Grand Rounds is Up!

This weeks Grand Round is up at signout, a site run by a medical intern (a flea and a tern to those in the ‘biz) with lots of med goodness.  I really liked the organization folowing a medical article and it is very easy to read with great posts.  I usuallly HATE themed GR (too limiting) but this one was done with flexibility and is great.

As they write on the theme: “bloggers’ thoughts on the interface of scientific evidence with health and health care”.

Thanks to signout for including my post on electronic medical publishing – Is paper medical publishing dead?  This post reviews  the economics of ebooks and epublishing.  This correctly portends the inevitabe replacement of a significant amount of publishing (most?) by electronic replacements.  Several tends and technologies are poised to help push this.  My post reviews the tends in ebook publishing in general and specifically the open source and electronic revolution in medical publishing.  Info from medical journal editors I spoke with and my opinion as a reviewer are included.

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Bionic Borg Cat Eye Implant Holds Promise For Blindness Cure

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Biohacking, or the idea artificially enhancing biology is a hot topic.  There is even a whole blog devoted to it.  A story just hit the wires about a series of blindness reversing operations in cats.  Apparently, some felines get a version of retinitis pigmentosa and go blind just like their human counterparts.  Several have been fortunate (?) enough to play guinea pig and receive a kitty version of an experimental human retinal implant.

The story describes:

The chips, which provide their own energy, have shown encouraging results in clinical human trials, in some cases improving sight in people with retinitis pigmentosa or at least slowing the disease’s development. Narfstrom said chips have been implanted in 30 people.

Narfstrom’s cats will help researchers fine-tune the chips’ performance and train physicians on surgical techniques to implant the devices, because the structure of cat eyes is similar to human eyes.

The 2-millimeter-wide chips, developed by Optobionics Corp. of Naperville, Ill., are surgically implanted in the back of eye. Each chip’s surface is covered with 5,000 microphotodiodes that react to light, sending electric signals along the eye’s optic nerve to the brain.

“We’re placing it right where the photoreceptors are and if they’re lacking, this is supposed to replace what they’re doing,” she said. “At this point, its impulses of light they’re seeing (as opposed to images), but the aim of the research is to get more information out of the chip.”

Of course they do cite the many other companies working in this arena:

“Then there are the many attempts, like Optobionics, of creating artificial sight. Some efforts include miniature video cameras that pipe images straight to the brain, devices that send signals to a network of miniature electrodes attached to the retina or chips that eventually could graft themselves to retinal cells, creating a cyborg-like system for producing images.  A French company is conducting trials for an implant that would release proteins in the eyeball to offset the damage done to retinal cells, perhaps indefinitely.”

On a philosophical note how far would you go–A DARPA program administrator spoke to me about artificial limbs and the army’s work on “bionic” prosthetics (read more here and here).  He asked- “what if your daughter came up to you 10 years from now and said Daddy I want to be the fastest runner in the world- please cut off my legs and give me the prosthetic ones”.  We are approaching the technological inevitability when replacement body parts may surpass the abilities of our natural ones.  Legs that run faster or eyes that can see farther, sharper, or in the dark.  Would you get one implanted?  I also spoke with a doctor who was in charge of drug and genetic testing at the Olympics (genetic as in making sure the boys are boys and the girls are girls at the DNA level).  He asked a similar question about performance enhancing drugs and cited reports of college students using performance enhancing sleep deprivation drugs designed for the military.  If a drug was available with no short term side effects that could allow you to not nned to sleep for a few days and enhance memory and performance what proportion of college students would take it before exams?  What is the limits you would go to to enhance your performance?  I think my wife fears the day I come home with a Matrix-plug in the base of my skull….

 

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2006 Medblog Awards Announced- Docinthemachine Receives Special Judges Recognition

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Once of my favorite blogs Medgadget has announced the winners of the 2006 Medical Blog awards.  If you see some unfamiliar names check all the finalist blogs out.  Each of them is really fantastic. 

I am honored to have been singled out by the judges for this blog in the medical technology category

“Special mention from the judges goes to Dr. Steven Palter’s Docinthemachine, for his excellence in in-depth reporting on the latest medical technologies.

The winners are:

The winner of Best New Medical Blog is…

Flea, a weblog by an anonymous pediatrician “in solo practice in the Northeast U.S.” On his website, Flea tackles many issues facing pediatricians today: from childhood obesity to anti-vaccination moonbats and their websites that scare parents with pseudo-scientific proclamations.  Special mention goes to ScienceRoll, a weblog by Bertalan Meskó, a medical student at the University of Debrecen, Hungary

The winner of Best Literary Medical Blog is…

NHS Blog Doctor by Dr. John Crippen.  Special mention goes to Maria at Intueri who has received almost a perfect score from judges.

The winner of Best Clinical Sciences Weblog is…Anxiety, Addiction and Depression Treatments, a psychiatry website run by TreatmentOnline.  Special mention goes to Clinical Cases and Images

The winner of Best Health Policies/Ethics Weblog is…NHS Blog Doctor.  Special mention from judges goes to Kevin, M.D. for his excellent daily blog that mixes politics, ethics, clinical issues and curiosities of medicine.

The winner of Best Medical Technologies/Informatics Weblog is…  The Healthcare IT Guy by Shahid N. Shah, who is CEO of Netspective. His blog offers an insider’s view on all the fast changes that happen in healthcare IT.   Special mention from the judges goes to Dr. Steven Palter’s Docinthemachine, for his excellence in in-depth reporting on the latest medical technologies.

The winner of this year’s Best Patient’s Blog is…The Furry Monkey by Karen Theobald, a patient with Non-Hodgkin’s Lymphoma. Special mention goes to Amy Tenderich for her Diabetes Mine, an excellent blog by a diabetes patient.

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Gesture Control: For the Surgeon and the iPhone

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Engadget reports on how Apple snapped up 2 hot engineers responsible for the Fingerworks device.  This was an anazing device that pushed the envelope of computer gesture control with nontouch finger movements directing the show.

As they write:

Word is getting out of John Elias and Wayne Westerman, co-founders of FingerWorks, who were struggling to keep their dream of gesture-operated gadgetry alive when the company suddenly closed up shop a year and a half ago. Few doubt Apple snapped up the pair, and with interesting touchscreen abilities of the iPhone, it looks like it found a use for the men in some secretive underground laboratory. The greatest admission so far to such cahoots comes from Westerman, who said recently: “The one difference that’s actually quite significant is the iPhone is a display with the multi-touch, and the FingerWorks was just an opaque surface. That’s all I’m going to say there. There’s definite similarities, but Apple’s definitely taken it another step by having it on a display.” FingerWorks devices, which included a no-touch keyboard, mouse-less mouse pad and other multi-touch devices, have developed a bit of a cult following from “Fingerfans” on the internets, with people paying upwards of $1,500 for a FingerWorks keyboard that originally sold for $250. The ergonomics and usability enhancements of FingerWorks devices appeal to a small niche right now

Read about the concept of gesture control in medicine here and and see videos here.  I am sure this idea will make it to the operating room of the future.

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New Swallowable Pillcam Aims to Sniff not Just Look

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I have written a lot about the coming radical transformation of medicine where traditional surgery will be replaced by remote sensing and interventional devices. You can read background about another pillcam here and a cardiac rover here.

Medgadget reports on the development of the next stage of the Pillcam – a swallowable remote gut camera. Called Nemo – they describe it as:

The objective of the NEMO project is to increase patient compliance with currently recommended screening guidelines by developing an advanced cancer screening system that is patient-friendly, highly sensitive and specific for early detection of cancer. To achieve this NEMO will converge optical technologies with Nano-technologies, biosensing and maneuvering technologies to create a unique PillCam capsule endoscope capable of secretion analysis and the detection of marked and deep tissue disorders. The consortium believes the combination of the image and molecular analysis to mark the tumor may provide a novel and effective medical device for mass screening for GI cancer

A company press release is here.

What is so exciting here is companies are now making the move to adding next generation diagnostic capabilities to older devices.  It’s just a matter of time until metabolomics, proteomics, and noninvasive optical biopsies are incorporated.

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Lifeboat Foundation Begins Blog

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I was excited to see the announcement that the Lifeboat Foundation has started a blog which can be found here.  There frst posts incude some excellent commentary on nanotechnology.

For those unfamiliar with them, their mission statements sums it up:

The Lifeboat Foundation is a nonprofit nongovernmental organization dedicated to encouraging scientific advancements while helping humanity survive existential risks and possible misuse of increasingly powerful technologies, including genetic engineering, nanotechnology, and robotics/AI, as we move towards a technological singularity.
 
Lifeboat Foundation is pursuing a variety of options, including helping to accelerate the development of technologies to defend humanity, including new methods to combat viruses (such as RNA interference and new vaccine methods), effective nanotechnological defensive strategies, and even self-sustaining space colonies in case the other defensive strategies fail.
 
We believe that, in some situations, it might be feasible to relinquish technological capacity in the public interest (for example, we are against the U.S. government posting the recipe for the 1918 flu virus on the internet). We have some of the best minds on the planet working on programs to enable our survival.

They have an impressive Scientific Advisory Board including a large helping of professors and Nobel Laureats (and me).  You can read more about them here.

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REVOLUTION-Destop Fabricator: Build Your Own Device Prototype!

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From the Who Needs VC Department comes an amazing development from Cornell.  The Fab @ Home poject has developed a desktop fabricator that will sell for under $2500.  For those of you not familiar with these devices check out the video- they are a marvel to watch!

In the past, developing a model of a device was an elaborate process of molding and carving.  I remember meeting the VP of R&D of a major surgical company a few yers back for a factory tour of his plant.  He showed me the decade old system they used to make models (useful for testing ergonomics of surgical devices, button placements, handle designs, etc).  I asked him why they did not used a prototyping device and he had no good answer.  maybe that’s why they no longer exist in the marketplace!

Back to the device.  You may have seen the ads in the back of PC Mag for the Versalaser.  This device uses a desktop laser to control a device that looks like a printer- only it uses a laser to cut and engrave an object to make 3D objects.  I always thought that was an amazing step forward for home modelling.

The new device is a a step forward to the next level.  This device literally builds a 3-D model out of plastic like materials creating a 3D prototype.  This could be the equivalent of the Guttenberg printing press for device development (and it’s open source)! 

As New Scientist reports:

The standard version of their Freeform fabricator – or “fabber” – is about the size of a microwave oven and can be assembled for around $2400 (£1200). It can generate 3D objects from plastic and various other materials. Full documentation on how to build and operate the machine, along with all the software required, are available on the Fab@Home website, and all designs, documents and software have been released for free.

These machines typically cost from $20,000 to $1.5 million, says Hod Lipson from Carnegie Mellon University, US, who launched the Fab@Home project with PhD student Evan Malone in October 2006.

“We are trying to get this technology into as many hands as possible,” Malone told New Scientist. “The kit is designed to be as simple as possible.” Once the parts have been bought, a normal soldering iron and a few screwdrivers are enough to put it together. “It’s probably the cheapest machine of this kind out there,” he adds.

The machine connects to a desktop computer running software that controls its operation. It then creates objects layer-by-layer by squeezing material from a mechanically-controlled syringe. A video shows a completed machine constructing a silicone bulb (16MB, wmv format).

Unlike commercial equipment, the Fab@Home machine is also designed to be used with more than one material. So far it has been tested with silicone, plaster, play-doh and even chocolate and icing. Different materials can also be used to make a single object – the control software prompts the user when to load new material into the machine.

Malone and Lipson hope Fab@Home will grow into a community of enthusiasts who share designs for 3D objects and even modify the machines for themselves. This will prompt the emergence of widespread personal fabrication, Lipson hopes.

“We think it’s a similar story to computers,” he explains. “Mainframes had existed for years, but personal computing only took off in the late seventies.” A cheap self-assembly computer called the Altair 8800, launched in 1975, sparked the rapid development of personal computing, he notes: “We hope Fab@Home can do the same for rapid prototyping.”

Check out the video link !

No doubt many a geek will want one of these to make his own star wars action figures.

See you at the million dollar design factory desk in my basement…

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Near IR Vein Reader at CES 2007

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I have written a lot on the use of near ir (NIR) technology for visualizing veins through your skin.  Beyond this use, using wavelengths of light beyond normal human vision is the first application of what I call “future vision” as part of the radical transformation of surgery.  You can read more about type of technology with a video of my veins here and other ideas of mine for surgical microscopy along this line here.

At CES 2007  a new device using this technology for biometrics was shown.  The PalmSecure(TM) authentication system works by capturing a person’s vein pattern image while radiating it with near-infrared rays. The sensor utilizes the latest in biometric security technology.

You can read more about this device here.

According to the manufacturer:

How does Palm Vein work?
PalmVein captures the unique palm vein image via near-infrared radiation. The deoxygenated haemoglobin in the palm absorbs these rays causing the veins to appear as a black pattern. This vein pattern is then verified against vein patterns stored in a database to authenticate the individual.

Hey the best and scariest biometric feature is it can tell the difference between a live and a chopped off dead hand.  I do not even want to ask why they felt they had to put that in the promotional materials but the conference is in Vegas..

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CES OLED Innovation for Future Med

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Engadget reports a new Sony OLED HD TV at CES–

I can guarantee you will see OLED’s in a next generation surgical video display and in a surgical HMD

Some people need bigger and better LCDs, but we’re just fine with the 27-inch prototype Sony mentioned during its press conference yesterday. With a contrast ratio of greater than 1,000,000:1 (not a misprint) to go with its 1080p resolution, and >100% NTSC color reproduction, we’ll take this Organic LED great looks in a small package any day. We promised to hunt it down on the show floor and so we did, finding it hiding amongst a rookery of 11-inch displays. Take a look at the gallery for a few more shots of this HDTV and hope it hits shelves someday.

OLED has many attributed making it ideal for a medical display unit.  Especially high contrast and the ability to produce it on a thin flexible film enabling new unimagined displays. Other advantages include:

OLEDs can provide desirable advantages over today’s liquid crystal displays (LCDs), as well as benefits to product designers and end users. OLEDs feature:

 Excellent grayscale
Full-motion video
Wide viewing angles from all directions
A wide range of pixel sizes
Low power consumption
Low operating voltages
Wide operating temperature range
Long operating lifetime
A thin and lightweight form factor
Cost-effective manufacturability

 

Imagine having a high-definition TV that is 80 inches wide and less than a quarter-inch thick, consumes less power than most TVs on the market today and can be rolled up when you’re not using it.

    You can read a lot about how they work here 

    oled-cell.gifstructure of OLED’s

      oled-process.gifhow its made

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ElectriPlast: Conductive Plastic from CES 2007

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The first innovation from CES 2007 that caught my eye is ElectriPlast from Integral Technologies. There is not too much information about this available. In short, it is an electrically conductive plastic resin. Today most electric conductive tools (eg electrosurgical instruments) are made of metal with an insulating covering. They have a limited lifespan and inevitably the insulator starts to break down risking electrical patient injuries. In addition, we are fairly limited in the physical characteristics, shapes, and durability of the metal core of the tool.

ElectriPlast provides (according to the manufacturer)

• Dramatic performance improvement.
• Design flexibility – molded resin, ability to miniaturize.
• Raw materials and manufacturing capacity readily available.
• Broad functionality and applicability.

Since this is a resin based material it can be cast or estruded and entire new shapes and configuration of tools could be produced.

Electriplast is a highly conductive recipe that can be molded into virtually any shape or dimension associated with the range of plastics, rubbers and polymers CES chose this technology with a 2007 Innovation honoree for enabling technologies. Now it’s just a matter of convincing manufacturers to look at the small medical tool market and not focus on its current #1 use- next generation cell-phone antenna.

Plus how many new products have their own blog?

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