Tuesday, June 25, 2013

10 technologies that could change the world


Home News by technology World of tech 10 technologies that really could change the world
10 technologies that really could change the world
IN DEPTH Phone tracking, biohacking and alternatives to fracking
By Gary Marshall 12 hrs ago

We're told that all kinds of technologies changed the world - Popular Mechanics' list includes the stapler - but today's researchers are working on ideas even more ambitious than joining several bits of paper together.
New technologies could replace fossil fuels, turn your house into a power station, save thousands of lives - and maybe even create new lifeforms.
Here are 10 technologies that have the potential to change the world all over again.
1. Phones

In developing countries the phone is more important than the PC: mobiles are used for banking, and for forecasting the weather (a critical business when a farmer has to pick the best time to sow or reap a precious crop). But phones can do even more.
For example, in Africa cell phone tower data is used to map people's movements - and that mapping can help track diseases such as malaria and identify patterns of transmission.
Phone location data might also be useful in dealing with natural disasters, improving public transport or just helping retailers make shopping malls more profitable.
Phone tracking data is already fighting infectious diseases, and might help with disasters too Is Firefox OS the key to bringing smartphones to the world?
2. Digital imaging

As imaging technology improves we'll see our world like never before, both outside and inside. DARPA recently showed off a 1.8 gigapixel surveillance drone that can watch 25 square kilometres at a time, while advances in medical imaging tech enable doctors to look inside patients with unprecedented levels of detail.

3. Better fibre-optic cables

Fibre-optic cabling has been around since the 19th century, but it wasn't until 1970 that the problem of attenuation - signals degrading over distance - was solved.
Since then fibre-optic has become part of the fabric of the internet, but it's a fabric that, for most people, stops long before it gets to their house.
When fibre broadband finally makes it into every home - which it will, albeit not until some of us are really, really old - it promises to revolutionise the way people use the internet all over again.
Fibre everywhere means internet-connected services we can't even imagine
Sattelite broadband can speed things up too. Here's what you need to know

4. Mind-controlled prosthetics

DARPA calls it Targeted Muscle Re-innervation, or TMR for short. We call it astonishing: TMR makes brain-controlled prosthetic limbs almost as responsive as real ones, providing sensory feedback that enables prosthetic users to riffle through a bag or grab an object without having to look at it.
From electronic eyes to entire exoskeletons, the combination of serious technical talent and enormous piles of cash is bringing us ever closer to a cybernetic future.

While you wait for your robot arm, the robots are working on their writing skills
5. 3D printing

3D-printed guns and drugs may get the headlines, but the real effect of 3D printing is likely to be less sensational and much more useful.
It's already helping to revolutionise manufacturing by slashing research and development costs, and in the longer term it might mean that instead of ordering online and waiting for couriers to deliver, we'll just print products at home - maybe even food.
That's good for the environment but could have disastrous consequences for many people's jobs.

6. Small, smart sensors

Research firm ON World reckons that in 2017, firms will ship some 515 million sensors for wearable, implantable or mobile health and fitness devices, and that's just the tip of an electronic iceberg.
Networks of small, smart sensors could change health care, finally make home automation something people actually use, help you find a parking space or look for aliens on Mars.

7. Predictive policing

The row over the Prism surveillance system rumbles on, but there's no doubt that the technology to watch people's every move exists: one version, dubbed RIOT, mines public websites such as social networks to build up a surprisingly detailed picture of individuals and their likely future behaviour.
Another, PREDPOL, uses algorithms and mapping data to predict where and when crimes are likely to occur. Put them together, add a bit of Tom Cruise and you're getting awfully close to Minority Report-style policing where the cops turn up before the crime is committed.
Predicting where crime's likely to occur and when it'll happen? There's an app for that
Just how scared of the Prism surveillance program should you be?
8. Serious solar

Solar technology has been held back by several issues: solar panels are hefty, pricey, and of course they don't provide energy when it's dark. The biggest problem, though, is efficiency: as National Geographic reports, they only capture 10 to 20 percent of the sunlight that strikes them.
The future? Nanotech that makes the panels much less reflective, much cheaper to produce and much more efficient. Other ideas include tiny antennae on devices that capture solar energy and instantly convert it to power, solar panels that can actually store energy, and nanotech paint that turns entire buildings into solar energy collectors.
Solar panels are famously inefficient, but nanotech could solve that problem (Credit: Mhassan Abdollahi)
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9. Biohacking

There's a controversy brewing on Kickstarter: the Glowing Plant project plans to engineer glow-in-the-dark plants, and some experts are worried: they fear that this is the thin end of a very big and scary wedge.
As Nature reports, "they fear that distributing the plants could set a precedent for unsupervised releases of synthetic organisms, and might foster a negative public perception of synthetic biology - an emerging experimental discipline that involves genetically engineering organisms to do useful tasks."
Biohackers could engineer entirely new lifeforms, good or bad, and the emerging sector is almost entirely unregulated. Friends of the Earth has called for a global moratorium on the release of synthetic organisms "until the proper regulations and safety mechanisms have been put in place".

10. Genetic scanning

The MyGenome iPad app is a glimpse of the future, enabling you to analyse the full genetic makeup of someone. For now that someone is the developers' CEO, but if DNA sequencing prices continue to plummet - the cost per person has dropped from US$2.7 billion to US$5,000 in ten years - then full genome analysis could be in many of our futures.
That could have profound implications: we could discover if we're prone to particular kinds of cancer, or if we have higher than average risks of various unpleasant conditions, or if particular drugs could kill rather than cure us.
Angelina Jolie's recent preventive surgery was an example of DNA sequencing in action: Jolie has the BRCA1 gene, which means she has a high risk of developing the breast cancer that killed her mother.
As Carole Cadwalladr writes in The Guardian: "revealing our full DNA will revolutionise medicine - but it will also raise huge ethical questions about what we do with the information".
Genomic medicine could warn us of any ticking time-bombs that might lurk in our genetic make-up
You can't control your genes, but you can enhance your body with this wearable tech



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Saturday, June 22, 2013

A new blog for seniors with IOS devices

It is not that I don't have enough to do, I do. In any case I am starting a blog for those of us who have reached the ranks of Seniors and own an iOS device. As simple as these devices are to operate, we seniors often don't know about all their capabilities or the tricks of the trade when using them.

Now for those that are not sure if they do or not have an iOS device, iOS devices are iPhones, iPads, iPods, and Apple TVs.

Having said that, from time to time I will post informational items, tips, and tricks I have found and I think you might find useful. For example, coming very soon is a post on changes coming to Apple TV, not to mention IOS 7, the new iPads as well as iPhones, so check back often.

If you have friends or family that might be interested let them know about this effort at well. We are at http://seniorsipad.blogspot.com/

For questions or comments email me at gwtr0940@icloud.com


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Thursday, June 20, 2013

State Health Cost Websites Not Much Help

Health Cost Websites Not Much Help
By Salynn Boyles, Contributing Writer, MedPage Today
Published: June 19, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
Action Points
A growing number of state-run websites are designed to help consumers compare the cost of healthcare services, but most lack critical pricing information and aren't all that useful, a study found.
The study authors suggest that by focusing information on services that are predictable, non-urgent, and subject to deductibles (e.g., routine outpatient care for chronic diseases), greater relevance to patients could be provided.
A growing number of state-run websites are designed to help consumers compare the cost of healthcare services, but most lack critical pricing information and aren't all that useful, a study found.

Most of the 62 state-sponsored websites studied focused on in-hospital services rather than routine, non-urgent outpatient care, and most reported "billed" charges instead of the negotiated fees patients usually end up paying, according to the study, which was published in the June 19 issue of the Journal of the American Medical Association.

Although pricing transparency has improved greatly over the past few years, patients are still not getting the information they need to make informed decisions about healthcare spending, said lead author Jeffrey Kullgren, MD, MPH, of the Ann Arbor (Mich.) VA Health Care System and the University of Michigan Medical School.

"Ours is really the first empirical effort to examine what is being reported and identify specific areas that can be improved upon, and we did find clear opportunities to make these sites more relevant to consumers," Kullgren told MedPage Today.

With almost one in three privately insured adults now enrolled in high-deductible plans, providing usable pricing information to help consumers anticipate their out-of-pocket costs and understand their options is critical, he said.

Between January and May of 2012, the University of Michigan and Ann Arbor VA researchers conducted systematic Internet searches to identify publicly available state-run websites designed to do just that.

They excluded websites run by specific health plans, because those sites are usually intended for enrollees only. Websites run by third parties were also excluded from the analysis.

As of early 2012, the researchers identified 62 websites run by state government agencies or hospital associations. About half (46.8%) had been launched since 2006.

The analysis revealed that:

Most of the websites reported prices for inpatient care involving specific medical conditions (72.6%) or surgeries (71%).
Far fewer sites reported pricing information for more routine outpatient services, such as diagnostic or screening procedures (37.1%), radiology studies (22.6%), prescription drugs (14.5%), or lab tests (9.7%).
Most websites included only the billed charges (80.6%). For services that included facility and professional fees, most price estimates (66%) included only the facility fee.
Fewer than one in 10 (9.7%) price estimates incorporated patient insurance status or specific health plan information (8.1%). And for nonstandardized services -- outpatient surgery, for example -- quality information was rare (13.2%).
"Greater relevance to patients could be realized by focusing information on services that are predictable, non-urgent, and subject to deductibles (e.g., routine outpatient care for chronic diseases) rather than services that are unpredictable, emergent, or would exceed most deductibles (e.g., hospitalizations for life-threatening conditions)," the researchers wrote.

Likewise, basing cost estimates on negotiated payments and not the bills patients see would provide more useful information to consumers, but only a few state-run websites are doing this, Kullgren said.

"We often hear that negotiated rates are proprietary information, but an increasing number of states have passed laws that allow them to collect and report those data so this is not as big of an issue as it once was," he added.

He cited New Hampshire's 'HealthCost' site as a consumer-friendly website that succeeds in giving patients useful information about healthcare costs.

Patients who provide their ZIP code, insurance provider, deductible, and coinsurance can obtain estimates of what they would be expected to pay and what their insurer would pay for a medical procedure or service at facilities in their area, based on negotiated rates.

One other challenge is reporting the entire cost of a procedure, such as a colonoscopy, when there are facility fees and multiple specialists involved, Kullgren said.

"Ideally, if the goal is to inform patient decisions, we need to pull together a price that reflects the full episode of care as opposed to piecemeal reporting," he said.



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Wednesday, June 12, 2013

A Leadless Pacemaker Shows Promise

Leadless Pacemaker Shows Promise
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: May 12, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

DENVER -- A small leadless device implanted via a catheter into the heart appears to be feasible for single-chamber pacing, a first-in-man study showed.

The leadless cardiac pacemaker was successfully implanted in 32 of 33 patients attempted (97%) and performed for pacing the same as expected with traditional lead-based pacemakers, Vivek Reddy, MD, of Mount Sinai School of Medicine in New York City, and colleagues found.

"This is a relatively small feasibility study but raises the possibility of eliminating what has been the weakest link in pacemakers: the lead," Reddy told attendees during a late-breaking session at the Heart Rhythm Society (HRS) meeting here.

Standard pacemakers are highly reliable, but the risk of complications range from about 7% to 8% over the life of the device, including lead fracture, infection, and pocket hematomas, he noted at an HRS press conference.

Eliminating the surgical pocket isn't such a big deal, because the implantation is such a minor surgery, commented Gordon Tomaselli, MD, of Johns Hopkins University in Baltimore and a past president of the American Heart Association.
."That's not the game changer here, the game changer is no lead. You can ask anybody who has done this for a long time; leads are the bane of our existence," he said in an interview with MedPage Today. "And if you can easily get these devices out and replace them, it's going to be great for selected patients."

The novel pacemaker is the size of a AAA battery and is implanted by screwing the end into the heart tissue. It can be retrieved or repositioned by simply grabbing the end with a snare and unscrewing it.

Two such cases were documented in the study:

Case 1: Reposition the pacemaker into the right ventricular apex after it had inadvertently been placed in the left ventricle via a patent foramen ovale
Case 2: Replace the pacemaker with an implantable cardioverter-defibrillator (ICD) due to repeated syncope and spontaneous ventricular tachycardia after discharge home with the leadless device
The explantation took 6 minutes in the first case and 13 minutes in the second.

"This is proof of principle in at least two patients," Reddy said.

Preclinical work showed that the device could be removed just as easily at 6 months, although that hasn't been tested in humans yet, Reddy pointed out.

He said it also is expected to be "inherently" MRI compatible, because "magnetic induction can't reach a leadless pacer," although this also hasn't been tested.

The device uses a lithium composite phosphate battery that should last 8 to 17 years, dependent on pacing parameters.

A major problem in the trial was a single case that wasn't successfully implanted. That 70-year-old patient sustained a cardiac perforation and tamponade during implantation and then died from a large right-sided stroke in the hospital 5 days after the procedure.

The only other adverse event among the 33 cases in the LEADLESS first-in-man study was a minor groin hematoma that didn't require treatment.

The device is going into commercial sale in Europe this year, with a large multicenter study anticipated to start in the U.S. next year.

It is only capable of single chamber pacing currently, but it is being developed for atrial use to allow multi-chamber pacing, Reddy said.

There's little chance the technology could be developed as an ICD, Tomaselli noted.

"The capability to deliver large amounts of energy isn't there," he explained. "It's exclusively for pacing. The ICD lead does a lot of things, not only detect heart rate but also some rhythm discrimination. This device is limited in that regard."




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Friday, June 7, 2013

New Drugs Slow a Fast-Spreading Cancer

New Drugs Slow a Fast-Spreading Cancer - WSJ.com
The Wall Street Journal by JONATHAN ROCKOFF

New generations of drugs have helped given victims of multiple myeloma hope for longer survival. WSJ’s Jonathan Rockoff and International Myeloma Foundation co-founder and chairman Dr. Brian Durie discuss on Lunch Break. Photo: AP.

Two new drugs for multiple myeloma, approved in recent months, promise to extend life expectancy for patients with the blood cancer.

They follow new treatments that over the last decade have transformed the prognosis for multiple myeloma—once a short death sentence—into a manageable condition that can be survived for up to seven years or more. There is still no cure for the disease.

The new drugs were approved for patients whose blood cancer returned after developing resistance to older treatments.

Karen Countryman is one of those patients. When she was diagnosed in 2004, doctors gave her three years to live, she recalled. She underwent the standard treatment of the time, a harsh regimen of chemotherapy and a stem-cell transplant. The first of a wave of myeloma drugs had just been approved. And after her blood cancer returned in 2008, Ms. Countryman turned to one of the new therapies and then to others as her myeloma progressed.

Her myeloma remains in check, she says. “It’s a miracle, and this is all due to new drugs and research,” said Ms. Countryman, a 63-year-old nurse from Boise, Idaho. She is currently finishing a course of treatment with one of the newest drugs, Kyprolis.

Taken intravenously, Kyprolis was greenlighted last July. The newest myeloma treatment, a pill called Pomalyst, was approved last month.

They follow four other drugs that were cleared since 2003 to treat multiple myeloma, a cancer that starts in the soft, spongy marrow inside bones that makes blood cells. From there, myeloma spreads, damaging bones, kidneys and the immune system.


What Is Multiple Myeloma

What causes it: Multiple myeloma, a.k.a. blood cancer, occurs when plasma cells (which make antibodies that help the body fight infections) grow out of control in the bone marrow, forming tumors in bones. As these tumors grow, the ability of bone marrow to make healthy blood cells and platelets diminishes.
How many people have it: In 2013, an estimated 22,350 cases will be diagnosed and an estimated 10,700 people will die.
How long patients live with it: In 2001, life expectancy was 3.5 years. By 2010, it grew to 7.3 years. Today, it’s believed by many researchers to be as long as 10 years, but there is no hard data yet to support that time frame.
Cost of the newest drug regimens: Around $10,000 a month for Pomalyst; $9,950 a month for Kyprolis
Each year, nearly 22,000 people in the U.S. are diagnosed with the condition, many of whom are 65 years or older. More than 10,000 patients will die.

Yet thanks to all of the new drugs, the median survival for patients has doubled over the last decade, according to Brian Durie, co-founder and chairman of the International Myeloma Foundation.

“The focus has shifted from just keeping patients alive” to giving them a good quality of life while they manage the disease, said Dr. Durie, who is also a myeloma doctor at Cedars-Sinai Medical Center in Los Angeles. He has worked with several drug makers who sell and are researching myeloma treatments.

The wave of new drug development in myeloma dates to the late 1990s and early 2000s, when researchers were scouring old treatments for one that might have an impact on the cancer.

At that time, a myeloma prognosis could mean a few years to live. Paula Van Riper, who was diagnosed in late 1999, underwent hip replacement surgery to remove a large tumor. Afterward, she recalled being told by doctors to hold off treatment, since there weren’t any good options available until the disease worsened.

“It never occurred to me that I would be around 13 years later, feeling well, going to work every day and thinking maybe I can retire,” said Ms. Van Riper, 65, an assistant dean at Rutgers University in New Jersey, who is now taking Pomalyst.

A turning point in the treatment of myeloma, doctors say, was the discovery in the late 1990s that a controversial drug called thalidomide had an impact.

Thalidomide was famously pulled as a sleeping pill in 1962, after it was associated with birth defects. But it turned out to have a positive impact on myeloma, interfering with the surrounding environment in the bone marrow that the cancer cells need to flourish. Thalidomide’s success drew researchers and drug makers into the hunt for even more treatments.

Velcade, approved in 2003, and Revlimid, a thalidomide successor approved in 2006, are now backbones of myeloma treatment, doctors say. The two drugs attack myeloma in different ways, and doctors tend to use them in combination and with other drugs because the combination amplifies the effect of the therapies.

Despite the new approvals, doctors like David Siegel still plan on typically starting patients with a combination of Velcade, Revlimid and a steroid called dexamethasone.

Dr. Siegel, chief of the myeloma division at John Theurer Cancer Center in Hackensack, N.J., further attacks the cancer by following up that combination with a heavy dose of a chemotherapy drug called melphalan. Dr. Siegel says he will then transplant stem cells in the bone marrow to restore the marrow killed by chemotherapy.

In most patients, these treatments will drive myeloma into hiding.

But the disease tends to return. Over the course of this cycle of relapse and remission, Dr. Siegel will draw from the full arsenal of available treatments, eventually including the two newly approved therapies.

However, for now, the U.S. Food and Drug Administration has approved Kyprolis and Pomalyst for later use by patients whose disease progressed after treatment with other therapies. Insurance companies are also steering use of the older drugs first, doctors say.

“In the end,” said Dr. Siegel, “everyone feels these drugs will move closer” to early use. He has worked with several drug makers, including Celgene Corp., the maker of Revlimid and Pomalyst; Onyx Pharmaceuticals Inc., which sells Kyprolis; and Takeda Pharmaceutical Co. Ltd.’s Millenium unit, which sells Velcade.

Treatment costs for both Kyprolis and Pomalyst run close to $10,000 a month.

A common side effect of some of the older therapies is a painful condition called peripheral neuropathy, which can cause tingling or numbness in fingers and feet. That is not an issue with Revlimid, Celgene says, and many doctors believe that won’t be as much of an issue with Kyprolis and Pomalyst.

Kyprolis and Pomalyst were associated with low blood-cell counts, a common problem with most anticancer therapies, which can hurt the body’s ability to fight off infections. Heart failure and shortness of breath were serious side effects seen with Kyprolis. Pomalyst shouldn’t be used by pregnant women or women contemplating pregnancy because it can cause serious birth defects and life-threatening blood clots.

For all the gains in treating myeloma, the disease still lacks a cure for most patients. Doctors believe what is needed are drugs that work differently from the currently approved treatments.

“The problem in myeloma right now is many of the new drugs are in the same two classes,” said Vincent Rajkumar, a myeloma specialist at the Mayo Clinic. “If you want a sea change, you want a new class,” he added, because the cancer cells get smart and develop resistance to the older drugs.

Several new classes of drugs are in development. Among the furthest along in the pipeline is a monoclonal antibody called elotuzumab from Bristol-Myers Squibb Co., that several doctors singled out as promising.

The Multiple Myeloma Research Foundation, which encourages research collaborations between academia and industry and funds drug development, is also conducting a study whose results could be used to profile which patients will benefit from which treatment combinations.

A version of this article appeared March 5, 2013, on page D3 in the U.S. edition of The Wall Street Journal, with the headline: New Drugs Slow a Fast-Spreading Cancer.

The Wall Street Journal by JONATHAN ROCKOFF



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Monday, June 3, 2013

Big Data and medicine

The Georgetown Advocate
Webster Russell

Longitudinal data is a powerful analytical tool. Now that sentence is not one of those gems of wisdom you would hand down to your children or grand children, nor is it something you would lovingly whisper in the ear of a loved one. That being said, it is a truism that the longer the data stream the more accented the trends, therefore the better the decisions that can be made. OK enough of that statistical stuff, the real question is what in the heck has this got to do with our conversation? A great deal actually. One of the many things we have learned over our years in healthcare is that the quality and effectiveness of the healthcare you receive is in large part dependent upon your ability to effectively communicate with your physician.

When one of us was diagnosed with cancer, this premise was sorely tested. As you may very well know chemotherapy is fraught with potential side effects. The consequences of those side effects can be difficult to measure. Questions like, how do you feel, how is the pain, or how is the nausea may well focus your answers on the short term, and therefore doesn't really give your physician the long term information he/she needs to work with. This isn't only true of cancer treatment but with any long term therapeutic regimen as well.

Being married to a nurse and having spent 20 years at the bedside in the treatment and research arm of healthcare, I developed a real interest in integrating computers into the healthcare, and as you so astutely surmised it has continued to the present day.

Taking the truism I noted earlier and combining it with my interest in computers, we created a patient friendly chemo therapy log which is designed to give the oncologist the longitudinal (long term) data that can help him/her evaluate the side effects that occur secondary to chemo therapy. As sophisticated as it sounds, we did this with an iPad, a $10.00 app, a bit of creativity, and about 60 hours of design and testing. To say the least, it has really helped our physician and the patient evaluate and manage the chemo-therapy side effects.

So how does this help make you a tech savvy patient? It gives you and your physician some real long term information about how you believe you are really doing, and that is key to the successful approach to your treatment.



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