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#434823 The Tangled Web of Turning Spider Silk ...

Spider-Man is one of the most popular superheroes of all time. It’s a bit surprising given that one of the more common phobias is arachnophobia—a debilitating fear of spiders.

Perhaps more fantastical is that young Peter Parker, a brainy high school science nerd, seemingly developed overnight the famous web-shooters and the synthetic spider silk that he uses to swing across the cityscape like Tarzan through the jungle.

That’s because scientists have been trying for decades to replicate spider silk, a material that is five times stronger than steel, among its many superpowers. In recent years, researchers have been untangling the protein-based fiber’s structure down to the molecular level, leading to new insights and new potential for eventual commercial uses.

The applications for such a material seem near endless. There’s the more futuristic visions, like enabling robotic “muscles” for human-like movement or ensnaring real-life villains with a Spider-Man-like web. Near-term applications could include the biomedical industry, such as bandages and adhesives, and as a replacement textile for everything from rope to seat belts to parachutes.

Spinning Synthetic Spider Silk
Randy Lewis has been studying the properties of spider silk and developing methods for producing it synthetically for more than three decades. In the 1990s, his research team was behind cloning the first spider silk gene, as well as the first to identify and sequence the proteins that make up the six different silks that web slingers make. Each has different mechanical properties.

“So our thought process was that you could take that information and begin to to understand what made them strong and what makes them stretchy, and why some are are very stretchy and some are not stretchy at all, and some are stronger and some are weaker,” explained Lewis, a biology professor at Utah State University and director of the Synthetic Spider Silk Lab, in an interview with Singularity Hub.

Spiders are naturally territorial and cannibalistic, so any intention to farm silk naturally would likely end in an orgy of arachnid violence. Instead, Lewis and company have genetically modified different organisms to produce spider silk synthetically, including inserting a couple of web-making genes into the genetic code of goats. The goats’ milk contains spider silk proteins.

The lab also produces synthetic spider silk through a fermentation process not entirely dissimilar to brewing beer, but using genetically modified bacteria to make the desired spider silk proteins. A similar technique has been used for years to make a key enzyme in cheese production. More recently, companies are using transgenic bacteria to make meat and milk proteins, entirely bypassing animals in the process.

The same fermentation technology is used by a chic startup called Bolt Threads outside of San Francisco that has raised more than $200 million for fashionable fibers made out of synthetic spider silk it calls Microsilk. (The company is also developing a second leather-like material, Mylo, using the underground root structure of mushrooms known as mycelium.)

Lewis’ lab also uses transgenic silkworms to produce a kind of composite material made up of the domesticated insect’s own silk proteins and those of spider silk. “Those have some fairly impressive properties,” Lewis said.

The researchers are even experimenting with genetically modified alfalfa. One of the big advantages there is that once the spider silk protein has been extracted, the remaining protein could be sold as livestock feed. “That would bring the cost of spider silk protein production down significantly,” Lewis said.

Building a Better Web
Producing synthetic spider silk isn’t the problem, according to Lewis, but the ability to do it at scale commercially remains a sticking point.

Another challenge is “weaving” the synthetic spider silk into usable products that can take advantage of the material’s marvelous properties.

“It is possible to make silk proteins synthetically, but it is very hard to assemble the individual proteins into a fiber or other material forms,” said Markus Buehler, head of the Department of Civil and Environmental Engineering at MIT, in an email to Singularity Hub. “The spider has a complex spinning duct in which silk proteins are exposed to physical forces, chemical gradients, the combination of which generates the assembly of molecules that leads to silk fibers.”

Buehler recently co-authored a paper in the journal Science Advances that found dragline spider silk exhibits different properties in response to changes in humidity that could eventually have applications in robotics.

Specifically, spider silk suddenly contracts and twists above a certain level of relative humidity, exerting enough force to “potentially be competitive with other materials being explored as actuators—devices that move to perform some activity such as controlling a valve,” according to a press release.

Studying Spider Silk Up Close
Recent studies at the molecular level are helping scientists learn more about the unique properties of spider silk, which may help researchers develop materials with extraordinary capabilities.

For example, scientists at Arizona State University used magnetic resonance tools and other instruments to image the abdomen of a black widow spider. They produced what they called the first molecular-level model of spider silk protein fiber formation, providing insights on the nanoparticle structure. The research was published last October in Proceedings of the National Academy of Sciences.

A cross section of the abdomen of a black widow (Latrodectus Hesperus) spider used in this study at Arizona State University. Image Credit: Samrat Amin.
Also in 2018, a study presented in Nature Communications described a sort of molecular clamp that binds the silk protein building blocks, which are called spidroins. The researchers observed for the first time that the clamp self-assembles in a two-step process, contributing to the extensibility, or stretchiness, of spider silk.

Another team put the spider silk of a brown recluse under an atomic force microscope, discovering that each strand, already 1,000 times thinner than a human hair, is made up of thousands of nanostrands. That helps explain its extraordinary tensile strength, though technique is also a factor, as the brown recluse uses a special looping method to reinforce its silk strands. The study also appeared last year in the journal ACS Macro Letters.

Making Spider Silk Stick
Buehler said his team is now trying to develop better and faster predictive methods to design silk proteins using artificial intelligence.

“These new methods allow us to generate new protein designs that do not naturally exist and which can be explored to optimize certain desirable properties like torsional actuation, strength, bioactivity—for example, tissue engineering—and others,” he said.

Meanwhile, Lewis’ lab has discovered a method that allows it to solubilize spider silk protein in what is essentially a water-based solution, eschewing acids or other toxic compounds that are normally used in the process.

That enables the researchers to develop materials beyond fiber, including adhesives that “are better than an awful lot of the current commercial adhesives,” Lewis said, as well as coatings that could be used to dampen vibrations, for example.

“We’re making gels for various kinds of of tissue regeneration, as well as drug delivery, and things like that,” he added. “So we’ve expanded the use profile from something beyond fibers to something that is a much more extensive portfolio of possible kinds of materials.”

And, yes, there’s even designs at the Synthetic Spider Silk Lab for developing a Spider-Man web-slinger material. The US Navy is interested in non-destructive ways of disabling an enemy vessel, such as fouling its propeller. The project also includes producing synthetic proteins from the hagfish, an eel-like critter that exudes a gelatinous slime when threatened.

Lewis said that while the potential for spider silk is certainly headline-grabbing, he cautioned that much of the hype is not focused on the unique mechanical properties that could lead to advances in healthcare and other industries.

“We want to see spider silk out there because it’s a unique material, not because it’s got marketing appeal,” he said.

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Posted in Human Robots

#434797 This Week’s Awesome Stories From ...

GENE EDITING
Genome Engineers Made More Than 13,000 Genome Edits in a Single Cell
Antonio Regalado | MIT Technology Review
“The group, led by gene technologist George Church, wants to rewrite genomes at a far larger scale than has currently been possible, something it says could ultimately lead to the ‘radical redesign’ of species—even humans.”

ROBOTICS
Inside Google’s Rebooted Robotics Program
Cade Metz | The New York Times
“Google’s new lab is indicative of a broader effort to bring so-called machine learning to robotics. …Many believe that machine learning—not extravagant new devices—will be the key to developing robotics for manufacturing, warehouse automation, transportation and many other tasks.

VIDEOS
Boston Dynamics Builds the Warehouse Robot of Jeff Bezos’ Dreams
Luke Dormehl | Digital Trends
“…for anyone wondering what the future of warehouse operation is likely to look like, this offers a far more practical glimpse of the years to come than, say, a dancing dog robot. As Boston Dynamics moves toward commercializing its creations for the first time, this could turn out to be a lot closer than you might think.”

TECHNOLOGY
Europe Is Splitting the Internet Into Three
Casey Newton | The Verge
“The internet had previously been divided into two: the open web, which most of the world could access; and the authoritarian web of countries like China, which is parceled out stingily and heavily monitored. As of today, though, the web no longer feels truly worldwide. Instead we now have the American internet, the authoritarian internet, and the European internet. How does the EU Copyright Directive change our understanding of the web?”

VIRTUAL REALITY
No Man’s Sky’s Next Update Will Let You Explore Infinite Space in Virtual Reality
Taylor Hatmaker | TechCrunch
“Assuming the game runs well enough, No Man’s Sky Virtual Reality will be a far cry from gimmicky VR games that lack true depth, offering one of the most expansive—if not the most expansive—VR experiences to date.”

3D PRINTING
3D Metal Printing Tries to Break Into the Manufacturing Mainstream
Mark Anderson | IEEE Spectrum
“It’s been five or so years since 3D printing was at peak hype. Since then, the technology has edged its way into a new class of materials and started to break into more applications. Today, 3D printers are being seriously considered as a means to produce stainless steel 5G smartphones, high-strength alloy gas-turbine blades, and other complex metal parts.”

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Posted in Human Robots

#434792 Extending Human Longevity With ...

Lizards can regrow entire limbs. Flatworms, starfish, and sea cucumbers regrow entire bodies. Sharks constantly replace lost teeth, often growing over 20,000 teeth throughout their lifetimes. How can we translate these near-superpowers to humans?

The answer: through the cutting-edge innovations of regenerative medicine.

While big data and artificial intelligence transform how we practice medicine and invent new treatments, regenerative medicine is about replenishing, replacing, and rejuvenating our physical bodies.

In Part 5 of this blog series on Longevity and Vitality, I detail three of the regenerative technologies working together to fully augment our vital human organs.

Replenish: Stem cells, the regenerative engine of the body
Replace: Organ regeneration and bioprinting
Rejuvenate: Young blood and parabiosis

Let’s dive in.

Replenish: Stem Cells – The Regenerative Engine of the Body
Stem cells are undifferentiated cells that can transform into specialized cells such as heart, neurons, liver, lung, skin and so on, and can also divide to produce more stem cells.

In a child or young adult, these stem cells are in large supply, acting as a built-in repair system. They are often summoned to the site of damage or inflammation to repair and restore normal function.

But as we age, our supply of stem cells begins to diminish as much as 100- to 10,000-fold in different tissues and organs. In addition, stem cells undergo genetic mutations, which reduce their quality and effectiveness at renovating and repairing your body.

Imagine your stem cells as a team of repairmen in your newly constructed mansion. When the mansion is new and the repairmen are young, they can fix everything perfectly. But as the repairmen age and reduce in number, your mansion eventually goes into disrepair and finally crumbles.

What if you could restore and rejuvenate your stem cell population?

One option to accomplish this restoration and rejuvenation is to extract and concentrate your own autologous adult stem cells from places like your adipose (or fat) tissue or bone marrow.

These stem cells, however, are fewer in number and have undergone mutations (depending on your age) from their original ‘software code.’ Many scientists and physicians now prefer an alternative source, obtaining stem cells from the placenta or umbilical cord, the leftovers of birth.

These stem cells, available in large supply and expressing the undamaged software of a newborn, can be injected into joints or administered intravenously to rejuvenate and revitalize.

Think of these stem cells as chemical factories generating vital growth factors that can help to reduce inflammation, fight autoimmune disease, increase muscle mass, repair joints, and even revitalize skin and grow hair.

Over the last decade, the number of publications per year on stem cell-related research has increased 40x, and the stem cell market is expected to increase to $297 billion by 2022.

Rising research and development initiatives to develop therapeutic options for chronic diseases and growing demand for regenerative treatment options are the most significant drivers of this budding industry.

Biologists led by Kohji Nishida at Osaka University in Japan have discovered a new way to nurture and grow the tissues that make up the human eyeball. The scientists are able to grow retinas, corneas, the eye’s lens, and more, using only a small sample of adult skin.

In a Stanford study, seven of 18 stroke victims who agreed to stem cell treatments showed remarkable motor function improvements. This treatment could work for other neurodegenerative conditions such as Alzheimer’s, Parkinson’s, and ALS.

Doctors from the USC Neurorestoration Center and Keck Medicine of USC injected stem cells into the damaged cervical spine of a recently paralyzed 21-year-old man. Three months later, he showed dramatic improvement in sensation and movement of both arms.

In 2019, doctors in the U.K. cured a patient with HIV for the second time ever thanks to the efficacy of stem cells. After giving the cancer patient (who also had HIV) an allogeneic haematopoietic (e.g. blood) stem cell treatment for his Hodgkin’s lymphoma, the patient went into long-term HIV remission—18 months and counting at the time of the study’s publication.

Replace: Organ Regeneration and 3D Printing
Every 10 minutes, someone is added to the US organ transplant waiting list, totaling over 113,000 people waiting for replacement organs as of January 2019.

Countless more people in need of ‘spare parts’ never make it onto the waiting list. And on average, 20 people die each day while waiting for a transplant.

As a result, 35 percent of all US deaths (~900,000 people) could be prevented or delayed with access to organ replacements.

The excessive demand for donated organs will only intensify as technologies like self-driving cars make the world safer, given that many organ donors result from auto and motorcycle accidents. Safer vehicles mean less accidents and donations.

Clearly, replacement and regenerative medicine represent a massive opportunity.

Organ Entrepreneurs
Enter United Therapeutics CEO, Dr. Martine Rothblatt. A one-time aerospace entrepreneur (she was the founder of Sirius Satellite Radio), Rothblatt changed careers in the 1990s after her daughter developed a rare lung disease.

Her moonshot today is to create an industry of replacement organs. With an initial focus on diseases of the lung, Rothblatt set out to create replacement lungs. To accomplish this goal, her company United Therapeutics has pursued a number of technologies in parallel.

3D Printing Lungs
In 2017, United teamed up with one of the world’s largest 3D printing companies, 3D Systems, to build a collagen bioprinter and is paying another company, 3Scan, to slice up lungs and create detailed maps of their interior.

This 3D Systems bioprinter now operates according to a method called stereolithography. A UV laser flickers through a shallow pool of collagen doped with photosensitive molecules. Wherever the laser lingers, the collagen cures and becomes solid.

Gradually, the object being printed is lowered and new layers are added. The printer can currently lay down collagen at a resolution of around 20 micrometers, but will need to achieve resolution of a micrometer in size to make the lung functional.

Once a collagen lung scaffold has been printed, the next step is to infuse it with human cells, a process called recellularization.

The goal here is to use stem cells that grow on scaffolding and differentiate, ultimately providing the proper functionality. Early evidence indicates this approach can work.

In 2018, Harvard University experimental surgeon Harald Ott reported that he pumped billions of human cells (from umbilical cords and diced lungs) into a pig lung stripped of its own cells. When Ott’s team reconnected it to a pig’s circulation, the resulting organ showed rudimentary function.

Humanizing Pig Lungs
Another of Rothblatt’s organ manufacturing strategies is called xenotransplantation, the idea of transplanting an animal’s organs into humans who need a replacement.

Given the fact that adult pig organs are similar in size and shape to those of humans, United Therapeutics has focused on genetically engineering pigs to allow humans to use their organs. “It’s actually not rocket science,” said Rothblatt in her 2015 TED talk. “It’s editing one gene after another.”

To accomplish this goal, United Therapeutics made a series of investments in companies such as Revivicor Inc. and Synthetic Genomics Inc., and signed large funding agreements with the University of Maryland, University of Alabama, and New York Presbyterian/Columbia University Medical Center to create xenotransplantation programs for new hearts, kidneys, and lungs, respectively. Rothblatt hopes to see human translation in three to four years.

In preparation for that day, United Therapeutics owns a 132-acre property in Research Triangle Park and built a 275,000-square-foot medical laboratory that will ultimately have the capability to annually produce up to 1,000 sets of healthy pig lungs—known as xenolungs—from genetically engineered pigs.

Lung Ex Vivo Perfusion Systems
Beyond 3D printing and genetically engineering pig lungs, Rothblatt has already begun implementing a third near-term approach to improve the supply of lungs across the US.

Only about 30 percent of potential donor lungs meet transplant criteria in the first place; of those, only about 85 percent of those are usable once they arrive at the surgery center. As a result, nearly 75 percent of possible lungs never make it to the recipient in need.

What if these lungs could be rejuvenated? This concept informs Dr. Rothblatt’s next approach.

In 2016, United Therapeutics invested $41.8 million in TransMedics Inc., an Andover, Massachusetts company that develops ex vivo perfusion systems for donor lungs, hearts, and kidneys.

The XVIVO Perfusion System takes marginal-quality lungs that initially failed to meet transplantation standard-of-care criteria and perfuses and ventilates them at normothermic conditions, providing an opportunity for surgeons to reassess transplant suitability.

Rejuvenate Young Blood and Parabiosis
In HBO’s parody of the Bay Area tech community, Silicon Valley, one of the episodes (Season 4, Episode 5) is named “The Blood Boy.”

In this installment, tech billionaire Gavin Belson (Matt Ross) is meeting with Richard Hendricks (Thomas Middleditch) and his team, speaking about the future of the decentralized internet. A young, muscled twenty-something disrupts the meeting when he rolls in a transfusion stand and silently hooks an intravenous connection between himself and Belson.

Belson then introduces the newcomer as his “transfusion associate” and begins to explain the science of parabiosis: “Regular transfusions of the blood of a younger physically fit donor can significantly retard the aging process.”

While the sitcom is fiction, that science has merit, and the scenario portrayed in the episode is already happening today.

On the first point, research at Stanford and Harvard has demonstrated that older animals, when transfused with the blood of young animals, experience regeneration across many tissues and organs.

The opposite is also true: young animals, when transfused with the blood of older animals, experience accelerated aging. But capitalizing on this virtual fountain of youth has been tricky.

Ambrosia
One company, a San Francisco-based startup called Ambrosia, recently commenced one of the trials on parabiosis. Their protocol is simple: Healthy participants aged 35 and older get a transfusion of blood plasma from donors under 25, and researchers monitor their blood over the next two years for molecular indicators of health and aging.

Ambrosia’s founder Jesse Karmazin became interested in launching a company around parabiosis after seeing impressive data from animals and studies conducted abroad in humans: In one trial after another, subjects experience a reversal of aging symptoms across every major organ system. “The effects seem to be almost permanent,” he said. “It’s almost like there’s a resetting of gene expression.”

Infusing your own cord blood stem cells as you age may have tremendous longevity benefits. Following an FDA press release in February 2019, Ambrosia halted its consumer-facing treatment after several months of operation.

Understandably, the FDA raised concerns about the practice of parabiosis because to date, there is a marked lack of clinical data to support the treatment’s effectiveness.

Elevian
On the other end of the reputability spectrum is a startup called Elevian, spun out of Harvard University. Elevian is approaching longevity with a careful, scientifically validated strategy. (Full Disclosure: I am both an advisor to and investor in Elevian.)

CEO Mark Allen, MD, is joined by a dozen MDs and Ph.Ds out of Harvard. Elevian’s scientific founders started the company after identifying specific circulating factors that may be responsible for the “young blood” effect.

One example: A naturally occurring molecule known as “growth differentiation factor 11,” or GDF11, when injected into aged mice, reproduces many of the regenerative effects of young blood, regenerating heart, brain, muscles, lungs, and kidneys.

More specifically, GDF11 supplementation reduces age-related cardiac hypertrophy, accelerates skeletal muscle repair, improves exercise capacity, improves brain function and cerebral blood flow, and improves metabolism.

Elevian is developing a number of therapeutics that regulate GDF11 and other circulating factors. The goal is to restore our body’s natural regenerative capacity, which Elevian believes can address some of the root causes of age-associated disease with the promise of reversing or preventing many aging-related diseases and extending the healthy lifespan.

Conclusion
In 1992, futurist Leland Kaiser coined the term “regenerative medicine”:

“A new branch of medicine will develop that attempts to change the course of chronic disease and in many instances will regenerate tired and failing organ systems.”

Since then, the powerful regenerative medicine industry has grown exponentially, and this rapid growth is anticipated to continue.

A dramatic extension of the human healthspan is just over the horizon. Soon, we’ll all have the regenerative superpowers previously relegated to a handful of animals and comic books.

What new opportunities open up when anybody, anywhere, and at anytime can regenerate, replenish, and replace entire organs and metabolic systems on command?

Join Me
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Posted in Human Robots

#434755 This Week’s Awesome Stories From ...

ARTIFICIAL INTELLIGENCE
DeepMind and Google: The Battle to Control Artificial Intelligence
Hal Hodson | 1843
“Hassabis thought DeepMind would be a hybrid: it would have the drive of a startup, the brains of the greatest universities, and the deep pockets of one of the world’s most valuable companies. Every element was in place to hasten the arrival of AGI and solve the causes of human misery.”

ROBOTICS
Robot Valets Are Now Parking Cars in One of France’s Busiest Airports
James Vincent | The Verge
“Stanley Robotics say its system uses space much more efficiently than humans, fitting 50 percent more cars into the same area. This is thanks in part to the robots’ precision driving, but also because the system keeps track of when customers will return. This means the robots can park cars three or four deep, but then dig out the right vehicle ready for its owner’s return.”

COMPUTING
Quantum Computing Should Supercharge This Machine-Learning Technique
Will Knight | MIT Technology Review
“Quantum computing and artificial intelligence are both hyped ridiculously. But it seems a combination of the two may indeed combine to open up new possibilities.”

BIOTECH
Scientists Reawaken Cells From a 28,000-Year-Old Mammoth
Becky Ferreira | Motherboard
“Yuka the woolly mammoth died a long time ago, but scientists gave her cells a short second life in mouse egg cells.”

ETHICS
CRISPR Experts Are Calling for a Global Moratorium on Heritable Gene Editing
Niall Firth | MIT Technology Review
“We still don’t know what the majority of our genes do, so the risks of unintended consequences or so-called off-target effects—good or bad—are huge. …Changes in a genome might have unforeseen outcomes in future generations as well. ‘Attempting to reshape the species on the basis of our current state of knowledge would be hubris,’ the letter reads.”

GENETICS
Unleash the Full Potential of the Human Genome Project
Paul Glimcher | The Hill
“So how do the risks embedded in our genes become the diseases, the so-called phenotypes, we seek to cure or prevent? …It is not just nature, but also nurture, which leads to disease. This is something that we have known for centuries, but which we seem to have conveniently forgotten in our rush to embrace the technology of genetics. In 1990 the only thing we could measure comprehensively was genetics, so we did it. But why did we stop there?”

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Posted in Human Robots

#434658 The Next Data-Driven Healthtech ...

Increasing your healthspan (i.e. making 100 years old the new 60) will depend to a large degree on artificial intelligence. And, as we saw in last week’s blog, healthcare AI systems are extremely data-hungry.

Fortunately, a slew of new sensors and data acquisition methods—including over 122 million wearables shipped in 2018—are bursting onto the scene to meet the massive demand for medical data.

From ubiquitous biosensors, to the mobile healthcare revolution, to the transformative power of the Health Nucleus, converging exponential technologies are fundamentally transforming our approach to healthcare.

In Part 4 of this blog series on Longevity & Vitality, I expand on how we’re acquiring the data to fuel today’s AI healthcare revolution.

In this blog, I’ll explore:

How the Health Nucleus is transforming “sick care” to healthcare
Sensors, wearables, and nanobots
The advent of mobile health

Let’s dive in.

Health Nucleus: Transforming ‘Sick Care’ to Healthcare
Much of today’s healthcare system is actually sick care. Most of us assume that we’re perfectly healthy, with nothing going on inside our bodies, until the day we travel to the hospital writhing in pain only to discover a serious or life-threatening condition.

Chances are that your ailment didn’t materialize that morning; rather, it’s been growing or developing for some time. You simply weren’t aware of it. At that point, once you’re diagnosed as “sick,” our medical system engages to take care of you.

What if, instead of this retrospective and reactive approach, you were constantly monitored, so that you could know the moment anything was out of whack?

Better yet, what if you more closely monitored those aspects of your body that your gene sequence predicted might cause you difficulty? Think: your heart, your kidneys, your breasts. Such a system becomes personalized, predictive, and possibly preventative.

This is the mission of the Health Nucleus platform built by Human Longevity, Inc. (HLI). While not continuous—that will come later, with the next generation of wearable and implantable sensors—the Health Nucleus was designed to ‘digitize’ you once per year to help you determine whether anything is going on inside your body that requires immediate attention.

The Health Nucleus visit provides you with the following tests during a half-day visit:

Whole genome sequencing (30x coverage)
Whole body (non-contrast) MRI
Brain magnetic resonance imaging/angiography (MRI/MRA)
CT (computed tomography) of the heart and lungs
Coronary artery calcium scoring
Electrocardiogram
Echocardiogram
Continuous cardiac monitoring
Clinical laboratory tests and metabolomics

In late 2018, HLI published the results of the first 1,190 clients through the Health Nucleus. The results were eye-opening—especially since these patients were all financially well-off, and already had access to the best doctors.

Following are the physiological and genomic findings in these clients who self-selected to undergo evaluation at HLI’s Health Nucleus.

Physiological Findings [TG]

Two percent had previously unknown tumors detected by MRI
2.5 percent had previously undetected aneurysms detected by MRI
Eight percent had cardiac arrhythmia found on cardiac rhythm monitoring, not previously known
Nine percent had moderate-severe coronary artery disease risk, not previously known
16 percent discovered previously unknown cardiac structure/function abnormalities
30 percent had elevated liver fat, not previously known

Genomic Findings [TG]

24 percent of clients uncovered a rare (unknown) genetic mutation found on WGS
63 percent of clients had a rare genetic mutation with a corresponding phenotypic finding

In summary, HLI’s published results found that 14.4 percent of clients had significant findings that are actionable, requiring immediate or near-term follow-up and intervention.

Long-term value findings were found in 40 percent of the clients we screened. Long-term clinical findings include discoveries that require medical attention or monitoring but are not immediately life-threatening.

The bottom line: most people truly don’t know their actual state of health. The ability to take a fully digital deep dive into your health status at least once per year will enable you to detect disease at stage zero or stage one, when it is most curable.

Sensors, Wearables, and Nanobots
Wearables, connected devices, and quantified self apps will allow us to continuously collect enormous amounts of useful health information.

Wearables like the Quanttus wristband and Vital Connect can transmit your electrocardiogram data, vital signs, posture, and stress levels anywhere on the planet.

In April 2017, we were proud to grant $2.5 million in prize money to the winning team in the Qualcomm Tricorder XPRIZE, Final Frontier Medical Devices.

Using a group of noninvasive sensors that collect data on vital signs, body chemistry, and biological functions, Final Frontier integrates this data in their powerful, AI-based DxtER diagnostic engine for rapid, high-precision assessments.

Their engine combines learnings from clinical emergency medicine and data analysis from actual patients.

Google is developing a full range of internal and external sensors (e.g. smart contact lenses) that can monitor the wearer’s vitals, ranging from blood sugar levels to blood chemistry.

In September 2018, Apple announced its Series 4 Apple Watch, including an FDA-approved mobile, on-the-fly ECG. Granted its first FDA approval, Apple appears to be moving deeper into the sensing healthcare market.

Further, Apple is reportedly now developing sensors that can non-invasively monitor blood sugar levels in real time for diabetic treatment. IoT-connected sensors are also entering the world of prescription drugs.

Last year, the FDA approved the first sensor-embedded pill, Abilify MyCite. This new class of digital pills can now communicate medication data to a user-controlled app, to which doctors may be granted access for remote monitoring.

Perhaps what is most impressive about the next generation of wearables and implantables is the density of sensors, processing, networking, and battery capability that we can now cheaply and compactly integrate.

Take the second-generation OURA ring, for example, which focuses on sleep measurement and management.

The OURA ring looks like a slightly thick wedding band, yet contains an impressive array of sensors and capabilities, including:

Two infrared LED
One infrared sensor
Three temperature sensors
One accelerometer
A six-axis gyro
A curved battery with a seven-day life
The memory, processing, and transmission capability required to connect with your smartphone

Disrupting Medical Imaging Hardware
In 2018, we saw lab breakthroughs that will drive the cost of an ultrasound sensor to below $100, in a packaging smaller than most bandages, powered by a smartphone. Dramatically disrupting ultrasound is just the beginning.

Nanobots and Nanonetworks
While wearables have long been able to track and transmit our steps, heart rate, and other health data, smart nanobots and ingestible sensors will soon be able to monitor countless new parameters and even help diagnose disease.

Some of the most exciting breakthroughs in smart nanotechnology from the past year include:

Researchers from the École Polytechnique Fédérale de Lausanne (EPFL) and the Swiss Federal Institute of Technology in Zurich (ETH Zurich) demonstrated artificial microrobots that can swim and navigate through different fluids, independent of additional sensors, electronics, or power transmission.

Researchers at the University of Chicago proposed specific arrangements of DNA-based molecular logic gates to capture the information contained in the temporal portion of our cells’ communication mechanisms. Accessing the otherwise-lost time-dependent information of these cellular signals is akin to knowing the tune of a song, rather than solely the lyrics.

MIT researchers built micron-scale robots able to sense, record, and store information about their environment. These tiny robots, about 100 micrometers in diameter (approximately the size of a human egg cell), can also carry out pre-programmed computational tasks.

Engineers at University of California, San Diego developed ultrasound-powered nanorobots that swim efficiently through your blood, removing harmful bacteria and the toxins they produce.

But it doesn’t stop there.

As nanosensor and nanonetworking capabilities develop, these tiny bots may soon communicate with each other, enabling the targeted delivery of drugs and autonomous corrective action.

Mobile Health
The OURA ring and the Series 4 Apple Watch are just the tip of the spear when it comes to our future of mobile health. This field, predicted to become a $102 billion market by 2022, puts an on-demand virtual doctor in your back pocket.

Step aside, WebMD.

In true exponential technology fashion, mobile device penetration has increased dramatically, while image recognition error rates and sensor costs have sharply declined.

As a result, AI-powered medical chatbots are flooding the market; diagnostic apps can identify anything from a rash to diabetic retinopathy; and with the advent of global connectivity, mHealth platforms enable real-time health data collection, transmission, and remote diagnosis by medical professionals.

Already available to residents across North London, Babylon Health offers immediate medical advice through AI-powered chatbots and video consultations with doctors via its app.

Babylon now aims to build up its AI for advanced diagnostics and even prescription. Others, like Woebot, take on mental health, using cognitive behavioral therapy in communications over Facebook messenger with patients suffering from depression.

In addition to phone apps and add-ons that test for fertility or autism, the now-FDA-approved Clarius L7 Linear Array Ultrasound Scanner can connect directly to iOS and Android devices and perform wireless ultrasounds at a moment’s notice.

Next, Healthy.io, an Israeli startup, uses your smartphone and computer vision to analyze traditional urine test strips—all you need to do is take a few photos.

With mHealth platforms like ClickMedix, which connects remotely-located patients to medical providers through real-time health data collection and transmission, what’s to stop us from delivering needed treatments through drone delivery or robotic telesurgery?

Welcome to the age of smartphone-as-a-medical-device.

Conclusion
With these DIY data collection and diagnostic tools, we save on transportation costs (time and money), and time bottlenecks.

No longer will you need to wait for your urine or blood results to go through the current information chain: samples will be sent to the lab, analyzed by a technician, results interpreted by your doctor, and only then relayed to you.

Just like the “sage-on-the-stage” issue with today’s education system, healthcare has a “doctor-on-the-dais” problem. Current medical procedures are too complicated and expensive for a layperson to perform and analyze on their own.

The coming abundance of healthcare data promises to transform how we approach healthcare, putting the power of exponential technologies in the patient’s hands and revolutionizing how we live.

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