Broadcasting Brain Waves

I grew up with Dick Tracy, and I always wanted a two-way radio watch. I have also had  patients who thought their brain waves were being monitored by governmental agencies.

Now reality extends science and the paranoid ideas of unfortunate patients. In the April 4, 2014 issue of Science, Xu et al published an elegant article on making a wearable system of thin electronic modules in a highly visco-elastic polymer that adapts to and follows the changes in skin’s movement, temperature, and physical properties. The kit includes a radio that can send electrical waves (e.g., electrocardiograms, electroencephalograms) from the body. Engineers will love the technical  wizardry; physiologists, clinicians, and exercise physiologists will be excited about the ability to get real-time electrical readings from the brain, muscles, and the eyes.

No doubt in a back  room someone will be working on realtime functional nuclear magnetic images to broadcast from a skin radio. . . . Will security agencies be monitoring body waves as well?

As important as the science is the organization of the groups reporting these findings.

Eighteen authors — not that exceptional today, especially considering the variety of scientific disciplines involved for this project.

Teams from three countries:  People’s Republic of China, Republic of Korea, and the US, with funding from at least two of those nations.

This model and mode  of collaborative science will become more the norm as science research  progresses beyond single disciplines. This is our brave new world. Dick Tracy would be amazed and impressed.

 

REFERENCE

Xu S, Zhang Y, Jia L, et al.  Soft Microfluidic Assemblies of Sensors, Circuits, and Radios for the Skin.  Science 344:70-74 doi:10.1126/science.1250169

Bringing the US Biomedical Research Establishment into Equilibrium

The need is great, and the time is now. The recent PNAS article “Rescuing US biomedical research from its systemic flaws” should be studied and discussed by individuals, educational and research institutions, and scientific societies. There may be no more, or fewer, sacred cows in biomedical research — and many oxen may be gored as well.

The paragraph below is reprinted from an AAMC newsletter of April 17, 2014.

Bruce Alberts, Marc Kirschner, Shirley Tilghman, and Harold Varmus describe specific ways for “rescuing U.S. biomedical research from its systematic flaws” in this week’s Proceedings of the National Academy of Science. They write, “The long-held but erroneous assumption of never-ending rapid growth in biomedical science has created an unsustainable hypercompetitive system that is discouraging even the most outstanding prospective students from entering our profession-and making it difficult for seasoned investigators to produce their best work. This is a recipe for long-term decline, and the problems cannot be solved with simplistic approaches.” The authors suggest reforms on the funding of graduate students, postdoc compensation, and peer review. They also would reconsider rules on indirect facilities cost reimbursement and salary support on research project grants.

Cookie Monster Says “More Data!”

Sesame Street fans remember Cookie Monster saying “. . .Me want cookie!”.  At the 72nd Annual Meeting of the American Academy of Dermatology in Denver, two of the plenary lectures that at first glance might seem to be coming from different poles of the expanding universe had an identical message:  Not “more cookies” . . . but  “MORE (and better) DATA!”

Jack Resneck, Jr, MD of the University of California San Francisco School of Medicine addressed the need for more and better  data on how dermatology is practiced to ensure that  care is delivered effectively and efficiently and that dermatologists are being appropriately compensated for their efforts. He emphasized that data are going to be necessary and that dermatologists should  require that decisions  be data driven and that dermatologists be involved in the generation and analysis of this data. One might argue that this is advocating for the fox guarding the hen house, but DATA — when excellent and complete — may save both the fox and the hens.

Starting  from a molecular perspective, Lynda Chin, MD (MD Anderson University of Texas, Houston) inferred that reducing health disparities and improving inadequate or less-than-optimal medical care requires more and better DATA. The data in the studies  she recounted emphasized the molecular and biological heterogeneity among cutaneous melanomas. Her experience creating large data warehouses  for clinical, biological, and therapeutic data sets was a compelling path to the future.   She clearly  showed  that multiple agents to treat individual cases of melanoma may be the evolving new norm based in the molecular biology of lesions and cross-talk and interactions between molecular pathways.

The entire village of medicine will be necessary for these studies to succeed. Molecular studies are often technology -based, and although errors that may creep in, their data integrity can be high and seems straightforward. Capturing the essential clinical data on patients, especially when  multiple clinicians are involved, could be much more  challenging — and even more so when an international consortium is involved. Capturing retrospective data on historical nutritional and environmental exposures for individual patients represents an additional complexity.   How  credit will be distributed  for participation in studies, in terms of publication, tenure, time for academic affairs, salary, and bonuses, will be issues the academic and medical care systems must address. Will the cookie be in so many crumbs that the bits will not be very appetizing to those necessary for successful and useful  studies?

Since conclusions are often  tentative, and they are moving targets considering anticipated additional  DATA, the role of the individual patients and their physicians in deciding  what therapy should be used will be the next challenging frontier, and DATA tailored for patient and doctor education will be necessary.

 

Resneck, JS, Jr:  The Future of Our Specialty in a Time of Unprecedented Change

Chin, L:  Genomic Medicine: Transforming Research and Patient Care

Presented at the Plenary Session, 72nd Annual Meeting of the American Academy of Dermatology Sunday, March 23, 2014, Denver, CO, USA.

No Cell Sings Alone

An organism is  a chorus. Through an invisible song book its cells follow an omniscient conductor who directs them when to open their mouths and utter a note or a phase;  when the concert concludes, the effects suggest cosmic regulation. Ervin H. Epstein, Jr., MD and Anthony Eugene Oro, MD, PhD investigate how cells work and interact to make normal epithelial organs, such as skin and hair follicles: cells follow molecular conductors, pick up brief nuanced clues, nods, and signals, and they interact with other cells, hormones, and tissues. Sometimes a cell and its progeny follow discordant paths; then cacophony, discomforting rhythms, and disease occur, leaving the chorus a jumbled racket.

Epstein described how  small molecules could be used to correct these aberrant voices and make them rejoin the chorus; alternately, they could be made to abate their shouting and go away completely; or, perhaps, they could be made to wither away and allow other singers to continue on in tune. It can take decades to first identify the squeaky voice in a disease and then to develop an effective and safe means   for silencing it or training it.  Outstanding examples for new and effective treatment for the basal  cell nevus syndrome and the more common basal cell carcinomas of the skin were presented.

Oro discussed how cells could be returned to their youthful, pristine voices and directed to produce clear  tones in harmony with their sister cells.  Dermatologists in the audience perceived how drugs could take the place of surgery or ionizing radiation for treating of skin tumors, and how devastating genetic diseases could be ameliorated with a new set of an individual’s own cells.   Work in progress will focus on preventing resistant clones from growing in tumors undergoing treatment and developing drugs with fewer side effects, or maybe evolving completely new therapeutic modalities.

The final song will be worth the effort.

 

Epstein, EE Jr:  Twacking the Hedgehog

Oro, AE:  Heal Thyself: Using Stem Cell Biology for Skin Disease

 

Presented at the Plenary session of the 75th Annual Meeting of the American Academy of Dermatology, Sunday March 23, 2014, Denver CO, USA.