Bizarre Russian Interactive Art is Surgery Control Concept!

I have written many times on the concept of what I call “gesture control”. This is the idea of waving your arm or hand in a movement that is picked up by sensors (optical or other tracking) and which is then translated into the movement of a robotic surgical device, OR room or equipment control, or energy delivery system. You can see all these posts by clicking gesture control on the category drop down on the sidebar. Some faves are here here and here.

Lily Chaos has reviewed a bizzare interactive Russian art display that employs gesture control concepts.

She writes

A new video art installation by Russian media artist Sergey Kotsun invites the viewer to become the author and main character of an interactive audio-visual performance.

The viewer’s image is captured via a webcam and thrown up onto a projection screen. On the screen, two lines of transparent square boxes are also displayed, with the lines approaching each other at the top and veering away at the bottom, almost forming two sides of a triangle. Inside the boxes are different geometrical shapes.

As the viewer waves or makes other motions that can be picked up by the webcam, a computer program analyzes those movements. Any time a movement is perceived to intersect with one of the transparent squares, the corresponding geometrical shape displays onscreen and the sound of a musical instrument is played.

The viewer, in effect, becomes the artist as well as an integral part of the performance, creating movements that translate into sounds and abstract compositions of circles, squares, lines and half-moons. Kind of like playing an air banjo from inside a colorful kaleidoscope.

Here is a video of it in play- too Yoko Ono for my musical taste but pay attention to how the participant’s gestures are picked up by the camera and converted into actions- the same principle I advocate in the OR.

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If you have a webcam you can try a home demo!

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Glimpse the Future of Medicine at a Cell-Phone Convention: What is 4G?

The annual cell-phone (I should say wireless) convention of the year just wound up over at CTIA in Vegas. Usually these meeting spark some idea in me due to a new device or new wireless technology such as a universal wireless device charger, or an image recognition and analysis system that can lead to a future medical device. No such individual device or software at this meeting- but much bigger I am amazed at the awesome potential of the next generation wireless system in general: 4G wireless. This always on technology promises a wireless future where multiple devices that are always on will pull and deliver all sorts of data from your patients or surgical devices. A 4G system will be able to provide a comprehensive solution where voice, data and streamed multimedia can be given to users on an “Anytime, Anywhere” basis, and at higher data rates.

My analysis of the awards given out at CTIA was struck by the focus on developing 4G technologies.

First some background definitions – What is 4G: The History of Wireless Cell-phone Technologies: Briefly the first generation systems were analog based (1G). 2G second generation systems were the first that were all digital. Reported advantages of digital 2G systems are voice data can be compressed more effectively than allowing more calls to be packed into the same amount of radio bandwidth and they required less radio power.

3G systems promised: (such as Verizon’s EV-DO)

  1. Enhanced multimedia (voice, data, video, and remote control).

  2. Usability on all popular modes (cellular telephone, e-mail, paging, fax, videoconferencing, and Web browsing).

  3. Broad bandwidth and high speed (upwards of 2 Mbps).

  4. Roaming capability throughout Europe, Japan, and North America

Why 4G Will Transform Medicine & Surgery: Let me be the first to ring the bell for the promise of 4G in medicine. It has been written that it is expected that end-to-end intenet lanuage (IP) based system and high-quality streaming video will be among 4G’s distinguishing features. Fourth generation networks are likely to use a combination of WiMAX and WiFi- like your high speed wireless internet at home. The explosive potential is:

When fully implemented, 4G is expected to enable pervasive computing, in which simultaneous connections to multiple high-speed networks provide seamless handoffs throughout a geographical area. Network operators may employ technologies such as cognitive radio and wireless mesh networks to ensure connectivity and efficiently distribute both network traffic and spectrum.

4G networks, when coupled with cellular phones equipped with higher quality digital cameras and even HD capabilities, will enable vlogs to go mobile, as has already occurred with text-based moblogs. New models for collaborative citizen journalism are likely to emerge as well in areas with 4G connectivity.

In medicine this means you can have surgical devices, electronic medicial records, imaging devices, and your cell-phone like handheld all communicating and sharing info at broadband speeds in HD.

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Can Vision Testing Improve Surgical & Athletic Performance?

visual testing Gizmodo is reporting today about how White Sox catcher A.J. Pierzynski said he improved his performance though the daily use of a Nintendo video game. This reminded me of research I did while at Yale on similar visual testing on surgeons. We found back then that for both athletes, and surgeons (especially endoscopic surgeons) visual acuity correlated with performance and both could be improved with exercises.

First the report on the catcher and the video game. Gizmodo writes:

We were just about to stuff Nintendo’s Flash Focus vision game into the snake oil file when White Sox catcher A.J. Pierzynski revealed he actually improved his hitting through daily use of the software. Like many of the White Sox batters last year, Pierzynski stunk, and to come around he played Flash Focus in the off season. Now, one week into the 2008 schedule, the hapless catcher has two home runs, a .529 average and a team-leading seven RBIs.

What is Flash Focus?: Flash Focus is a video game for the Nintendo DS. Basically it is a series of hand eye coordination exercises designed to improve overall visual acuity through vision “exercises”. A review of the game and screen shots are here.

The Concept of Optomeric Testing for Athletes and Surgeons: The idea behind optomic testing is two fold. First, there are innate differences in visual performance between people second, elite athletes perform significantly better on objective tests of visual performance and hand-eye coordination, and third, specific testing and exercises can identify areas of optical performance weakness and improve them- and performance.

A review of optometric testing in general for athletes can be read here:

The basic tests they mention are:

  1. Visual acuity – right and left eye separately without an occluder
  2. Stereopsis at distance – contour and random dot
  3. Ocular dominance – independent of handedness
  4. Letter contrast
  5. Contrast sensitivity – at spatial frequencies known to be related to sport performance
  6. Contrast sensitivity with glare
  7. Reaction time
  8. Reaction time with varying targets

Our experiments with surgeons- Some years ago whenI was at Yale My Partner David Olive and I conducted a lerge study of novice and expert endoscopic surgeons using the validated athletic optometric testing tools. We testing a very large group of trainees as well as experts at an international AAGL conference. We found similar patterns as with the athletes. Namely significant differerences existed between visual ability and eye hand coordination skills and these were related to measures of performance and skill. We also found that with exercise performance could improve.

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FDA Ob/Gyn Update: Panel Meeting to Review New Female Condom

I will be posting an ongoing series on FDA reviews and decisions on new devices focusing on minimally invasive surgery, future medical technologies, and Ob/Gyn devices.  What better way to start off the series then with the latest announcement of the FDA Gyn device review panel (Obstetrics and Gynecology Devices Panel of the Medical Devices Advisory Committee) notice of meeting.

The panel will meet May 16, 2008, from 8 a.m. to 5:30 p.m. at the Holiday Inn, Grand Ballroom, Two Montgomery Village Ave.,  Gaithersburg, MD. to discuss none other than the newest version of the female condom (FC2 by Femalehealth).  Hey I wanted my FDA series to satrt off with some new infrared scanner implant but the FDA just gave me a condom.  Notice of the FDA meeting is here.

As an aside as an in-trining Ob Gyn resident I remmber calling the company that made the first female condom and requeesting samples for “clinical testing” and “product evaluation” before it got FDA approval. 

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New Monitoring System Approved by FDA- Potential for Future Robotic Diagnostics

freestyle glucose sensor

The FDA has just approved the FreeStyle Navigator Glucose Monitoring System – a glucose sensor that reports glucose values continuously for up to 120 hours.  Here is a copy of the FDA PMA letter.  This device is interesting to me since it works with a sensor inserted in either the abdomen or the back of the upper arm.   The device then continuous provides glucose readings and updated glucose trend information for viewing and contains a built-in alarm that can be programmed to alert the user when results fall below pre-set values.  Other similar devices have been approved that monitor for 7 days

Potential for Future Robotic Diagnostics  I have written before that I predict a whole new field of chip based biologic disease screening and monitoring in the future.  This is another step to that result.  Here a sensor is placed under the skin that measure blood sugar.  In the future minitaturized chips could be placed in any body cavity or organ to sense any imaginable molecule.

Options for Future Diagnostics: 

  1. DNA based sensors screen for cancer metastasis or recurrances such as an intrabdomnal ovarian cancer detector.
  2. Sensore that measure drug levels in target tissues – chemotherapy of course comes to mind
  3. protein sensors that look for the earliest stages of disease development.

As personalized genetics becomes more widespread, we will identify individuals at particular risk for particular diseases before they occur.  Since the genetic basis of these diseases will be known markers will likely exist.  Implanted chip sensors could then be placed to sniff for these markers and wireless transmit the alarm- or even deliver a predetermined treatment agent- all before there is any external sign of the disease.  First generation implantable devices such as this for blood sugar monitoring are lisated here (none yet available):

Here are links to some of the technology that will be involved for these future diagnostics including tiny sensors that transmit with RFID, smartdust sensors the size of a speck of dust or less, smart pills that travel through the body transmitting data and the concept of personalized genetic information based diagnostics and personalized genetics in general.

All approved continuouis blood sugar monitoring devices are here and a comparison from a patient site here:  

As an aside – in terms of glucose monitoring the use of thse devices may come into question.  An ongoing diabetes study called ACCORD was cut short in one treatment arm when it was shown that ultra tight strict blood sugar control in diabetics with heart disease actually WORSENED outcomes!

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Welcome to Docinthemachine 2.0

Welcome to the new layout theme for docinthemachine.  Now that the site database and wordpress install have been debugged and upgraded we needed a snazzy new look to show off to the world.

Stay tuned for more posts on future medical technology.  As always, I will focus on future technologies and how they will transform medicine.  By looking outside of medicine into the digital technological revolution I will make predictions of how the technology behind these devices will impact medicine.  I will review new medical devices approved or in development and make cross specialty predictions.  I provide a general overview of medicine with a special focus on minimaly invasive surgery, laparoscopy, women’s health, and fertility.

Let me know how you like the new look!

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DITM is Back Blogging! Blog Database Error Fixed!

Good News!  The sql database errors and wordpress corruption have all been fixed!  Thanks to the brilliant work of Gene the site is up and alive again.  In the process we upgraded WP 2.5.  No thanks go to my ISP who moved and hid my entire blog sql database without ever telling us as they went thrrough a server upgrade- making it totally inaccessible to us. 

Well at the end of the day we are back online.  If the site stays up and running trough our testing today I will launch the new site redesign this week. 

Thanks for coming by and I look forward to seeing you all again.

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