Braingate's 100 electrode array is tiny, but it opens up the entire world to paralyzed patients who can use it to communicate with computers.

The latest report from academia: when you hack someone’s brain to turn them into a cyborg, count on it lasting for a few years. Scientists developing Braingate, the revolutionary device that translates brain impulses into commands for computer cursors and robotic wheelchairs, recently announced that the cranial implant was still working in a patient 1000 days after it was installed. Paralyzed patients fitted with Braingate have electrodes hardwired into their neurons which allow them to connect to computers directly. They think about moving their body and a computer interprets that signal like the movements of a mouse or touchpad. A female patient known as S3 underwent five days of rigorous testing to see how well the brain-computer interface hardwired in her skull was functioning. While many of the electrodes had failed, the patient’s overall success with the device was still high when asked to move a cursor on a screen (91.3%). Watch examples of the tasks she performed in the video below. S3′s success means that patients fitted with brain implants like these may be able to go years between upgrades to their hardware, making the process that much more appealing. No doubt about it, Braingate is still in its early stages, but this technology is nothing short of extraordinary.

Brain-computer interfaces are fairly awe-inspiring on their own, but the longevity of Braingate is truly noteworthy. As mentioned in their report in the Journal of Neural Engineering, the scientists behind Braingate first implanted S3 with her device back in 2005. The ’1000 days later’ study was conducted in 2008. According to Brown University (where most of the Braingate team is associated) S3 continues to participate in clinical trials, suggesting her implant is still functioning at some level now almost another three years later! Braingate team members won’t comment on the most current data on S3 (as this latest work hasn’t been published yet) but I highly suspect I’ll eventually be writing another article about this device with ’2000 Days’ in the title.

Of course, even if S3′s brain implant has been functioning for six years it probably hasn’t been doing so at full capacity. During the 2008 study, scientists found that only about 41 of the electrodes in S3′s brain were providing meaningful signals. Originally she was implanted with a 4mm x 4mm array of 100 electrodes (96 of which connected successfully to some degree). That means that less than half of the array was still playing a meaningful role in the 1000 days trial. Will S3 continue to lose electrode connections as the implant ages? Perhaps. Yet her performance was still very high (91.3% success) after her signals were re-calibrated for the five day study. S3 was able to center a cursor inside shapes, and move it to random targets fairly well (both tasks you would want if you needed to replace a mouse with a brain-computer interface). Even with less electrodes functioning, S3 was doing well back in 2008. Hopefully Braingate is robust enough to work as the connections falter.

We are still very early in the development of brain-computer interfaces, but the stakes for early adopters is very high. S3 developed tetraplegia in the late 1990s after a stroke. She, like other Braingate patients, is almost completely paralyzed. These brain implants aren’t just cool gadgets, they’re lifelines to the outside world. As this technology improves, many more people with this kind of locked-in syndrome may be able to interact with the world again by directly controlling computers with their brains. Eventually we may perfect these systems to the point where anyone can use them. When that happens, we won’t want these implants to last 1000 days, or even 10,000 days – we’ll want them to last our entire lives. After all, once you can command a machine with your thoughts, why would you ever give that up?

[image credit: Matthew McKee/BrainGate Collaboration via Brown University News]
[video credti: Simeral et al JNE 2011 via IOP Science]
[sources: Braingate2, Simeral et al Journal of Neural Engineering 2011 (PDF), Brown University News]

Medtronic's proposed pacemaker is smaller than Lincoln's head.

Look at the nail on your smallest finger. Chances are that it’s about twice as big as the pacemaker Medtronic is hoping to build in the next five years. The Minnesota based medical technologies giant is developing the world’s smallest pacemaker, small enough to fit directly on the heart. Not only will this allow the tiny device to work without electrical leads (wires) it will mean the device can be inserted via a catheter. No major surgery required. Still in the research phase, Medtronic has already created the majority of necessary components for the tiny pacemaker: circuit board, oscillator, capacitor, memory, and wireless telemetry so that the device can ‘speak’ to external monitoring devices. The only real thing missing is a power source. That hasn’t stopped Medtronic’s Vice President for Medicine and Technology, Stephen Oesterle, from showing off prototypes of the device at last year’s TEDMED conference and more recently to Technology Review’s Emily Singer. (Catch the amazing pics to the side and below.) If eventually successful, Medtronic’s miniaturization of the pacemaker will be a major accomplishment – helping lower the risks and improve the benefits of these kinds of devices. This is another great example of how implants are becoming better, smaller, and more common as medical technology continues to advance.

Singularity Hub usually doesn’t review devices that are still firmly entrenched in the research phase. Yet this proposed miniature pacemaker isn’t simply another idea on paper. This is the same company that currently dominates the pacemaker market, with each generation of their products becoming smaller, more resilient, and better suited to modern medicine. (For instance, they recently unveiled a pacemaker that is safe for use in MRI machines.) When Medtronic sends its VP out into public forums to announce the arrival of a minuscule new device set to arrive in the next five years, you can bet they have the resources and expertise to bring that product to market. And the potential benefits of this device are huge.

Oesterle showed off concept designs for the new pacemaker back in October 2010 at TEDMED. Notice the smart phone is talking to the pacemaker through wireless communication telemetry.

As Oesterle points out in his comments to Technology Review, the leads of a pacemaker represent an “invasive and inefficient” necessity of the current level of the technology. By removing the leads and having the new pacemaker directly stimulate the heart, Medtronic is making the device safer as well as smaller. At just a fraction of the size of current devices, the new pacemaker could be inserted using a catheter and a small incision. No more need to slice open the upper chest and create a pocket to hold the pacemaker. No more need to run leads down veins into the heart. A single incision, a single implantation of a tiny device, and Medtronic’s future patients would be done.

From Oesterle's TEDMED presentation, a better view of the pacemaker inside the heart.

Clearly there are many obstacles in the way of bringing a device like this to patients. The most challenging engineering step seems to be power, which Oesterle admits is a fundamental part of the pacemaker they simply don’t have yet. Considering the proposed positioning, however, the power requirements for the device will be much smaller than traditional pacemakers. Oesterle told Technology Review that Medtronic was already in discussion with thin film battery developers on the problem. Hopefully that means a solution is in the works.

From the TEDMED presentation, the new pacemaker on the left, a penny center, and a standard Medtronic pacemaker on the right. Which of the three would you prefer to have in your chest? The latest photo of the pacemaker (see above) shows it even smaller.

Even if all the technical issues are solvable in the next few years, we should keep in mind that the bureaucratic hurdles for medical devices are significant. There will need to be several rounds of FDA trials before the miniature pacemaker would be approved for general use. Oesterle’s claims to Technology Review that the device could be on the market in the next five years should it be accepted with the understanding that federal oversight will have to proceed very smoothly in order for such a goal to be met.

Engineering and regulatory obstacles withstanding, my money is on Medtronic succeeding in creating this wonderfully small pacemaker. Developing and selling better versions of medical technology is what this company is all about.

The advances made for this proposed pacemaker will find uses in other devices. We’ve seen how other Medtronic electrical stimulating implants (roughly similar to pacemakers) are used to treat brain disorders like epilepsy. Imagine when these kinds of implants are also miniaturized, leading to even wider adoption. The concept of cybernetics may conjure up images of robotic limbs and artificial senses, but the era of cyborgs has already arrived in a different guise. There are hundreds of thousands of people with pacemakers in the world, tens of thousands with brain implants, millions total who have corrective implants of some variety (for diabetes, deafness, etc). Looking past this pacemaker, I think there are even smaller and more capable devices on our horizon. One day such implants will be deployable with an injection, and could help us treat a growing array of major medical issues. Heart disease claims millions of lives each year, but implants are one of the many ways we can fight back. Hopefully Medtronic will succeed with this tiny pacemaker and help lead the industry to even better devices beyond.

[image credits: Medtronic via Technology Review, Engadget]
[sources: Technology Review, Engadget]

An artificial cornea (prototype shown here) could restore sight to thousands starting this year.

An expansive EU project to produce an artificial cornea has found success thanks to the work of Joachim Storsberg of the Fraunhofer Institute for Applied Polymer Research IAP in Germany. Storsberg helped develop a new version of an opthalmological polymer which the eye will bond to and still allow to function properly. The new polymer could help restore sight to thousands waiting for corneal transplants around the world. The artificial cornea has passed clinical trials and is ready to see expanded use in patients this year. Very soon those with corneal blindness may find a ready cure in the form of the new implant.

Corneal blindness affects millions around the world. According to the WHO, about 5 million cases of blindness in the world (as of 2001) were a result of corneal damage or dystrophy. We’ve seen several high-tech approaches to fighting corneal blindness including the application of embryonic stem cells to generate new tissue. For most of those affected around the world, however, corneal transplants represent the surest and most accessible treatment for their condition. A readily accessible, easily made artificial cornea is a huge boon to corneal transplants.

More than one hundred thousand patients wait for corneal transplants each year (~40k in EU, another 40k in the US, and many more around the world). While such transplants are fairly routine and regularly successful operations, they require the donation of the tissue from another human being, almost always someone recently deceased. The artificial cornea not only eases the pressure on finding enough donors for recipient needs, it also provides the opportunity for hospitals to increase the speed and availability of such treatments. Ideally, no one will ever have to go without a new cornea ever again.

Joachim Storsberg poses with the new artificial cornea set to see continued use in 2010.

In order to work in the human body, an artificial cornea has to meet some rather stringent requirements. First, it has to bond to the human eye around its edge, but stay unclouded by cells in its center. To that end, Storsberg took a widely used opthalmological polymer (found often in intraocular lenses) and adapted it with other special polymers around the edges. Combined with the application of a growth factor protein, the modified edge promoted cell growth around the periphery of the implant and secured it in place using the body’s own cells. The center of the artificial cornea, however, does not promote cell growth and remains clear so that it can be seen through. The artificial cornea also has to move freely with the eyelid and balance moisture on its faces. The polymer Storsberg chose is hydrophobic, allowing tears to lubricate the surface and provide the correct moisture on both of its sides.

Storsberg’s work was part of a larger EU funded endeavor, the Artificial Cornea Project, which sought to create a non-human based replacement for damaged corneas. The Artificial Cornea Project took three years, and the work of many collaborators around the continent, to produce the new implant. Miro GMBH handled the actual production of the material. Animal trials in pigs and rabbits were successful and lead to the first human uses in 2009. Those early human cases showed enough success to get EU approval for the device and the artificial cornea is expected to see its first widespread use sometime in 2010. That’s very exciting news. This project has not only succeeded, but the fruits of its labor are about to be (readily?) available to patients throughout the EU very soon.

A non-degrading piece of plastic permanently grown into your eye does not sound like the most elegant solution to the problem of corneal blindness, especially when regeneration of tissue through stem cells is on the horizon. But the artificial cornea is a solution which is (almost) available NOW. That’s immensely important. As with so many other current endeavors in medicine, curing blindness is likely to see a staged series of solutions using various emergent technologies. Artificial materials and implants in the near term, autologous stem cells in the far term, and DNA based solutions in the very far term. We need all of these solutions to help transition into a time when blindness is no more of medical hurdle than a broken bone. I wish nothing but the best of luck to Storsberg and the rest of the large team from the Artificiail Cornea Project. With their help I think we are continuing our journey towards an age when medicine can regenerate or replace absolutely any part of your body. Check off “building new eyes” on the list of requirements for immortality.

[image credits: Artificial Cornea Project, Fraunhofter/Dirk Mahler]
[source: Fraunhofer Press Release, Artificial Cornea Project, National Institute of Health]

Biofuel cells turned glucose into electricity in rats.

Researchers at Joseph Fourier University in France have created a new biofuel cell that harnesses oxygen and glucose from the body to produce electricity. Glucose biofuel cells (GBFCs) were placed inside the bodies of rats, and displayed peak energy densities of 24.4 microwatts per milliliter – better than many pacemaker batteries. Glucose and oxygen flow into the fuel cell, and waste products flow out, but the enzymes and metals inside don’t contiminate the body. The work was detailed in a paper published in PLoS. The JFU team hopes that a new generation of GBFCs will be able to power all kinds of implants in humans. This is another small step towards creating cyborgs.

Humans are already fitted with cybernetic implants on a regular basis. While pacemakers are the most obvious example, there are implants to help with heart monitoring, epilepsy, blindness, diabetes, and other conditions. These devices often run on batteries, or are charged through induction or external wires to a power supply. A glucose based biofuel cell would provide a clear advantage – it is dependent only on chemicals already present in the body (sugar and oxygen). GBFC powered implants could laster longer between replacements, and thus reduce the number of necessary surgeries. Big benefits are to be had in patient safety and lower costs.

Several GBFC configurations were tested for this research. Maximum power was seen from enzymes embedded in graphite discs (shown in the image above). This setup produced peak power density of 24.4 microwatts/mL, with peak power of 6.5 microwatts, and sustained power around 2 microwatts (for eleven days). A typical pacemaker requires power near 10 microwatts, but pacemaker batteries don’t have as much power density as this GBFC. In other words, while this particular biofuel cell was not powerful enough to run a pacemaker implant, a larger one could have done so easily, and would likely have still been smaller than a typical pacemaker battery.

According to PLoS, previous attempts at making GBFCs had yielded higher peak powers. These systems, however, usually require low pH (acidic conditions), and were tested in vitro with high glucose levels (~30mM), not in a live animal. The JFU GBFC worked in the rat body’s extracellular fluid which has a pH near 7 and glucose levels near 5mM.

This GBFC produced power for three months in a rat without causing inflammation. Notice how the rat cells have surrounded the device. Before implanting (left) and after removal (right).

What makes the research published in PLoS so promising is that it actually tested several necessary conditions for getting a working GBFC in a living organism. First there were the power trials noted above. Next JFU determined how long a GBFC might function in a human body. Enzymes on barium beads were wrapped in dialysis tubing and a teflon sleeve and left inside a rat for three months. During that time gluconate levels in the rat’s urine indicated that the GBFC was producing power. This GBFC was then removed and showed how the rat’s body had enveloped and accepted the device. A final GBFC was successfully shown to run on both glucose and urea - which opens up new possibilities for placement and power.

Of course, the JFU research is still in a very early phase. Rodents and humans have different body chemistries, sizes, and tolerances. As mentioned in PLoS, the team hopes to move on to pig tests soon, which would allow larger GBFCs to be tried. They want to create more than 133 microwatts of peak energy, enough for larger bladder implants often used to treat incontinence in humans, and which typically require manual pumping or other awkward methods of powering.

It’s hard to know how far these biofuel cell technologies may be from actual human trials – many years probably. Still they demonstrate the possibility that our bodies could power electromechanical devices without batteries. There’s a good chance that we will want to include more such devices in our systems soon, and it would be nice to have them fueled the same way we are: through blood sugar. If so, the appeal of implants will increase, and our cyborg population may blossom. This research may be preliminary, but GBFCs look like a good step towards merging man and machine.

[image credits: Département de Chimie Moléculaire/JFU]
[source: PLoS, Département de Chimie Moléculaire/JFU]

JoAnn Lewis, 79, one of the handful of patients who has enjoyed restored vision thank to the Argus artificial retina.

Modern science is mimicking the miraculous by restoring sight to the blind. The Argus line of artificial retinas has been able to give a primitive (low resolution) vision to patients with retinitis pigmentosa for years now. An external camera transmits images to an electrode array implanted directly on the patient’s retina. We’ve been consistently impressed by the capabilities of these implants which were developed for the US Department of Energy’s Artificial Retina Project. Now, as the third phase of development (Argus III) is gearing up, we’d thought it be a great time to look at some of the amazing accomplishments of this project. We’ve got some awesome videos of patients using the Argus I and Argus II below, as well as a truly moving clip from National Geographic. Enjoy.

Linda Morford was interviewed by Britain’s SkyNews back in 2008. Fitted with a 16 pixel array (Argus I), she was able to regain enough vision to walk through and interact with her environment. Interviewer Thomas Moore gives a great overview of the Argus technology starting at 0:45.

Kathleen Blake’s interview on Nightly News in 2009 highlights her personal experience with the Argus II and its ~60 pixel array. She gives great insight into what it means to be one of the few people on the planet to have their vision restored with such a device:

JoAnn Lewis was the 17th person to be fitted with an Argus (one of the mark II series), and she was already 79 when it happened. Instead of giving us a technical look at the artificial retina, National Geographic took a much more visceral approach. Fair warning, the following video contains graphic depictions of eye surgery. It does a great job of conveying the sense of vision loss and restoration:

Every iteration of the Argus is improving the resolution of the device from 4 pixels to 16 to 60, and the Argus III will have hundreds, perhaps even more than a thousand. This means that every generation is taking another step towards restoring sight that would allow a blind person to operate without a cane or guide. Other technologies have even better resolution (Brainport is already above 1000 points of information) but the Argus system works in a way that most closely resemble natural use of the eyes. In the years to come, prosthetics of all kinds are set to improve, and it may only take a few more iterations before these devices are in fact superior to our natural organs. I look forward to the day when technology cannot only restore sight to the blind, but give a new range of vision to everyone.

[image credit]
[video credits: Sky News, NBC Nightly News With Brian Williams, National Geographic]
[source: DOE, Second Sight]

This tiny implant is able to monitor important chemicals near a tumor.

The little implant works in a really cool way. Only five millimeters long, the cylinder contains magnetic nanoparticles coated with antibodies. These antibodies will bond to whichever chemical the implant is designed to monitor. A semi-permeable membrane keeps the nanoparticles in the implant while still allowing ambient particles in and out. When the antibodies bond to a chemical they form clumps. These clumps are then read using an MRI.

It’s surprising what you can learn from clumps. Chorionic gonadotropin is a hormone produced by human tumors. The CCNE implant Dr. Cima designed can help monitor levels of this hormone to determine the relative size of a tumor over time. Already, Cima’s team has tested the effectiveness of their implant by using them on mice that have human tumors transplanted inside. Over the period of a month Cima was able to track the changes in tumors using their setup.

The CCNE implant uses antibodies to clump around important indicator particles (analytes).

Giving mice human tumors sounds a little too much like mad-science, but the technology speaks for itself. While some researchers are developing take home kits to test for cancer, and others seek for robots to explore the body or have nanobots fight the disease, a passive and continuous monitor is a unique and necessary addition. The ability to correlate chemotherapy drug levels with tumor size is going to be crucial in customizing care to each patient. The implant, which could help determine if a tumor has metastasized, can be placed during the first biopsy, removing the need for repetitive exploratory surgery.

As mentioned by Catherine Mohr in her talks on advances in surgery, improvements in sensing are going to be as important as improvements in cutting. Surgeons need a better understanding of how their operations have affected their patient. The implant can serve that purpose while still helping other doctors choose chemotherapy levels or monitor how their patient is responding to another treatment.

Dr. Cima believes that a version of the implant that tests for pH levels could be ready in as few as five years. That’s still a ways off, but it won’t take long after the pH implants are approved before the hormone and oxygen level monitors follow suit. Continuous observations will be a successful ingredient in maintaining our health. Just like big brother always said.

Release the Drones

Forget the future for a moment, and just consider our present. The U.S. military employs more than 7000 unmanned drones in operations all over the world. Even just 15 years ago, the number of active drones was just a few dozen at most. Now, the use of Predator drones is regularly covered by major media outlets. The Predator, an unmanned, remotely flown drone capable of delivering explosive payloads, is able to seek out and destroy hostile targets thousands of miles from the soldier controlling it. A Raven drone, another Unmanned Aerial Vehicle (UAV), is capable of short range reconnaissance and lightweight enough to be carried into the field by a foot soldier. See the video after the break.

These UAVs are just the tip of the drone iceberg. Besides specialized anti-munitions drones, defense turrets, and surveillance drones already in use, the U.S. military is developing rolling ground vehicles, water surface vehicles, and remote bombers that could all see action in the next few years. There are several competing models for each category, but the Crusher (ground), X-45 (air), and USV (water) are advanced enough to have videos available on the web. Each of these drones would be piloted by controllers many miles away from the field (eventually even from the other side of the world). Closer to home, pocket sized reconnaissance drones may become a part of every soldier’s arsenal  (like the Ember from iRobot we talked about recently) , allowing them to explore dangerous areas without risking their own skin.

Singularity Hub covered the release of P.W. Singer’s new book Wired for War, an overview of how war and technology are evolving together. Singer highlights how quickly drones have been adopted by the U.S. military, taking on mission-critical observation, hunter-killer, and counter-strike roles. The ability to remove a soldier from danger but keep him or her in direct control of a situation is so desirable that is it actively changing the way operations are planned and executed in the Iraq War. Unmanned drones are, in part, the U.S. answer to IEDs and guerilla warfare. In many situations drones not only keep humans from danger, but they also perform their duties better than a human could alone.

A predator drone releases a hell-fire missile.

Soldiers as Middle Managers

Not all robotic systems in the military are super-powered versions of remote-controlled vehicles. Many are reaching levels of autonomy that allow them to be observed rather than controlled. Primary and most widely-spread of these are targeting systems. Bomb and missile guidance requires pinpoint accuracy and split-second reactions. As such, most aircraft and naval level ballistic weapons are aimed and guided with computer assistance. Humans pull the trigger but computers hit the target. Often, the computers also tell the humans when they should pull the trigger in the first place.

Advanced drones like the Global Hawk or the CRAM often work with minimal interference by human controllers. The Global Hawk is an aerial drone that, according to P.W. Singer, is effectively replacing the U2 spy plane. It can take-off, fly 3000 miles, complete its mission, return and land autonomously. Human pilots set its mission parameters, but otherwise are minimally involved while it is in flight. CRAM (counter-rocket artillery mortar) is used in the Iraq Green Zone to provide automated turret defense against surprise rocket and rpg attacks. Much faster than a human could even begin to command it to fire, the CRAM shoots down harmful attacks completely based on its own parameters. Besides turning CRAM on and off, humans are negligible in its operation. By design.

This trend is set to continue. The data that drones collect is already too vast for humans to review on their own. New computer algorithms, or AIs will have to be developed to sift and prioritize this information. This will further push humans into a managerial role.

In the not too distant future, machines may take on very complex roles, such as security. Singularity Hub already discussed the way that security checks are advancing in form and function, and now those same security checks can be integrated into drone technology. Anti-sniper turrets could scan and recognize hostile objects or human posture, attacking with lethal or nonlethal countermeasures as needed. Once these systems prove themselves in field testing, the military will use them. The rapid adoption of drones is sure proof of that.

But can we trust computers and robots with situations in which they may use lethal force against civilians? Opponents to a computerized military often point out that computers will make errors, it’s inevitable, and they will kill innocent people. Maybe they’ll assume a man running from an explosion was responsible for setting a bomb, maybe they’ll shoot a smoking truck because it resembles a suicide bomb attack — the possible scenarios are nearly endless. Of course, humans have already made these exact same mistakes. We need to remember that no soldier, human or robotic, can perform perfectly and they often kill innocent civilians. That’s an argument against war altogether, but as long as robot/computer error is comparable or less than human error it’s no argument against using robots in the field.

Meet Soldier 2030

A concept photo for the U.S. Army's Future Soldier 2030 program.

As robotics and computer technologies improve, will humans even have a direct combat role? The U.S. Army is answering yes for now. Their Future Soldier 2030 program is an approach to augmenting human soldiers to become mobile combat platforms. Hundreds of millions are being spent on this new initiative and probable goals include: powered exoskeletons, advanced armor, enhanced metabolisms, advancing sensing, HUDs, and increased/variable lethality. If you’ve seen it in a science fiction movie, chances are the army is willing to consider it.

Under this initiative, the new soldier is viewed more as a machine than a grunt. Like all machines, it will be inspected to insure that it is well maintained. The Pentagon has been pursuing implantable Radio Frequency IDs (RFIDs) since 2007. These RFIDs should be able to not only track the solider of the future, but also relate his or her health to commanding officers back at base. Even with just $1.6 million in funding, the RFIDs are seen as a serious possibility for all field-operative soldiers.

And if a soldier is injured? The Pentagon recently completed phase one of its regrowing limbs research experiment. As of March of this year, military labs are able to turn skin cells into a blastema, a type of cell that can be converted into different kinds of tissue. The next phase will be to get that blastema to convert itself into muscle, bone, or nerve cells as needed.

DARPA is spending more than $4 million to try and make the future soldier telepathic. Singularity Hub loves to discuss mind-reading machines, and apparently DARPA does too. Rather than pursue some sort of traditional ESP, or telepathic communication, DARPA is looking into computer-mediated brain to brain networking. The soldiers of the future may be able to have their helmets read their thoughts and transmit them to their squad so that the entire unit can act as one.

In the short run, soldiers can look forward to simply lightening their loads. The typical operative in Afghanistan may carry up to 52 kg of equipment on his back. That’s around 60% of his own weight or more. By switching from many redundant power packs, armor pieces, and instruments to an open modular system, researchers are hoping to reduce that load to under 30 or even 25 kg. Such a system would allow soldiers to adapt the the armor and equipment they carry as situations change in the field. Where will they put the extra gear when it’s not in use? On a mule of course. The U.S. military has an unmanned autonomous vehicle, sometimes called the big dog, that will act as a walking storage platform. Check out the video. I find something about the way this thing moves very creepy:

[big dog robotic mule]

…and knowing is half the battle

With this huge wall of technology looming behind them, what do our military leaders plan on changing? First off, the budget. U.S. Defense Secretary Robert Gates revamped the Pentagon’s budget in April so that it reflects not just the new kinds of technology, but also the new kinds of war. He plans on spending about 50% on conventional warfare, 10% on irregular warfare, and 40% on dual use materials and personnel. This includes a $2 billion dollar increase in drones like the Predator.

This shift in spending reflects the new combat situations that the U.S. military is facing. The U.S. really hasn’t fought a conventional war since Korea, maybe since WWII. Most of the military actions taken have been in asymmetric warfare situations: guerrilla tactics, counter-insurgency maneuvers, peace-keeping missions within civilian populations. Those aren’t the times to rely on big tanks, fighter jets, and battleships.

The wars of the future are going to focus on surveillance and information. Finding that one terrorist among the thousands of innocent civilians and neutralizing him or her quickly will be more important than devastating nuclear weapons. Quick assessments, and rapid reactions will dominate the field, and those requirements are best served by computers and machines, not humans. We are looking at a future where war is the split second recognition of a small, deadly threat that is eliminated by a computer.

And that, my friends, is where this goes from a serious and interesting discussion about technology to a rather scary realization about the future. Irregular wars? They look a lot like occupying forces performing police actions. Or like governments being able to kill dissenters in their beds. Even if we want to trust the soldier-managers of the new drone armies, they may be too far removed to feel the emotional impact that causes the common soldier to recoil from committing atrocities. How much do you regret killing someone in a video game? By replacing soldiers with computers we may be removing what little morality is in war.

At the same time, we may be increasing the number of people able to create a military. Most of the surveillance devices can be constructed or even purchased by civilians. According to P.W. Singer, spy drones are already in the hands of border-guard groups that have no official sanction by the U.S. military. While artillery is tightly controlled, these surveillance bots give a great tactical advantage in the field even if they’re not armed.

Undoubtedly the future of war will look different. Drones will take an ever increasing role, and in different sizes, from nanotechnology to huge air fortresses that don’t need to land but once a year. Those humans still in the field will be augmented by equipment outside and inside their bodies. The whole system will focus on quick reactions to small scale threats while still being ready for large-scale confrontations. These same tactics may creep into our police forces, or even find use by private citizens. Yet, despite these changes, some things about war will never change: it will be terrifying, deadly, undesirable, and perhaps necessary.

More videos:

[raven catch]

[german microdrone]

The Enterra neurostimulator implant as seen after installation. Photo from botjunkie.com

It takes general anesthesia and surgery to place the Enterra ® device, but afterwards doctors can adjust it externally, using a remote apparatus. Not a bad trick, and one that allows patients to avoid further invasive procedures. While it may take a little more work to install than other implants (did you know that a pacemaker only requires local anesthesia nowadays?) it has benefited from their popularity. Medtronic received special humanitarian device exemption (HDE) from the US FDA for Enterra ®. This means that while the device’s benefits haven’t been proven rigorously, the FDA is willing to let it be placed in patients. All it takes is a facility’s institutional review board to approve the device, and many have already done so.

That’s a big leap in faith for government and patient alike, and it says something about our modern opinion of implants. We’ll take any solution that’s likely to work, and especially if it seems high tech enough. Singularity Hub recently discussed stem cell treatments for diabetes, but the truth is that most of the people suffering from diabetes and related disorders need treatments that are available today. For some of those, implants are a solution, and are well worth any associated risks.

The intestinal implant closely resembles a pacemaker. Photo from Medtronic

Like most other implants, Enterra® is a neurostimulator, working to replace or compensate for our most finicky of cells: nerves. As technology progresses, however, implants will likely evolve from purely electrical devices to chemical synthesizers. With the advance in technology, you can bet patients will be clambering to try them out. Why not? — we all want to upgrade.

Everywhere we look, cybernetics is working its way into our lives and under our skin. The Enterra® implant is only one of the many possible paths to introducing cyborgs into our lives. Singularity Hub has shown you the telescopic eye, continuous body sensors, external robotic skeletons, and brain-controlled arms and wheelchairs — all possible routes to melding man and machine. While some of these technologies hope to improve individuals beyond human limits, most will also be used to level the playing field for humans with disabilities. In either case, cybernetics may one day develop into the cure for the common human.

While few currently used implants are considered “cures”, most have proven to be invaluable as treatments. Hopefully Enterra ® will join the pacemaker as a safe and functional solution to a common disorder. When it comes to sufferers of gastroparesis, we can rebuild them…better, stronger, faster…or at least with the ability to pass food through their stomachs.

]]> http://singularityhub.com/2009/05/19/intestinal-implants-make-cyborgs-out-of-diabetics/feed/ 1 http://singularityhub.com/2009/03/20/body-20-continuous-monitoring-of-the-human-body/ http://singularityhub.com/2009/03/20/body-20-continuous-monitoring-of-the-human-body/#comments Fri, 20 Mar 2009 18:01:01 +0000 Keith Kleiner http://singularityhub.com/?p=1199 Did you ever stop to think how silly and also how dangerous it is to live our lives with absolutely no monitoring of our body’s medical status?  Years from now people will look back and find it unbelievable that heart attacks, strokes, hormone imbalances, sugar levels, and hundreds of other bodily vital signs and malfunctions were not being continuously anticipated and monitored by medical implants.  We can call this concept body 2.0, or the networked body, and we need it now!

Above: concept illustration from yankodesign

The trio of biomedicine, technology, and wireless communication are in the midst of a merger that will easily bring continuous, 24×7 monitoring of several crucial bodily functions in the years ahead.  Unfortunately, as is often the case with medical products, the needed innovations are either already developed or will be soon, but some of the best commercial products won’t make it to the market until years of testing have proven their safety.

In the future your doctor might call you before you have a heart attack, responding to an alarm sent out by monitoring systems in your body that have detected the precursors to a heart attack hours or days ahead of time.  With body 2.0, medicine dosages could be tailored precisely to your body chemistry and metabolism.  Real-time monitoring of chemical concentrations in your blood could allow for increasing or decreasing dosages accordingly.

The huge amounts of data that would be accumulated from hundreds of thousands of continuously monitored people would be nothing short of a revolution for medical research and analysis.  This data could be harvested to understand the minute by minute changes in body chemistry that occur in response to medication, stress, infection, and so on.   As an example, the daily fluctuations in hormone levels of hundreds of thousands of individuals could be tracked and charted 24/7 to determine a baseline from which abnormalities and patterns could be extracted.  The possibilities are enormous.

Given the advantages, we must wonder why body monitoring is not already more successful and widespread.  The answer is that most of the interesting body monitoring we desire requires direct access to the blood stream and other bodily fluids, and this is not an easy problem to overcome.

A straightforward technique is to prick the skin periodically to extract and analyze blood, yet this only works for periodic monitoring.  It does not provide continuous access to bodily fluids.  Sensors implanted permanently into the blood stream are what is needed, but the difficulty is that moisture, enzymes, and the immune system quickly wreak havoc on mechanical devices and destroy them.  Implants also pose several opportunities for life threatening infection to take hold, and this must be addressed.

The video below opens our eyes to the possibilities:

Although the road to continuous body monitoring poses challenges, these challenges are certainly within our means to overcome, and exciting progress is being made all over the world.  The medical monitoring, device, and implant space is absolutely enormous, so there is no way we can do justice to the myriad of companies and research projects that are out there.  Nevertheless, here are a few of the companies and products that we are aware of:

Proteus Biomedical:

One of the biggest names in the industry is a company we have reported on before, Proteus Biomedical…

Proteus has designed a platform for body monitoring, called Raisin, which measures when and if a patient takes their medication, and also measures how various bodily vital signs, such as heart rate, respond to the medication.  From the Proteus website:

Proteus ingestible event markers (IEMs) are tiny, digestible sensors…Once activated, the IEM sends an ultra low-power, private, digital signal through the body to a microelectronic receiver that is either a small bandage style skin patch or a tiny device insert under the skin. The receiver date- and time-stamps, decodes, and records information such as the type of drug, the dose, and the place of manufacture, as well as measures and reports physiologic measures such as heart rate, activity, and respiratory rate.

All of the data collected by the Proteus system can be sent wirelessly to the doctor for remote monitoring.  The system is currently in clinical development.

Cardionet:

Next we have, Cardionet, creator of a system that monitors every heartbeat, non-invasively, during the patient’s normal daily activities, for up to 21 days, and detects, records, and transmits event data automatically to the prescribing physician via wireless phone.  Patients wear three leads attached to a lightweight sensor worn on a neck strap or belt clip that continuously transmit two channels of ECG data to the monitor.  The monitor analyzes the patient’s ECG in real time, heartbeat by heartbeat.

The Cardionet system has been extremely successful, as evidenced by the recent IPO of the company.

Bodymedia:

Next we have Bodymedia, maker of an arm band, called Sensewear, that enables automated monitoring of calories burned, dietary intake, duration of physical activity and sleep. A USB port allows the patient to periodically upload data from the armband to a website loaded with charts, graphs, and other data that allows both patient and physician to make informed decisions.

Click on the report below to see the interesting and detailed data that can be gathered by this system:

Toumaz:

Finally, we have Toumaz, maker of a wearable body monitor similar to Sensewear, but apparently even more sophisticated and capable.  The Toumaz system, called Sensium, provides ultra low power monitoring of ECG, temperature, blood glucose and oxygen levels. It can also interface to 3 axis accelerometers, pressure sensors and includes a temperature sensor on chip.  Toumaz offers a product called the Sensium Life Pebble, which streams the data using a wireless datalink over a short range ( ~5m) to a Sensium USB adapter or data logger. The Life Pebble is designed for use in a wide range of professional sports monitoring, lifestyle and healthcare applications.

Above: The Sensium Life Pebble

Of course, there are several technologies that we have missed in this small sampling.  Please use the comments to tell us the ones that you know about!