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! 

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 here.  If 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. 

“ Though sold as a game console, what will in fact enter the home is a Cell-based computer. ” - Ken Kutaragi

“Cell-based computers will revolutionize medical imaging” - Docinthemachine

The IBM Cell graphics processor at the heart of the PS3 is a remarkable chip.  Cell is shorthand for Cell Broadband Engine Architecture.  It has been described as “seemingly obscene computing capabilities for what will rapidly become a very low price.” 

A newer miniaturized lower power version has just been announced by ars technica that I predict will make it to medical video and VR processing.  I recently led a session on the use of VR in medicine where Andy Van Dam (VR pioneer , professor of computer science at Brown, and founder of Siggraph) and I spoke about the future of VR processing.  He predicted that the video grame industry hardware innovations will make the most dramatic strides and that this technology will then trickle down to VR due to its sheer massive computational power- beyond that of the old CAVEs of DARPA.

You may be unaware that this represent a new form of computer processing: 

The Cell concept was originally thought up by Sony Computer Entertainment inc. of Japan, for the PlayStation 3.  The genesis of the idea was in 1999 when Sony’s Ken Kutaragi  “Father of the PlayStation” was thinking about a computer which acted like Cells in a biological system.  A patent was applied for listing Masakazu Suzuoki and Takeshi Yamazaki as the inventors in 2002

The architecture as it exists today was the work of three companies: Sony, Toshiba and IBM.  Sony and Toshiba previously co-operated on the PlayStation 2 but this time the plan was more ambitious and went beyond chips for video games consoles.  The aim was to build a new general purpose processor for a computer.

In lay terms here is the muscle behind the processor:   

The setup of the Cell processor is like having a team of processors all working together on one chip to handle the large computational workload needed to run next-generation video games. In order to understand how the Cell processor works, it helps to look at each of the major parts that comprise this processor.

The “Processing Element” of the Cell is a 3.2-GHz PowerPC core equipped with 512 KB of L2 cache. The PowerPC core is a type of microprocessor similar to the one you would find running the Apple G5. It’s a powerful processor on its own and could easily run a computer by itself; but in the Cell, the PowerPC core is not the sole processor. Instead, it’s more of a “managing processor.” It delegates processing to the eight other processors on the chip, the Synergistic Processing Elements.

The computational workload comes in through the PowerPC core. The core then assesses the work that needs to be done, looks at what the SPEs are currently processing and decides how.

Watch out for our robot PS3 overloards.  This Chip has the potential to expand itself and distribute workloads over networks.  Don’t worry this is not some Singularity scenario where the chips start to think on their own.  Here is a review of the potnetial of the chip:

Chip giants such as Intel have already started working on dual-core chips, but Cell goes several steps further by giving processing units a measure of independence. Current multicore chips typically chop a single computing task into parts, which are distributed among processing units. Cell’s processing units–called “software cells”–can handle completely separate jobs.

“The software cells are designed to be kind of self-contained–they can kind of roam around,” Halfhill said.

Cells can even roam over a network, allowing the processor to perform a type of distributed or grid computing, an increasingly popular enterprise technique in which demanding tasks are divvied up among a gang of networked computers. A PlayStation 3 could borrow unused processing power from other consoles on a network, for example, to complete a demanding task such as delivering streaming video.

“The Cell architecture is designed to make grid computing almost universal,” Halfhill said. “It makes distributed processing part of the design. If you have several of these machines on a network, the work can be spread across a network.”

The cell design can allow cooperation between video devices:  “This architecture is not fixed, if you have a computer, PS3 and HDTV which have Cell processors they can co-operate on problems.  They’ve been talking about this sort of thing for years of course but the Cell is actually designed to do it.  According to IBM the Cell performs 10x faster than existing CPUs on many applications.  This may sound ludicrous but GPUs (Graphical Processors Units) already deliver similar or even higher sustained performance in many non-graphical applications.”

Medical uses:  We are at the cusp of a revolution due to the integration of computer video processing and surgical and radiological imaging.  Details of this concept of mine are here and a podcast here.  As we move ahead with virtual imaging and newer forms of optical processing it is the computational power of these kinds of chips that will be enabling.

Disclosure:  As I previously wrote, I was chosen to be a Sony Medical HD Luminary Site.  I receive no financial payment for this relationship which is only with Sony’s Medical division and is part of my medical research work on surgical tools and imaging.  Heck- I had to buy my PS3 at Best Buy just like anybody else. 

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

This year is the 50th anniversary of DARPA, or the Defense Advanced Research Projects Agency, the Pentagon research arm who turns science fiction fantasy into military reality.  DARPA conducts high-risk military research and in the process develops amazing medical technology.  To kick things off right at their 3-day DARPA tech conference (or official site here) they announced the upcoming deployment of the remote battlefield medic/surgeon Trauma Pod robotic system by 2009!  Surgical robotics was initially conceived by DARPA as remote battlefront or space surgical robots and this technology is now widely available in the DaVinci surgical robots. 

As Popular Mechanics reported from the Conference:  (skip to the end for links to videos)

the first portable, self-contained surgical robot will be deployed in the next two years. Brett Giroir, director of the research agency’s Defense Sciences Office also announced that the system, called Trauma Pod, has successfully “treated” a mannequin during a test, with no complications.

A single human will operate the robot remotely during surgery, but Trauma Pod will be able to perform a number of functions, such as fluid administration and surgical assistance, autonomously. The goal is to stabilize injured soldiers as quickly as possible, and previous Trauma Pod designs have included related systems that evacuate the patient. Giroir said that a prototype will be delivered to troops within two years.

Details of the System and its Use:

According to DSO Director Brett Giroir, the goal of the Trauma Pod is to conduct “emergency control surgery.” That means diagnosing and treating major trauma, focusing on airway management, head wounds and, as Giroir put it, “controlling uncontrollable bleeding.”

And while a surgeon will be controlling some of the Pod’s functions, such as the more invasive procedures, the system relies heavily on autonomous control. The robots in the Pod would insert breathing tubes and IVs, but the surgeon would direct the scalpel. Even during remote operation, auto-targeting systems will assist the surgeon, completing or fine-turning certain actions. “It’s not doing surgery the way a person is,” Giroir said. Instead of an exercise in advanced telepresence, the Trauma Pod is a synthesis of human judgement and robotic precision. Much of the surgeon’s input will be to tell the robots not to do something, such as inserting a breathing tube. Many of the systems are still up in the air, but Giroir expects the Pod to rely on CT scans for diagnosing trauma, and various surgical instruments that, as depicted in the video, the robots will literally grab out of a rack. It might incorporate technology from other programs, such as a device that triggers coagulation in a severed artery through high-intensity focused ultrasound.

Getting the patient off the battlefield and into a hospital is another matter. While the Pod is supposed to eventually meet certain size and weight restrictions, there are no plans yet to incorporate specific vehicles. Giroir does believe it will be compact enough to fit in the back of a Stryker vehicle, for example, and the experimental model that will be delivered in two years might still need to be trimmed down. The Trauma Pod is expected to be used by the Army initially, with possible, full-production deployment happening between 2011 and 2013. That’s a very rough estimate from Giroir, and much of the timing will depend on how quickly the system can be miniaturized, and whether it actually works.

Giroir was also excited about the Pod’s potential civilian use, for when trauma centers are often too far away to save a patient’s life. Local hospitals could stock a single Trauma Pod, and have a surgeon thousands of miles away assist in stabilizing the patient.

They say there are no video or photos available but here at docinthemachine I posted a report and videos of the systems concept and prototypes back last year.  You see the post and all the clips at Awesome Army Videos-Terminator 2025 Battlefield Surgery Built NOW!

For Those Who Want More DARPA Hi Tech Medical Information:  I have prevously written about DARPA and the medical offshoots of its research .  You can read about why DARPA can take the big risks in medical development private industry won’t in Risky Business:Why DARPA Does What Medical Industry Won’t.  Be sure to read Army Axing High-Tech Soldier of Tomorrow- MedTech Losses Predicted for all ofthemedicalbenefits of the Soldier of Tomorrow “Land Warrior” Program.  You can read about the history and future projects planned by DARPA in 2007 in DARPA Releases Strategic Plan 2007 and about it’s amazing array of projects in DARPA 2007 Pt2: Major Achievements, Future Plans, & Medical Benefits (including Newton’s Laws for Biology, Prosthetics, Biological Warfare Defense, and Real-Time Accurate Language Translation). 

Come back tomorrow for my next post reviewing the other robots they showcased…

I am very excited to begin guest blogging over at Medgadget!  I am sure many of you are familiar with the site.  Medgadget is a hugely popular site that reviews new medical devices.  My first post is Bionic Implants Available Today: Docinthemachine Guest Post and reviews the state of the art of current human bionics; technology and ethics.

Medgadget is edited by Michael Ostrovsky, M.D. & Nicholas Genes, M.D., Ph.D. (of blogborygmi and grand rounds fame) & Timothy Odell along with webmaster Gene Ostrovsky.  After admiring their work from when I began blogging, I was honored to be one of their finalists for best medical technology blog 2006.  Then the real suprise cam when I received an email from Nich & Michael asking if I would consider guest blogging on medgagdet as a regular feature. 

They wrote:

I was also talking this over with my colleagues at Medgadget.com, we’re grateful for your comments to the site and were wondering if you’d like to formalize your relationship, which is to say, write for Medgadget. As we talked about it, you could post about your research, other technology that catches your eye, your expectations for future development. 

Since I have ideas galore and love their site I quickly wrote back - YES!

Thank you so much for the kind words and your support.  As far as medgadget, I know the site well and greatly respect and enjoy it.  I am honored by your request.  

After we got this arranged I found out Nick and Gene were both invited to the J&J Blogging Summiit in NYC along with me.  We had a great discussion and exchange of ideas and made arrangements for me to start guest blogging. 

Gene, myself, and Nick at the Medical Blogging Dinner

I hope you will all go check out my gest blogging.  Please send comments to me here or the medgadget people over on their site and let us know if you enjoy my visit over there.  I plan on posting on their site very other week or so.

 I am honored and excited to have been invited to guest blog on the Lifeboat Foundation Blog.  My first post is on the new DARPA 2007 focus plan and its relation to medical technology. 

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.  

this stuff makes crank look like candy

Gizmag reports on the further evolution of no-sleep performance enhancing drugs.

The original version of these substances was the “time-shifting” drug, Modafinil that enables you to stay awake for 40+ hours with close to full mental capacity and with few side effects. (produced by Cephalon as PROVIGIL®, MODIODAL® in France and VIGIL® in Germany, for excessive sleepiness associated with narcolepsy and for “shift work sleep disorder” - hear that you medical interns?- web site advertises free 7 day trial supply).  

This is precisely the substance the the former chief medical director of the olympic committee spoke to me of.  He asked - once this stuff hits the street don’t you think a majority of college students would use it to perform better on exams?   The military sure thinks its a god idea for soldiers and pilots.  You can read my thoughts on how far people will go in the future to enhance their bodies here.  If you think plastic surgery is the rage of body enhancement - wait until we get performance enhancing bionics and cognitive enhancing drugs and implants!

The drug is a eugeroic 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.

What’s a Eugeroic you ask?  - Literally the term means “Good Arousal” .  They are a class of novel stimulants that produce long-lasting mental arousal. They are unique in producing hypervigilence and alertness without peripheral effects or addidition of usual stimulants.  Strangely, they have minimal effect on sleep structure, and do not cause rebound hypersomnolence (crashing).

You might also be interested in Ampakines are similar but also cause memory enhancement (just a bit of abuse potential there).  One of these - a drug code-named CX717 from Cortex - reportedly enabled sleep deprived rhesus monkeys to outperform rested normal monkeys on memory tasks. 

Under carefully controlled conditions and constant medical monitoring, the monkeys were individually sleep-deprived for 30-36 hours and re-tested at that time. When monkeys are sleep deprived their performance accuracy is reduced by 15-25%, and their reaction times slow by at least 50%. A dose of 0.8 mg/kg of CX717 completely reversed the performance deficits associated with sleep-deprivation. In addition, specific brain EEG changes that occur after sleep deprivation were returned to the non-sleep-deprived state in the CX717 group, but not in the control group. Thus, CX717 counteracted the effects of periods of prolonged sleep deprivation when given immediately before testing  

Not surprisingly, DARPA had a hand in these experiments.

Man, I remember as an intern a 43 hour shift I once did (Friday AM straight to Monday afternoon).  By Sunday I was practically hallucinating, everthing was in slow motion , and there was a constant sound of running water…  I predict these drugs have an abuse potential greater than any drug since alcohol.

I hear there is a new super eugeroic called armodafinil coming down the pike with even more potent effects.