wildfire recovery, expert says

Though fires burn indiscriminately, the ability to recover from a disaster isn’t evenly distributed, Smith-Greenaway said. Access to resources play a critical role in determining who can effectively navigate the challenges and rebuild their lives.

“There is often a sense that Mother Nature is the great equalizer: She pays no mind to what we humans engineer and manufacture, including the inequalities on which we build our societies,” said Smith-Greenaway, whose research examines how social factors, including inequalities, shape the experiences of individuals and families.

“Yet in reality access to resources color every dimension of navigating a natural disaster — the ability to prepare, to protect and to pick up the pieces in its aftermath is aided by resources,” she said.

Well-resourced families, who are embedded in similarly resourced family and social support networks, can more effectively find the stability and resources needed to grieve their losses in a secure and supportive environment, Smith-Greenaway said.

“Those who lack such financial security will likely smother their grief out of a necessity to focus on their survival, even if at the expense of their well-being,” she said.