Archives: 5/2011

FmedLogo FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreWe’re here at Singularity University’s FutureMed after a dense day of exploring mind-melding medical advances. During conferences like this it’s difficult to pick and choose what we write about. So, in a similar process to how we cover TEDMED, we’ll be posting candid, informal end-of-day recaps of FutureMed to give you a high level look at the goings-on and then we’ll follow suite with individual posts on the technologies and advances we found to be most fascinating. So, stay tuned over the coming days!

Let’s start with the basics – The Singularity University (SU) mission is to explore the exponential growth in technological advances of the sort related to the hypothetical technological singularity, a point in time where progress is so rapid that the future is increasingly difficult to predict. Founded by Peter Diamandis and Ray Kurzweil, Singularity University lives and breathes exponential technologies. FutureMed, chaired by Daniel Kraft, is the executive education program exploring how these advances are changing and will continue to change medicine and benefit human health. The 5 day conference consists of lectures, field trips, work shops, and more.

kfy06ei1 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and More

Given SU’s mission, the day naturally started with a talk by the luminary of exponential change, Ray Kurzweil, who opened by noting that the evolution of health care advances have moved from linear growth into exponential growth as medicine has become increasingly an information technology. FutureMed beamed Ray in from Boston using an eerie, but spectacular, teleprompter in which Ray seemed to be floating in space in front of us all, giving everyone the feeling that this icon of the future was in fact coaching us from the future himself.

tji38cxh1 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and More

One fascinating insight from Ray’s talk was that these exponentially growing advances are often the combination of many different paradigms that grow and develop in a sigmoidal fashion. The exponential growth of computational power per dollar, for instance, is driven by say, vaccum tubes, which start slow, progress extremely rapidly, and then level off, only to be replaced by transistors, which did the same thing until integrated circuits came into the picture. Collectively, even though each of these technological paradigms hit a wall at some point, they were replaced by another advance that allowed the final outcome of computational power to continue to scale exponentially. In proof of this, Ray showed us what seemed to be an exponentially increasing number of charts that demonstrated exponential technological growth.

N67zw6sz3x FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and Moreeil Jacobstein, the president of Singularity University, got on stage to talk about artificial intelligence and its implications in medicine. In the world of health care, he asked us to think of artificial intelligence as an innovation amplifier, in that it might be used to help design new drugs, help physicians form better hypotheses, and simulate the effect of therapy before it’s administered. He noted that right now we’ve got AI systems that are narrowly focused, like chess-playing or jeopardy-playing computers, but in time these will lead to increasingly broad AI. The world of medicine will benefit as this happens.

Ralph Merklek6hehpwc FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and More was up next to discuss nanomedicine and how manufacturing principles of larger systems are, and will move more rapidly into the atomic realm. Currently, the tools we have to manipulate atoms are only in 2D, like the famous IBM printing of xenon atoms on nickel, but will soon move to 3D. Once that happens, we’ll be able to build molecular tools such as bearings and universal joints that will allow nanotechnology to develop into something far more functional and medically useful than what we’ve seen so far. He asked us to think about some devices that might be potentially useful, one being a “respirocyte,” a nano oxygen tank of sorts that holds 10x the oxygen carrying capacity of red blood cells and deploys the gas as needed. He imagined a world where a therapeutic injection of these tiny “machines” might allow someone to hold their breath for an hour.

uarolv5g4 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreAfter Ralph, Brad Templeton, a key member of Google’s self-driving car project got on stage to tell us about the history of self driving cars and give us some insight into how Google’s car works and what this change might mean for both the safety and efficiency of transportation. Human drivers kill 34,000 people per year in the USA alone, and worldwide there are 1.2 million deaths annually from automobiles. Self-driving cars are clearly coming to consumers in the not so distant future, and our concept of transportation will change tremendously. Imagine, for instance, that city streets might seamlessly adapt to traffic needs by changing the direction of one-way streets, manipulating stoplights, etc.

The next set of talks by Dan Barry and Gabor Forgacs focused on 3D printing technologies and how they’ll change both consumer and medical products. 32jydgm4 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreDan, a former astronaut, has been actively exploring how these technologies will change our future. In a world where hgcr3u2a FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and More3D printing (using both plastics and metals) are the standard for manufacturing, increasingly, the complexity of these objects will actually not cost any additional money. Not only that, customization for the consumer and patient will be considerably easier and common. A dentist office, for instance, might be able to print replacement teeth on site. Or an orthopedic surgeon might be able to print a replacement bone that will fit perfectly into the patient. Dan passed around some incredibly complicated objects that would be nearly impossible to make through other manufacturing methods, yet were crafted with ease using 3D printers.

8bv9kwl9 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreGabor Forgacs, researcher and founder of Organovo, discussed how these 3D printing techniques are being applied to organs. In Gabor’s viewpoint, the world of scaffold-based tissue engineering is transitioning into both decellularized (where you use natural ECM structures) and scaffold-free (where you print tissue and let it organize) tissue engineering. He showed some absolutely remarkable research where his team printed a neural graft, severed the sciatic nerve of a mouse, and then installed the graft only to find that the mouse was able to move its hind legs again in 17 days. At the close of his talk, Gabor pointed out that printed organs are not likely to have the same shape and look of our current organs, only similar function. It’s not realistic or sensible, he says, to print a kidney that resembles anything close to a natural kidney. However, masses of tissue that function as kidneys do could potentially be engineered using his techniques.

g7phvtgf FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreNext up, Eythor Bender from Berkeley Bionics gave a talk about his company’s eLegs, which allow patients with spinal cord injuries to stand-up straight and walk again. The technology, demonstrated live on stage by Ted, a patient who works closely with Eythor and team, is a moving example of how robotics can affect the lives of patients.

Berekely Bionics has a audacious and remarkable goal to supplement (and in some cases replace) the wheelchair for paralyzed individuals.

bbq2dads FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and More

eLegs work without an innervation into the patient’s nervous system, but rather automatically (based on pressure from two crutches the patient holds) move the extremities in a walking pattern that allows patients to take steps. Their first customers will be rehabilitation centers, but the company is pushing hard to bring the price down to a point where it will be attractive and optimally reimbursable for patients to use on their own.

After Eythor, we had a string of talks on web-enabled health including Thomas Goetz from Wired Magazine, Michael Gillam from Microsoft, and Roni Zeiger from Google.

kd5vmrbr FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreIf you read our TEDMED coverage, you may remember Thomas’s effort as part of Wired Magazine to re-design the lab report and make it relevant and actionable for patients. The work was exceptional and folks at TEDMED were left wondering if / when big laboratories like LabCorp and Quest Diagnostics would make this move. Yesterday we learned the great news that Thomas has started a company called 1+1 Labs to bring these reports to patients. Bravo.

After Thomas, we heard from both Michael Gillam, and then Roni Zeiger, who talked aygpp5x21 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and Morebout some of the advances they’re seeing and pushing from their posts at Microsoft and Google, respectively. Michael spoke about the historically large lag between scientific discovery and translation to clinical practice, and how that has changed and improved over time, as well as how advances might be brought to patients in the future. He pointed out that there’s an emergence of consumerized medical tools and software that directly serve as an intermediary to patients and their doctors. He also noted that there are currently already 85+ devices that are sold to consumers that can connect to health records.

xxbbwqmp9 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreRoni talked about some of Google’s more recent efforts in health outside the PHR space, ranging from the simple but powerful introduction of smarter health realted search queries like “poison control,” which immediately returns the number for the US poison control center, and “suicide,” which displays the number for the US suicide prevention hotline. He also demonstrated Google’s Body Browser, an interactive anatomy tool that lets laymen and experts alike explore the inner workings of the human body.

bbbbwqmp9 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreNext we heard from Health IT gurus Christopher Longhurst, who rolled out the EMR at the Lucile Packard Children’s Hospital, and Daniel Riskin from Vanguard Medical Technologies. Both described the power of implementing health IT smartly and some of the trends and technologies ahead.

Two pieces of information stood out most from Christopher’s talk. One was that Lucile Packard Children’s Hospital was one of the first to publish direct evidence of the reduction of all-hospital mortality after implementation of an EMR. The other was how insanely expensive it is to implement EMRs in an in-patient setting, and how he hopes and believes that these systems will become less expensive and more like commodities in the near future.

a4bj7kqs FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreDaniel described how the most powerful analytics in health care will come from fully structuring a patient’s record. To this aim he spoke about and demonstrated an application called DocTalk that uses speech recognition to automatically translate a doctor’s dictation into structured clinical data. This allows physicians to avoid the painful process of categorizing and organizing every piece of information on patients by him- or herself.

The next section of the conference were rapid fire talks by four up and coming health startups: HealthTap, Massive Health, Basis, and Zipongo. All are working on ways to change behavior and improve health through the smart use of personalized data, feedback loops, and technology. Basis in particular stood out with their soon to be shipped ultra-watch that measures your heart rate, calorie burn, galvanic skin response, and movement. It’s a beautiful device that’s a technological marvel as well. We can’t wait to get our hands on one!

7uyqw5 FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreTo further the discussion of wearable sensors, Astro Teller, who founded Body Media, took to the stage and spoke about his efforts building both the technology behind Body Media’s sensor and the company to sell it. His candid talk highlighted the challenges such devices have in being relevant, comfortable, and desirable enough to become routine in patients’ lives. He also noted the difficulties in getting health care insurer support for such devices, and the need to focus on “decoding the human lifestyle” to figure out the best ways to motivate people to adopt healthy behaviors.

After dinner, z7ybst9y FutureMed Day 1 – Ray Kurzweil, Gabor Forgacs, Eythor Bender, and MoreLawrence Sherman spoke about the future of medical education, including the ludicrously poor state of Continuing Medical Education (CME). He noted that in the current system an obstetrician can get CME credits for learning about urology and that around 50% of CME offerings are paid for by the pharmaceutical industry. He advocates not only reformed CME, but reformed primary medical education in which budding doctors are exposed to patients from the very beginning of medical school, and alternative learning modalities are used to make medical education more engaging and efficient.

FutureMed day one wrapped up with an un-conference in which participants taught each other about things of their choosing.

Wow, it was a long but rich day! Today we start with a half day of personalized medicine and then a field trip over to Kaiser’s Garfield Innovation Center.

wxqig95x Sanofi Pasteurs Fluzone Intradermal Flu Vaccine Approved in U.S.
Sanofi won FDA approval for Fluzone Intradermal flu vaccine system. Indicated for ages 18 through 64, the system uses a microinjection needle to deliver the vaccine into the dermis. This is a big improvement in comfort over intramuscular injections, and the fact that Sanofi is making the new product available for the next flu season should help soothe the nerves of needle phobics.
xbd0o7xt Sanofi Pasteurs Fluzone Intradermal Flu Vaccine Approved in U.S.

The new formulation of Fluzone Intradermal vaccine is the first influenza vaccine licensed in the U.S. that uses a novel microinjection system for intradermal delivery. Fluzone Intradermal vaccine features an ultra-fine needle that is 90 percent shorter than the typical needle used for intramuscular injection of influenza vaccine. Sanofi Pasteur has previously licensed microinjection intradermal influenza vaccines, marketed as Intanza® or IDflu® vaccines, in more than 40 countries including Australia, Canada and countries in Europe.
Fluzone Intradermal vaccine incorporates a new, easy-to-use, prefilled microinjection system designed to consistently deposit vaccine antigens into the dermal layer of the skin of adults. The dermal layer contains a high concentration of specialized cells known as dendritic cells, which play a key role in generating an immune response. In clinical trials, Fluzone Intradermal vaccine produced an immune response at rates similar to Fluzone vaccine administered intramuscularly.
Typically, adult influenza vaccines are administered into the muscle utilizing a needle 1 inch to 1.5 inches (25 mm to 38 mm) in length. Fluzone Intradermal vaccine features an ultra-fine needle that is 0.06 inches (1.5 mm) in length. Fluzone vaccine contains 15 mcg of hemagglutinin per strain of influenza in a 0.5 mL dose. Fluzone Intradermal vaccine contains 9 mcg of hemagglutinin per strain of influenza in a 0.1 mL dose.
Fluzone Intradermal vaccine will be available to health-care providers in the U.S. for the 2011-2012 influenza season.


Press release: FDA Licenses Sanofi Pasteur’s New Influenza Vaccine Delivered by Intradermal Microinjection…

vl6mp3cx Bioness NESS L300 Plus System Gets Green Light in U.S.
Bioness out of Valencia, California has received U.S. FDA approval for its NESS L300 Plus System, wlpqq936 Bioness NESS L300 Plus System Gets Green Light in U.S.a combination of the NESS L300 Foot Drop System with a thigh stimulation device. Intended for patients with upper motor neuron injury, post stroke, and other conditions, the system helps with knee flexion and extension, as well as ankle dorsiflexion.
From the announcement:

The NESS L300 Plus builds on the proven success of Bioness’ NESS L300 Foot Drop System and is designed to additionally stimulate the muscles of the thigh. The addition of the thigh stimulation cuff, synchronized with a wireless heel sensor to detect when the foot is on or off the ground, controls the knee, making it easier to walk. Historically, patients have relied on rigid plastic braces which restrict thigh and ankle movements and can lead to additional problems, including increased falls.

Product page: NESS L300 Foot Drop System…
Press release (pdf): BIONESS INC. RECEIVES FDA CLEARANCE OF ITS NESS L300 PLUS SYSTEM…

yaiowrny Study Finds That iPhone App Can Make Accurate Stroke Diagnosis
Researchers from the University of Calgary have shown that doctors can make a stroke diagnosis using an iPhone application just as accurately (and faster) than they can on a traditional computer. In a study recently published by Journal of Medical Internet Research, two neuro-radiologists looked at 120 consecutive noncontrast computed tomography (NCCT) scans and 70 computed tomography angiogram (CTA) head scans. cuqf1gz9 Study Finds That iPhone App Can Make Accurate Stroke Diagnosis One used a diagnostic workstation and the other using Calgary Scientific‘s ResolutionMD Mobile app. The study results showed that using the ResolutionMD app is between 94%-100% accurate in diagnosing acute stroke, compared to a medical workstation.
In addition to accurately diagnosing a stroke, the app was also praised for its ability to handle a large number of images seamlessly and to detect subtle, but potentially critical findings in CT scans. Moreover, the mobile nature of the app gives doctors the ability to analyze and diagnose strokes from practically anywhere.
ResolutionMD Mobile was released last April and allows doctors to quickly and securely access medical images from central hospital servers and manipulate them to assist in making an accurate diagnosis. Of note, our friends at iMedicalApps have a review of ResolutionMD, and anyone can download the app for free from the iTunes Store.
Article from the University of Calgary: Stroke diagnosis using iPhone app extremely accurate study finds…
Journal article: A Smartphone Client-Server Teleradiology System for Primary Diagnosis of Acute Stroke
Product page: ResolutionMD Mobile…

twitterbrain University of Cambridge Professor Explains Human Brain Network With TwitterEd Bullimore, a professor at the University of Cambridge, recently gave a talk to an audience of eager Britons about the amazing complexity of the brain. He shared how it is known that the human brain contains billions of neural cells connected to each other by trillions of synapses. However, as Professor Bullimore is studying the brain from a network point-of-view, his description of the brain shifted as he explained how he reduced his vision of the brain to mathematical equations rather than a large number of biological parts.
Bullimore explained that by viewing the brain in this manner, he discovered that the organ has much in common with computer chips and stock markets in the way they process information. Brain networks represent a balance of efficiency of information transfer and connection cost. Moreover, different patterns of network connections in the brain correspond with different types of thinking, and age and neurological disorders can rapidly affect different network “configurations”.
To illustrate some of these concepts, Bullimore performed a live experiment during his talk using Twitter. Members of the audience were asked to tweet during the lecture about the concepts that were being discussed using a special hashtag. At the conclusion of his talk, he displayed an image that showed the interconnectivity of the hashtagged tweets (image above) and explained how the “twitterbrain” network is analogous to the human brain network.
“We found that the #twitterbrain network was somewhat like the brain network in being small-world and modular with highly connected hub nodes," explains Bullimore, "however the brain network was more clustered and less efficient than the twitter network. So at first sight there were some points in common and some points of difference between these two information processing networks.”
Take a look at the video clip below that shows a simple model of the human brain network:


Caption and explanation:

Each node of the network represents a different brain region and is colour-coded according to the larger area is located in. Pairs of nodes are linked if the activity of the two regions is found to synchronize a lot of the time during an fMRI brain scan, and the size of nodes represents how many other regions a given node is linked to.
The resulting network is used to analyze information flow in brains of healthy people as well as patients with disorders such as schizophrenia. To better understand these networks, we can decompose them into communities of nodes which are more densely connected with each other than with the rest of the network. This gives rise to a different picture, where the nodes are layed out in space according to the communities they participate in, rather than their location in real anatomical space.
The above video shows the transition from a network showing the connections between different brain regions in their anatomical locations, and a new layout emphasizing the network’s structure, with nodes relocated and re-coloured based on their membership in network communities.

Article from the University of Cambridge: Neuro-tweets: #hashtagging the brain…

bc02tq6m New Program Predicts Salmonella Levels in PorkWarning: don’t read the following if you’ve recently dined on pig! A new program developed by the UK’s Institute of Food Research, the US Department of Agriculture, and Australia’s Food Safety Centre seeks to predict the amount of Salmonella present on different levels of the pork supply chain.
Tracing the cause of Salmonella, or any bacterial contamination, along a food supply chain can be difficult due to different environmental conditions, so the foundation of the program was Combase, a database of microbial growth data in various environmental conditions from previous research. Taking into account the temperature, pH, and water activity of actual processing conditions, the program can give accurate probabilistic and kinetic models of Salmonella concentration.
The program’s predictions have been validated with comparisons to actual pork products.
Certainly a helpful tool for meat packagers, but as consumers please remember to cook your pork thoroughly to at least 160 °F (71 °C) so any salmonella in the pork supply chain doesn’t end up on your plate.
Article from Food Production Daily: New software tool to predict Salmonella levels in pork…
Journal article: Modelling Salmonella concentration throughout the pork supply chain by considering growth and survival in fluctuating conditions of temperature, pH and a(w)
Image credit: NIH

maryt1ap Biomagnetics Announces the First Urine Based Test for TuberculosisTraditional tuberculosis testing can take days to return a result, and, while newer PCR tests can deliver results in a matter of hours, they are much more expensive. Orangevale, CA-based Biomagnetics Diagnostics Corporation claims that its new urine-based test will solve both the time and cost problems by providing results in about 20 minutes, at a significantly lower cost than PCR-based testing. The new test is performed using optical biosensor technology which Biomagnetics licensed from Los Alamos National Laboratory last year. The company plans to incorporate the new technology into a handheld device to enable point of care testing.
From the product page:

Biomagnetics Diagnostics’ triggered optical biosensor is based on protein-receptor binding that brings two or more optically tagged receptors into close proximity using planar optical waveguides, thereby triggering fluorescence changes identified almost instantly by tiny on-board detectors. These devices are specifically designed to be battery operated and ultraportable, allowing for the rapid detection of various viral and bacterial pathogens by relatively untrained personnel outside of the laboratory setting.
Los Alamos originally developed the concept of a reagent-less, laser-based system for homeland security purposes, aiming to allow first responders to rapidly identify toxins and pathogens in the field. Broader applications, such as disease diagnostics, blood bank screening and hospital use, offer commercial partners an interesting opportunities.


Press release: Biomagnetics Unveils World’s First Urine-Based Tuberculosis Diagnostics Tool in New Video…
Product page: Integrity Optical Biosensor…
Flashback: Biomagnetics Diagnostics Corp. Introduces an Optical Diagnostic Biosensor

vq3vsdf For Our Readers: Free Auscultation Apps from Thinklabs Medical
Futuremed kicked off this morning at NASA’s Ames Research Park and all the attendees will be getting copies of Thinklabs Medical‘s iMurmur 2 and Heart Record apps for iPhone and iPad. iMurmur is a valuable application for learning heart murmurs and other cardiac sounds, while Heart Record is a non-clinical app that uses the iPhone as a basic electronic stethoscope.
To coincide with Futuremed, our friends at Thinklabs decided to give away the apps for free, since most of you will not able to attend the exclusive event. You’re hearing it first here, so be sure to get them this week while they’re free. Here’s more about the apps with download links further down:

 For Our Readers: Free Auscultation Apps from Thinklabs Medical

iMurmur uses real patient recordings to provide authentic heart sounds so that learners know how real patients sound, rather than mere simulations. The App includes reference waveforms, diagrams and educational material, and is designed as a quick mobile reference for medical students, residents, teaching faculty, and practicing clinicians. iMurmur is also a valuable tool in nursing and EMT communities. The App can be used on Apple iPhone, iPod Touch and iPad platforms.
Heart Record is a fun, recreational App for non-clinical use that turns the iPhone into a consumer electronic stethoscope. Heart sounds can be captured, displayed and emailed – a terrific way for lay users to listen to the heart without a stethoscope.
Heart Record is a consumer version of Thinklabs Stethoscope App, a professional sound recorder with multi-touch user interface, real phonocardiographic waveform display, email and annotation capability, and many other features. Stethoscope App provides live sound recording from Thinklabs Digital Stethoscopes, enabling clinicians to capture patient heart and lung sounds at the bedside or office for EMR, research, second opinion, telemedicine, and educational use.
Thinklabs is the first company to provide an electronic stethoscope with connectivity for recording and display of heart and lung sounds on the Apple iPhone and iPad.

Download links: iMurmur 2; Heart Record
Thinklabs press release…
Thinklabs Medical homepage…

nw45hff Abbott FreeStyle InsuLinx Blood Glucose Monitoring System with Insulin Calculator Receives CE MarkAbbott has received CE approval for its FreeStyle InsuLinx Blood Glucose Monitoring System, which, in addition to measuring blood glucose, calculates suggested insulin doses.
Calculating appropriate mealtime insulin doses based on blood glucose level and carbohydrate intake can be a challenging task for some patients. The FreeStyle automates this step by recommending the right bolus dose.
Furthermore, it features a touch screen interface, automated logbook, personalization preferences and USB connectivity.
The accompanying FreeStyle Auto-Assist software (available for PC and Mac) helps manage diabetes with reports, reminders and messages. The device will be available beginning in May.


Press release: Abbott’s New FreeStyle InsuLinx Blood Glucose Monitoring System with Insulin Calculator Receives CE Mark…
Product page: Freestyle InsuLinx…