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#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?

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#434753 Top Takeaways From The Economist ...

Over the past few years, the word ‘innovation’ has degenerated into something of a buzzword. In fact, according to Vijay Vaitheeswaran, US business editor at The Economist, it’s one of the most abused words in the English language.

The word is over-used precisely because we’re living in a great age of invention. But the pace at which those inventions are changing our lives is fast, new, and scary.

So what strategies do companies need to adopt to make sure technology leads to growth that’s not only profitable, but positive? How can business and government best collaborate? Can policymakers regulate the market without suppressing innovation? Which technologies will impact us most, and how soon?

At The Economist Innovation Summit in Chicago last week, entrepreneurs, thought leaders, policymakers, and academics shared their insights on the current state of exponential technologies, and the steps companies and individuals should be taking to ensure a tech-positive future. Here’s their expert take on the tech and trends shaping the future.

Blockchain
There’s been a lot of hype around blockchain; apparently it can be used for everything from distributing aid to refugees to voting. However, it’s too often conflated with cryptocurrencies like Bitcoin, and we haven’t heard of many use cases. Where does the technology currently stand?

Julie Sweet, chief executive of Accenture North America, emphasized that the technology is still in its infancy. “Everything we see today are pilots,” she said. The most promising of these pilots are taking place across three different areas: supply chain, identity, and financial services.

When you buy something from outside the US, Sweet explained, it goes through about 80 different parties. 70 percent of the relevant data is replicated and is prone to error, with paper-based documents often to blame. Blockchain is providing a secure way to eliminate paper in supply chains, upping accuracy and cutting costs in the process.

One of the most prominent use cases in the US is Walmart—the company has mandated that all suppliers in its leafy greens segment be on a blockchain, and its food safety has improved as a result.

Beth Devin, head of Citi Ventures’ innovation network, added “Blockchain is an infrastructure technology. It can be leveraged in a lot of ways. There’s so much opportunity to create new types of assets and securities that aren’t accessible to people today. But there’s a lot to figure out around governance.”

Open Source Technology
Are the days of proprietary technology numbered? More and more companies and individuals are making their source code publicly available, and its benefits are thus more widespread than ever before. But what are the limitations and challenges of open source tech, and where might it go in the near future?

Bob Lord, senior VP of cognitive applications at IBM, is a believer. “Open-sourcing technology helps innovation occur, and it’s a fundamental basis for creating great technology solutions for the world,” he said. However, the biggest challenge for open source right now is that companies are taking out more than they’re contributing back to the open-source world. Lord pointed out that IBM has a rule about how many lines of code employees take out relative to how many lines they put in.

Another challenge area is open governance; blockchain by its very nature should be transparent and decentralized, with multiple parties making decisions and being held accountable. “We have to embrace open governance at the same time that we’re contributing,” Lord said. He advocated for a hybrid-cloud environment where people can access public and private data and bring it together.

Augmented and Virtual Reality
Augmented and virtual reality aren’t just for fun and games anymore, and they’ll be even less so in the near future. According to Pearly Chen, vice president at HTC, they’ll also go from being two different things to being one and the same. “AR overlays digital information on top of the real world, and VR transports you to a different world,” she said. “In the near future we will not need to delineate between these two activities; AR and VR will come together naturally, and will change everything we do as we know it today.”

For that to happen, we’ll need a more ergonomically friendly device than we have today for interacting with this technology. “Whenever we use tech today, we’re multitasking,” said product designer and futurist Jody Medich. “When you’re using GPS, you’re trying to navigate in the real world and also manage this screen. Constant task-switching is killing our brain’s ability to think.” Augmented and virtual reality, she believes, will allow us to adapt technology to match our brain’s functionality.

This all sounds like a lot of fun for uses like gaming and entertainment, but what about practical applications? “Ultimately what we care about is how this technology will improve lives,” Chen said.

A few ways that could happen? Extended reality will be used to simulate hazardous real-life scenarios, reduce the time and resources needed to bring a product to market, train healthcare professionals (such as surgeons), or provide therapies for patients—not to mention education. “Think about the possibilities for children to learn about history, science, or math in ways they can’t today,” Chen said.

Quantum Computing
If there’s one technology that’s truly baffling, it’s quantum computing. Qubits, entanglement, quantum states—it’s hard to wrap our heads around these concepts, but they hold great promise. Where is the tech right now?

Mandy Birch, head of engineering strategy at Rigetti Computing, thinks quantum development is starting slowly but will accelerate quickly. “We’re at the innovation stage right now, trying to match this capability to useful applications,” she said. “Can we solve problems cheaper, better, and faster than classical computers can do?” She believes quantum’s first breakthrough will happen in two to five years, and that is highest potential is in applications like routing, supply chain, and risk optimization, followed by quantum chemistry (for materials science and medicine) and machine learning.

David Awschalom, director of the Chicago Quantum Exchange and senior scientist at Argonne National Laboratory, believes quantum communication and quantum sensing will become a reality in three to seven years. “We’ll use states of matter to encrypt information in ways that are completely secure,” he said. A quantum voting system, currently being prototyped, is one application.

Who should be driving quantum tech development? The panelists emphasized that no one entity will get very far alone. “Advancing quantum tech will require collaboration not only between business, academia, and government, but between nations,” said Linda Sapochak, division director of materials research at the National Science Foundation. She added that this doesn’t just go for the technology itself—setting up the infrastructure for quantum will be a big challenge as well.

Space
Space has always been the final frontier, and it still is—but it’s not quite as far-removed from our daily lives now as it was when Neil Armstrong walked on the moon in 1969.

The space industry has always been funded by governments and private defense contractors. But in 2009, SpaceX launched its first commercial satellite, and in subsequent years have drastically cut the cost of spaceflight. More importantly, they published their pricing, which brought transparency to a market that hadn’t seen it before.

Entrepreneurs around the world started putting together business plans, and there are now over 400 privately-funded space companies, many with consumer applications.

Chad Anderson, CEO of Space Angels and managing partner of Space Capital, pointed out that the technology floating around in space was, until recently, archaic. “A few NASA engineers saw they had more computing power in their phone than there was in satellites,” he said. “So they thought, ‘why don’t we just fly an iPhone?’” They did—and it worked.

Now companies have networks of satellites monitoring the whole planet, producing a huge amount of data that’s valuable for countless applications like agriculture, shipping, and observation. “A lot of people underestimate space,” Anderson said. “It’s already enabling our modern global marketplace.”

Next up in the space realm, he predicts, are mining and tourism.

Artificial Intelligence and the Future of Work
From the US to Europe to Asia, alarms are sounding about AI taking our jobs. What will be left for humans to do once machines can do everything—and do it better?

These fears may be unfounded, though, and are certainly exaggerated. It’s undeniable that AI and automation are changing the employment landscape (not to mention the way companies do business and the way we live our lives), but if we build these tools the right way, they’ll bring more good than harm, and more productivity than obsolescence.

Accenture’s Julie Sweet emphasized that AI alone is not what’s disrupting business and employment. Rather, it’s what she called the “triple A”: automation, analytics, and artificial intelligence. But even this fear-inducing trifecta of terms doesn’t spell doom, for workers or for companies. Accenture has automated 40,000 jobs—and hasn’t fired anyone in the process. Instead, they’ve trained and up-skilled people. The most important drivers to scale this, Sweet said, are a commitment by companies and government support (such as tax credits).

Imbuing AI with the best of human values will also be critical to its impact on our future. Tracy Frey, Google Cloud AI’s director of strategy, cited the company’s set of seven AI principles. “What’s important is the governance process that’s put in place to support those principles,” she said. “You can’t make macro decisions when you have technology that can be applied in many different ways.”

High Risks, High Stakes
This year, Vaitheeswaran said, 50 percent of the world’s population will have internet access (he added that he’s disappointed that percentage isn’t higher given the proliferation of smartphones). As technology becomes more widely available to people around the world and its influence grows even more, what are the biggest risks we should be monitoring and controlling?

Information integrity—being able to tell what’s real from what’s fake—is a crucial one. “We’re increasingly operating in siloed realities,” said Renee DiResta, director of research at New Knowledge and head of policy at Data for Democracy. “Inadvertent algorithmic amplification on social media elevates certain perspectives—what does that do to us as a society?”

Algorithms have also already been proven to perpetuate the bias of the people who create it—and those people are often wealthy, white, and male. Ensuring that technology doesn’t propagate unfair bias will be crucial to its ability to serve a diverse population, and to keep societies from becoming further polarized and inequitable. The polarization of experience that results from pronounced inequalities within countries, Vaitheeswaran pointed out, can end up undermining democracy.

We’ll also need to walk the line between privacy and utility very carefully. As Dan Wagner, founder of Civis Analytics put it, “We want to ensure privacy as much as possible, but open access to information helps us achieve important social good.” Medicine in the US has been hampered by privacy laws; if, for example, we had more data about biomarkers around cancer, we could provide more accurate predictions and ultimately better healthcare.

But going the Chinese way—a total lack of privacy—is likely not the answer, either. “We have to be very careful about the way we bake rights and freedom into our technology,” said Alex Gladstein, chief strategy officer at Human Rights Foundation.

Technology’s risks are clearly as fraught as its potential is promising. As Gary Shapiro, chief executive of the Consumer Technology Association, put it, “Everything we’ve talked about today is simply a tool, and can be used for good or bad.”

The decisions we’re making now, at every level—from the engineers writing algorithms, to the legislators writing laws, to the teenagers writing clever Instagram captions—will determine where on the spectrum we end up.

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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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#434580 How Genome Sequencing and Senolytics Can ...

The causes of aging are extremely complex and unclear. With the dramatic demonetization of genome reading and editing over the past decade, and Big Pharma, startups, and the FDA starting to face aging as a disease, we are starting to find practical ways to extend our healthspan.

Here, in Part 2 of a series of blogs on longevity and vitality, I explore how genome sequencing and editing, along with new classes of anti-aging drugs, are augmenting our biology to further extend our healthy lives.

In this blog I’ll cover two classes of emerging technologies:

Genome Sequencing and Editing;
Senolytics, Nutraceuticals & Pharmaceuticals.

Let’s dive in.

Genome Sequencing & Editing
Your genome is the software that runs your body.

A sequence of 3.2 billion letters makes you “you.” These base pairs of A’s, T’s, C’s, and G’s determine your hair color, your height, your personality, your propensity to disease, your lifespan, and so on.

Until recently, it’s been very difficult to rapidly and cheaply “read” these letters—and even more difficult to understand what they mean.

Since 2001, the cost to sequence a whole human genome has plummeted exponentially, outpacing Moore’s Law threefold. From an initial cost of $3.7 billion, it dropped to $10 million in 2006, and to $5,000 in 2012.

Today, the cost of genome sequencing has dropped below $500, and according to Illumina, the world’s leading sequencing company, the process will soon cost about $100 and take about an hour to complete.

This represents one of the most powerful and transformative technology revolutions in healthcare.

When we understand your genome, we’ll be able to understand how to optimize “you.”

We’ll know the perfect foods, the perfect drugs, the perfect exercise regimen, and the perfect supplements, just for you.
We’ll understand what microbiome types, or gut flora, are ideal for you (more on this in a later blog).
We’ll accurately predict how specific sedatives and medicines will impact you.
We’ll learn which diseases and illnesses you’re most likely to develop and, more importantly, how to best prevent them from developing in the first place (rather than trying to cure them after the fact).

CRISPR Gene Editing
In addition to reading the human genome, scientists can now edit a genome using a naturally-occurring biological system discovered in 1987 called CRISPR/Cas9.

Short for Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated protein 9, the editing system was adapted from a naturally-occurring defense system found in bacteria.

Here’s how it works:

The bacteria capture snippets of DNA from invading viruses (or bacteriophage) and use them to create DNA segments known as CRISPR arrays.
The CRISPR arrays allow the bacteria to “remember” the viruses (or closely related ones), and defend against future invasions.
If the viruses attack again, the bacteria produce RNA segments from the CRISPR arrays to target the viruses’ DNA. The bacteria then use Cas9 to cut the DNA apart, which disables the virus.

Most importantly, CRISPR is cheap, quick, easy to use, and more accurate than all previous gene editing methods. As a result, CRISPR/Cas9 has swept through labs around the world as the way to edit a genome.

A short search in the literature will show an exponential rise in the number of CRISPR-related publications and patents.

2018: Filled With CRISPR Breakthroughs
Early results are impressive. Researchers from the University of Chicago recently used CRISPR to genetically engineer cocaine resistance into mice.

Researchers at the University of Texas Southwestern Medical Center used CRISPR to reverse the gene defect causing Duchenne muscular dystrophy (DMD) in dogs (DMD is the most common fatal genetic disease in children).

With great power comes great responsibility, and moral and ethical dilemmas.

In 2015, Chinese scientists sparked global controversy when they first edited human embryo cells in the lab with the goal of modifying genes that would make the child resistant to smallpox, HIV, and cholera.

Three years later, in November 2018, researcher He Jiankui informed the world that the first set of CRISPR-engineered female twins had been delivered.

To accomplish his goal, Jiankui deleted a region of a receptor on the surface of white blood cells known as CCR5, introducing a rare, natural genetic variation that makes it more difficult for HIV to infect its favorite target, white blood cells.

Setting aside the significant ethical conversations, CRISPR will soon provide us the tools to eliminate diseases, create hardier offspring, produce new environmentally resistant crops, and even wipe out pathogens.

Senolytics, Nutraceuticals & Pharmaceuticals
Over the arc of your life, the cells in your body divide until they reach what is known as the Hayflick limit, or the number of times a normal human cell population will divide before cell division stops, which is typically about 50 divisions.

What normally follows next is programmed cell death or destruction by the immune system. A very small fraction of cells, however, become senescent cells and evade this fate to linger indefinitely.

These lingering cells secrete a potent mix of molecules that triggers chronic inflammation, damages the surrounding tissue structures, and changes the behavior of nearby cells for the worse.

Senescent cells appear to be one of the root causes of aging, causing everything from fibrosis and blood vessel calcification, to localized inflammatory conditions such as osteoarthritis, to diminished lung function.

Fortunately, both the scientific and entrepreneurial communities have begun to work on senolytic therapies, moving the technology for selectively destroying senescent cells out of the laboratory and into a half-dozen startup companies.

Prominent companies in the field include the following:

Unity Biotechnology is developing senolytic medicines to selectively eliminate senescent cells with an initial focus on delivering localized therapy in osteoarthritis, ophthalmology and pulmonary disease.
Oisin Biotechnologiesis pioneering a programmable gene therapy that can destroy cells based on their internal biochemistry.
SIWA Therapeuticsis working on an immunotherapy approach to the problem of senescent cells.

In recent years, researchers have identified or designed a handful of senolytic compounds that can curb aging by regulating senescent cells. Two of these drugs that have gained mainstay research traction are rapamycin and metformin.

Rapamycin
Originally extracted from bacteria found on Easter Island, Rapamycin acts on the m-TOR (mechanistic target of rapamycin) pathway to selectively block a key protein that facilitates cell division.

Currently, rapamycin derivatives are widely used as immunosuppression in organ and bone marrow transplants. Research now suggests that use results in prolonged lifespan and enhanced cognitive and immune function.

PureTech Health subsidiary resTORbio (which started 2018 by going public) is working on a rapamycin-based drug intended to enhance immunity and reduce infection. Their clinical-stage RTB101 drug works by inhibiting part of the mTOR pathway.

Results of the drug’s recent clinical trial include:

Decreased incidence of infection
Improved influenza vaccination response
A 30.6 percent decrease in respiratory tract infections

Impressive, to say the least.

Metformin
Metformin is a widely-used generic drug for mitigating liver sugar production in Type 2 diabetes patients.

Researchers have found that Metformin also reduces oxidative stress and inflammation, which otherwise increase as we age.

There is strong evidence that Metformin can augment cellular regeneration and dramatically mitigate cellular senescence by reducing both oxidative stress and inflammation.

Over 100 studies registered on ClinicalTrials.gov are currently following up on strong evidence of Metformin’s protective effect against cancer.

Nutraceuticals and NAD+
Beyond cellular senescence, certain critical nutrients and proteins tend to decline as a function of age. Nutraceuticals combat aging by supplementing and replenishing these declining nutrient levels.

NAD+ exists in every cell, participating in every process from DNA repair to creating the energy vital for cellular processes. It’s been shown that NAD+ levels decline as we age.

The Elysium Health Basis supplement aims to elevate NAD+ levels in the body to extend one’s lifespan. Elysium’s clinical study reports that Basis increases NAD+ levels consistently by a sustained 40 percent.

Conclusion
These are just a taste of the tremendous momentum that longevity and aging technology has right now. As artificial intelligence and quantum computing transform how we decode our DNA and how we discover drugs, genetics and pharmaceuticals will become truly personalized.

The next blog in this series will demonstrate how artificial intelligence is converging with genetics and pharmaceuticals to transform how we approach longevity, aging, and vitality.

We are edging closer to a dramatically extended healthspan—where 100 is the new 60. What will you create, where will you explore, and how will you spend your time if you are able to add an additional 40 healthy years to your life?

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#433954 The Next Great Leap Forward? Combining ...

The Internet of Things is a popular vision of objects with internet connections sending information back and forth to make our lives easier and more comfortable. It’s emerging in our homes, through everything from voice-controlled speakers to smart temperature sensors. To improve our fitness, smart watches and Fitbits are telling online apps how much we’re moving around. And across entire cities, interconnected devices are doing everything from increasing the efficiency of transport to flood detection.

In parallel, robots are steadily moving outside the confines of factory lines. They’re starting to appear as guides in shopping malls and cruise ships, for instance. As prices fall and the artificial intelligence (AI) and mechanical technology continues to improve, we will get more and more used to them making independent decisions in our homes, streets and workplaces.

Here lies a major opportunity. Robots become considerably more capable with internet connections. There is a growing view that the next evolution of the Internet of Things will be to incorporate them into the network, opening up thrilling possibilities along the way.

Home Improvements
Even simple robots become useful when connected to the internet—getting updates about their environment from sensors, say, or learning about their users’ whereabouts and the status of appliances in the vicinity. This lets them lend their bodies, eyes, and ears to give an otherwise impersonal smart environment a user-friendly persona. This can be particularly helpful for people at home who are older or have disabilities.

We recently unveiled a futuristic apartment at Heriot-Watt University to work on such possibilities. One of a few such test sites around the EU, our whole focus is around people with special needs—and how robots can help them by interacting with connected devices in a smart home.

Suppose a doorbell rings that has smart video features. A robot could find the person in the home by accessing their location via sensors, then tell them who is at the door and why. Or it could help make video calls to family members or a professional carer—including allowing them to make virtual visits by acting as a telepresence platform.

Equally, it could offer protection. It could inform them the oven has been left on, for example—phones or tablets are less reliable for such tasks because they can be misplaced or not heard.

Similarly, the robot could raise the alarm if its user appears to be in difficulty.Of course, voice-assistant devices like Alexa or Google Home can offer some of the same services. But robots are far better at moving, sensing and interacting with their environment. They can also engage their users by pointing at objects or acting more naturally, using gestures or facial expressions. These “social abilities” create bonds which are crucially important for making users more accepting of the support and making it more effective.

To help incentivize the various EU test sites, our apartment also hosts the likes of the European Robotic League Service Robot Competition—a sort of Champions League for robots geared to special needs in the home. This brought academics from around Europe to our laboratory for the first time in January this year. Their robots were tested in tasks like welcoming visitors to the home, turning the oven off, and fetching objects for their users; and a German team from Koblenz University won with a robot called Lisa.

Robots Offshore
There are comparable opportunities in the business world. Oil and gas companies are looking at the Internet of Things, for example; experimenting with wireless sensors to collect information such as temperature, pressure, and corrosion levels to detect and possibly predict faults in their offshore equipment.

In the future, robots could be alerted to problem areas by sensors to go and check the integrity of pipes and wells, and to make sure they are operating as efficiently and safely as possible. Or they could place sensors in parts of offshore equipment that are hard to reach, or help to calibrate them or replace their batteries.

The likes of the ORCA Hub, a £36m project led by the Edinburgh Centre for Robotics, bringing together leading experts and over 30 industry partners, is developing such systems. The aim is to reduce the costs and the risks of humans working in remote hazardous locations.

ORCA tests a drone robot. ORCA
Working underwater is particularly challenging, since radio waves don’t move well under the sea. Underwater autonomous vehicles and sensors usually communicate using acoustic waves, which are many times slower (1,500 meters a second vs. 300m meters a second for radio waves). Acoustic communication devices are also much more expensive than those used above the water.

This academic project is developing a new generation of low-cost acoustic communication devices, and trying to make underwater sensor networks more efficient. It should help sensors and underwater autonomous vehicles to do more together in future—repair and maintenance work similar to what is already possible above the water, plus other benefits such as helping vehicles to communicate with one another over longer distances and tracking their location.

Beyond oil and gas, there is similar potential in sector after sector. There are equivalents in nuclear power, for instance, and in cleaning and maintaining the likes of bridges and buildings. My colleagues and I are also looking at possibilities in areas such as farming, manufacturing, logistics, and waste.

First, however, the research sectors around the Internet of Things and robotics need to properly share their knowledge and expertise. They are often isolated from one another in different academic fields. There needs to be more effort to create a joint community, such as the dedicated workshops for such collaboration that we organized at the European Robotics Forum and the IoT Week in 2017.

To the same end, industry and universities need to look at setting up joint research projects. It is particularly important to address safety and security issues—hackers taking control of a robot and using it to spy or cause damage, for example. Such issues could make customers wary and ruin a market opportunity.

We also need systems that can work together, rather than in isolated applications. That way, new and more useful services can be quickly and effectively introduced with no disruption to existing ones. If we can solve such problems and unite robotics and the Internet of Things, it genuinely has the potential to change the world.

Mauro Dragone, Assistant Professor, Cognitive Robotics, Multiagent systems, Internet of Things, Heriot-Watt University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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