Meet Jules, the most life-like robot you have ever seen. The robot is programmed with the most sophisticated artificial intelligence features. It can recognize babies vs. adults, its creator and people he has ‘met’.
video of “intelligent” android
Woody Guthrie Died from Huntington’s Chorea
Medviews (host of next weeks grand rounds) has an interesting post about the dilemmas of genetic testing for deadly diseases such as Huntington’s Disease (he has one error- he calls it autosomal recessive but it is actually an autosomal dominant disease). For those unfamiliar see notes from the Huntington’s disease society on testing. The issue is if you get a copy of the disease gene from a parent you will develop the disease – and it is an awful one. There is progressive motor and cognitive degeneration ultimately leading to death.
He writes
There was a wonderful and touching piece in today’s New York Times detailing a young woman’s life as she comes to grips with her family’s history of Huntington’s Chorea (HC), an inherited disorder striking a patient with dementia and muscular discoordination in mid-life.
Ms. Moser, in a poignant and courageous decision, decided to take a genetic test to see whether she would develop the disorder. Unfortunately, the result came back positive, which, because of its recessive genetic nature, meant that both she and her mother would have the disease. Ms. Moser has come to grips with the life-altering nature of the news. She will apparently not have children, and will continue to devote her working life to the care of HC patients.
You see the standard up until now has been that since there is no treatment, diagnosis is a death sentence. Would you choose to know you have it? How would it affect your life? Many at risk have chosen NOT to be tested (it is a 50:50 shot if a parent has it that you would get it).
What many don’t know is that the genetic puzzle is now even more complicated due to PGD- preimplantation genetic testing. In PGD a fertility doc like myself will have the patient undergo IVF. When the embryos are at the 3 day 8-10 cell stage we biopsy them, take a cell, and do a rapid genetic sequencing to look for the target gene- in this case Huntington’s. If that particular embryo is affected we choose not to place it back into the womb and instead choose and unaffected one.
What happens in Huntingtons where the patients often have chosen to not even be tested themselves? I have had these patients. We can do what is called “non-disclosing PGD”. Here, we go through the whole process but the results not shared with the patient (by their choice). We choose the unaffected one to replace and the patient does not know if there even were any embryos that were affected. Either they don’t have the disease (and all embryos are healthy) or they do have it (and we just did not put the affected ones back in).
Personally, I think I would want to know but then again I am not in their shoes. As it has been said- live each day as if it were your last.
More amazing is that this technique of PGD could potentially be used someday to help eradicate single gene disease from the human genome. Do you think it should be used to rid the population of diseases? If so which ones?!
Read more about PGD and controversy surrounding it here
The BBC is reoprting that a new geneticaly medified mosquito has been created that is relatively reistant to malaria.
The study publsihed in PNAS reports
The approach exploits the fact that the health of infected mosquitoes is itself compromised by the parasite they spread. Insects that cannot be invaded by the parasite are therefore likely to be fitter and out-compete their disease-carrying counterparts.
BBC says;
The organism is passed to humans through the bite of the Anopheles mosquito. Each year it makes 300 million people ill and causes a million deaths worldwide. Some 90% of cases are in sub-Saharan Africa, where a child dies of malaria every 30 seconds.
Before you spill all of your quinine out, the malaria variation tested was a rdent one and the researchers predict tit will be 10-20 years before GM mosq’s will be released into the wild.
Many people do not realize that the gene for sickle cell anemia functions in a similar fashion. While deadly in its full disease form, the carrier state (or sickle cell trait) confers a relative immunity to malria and is likely the reason this genetic variation is so common in the Africal population.
While on the subject of GM mosquitos there have been frankencreatures and frankenpets before that have a fluorescent gene stuck into their genome.
The most famous is Glofish. For more info – Here’s how the fluorescent glofish are made. Nothing like genetic engineering to create cute pets. Hey why not knock out growth hormone so you kitten never grows up!
Beppe in NYC
Now I have seen it all. Old school med-industy came to NYC a-courtin’ new school med-bloggers last night. I was invited to a dinner at Beppe a well ranked (not bad in Zagat – menu here) Italian restaurant near Grammercy Park by the Corporate Communication Folks at Johnson & Johnson.
The big pharma folks are exploring the blogosphere and testing the waters before they tread deeply. Their goal was to explore the medical blogging environment and garner information to help them decide how to get involved.
In attendance were a cadre of marketing and corporate communication execs from J&J (Heidi Youngkin (executive director/global marketing group), David Swearingen (vp corp comm), Mark Monseau (director of media relations), Jeffrey Leebaw, Ray Jordan (vp public affairs), Rob Halper (director of corporate TV) and others whose cards did not make my pocket. They brought Adriana Lukas of mediainfluencer and bigblogcompany along with them from across the pond (UK)to try to stir-up the waters. Nothing like having a new media marketer sitting next to an ex-official FDA marketer for fun dinner talk.
On the medblogging side was (along with myself) Jim from BrandWeekNRX, Bob and Peter from Drugwonks and CPMI, Fard from Envisioning 2.0 and , Ed Silverman from Pharmalot , and a highlight for me – a chance to meet my electronic pals from medgadget and blogborygmi Gene Ostrovsky and Nick Genes (of Grand Rounds Fame).
L to R Gene Me and Nick!-
guess who works in the ER, who is a computer programmer, and who came from a full day of patient office hours?
The conversations focused on how industry could partner with bloggers, should they give emplyees free-reign to blog about their work (sure the attorney with NDA in hand will love that), and how the public is using inernet and blog med info. Personally, I spoke about what I see in patient disease chats and discussion forums. There is so much great information but so much disinformation and inaccuracies. I volunteer my time to answer medical questions on forums like these such as ATIME. I believe industry can play a role to foster moderation of information (think Citizendium to Wikipedia). A bit of industry support could help get a panel of docs pharmacists nurses etc time to respond to the mass of information requests and provide an objective commentary (when requested). Real partnerships between industry and patient groups could be fostered on education and not just financing.
I also enjoyed picking Peter Pitts (former FDA’s “chief messaging officer,” serving under Commissioner Mark B. McClellan) brain about 1) why the FDA and legislature is not tackling the herbal and alternative medicine horrors MD’s are seeing (ie who’s getting the payoff) and 2) if FDA does not think herbals are drugs to be regulated why they think sperm, eggs, and embryos are (but that the subject of a whole series of posts to come…)
UPDATE- wow some people are actually blogging about the dinner and who did or did not get invited. You can see the Post on Rost’s whistleblower site and my comments back here
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.
Technology is neither good nor evil, it’s the use that crosses the moral boundaries.
As technology is leaping forward an unprecedented pace, this old question is more pressing now than ever. (If you’re short on time skip to the last paragraph for my conclusions)
A review of this debate can be found here including this question:
As we have seen, technology can be neutral, and … “can act as a catalyst to engender trust” … It is also clear that in many situations, technology is certainly not neutral; technology can marginalize people, incite divisiveness, block knowledge flow… Is technology a neutral “tool” that is designed to carry out the will of the user?
Ars technica in a post ipods at war related this debate to the Myth of Icarus. Unfortunately, their conclusion is so far off the mark. They claim we are victims of technology that we have become addicted to. War ravages as the American Army is shaped by video games and movies to kill. Sorry, folks, the Ozzy Osbourne made me kill myself lawsuit just didn’t hold up.
I really like the inference they make that the Icarus myth is really a story about technology; “when father Daedalus creates the artificial wings for himself and his son, he makes it possible for them to experience something new, but the technology also makes it easy for Icarus to destroy himself.”
ICtforpeace goes on to argue that technology is not morally neutral (and the military is inherently evil).
A Walther PPK would make, I am sure, a pretty good paper-weight, but it was made for a specific purpose and it is rather good when used for its intended purpose, and less elegant when used for others.
They mistakenly suggest
many technologies can be used for both good and bad purposes. But usually neutrality is taken to have a stronger meaning, such as that technologies are equally easy to use for different purposes, which is not helpful when comparing compact disks and cruise missiles.
Philosophical theories on this point can be found on this webpage
Those who believe that technology is neutral argue that “guns don’t kill people, people do”, or that a knife can be used to “cook, kill, or cure.” Those who believe the opposite counter with evidence that technology cannot be evaluated in a vacuum and that there are traits common to all technological developments: (1) technological objects are unique; they are designed to function in a particular and limited way, and (2) technological objects are intertwined with their environment; they interact in unique ways with the rest of reality.
More philosophical musings on the neutrality question can be found here.
I believe in technological neutrality. While it seems that in some scenarios (such as weapons) technology is clearly more likely to be used in one way rather than another, it is just that particular application of the technology that sets off our reaction. There is no better example than the work of DARPA which I have written about. Nuclear technology did not just lead to the bomb it also can be used for medicine and energy. The knowledge of the technology is not that is evil.
While many lament the development of expensive military technology I see the beneficial medical applications inherent in these projects. While one person might see evil and death I can see good and life come from the exact same technologies. Read about the medical uses of military technology here, here, and here.
As my friend Dr. Rick Satava (surgeon, colonel, and Program Manager at DARPA) said:
Technology is Neutral – it is neither good or evil
It is up to us to breathe the moral and ethical life into these technologies
And then apply them with empathy and compassion for each and every patient
Grand Rounds 3.25 is up over at Scienceroll. A gret blog I have mentioned before it is run by Bertalan Meskó, a Hungarian Medical Student wit a passion for genetics. Definitely worth checking out there are about 60 posts but excellently organized in categories to make the reading clear and quick. A nice variety.
I am honored that he chose two submissions from docinthemachine (one I submitted and one submitted by somemone else!). There are links to my posts on :
docinthemachine’s first podcast on the coming technological revolution in surgery (in a new web 2.0 section of grand rounds )and also on new regulations to spread information and increase post marketing surveillance of drugs from the FDA
Continuing in the Sunday Fun Posts from Fans in Japan. This one is from the “Japan Culture Lab” on How to Eat Sushi- All the Japanese etiquette you need. I went a good ways through it before realizing it was a spoof. (The two guys in the videos are a comedy duo in Japan called “Ra-menzu” (Rahmens) ラーメンズ who also feature on the Mac vs. PC ads.
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Japanese TV and humor is unique in the world. I spent some time in Yokahama and Tokyo teaching surgical technique to doctors there. I remember watching game shows like one where babys in walkers race through a maze but if they hit the sides their dad gets an electric shock. This video is so fun because I remember being told “there are 50 ways to offend before you even begin your meal.”
I also published with Japanese collegues the largest series of women ever undergoing repair of blocked tubes with tiny angioplasty catheters from the inside out. (Hey I needed a medgadget hook for the post). It was an honor to work with Professors Osada and Satoh from Nihon University School of Medicine in Tokyo.
For all the DITM fans visiting here over the weekend, I wanted to give you a few fun posts. I have been having a lot of correspondence lately from researchers and technicians in Japan working on the concepts I write about (i’ll post the real Japanese medical technology posts next week). In a burst of research and link-exchange I was sent these strange clips.
First is a new species of octopus recently discovered that defends itself with a Batman Cape. As they write:
Most octopi squirt thick clouds of black ink to confuse predators. Tremoctopus, or blanket octopus (murasakidako in Japanese) when threatened, unfurls a giant sheet of webbing that trails behind like a cape. The webbing breaks apart rather easily when attacked — much like a lizard’s tail — and it gets wrapped around the predator’s face, giving the octopus a chance to flee.
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Here it is folks, docinthemachine’s first podcast to play on the site. This piece is near and dear to my heart. The Topic is “Future Vision” – and it’s about the coming radical transformation of surgery. I review how endoscopy allowed us to move from invasive to minimaly invasive surgery. What’s next? The transformation to microinvasive surgery (miniaturized robotic rovers inside the body) and non-invasive surgery (3D reconstructed diagnostic imaging and therapeutics via powerful computers).
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This podcast was an interiew I did at the 35th annual AAGL conference in Las Vegas. Coming soon I will post my keynote lecture on this topic with powerpoint and videos along with the entire plenary session on this topic featuring Dr. Chutkin (GI swallowable pill cams), Barish (radiology virtual imaging), and Andy Van Dam (yes the founder of sigggraph on virtual reality data manipulation).
you can read more of my ideas about the future of surgery including alternative visualization (seeing what the eye cannot) here
I hope you enjoy these as much as I did making them!
