DITM Podcast on Future of Video for Entertainment & Medicine With Sony Exec

I have been getting great feedback on my DITM medical technology podcast which starts the podcast series I’ll be doing regularly.  Several people wrote to ask if I could post a version with just the interview since they loved it so much and wanted to share that segment.  The original podcast starts with FDA approvals then has an interview with Sony Exec Bob Ott on the future of video technology in entertainment and medicine that we did a the NAB broadcast meeting in Vegas.

Here’s an edit version with just the interview enjoy and share with your friends!

 

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FDA Update: Ophthalmic Device Panel Meeting To Review LASIK Safety

eyeballLASIK Safety Review

On April 25, 2008, the committee will discuss general issues concerning the experience and quality of life of patients who have had LASIK.

How Serious is the Problem?  Are the Patients Going Blind?

Dr. Daniel Schultz, director of FDA’s Center for Devices and Radiological Health, said a number of concerns have been raised concerning patient satisfaction with LASIK.

Companies that could be affected by such a meeting include LASIK device makers such as Advanced Medical Optics Inc, as well as LASIK providers such as TLC Vision Corp and LCA-Vision Inc.

Obviously, it’s a technology that has caught on and is used very, very widely. And there have been questions raised in terms of … quality of life and what does it actually do for the patient as opposed to the technology itself,” Schultz told reporters.  Shultz said the meeting will focus on the quality of patients’ lives after surgery.

Known complications from the procedure can include dry eyes, glare, double vision, an increased risk of corneal inflammation or infection, and blindness.

Patients Call for Ban: In July 2007, the FDA responded to petitions from an individual asking for a halt to the procedures and a withdrawal of their approval. The agency said the devices were safe and effective but advisory panel discussions “could complement” its other safety monitoring.

The Boston Globes writes on the adverse effect of the current economic downturn on Lasik numbers and the potential adverse effect of this meeting on Lasik businesses.

But the declining U.S. economy continues to impact the number of laser vision correction surgeries, and Biegelsen cautioned investors that the outcome of the upcoming FDA Lasik advisory committee meeting on April 25 will likely be neutral at best.

“A best case scenario is little-to-no negative headlines in the media and the panel endorses the long safety of Lasik and encourages further use of femtosecond lasers,” he wrote in a note to clients. “On the downside, negative media coverage of unhappy Lasik patients and a panel recommendation to narrow the indications could drive volume down further. We think the most important variable is the media coverage which tends to be negative.”

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FDA Update: Ophthalmic Device Panel Meeting To Review Implantable Eye Telescope

The FDA Ophthalmic Devices Panel will meet Apr 24, 08 8:30 AM – 5:00 PM & Apr 25, 08 8:30 AM – 5:00 PM in the Gaithersburg Holiday Inn, Ballroom – 2 Montgomery Village Ave. Gaithersburg , MD

On April 24, 2008, the committee will discuss, make recommendations, and vote on a premarket approval application, sponsored by VisionCare Technologies, Inc., for an implantable miniature telescope (IMT™). The IMT™, a visual prosthetic device, is indicated for monocular implant in patients with stable, moderate to profound central vision impairment due to bilateral central scotomas associated with end-stage macular degeneration with geographic atrophy or disciform scar, foveal involvement and cataract.

Since these diseases lead to central dysfunction of the retina the implantable telescope spreads the visual image over a larger area of normal retina.

The prosthetic telescope, together with the cornea, acts as a telephoto system to enlarge images 3X or 2.2X, depending on the device model used. The telephoto effect allows images in the central visual field (‘straight ahead vision’) to not be focused directly on the damaged macula, but over other healthy areas of the central and peripheral retina. This generally helps reduce the ‘blind spot’ impairing vision in patients with AMD

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Top Scientists Using Performance Enhancing Drugs

This is your brain on performance enhancing drugs

Perhaps the top science journal in the world - Nature – reported today on epidemic-like levels of cognitive performance enhancing drug abuse by top academic scientists.

why they began the survey

The survey was triggered by a Commentary by behavioural neuroscientists Barbara Sahakian and Sharon Morein-Zamir of the University of Cambridge, UK, who had surveyed their colleagues on the use of drugs that purportedly enhance focus and attention (Nature 450, 1157–1159 ; 2007). In the article, the two scientists asked readers whether they would consider “boosting their brain power” with drugs. Spurred by the tremendous response, Nature ran its own informal survey. 1,400 people from 60 countries responded to the online poll.

They looked at illegally obtained (no prescription) use of three drugs: methylphenidate (Ritalin), a stimulant normally used to treat attention-deficit hyperactivity disorder but well-known on college campuses as a ‘study aid’; modafinil (Provigil), prescribed to treat sleep disorders but also used off-label to combat general fatigue or overcome jet lag; and beta blockers, drugs prescribed for cardiac arrhythmia that also have an anti-anxiety effect.”

One in five respondents said they had used drugs for non-medical reasons to stimulate their focus, concentration or memory. Use did not differ greatly across age-groups

Favorite drugs of the performance enhancing professor:

For those who choose to use, methylphenidate was the most popular: 62% of users reported taking it. 44% reported taking modafinil, and 15% said they had taken beta blockers such as propanolol, revealing an overlap between drugs. 80 respondents specified other drugs that they were taking. The most common of these was adderall, an amphetamine similar to methylphenidate. But there were also reports of centrophenoxine, piractem, dexedrine and various alternative medicines such as ginkgo and omega-3 fatty acids.

As I have srtten many times before. Prepare for the upcoming epidemic of performance enhancing drug abuse. I predict these drugs will be used at rates surpassing any other illegal drug in history. They have minimal side-effects and are becomming increasing viewed on college campuses as nothing more than a no-doze.

Read my previous posts on this topic here:

  1. New Drugs Enhance Performance, Eliminate Need to Sleep
  2. New Generation of Performance Enhancing Drugs
  3. How far would you enhance your body for performance?

Would you use it? My history of working to the limit. I was in an accelerated 6-year combined college and medical school program. Balancing the advantage of being accepted to medical school while still in high school was taking full years of college courses ever summer to catch up on the skipped time. At one point I had medical school 8-5 followed by college classes from 6-10. All was manageable until med school finals hit the same week as college midterms. I remember giving up sleep and filling 2-liter soda bottles with iced coffee to get through the day. We moved onto iced coffee in Captain Crunch next. I stopped at this point (actually at two of these bottles a day= 3000 mg caffeine). I knew others who went the route of amphetamines no-doze and pizza. While an intern my worst shift ever in the hospital was 7AM Friday until 4PM monday= 81 hours. By sunday night I was unwell to say the least. Will drugs help this? I have a good friend who is a leading academic physician. He is a brilliant physician, professor and inventor. He could not believe I had not taken modenifil and raved about how well it worked for him.

Apparently other experts agree with me:

“Neuroscientist Anjan Chatterjee of the University of Pennsylvania in Philadelphia predicts a rise in the use of these drugs and other neuroenhancing products and procedures as they become available (A. Chatterjee Cam. Q. Healthc. Ethics 16, 129–137; 2007). Like the rise in cosmetic surgery, use of cognitive enhancers is likely to increase as bioethical and psychological concerns are overcome and as the products gain cultural acceptance. One difference, Chatterjee says, is that use of cognitive enhancers doesn’t rely on training of medical specialists such as surgeons. Internet availability will also greatly accelerate use, he says.”

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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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How Smartdust, Souveillance, Web 3.0, and Personalized Genetics Will Transform the Future of Medical Diagnostics

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There has been a flurry of debate in the military, industrial, and privacy sectors on “smartdust” and the concept of “souveillance” – but no one has yet realized this technology is poised to springboard into medicine and transform medical diagnostics.  Here I wanted to give you an overview of what this idea is and why you should keep your eye on it. 

First the general concept background:

“Smartdust” refers to micro devices (called motes) which are detection microchips each potentially the size of a speck of dust.  These grains of sand however can automatically self-network.  So far people have conceived of these low-power distributed sensing networks as having functions for climate control systems, entertainment devices and especially for big brother type surveillance systems.  

Wikipedia wrote “the smartdust concept was introduced by Kristofer S. J. Pister (University of California) in 2001 , though similar ideas existed in science fiction before then. A recent review discusses various techniques to take smartdust in sensor networks beyond millimeter dimensions to the micrometre level.  A typical application scenario is scattering a hundred of these sensors around a building or around a hospital to monitor temperature or humidity, track patient movements, or inform of disasters, such as earthquakes. In the military, they can perform as a remote sensor chip to track enemy movements, detect poisonous gas or radioactivity. The ease and low cost of such applications have raised privacy concerns.”  Beyond web 2.0 vast networks of these real time sensors are once possible technology leap of the yet inknown web 3.0.

General concept – What is Souveillance?:  is a term from Steve Mann that refers to “bottom up” surveillance using smart dust as opposed to “top down” big brother networks looking at us little people.  Here instead activities are recorded from the “perspective of a participant in the activity, typically by way of small portable or wearable recording devices that often stream continuous live video to the Internet.”  Remember the impact of the Rodney King video and of all the user generated video content on the web.  Now fast forward to a world where a large segment or even a majority of the populice had real time streaming video devices on all the time (no we are not going to discuss the porn angle on this).   This has also been called “inverse surveillance”.

Privacy advocates have been debating the merits or horrors of this type of sensor technology.   I serve on the Scientific Advisory Board of the Lifeboat Foundation which is dedicated to protecting us from future technological threats through advocacy research and education.  They have been having a heated debate on the “paradox of smart dust: we may not live without the greater security provided by smart dust, but many think they could not live with smart dust impinging on our privacy.’  

Medical Implications:  I have a vision that once this type of low power networked microsensor technology exists it will logically lead to medical sensor technology.  Potential uses I see include:

  1. mass screening for infectious disease or bioterror agents.  Subjects walking into screening areas could be checked for signature molecules associated with infectious agents.  Just as we have metal detectors and now have molecular signature detectors (the litle wipe test for explosives at the airport) we will have such biological screening techology.
  2. The next step will be similar screening for disease states.  Metabolomics is one such technology. Metabolomics is the study of the small-molecule metabolite byproducts left behind from cellular processes.  In simple terms it’s like examining poop.  The concept is that by measuring the collection of all the byproducts of the cells metabolism you can get a snapshot of the physiology of a cell or organism that translates to health.  One such sensor is being developed as a breath sensor for disease.  This could lead to Star Trek like medical sensors. 
  3. Similarly, such technology will lead to individual genetic screening for disease risk using chips that interact with the tiny bits of DNA we shed every time we touch something. Companies commercializing this approach also already exist and have products
  4. Taking a clue from smart dust we will then inject such sensors into our bodies where thy could circulate in the bloodstream or sit in the abdminal cavity silently sensing for disease, infectious agents, or the DNA or signature molecules of a cancer cell.  Alternative chips could exist that sit and slowly release drugs when such cell reappear once a patient is diagnosed.

I will be writing more about the details of these concepts and devices being developed in future posts now that I have introducted the concepts.  Let me know what you think! 

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New Generation of Performance Enhancing Drugs

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NatureNews has just reported on a new drug that plugs calcium leaks in muscles and boosts stamina (in mice).  I have previously written of the next wave of what I call “designer drug abuse” coming- performance enhancing drugs.  The first batch are called eugeroics and offers improved memory, mood enhancement, improved alertness and cognitive powers without any of the nasty side effects and mass murder of speed and crank.  This new class is a physical performance enhancer.   You can read my thoughts on how far people will go in the future to enhance their bodies hereIf you think plastic surgery is the rage of body enhancement – wait until we get performance and congnitive enhancing bionics, drugs, and implants!

Nature writes of the published in the online edition of the Proceedings of the National Academy of Sciences today (Bellinger, A. M. et al. Proc. Natl Acad. Sci. USA 105, 2198-2202 (2008).

Researchers have shown how intense exercise can damage muscles, and developed a drug that can hinder the effect in mice. Mice on a taxing work-out schedule were stronger and had more endurance when given the drug.

The drug, called S107, prevents calcium from leaking into muscle cells. Calcium causes muscles to contract, but calcium leaks can reduce the force of contraction and activate an enzyme that chews up muscle protein.

They go on to say that “leaky calcium channels have been associated with the fatigue and soreness that follows intense, sustained exertion, such as running a marathon or long-distance cycling. This weakness can last for days or weeks, and is not the same as the brief discomfort that follows a typical work-out.”

As expected there is a start-up ARMGO Pharma, that plans to develop S107 and others like it for clinical use in patients with chronic tiredness from disease.

Nature hits upon the potential for abuse just as I predicted.  “Don Catlin, director of the Olympic Laboratory drug-testing centre at the University of California, Los Angeles, says that a drug such as S107 could also become prime fodder for athletes looking to improve their stamina.

I myself had dinner with the former chief medical director of the olympic committee (the guy in charge of thesting if the women really are women and vice versa).  He told me he is very concerned about athletes and students using performance enhancing drugs.  Imagine a high school athlete or student offered a pill that could makethem run faster or longer or increase memory without adverse effects.  How many do you think would take them.  I recall his worry- your child saying daddy I want to be a track star- can you amputate my legs so I can get the new bionic ones. 

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OCR to the Rescue: Device Reads Any Text for Blind

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Chalk up another innovation to Ray Kurzweil America’s leading inventor (and Lifeboat Foundation Advisor along with me).  This one is a simple and elegant solution to help the visually impaired.

Developed in conjunction with the National Federation of the Blind, the device (The Kurzweil-National Federation of the Blind Reader) is a digital camera that can photograph any text or sign and then digitally OCR it and read it outload to the user!  Quite a simple concept.

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Kurzweil recalls the invention of the First OCR Reader in 1974

“In 1974, computer programs that could recognize printed letters, called optical character recognition (OCR), were capable of handling only one or two specialized type styles. I founded Kurzweil Computer Products, Inc. that year to develop the first OCR program that could recognize any style of print, which we succeeded in doing later that year. So the question then became, ‘What is it good for?’ Like a lot of clever computer software, it was a solution in search of a problem…I had found the problem we were searching for—we could apply our ‘omni-font’ (any font) OCR technology to overcome this principal handicap of blindness.

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New System is Portable  “The National Federation of the Blind (NFB) and Kurzweil Technologies, Inc. (KTI) have created the world’s first portable OCR device, that allows an ordinary page of text to be photographed and subsequently translated into voice. Over the last three decades there have been several computer-based solutions for translating OCR to voice, but none of them are portable.”

Click here for video of the device in action[wmv width="375" height="211"]http://mfile3.akamai.com/12032/asf/kurzweil.download.akamai.com/12032/knfbr/CNN_Device_opens_the_world_for_blind.asf[/wmv]

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HD Endoscopy Series Coming

I have been inundated with requests for information and critiques of Medical HD endoscopy/laparoscopy systems.  To meet the rising tide of demand for information I will begin an ongoing series of posts of HDTV in surgery, laparoscopy and endoscopy.  You can read about my testing of the World’s Highest Resolution HDTV Surgical Camera – Ever! – First Exclusive Evaluation here.

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Army’s Robotic Prosthetic Arm Demo’d

bioarm.jpg  

I have previously written about the Army’s robotic prosthetic arm projects – run of course through DARPA.  You can see my posts and a video fest at Video Fest of Brain-Computer Links & Control

An equally amazing story is how the project has come to be- DARPA contacted Deam Kamen (and team at DEKA of Segway fame) and challenged him to create this amazing feat of technology. The NYT reports

Eighteen months ago Segway entrepreneur and serial inventor Dean Kamen received a visit from Anthony Tether, the electrical engineer who runs the Defense Advanced Research Projects Agency, the military’s research and development agency.

Mr. Tether had come to Mr. Kamen’s rural western Massachusetts workshop to persuade him to tackle a challenging engineering problem: a robotic arm that would make it possible for any of the 1,600 or more Iraq veteran amputees to resume a semblance of a normal life.

Mr. Kamen, who designed the two-wheeled Segway balancing transporter and several high tech wheel chairs, and who has a wealth of robotic engineering expertise, said that he initially thought the idea “was nuts.”

A more extensive review of the two parts of the project is at Wired’s Danger Room where Noah reports on the two phases of the program. 

Project 1 – the Holy Grail: Kuniholm and his fellow engineers at Johns Hopkins University’s Applied Physics Laboratory, or APL, are at work on the most ambitious prosthetics project in history. They seek the field’s holy grail — to build an artificial human arm that acts, looks and feels to its user like his native arm, and to do it with astonishing speed by the end of 2009.  (called Revolutionizing Prosthetics 2009)

Project 2- Hedge your bets:  The Kamen project: produce the best prosthetic arm possible with currently available technology

For now, both Deka and APL are based on cutting-edge myoelectric control systems pioneered by Todd Kuiken at the Rehabilitation Institute of Chicago, or RIC. Conventional myoelectric controls use electrodes on the surface of the skin to read muscle signals from some part of a user’s body unaffected by his amputation — his back for example — and pass the signal on to an artificial limb. The user twitches her back, and the limb moves in response.

 

A video has been released of the project’s progress so far in a demo. It was shown at the DARPA tech conference.  You can check it out here (sorry can’t get the youare.tv player to run in wordpress blog engine).

Another video is here

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