Does violence spread like a contagious disease? Gary Slutkin of Cure Violence says the issue has been misdiagnosed, and instead created science-based strategies that aim to interrupt violence before it becomes an epidemic.
Many affected by illness and disability find profound meaning, inspiration and identity in their differences, says “Far From the Tree” author Andrew Solomon, who holds that it is diversity that truly unites us all. Watch him at TEDMED 2013.
In an intellectual and creative adventure, five Rhode Island School of Design (RISD) faculty members and 20 students have contributed their talents by creating portraits of TEDMED’s 2013 speakers.
In his STEM to STEAM initiative, RISD President John Maeda — who will be on stage at TEDMED 2013 as a speaker – is attempting to transform thinking about the role of art and design in civic life, in commerce, and as an agent of innovation in the fields of Science, Technology, Engineering and Mathematics.
RISD’s Illustration Department has long pursued partnerships in learning through its practical course offerings and partnerships with academic, corporate and research institutions, working side-by-side with physicians, scientists, computer programmers and engineers.
“With the TEDMED project we jumped at the chance to immerse our students and faculty in worlds of inquiry that have broadened our enthusiasm and scope of understanding about the terrific work these people are doing,” said Robert Brinkerhoff, Professor and Illustration Department Head at RISD.
“That partnership alone has expanded the thinking of the illustrators involved in the project, but we must also recognize that artists and designers are able to formulate deep questions and observations that can help propel research and discovery into new territories. Behind all innovation are eloquent, imaginative, creative personae and it’s been an absolute pleasure to convey the energy underlying such fascinating enterprise,” he said.
The portraits will be featured in the TEDMED conference book and throughout the event.
By Ali Ansary
In the future, implanted chips will have the ability to stop food absorption when caloric intake reaches 2200. Cells in our forearm will be able to monitor our glucose levels and adjust our insulin appropriately. These implantable cells or “chips” have their own IP address with their own circuitry that is connected to a network 24/7. Through this network, cells communicate with real-time super computers to synthesize the next step for an individual’s body. If Dr. Anthony Atala can utilize 3D printers to create a new kidney, then it is only a matter of time before we can incorporate the circuitry within an organ necessary to monitor its function wirelessly.
This was the future I was challenged to paint in my talk at TEDMED 2012 at the Kennedy Center for the Performing Arts in Washington, DC. As TEDMED 2013 commences, I ask myself, where are we one year later?
A caveat: The following are simple overviews on novel technologies I had been tracking over the past year and does no justice to the many amazing leaps we have made in innovative science and medicine during this time.
Thomas Goetz beautifully discusses in The Atlantic that diabetics, although “loath” it, have been self-monitoring for years. Goetz goes on to say that the “….distaste falls into three categories: self monitoring for diabetes is an unremitting and unforgiving labor; the tools themselves are awkward and sterile; and the combination of these creates a constant sense of anxiety and failure.”
However, what if we had an implantable sensor that simply monitors an individual’s glucose? In 2010, Dr. David Gough from the University of California, San Diego demonstrated that you could potentially monitor an individual’s glucose by wireless telemetry. A patient can be in San Francisco with his or her physician having access to the data in Los Angeles.
And what if the immune system renders the chip incapable of functioning? Dr. Melissa Grunlan at the University of Texas A&M has been working to develop a self cleaning mechanism that prevents implantable glucose sensors from being “shielded” by the body’s immune system.
Dr. Giovanni de Micheli and Dr. Sandro Carrara at the École polytechnique fédérale de Lausanne in Switzerland have developed a 1.4 cm implantable device that can measure proteins and organic acids in real time. Imagine a signal being sent to your cell phone, and your doctor’s phone, indicating an increase in cardiac enzymes- potentially a heart attack. This device functions on a battery-less system that connects to a patch resting on the surface of the skin.
Natural anatomy acts as a barrier to implantable batteries. Yet, as Dr. Ada Poon and her team at Stanford University have developed a medical device that can be powered wirelessly using electromagnetic radio waves. Now, the tiny devices we envisioned can circulate into the depths of our vascular system without fear of losing power. Reminds me of “The Magic School Bus” episode when Ms. Frizzle takes her class on a field trip through the human body.
A personal favorite of mine: At the Massachusetts Institute of Technology, Dr. Konstantina Stankovic has demonstrated the ability to use the natural electric potential from electrolytes in the inner ear to power devices that can monitor biological activity in people with auditory and balance issues.
Early detection is fundamental in many of these devices, especially for cancer patients who have aggressive diseases prone to metastasis. Take, for example patients with malignant melanoma, one of the deadliest cancers and one that has seen little progress in its treatment. Dr. Shuang Hou and his team at UCLA have demonstrated a proof of concept of a “nanovelcro” chip that can capture highly specific and isolated circulating tumor cells.
And what about regulating food intake and nutrient absorption? Intrapace has created Abiliti, an implantable gastric stimulator and food detection system that is implanted into the stomach. As soon as food is detected, it stimulates the stomach to create a sense of fullness. I can see eventually a system that can monitor an individual’s caloric input over, say, 24 hours. This would allow us to eat normally without overindulging.
A quick mention on a hot topic. As popular discussions emphasize trends like the Nike+ FuelBand, one step closer to wearable sensors are what Dr. John Rogers at the University of Illinois at Urbana-Champaign has developed: An electronic sensor that can be directly printed onto your skin using a rubber stamp and last for up to two weeks as highlighted in MIT’s Technology Review. The potential for this goes beyond saying.
The Fine Line
This is just a short list of exciting new innovations. Of course many people may be taken aback by such technologies, which is fine. The purpose of my talk was to create discussion while painting a potential future that may be upon us soon. It is important for all of us to be active in our own healthcare. If we aren’t, then someone else will be.
Knowledge about our glucose or hemoglobin and hematocrit in our time is just as important as knowing whether or not to fuel our cars with unleaded or diesel. But we still need an expert mechanic’s help. Let me explain. I do believe that growth in this field, like anything else in medicine in the 21st century, will need to be not only through adoption by the empowered and informed patient, but also via healthcare providers.
Old mechanics would drive a problematic car themselves to assess damage. Simple things such as hearing a funny sound or seeing the car pull to the left would give them enough information to diagnose the problem. Today the engineering of a car is so sophisticated that sensors continuously monitoring the “health” of the engine alert the driver when something is wrong. That unwelcome signal – a picture of a wrench, perhaps, or a flat tire – notifies the driver and the mechanic what part has gone wrong, what’s wrong with it, and what needs to be done.
So the mechanic had to evolve the way he (or she) fixed a car. The physician today is much like that mechanic. While the human body is far more sophisticated than even a brand new Mercedes Benz, newly trained physicians need to adjust how they care for their patients’ health.
Growth in this field, like anything else in medicine in the 21st century, will need to be not only through adoption by the e-patient, but also via tech-savvy healthcare providers.
How would you like to die? How would you like to be remembered? And what’s the best death you’ve ever seen?
It’s difficult thinking about these questions, let alone verbalizing answers. There are consequences, though, for trying to avoid the inevitable. Some 70 percent of Americans say they would prefer to die at home, yet only 30 percent actually do. Dying in a hospital, perhaps with unplanned or unwanted treatment, can be hugely expensive for patients’ families and for taxpayers: The Wall Street Journal reports that in 2009, the 1.6 million Medicare patients who died that year accounted for 22.3% of total hospital expenditures.
A new project, Let’s Have Dinner and Talk about Death, aims to give people the opportunity to broach what might be perhaps the toughest subject of all over a table rather than a hospital bed rail. It’s built around the idea that mealtime discussions offer a convivial forum for participants to talk about, quite simply, how they would like to die. Hopefully, expressing wishes out loud will lead to having an end-of-life plan in place with family and healthcare providers.
The concept comes from chef Michael Hebb, a TEDMED 2013 speaker, and Scott Macklin, a Teaching Fellow and Associate Director at the University of Washington’s (UW) Digital Media program. Hebb says humans have an innate urge to communicate over a meal. ”The table and the fire are where we first concentrated calories by cooking,” he says. “There is a safety and comfort among food and drink, and a sense that issues of gravity can be discussed.”
A web site devoted to the experience, www.deathoverdinner.org, which will be fully operational this summer, will share ideas for hosting dinners devoted to morbidity and will invite users to share their stories in its online community. It’s also the basis of a new UW course. The enterprise is a division of the non-profit Engage With Grace, and two TEDMED partners, Shirley Bergin and Jonathan Ellenthal, are advisors.
And what’s the ideal menu for such a dinner? First, Hebb says, serve something you know how to cook. “Unless you are a culinary wizard, I wouldn’t suggest molecular gastronomy or any new kitchen terrain,” he says. “Make something that makes you happy, both to prepare and to eat.”
For more about the project, visit www.deathoverdinner.org and follow #deathoverdinner.
They make peace with death – and incorporate it into life. They’re redefining cancer and launching a citizen science project to map our biomes; they’re inspiring with the spoken word and crowd-sourcing art. Presenting our latest group of speakers for the upcoming TEDMED 2013 program:
For details and to apply, visit TEDMED.com.
In 1900, the leading causes of death in the U.S. were flu, tuberculosis and gastrointestinal infections. Today, they are heart disease, cancer, and chronic respiratory diseases, with stroke and diabetes in the top ten – largely preventable conditions.*
The problem is, our healthcare system, devoted as it is to acute, curative care, still thinks it’s 1900, with disastrous results. As Ali Ansary, Sandeep “Sunny” Kishore and Jacob Scott, all TEDMED 2012 speakers, wrote in The Huffington Post,
“With increasingly tragic consequences, the reactionary medical paradigm has not provided the preventive care or chronic illness management that our culture needs. Healthcare spending currently consumes 17 percent of our GDP and without a radical shift in thinking, this number may grow even higher.”
Change begins with conversation. To that end, the three have launched a movement called Tomorrow’s Doctor, in which they call for ideas on how to reimagine medicine of the future, starting with med ed. We must re-align priorities, they say, and take advantage of gains already made in technology and public health.
“We need to stop the “imaginectomies” and help, collectively, step by step, to make creativity, imagination and compassion the 21st century standards of medical education.”
Sources: Centers for Disease Control and Prevention; New England Journal of Medicine
This is a guest post by Sandeep Kishore, a post-doctoral fellow at Harvard Medical School and TEDMED 2012 speaker.
Recently, I’ve been struggling on how to explain to other folks what it is that I do – or what it is that I am attempting to do.
I still don’t really know.
But I have found some clues recently via a Harvard University website called the Catalyst. It effectively catalogues all people at 17 schools and hospitals associated with Harvard University (from those studying anthropology to appendicitis, from molecules to masses), ‘catalyzes’ new connections, and provides pilot grants to help incent people to work on problems together.
What I like most is that the translation agenda via this website. It provides a useful frame for PhD basic scientists to communicate with MD clinicians and with the policy/public health community.
In the university community, and certainly in training, there are rifts between bench scientists and the clinical docs. Now add in the fact that the biological/pathogen model is old news, mental models are shifting and there are new behavioral/social issues that add to the canonical biomedical approaches, and now we have a real and urgent need for translation.
The Catalyst profiles a translation agenda labeled T1 thru T4:
T1: Basic Scientific Discovery to Clinical Insights
T2: Clinical Insights to Implications for Practice
T3: Implications for Practice to Implications for Population Health
T4: Implications for Population Health to Improved Global Health
This provides a useful continuum and includes tools to broker linkages along the way. And the curation of resources begins the moment any staff member joins Harvard University. In a moment, your publications, your topic areas, people who publish/think like you and even people who physically sit next to you are highlighted. The website is designed to foster creativity and collaboration – and is blind to exactly where those insights might come from. Anyone, from student to president, can participate and link-up.
Best of all, the site is public so that anyone else can view, learn and engage. This is the sort of multidisciplinary effort that we will need for complex health challenges –and I’m delighted that it’s housed at a major university with access to ideas, young blood and energy.
I connected with Dr. Lee Nadler and Dr. Elliott Antman, founders and leaders of the platform, to learn more on the origins and functions of the Harvard Catalyst. I was looking for practical outputs of this network. They relayed one challenge where engineers and researchers were searching for practical applications of next-generation imaging techniques; and one in which radiologists were searching for, well, next generation imaging modalities. Both groups were unintentionally boxed in their professional silos. The Harvard Catalyst challenged the community – write in 250 words, one big idea to bridge the gap, identify how a biological/medical problem could be solved by imaging techniques.
They expected maybe 30 submissions across the 12,000 people unified on the platform. They received 500.
Next, they arranged a poster session where 150 people presented their idea over three evenings. New ideas including novel ways to image islet cells of the pancreas emerged. Success: People not aware of each other’s existence came together; new teams were formed and there was even a bit of funding for pilot grants to try out the best, most promising ideas. As Drs. Nadler and Antman say, their vision is not to bring institutions together; it is to bring people together.
TEDMED and a network I co-founded, the Young Professionals Chronic Disease Network (YP-CDN) provide some examples of the sort of ‘safe spaces’ for incubation, networking, curation and then translation of ideas to action. Particularly for the way we train the next generation of university students. These initiatives are exciting in that they provide a new nidus for meet ups that foster imagination, innovation and inspiration and that move us beyond hardened paradigms. This is critical for this generation, and even more so for the next.
It all reminds me of the quote by the playwright Edith Wharton relayed to me by an old mentor: “There are two ways of spreading light: to be the candle or the mirror that reflects it.”
These incubators serve as mirrors that help focus, amplify and merge our individual lights of inspiration. This is a neglected, but vital function, for translators. Maybe I’ll grow up to be a mirror?
Non-invasive focused ultrasound surgery, which can be performed as a non-anesthetic outpatient procedure — with much less pain and shorter recovery time for patients — is gaining ground as an effective and highly beneficial treatment for the symptoms of Parkinson’s disease and other movement disorders.
As Medgadget reports, InSightec, makers of an MR-guided interventional ultrasound system, received approval in Europe for its ExAblate Neuro system, which is designed to treat Parkinson’s disease, essential tremor and neuropathic pain.
The procedure uses sound waves to target affected areas of the brain. Compared to the current prevalent surgical therapy of deep brain stimulation, which involves drilling into the skull and implanting a pacemaker-like device, the minimally invasive ultrasound procedure poses much less risk to surrounding brain areas.
ExAblate is as yet unapproved in the US to treat Parkinsons, but is in clinical trial at the University of Virginia. A first round showed promising results in controlling Parkinson’s related tremors.
Yoav Medan, vice president and chief systems architect of InSightec, described how the surgery works at TEDMED 2011. Watch his talk:
Should physicians be mandated to prescribe a daily aspirin as preventive care?
In an op-ed in today’s New York Times, two-time TEDMED speaker David Agus talks about when, if ever, encouraging proven preventive behavior should be made public policy, similar to New York City Mayor Michael Bloomberg’s restrictions on trans fats and soda sizes.
Why not aspirin? The 2,000-hear-old drug, he posits, has shown great benefit in reducing cardiovascular risks and cancer in recent studies as well as, of course, being an effective pain reliever. As we are all essentially paying for one another’s medical bills via Medicare, Medicaid and other taxpayer-financed health programs, it should be public policy for middle-aged people without adverse risk factors to use it. As he says:
The data are screaming out to us. Aspirin, one of the oldest remedies on the planet, helps prevent heart disease through what is likely to be a variety of mechanisms, including keeping blood clots from forming. And experts believe it helps prevent cancer, in part, by dampening an immune response called inflammation.
So the question remains: given the evidence we have, why is it merely voluntary for physicians to inform their patients about a health care intervention that could not only help them, but also save untold billions in taxpayer dollars each year?
Read the entire piece here.
And below is Agus’s speech at TEDMED 2011, in which he talks about the latest research on what works to prevent most major diseases.