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When People Get Animal Parts

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Xenotransplantation: When People Get Animal Parts

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This video describes what xenotransplantation is - the transfer of tissue/organs from one species to another. It also details some specific examples like pig kidneys for human subjects - that show how useful and lifesaving this innovation could be if we went further with it.

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A picture I can use to help me remember what my innovation is. 

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A picture I can use to help me remember what my innovation is. 

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Drone use for commercial purposes has gotten much press of late due to Amazon announcing it intends to use drones to deliver packages to customers. This is a very intriguing and transformational idea with many intended and unintended consequences.

The future use of drones in healthcare also is very thought provoking. How can the industry best use this technology to improve safety and care delivery? Well for starters, drones already have been trialed to deliver food aid and medical supplies to areas hit by disaster, such as Haiti, by a startup called Matternet.

The rapid delivery of vaccines, medications and supplies right to the source could quash outbreaks of life-threatening communicable diseases. Communication equipment, mobile technology, portable shelter comprise the vast list of what could be delivered in a rapid fashion to areas where critical infrastructure damage would prevent ground or typical air transport.

Drones help provide more efficient healthcare to patients from a distance or while mobile

In the future, small indoor drones could deliver medicine to the bedside of a patient from the pharmacy, thus eliminating some human steps. This would lead to more rapid and less error prone administration of medications. Nurses and pharmacists can work more efficiently as supplies can be summoned to the bedside instead of the time consuming task of gathering necessary items.

Drones could deliver medications and supplies to patients being cared for in the home instead of a hospital-based setting. The future will see more outpatient care and even home-based care that used to be delivered in the hospital. For many conditions, drone technology may make it easier and safer to provide this home-based care. When a provider rounds on a home patient, blood can be drawn and immediately sent by drone to the lab to be tested. Medications, antibiotics and treatments ordered by the provider may be delivered to the home by drone.

Healthcare organizations already are deploying mobile technology to solve some of the problems in the industry today. Mobile devices, wearable tech, remote monitoring, telemedicine and information sharing platforms all are transforming healthcare. Likely in the foreseeable future, drones, robots and artificial intelligence will assume many tasks in healthcare that are performed by humans, to reduce variability, cost and error.

"Drones are going to decrease the reliance on human beings that provide care and decrease the cost of assisting people," said Dr. Jeremy Tucker, vice president patient safety and regional medical director at MEP Health. "Being able to cross long distances at faster speeds to deliver blood products and lab samples also is a huge benefit. Now transporting blood products between hospitals, for example, involves vehicles on the ground that are prone to accidents and delays. Drones can help decrease those incidents."

As drones are incorporated more into the health care industry, Tucker said the first area that will see the most benefit is delivery. Extensive research is already being done in this area with some countries beginning to benefit from this type of UAS application.

This isn't the first time Flirtey has completed successful missions for the health care field. Last summer, the company was part of the Let's Fly Wisely event in Wise, Va., where they worked with the Remote Area Medical clinic (RAM), the Mid-Atlantic Aviation Partnership at Virginia Tech (MAAP) and NASA to deliver medical packages to volunteers on the ground, who in turn made sure underserved attendees received the packages-marking the first time a UAS delivered medical supplies and pharmaceuticals in the US.

"It would be extremely helpful if we were able to send packages of medicine and vaccines over great distances by drone," Brock said. "In that part of Virginia (where Let's Fly Wisely took place), a large number of underserviced people can't get out of the house during the winter, particularly during inclement weather, but are in desperate need of blood pressure medicine or whatever medicine it is. A drone could take that medicine to them where a vehicle wouldn't be able to do so."

"If you can get a drone to a downed person having a heart attack quicker than an ambulance, you can save lives," Head said. "The thing about a defibrillator is it doesn't matter how you use it as long as you can get to the patient quickly. It's the time after the event that's critical."

The UPS Foundation, and Gavi, the Vaccine Alliance recently formed a partnership to begin transporting blood and vaccines to rural areas in Rwanda. They're also working closely with the Rwandan government, whose leadership is actively looking for ways to dispatch vaccines and medicine to its citizens, Gavi spokesperson Frédérique Tissandier said.

During the first phase of the 18-month project, which is expected to begin in mid-August, the UAS will deliver blood to transfusion facilities. The blood will primarily be used to save women experiencing postpartum hemorrhaging, which is a common problem in the country, Gavi Manager of Global Operational Partnerships Mozammil Siddiqui said. After evaluating and determining how well the UAS were operated, how many deliveries were made and how the UAS were perceived, the second phase, which involves delivering rabies vaccine, will begin.

Time is critical in emergency situations, especially when victims need blood or a rabies vaccine, Siddiqui said. If a child in Rwanda is bitten by a rabid animal, for example, instead of waiting hours to get the necessary vaccine, a UAS can deliver it in about 15 minutes. This type of use is why Gavi has been looking into using drones for vaccine delivery for a few years now. They just needed the right partners to help them move forward, which they found through Zipline and its drone's capabilities and the UPS Foundation's logistic expertise.

While drone delivery makes it possible to courier needed vaccines to remote areas in harsh weather, it isn't without its challenges. Both blood and the vaccines must be kept at a certain temperature during transport, Siddiqui said, or they will be unusable when they arrive. Anyone working with the payloads must be properly trained to ensure the products arrive at the right temperature and that deliveries go smoothly.

Zipline has been developing the UAS, known as Zips, for the last two years, software team lead Ryan Oksenhorn said. The drones have the ability to complete about 150 blood deliveries a day to transfusing facilities in the western half of the country. The development team had to overcome a variety of challenges, such as finding a way to make deliveries without actually landing at the site and creating a UAS designed for this type of long-distance delivery.

One way is by transporting blood samples and medications from floor to floor or building to building, rather than making such deliveries by foot or through the pneumatic tube systems hospitals typically use, Stavanja said. This can be particularly helpful for growing hospitals making additions. Expanding a pneumatic tube system is a costly endeavor, but using a drone instead gives hospitals the ability to transport specimens and medications from floor to floor at a low cost.

While Stavanja is excited about the potential uses for drones inside hospitals, like most UAS applications, there are several challenges to making it a reality. The first is communication. Outdoor drones rely on GPS signals and radio frequencies to complete their missions, both of which are limited indoors. Blue tooth technology might offer a solution to that challenge, but researchers also need to figure out a way to fully automate drones so they understand their environment and remember where they are. Then there's the weight. Typically the smarter the UAS, the larger it is-and the more expensive. To keep costs down, these drones will need to be small. And of course, safety is always a concern, as well as the battery life needed to get from point A to point B.

Many of the people reluctant to use drones inside hospitals are worried it could cost people their jobs, Stavanja said. But he argues it will free them up to spend more time with patients and focus on other tasks. There will also be a need for people to provide flight paths and manage the drones to ensure they're transporting the right package at the right temperature to the right location.

Not only is robotics important to this type of research, so is the psychology, Hovakimyan said. The team must develop flight paths that humans find both safe and acceptable. To that end, the team is working closely with psychology experts.

The main challenge is developing a robot that is as reliable as your refrigerator or washer, Hovakimyan said. But unlike your refrigerator or washer, these drones must be able to move around all over the home and reliably deliver every time, whether they're fetching medicine or cleaning. Researchers must also create a drone that elderly from all different backgrounds will consider safe. For it to work, they must feel comfortable interacting with it.

As with every industry interested in implementing UAS, there are challenges to overcome ranging from payload capacity to battery life and, of course, regulations, Tucker said. A lot of the research being done for health-related delivery services is happening in other countries because the restrictions make it too difficult to complete testing in the U.S. And while the new Part 107 regulations the Federal Aviation Administration released earlier this summer remove some of the limitations, some uncertainty remains. But as the barriers start to come down, Tucker sees more people in the industry becoming interested in UAS and reaping the many benefits the technology can provide, starting with delivery services and then moving on to more complicated applications in the next five to 10 years.

"The early adopters are there. I know colleagues who are testing these solutions on their own," Tucker said. "Early adopters are out there trying to work with these solutions but there are barriers. Some people are just reluctant. They're reluctant to spend money on new technology because they're wondering what the cost is going to be and they're worried about making a business case for it because of the regulations. The FAA has been the biggest barrier, but that is starting to change.

The wait is finally over. After years of wondering exactly what rules commercial drone operators will have to abide by, the industry finally got its answer. Released in June, the Part 107 rule applying to for-profit flights with drones weighing 55 pounds or less, including payload, takes effect in late August.

The rules provide operators of unmanned aircraft systems (UAS) with specific mandates while easing many of the restrictions that have made it difficult to operate UAS businesses in the U.S. Drone pilots won't need a pilot's license, they will be able to take a test for the necessary certification. The rules also make it easier to fly. Not only will most operators not need to obtain a Section 333 exemption, there'll be no need to go through the delay-prone and widely despised process to get a Certificate of Waiver or Authorization (COA) to fly some specific missions.

"We've been in limbo for a long time waiting for the rule," said Rose Mooney, executive director of the Mid-Atlantic Aviation Partnership at Virginia Tech, or MAAP. "The rule gives manufacturers and operators a path toward more extensive use, albeit limited to daylight operations and within visual line of sight. The new rule will open up opportunities in areas such as roof inspections, infrastructure inspections and real estate, allowing for business growth."

But there are many who would like to see more, especially when it comes to flying beyond the visual line of sight of the pilot. Under Part 107 operators still need to apply for a Section 333 and prove the safety case for permission to perform such flights. Limitations remain as well on night flights and operations over populated areas.

Even with the restraints, there are still opportunities to fly at night or beyond visual line of sight through the waiver process, though it's unclear exactly how the process will work and how many of these waivers will be granted, said David Proulx, vice president of product and marketing for Aeryon Labs. Regardless, the waivers represent the opportunity for more potential applications and even more growth.

"From my perspective what (107) does, at a high level, is it ensures that there's a commercial UAS industry in the United States," said Robert Blair, vice president of agriculture at Measure. Among the benefits, he said, is that it is no longer necessary to have a visual observer along during flights. "That reduces costs-that's huge."

"The entire UAS industry benefits from this rule," Miller said. "The bottom line is, instead of having to go through a process to get permission to fly, I can look up the rule and I'm good to go. That's very different. It (the new rule) is disruptive and I don't think people realize that yet. The psychology of that is huge."

Industries that want to deploy small UAS for data collection will benefit most from the Part 107 regulations, said William Janicki, a partner with the law firm Schnader Harrison Segal & Lewis. That includes mining, real estate, some agriculture applications and industries interested in infrastructure inspection such as utilities, wind farms and oil and gas.

Because Dominion Virginia Power already has a section 333 exemption, Eisenrauch said Part 107 doesn't really open up new applications for the company. The rule does get them one step closer to flying beyond visual line of sight, however, which would be a game changer for utilities and a variety of other industries.

Trying to fly beyond visual line of sight with these restrictions is cumbersome and not very practical, said Grant Leaverton, vice president and general manager for AAIR, a company that provides inspection services for a variety of industries using the Falcon 8 and the SteadiDrone Mavrik drones. But the regulations the FAA put in place are a start, he said. He would like to see the FAA continue to evaluate the regulations and learn more about how operators can safely fly beyond visual line of sight to effectively assess transmission lines, gas pipelines and other similar assets.

"I think that's one of the most intriguing parts of the rule," Proulx said. "It remains to be seen how the process will be carried out in practice and what level of risk mitigation operators will be required to present to satisfy the FAA. It's a really interesting concept and certainly opens the door to a lot of interesting things, but how operators take advantage of it and how the FAA responds will determine how impactful it really is."

Dropping the pilot license requirement is huge, Mooney said, and will open the door for wider adoption of UAS in a variety of industries, creating business opportunities for service providers and manufacturers.

Dorgan said the pilot license requirement has been holding up the entire industry and is the biggest, most positive impact the rules provide. Pretty much anybody can take the certification test now, and once they pass they can legally fly a UAS for commercial purposes, as long as they follow the rules.

"We can find talented people who have experience flying these types of aircraft. We can incorporate these folks into the team without worrying if they have a pilot's license or spending $10,000 to get one. They can get the certification and then we can train them up on our platforms," Leaverton said. "It opens up labor markets and gives flexibility to a larger pool of talent, leading to lower costs. Industrial and infrastructure inspection operations will see a benefit from both cost and safety aspects, which are huge drivers on the OEM side."

While Part 107 represents an important step in the UAS industry, there's still challenges to overcome and a long way yet to go before drones truly reach their full potential.

One challenge Eisenrauch sees is the increased demand the new regulations will bring. As more companies want to use drones, the already established manufacturers and service providers might struggle to maintain the same level of service and quality they're able to offer today. New companies will enter the market, but while they get up to speed current businesses will need to meet the demand-which could become overwhelming.

Thomas Bartlett, who owns Image in Flight, a company that primarily flies UAS for the construction industry, sees safety as another challenge. While most are excited about the FAA dropping the pilot license requirement, he's concerned if everyone with a drone can get a certificate to fly, it could lead to safety issues.

"It's so easy to fly now there's going to be a flood of people," Bartlett said. "Someone else's accident could put us all out of business. With this new freedom comes responsibility for every one of these operators."

Andy Von Stauffenberg, of VStar Systems, a company focused on developing UAS for military applications which also has in the commercial market, said it won't be long before insurance companies become more involved, adding another layer of complexity. Insurance companies will likely develop their own requirements, even stricter than the FAA's, that could hold some operators back. This might include requiring a specific amount of flight hours to perform certain tasks. "Once we see more and more UAS come out and operate, the insurance companies are going to take a critical look and that will drive a lot more of the requirements," he said. "The insurance companies will have a big say on the minimums they want to see before they'll insure someone for a UAS. There's no way around it."

The new rules for flying UAS commercially help UAS manufacturers as well as drone-centric service firms like AAIR, Image in Flight and Altavian, which is building a data-on-demand network based, initially, on the drone operators using its hardware platform and its Fetch data software.

Drive north of Baltimore, on the East Coast of the United States, for an hour or so and you'll find one. Every now and then, you'll see a team there, wearing gloves and lab coats, flying a small white drone.

This special white drone is made of Styrofoam, weighs just four pounds, and costs less than $100. This hobby-grade drone could represent the future of medical delivery.

Back down in Baltimore, the Core Laboratory at Johns Hopkins Hospital is busy.

Medical samples are tested here -- everything from hair to urine to blood. Some 10,000 samples come through here every day and the need for testing is on the rise.

Non-communicable diseases, such as heart disease or diabetes, are now responsible for more deaths than infectious diseases. According to the World Health Organization (WHO), non-communicable diseases kill 38 million people worldwide each year.

These diseases are not passed from person to person, but develop over time and require continued testing, often over the lifetime of a patient. This needs access to labs for biological samples and tests.

Dr. Timothy Amukele is a pathologist at Johns Hopkins. After visiting labs around the world, particularly in sub-Saharan Africa, Amukele had an idea.

If access to labs and transporting samples for medical testing were some of the biggest hurdles -- because of traffic, poor roads and lack of accessibility -- why not remove those factors altogether?

Why not fly the samples in a drone?

"The idea for using drones first came from the problems of moving samples internationally," Amukele said.

"There's a need in places that are really poor that don't have roads. And then in places like here in the United States, we have issues with traffic."

When you get your blood drawn, or give a urine sample at the doctor's office, testing is rarely done at the same location. According to Amukele, most clinics are primarily collection sites that can perform a few key tests, but not the full range. The latter requires samples to be moved.

Amukele acknowledged this success is the first in a long line of steps. The regulations for drones differ in every country, and in many cases, are still being worked out. There are other questions too, like who would fly it? And how do they make it secure?

"When we say the word 'drones, people think of things that fly over their heads and kill their children," Amukele said.

That's not what we're talking about here. We're talking about small, unmanned flying systems. We're talking about a different way to transport goods."

The use of drones for healthcare delivery is also being trialed elsewhere. Teams at Delft Technical University are testing them to deliver emergency equipment, such a defibrillators, to quickly care for patients after a heart attack. If successful, they could be used by ambulance services.

Reports have also been made of "drone-ports" being piloted in Rwanda later this year where drones will be trialed to deliver blood and other emergency supplies.

The next step for Amukele's team, however, is more testing. Further trials are estimated to be up and running in the United States, and abroad, within the next six months.

"People are starting to realize that drones can be used for good," Amukele said. "Already, in the United States, they are being used for agriculture and film making , but what they haven't been used for is healthcare. Healthcare is the industry where we need this capacity."

The samples are packed in a special foam with a sponge that would fully absorb the specimens in case the drone were to crash.

"It doesn't answer all the other questions," Amukele said. "But the key question was does the blood arrive ok, because if it doesn't arrive ok, then none of it matters."

Perhaps the biggest hurdle now might be the word 'drone' itself.

"Speed is everything," Amukele said. "If it sits there for a long time, at some point the specimen starts deteriorating. It's not so useful anymore."

A lack of obstructions would speed up the process -- that's where the drones come in.

"A drone is a transport mechanism," Amukele said. "I think in 5-10 years it will be just like having a motorcycle, where it doesn't matter what you put on it, as long as you package it safely."

The first of its kind, Amukele ran a proof-of-concept study to see if blood samples could be successfully transported via drone. Six blood samples were taken from 56 volunteers. Half of the samples were taken to the Hopkins lab and the other half were loaded on a drone and flown around for varying time periods between six to 38 minutes.

Initial questions focused on the samples themselves, and if the drone flight would deteriorate them. Changes in air pressure and the shaking of the drone in the wind and during the take-off and landing were all concerns.

But the drone test worked -- and Amukele was on to something.

San Francisco-based Zipline, which launched its autonomous drone medical supply delivery program in Rwanda, is bringing its live-saving robots to the U.S. as regulations ease.

Zipline, a San Francisco-based robotics company, is expanding its medical supply and blood program it started last month in Rwanda to rural, hard-to-reach communities in Maryland, Nevada and Washington state, the company announced this week.

, which was founded in 2011 by Keller Rinaudo, Will and Keenan Wyrobek, is currently delivering life-saving supplies via its 25-pound drone all over Rwanda. The electric drones can carry 3 pounds of blood or medicine and can fly 75 miles before recharging. The company's U.S.-based program should be in the air in a year.

"When you look at rural or isolated communities, particularly Native American populations, populations that live on islands, you have serious health outcome inequalities," Rinaudo, Zipline's and CEO, tells The Verge. "There's a linear relationship between how far away you live from a city and your expected lifespan. So our hope is that this type of technology can solve those kinds of inequalities."

Ordering Zipline's service is almost as easy as hailing an Uber. When a patient needs a blood transfusion, antibiotics, vaccines, or antivenom, a doctor, nurse, or health center technician sends Zipline a text message and a drone airdrops the needed supplies within 30 minutes. The drone will send a message to the health center when it is two minutes away and the package, equipped with a parachute, will fall to the ground. The craft will then return to the launch site on its own.

Zipline, which has raised $18 million in funding from investors including Sequoia Capital, Google Ventures, and Microsoft co-founder Paul Allen, is staffed by former aerospace employees from NASA, SpaceX, and Boeing. The company partnered with the National Center of Blood Transfusion and signed a deal with Rwanda's ministry of health to provide medical delivery services. After launching in Africa, the White House asked Rinaudo about starting the same program in the U.S. to serve remote communities, including those in Native American reservations.

If you follow drone regulations, you know exactly why Zipline launched abroad. Commercial drone use in the U.S. has been held back by regulations. Drones are considered aircraft and pilots must adhere to strict line-of-sight rules, caps on altitude, and other restrictions. But in June, the Federal Aviation Administration (FAA) released new rules that will hopefully help commercial drone pilots be authorized to take to the skies for commercial purposes. Strict rules will still remain: pilots must be able to see the drone at all times and drones can only undertake one mission at a time. Rinaudo says Zipline is applying for waiver so it can start operating and let its autonomous drones fly without a pilot following beneath the aircraft in the air.

Back in April, Rinaudo said he believes Zipline's drones, which are called "Zips," will be able to help revolutionize the way emergency medicine is delivered to people in remote locations.

"Patients frequently die because of lack of access to a basic medical product that exists in a central warehouse 75 kilometers away but can't make it out that final mile to the person who needs it," said Rinaudo.

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Drone use for commercial purposes has gotten much press of late due to Amazon announcing it intends to use drones to deliver packages to customers. This is a very intriguing and transformational idea with many intended and unintended consequences. The future use of drones in healthcare also is very thought provoking.

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In this article it talks about the use of drones in these current years being used for delivering packages  by Amazon. Recently the same idea sparked but by using drones with medical supplies. This article points out how using drones to deliver medicine and medical supplies to patients at their home can be very beneficial for a home based care.

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Empowering patients with implanted cardiac pacemakers to use a smart device app for remote monitoring resulted in a significantly higher rate of scheduled transmission success compared with traditional manual and automatic bedside monitoring technologies, report investigators with the international BlueSync Field Evaluation. They also found a comparable rate of transmission success among patients using the new technology outside the study, suggesting a similar experience in real-world use.

"There is abundant evidence that remote monitoring of pacemakers can improve patient outcomes, but patient adoption of and adherence to remote monitoring has remained suboptimal," says the study's principal investigator, Khaldoun Tarakji, MD, MPH, who presented the findings virtually this week as a late-breaking clinical trial during the Annual Scientific Sessions of the Heart Rhythm Society.

"This study is the first large assessment of the use of smartphones or tablets for direct monitoring of pacemakers," says Dr. Tarakji, Associate Section Head of Cardiac Electrophysiology at Cleveland Clinic. "Its encouraging findings have the potential to reshape monitoring of patients with pacemakers and other cardiac implantable electronic devices."

How the technology works

The BlueSync Field Evaluation takes its name from Medtronic's BlueSync ® technology, which employs low-energy Bluetooth ® wireless telemetry to allow patients to use their own smart device, whether a smartphone or a tablet, to directly monitor their new-generation pacemaker or biventricular pacemaker (including cardiac resynchronization therapy [CRT] pacemakers). Patients do so by leveraging an app-based platform, the MyCareLink Heart™ App, that can transfer pacemaker data to patient management networks, such as CareLink™, without use of a traditional bedside monitor. End-to-end encryption keeps the pacemaker data secure.

"The app allows patients to use their smartphone or tablet as their transmitter," Dr. Tarakji explains. He adds that it also represents the first time that patients are given direct access to some of their pacemaker data, including information about their implanted device, activity tracker data and transmission history.

Study design

The Medtronic-sponsored investigation was a prospective, multicenter evaluation of patients with bradycardia from the U.S., France, Italy and the United Kingdom. All had a BlueSync-compatible pacemaker or CRT pacemaker implanted either de novo or for device replacement.

Patients were enrolled from April through December 2018 using the MyCareLink Heart App and followed for 12 months. To be included in the analysis, patients needed to own a compatible smart device and be willing to use it during the study period. They also needed to have at least one scheduled data transmission between months 1 and 12 following enrollment.

Patients in the BlueSync group were compared with three historical real-world control groups who were activated in the CareLink patient management network at some point in 2016-2018 and followed for at least one year. The control groups consisted of the following:

Pacemaker patients (N = 128,607) using a wand to manually communicate via bedside console (active transmission with CareLink 2490)

Pacemaker patients (N = 69,313) using wireless automatic communication via bedside console (active and passive transmission with MyCareLink 24952)

Defibrillator patients (N = 47,457) using similar automatic communication via similar bedside console (MyCareLink 24952)

The primary endpoint was the success rate of scheduled data transmissions over 12-month follow-up.

Comparative transmission success rates

In the BlueSync group, 245 patients were eligible for analysis; they had a mean age of 65 years and were predominantly (58%) male. Most (79%) had a pacemaker (nearly all dual-chamber devices), with 21% having a CRT pacemaker.

Over 12 months, these 245 BlueSync patients had a total of 953 scheduled transmissions, of which 902 were successfully completed, yielding a success rate of 94.6%.

After an algorithm was used to match the three control groups to the BlueSync group for age, sex and number of device chambers, the following scheduled transmission success rates were identified:

3% for pacemaker patients using manual transmission via bedside console

0% for pacemaker patients using wireless automatic transmission via bedside console

1% for defibrillator patients using wireless automatic transmission via bedside console

Each of these success rates was significantly lower than that in the BlueSync group ( P < 0.001).

A glimpse into real-world use

To get a sense of real-world use of the BlueSync technology, the researchers also tracked scheduled transmission success for 811 patients using the MyCareLink Heart App for at least 12 months outside of the study. Among these patients (mean age, 69 years; 62% male), the success rate was 92.8%, highly consistent with the 94.6% rate in the formal BlueSync evaluation group.

A technology shift may be in store

"This study shows that long-term follow-up with BlueSync-compatible pacemakers using an app-based platform produces a higher rate of success in scheduled transmissions compared with traditional remote monitoring options," Dr. Tarakji notes. "And the findings from our real-world assessment suggest that actual experience with this technology outside an investigative setting is similar what we observed in the study."

He and his coinvestigators acknowledge that this evaluation is limited by its nonrandomized nature and the fact that not all factors influencing transmission success could be assessed.

Despite these limitations, the findings suggest a likely shift in remote monitoring and patient experience with cardiac implantable electronic devices in general, says Dr. Tarakji's colleague, Oussama Wazni, MD, Section Head of Cardiac Electrophysiology at Cleveland Clinic. "Some patients find traditional remote monitoring technology daunting or unwieldy," Dr. Wazni observes. "Even when traditional systems function properly, the transmission process remains invisible to the patient. When monitoring is done via smart devices, patients know more about their health status. That can be empowering as well as more convenient and reliable."
Photo at top courtesy of Medtronic.

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Direct Pacemaker Monitoring Via Smartphone Enables High Rates of Transmission Success

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Empowering patients with implanted cardiac pacemakers to use a smart device app for remote monitoring resulted in a significantly higher rate of scheduled transmission success compared with traditional manual and automatic bedside monitoring technologies, report investigators with the international BlueSync Field Evaluation.

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The development of conventional pacemakers is already considered a great biomedical innovation, but the transformation to smartphone-connected pacemakers is a much more fascinating and convenient innovation. A smartphone connected pacemaker device utilizes Bluetooth and a phone app to remotely monitor a patient's heart beat, eliminating the need for other monitoring systems. These connected devices allow patients greater insight into the health data from the pacemakers and transmit the health information to their physicians.

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A picture that helps me remember drone-delivered medical supplies 

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A picture that helps me remember drone-delivered medical supplies 

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Haemoglobinopathies are genetic disorders that can affect the structure and production of te haemoglobin molecule. It is a red protein that is very much responsible for transporting oxygen into the blood. Haemoglobinopathies are disorders which are sickle cell disease and thalassemia. It is know that these types of this molecule affects more than 330,000 children born each year worldwide. The sickle cell disease affects more than 100,000 patients in the Untied States alone. There is a therapy that will be able to create functional haemoglobin molecules that will reduce the presence of sickle blood cells or red blood cells, it will be possible to prevent complications with the disorders invovled.

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The 10 Biggest Medical Innovations For 2021 According to Cleveland Clinic – HealthTech

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The annual Medical Innovation Summit, organised by Cleveland Clinic Innovations, the development and commercialization division of Cleveland Clinic, is now in its 18th year and has served as a key platform for the introduction of the 10 biggest medical innovations for 2021.

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This article explains how these implantables for severe paralysis with BCI technology, brain-computer interface technology, by using electrodes to collect movement signals from the brain and interpret them into moving commands. Although, there is no cure for this it has been on a clinical trial of 70 to 100 patients and it has been shown to help out patients bring back their strength to do voluntary movements and overall improve their quality of life.

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Three men paralyzed in motorcycle accidents have become the first success stories for a new spinal stimulation device that could enable faster and easier recoveries than its predecessors. The men, who had no sensation or control over their legs, were able to take supported steps within 1 day of turning on the electrical stimulation, and could stroll outside with a walker after a few months, researchers report today. The nerve-stimulating device doesn't cure spinal cord injury, and it likely won't eliminate wheelchair use, but it raises hopes that the assistive technology is practical enough for widespread use.

"This [result] I would call a big deal," says Vivian Mushahwar, a biomedical engineer and neuroscientist at the University of Alberta, Edmonton, who was not involved in the work. "This adds a level of refinement that allows for these approaches ... to make it to the clinic and hopefully help a large number of people."

When trauma severely damages the bundle of nerves that make up a person's spinal cord, the brain's electrical signals no longer reach the body's muscles, resulting in paralysis. But epidural stimulation devices, thin sheets of electrodes implanted beneath the vertebra of the lower spine, can re-create those commands beyond the injury site and trigger leg movements. When such stimulation is turned on, even some patients with "complete" paraplegia-no movement or sensation in the lower body-have been able to walk after extensive training and with assistance from supportive devices or a therapist.

But spinal cord stimulators, developed in the 1980s to treat chronic pain, weren't designed with spinal cord injury in mind, says Grégoire Courtine, and neuroscientist at the Swiss Federal Institute of Technology, Lausanne. One problem with existing implants is their shape: They consist of a narrow silicone strip that targets the center of the spinal cord to disrupt pain signals ascending to the brain. To trigger leg and torso movements, researchers need to stimulate the dorsal roots, pairs of thick sensory fibers extending from either side of the spinal cord. Existing electrode strips are also too short to reach the dorsal roots that control the trunk and enable bending and straightening the torso, Courtine says.

So he and his colleagues designed a longer and wider implant, roughly the size of a pointer finger. To position electrodes along its surface so they would precisely stimulate the dorsal roots, the researchers studied cadavers and images of healthy spines. Once they had the new design, they used computer models to predict the ideal position of the implant on each patient's spinal cord.

Finally, the team designed software to activate the electrodes in set patterns that produce movements such as standing up and stepping. Typical epidural implants deliver uniform, repetitive pulses of electricity, says Peter Grahn, a neuroscientist at the Mayo Clinic. Patterned stimulation might help retrain damaged networks of nerves in the spinal cord to better receive and interpret signals descending from the brain that are preserved after spinal cord injury, he says. But just how the electrical stimulation interacts with spinal networks, and in turn the relative advantages of the two approaches, aren't clear yet, he adds.

In 2018, this patterned stimulation approach got a big test: People with spinal cord injuries who had some residual leg sensation or movement were able to walk and cycle . But the participants in the new study had more severe, complete injuries, all of which occurred at least 1 year before their enrollment. With the new, larger implant and custom-positioned electrodes, all three could take steps on a treadmill within the first day after the stimulation was turned on-albeit with harnesses that supported more than half of their weight, the team reports today in . Nature Medicine

" That is remarkable to see within 1 day with a severe injury like this," says Megan Gill, a research physical therapist at the Mayo Clinic who was not involved in the study. Previous studies have shown leg movements early on for people with complete paralysis, but this is the first time Gill has heard of such patients stepping their legs in an upright, "loaded" position in the first day of therapy.

After 4 to 6 months, all three participants were able to walk across the ground using only a walker for stability. It took participants in previous studies more than 1 year to achieve overground stepping, Mushahwar notes . "Intense therapy for a year and a half is a little bit impractical under current health care systems, at least in the U.S." she says. The new work makes such therapy "meaningful from a health care management perspective." And such daily movement is valuable to patients with spinal cord injuries: Even short walks can lead to better cardiovascular function, more bowel and bladder control, increased bone density, and less risk of pressure injuries from prolonged sitting.

Using different stimulation patterns, the participants in the new study could swim, cycle, and do leg presses and sitting forward bends. One patient was even able to climb a staircase. But with the stimulation off, their abilities remain limited. One regained some ability to activate leg muscles, but not to make functional movements. And two participants in a previous study who had incomplete paralysis could eventually stand without stimulation. How much ability spinal cord stimulation can restore long-term is unclear, Courtine says. It may depend on severity of the original injury and how soon after that injury the device is implanted, he adds.

For now, sending commands to the device is cumbersome. Users must select their desired movement on a tablet, which sends Bluetooth commands to a transmitter worn around the waist. That device must be positioned next to a "pulse generator" implanted in the abdomen, which then activates electrodes along the spine. Setting up to use the stimulation takes 5 to 10 minutes, Courtine says.

But the next generation of devices should allow users to activate the pulse generator by giving voice commands to a smartwatch, says Courtine, who is also chief scientific officer of the medical technology company ONWARD. In 2024, the company plans to test this newer mobility system in a multisite clinical trial of 70 to 100 participants that the team hopes will lead to U.S. regulatory approval.

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Next-generation spinal implants help people with severe paralysis walk, cycle, and swim

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Three men paralyzed in motorcycle accidents have become the first success stories for a new spinal stimulation device that could enable faster and easier recoveries than its predecessors. The men, who had no sensation or control over their legs, were able to take supported steps within 1 day of turning on the electrical stimulation, and could stroll outside with a walker after a few months, researchers report today.

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The MegaVac Thrombectomy System is a single-use intravascular mechanical thrombectomy and aspiration system including a ThromboWire containing an embolectomy element. A wire is inserted through the blood clot, it can deploy, expand, and pull back the blood clot which helps blood flow smoothly.

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How This Device Safely Removes Blood Clots

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He's the MegaVec and spiderman is the blood clot, in my world he actually catches spider man.

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Novel Drug for Treatment of Type 2 Diabetes

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In this article it talks about using 3D printers to print body parts for humans and in the future possibly organs. They successfully printed parts such as ears for a human. Scientist and doctors have also printed parts such as blood vessels and inserted them into a monkey. Getting quality and material to act and resist as an actual organ tissue it what's challenging for them but skin and things like ears are now being printed.

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New technology is revolutionizing the science of transplants- from ears to skin to internal organs.

In 2015, more than 125,000 organs, mostly kidneys, were transplanted from one human being to another in the United States. Sometimes the donor was a living volunteer. Usually, though, he or she was the victim of a car accident, a stroke, a heart attack, or a similar sudden event that had terminated the life of an otherwise healthy individual. But a lack of suitable donors, particularly as cars get safer and first aid becomes more effective, means the supply of organs is limited. Many people therefore die waiting for a transplant. That has led researchers to study the question of how to build organs from scratch.

One promising approach is to print them. Lots of things are made these days using three-dimensional printing, and there seems to be no reason why body parts should not be among them. As yet, such "bioprinting" remains largely experimental. But bioprinted tissue is already being sold for drug testing, and the first transplantable tissues are expected to be ready for use in a few years' time.

Bioprinting originated in the early 2000s, when it was discovered that living cells could be sprayed through the nozzles of inkjet printers without being damaged. Today, using multiple printheads to squirt out different cell types, along with polymers that help the structure keep its shape, it is possible to deposit layer upon layer of cells that will bind together and grow into living, functional tissue. Researchers are tinkering with kidney and liver tissues, skin, bones, and cartilage, as well as the networks of blood vessels needed to keep body parts alive. They have implanted printed ears, and also muscles, into animals and watched these integrate properly with their hosts. Last year, a group at Northwestern University even printed working bioprosthetic ovaries for mice. The recipients were able to conceive and give birth with the aid of these artificial organs.

No one is yet talking of printing gonads for people. But blood vessels are a different matter. Sichuan Revotek, a biotechnology company based in Chengdu, China, has successfully implanted a printed section of artery into a monkey. This is the first step in trials of a technique intended for use in humans. Similarly, Organovo, a firm in San Diego, California, announced that it had transplanted printed human-liver tissue into mice and that this tissue had survived and worked. Within three to five years, Organovo hopes to develop this procedure into a treatment for chronic liver failure and for inborn errors of metabolism in young children. The market for such treatments in America alone, the firm estimates, is worth more than $3 billion a year.

Johnson & Johnson is so convinced that bioprinting will transform parts of medical practice that it has formed several alliances with interested academics and biotechnology firms. One of these alliances, with Tissue Regeneration Systems, a firm in Michigan, is intended to develop implants for the treatment of defects in broken bones. Another, with Aspect Biosystems Ltd., a biotechnology company in Canada, is trying to work out how to print parts of the human knee known as the menisci. These are crescent-shaped cartilage pads that separate the femur from the tibia and act as shock absorbers between these two bones. Playing that role causes a lot of wear and tear, so surgical repair is often required.

Bioprinting can help with the development of other treatments. Organovo already offers its kidney and liver tissue for use in testing new drugs for effectiveness and safety. That should please animal rights activists, as such tests cut down on the number of animal trials. It should please drug companies, too-because the tissue being tested is human, the results should be more reliable than those from tests on other species.

With similar motives in mind, L'Oréal, a French cosmetics firm; Procter & Gamble, an American consumer-goods company; and BASF, a German chemical concern, are working on printing human skin. They propose to use it to test their products for adverse reactions. L'Oréal already grows almost 54 square feet of skin each year using older and slower technology. Bioprinting will be faster and also allow different skin types and textures to be printed.

Printed skin might eventually be employed for grafts, repairing burns and ulcers. Plans are also afoot, as it were, to print skin directly onto the surface of the body. Renovacare, a firm in Pennsylvania, has developed a gun that will spray skin stem cells directly onto the wounds of burn victims. (Stem cells are cells that proliferate to produce all the cell types that a tissue is composed of.) If the stem cells in question come from the patient himself or herself, there is no risk that the immune system will reject the new tissue.

The real prize of all this effort would be to print entire organs. For kidneys, Roots Analysis, a medical-technology consultancy, reckons that should be possible in about six years. Livers, which have a natural tendency to regenerate, should also arrive reasonably soon. Hearts, with their complex internal geometries, will take longer. In all cases, though, printed organs would mean that those needing transplants have to wait neither for the altruism of another nor the death of a stranger to provide the means to save their lives.

Next, check out the other cool things 3D printers can make.

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Here's How 3D Printers Are Making Human Body Parts

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New technology is revolutionizing the science of transplants­- from ears to skin to internal organs. In 2015, more than 125,000 organs, mostly kidneys, were transplanted from one human being to another in the United States. Sometimes the donor was a living volunteer.

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Katie Stubblefield's wit shows through when she describes her face transplant surgery.

"Longest nap of my entire life," she says.

Those unfamiliar with Katie's still-developing speech pattern may not easily make out those words, but her parents are usually there to interpret. Robb and Alesia Stubblefield have been by her side - helping her "take four steps forward, two steps back," as Robb describes it - since Katie, then 18, endured severe facial trauma and significant complications from a self-inflicted gunshot wound on March 25, 2014.

It would take a team of 11 Cleveland Clinic surgeons and multiple specialists to perform the hospital's third face transplant - and its first total face transplant - on Katie. At 21, Katie was the youngest person in the United States to receive a face transplant.

And, indeed, it was extensive: The surgery included transplantation of the scalp, the forehead, upper and lower eyelids, eye sockets, nose, upper cheeks, upper jaw and half of lower jaw, upper teeth, lower teeth, partial facial nerves, facial muscles, and skin - with 100 percent of her facial tissue effectively replaced.

Despite the success of the transplant, Katie's journey is far from over. She currently remains unable to see; so, Katie is learning Braille. She's also undergone additional surgeries to improve function in her tongue and jaw.

But the path forward - to college (she would like to be a counselor, or a teacher), to independence, and to walking down the street "and blending in," as Katie describes it - seems reachable at last.

"Katie gets a second chance at life," said Alesia.

As Katie herself told the Cleveland Clinic Ethics Committee, during a meeting to ensure she was ready for her face transplant surgery: "I can't go backward. I have to go forward."

Katie had suffered life-threatening, severely traumatic injuries from her gunshot wound. However, when paramedics arrived a few minutes later, one called out: "She's alive. We got a pulse."

While the single bullet pierced through her mouth and nasal cavity, exiting her skull between her eyebrows, it miraculously only grazed her brain tissue.

Sped by ambulance to a hospital in Oxford, Miss., Katie was quickly intubated with an endotracheal tube and placed on a ventilator. When her condition stabilized, she was flown the 22 minutes by helicopter to a Memphis hospital with a Level I trauma center.

By the time Robb and Alesia arrived, by car, a half-hour or so later, Katie was already in surgery; it would be the first of more than a dozen operations she would receive in the ensuing years.

"The surgeons were very matter-of-fact with us. No gloom and doom, but no peaches and cream, either. One of them - an elderly gentleman - said it was the worst case he'd ever seen," said Robb.

And then the physician used a phrase Robb had never heard before, in all his life.

"He said, 'Outside of a face transplant, I just don't know.'"

"And I'm thinking, 'Face transplant? What is that?'"

Five weeks later, in early May 2014, Katie was flown to Cleveland, Ohio, and admitted to Cleveland Clinic.

Robb and Alesia also accompanied her to Cleveland, and they haven't left since.

Soon after Katie's time in Memphis, the opportunity for her to be transferred to Cleveland Clinic - ultimately, for a possible face transplant - emerged. On a Sunday morning, the family met Brian Gastman, MD, who would become Katie's primary plastic surgeon and a member of the face transplant team. Robb described him as a ball of energy, who came to their meeting armed with a 3D image of Katie's head.

"I'm seeing inside of my child's head. Everything. The wound area, her bone structure. It was fascinating."

They also learned face transplantation was the ultimate goal, but it would be "way down the road somewhere," said Robb. To get there would require many preparatory procedures including a jaw reconstruction surgery, using bone from Katie's leg and a metal prosthesis.

Over time, as Katie endured many other operations, dozens of other physicians and specialists from other disciplines entered her life. Robb and Alesia have kept a running list: Nutritionists. Physical therapists. Endocrinologists. Infectious disease specialists. Neurosurgeons. Ophthalmologists. Social workers. Bioethicists. Psychiatrists. Anesthesiologists. Dentists. Pharmacists. Internal medicine specialists. Vascular surgeons. Dozens and dozens of nurses. And of course, plastic surgeons.

Throughout this process, Cleveland Clinic psychiatrist Kathy Coffman, MD, was a key specialist.

Dr. Coffman has counseled all three of Cleveland Clinic's face transplant patients, typically starting a year before the surgery and extending a full year or more afterwards. As she has written, "Facial transplantation combined with the right psychological care can enable (patients) to reclaim their identity, reestablish their social contacts and ultimately get their life back."

As Katie inched closer and closer to the possibility of a full facial transplant, Dr. Coffman would gently prod her with questions, to ensure this is what Katie really wanted.

Alesia vividly remembers one of those conversations: "Dr. Coffman was speaking about all the risks involved. Katie let her finish, and then she says, 'I still want to do this, Dr. Coffman.'

'I want to be able to go out in the world. And not be looked at like this.'"

Katie signed the consent forms for facial transplant surgery in November 2015. It would be another 18 months before she would be physically and mentally prepared - and the search could then begin for a suitable donor.

It would prove to be a difficult process. Because of Katie's small stature, and relatively young age, the potential donor pool was smaller. And even smaller because the majority of available donors are male. Additionally, the donor's other organs would possibly be used for other patients with more life-threatening conditions, meaning they could take precedence over a face transplant.

"My biggest concern is getting her the right donor, one that is really appropriate for her," Dr. Gastman said in an interview, months before the transplant.

In those long months before her surgery, Katie's team assembled. Frank Papay, MD, chairman of Cleveland Clinic's Dermatology & Plastic Surgery Institute, would co-direct the surgical team with Maria Siemionow, MD, PhD, former director of Cleveland Clinic's Department of Plastic Surgery Research.

As her primary team readied her for surgery, the face transplant team conducted numerous practice surgeries - some using an innovative technology called HoloLens, a self-contained mixed-reality computer headset that allowed the user to see holograms of 3D images of Katie's head. The technology allows surgeons to virtually practice aspects of the surgery, prior to entering the operating room.

"We deliberate and discuss and respectfully argue, about what we should or should not do for Katie. It's very complex, and every face transplant is unique," said Dr. Gastman. "If something is going to increase the risk to the patient, we have to decide, is it really worth it?"

From the moment of Katie's arrival, the team had the end goal of face transplantation in mind - as facial reconstruction alone would not correct her facial disfigurement or improve her quality of life. Thus, during her preparatory reconstruction surgeries, the surgeons were able to safeguard any potential blood vessels that could be used for the transplant.

"Plastic surgery is about restoring form and function," said Dr. Papay. "Function comes before form, and prior to the face transplant, Katie had extremely poor function and form."

A face transplant was the only option to truly transform her life.

It would be three years to the day Katie arrived in Cleveland that Cleveland Clinic doctors would receive a call for a potential donor. That donor would ultimately be Katie's. When the day for surgery arrived, Katie was ready. And her "longest nap ever" began.

At various points during the 31-hour procedure, Drs. Papay and Gastman would leave the surgical suite armed with photos taken during the surgery to discuss next steps and options with Robb and Alesia.

As Dr. Papay explained, "We were well prepared. But we knew our game plan could change in the middle of surgery. And that's what happened. We ended up using more of the donor's face than we originally planned and went to option B about halfway through the surgery," which would increase the risk but improve both the form and function of her face.

Alesia remembered at first she was shocked the medical experts would ask her opinion. But she ultimately appreciated she and Robb had a role in weighing options and making some of the decisions, as the choices would have aesthetic implications that would also increase the surgical risks.

"I kept thinking, 'What do we think Katie would have wanted to do?'" said Alesia. Rob added, "At some point, someone said, 'Katie would want us to go all the way.' And it clicked in. We knew what we had to do."

Ultimately, with option B, doctors effectively replaced 100 percent of Katie's facial tissue with the donor's, from mid-scalp all the way down to her jaw and neckline. Further, her upper jaw and the area beneath her orbital floors, as well as two-thirds of her lower jaw, are bone from the donor. One of the trickiest parts of the surgery involved her vascularity, ensuring blood vessels remained functional and sufficiently carried blood throughout her body.

Including her face transplant, Katie has endured more than 17 surgeries at Cleveland Clinic. Collectively, those procedures have given her the capability to breathe, chew, and swallow more effectively. She's also able to use her face to better express emotions. In addition to significantly improved physical function, Katie is on the way to having enhanced physiological, psychological, and social function.

On reflection, a year later, Dr. Papay calls Katie's transplant a success. She has not suffered any signs of rejection, or side effects from being on immunosuppressant drugs, and a series of subsequent operations to fine-tune certain areas (including her tongue to improve speech) have gone as planned.

Beyond the medical triumphs, he is certain Katie would not be on the verge of a new life if not for the constant support of her parents, siblings and extended family. "In addition to the physical trauma that Katie went through is the emotional trauma they all suffered," Dr. Papay stated. "They are about as resilient as you can be, and I am proud of them as much as I'm proud of Katie."

When speaking of face transplants doctors aren't sure what the future holds for these types of surgeries, including the possibility of hand transplants and uterine transplants. To date, most U.S. face transplants have been paid for by the U.S. Department of Defense's Armed Forces Institute of Regenerative Medicine I (AFIRM I) grant program, which is designed to help improve the treatment of U.S. service members wounded on the battlefield.

"Will third party government and private payers support these patients that are in desperate need of a transplant?" Dr. Papay asked. "The key for (the future) is the source of financial support in these cases."

In a statement Katie prepared for the media when her face transplant was complete, she spoke of her gratitude to everyone involved. "I am forever grateful for the care this hospital has given me and continues to offer on my journey of recovery and healing," she stated. "And to my donor and her family - words cannot express the appreciation I have for this incredible gift. With a grateful heart, I say thank you to all who have made this possible for me."

Alesia believes in many respects, Katie is just beginning her journey. "I don't know how exactly, but I know Katie will help people. I feel in my heart she will as a mom. I just want Katie to enjoy life and make a difference in society. And I want her to be able to be independent."

Rob added, "We have a road to go yet. But we're thankful that we have a road."

Related Institutes: Dermatology & Plastic Surgery Institute

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Road to Recovery: Woman is Youngest Patient in United States to Receive Face Transplant

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Katie Stubblefield's wit shows through when she describes her face transplant surgery. "Longest nap of my entire life," she says. Those unfamiliar with Katie's still-developing speech pattern may not easily make out those words, but her parents are usually there to interpret.

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Faster? Stronger? More powerful? Bionic bodies-and what they may be capable of-have captivated the human mind for centuries. From the bumbling Inspector Gadget to the near‐indestructible Terminator, the idea of using technology to build a 'better human' has resulted in continuous technological advances.

The term 'bionics' was first used in the 1960s. It combines the prefix 'bio'-meaning life-with the 'nics' of electronics. Bionics is the study of mechanical systems that function like living organisms or parts of living organisms.

While the world of bionics now encompasses almost all parts of the human body-external and internal-here we will look in detail at bionic limbs and how the technology is progressing. For more information on other bionic advancements, stay tuned for the next chapter in Nova's series on bionics.

Artificial limbs, or prostheses, are used to replace a missing body part which may have been lost due to trauma, disease or congenital defect. The type of prosthesis a person can use is dependent on the individual, including the cause of amputation or limb loss, and the location of the missing extremity.

Basic artificial limbs have been used since 600 BC. Wooden legs, metal arms, hooks for hands-while these primitive replacements gave the wearer back some semblance of movement or function, they were often uncomfortable, difficult to use, had poor functionality and were cosmetically unattractive.

A prosthetic leg from WWI. Image source: Thomas Quine / Flickr.

Today, researchers are striving to develop lighter, smaller, better‐controlled, more lifelike and affordable options. What's different about the new generation of prosthetic limbs is their union with bionic technology, and the way they combine fields of study as diverse as electronics, biotechnology, hydraulics, computing, medicine, nanotechnology and prosthetics. Technically, the field is known as biomechatronics, an applied interdisciplinary science that works to integrate mechanical elements and devices with biological organisms such as human muscles, bones, and the nervous systems.

External prosthetic limbs

Recent progress in both materials science and technology has resulted in significant advancements in prosthetic limbs. While it's tempting to imagine these limbs as giving the wearer some kind of superhuman edge, in reality, researchers at present are simply trying to recreate the functionality and range of motion experienced by a healthy human limb. This is more difficult than it sounds.

Think about it-if your nose is itchy, you scratch it. But take a moment to consider how you actually do this. First, you need to bend your elbow while raising your forearm so that it's in the correct position close to your nose. Then you need to rotate your forearm to the required angle so that your finger can reach your nose, then extend a finger and move it up and down repeatedly on the itch. And you have to do all this while applying the right amount of pressure to stop the itch, but without scratching off any skin. As you can imagine, creating a robotic limb to do all these things seamlessly, easily and quickly is quite a challenge.

Precision and calculation subconsciously underpin many seemingly simple tasks, like scratching your nose. Image source: Search Engine People Blog / Flickr.

So while giving a high five or walking up a flight of stairs might not seem like very complex activities, behind the scenes (or inside your head) your brain is constantly working to help you perform even the simplest gestures. Nerves, muscles, synapses, brain cortices-they all need to be working seamlessly to allow you to perform these tasks.

It is this interaction between thought, action and response that researchers across the world have been trying to replicate in their bionic technologies.

A number of bionic prosthetic limbs are now available which are beginning to mimic some of the functionality of the original lost limbs. Others are still at the research and development stage, but are showing great promise. Let's take a look at some of them.

Myoelectric limbs

Traditionally, upper‐limb prostheses were body powered, using cables and harnesses attached to the individual and relying on body movements to manipulate cables that control the prosthetic limb. This can be physically tiring, cumbersome and unnatural.

Myoelectric limbs are externally powered, using a battery and electronic system to control movement. Each prosthesis is custom made, attaching to the residual limb using suction technology.

Once the device has been securely attached, it uses electronic sensors to detect even the smallest traces of muscle, nerve and electrical activity in the remaining limb. This muscle activity is transmitted to the surface of the skin where it is amplified and sent to microprocessors, which use the information to control the movements of the artificial limb.

Based on the mental and physical stimulus provided by the user, the limb moves and acts much like a natural appendage. By varying the intensity of the movement of their existing functional muscles the user can control aspects such as strength, speed and grip in the bionic limb. If muscle signals cannot be used to control the prosthesis, switches with a rocker, pull-push or touch pad can be used. Improved dexterity is achieved via the addition of sensors and motorised controls, thus enabling users to perform tasks such as using a key to open a door or getting cards out of a wallet.

One of the features of this technology is the 'autograsp' function, which automatically adjusts tension when it detects a change in circumstance (such as holding a glass that is then filled with water). An added bonus of the myoelectric limb is that, like traditional body-powered devices, it can be made to replicate the appearance of a natural limb.

The disadvantages of this technology are that the battery and motor inside it makes it heavy, it's expensive, and there's a slight time delay between the user sending a command and the computer processing that command and turning it into action.

Osseointegration

Another bionic limb breakthrough is known as 'osseointegration' (OI). Derived from the Greek 'osteon', meaning bone, and the Latin 'integrare', which means to make whole, the process involves creating direct contact between living bone and the surface of a synthetic-often titanium‐based-implant.

The procedure was first performed in 1994, and uses a skeletally integrated titanium implant, connected through an opening (stoma) in the residual limb to an external prosthetic limb. The direct connection between the prosthesis and bone has several advantages:

1. It provides greater stability and control, and can reduce the amount of energy expended.

2. It does not require suction for suspension, which makes it easier and more comfortable for the user.

3. The weight‐bearing is brought back to the femur, hip joint, tibia or other bone, reducing the possibility of degeneration and atrophy that can accompany traditional prostheses.

Traditionally, the procedure requires two operations. The first involves the insertion of titanium implants into the bone and, often, extensive soft-tissue revision. The second stage, around six to eight weeks later, includes the refinement of the stoma and the attachment of the hardware that connects the implant to the external prosthetic leg. Gradually, bone and muscle begin to grow around the implanted titanium on the bone end, creating a functional bionic leg. The external prosthesis can be easily attached and removed from the abutment GLOSSARY abutment the portion of an implant that protrudes through the tissues and is designed to support a prosthesis. within a few seconds. Recently, Australia‐based surgeon Associate Professor Munjed Al Muderis has been able to perform the surgery in a single operation.

Because the prosthesis is attached directly to the bone, it has a greater range of movement, control and, in some cases, has allowed wearers to distinguish tactile difference between surfaces (such as carpet versus tiles) via osseoperception.

Monetite crystals (CaHPO₄) can be used with titanium to make it more compatible with the body. Image source: Wellcome Images / Flickr.

Gait-training, strengthening and rehabilitation are all important parts of the pre and post‐surgery procedure. Many of the recipients of the new technology have been up and walking independently within weeks of the operation, and have been able to regain much of their quality of life.

A continuing development in the field of OI is the introduction of products that use a porous metal construction, such as titanium foam. Traditional OI designs intended for the femur were not successful when applied to the tibia as the proximal tibial bone structure is highly spongy.However, with the development of titanium foam technology the application of OI has now been expanded to transtibial amputees. Associate Professor Al Muderis has pioneered a 3D-printed foam surface implant which is successfully used in transtibial amputees. These 3D-printed metal foams may promote and contribute to bone infiltration and the formation and growth of vascular systems within the defined area. In this way, the porous, bone‐like metal foam allows osteoblast GLOSSARY osteoblast a cell which secretes the substance of bone. activity to begin.

Recipients of the OI procedure say that it almost feels like the real thing. Drawbacks of this type of prosthesis are that it is costly (generally over A$80,000), and unsuitable for many types of amputee.

Mind‐controlled bionic limbs

The next advance in bionic limb technology is the emergence of mind‐controlled bionic limbs. These are prostheses which can be integrated with body tissues, including the nervous system. They are highly advanced, able to respond to commands from the central nervous system and therefore to more closely replicate normal movement and functionality, while also instantly triggering the desired movement with less 'lag time'. There are several different procedures and technologies currently in the research and development phase.

A mind-controlled prosthetic arm. Image source: US Navy / Flickr.

Targeted muscle reinnervation

A surgery called targeted muscle reinnervation uses nerves remaining after an amputation, and the same impulses from the brain that once controlled flesh and blood, to control an artificial limb. The surgery reattaches nerves that control the joints from the missing part of the limb into muscle tissue in the residual limb to allow a more natural thought process and control the prosthesis the same way as myo-electric control. Effectively, the brain impulses are linked to a computer in the prosthesis that directs motors to move the limb.

In 2014, Les Baugh, a bilateral shoulder disarticulation (through the joint) amputee, was able to use this technology to operate two upper limb prosthesis for the first time. Working with researchers at Johns Hopkins University, he was able to lift cups and perform a variety of tasks with each arm, a result of a procedure which could change the way prosthetic limbs are thought about, developed and used.

The procedure involved numerous steps over many months:

1. Les underwent targeted muscle reinnervation surgery, a procedure which reassigns nerves that once controlled the arm and hand. By reassigning the existing nerves, it became possible for Les to control his prosthetic limbs merely by thinking about the action he wanted it to perform.

2. After recovery, Les was given training on the pattern recognition system that makes up a key part of the technology. Pattern recognition algorithms are used to identify individual muscles, how they are contracting, communicating and working with each other, as well as their amplitude and frequency. This information is then used to create the actual movements of the prosthesis.

3. A brace was custom made for Les's torso and shoulders. This device supports the prosthetic limbs, while also making the neurological connections with the reinnervated muscles.

4. Les undertook further training on the limb system using a virtual integration environment.

5. Finally, the limbs were attached to the brace, and Les was able to begin to put his training into practice, moving various objects.

Researchers were surprised by the speed at which Les was able to control the technology, particularly his ability to control a range of motions across both arms at the same time-a first for simultaneous bimanual control.

I think we are just getting started ... There is just a tremendous amount of potential ahead of us, and we've just started down this road. And I think the next five to 10 years are going to bring phenomenal advancement. Revolutionizing Prosthetics Principal Investigator, Michael McLoughlin

There was also an unexpected effect in some patients undergoing this procedure: not only can they move their new limb, they can feel some sensation with it.

Implanted myoelectric sensor technology

Arms aren't the only part of the body to benefit from improved technologies. Researchers from Iceland have created a mind‐controlled prosthetic leg that uses implanted myoelectric sensor (IMES) technology. This involves sensors implanted directly into the patient's limb muscles but, unlike nerve reinnervation, there is no need to transplant nerve tissue from one part of the body to another. Implanting the IMES technology is relatively easy and simple-requiring only a 15-minute operation where each sensor is placed into the tissue via incisions just 1 centimetre long. Once inserted, the sensors don't need to be replaced unless they become damaged.

Thorvaldur Ingvarsson, the surgeon who completed the operation, described the process: "The technology allows the user's experience with their prosthesis to become more intuitive and integrative ... They no longer need to think about their movements because their unconscious reflexes are automatically converted into myoelectric impulses that control their bionic prosthesis."

A participant in the study, Gudmundur Olafsson, said, 'As soon as I put my foot on, it took me about 10 minutes to get control of it. I could stand up and just walk away ... It was like, I was moving it with my muscles, there was nobody else doing it, the foot was not doing it, I was doing it, so it was really strange and overwhelming.'

The exciting thing about IMES technology is that it can be relatively simple to fit (it does not require complex surgery), functions well in 'real life' scenarios and can work for an extended period of time.

A mind-controlled bionic leg. Image source: Army Medicine / Flickr.

Taking this a step further, in 2015 researchers at the US Defense Advanced Research Projects Agency (DARPA) announced that they had given a paralysed man the ability to feel physical sensations via a prosthetic robotic hand that had wires directly connected to his brain. When blindfolded, the man was able to successfully identify when which fingers on his prosthetic hand were being touched, and when.

We've completed the circuit ... Prosthetic limbs that can be controlled by thoughts are showing great promise, but without feedback from signals travelling back to the brain it can be difficult to achieve the level of control needed to perform precise movements. By wiring a sense of touch from a mechanical hand directly into the brain, this work shows the potential for seamless bio‐technological restoration of near‐natural function. DARPA program manager, Justin Sanchez

How does it all work? An array of electrodes were clinically implanted onto the man's sensory cortex-the region of the brain responsible for identifying tactile sensations such as pressure and texture. The team also placed arrays on the volunteer's motor cortex, the part of the brain that directs body movements. Wires from these arrays were connected externally to a mechanical hand, which gave the volunteer the ability to control the hand's movements. Most importantly, however, the hand contained complex torque sensors which were able to detect different levels of pressure, converting those sensations into electrical signals. These signals were then routed back to the arrays on the volunteer's brain, stimulating the sensory neurons in the brain and allowing the sensation and feeling of each finger to be 'felt' by the patient.

The technology is not yet commercially available, but offers great potential for future developments.

Such advances have made these artificial limbs more practical and intuitive, but even the most state‐of‐the-art prostheses cannot yet replicate the full functionality of natural limbs.

Cosmetic improvements

The emergence of 3D printing and computer‐aided design is beginning to help create limbs that are a perfect custom‐fit for the wearer, and should, as time progresses, become more affordable.

While many of the new bionics look like something out of a science‐fiction movie, researchers are also succeeding at creating options that look more realistic than ever before. Prostheses can now be created with anatomically correct shapes that mirror the form of the wearer, and can incorporate details such as accurate skin colour, freckles, birthmarks, hair, veins, tattoos, fingerprints and fingernails. These life-like creations can be made from PVC or a range of silicones and cover the prosthetic limb using a variety of methods, such as adhesive, stretchable skins, suction, form fitting, or a skin sleeve. For many amputees, having a limb that does not attract unwanted attention is very important.

A prosthetic hand (the person's right hand), made to be cosmetically similar to their real (left) hand. Image source: WBUR Boston's NPR News Station / Flickr.

Conclusion

What makes us human? Is it our bodies? Our brains? Our emotions? Or something more intangible? Advances in human bionics may eventually require us to rethink our concepts of what it is to be human, as the lines between human and machine become increasingly blurred.

Yet despite the desire to imagine a future of cybernetic enhancements, at present bionic limbs remain chiefly medical devices, designed to restore function and provide people who have lost limbs with a better quality of life. The bionics may look impressively futuristic, but they are not yet able to fully replicate the complexity, range of movement and functionality of a normal human limb.

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Faster? Stronger? More powerful? Bionic bodies-and what they may be capable of-have captivated the human mind for centuries. From the bumbling Inspector Gadget to the near‐indestructible Terminator, the idea of using technology to build a 'better human' has resulted in continuous technological advances. The term 'bionics' was first used in the 1960s.

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This video explain that a once-a-week injectable undergoing FDA approval is soon to be on the market to help individuals with type 2 diabetes. This drug would help activate glucose and block glucagon in an effort to reduce sugar spikes. This drug also supports weight loss which when paired with helping diabetes, is the next best drug created to treat diabetes yet.

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Full face transplants have been used for patients with incredibly severe face trauma. The surgery includes transplantation of the scalp, the forehead, upper and lower eyelids, eye sockets, nose, upper cheeks, upper jaw and half of lower jaw, upper teeth, lower teeth, partial facial nerves, facial muscles, and skin with 100 percent of the facial tissue replaced. All of this is taken from donor tissue of someone who has died. About 40 full face transplants have been done worldwide.

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Analyzing an individual's vocal patterns to distinguish characteristic of a disease, development stages, diagnose or severity.

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Targeted therapy is a cancer treatment that uses drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells. Targeted therapy can affect the tissue environment that helps a cancer grow and survive or it can target cells related to cancer growth, like blood vessel cells.

Doctors often use targeted therapy along with chemotherapy and other treatments. The U.S. Food and Drug Administration (FDA) has approved targeted therapies for many types of cancers. Research is also underway to find new targeted therapy treatments.

How does targeted therapy work?

There are many types of cells that make up every tissue in your body. For example, there are blood cells, brain cells, and skin cells. Each type has its own job. Cancer starts when certain genes in healthy cells change and become abnormal over time. This change is called a genetic mutation.

Genes tell cells how to make proteins to keep the cell working. If the genes mutate, these proteins change, too. This can make cells divide too much or too quickly and allow the cells to live much longer than they normally would. When this happens, the cells grow out of control and form a tumor. Learn more about the genetics of cancer.

To develop targeted therapies, researchers first identify the genetic changes that help a tumor grow and change. A potential target for this therapy would be a protein that is present in cancer cells but not healthy cells. This can be caused by a mutation. Once researchers have identified a mutation, they develop a treatment that targets that specific mutation.

Targeted therapies can do different things to the cancer cells they target:

To best match the best targeted therapy for your tumor, your doctor may order tests to learn about the genes, proteins, and other factors that are unique to your tumor. This helps find the most effective treatment. Like other treatments, targeted therapies can cause side effects, so it is important that your doctor matches your tumor to the best possible treatment and dose. The dose of targeted therapy that you will receive is based on many factors, like your body weight and your risk of developing severe side effects. Talk to your health care team about why they recommended a certain dose.

Are there different types of targeted therapy?

There are several different types of targeted therapy. The most common types are monoclonal antibodies or small-molecule drugs.

Monoclonal antibodies. Drugs called monoclonal antibodies block a specific target on the outside of cancer cells. The target might also be in the area around this cancer. Monoclonal antibodies can also send toxic substances right to cancer cells. For example, they can help chemotherapy and radiation therapy reach cancer cells better. Monoclonal antibodies are also a type of immunotherapy.

Small-molecule drugs. Drugs called small-molecule drugs can block the process that helps cancer cells multiply and spread. Angiogenesis inhibitors are an example of this type of targeted therapy. Angiogenesis is the process for making new blood vessels. A tumor needs blood vessels to bring it nutrients. The nutrients help it grow and spread. Angiogenesis inhibitors starve the tumor by keeping new blood vessels from forming in the tissue around it.

Other types of targeted therapy include other immunotherapies, angiogenesis inhibitors, and apoptosis inducers (therapies that start cell death, or apoptosis).

Some types of targeted therapies are specific to a type of cancer. Others are known as tumor-agnostic or site-agnostic treatments. They treat tumors anywhere in the body by focusing on the specific genetic change instead of the type of cell. Learn more about tumor-agnostic treatments.

Examples of targeted therapies

Targeted therapies are a rapidly growing field of cancer research and researchers are studying many new targets and drugs through clinical trials. Below are a few examples of targeted therapies that are available now. Ask your health care team for more information.

Breast cancer. About 20% to 25% of breast cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2). This protein makes tumor cells grow. If the cancer is "HER2 positive", there are many targeted therapy options. Learn more about targeted therapy for breast cancer.

Chronic myeloid leukemia (CML). Almost all cases of chronic myeloid leukemia are driven by the formation of a gene called BCR-ABL. This gene leads to the production of an enzyme called the BCR-ABL protein. This protein causes normal myeloid cells to start behaving like cancer cells. This was the very first mutation and cancer treated with targeted therapy. Learn more about targeted therapy for chronic myeloid leukemia.

Colorectal cancer. Colorectal cancer often makes too much of a protein called epidermal growth factor receptor (EGFR). Drugs that block EGFR may help stop or slow cancer growth. These cancers have no mutation in the KRAS gene. Another option is a drug that blocks vascular endothelial growth factor (VEGF). This protein helps make new blood vessels. Learn more about targeted therapy for colorectal cancer.

Lung cancer. Drugs that block EGFR may also stop or slow lung cancer growth. This may be more likely if the EGFR has certain mutations. There are also drugs for lung cancer with mutations in the ALK and ROS genes. Doctors can also use angiogenesis inhibitors for some lung cancers. Learn more about targeted therapy for non-small cell lung cancer.

Lymphoma. In lymphoma, there is an overproduction of B cells, a type of white blood cell that fights infections. Targeted drugs that block the enzyme that leads to this overproduction of B cells have been very successful for the treatment of lymphomas and some B-cell leukemias. Learn more about targeted therapies for lymphoma.

Melanoma. About half of melanomas have a mutation in the BRAF gene. Researchers know certain BRAF mutations make good drug targets. So there are many FDA-approved BRAF inhibitors. But these drugs can be harmful if your tumor do not have the BRAF mutation. Learn more about targeted therapy for melanoma.

The list of examples above does not include every targeted therapy. You can learn more about targeted therapy in each cancer-specific section on Cancer.Net in the "Types of Treatment" and "Latest Research" pages. You can also learn more about the latest targeted therapy research on the Cancer.Net blog.

Are there limitations to targeted therapy?

As with any cancer treatment, targeted therapy may not be the best treatment for every person with cancer. It may seem simple to use a drug for your specific cancer, but targeted therapy is complex, and it does not always work. It is important to know that:

A targeted treatment will not work if the tumor does not have the target

Having the target does not mean the tumor will respond to the drug

The response to the treatment may not last over time

For example, the target may not be as important for the cancer's growth as previously thought, so the drug does not provide much benefit. Or cells may become resistant to the targeted therapy, so the drug might work at first but then stop working.

Also, targeted therapy drugs may cause serious side effects. These are usually not the same as chemotherapy effects. For example, people who get targeted therapy often have skin, hair, nail, or eye problems. It is always important to talk with your doctor about the specific side effects possible for each drug in your treatment plan.

Targeted therapy is an important type of cancer treatment. But, so far, doctors can only treat a few cancers with targeted therapy. Most people with cancer also need surgery, chemotherapy, radiation therapy, or hormone therapy.

Questions to ask your health care team

Talk with your health care team about whether targeted therapy may be part of your treatment plan. If so, consider asking these questions:

What type of targeted therapy do you recommend? Why?

What are the goals of this treatment?

Will targeted therapy be my only treatment? If not, what other treatments will be a part of my treatment plan?

How will I receive targeted therapy treatment and how often?

What are the possible short-term and long-term side effects of targeted therapy?

How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

What targeted therapy clinical trials are available for me?

Whom should I call with questions or problems?

Related Resources
What is Personalized Cancer Medicine? Introduction to Cancer Research Understanding Pharmacogenomics Understanding Immunotherapy
More Information
National Cancer Institute: Targeted Cancer Therapies My Cancer Genome: Overview of Targeted Therapies for Cancer

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Targeted therapy is a cancer treatment that uses drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells. Targeted therapy can affect the tissue environment that helps a cancer grow and survive or it can target cells related to cancer growth, like blood vessel cells.

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Artificial intelligence simplifies the lives of patients, doctors and hospital administrators by performing tasks that are typically done by humans, but in less time and at a fraction of the cost.

AI in healthcare shows up in a number of ways, such as finding new links between genetic codes, powering surgery-assisting robots, automating administrative tasks, personalizing treatment options and much more.

Put simply, AI is reinventing - and reinvigorating - modern healthcare through machines that can predict, comprehend, learn and act.

To give you a better understanding of the rapidly evolving field, we rounded up some of the top examples of AI in healthcare - as well as the companies that are leading the way.

Image: Shutterstock

Examples of AI in Medical Diagnosis

Every year, roughly 400,000 hospitalized patients suffer preventable harm, with 100,000 deaths. In light of that, the promise of improving the diagnostic process is one of AI's most exciting healthcare applications.

Incomplete medical histories and large caseloads can lead to deadly human errors. Immune to those variables, AI can predict and diagnose disease at a faster rate than most medical professionals.

Here are 13 examples of companies showing AI's ability to reduce errors and save lives.

Location: Boston, Massachusetts

With its early-detection platform for cognitive assessments, Linus Health is on a mission to modernize brain health. Its proprietary assessment technology DCTclock takes the gold standard pen-and paper clock drawing test for early signs of cognitive impairment and digitizes it, bringing together the most recent advances in neuroscience and AI to analyze over 50 metrics that reflect the patient's cognitive function.

Location: San Francisco, California

In healthcare, delays can mean the difference between life and death, so Viz.ai helps care teams react faster with AI-powered healthcare solutions. The company's AI products can detect issues and notify care teams quickly, enabling providers to discuss options, provide faster treatment decisions, thus saving lives.

Location: Boston, Massachusetts

PathAI develops machine learning technology to assist pathologists in making more accurate diagnoses. The company's current goals include reducing error in cancer diagnosis and developing methods for individualized medical treatment. PathAI worked with drug developers like Bristol-Myers Squibb and organizations like the Bill & Melinda Gates Foundation to expand its AI technology into other healthcare industries.

Location: Los Angeles, California

The healthtech startup Regard uses AI technology to diagnose patients. The company describes its automated system to be the "clinical co-pilot" to electronic medical records (EMRs). The data from EMRs is synthesized to discover a diagnosis. Additionally, healthcare providers receive specific recommendations about patient care. The system also updates patient documents automatically to reduce burnout among healthcare workers.

Read More 94 Top Healthcare Startups and Healthtech Companies

Location: Boston, Massachusetts

Developed by a team out of Harvard Medical School, Buoy Health is an AI-based symptom and cure checker that uses algorithms to diagnose and treat illness. Here's how it works: a chatbot listens to a patient's symptoms and health concerns, then guides that patient to the correct care based on its diagnosis.

Location: Fort Collins, Colorado

Enlitic develops deep learning medical tools to streamline radiology diagnoses. The company's deep learning platform analyzes unstructured medical data - radiology images, blood tests, EKGs, genomics, patient medical history - to give doctors better insight into a patient's real-time needs.

Location: San Francisco, California

Freenome uses AI in screenings, diagnostic tests and blood work to test for cancer. By deploying AI at general screenings, Freenome aims to detect cancer in its earliest stages and subsequently develop new treatments.

Location: Boston, Massachusetts

Harvard University's teaching hospital, Beth Israel Deaconess Medical Center, used AI for diagnosing potentially deadly blood diseases at an early stage. Doctors developed AI-enhanced microscopes to scan for harmful bacterias like E. coli and staphylococcus in blood samples at a faster rate than is possible using manual scanning. The scientists used 25,000 images of blood samples to teach the machines how to search for bacteria. The machines then learned how to identify and predict harmful bacteria in blood with 95 percent accuracy.

Location: Cambridge, Massachusetts

Iterative Health applies AI to gastroenterology to improve disease diagnosis and treatment. The company's AI Recruitment service uses computational algorithms to automate the process of identifying patients who are eligible to be potential candidates for inflammatory bowel disease clinical trials. Iterative Health also produces SKOUT, a tool that uses AI to help doctors identify potentially cancerous polyps.

Location: Peoria, Illinois

VirtuSense uses AI sensors to track a patient's movements so that providers and caregivers can be notified of potential falls. The company's products include VSTAlert, which can predict when a patient intends to stand up and notify appropriate medical staff, and VST Balance, which employs AI and machine vision to analyze a person's risk of falling within the next year.

Location: San Mateo, California

Caption Health combines AI and ultrasound technology for early disease identification. AI guides providers through the ultrasound process in real time to produce diagnostic-quality images that the software then helps to interpret and assess.

Location: San Francisco, California

Arterys creates products for precision medicine. Its medical imaging AI platform can be used for detecting breast cancer, analyzing cardiac MRI images, reading emergency department X-rays, tracking lung nodules, diagnosing brain tumors and detecting strokes.

Location: Fully Remote

Cleerly makes AI technology to improve cardiovascular care. The company's AI-enabled digital care platform measures and analyzes atherosclerosis, which is a buildup of plaque in the heart's arteries. The technology is able to determine an individual's risk of having a heart attack and recommend a personalized treatment plan.

Image: Shutterstock

Examples of AI in Drug Discovery

The drug development industry is bogged down by skyrocketing development costs and research that takes thousands of human hours. Putting each drug through clinical trials costs an estimated average of $1.3 billion, and only 10 percent of those drugs are successfully brought to market.

Due to breakthroughs in technology, biopharmaceutical companies are quickly taking notice of the efficiency, accuracy and knowledge AI can provide.

Here are some companies that rely on AI to develop the next wave of medicines.

Location: New Haven, Connecticut

BioXcel Therapeutics uses AI to identify and develop new medicines in the fields of immuno-oncology and neuroscience. Additionally, the company's drug re-innovation program employs AI to find new applications for existing drugs or to identify new patients.

Location: Cambridge, Massachusetts

Reverie Labs is a pharmaceutical company harnessing computational chemistry and machine learning tools for drug discovery and design. It uses predictive analytic s tools and expansive databases, with the ultimate goal of learning more about cancer and developing effective cancer treatments.

Read Next 10 Examples of Wearable Technology in Healthcare and Wearable Medical Devices

Location: Boston, Massachusetts

Valo uses artificial intelligence to achieve its mission of transforming the drug discovery and development process. With its Opal Computational Platform, Valo collects human-centric data to identify common diseases among a specific phenotype, genotype and other links, which eliminates the need for animal testing. The company then establishes the molecule design and clinical development.

Location: Cambridge, Massachusetts

Combining AI, the cloud and quantum physics, XtalPi 's ID4 platform predicts the chemical and pharmaceutical properties of small-molecule candidates for drug design and development. The company's investors have included Google, Tencent and Sequoia Capital.

Location: San Francisco, California

Atomwise uses AI to tackle serious diseases, including Ebola and multiple sclerosis. The company's neural network, AtomNet, helps predict bioactivity and identify patient characteristics for clinical trials. Atomwise's AI technology screens between 10 and 20 million genetic compounds each day and can reportedly deliver results 100 times faster than traditional pharmaceutical companies.

Location: Fully Remote

Deep Genomics ' AI platform helps researchers find candidates for developmental drugs related to neuromuscular and neurodegenerative disorders. Finding the right candidates during a drug's development statistically raises the chances of successfully passing clinical trials while also decreasing time and cost to market.

Location: London, England

The primary goal of BenevolentAI is to get the right treatment to the right patients at the right time by using AI to produce a better target selection and provide previously undiscovered insights through deep learning. BenevolentAI works with major pharmaceutical groups to license drugs, while also partnering with charities to develop easily transportable medicines for rare diseases.

Location: Menlo Park, California

Deepcell uses artificial intelligence and microfluidics to develop technology for single cell morphology. The company's platform has a variety of applications, including cancer research, cell therapy and developmental biology.

Location: New York, New York

Owkin leverages AI technology for drug discovery and diagnostics with the goal of enhancing cancer treatment. The company's AI tools help identify new drug targets, recommend possible drug combinations and suggest additional diseases that a drug can be repurposed to treat. Owkin also produces RlapsRisk, a diagnostic tool for assessing a breast cancer patient's risk of relapse, and MSIntuit, a tool that assists with screening for colorectal cancer.

Image: Shutterstock

Examples of AI Transforming Patient Experience

In the healthcare industry, time is money. Efficiently providing a seamless patient experience allows hospitals, clinics and physicians to treat more patients on a daily basis. Studies show hospitals whose patients have positive experiences have higher profits, while negative reviews can lead to financial losses.

We've rounded up some examples of how AI is helping healthcare facilities better manage patient flow.

Location: Austin, Texas

With the goal of improving patient care, Iodine Software is creating AI-powered and machine-learning solutions for mid-revenue cycle leakages, like resource optimization and increased response rates. The company's CognitiveML product discovers client insights, ensures documentation accuracy and highlights missing information.

Location: New York, New York

Kaia Health operates a digital therapeutics platform that features live physical therapists to provide people care within the boundaries of their schedules. The platform includes personalized programs with case reviews, exercise routines, relaxation activities and learning resources for treating chronic back pain and COPD. Kaia Health also features a PT-grade automated feedback coach that uses AI technology.

Location: New York, New York

Spring Health offers a mental health benefit solution employers can adapt to provide their employees with the resources to keep their mental health in check. The technology works by collecting a comprehensive dataset from each individual and comparing that against hundreds of thousands of other data points. The platform then uses a machine learning model to match people with the right specialist for either in-person care or telehealth appointments.

Location: Mountain View, California

Twin Health's holistic method seeks to address and potentially reverse chronic conditions like Type 2 Diabetes through a mixture of IoT tech, AI, data science, medical science and healthcare. The company created the Whole Body Digital Twin - a digital representation of human metabolic function built around thousands of health data points, daily activities and personal preference.

Location: Columbus, Ohio

Olive 's AI platform automates repetitive healthcare tasks, freeing up administrators to work on higher-level ones. The platform automates everything from eligibility checks to un-adjudicated claims and data migrations so staffers can focus on patient service.

Location: Mountain View, California

Qventus is an AI-based software platform that solves operational challenges, including those related to emergency rooms and patient safety. The company's automated platform can prioritize patient illness and injury and tracks hospital waiting times to help hospitals and health systems optimize care delivery.

Location: Cleveland, Ohio

The Cleveland Clinic teamed up with IBM on the Discovery Accelerator, an AI-infused initiative focused on faster healthcare breakthroughs. The joint center is building an infrastructure that supports research in areas such as genomics, chemical and drug discovery and population health. The collaboration employs big data medical research for the purpose of innovating patient care and approaches to public health threats.

Location: Baltimore, Maryland

Johns Hopkins Hospital partnered with GE Healthcare to use predictive AI techniques to improve the efficiency of patient operational flow. A task force, augmented with AI, quickly prioritized hospital activity to benefit patients. Since implementing the program, the facility has assigned patients admitted to the emergency department to beds 38 percent faster.

Location: Austin, Texas

Babylon is on a mission to reengineer healthcare by shifting the focus away from caring for the sick to helping prevent sickness, leading to better health and less health-related expenses. The platform features an AI engine created by doctors and deep learning scientists that operates an interactive symptom checker, using known symptoms and risk factors to provide the most informed and up-to-date medical information possible.

Location: New York, New York

One Drop provides a discreet solution for managing chronic conditions like diabetes and high blood pressure, as well as weight management. The One Drop Premium app allows people to manage their conditions head first, offering interactive coaching from real-world professionals, predictive glucose readings powered by AI and data science, learning resources and daily tracking of readings taken from One Drop's Bluetooth-enabled glucose reader and other devices.

Location: Palo Alto, California

CloudMedX uses machine learning to generate insights for improving patient journeys throughout the healthcare system. The company's technology helps hospitals and clinics manage patient data, clinical history and payment information by using predictive analytics to intervene at critical junctures in the patient care experience. Healthcare providers can use these insights to efficiently move patients through the system.

Location: Menlo Park, California

Subtle Medical uses AI to enhance images for radiology departments. The SubtlePET and SubtleMR products work with the machines a facility already uses to speed up MRI and PET scans while reducing image noise. The software has the potential to shrink wait times by scanning more patients each day.

Location: New York, New York

Twill describes itself as "The Intelligent Healing Company," delivering digital healthcare products and partnering with enterprises, pharma companies and health plans to develop products using its Intelligent Healing Platform. The company uses AI to tailor personalized care tracks for managing medical conditions like multiple sclerosis and psoriasis. These individualized programs can include digital therapeutics, care communities and coaching options.

Location: San Francisco, California

Augmedix offers a suite of AI-enabled medical documentation tools for hospitals, health systems, individual physicians and group practices. The company says its products use natural language processing and automated speech recognition to save users time, increase productivity and improve patient satisfaction.

Further Reading Cloud Computing in Healthcare: How It's Used and 10 Examples

Image: Shutterstock

Examples of AI for Healthcare Data Management

Healthcare is widely considered one of the next big data frontiers to tame. Highly valuable information can sometimes get lost among the forest of trillions of data points. Additionally, the inability to connect important data points slows the development of new drugs, preventative medicine and proper diagnosis.

Many in healthcare are turning to AI as a way to stop the data hemorrhaging. The technology breaks down data silos and connects in minutes information that used to take years to process.

Here are eight examples of AI companies helping the healthcare industry stay afloat in an ocean of data.

Location: Chicago, Illinois

Tempus uses AI to sift through the world's largest collection of clinical and molecular data to personalize healthcare treatments. The company develops AI tools that give physicians insights into treatments and cures.

Location: Armonk, New York

Once known as a Jeopardy-winning supercomputer, IBM's Watson now helps healthcare professionals harness their data to optimize hospital efficiency, better engage with patients and improve treatment. Watson applies its skills to everything from developing personalized health plans to interpreting genetic testing results and catching early signs of disease.

Location: Austin, Texas

ClosedLoop.ai is an end-to-end platform that uses AI to discover at-risk patients and recommend treatment options. Through the platform, healthcare organizations can receive personalized data about patients' needs while collecting looped feedback, outreach and engagement strategies and digital therapeutics. The platform can be used by healthcare providers, payers, pharma and life science companies.

Location: Fully Remote

Beacon Biosignals aims to treat neurological and psychiatric diseases through its EEG analytics platform, which utilizes portal reporting, standardized neurobiomarkers and machine learning algorithms that "increase the probability of success at each stage of drug development." Additionally, population stratification is used to identify various patient populations.

Location: Philadelphia, Pennsylvania

Proscia is a digital pathology platform that uses AI to detect patterns in cancer cells. The company's software helps pathology labs eliminate bottlenecks in data management and uses AI-powered image analysis to connect data points that support cancer discovery and treatment.

Location: Mountain View, California

H2O.ai 's AI analyzes data throughout a healthcare system to mine, automate and predict processes. It has been used to predict ICU transfers, improve clinical workflows and pinpoint a patient's risk of hospital-acquired infections. Using the company's AI to mine health data, hospitals can predict and detect sepsis, which ultimately reduces death rates.

Location: Shenzhen, China

ICarbonX uses AI and big data to look more closely at human life characteristics with its Digital Life Platform. By analyzing the health and actions of human beings in a "carbon cloud," the company hopes its big data will help manage all aspects of health. ICarbonX believes its technology can gather enough data to better classify symptoms, develop treatment options and get people healthier.

Location: San Francisco, California

AKASA 's AI platform helps healthcare providers streamline workflows by automating administrative tasks to allow staff to focus where they're needed. The automation can be customized to meet a facility's particular needs and priorities, while maintaining accuracy for managing claims, payments and other elements of the revenue cycle.

Image: Shutterstock

Examples of AI in Robotic Surgery

Popularity in robot-assisted surgery is skyrocketing. Hospitals are using robots to help with everything from minimally invasive procedures to open heart surgery. According to the Mayo Clinic, robots help doctors perform complex procedures with a precision, flexibility and control that goes beyond human capabilities.

Surgeons can control a robot's mechanical arms while seated at a computer console as the robot gives the doctor a three dimensional, magnified view of the surgical site that surgeons could not get from relying on their eyes alone. The surgeon then leads other team members who work closely with the robot through the entire operation.

Robot-assisted surgeries have led to fewer surgery-related complications, less pain and a quicker recovery time. Take a look at five examples of how robots are shaping the future of surgery.

Location: Waltham, Massachusetts

Vicarious Surgical combines virtual reality with AI-enabled robots so surgeons can perform minimally invasive operations. Using the company's technology, surgeons can virtually shrink and explore the inside of a patient's body in detail. Vicarious Surgical's technology concept prompted former Microsoft chief Bill Gates to invest in the company.

Read More Blockchain in Healthcare: 17 Examples to Know

Location: Sunnyvale, California

The Accuray CyberKnife system uses AI and robotics to precisely treat cancerous tumors. The technology lets providers personalize stereotactic radiosurgery and stereotactic body radiation therapy for each patient. Using the robot's real-time tumor tracking capabilities, doctors and surgeons can treat affected areas rather than the whole body.

Location: Sunnyvale, California

The first robotic surgery assistant approved by the FDA, Intuitive 's da Vinci platforms feature cameras, robotic arms and surgical tools to aid in minimally invasive procedures. Da Vinci platforms constantly take in information and provide analytics to surgeons to improve future procedures. Da Vinci has assisted in over 10 million operations.

Location: Pittsburgh, Pennsylvania

The Robotics Institute at Carnegie Mellon University developed HeartLander, a miniature mobile robot designed to facilitate therapy on the heart. Under a physician's control, the tiny robot enters the chest through a small incision, navigates to certain locations of the heart by itself, adheres to the surface of the heart and administers therapy.

Location: Eindhoven, Netherlands

Microsure 's robots help surgeons overcome their human physical limitations. The company's motion stabilizer system is intended to improve performance and precision during surgical procedures. Its MUSA surgical robot, developed by engineers and surgeons, can be controlled via joysticks for performing microsurgery.

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Artificial Intelligence in Healthcare: 39 Examples Improving the Future of Medicine

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Artificial intelligence simplifies the lives of patients, doctors and hospital administrators by performing tasks that are typically done by humans, but in less time and at a fraction of the cost. AI in healthcare shows up in a number of ways, such as finding new links between genetic codes, powering surgery-assisting robots, automating administrative tasks, personalizing treatment options and much more.

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School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA, Australia

Department of Electrical and Electronic Engineering, United International University, Dhaka, Bangladesh

Advanced Intelligent Multidisciplinary Systems (AIMS) Lab, Department of Computer Science and Engineering, United International University, Dhaka, Bangladesh

Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

Healthcare Engineering Innovation Center, Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates

Brain computer interfaces (BCI) provide a direct communication link between the brain and a computer or other external devices. They offer an extended degree of freedom either by strengthening or by substituting human peripheral working capacity and have potential applications in various fields such as rehabilitation, affective computing, robotics, gaming, and neuroscience. Significant research efforts on a global scale have delivered common platforms for technology standardization and help tackle highly complex and non-linear brain dynamics and related feature extraction and classification challenges. Time-variant psycho-neurophysiological fluctuations and their impact on brain signals impose another challenge for BCI researchers to transform the technology from laboratory experiments to plug-and-play daily life. This review summarizes state-of-the-art progress in the BCI field over the last decades and highlights critical challenges.

1. Introduction

1.1. Characterization of BCI Systems

1.2. Factors Influencing BCI Performance

Many factors influence BCI performance; taking the underlying cortical-subcortical networks into consideration is of crucial importance. For example, MI-induced signals are best recorded from premotor and motor areas, because premotor cortex, primary motor cortex and supplementary motor area along with basal ganglia and thalamus of the subcortical areas are the mostly activated areas during MI ( Marchesotti et al., 2017). While EEG can capture premotor and motor area activation ( Edelman et al., 2015; Saha et al., 2019a), intracortical electrodes can record signals from basal ganglia and thalamus ( Sand et al., 2017).

2. Challenges

2.1. Psychophysiological and Neurological Challenges

Around 15-30% of individuals are inherently not able to produce brain signals robust enough to operate a BCI ( Blankertz et al., 2009; Halder et al., 2019; Cecotti, 2020). Considering neurophysiological phenomena may reduce BCI illiteracy. An adaptive machine learning approach incorporating neurophysiological and psychological traits has been proposed to reduce BCI illiteracy ( Vidaurre and Blankertz, 2010). The causes of BCI illiteracy do not exclusively rely on users' ability to produce signals. Sometimes technological limitations may hinder essential features extraction for a successful BCI operation for an individual. For example, measurements of scalp EEG/MEG may not show good task-specific signals due to the folding of the cortex or scalp-to-cortex distance for that individual ( Andersen et al., 2020).

Other case-specific investigations on neuro-psycho-physiological parameters contributing to BCI performance are essential. For the rehabilitation of stroke survivors, affected neural circuits, i.e., lesions are to be identified carefully, because brain responses fluctuate according to the spatial location of the stroke lesion ( Park et al., 2016). Although current neuroimaging methods are effective in capturing stroke lesion sites, a case-specific BCI design that incorporates residual brain function is required for rehabilitative interventions. Highly individualized design impedes wide dissemination of BCI-driven rehabilitation of neurological conditions.

2.2. Technological Challenges

Probing sources in cortico-subcortical networks is another important limitation of scalp-based sensors such as EEG. Reconstructing task-induced networks while resolving the so-called inverse problem imposes a significant challenge. A two-equivalent-dipole model was applied on EEG data to discern the anatomical nature of the MI induced sources and to aid the classification performances ( Kamousi et al., 2005). Saha et al. proposed a wavelet-based source localization approach to investigate MI-related sources and their impact on BCI performance ( Saha et al., 2019a). The neuronal potentials attenuate through several tissue layers of complex geometry and diverse electrical properties; however, the magnetic permeability in the cerebrospinal fluid, skull, and skin, is consistent ( da Silva, 2013). Thus, MEG can capture signal with less distortion than EEG. Although MEG provides better spatiotemporal resolution as compared to EEG, the magnetic field created by the brain is very small, requiring costly, stationary recording equipment ( Mellinger et al., 2007; Corsi et al., 2019).

The BCI classifier design has to address two issues ( Bashashati et al., 2007; Lotte et al., 2007, 2018). First, the dimensionality of the features set used for estimating the model parameters should be chosen for optimal performance based on the nature of the classifier. Second, the trade-off between bias and variance has to be considered and may involve regularizing the parameter estimation.

3. Neuroplasticity, Sensors, Signal Processing, Modeling, and Applications

Exploiting neuroplasticity, designing hi-fidelity and customized neural sensors, applying advanced signal processing, and machine learning techniques are the key aspects of an effective BCI design. Tables 2- 5 highlight diverse characteristics of BCI components and applications including signal acquisition modality, experimental paradigm, data analysis and pattern recognition, application field, and significance. Notably, there are no specific selection criteria for studies in Tables 2- 5 due to the broad spectrum of topics covered in this review; however, they are summarized such that critical advances over the last several years can be appreciated.

3.1. Neuroplasticity and Cognitive Rehabilitation

The time-variant behavior of synapses within complex neural networks underpins the plastic characteristics of the brain and was first illustrated by Donald O. Hebb in 1949 ( Brown and Milner, 2003). Neuroplasticity not only helps to assist cognitive and perceptual learning but also is the main ingredient for neurorehabilitation. How plastic a particular brain area is, may define the effectiveness of a neurofeedback strategy to induce specific activity patterns. Studies have shown visual cortices are plastic enough to produce robust neural signals for post-neurofeedback perceptual learning ( Shibata et al., 2011; Amano et al., 2016). Another study has demonstrated if right/left hemispheric differences in neurofeedback-induced alpha activities are associated with visual information processing and motor behaviors, and, thus, control spatial attention ( Jones and Sliva, 2020). fMRI-based neurofeedback training sessions induce the plasticity of attention-related behavior. Implications suggest that neurofeedback can offer rehabilitation of attentional deficit ( Megan et al., 2015). A recent study has used neurofeedback to generate robust somatosensory oscillations associated with human perception ( Brickwedde et al., 2019).

The extent of BCI-induced plasticity entails several factors, including (1) the selection of the signal acquisition modality, which plays an important role in diagnosing neural states, (2) the design of feedback modality that has explicit association with the neural signal classification performance, (3) the consideration of application-specific feedback delays, and (4) the utilization of a suitable feedback modality ( Grosse-Wentrup et al., 2011). Neural ensemble recordings using signal acquisition modalities such as EEG, MEG, fNIRS, and fMRI have become dominant over single unit recordings. Behavioral activities are likely to be distributed across three-dimensional cortical-subcortical networks and that cannot be captured within single unit recordings ( Nicolelis and Lebedev, 2009).

Externally stimulating the affected brain areas by electric or magnetic fields holds promise for stroke rehabilitation. A recent study demonstrated the induction of neuroplasticity in white matter and cortical functions in chronic stroke patients by motor imagery-based BCI and transcranial direct current stimulation applied to targeted brain areas ( Hong et al., 2017). Magnetic stimulation of brain areas driven by BCI increases cortical activation in stroke patients ( Johnson et al., 2018). The level of neuroplasticity achieved post-rehabilitation varies across subjects and, thus, an individual-specific training session is necessary ( Leamy et al., 2014). The use of BCI-based motor rehabilitation for locked-in patients is limited because they are unable to fully interact with the system ( Birbaumer and Cohen, 2007). Other examples of BCI-driven rehabilitations include optimizing the parameters for deep brain stimulation applied into the subthalamic nucleus in patients with Parkinson's disease ( Sand et al., 2017) and treating major depressive disorder by BCI-driven transcranial magnetic stimulation ( Ray et al., 2015).

3.2. Signal Acquisition, Signal Processing, and Modeling

The combination of signal processing and machine learning approaches plays critical role in translating any brain signal to a command for a computer or other external devices. Tables 2- 5 highlight different signal processing and machine learning techniques. Representing signals in the time-frequency-space is necessary to obtain physiological correlates of BCI outcomes ( McFarland et al., 2006; Bashashati et al., 2007). Fourier transform (FT) and autoregressive models are examples of time domain representations of brain signals while short time FT and wavelet transform are examples of time-frequency representations ( McFarland et al., 2006; Bashashati et al., 2007). In case of spatial filtering, the most popular filtering approaches are common spatial pattern, independent component analysis and the Laplacian filter. A diverse range of inverse models allow to discern the actual sources projected on three-dimensional cortical-subcortical networks ( Wronkiewicz et al., 2015; Saha et al., 2019a). Extracted features can be translated using various linear and non-linear classification algorithms. Examples of linear and non-linear classifier models are linear discriminant analysis and non-linear kernel-based support vector machines ( Lotte et al., 2007, 2018).

3.3. Neurosensors: The-State-of-the-Art

3.4. Affective Computing, Gaming, Robotics, and Miscellaneous Applications

Future computers are assumed to have emotional and perceptual capabilities, which could extend the use not only to assisting humans but also to making decisions ( Picard, 2000). Computers might able to recognize and interpret underlying affective states based on physiological and behavioral variables. Recent studies demonstrated BCI is a potential tool to investigate affective states, expanding the applications into psychology ( Piho and Tjahjadi, 2018; Song et al., 2018; Huang et al., 2019). Huang et al. have proposed an EEG-based BCI to detect positive and negative emotions induced by video stimulus ( Huang et al., 2019).

Integration of arts into BCI is referred to as artistic BCI ( Andujar et al., 2015). In the late 1960s, David Rosenboom began experimenting with ways to link brain functions with musical production, perception of musical forms and musical proprioception ( Rosenboom, 2014). Other examples of artistic BCI include affective states detection, playing video games and controlling virtual/augmented reality environment. Studies have demonstrated that a user can fully operate video games by SSVEP-BCI ( van Vliet et al., 2012; Filiz and Arslan, 2020). Other studies have proposed how multiple users can participate in a collaborative game, in which joint decision making is required to control the gaming environment ( Nijholt and Poel, 2016; Sekhavat, 2020). Another study previously suggested the aggregation of information from two intelligence analysts' brain signals may lead to better decision making than one's brain signals ( Stoica, 2012). The underlying cause could be explained by inter-individual differences in human cognitive and perceptual skills ( Kleinschmidt et al., 2012). Collaboration between users might assist an individual's decision making by diversity inclusion. A modified setup could investigate how people interact in different social contexts, extending BCI applications in sociology ( Amaral et al., 2017).

Figure 2. A schematic illustration of the evolution of the brain computer interface (BCI) applications: Cognitive & Perceptual Learning/Rehabilitation ( McMillan et al., 1995); Orthosis Control ( Pfurtscheller et al., 2000); Music BCI ( Rosenboom, 2014); Robotics ( Millan et al., 2004); Wheelchair Control ( Iturrate et al., 2009); Drowsiness Detection ( Lin et al., 2008); Affective Computing ( Zander et al., 2009); Brain Racers ( Perdikis et al., 2017); Multiplayer Gaming ( Nijholt and Poel, 2016); Brain-to-Brain Interface ( Rao et al., 2014).

4. Ethical Concerns and Socioeconomic Contexts

Irrespective of the scientific breakthroughs in BCI field, there are key factors pertaining to safety, ethics, privacy protection and data confidentiality, community acceptance and socioeconomic aspects that should be considered with adequate precautions to maximize users' benefits and social impacts ( Illes and Bird, 2006; Bostrom and Sandberg, 2009; Jebari, 2013; McCullagh et al., 2014). Obtaining an ethically sound informed consent from a BCI worn patient may be challenging for BCI researchers due to difficulty in communicating and the lack of alternatives. However, more awareness and attention to ethics policies are recommended to improve the chance for patients to get adequate information.

By creating a common networking platform for BCI researchers worldwide, the immediate proposition of a comprehensive list of universal guidelines is key to sustainable advancements of the field ( Vaadia and Birbaumer, 2009). Various alliance-based projects are running as common platforms for advancing the knowledge of neuroscience, for example, by strengthening efforts to fund neuroscience research projects ( Grillner et al., 2016). The European Union along with its partner universities have initiated the Human Brain Project. In addition, the Brain Initiative has been announced by the White House. In our opinion, advanced understanding of basic neuroscientific phenomena will determine the structure, efficacy and applications of futuristic BCI.

5. Conclusion

Numerous groundbreaking advances in neurosensors and computational tools herald great promise for more sophisticated and user friendly BCI systems requiring no or little maintenance. In addition to hi-fidelity signal acquisition, significant progress in signal processing and machine learning tools, their complementary roles, and high computation power and increased mobility of computers have significantly contributed in the emergence of BCI technologies. The future of BCI technology will rely greatly on addressing the following key aspects:

* Elucidating the underlying psychophysiological and neurological factors that potentially influence BCI performance.

* Designing less invasive sensors with reliable signal acquisition and resolution, while considering portability, easy maintenance, and affordability.

* Modeling session-to-session and subject-to-subject information transfer for the proposition of more generalized BCI models with insignificant or no calibration requirement.

* Establishing broad consensus on ethical issues and beneficial socioeconomic application of this technology.

Author Contributions

SS conceived the initial idea, wrote the first draft, and generated all figures and tables. KM, KA, RM, GN, and SD participated in the discussion and commented on the draft. AHK and MB provided further insight and helped SS to finalize the structure and materials. All authors read and approved the final paper.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

This manuscript has been released as a pre-print at https://arxiv.org/ ( Saha et al., 2019b). Authors would like to thank Prof. Moritz Grosse-Wentrup for providing his valuable feedback. This work was partially supported by a grant (Award No. RC2-2018-022 (HEIC) and KKJRC-2019-Health 2) from Khalifa University, Abu Dhabi, UAE.

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Progress in Brain Computer Interface: Challenges and Opportunities

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Brain computer interfaces (BCI) provide a direct communication link between the brain and a computer or other external devices. They offer an extended degree of freedom either by strengthening or by substituting human peripheral working capacity and have potential applications in various fields such as rehabilitation, affective computing, robotics, gaming, and neuroscience.

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Targeted therapy is a type of cancer treatment that uses drugs or other substances to precisely identify and attack certain types of cancer cells. A targeted therapy can be used by itself or in combination with other treatments, such as traditional or standard chemotherapy, surgery, or radiation therapy. If your treatment plan includes targeted therapy, knowing how it works and what to expect can often help you prepare for treatment and make informed decisions about your care.

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This article gives 35 instances where artificial intelligence is being used across the medical field and AI healthcare was one of them. The majority of AI used in the medical field is by Machine Learning (algorithms that can automatically learn new topics by themselves.) which makes them understand more as more happens. Natural language processing is one of these types of AI, and can utilize medical notes to better understand methods and give better results to patients. There is also AI in the administrative parts of the medical field that help with clinical documentation, claims processing, and medical records managing.

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Biomarkers are used to assess whether the body is responding normally or abnormally to treatments and the progression of a condition or disease. A vocal biomarker will be an indicator of using audio signal to monitor the patient, diagnose, severity of their condition, or effects of treatment. They have been used to perform in the field of Parkinson's Disease, Alzheimer's Disease, Multiple Sclerosis, Cardio vascular Disease, Mental Health, and Covid 19. In working within these it may help to monitor and diagnose early on with vocal characteristics, respiratory sounds, verbal interactions, and language. However, there are many challenges when it comes to surveying and using vocals. Such as the establishment of a standard type of voice recording, data collection, and audio preprocessing. As well using this information to fully extract and use the audio. Overall, it has a long way to go for a clinical routine use.

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In this article it explains how scientists and doctors use Bionics as a mechanical system that helps function living organs or parts of living organisms in this case humans. Such as bones, muscles and the nervous system. Bionics are used for limbs, prostheses which are then used to replace a missing body part which may have been lost due to trauma, disease, or congenital defect. This mechanical system will help give back some movement and function  that was lost. Although there is still some work and things to do for this system to be successful. Scientists goals for this system is to be lighter,smaller, and better controlled for the person using this system feels comfortable and safe to use.

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This is the picture that will help me remember bionic Prosthetic 

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This is the picture that will help me remember bionic Prosthetic 

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Traditional vaccines are what we depend on to help fight off diseases but this takes many years. Since they are so many new diseases we need a way to come up with vaccines faster which is where mRNA comes up. mRNA vaccines provide safe long lasting protection. For example with covid-19 it was a new and fast disease that we needed a rapid development of a vaccine. mRNA works by mimicking a viral protein and tricks the immune system into mounting an immune response against the invader. Then powerful antibodies are produced which provides long last protection against the viral infection. Even though this not really new, covid-19 helped bring it out to the open, on a new way to fight against diseases.

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A picture that helps me remember mrna vaccinology

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A picture that helps me remember mrna vaccinology

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The CyberKnife uses a combination of robotics and imaging in order to attack cancerous and also non-cancerous tumors. It uses intense precision, kills tumors with high doses of radiation. There are so many benefits that come along with CyberKnife that really do improve the innovations in biomedicine.

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Our expert radiologists use CyberKnife stereotactic radiation therapy to treat cancerous and noncancerous tumors, neurologic and other conditions.

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A picture that reminds me of CyberKnife 

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A picture that reminds me of CyberKnife 

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Understanding the new innovation and how it is created. 

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Understanding the new innovation and how it is created. 

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ultron is an AI that was created to bring peace to the world

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Bubble CPAP for Prevention of Chronic Lung Disease in Premature Infants

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Bubble CPAP for Prevention of Chronic Lung Disease in Premature Infants

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The article is basically giving insight into how this new machine works and its advantages. This apparatus works by using a breathing circuit with an inspiratory limb that delivers heated humidified gas to the baby. Then, there is an expiratory that is immersed in some water and its purpose is to create the desired pressure for the baby. The machine has advantages that include making it easier for the infant to breathe, increasing lung capacity, and reduces biotrauma.

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The discovery of surfactant was one of the most significant events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered nonviable. However, the prevention of chronic lung disease (CLD) did not progress, and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. ¹

The incidence of CLD differs significantly among institutions even after adjusting for centers' distributions of birth weight, race and sex. The wide variability could not be explained by biological factors and, therefore, respiratory management was considered key to creating or preventing CLD. The lowest incidence of CLD in literature has been reported from centers that use bubble CPAP (b-CPAP) as early as possible, preferentially in the delivery room and as the primary mode for respiratory support of all premature infants in respiratory distress. ²

I have previously demonstrated the reproducibility of b-CPAP use. In a center that had 33 percent of its very low birth weight (VLBW) infants develop CLD, the implementation of a b-CPAP program was associated with a reduction of CLD to 6 percent. However, the reduction of CLD rates did not occur immediately - it required significant time to develop staff experience and to achieve the full effect of b-CPAP. In a follow-up study, I demonstrated the consistency of outcomes over 12 years with a CLD rate of 5 percent. ³

How the apparatus works

The bubble CPAP apparatus is simple; it is composed of a breathing circuit with an inspiratory limb delivering heated humidified gas mixture to the infant and an expiratory limb immersed under water in a container to create the desired pressure. Gas flow generates bubbles under the water that cause oscillations of the water level and subsequently of the pressure delivered to the patient. Therefore, the patient on b-CPAP receives an oscillating rather than a constant pressure. This oscillation effect may add to the efficacy of b-CPAP in volume recruitment.

CPAP has multiple physiologic advantages. In spontaneously breathing premature infants, it eases respiratory efforts by stenting the airway and the diaphragm. It maintains alveoli inflated, increases the functional residual capacity of the lung, and optimally matches ventilation with perfusion. Compared with mechanical ventilation and tracheal intubation, CPAP minimizes volutrauma and subsequent biotrauma. CPAP induces a favorable strain that stimulates lung growth when administered to animals over a prolonged time. 4

Multiple randomized controlled trials were launched to compare the efficacy of early nasal CPAP to mechanical ventilation. These trials did not specify b-CPAP, but rather used any type of CPAP and did not offer details of competency-based training to ensure its efficacious use. Despite these reservations, trials confirmed the feasibility of applying CPAP early in life to premature infants, including those at the extreme premature age of 24-25 weeks, without change in mortality and CLD.

When these trials were considered collectively in a recent meta-analysis, early use of CPAP had a marginal benefit for the composite outcome of survival without CLD when compared to prophylactic surfactant with intubation. These findings do not reconcile with recurring reports on substantial reduction of CLD in neonatal units that used b-CPAP.

There are two factors that could explain the reduced CLD in b-CPAP units. The first is the type of CPAP and the type of nasal prongs. The second is the competency of the caregiver using b-CPAP at the bedside. Therefore, b-CPAP strategy is a complete bundle of care that requires clear practice guidelines and training process. In an effort to help neonatal units reproduce b-CPAP success, we offer a hands-on training program that familiarizes staff with b-CPAP components, indications for use, method of application, check points for maintenance, troubleshooting of problems, weaning methods and criteria for b-CPAP failure. ²

No studies have compared CLD in infants supported with b-CPAP versus infants supported with other CPAP devices. Data are scarce on short-term endpoints, including work of breathing and oxygenation that favored b-CPAP. Nonetheless, numerous studies compared short-term outcomes of using CPAP, biphasic nasal CPAP, nasal intermittent positive pressure ventilation, and high-flow nasal cannula while using various types of facial and nasal interfaces.

The American Academy of Pediatrics Committee on Fetus and Newborn recently acknowledged the deficiency of data on efficacy and safety of these modalities. Of note, none of these non-invasive modalities could mimic the success of b-CPAP in reducing CLD. In the absence of data on CLD reduction, the extrapolation that all CPAP and non-invasive techniques are as efficacious as b-CPAP are realistically unfounded. ¹
References

1. Aly H, Mohamed MA, Wung JT. Surfactant and continuous positive airway pressure for the prevention of chronic lung disease: History, reality, and new challenges. Semin Fetal Neonatal Med. 2017;22(5):348-353.

2. Aly H, Mohamed MA. Bubble continuous positive airway pressure. In: MacDonald MG, Ramasethu J. Eds. Atlas of Procedures in Neonatology. 5th Philadelphia, PA. Lippincott, Williams & Wilkins, 2012.

3. Aly H, Milner JD, Patel K, El-Mohandes AA. Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants? Pediatrics. 2004;114(3):697-702.

4. Aly H. Nasal prongs continuous positive airway pressure: a simple yet powerful tool. Pediatrics 2001;108(3):759-761.

Dr. Aly is Chair of the Department of Neonatology, Cleveland Clinic Children's, and Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

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Bubble CPAP for Prevention of Chronic Lung Disease in Premature Infants

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Implementation of b-CPAP program was associated with a reduction in chronic lung disease. Hany Aly, MD, Chair of the Department of Neonatology at Cleveland Clinic Children's, looks at the efficacy of respiratory support systems for very low birth weight infants.

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A picture that reminds me of Bubble CPAP

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A picture that reminds me of Bubble CPAP

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this is a picture that helps me remember implantable for severe paralysis

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this is a picture that helps me remember implantable for severe paralysis

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Human liver repaired using cells grown in a laboratory for the first time

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Human liver repaired using cells grown in a laboratory for the first time

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In the article it talks about how one of the hardest organs to transplant is the liver: there aren't a lot of donors, the liver can be damaged in cold storage, and malfunctioning bile ducts, a common reason for transplantation, can come back even in the new liver. However, they have found out how to create bile duct "mini organs" that can repair and even better a liver. These can be inserted into damaged livers ready for transplantation and may even be able to heal a liver that is inside someone. They were able to create these "organoids" by first, using RNA sequencing to study the biliary tree cells and noticed that gallbladder cells were not damaged by bile duct disease and could take those out and grow the organoids, which were then inserted into the liver so that they could repair the bile ducts. This was the first time that these kinds of procedures were done on human organs and hopefully they can start using it in clinics soon.

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NIHR-supported researchers have shown that a new technique to grow 'mini bile ducts' in a lab can be used to repair damaged human donor livers. In the future this new technique could potentially help treat patients whose own livers are not functioning correctly.

Bile ducts act as the liver's waste disposal system. Malfunctioning bile ducts are behind a third of adults and 70% of children's liver transplantations, with no alternative treatments. Even after a liver transplant, bile duct disease can still occur. The disease can return in up to a third of patients after transplantation.

Currently there is a shortage of liver donors. Many livers are unsuitable for transplant due to a number of reasons, such as the organ sustaining damage while being held in cold storage outside the body. With the shortage of livers, researchers wanted to find an alternative treatment to see if the liver could instead be repaired.

Researchers supported by NIHR Cambridge Biomedical Research Centre have used a technique to grow bile duct organoids - often referred to as 'mini organs' - in the lab and have shown that these can be used to repair damaged donor livers. This is the first time that the technique has been used on human organs.

Researchers have been able to show that it is possible to transplant cells grown in the lab known as cholangiocytes organoids - which in the bile duct that act as a barrier between the bile and other tissues - into damaged human livers to repair them.

The research team used a technique known as single-cell RNA sequencing to learn more about the individual cells lining the biliary tree. They found that although duct cells differ, biliary cells from the gallbladder, which are usually spared by bile duct diseases, could be converted into the cells of the bile ducts and replace and repair the damaged ones.

They grew cholangiocytes from the gallbladder using a technology known as 'organoids' - small groups of cells that mimic the organ's function - in the lab. And using the perfusion system, the researchers injected these organoids into a damaged donor liver.

The team were able to demonstrate that the transplanted organoids engrafted and repaired the bile ducts, allowing the liver to function correctly. This new technique has shown that a cell-based therapy could help restore damaged donor livers and may have the potential to fix a patient's own liver.

This is the first time that a procedure of this kind has been used on human donor organs. It could also increase the number of livers that are considered suitable for organ transplantation and ultimately save more lives.

The research provides a proof-of-principle for the development of new cell-based therapies and this approach could be applied to a range of organs and diseases to accelerate more cell-based therapy research.

Professor Ludovic Vallier, theme lead for Transplant and Regenerative Medicine theme at NIHR Cambridge BRC and joint senior author of this study, said: "This is the first time that we've been able to show that a human liver can be enhanced or repaired using cells grown in the lab. We have further work to do to test the safety and viability of this approach, but hope we will be able to transfer this into the clinic in the coming years.

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Human liver repaired using cells grown in a laboratory for the first time

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NIHR-supported researchers have shown that a new technique to grow 'mini bile ducts' in a lab can be used to repair damaged human donor livers. In the future this new technique could potentially help treat patients whose own livers are not functioning correctly.

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A picture that reminds me of repairing human livers with organoids.

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A picture that reminds me of repairing human livers with organoids.

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As amphibians go, axolotls are pretty cute. These salamanders sport a Mona Lisa half-smile and red, frilly gills that make them look dressed up for a party. You might not want them at your soiree, though: They're also cannibals. While rare now in the wild, axolotls used to hatch en masse, and it was a salamander-eat-salamander world. In such a harsh nursery, they evolved - or maybe kept - the ability to regrow severed limbs.

"Their regenerative powers are just incredible," says Joshua Currie, a biologist at the Lunenfeld-Tanenbaum Research Institute in Toronto who's been studying salamander regeneration since 2011. If an axolotl loses a limb, the appendage will grow back, at just the right size and orientation. Within weeks, the seam between old and new disappears completely.

And it's not just legs: Axolotls can regenerate ovary and lung tissue, even parts of the brain and spinal cord.

The salamander's exceptional comeback from injury has been known for more than a century, and scientists have unraveled some of its secrets. It seals the amputation site with a special type of skin called wound epithelium, then builds a bit of tissue called the blastema, from which sprouts the new body part. But until recently, the fine details of the cells and molecules needed to create a leg from scratch have remained elusive.

With the recent sequencing and assembly of the axolotl's giant genome, though, and the development of techniques to modify the creature's genes in the lab, regeneration researchers are now poised to discover those details. In so doing, they'll likely identify salamander tricks that could be useful in human medicine.

Already, studies are illuminating the cells involved, and defining the chemical ingredients needed. Perhaps, several decades from now, people, too, might regrow organs or limbs. In the nearer future, the findings suggest possible treatments for ways to promote wound-healing and treat blindness.

The idea of human regeneration has evolved from an "if" to a "when" in recent decades, says David Gardiner, a developmental biologist at the University of California, Irvine. "Everybody now is assuming that it's just a matter of time," he says. But, of course, there's still much to do.

Rainbow regeneration

In a working limb, cells and tissues are like the instruments in an orchestra: Each contributes actions, like musical notes, to create a symphony. Amputation results in cacophony, but salamanders can rap the conductor's baton and reset the remaining tissue back to order - and all the way back to the symphony's first movement, when they first grew a limb in the embryo.

The basic steps are known: When a limb is removed, be it by hungry sibling or curious experimenter, within minutes the axolotl's blood will clot. Within hours, skin cells divide and crawl to cover the wound with a wound epidermis.

Next, cells from nearby tissues migrate to the amputation site, forming a blob of living matter. This blob, the blastema, is "where all the magic happens," said Jessica Whited, a regenerative biologist at Harvard University, in a presentation in California last year. It forms a structure much like the developing embryo's limb bud, from which limbs grow.
This movie shows immune cells, labeled to glow green, moving within a regenerating axolotl fingertip. Scientists know that immune cells such as macrophages are essential for regeneration: When they are removed, the process is blocked. (Credit: Josh Currie)
Finally, cells in the blastema turn into all the tissues needed for the new limb and settle down in the right pattern, forming a tiny but perfect limb. This limb then grows to full size. When all is done, "you can't even tell where the amputation occurred in the first place," Whited tells Knowable Magazine.

Scientists know many of the molecular instruments, and some of the notes, involved in this regeneration symphony. But it's taken a great deal of work.

As Currie started as a new postdoc with Elly Tanaka, a developmental biologist at the Research Institute of Molecular Pathology in Vienna, he recalls wondering, "Where do the cells for regeneration come from?" Consider cartilage. Does it arise from the same cells as it does in the developing embryo, called chondrocytes, that are left over in the limb stump? Or does it come from some other source?

To learn more, Currie figured out a way to watch individual cells under the microscope right as regeneration took place. First, he used a genetic trick to randomly tag the cells he was studying in a salamander with a rainbow of colors. Then, to keep things simple, he sliced off just a fingertip from his subjects. Next, he searched for cells that stuck out - say, an orange cell that ended up surrounded by a sea of other cells colored green, yellow and so on. He tracked those standout cells, along with their color-matched descendants, over the weeks of limb regeneration. His observations, reported in the journal Developmental Cell in 2016, illuminated several secrets to the regeneration process.

For one thing, cell travel is key. "Cells are really extricating themselves from where they are and crawling to the amputation plane to form this blastema," Currie says. The distance cells will journey depends on the size of the injury. To make a new fingertip, the salamanders drew on cells within about 0.2 millimeters of the injury. But in other experiments where the salamanders had to replace a wrist and hand, cells came from as far as half a millimeter away.

More strikingly, Currie discovered that contributions to the blastema were not what he'd initially expected, and varied from tissue to tissue. "There were a lot of surprises," he says.

Chondrocytes, so important for making cartilage in embryos, didn't migrate to the blastema (earlier in 2016, Gardiner and colleagues reported similar findings). And certain cells entering the blastema - pericytes, cells that encircle blood vessels - were able to make more of themselves, but nothing else.

The real virtuosos in regeneration were cells in skin called fibroblasts and periskeletal cells, which normally surround bone. They seemed to rewind their development so they could form all kinds of tissues in the new fingertip, morphing into new chondrocytes and other cell types, too.

To Currie's surprise, these source cells didn't arrive all at once. Those first on the scene became chondrocytes. Latecomers turned into the soft connective tissues that surround the skeleton.

How do the cells do it? Currie, Tanaka and collaborators looked at connective tissues further, examining the genes turned on and off by individual cells in a regenerating limb. In a 2018 Science paper, the team reported that cells reorganized their gene activation profile to one almost identical, Tanaka says, to those in the limb bud of a developing embryo.

Muscle, meanwhile, has its own variation on the regeneration theme. Mature muscle, in both salamanders and people, contains stem cells called satellite cells. These create new cells as muscles grow or require repair. In a 2017 study in PNAS, Tanaka and colleagues showed (by tracking satellite cells that were made to glow red) that most, if not all, of muscle in new limbs comes from satellite cells.

Recipe for regeneration

If Currie and Tanaka are investigating the instruments of the regeneration symphony, Catherine McCusker is decoding the melody they play, in the form of chemicals that push the process along. A regenerative biologist at the University of Massachusetts Boston, she recently published a recipe of sorts for creating an axolotl limb from a wound site. By replacing two of three key requirements with a chemical cocktail, McCusker and her colleagues could force salamanders to grow a new arm from a small wound on the side of a limb, giving them an extra arm.

The first requirement for limb regeneration is the presence of a wound, and formation of wound epithelium. But a second, scientists knew, was a nerve that can grow into the injured area. Either the nerve itself, or cells that it talks to, manufacture chemicals needed to make connective tissue become immature again and form a blastema. In their 2019 study in Developmental Biology, McCusker and colleagues - guided by earlier work by a Japanese team - used two growth factors, called BMP and FGF, to fulfill that step in salamanders lacking a nerve in the right place.

The third requirement was for fibroblasts from opposite sides of a wound to find and touch each other. In a hand amputation, for example, cells from the left and right sides of the wrist might meet to correctly pattern and orient the new hand. McCuscker's chemical replacement for this requirement was retinoic acid, which the body makes from vitamin A. The chemical plays a role in setting up patterning in embryos and has long been known to pattern tissues during regeneration.

In their experiment, McCusker's team removed a small square of skin from the upper arm of 38 salamanders. Two days later, once the skin had healed over, the researchers made a tiny slit in the skin and slipped in a gelatin bead soaked in FGF and BMP. Thanks to that cocktail, in 25 animals the tissue created a blastema - no nerve necessary.

About a week later, the group injected the animals with retinoic acid. In concert with other signals coming from the surrounding tissue, it acted as a pattern generator, and seven of the axolotls sprouted new arms out of the wound site.

The recipe is far from perfected: Some salamanders grew one new arm, some grew two, and some grew three, all out of the same wound spot. McCusker suspects that the gelatin bead got in the way of cells that control the limb's pattern. The key actions produced by the initial injury and wound epithelium also remain mysterious.

"It's interesting that you can overcome some of these blocks with relatively few growth factors," comments Randal Voss, a biologist at the University of Kentucky in Lexington. "We still don't completely know what happens in the very first moments."

Once upon a time

If we did know those early steps, humans might be able to create the regeneration symphony. People already possess many of the cellular instruments, capable of playing the notes. "We use essentially the same genes, in different ways," says Ken Poss, a regeneration biologist at the Duke University Medical Center in Durham who described new advances in regeneration, thanks to genetic tools, in the 2017 Annual Review of Genetics.

Regeneration may have been an ability we lost, rather than something salamanders gained. Way back in our evolutionary past, the common ancestors of people and salamanders could have been regenerators, since at least one distant relative of modern-day salamanders could do it. Paleontologists have discovered fossils of 300-million-year-old amphibians with limb deformities typically created by imperfect regeneration. Other members of the animal kingdom, such as certain worms, fish and starfish, can also regenerate - but it's not clear if they use the same symphony score, Whited says.

Somewhere in their genomes, "all animals have the ability," says James Monaghan, a regeneration biologist at Northeastern University in Boston. After all, he points out, all animals grow body parts as embryos. And in fact, people aren't entirely inept at regeneration. We can regrow fingertips, muscle, liver tissue and, to a certain extent, skin.

But for larger structures like limbs, our regeneration music falls apart. Human bodies take days to form skin over an injury, and without the crucial wound epithelium, our hopes for regeneration are dashed before it even starts. Instead, we scab and scar.

"It's pretty far off in the future that we would be able to grow an entire limb," says McCusker. "I hope I'm wrong, but that's my feeling."

She thinks that other medical applications could come much sooner, though - such as ways to help burn victims. When surgeons perform skin grafts, they frequently transfer the top layers of skin, or use lab-grown skin tissue. But it's often an imperfect replacement for what was lost.

That's because skin varies across the body; just compare the skin on your palm to that on your calf or armpit. The tissues that help skin to match its body position, giving it features like sweat glands and hair as appropriate, lie deeper than many grafts. The replacement skin, then, might not be just like the old skin. But if scientists could create skin with better positional information, they could make the transferred skin a better fit for its new location.

Monaghan, for his part, is thinking about regenerating retinas for people who have macular degeneration or eye trauma. Axolotls can regrow their retinas (though, surprisingly, their ability to regenerate the lens is limited to hatchlings). He is working with Northeastern University chemical engineer Rebecca Carrier, who's been developing materials for use in transplantations. Her collaborators are testing transplants in pigs and people, but find most of the transplanted cells are dying. Perhaps some additional material could create a pro-regeneration environment, and perhaps axolotls could suggest some ingredients.

Carrier and Monaghan experimented with the transplanted pig cells in lab dishes, and found they were more likely to survive and develop into retinal cells if grown together with axolotl retinas. The special ingredient seems to be a distinct set of chemicals that exist on axolotl, but not pig, retinas. Carrier hopes to use this information to create a chemical cocktail to help transplants succeed. Even partially restoring vision would be beneficial, Monaghan notes.

Thanks to genetic sequencing and modern molecular biology, researchers can continue to unlock the many remaining mysteries of regeneration: How does the wound epithelium create a regeneration-promoting environment? What determines which cells migrate into a blastema, and which stay put? How does the salamander manage to grow a new limb of exactly the right size, no larger, no smaller? These secrets and more remain hidden behind that Mona Lisa smile - at least for now.

This article originally appeared in Knowable Magazine, an independent journalistic endeavor from nonprofit publisher Annual Reviews.

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Some Salamanders Can Regrow Lost Body Parts. Could Humans One Day Do the Same?

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As amphibians go, axolotls are pretty cute. These salamanders sport a Mona Lisa half-smile and red, frilly gills that make them look dressed up for a party. You might not want them at your soiree, though: They're also cannibals. While rare now in the wild, axolotls used to hatch en masse, and it was a salamander-eat-salamander world.

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Organ transplants can be a very long process for many. Some wait 1 year and some wait more than 5 years for a suitable match for a transplant. However in the the near future, this may not be an issue since researchers have been able to successfully 3D-print organs. These 3D-printed organs are able to mimic real organs but, it has not yet been confirmed whether they will work and function the same as a real organ. Besides this, the use of stem cells and the artificial organs can change the lives of many patients who have long awaited an organ transplant or repair. Therefore, this new innovation of artificial organs would help with the organ donor shortages and save many lives.

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This is a 3d printing machine and it would play a huge part in the making of artificial organs. 

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A picture that reminds me of Artificial Organs. 

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A picture that reminds me of Artificial Organs. 

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Artificial Intelligence (AI) in Healthcare & Medical Field

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Discover the benefits and examples of AI in healthcare with ForeSee Medical. ✓ Learn how artificial intelligence helps the medical field & improves care.

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The gist of this article is mainly to express more about artificial intelligence in healthcare and how this can further benefit our future. I find this interesting due to the fact that in our modern-day, technology has advanced over the course of decades and since this is the case, AI in healthcare would be something to expect since it helps us with other tasks in our daily lives such as getting transportation or even to just order food to us with a click of a button.

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As of March 2022, the U.S. Food and Drug Administration had approved over 60 immunotherapies that together cover almost every major cancer type:

1. Aldesleukin (immunomodulator) for kidney cancer and melanoma

2. Alemtuzumab (targeted antibody) for leukemia

3. Amivantamab (bispecific antibody) for lung cancer

4. Atezolizumab (checkpoint inhibitor) for bladder, liver, and lung cancer, and melanoma

5. Avelumab (checkpoint inhibitor) for bladder, kidney, and skin cancer (Merkel cell carcinoma)

6. Axicabtagene ciloleucel (CAR T cell therapy) for lymphoma

7. Bacillus Calmette-Guérin [BCG] (vaccine) for bladder cancer

8. Belantamab mafodotin-blmf (antibody-drug conjugate) for multiple myeloma

9. Bevacizumab (targeted antibody) for brain, cervical, colorectal, kidney, liver, lung, and ovarian cancer

10. Blinatumomab (bi-specific T cell-engaging antibody) for leukemia

11. Brentuximab vedotin (antibody-drug conjugate) for lymphoma

12. Brexucabtagene autoleucel (CAR T cell therapy) for leukemia and lymphoma

13. Cemiplimab (checkpoint inhibitor) for lung cancer and skin cancer (basal cell carcinoma andcutaneous squamous cell carcinoma)

14. Cetuximab (targeted antibody) for colorectal and head and neck cancer

15. Ciltacabtagene autoleucel (CAR T cell therapy) for multiple myeloma

16. Daratumumab (targeted antibody) for multiple myeloma

17. Denosumab (targeted antibody) for sarcoma

18. Dinutuximab (targeted antibody) for pediatric neuroblastoma

19. Dostarlimab (checkpoint inhibitor) for uterine (endometrial) cancer

20. Durvalumab (checkpoint inhibitor) for lung cancer

21. Elotuzumab (targeted antibody) for multiple myeloma

22. Enfortumab vedotin-ejfv (antibody-drug conjugate) for bladder cancer

23. Gemtuzumab ozogamicin (antibody-drug conjugate) for leukemia

24. Granulocyte-macrophage colony-stimulating factor, or GM-CSF (immunomodulator) for neuroblastoma

25. Hepatitis B Vaccine (Recombinant) (preventive vaccine) for liver cancer

26. Human Papillomavirus Quadrivalent (Types 6, 11, 16, 18) Vaccine, Recombinant (preventive vaccine) for cervical, vulvar, vaginal, and anal cancer

27. Human Papillomavirus 9-valent Vaccine, Recombinant (preventive vaccine) for cervical, vulvar, vaginal, anal, and throat cancer

28. Human Papillomavirus Bivalent (Types 16 and 18) Vaccine, Recombinant (preventive vaccine) for cervical cancer

29. Ibritumomab tiuxetan (antibody-drug conjugate) for lymphoma

30. Idecabtagene vicleucel (CAR T cell therapy) for multiple myeloma

31. Imiquimod (immunomodulator) for skin cancer (basal cell carcinoma)

32. Inotuzumab ozogamicin (antibody-drug conjugate) for leukemia

33. Interferon alfa-2a (immunomodulator) for leukemia and sarcoma

34. Interferon alfa-2b (immunomodulator) for leukemia, lymphoma, and melanoma

35. Ipilimumab (checkpoint inhibitor) for colorectal, liver, and lung cancer, and melanoma and mesothelioma

36. Isatuximab (targeted anytibody) for multiple myeloma

37. Lisocabtagene maraleucel (CAR T cell therapy) for lymphoma

38. Loncastuximab tesirine​ (antibody-drug conjugate) for lymphoma

39. Margetuximab (targeted antibody) for breast cancer

40. Mogamulizumab (targeted antibody) for lymphoma

41. Naxitamab-gqgk (targeted antibody) for neuroblastoma

42. Necitumumab (targeted antibody) for lung cancer

43. Nivolumab (checkpoint inhibitor) for bladder, colorectal, esophageal, GEJ, head and neck, kidney, liver, lung, and stomach cancer, lymphoma, melanoma, and mesothelioma

44. Obinutuzumab (targeted antibody) for leukemia and lymphoma

45. Ofatumumab (targeted antibody) for leukemia

46. Panitumumab (targeted antibody) for colorectal cancer

47. Peginterferon alfa-2b (immunomodulator) for melanoma

48. Pembrolizumab (checkpoint inhibitor) for bladder, breast, cervical, colorectal, esophageal, head and neck, kidney, liver, stomach, lung, and uterine cancer as well as lymphoma, melanoma, and any MSI-H or TMB-H solid cancer regardless of origin

49. Pertuzumab (targeted antibody) for breast cancer

50. Pexidartinib (immunomodulator) for tenosynovial giant cell tumor

51. Polatuzumab vedotin (antibody-drug conjugate) for lymphoma

52. Poly ICLC (immunomodulator) for skin cancer (squamous cell carcinoma)

53. Ramucirumab (targeted antibody) for colorectal, esophageal, liver, lung, and stomach cancer

54. Relatlimab (checkpoint inhibitor) for melanoma

55. Rituximab (targeted antibody) for leukemia and lymphoma

56. Sacituzumab govitecan-hziy (antibody-drug conjugate) for bladder and breast cancer

57. Sipuleucel-T (vaccine) for prostate cancer

58. Tafasitamab (targeted antibody) for lymphoma

59. Tebentafusp-tebn (bispecific antibody) for melanoma

60. Tisagenlecleucel (CAR T cell therapy) for leukemia (including pediatric) and lymphoma

61. Tisotumab vedotin (antibody-drug conjugate) for cervical cancer

62. Trastuzumab (targeted antibody) for breast, esophageal, and stomach cancer

63. Trastuzumab deruxtecan (antibody-drug conjugate) for breast, esophageal, and stomach cancer

64. Trastuzumab emtansine (antibody-drug conjugate) for breast cancer

65. T-VEC (oncolytic virus) for melanoma

New immunotherapies are being developed and immunotherapy clinical trials are under way in nearly all forms of cancer.

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Maella Lemon: Rehab in Virtual Reality, Isabel Van de Keere

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Maella Lemon: Rehab in Virtual Reality, Isabel Van de Keere

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Summary:
This article details an incredible innovation classified as "digital therapeutics for neuro-rehabilitation." This therapy involves the use of virtual reality to assist and exercise patients afflicted with conditions like a stroke or multiple sclerosis. This uses motivating digital graphics to solute the physical limitations of physical rehab.

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Immersive Rehab - Digital Therapeutics NeuroRehabilitation Programs

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Digital Therapeutics for NeuroRehabilitation Immersive Rehab creates engaging and motivating digital therapeutics solutions to existing limitations of neurorehabilitation services. By using Immersive Rehab's Virtual Reality NeuroRehabilitation Platform, we are providing an engaging and motivating solution to the current limitations of physical & neuro-rehabilitation, in particular for people with important neurological upper limb mobility limitations and...

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Summary; Laparoscopic surgery is the new way technology is used during surgery. The way it´s used is by diagnosing a wide range of conditions that develop in the abdomen or pelvis. It can also carry out damaged tissue for further testing and damaged or diseased organs. The benefits of this surgery are less pain, shorter hospital time, fewer complications, shorter recovery time, and smaller surgery scars. It was invented in the 1980s but was perfected in the 21st century and began to be used by doctors across the world.

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Wouldn't it be a wonderful world if no one had to fear a cancer diagnosis? What about knowing that a loved one wouldn't have to be put on a waiting list for an organ donation?

Every day, scientists and doctors are working hard to make medical advancements. The 21st century is only 19 years old, and we have already had some pretty amazing breakthroughs.

From the completion of the human genome draft to cutting-edge cancer treatments, there are some incredible medical breakthroughs that are changing the way conditions and diseases are treated.
‍ These advancements are in no particular order as each one is important in its own right.

Medical Breakthrough #1: Artificial Organs

Because of accidents, diseases, and birth defects, there's a constant need for organ transplants to continue a life. Currently, our only option is organ donation. While this is a great way to correct a problem, it takes either a living donor or a donor who has died to make this possible.

The emotional baggage that comes with accepting an organ from another person is tremendous - not to mention the worrying that takes place wondering if the new organ will be accepted or rejected.

Endless amounts of time and resources are being devoted to growing artificial organs in labs. Progress is being made, although it's a slow, painstaking process as organs are so complex.

According to Science Museums, there are 6 organs currently being grown in labs with some success:

Liver: using stem cells, scientists have grown liver cells that when transplanted into mice, have actually formed their own blood supply and matured into adult liver cells. When tested, these livers showed some normal liver functions. Hopes are that eventually, doctors can transplant fully-functioning lab-grown livers in humans.

Medical Breakthrough #2: HIV Treatments

HIV, or AIDS, treatments have come a long way since the inception of the disease in the 1980s. Originally, treatment consisted of a single regimen that was ineffective because there were many medications taken individually. It was hard for patients to stay on schedule taking so many medications, and the side effects were numerous.

The monotherapies (single drug treatments) also allowed HIV to change or mutate into a form that eventually stopped responding to the individual drugs. In other words, the disease was becoming immune to the treatments available.

In 2006, the FDA approved Atripla which combined three antiretroviral drugs into one which improved the treatment for AIDS. With three drugs being compiled into one, it was easier to stay on schedule, and the side effects were decreased.

Stribild, a medication approved for HIV patients in 2013, combined four HIV antiretroviral medications into one dose, which was even more effective in controlling the symptoms for these patients.

November of 2017 saw a big breakthrough in treating HIV. According to the FDA, Juluca was approved and was the first two-drug single-dose treatment for AIDS patients that were already on an antiretroviral treatment regimen. This was great for those patients, but patients that were not on an antiretroviral treatment already were still out of luck.

In April of 2019, Dovato, a two-drug single-dose treatment for HIV was approved for people who have not been on antiretroviral therapy. This breakthrough now makes it possible for all HIV patients to be on an effective single-dose therapy.

Medical Breakthrough #3: Functional MRI (Magnetic Resonance Imaging)

Functional MRIs, or fMRIs, are making it possible for doctors and scientists to virtually read minds.

Regular MRIs allow doctors to see how the brain looks, whereas fMRIs allow them to see what the brain does.

Doctors can actually track changes in the brain cells, oxygen levels, blood circulation, and how the neurons function, showing which parts of the brain are involved in specific activities.

By looking at normal, diseased, and injured brains, researchers can assess the brain and spinal cord without invasive procedures or using painful drug injections.

Medical Breakthrough #4: Controlling Heart Disease

Thanks to advancements in the area of cardiovascular health, deaths due to heart disease have dropped significantly over the past 10 years.

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If attended to quickly, a person having a heart attack can be successfully treated by busting the blockage that prevents the blood from circulating with t-PA, a genetically engineered tissue plasminogen activator.

Plaque in the blood vessels can then be opened by the use of a stent which is put into the artery. The damaged artery is then replaced with a new vessel through a procedure referred to as bypass surgery.

These advancements have dramatically increased the survival rate of heart patients.

Medical Breakthrough #5: Targeted Therapy in Cancer Treatment

Until recently, chemotherapy and radiation therapy were the only choices for treating cancer patients. These therapies not only attack cancerous cells, but they also attack the healthy cells which causes a new set of problems.

When given the option of these types of treatment or none at all, the chance of killing the cancer usually outweighs the result of having the cancer, so the side effects are expected and are dealt with as they come.

1. Interfere with the spread of cancer by blocking the cells that are involved in the tumor growth

2. Identifying and killing the deadly cancer cells

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Within the past 10 years, targeted cancer therapies have been developed that will work in one of two ways:

Either way, they target the cancerous cells and attack them but leave the healthy cells alone.

Researchers are focusing their energy on targeted therapies, and more than 25 drugs have been approved by the FDA for this purpose.

These targeted therapy drugs will allow treatments to be individualized based on each individual's tumor molecular makeup. This type of treatment does away with the side effects caused by chemo and radiation, which is great news for those affected by this disease.

Medical Breakthrough #6: Cyberknife

The cyberknife has opened up a whole new wave of treating patients. Surgeries that are not possible through conventional methods might be possible with the cyberknife because of the minimally invasive techniques it employs.

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The cyberknife uses a combination of robotics and imaging to attack cancerous and non-cancerous tumors. Using intense precision, it kills tumors with high doses of radiation.

No incisions

Minimally invasive

Less downtime after surgery

Less opportunity for infection

More effective than conventional surgery

Benefits of cyberknife technology include:

Medical Breakthrough #7: Bionic Prosthetics
Bionic limbs such as hands, arms, feet, and legs can be positioned through the use of an app on the iPad or a computer.

People who have lost limbs or are born without them now have the opportunity to replace that missing piece of their body with a fully functional device.

3-D computer models use socket designs to make these limbs useful and feel as real as possible.

Imagine the happiness a little boy feels when he gets to run again with the use of a bionic leg, or the joy a young girl feels when she does her own make-up and hair for prom with the use of her bionic hand.

Medical Breakthrough #8: Nanomedicine

The application of nanotechnology in medicine is an innovative use of nanomaterials. These nano (tiny) biosensors and nanoparticles make it possible to perform a corrective procedure right in the affected molecules.

Progress in this area has been quick with almost 130 drugs developed around the world.

When using nanomedicine, it is possible to target areas of infection or diseased areas without harming the surrounding tissue.

Medical Breakthrough #9: 3-D Printed Body Parts

Originating at the turn of the 21st century, it was found that living cells could be sprayed through inkjet printers without being harmed in any way.

Today, different cell types are combined with polymers and sprayed through various printheads. According to Reader's Digest, the polymers help the cell structure keep its shape making it possible to spray layers upon layers that bind together and grow into living, functional tissues.

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Body parts that have been successfully printed include:

Scientists have taken printed muscles and ears and planted them into animals which unified with their hosts. They have actually implanted printed ovaries into mice who conceived and gave birth with these artificial organs.

It is exciting to think of the possibilities that 3-D printing can offer for the human race.

Medical Breakthrough #10: Laparoscopic Surgery

Less pain

Shorter hospital stays

Fewer complications

Shorter recovery time

Smaller scars

Laparoscopic surgery has become as much of a normal procedure as conventional surgery. This minimally invasive surgery is done through one or more small incisions using small tubes and tiny cameras and instruments.

Benefits of laparoscopic surgery include:

Although this procedure was developed in the 1980s, it wasn't until the 21st century that it was perfected and began being used in many surgical specialities.

The use of laparoscopic surgery has opened the door to minimally invasive surgeries allowing patients that might not be able to withstand a conventional procedure the opportunity to obtain a cure.

Medical Breakthrough #11: New Class of Antibiotics

We are facing a major global health threat with the large increase in bacterial resistance against our current antibiotics.

It has been 30 years since a new class of antibiotics has been discovered. As we grow and evolve, we tend to develop a resistance to what we have been given over the years.

Teixobactin is a new class of antibiotics that is being developed to combat multidrug-resistant bacterial pathogens that are currently being used.

Teixobactin is a natural compound that can help us wipe out the superbugs that are invading our culture. Scientists are making great progress towards developing a version of teixobactin that can be prescribed to humans.

They are hopeful that this new class of antibiotics will aid in killing serious infections such as septicaemia and tuberculosis.

Medical Breakthrough #12: Completion of the Human Genome Draft

The human genome is all the genes that make up our DNA. In 2013, scientists completed the first ever draft that sequenced the human genome.

Information from DNA is used to develop new ways to treat, cure, or even prevent thousands of diseases affecting humankind.

Gene sequencing has already helped researchers identify single genes that cause diseases, enabling them to create treatments. This gene therapy is a huge step toward biomedical advancements.

The hope held by the medical community and the public is that the human genome draft sequencing will allow scientists and researchers to develop treatments or even cures for all diseases.

Medical Advancements Will Continue!

Throughout times, scientists have spent immeasurable hours and resources hunting for medical advancements that will save the lives of the people. When they encounter breakthroughs like the ones of the 21st century, we can see how important their work is for everyone.

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Scientific research is a slow but necessary process. Although some of these breakthroughs aren't immediately usable, we can see where they will become relevant as scientists and researchers continue their work.

Treating and even curing diseases through scientific breakthroughs in order to improve the quality of life is on the rise; what a great time to be alive!

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12 of the Biggest 21st Century Medical Advancements

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Wouldn't it be a wonderful world if no one had to fear a cancer diagnosis? What about knowing that a loved one wouldn't have to be put on a waiting list for an organ donation? Every day, scientists and doctors are working hard to make medical advancements.

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The main idea of this article is personalized medicine has a rather broad term, but ultimately, we're discussing how to use genetics or some other biomarker knowledge to guide treatment recommendations for individuals. These judgments might include who should receive certain types of medicines or certain dosages of a given therapy, or who should be followed more closely because they are prone to a specific safety concern. Bioinformatics, pharmacogenetics, personalized medicine, and pharmacogenomics are all names that have been used to describe the investigation of gene mutations and their impact on how people react to pharmaceuticals.

In general, personalized medicine has two components. The therapeutic intervention (drug, biologic, or other) comes first, followed by the diagnostic test. They are to create multi-center policies on personalized medicine including the Center for Devices and Radiological Health (CDRH), the Center for Biologics Evaluation and Research, and other FDA departments, in addition to CDER's rules. From roughly 2008 to 2011, it was difficult to organize such connections, in my opinion, primarily because the centres weren't really nearby to one other.