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Towards Human-Centric Wireless Technologies: Digital Twins in Health Sector

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If you are old enough to have watched the series “Bones,” then for sure you have bumped into the “Angelator,” a holographic projector developed for forensics. Based on data and evidence collected from the crime scene, a reconstruction is achieved, allowing inspectors to visualize a 3D representation of the victim or weapons used and study different hypotheses related to the incident itself. 

This fictitious device created for TV purposes several years ago is an incontestable premise to appreciate the realistic and future impersonation of the idea, namely, digital twins. The talks about the digital twins’ concept go as far as early 1990 with the publication of Mirror Worlds by David Gelernter. However, a clearer view of the concept was described by Grieves in 2002 and Vickers from NASA in 2010. 

Although the idea was clear at that time, the practical realization of a digital twin was not possible as the associated technology was not mature enough. Looking at IBM’s definition of a digital twin, that is, “A digital twin is a virtual representation of an object or system that spans its lifecycle, is updated from real-time data, and uses simulation, machine learning, and reasoning to help decision-making.”, one can clearly sense that the right time is now to start investing in this technology. 

Digital twins technology is at the crossroads of advanced telecom standards, powerful computing resources, and accurate artificial intelligence algorithms. The advent of the 5G wireless standard and, more importantly, the prospects of the following 6G standard would allow the achievement of the appropriate latencies and data rate for a real-time operation of the twin. The increasing investment in cloud and edge computing resources will provide the power to gather and analyze significant amounts of collected data. Finally, the constant improvement of AI algorithms will further lead to better decision-making. And the conditions will only get better for digital twin solutions as the development efforts are relentless on all fronts.

Precise disruptive technology for most sectors

Digital twins are disruptive at all fronts. Among others is its high contribution to the fourth industrial revolution, known as industry 4.0. It offers to migrate the agile development methodology from the software industry to a myriad of other applications. The ability to crunch huge amounts of data collected from sensors interpret them will allow manufacturers to validate their concepts, integrate components together, optimize the production process without the need to resort to the costly traditional approach of manufacturing prototypes and conducting rigorous testing. It also allows complex management of systems and dramatically simplifies troubleshooting tasks.

Healthcare is considered among the sectors which would be significantly affected by the inception of digital twins solutions, given its increasing reliance on advanced technology. The use cases of digital twins in healthcare are numerous, spanning logistics, operations, supply chain management, medical diagnostics, and therapeutics, among others. The latest coronavirus pandemic is one striking example that justifies twinning solutions. With the surge in the number of hospitalized people, the hospital ecosystem was placed under immense stress, nearly becoming non-functional with a shortage in protection equipment, ventilators, and, most importantly, emergency room beds. 

A digital twin solution would have allowed to proactively optimize the response to the pandemic through tweaks made to the digital twin, given all the patient and hospital data collected. Compared to traditional simulations, the new solution allows the visualization of the resolution, rather than just obtaining numbers that eventually need to be used. Visualizing the future certainly passes by a proper visualization of the present, which is the heart of the twinning solution.

Another use case relates to medical diagnostics. The sci-fi concept introduced in “Bones” will soon become a reality. Imagine a doctor having a visual update of a patient heart condition. The data collected from different sources such as heart rate, oxygen levels, electrocardiograms, and potentially medical imaging, will be useful in updating the patient’s virtual twin. 

The advanced computing and learning capabilities will even allow the caregiver to trial various drugs and therapeutic techniques, observing their impact, before administering them to the patient. Genomic medicine and mRNA-based treatments (such as some COVID-19 vaccines) can be developed better and easier to ensure a faster and more tailored response to illnesses and diseases.

Vanishing obstacles to make digital twins the norm?

The adoption of this digital twin in the healthcare sector hasn’t picked up yet properly due to many challenges. “Technology literacy” is one issue that needs to be addressed to increase the adoption rate, as Healthcare providers and caregivers need to be comfortable with the new technology to embrace the foreseen health revolution. Another major issue relates to data integrity and privacy. 

Biomedical data is considered among the essential sources of information as they nearly permit the reconstruction of a person’s profile. Thus, ensuring that the data used to construct the digital twins is unaltered (integrity) and will not leak out (privacy) will ensure that more institutions are willing to invest in the technology after proper guarantees that ethical principles are respected. 

Finally, the data itself should be detailed enough to ensure that the twin properly represents the patient and that all analyses and decisions made are accurate. While other industries are not as sensitive to these issues, health provision highly depends on it. 

The rise of digital twins startup companies

As in any new technology, early adopters of digital twins are mainly startups, each trying to commercialize its own use of this innovation. The German company Virtonomy aims at shortening the time-to-market of medical products. They rely on digital twins to study the anatomical constraints and design medical implants accordingly. Another company, namely, unlearn.ai, has implemented several twinning solutions to reduce the number of trials, offloading some of the developed twins. Another goal is to forecast the progress in patients who have Alzheimer’s disease. 

The French startup Nurea is employing digital twins to prevent cardiovascular accidents. The US startup Predictiv uses collected DNA samples to build your digital twin, then performs the analysis to predict genetic disorders. Another US startup in the name of Q-bio takes twinning to another level, utilizing their whole body Q Bio Mark I scanner to develop a digital twin for the whole body. Finally, the British company Babylon Health allows users to explore their bodies learn about possible risks and how to improve their health.

The aforementioned examples are only some among many startups flourishing worldwide and aiming to be at the forefront of the new healthcare revolution driven by digital twins. As the adoption of this solution increases among healthcare providers, it will become an integral part of our life. 

The development of wireless technologies will undoubtedly have a human-centric flavor, with several key performance indicators and use cases developed based on human-centric applications such as healthcare provision. The next few years will most certainly witness the rise of digital healthcare. The coronavirus pandemic has convinced a large group of people that the healthcare system as it stands is very brittle and that waves of change need to come as fast as possible. Digital twins are probably the first tidal wave that will lead to the metamorphosis of the healthcare sector.

PhD holder with over 10 years of experience in wireless communication systems, e-health informatics, and computer networks and a passion to investigate and educate people recent topics in artificial intelligence, blockchain technology, and biomimetics.

MedTech

Molecule Imaging Technique Allows Study of Memory Generation and Retrieval

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molecule imaging technique

Researchers have created a novel molecule imaging technique for seeing mRNA molecules in live mouse brains. The study offers a fresh understanding of how memories are created and retained in the brain and may one day help researchers better understand conditions like Alzheimer’s. The study was published in the Proceedings of the National Academy of Sciences (PNAS).

The method by which memory is really produced and stored in the brain is still shrouded in a great deal of uncertainty. It is generally known that the process of creating and storing memories causes the production of mRNA, a kind of RNA involved in the production of proteins, but the technology for investigating this process at the cellular level has been limited. In earlier research, the brains of mice were frequently dissected and examined.

The new molecule imaging technique provides scientists with a window into RNA creation in a mouse’s brain while the animal is still alive was created by a research team under the direction of a faculty member from the University of Minnesota Twin Cities.

“We still know very little about memories in the brain,” explained Hye Yoon Park, the study’s lead author and an associate professor in the University of Minnesota Department of Electrical and Computer Engineering. “It’s well known that mRNA synthesis is important for memory, but it was never possible to image this in a live brain. Our work is an important contribution to this field. We now have this new technology that neurobiologists can use for various different experiments and memory tests in the future.”

The procedure used by the team, which was directed by the University of Minnesota, included genetic engineering, two-photon excitation microscopy, and improved image processing software. The researchers were able to determine when and where the mouse’s brain released Arc mRNA by genetically altering the mouse to create mRNA that was tagged with green fluorescent proteins taken from a jellyfish.

The fact that the mouse is alive allowed the researchers to observe it for a longer amount of time. Using this novel molecule imaging technique, the researchers carried out two studies on the mouse in which they could observe in real time what the neurons, or nerve cells, were doing over the course of a month while the mouse developed and stored memories.

Neuroscientists have long hypothesized that certain neural networks fire in the brain during the formation of memories and then again during recall of those memories. But in both studies, the researchers discovered that separate neural networks activated on various days to activate the mouse’s memory.

In the retrosplenial cortex (RSC) region of the brain, they were able to identify a small cluster of cells that overlapped or consistently produced the Arc mRNA over the course of several days after the mouse formed this memory. They believe this cluster is in charge of the long-term storage of that memory.


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MedTech

LiveMetric’s LiveOne: A Bliss for Hypertension Patients

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Wearable technology has become an essential component of our daily life, especially for chronic diseases such as diabetes and hypertension. Driven by advances in communications and computing and improved sensor accuracy, smartwatches have become real diagnostic tools capable of measuring vital signs while providing insights into our medical conditions. Efficiently measuring blood pressure with clinically proven accuracy has been a daunting task for smartwatch manufacturers. Many fitness trackers and smartwatches available on the market have developed such capability using the array of embedded sensors, however most of them did not get the Food and Drug Administration (FDA) approval. To this end, LiveMetric has recently announced receiving the FDA clearance for its watch-like wearable blood pressure monitoring solution, the LiveOne. The announced news is a potential bliss for chronic hypertension patients, notably as far as managing their conditions continuously with time.

The LiveOne Solution

Traditional medical grade blood pressure monitoring technology relies on cuffs that wrap around the arm. The cuff is then inflated manually or automatically until it fits tightly around the arm. Once it starts deflating, systolic and diastolic pressures are recorded giving the patient the two known readings used to estimate his condition.

The LiveOne wearable provides the same accuracy without the need for the bulky cuff, but also allowing continuous measurements that are taken every 10 seconds. According to the company’s press release, the pressure waveform out of the radial artery, the blood vessel that supplies blood to the hand, is recorded. The new design allows 24-hour ambulatory blood pressure measurements (ABPM) in addition to longer period blood pressure monitoring.

The blood pressure wearable relies on an array of nano-sensors built using microelectromechanical systems (MEMS) technology.  The output from these miniaturized sensing devices is processed by machine learning algorithms to determine the blood pressure values.

The results of a study involving the LiveOne device were published in article in the American Journal of Hypertension. The measurements collected from the device were compared to A-line measurements, that is, where blood pressure is measured through a radial artery intra-arterial catheter. Measurements using both techniques showed high correlation which indicates a notable accuracy in the readings of the wearable device.

A Promise to Hypertension Patients

The new device provides high hopes for individuals suffering from hypertension. Hypertension is a silent disease which means that not everyone having it, actually know they do. According to the world health organization (WHO), less than half of the adults with hypertension are diagnosed and treated. Besides its impact on the heart, brain, and kidneys, hypertension is one of the causes of premature death.

The possibility of having a wearable device that provides continuous blood pressure measurements is important towards discovering hypertension issues at the earliest. In the case of individuals with confirmed hypertension, the device allows a proper management of the medical condition including the efficiency of the administered medical treatment. In a nutshell, with the FDA-approval and the reported accuracy, the LiveOne device is a bliss for hypertension patients.

The Omron HeartGuide: An FDA-Approved Competitor

The LiveOne wearable blood pressure measuring device is not the only product with FDA-approval on the market. The Omron HeartGuide is another FDA-approved device that provides continuous blood pressure measurements. Omron tries to replicate oscillometry principles used in automatic cuff devices to a smartwatch. The key to this is the miniaturization of several components involved in traditional oscillometric measurements. The blood pressure measurements are recorded every 30 seconds compared to the 10 seconds of the LiveOne. However, the HeartGuide provides all the functionalities of a smartwatch including activity tracking, sleep monitoring and other additional features. The blood pressures measurements using the Omron requires the subject to raise the wrist to be at heart level, the embedded cuff will then inflate and the procedure continuous like traditional measurement techniques until the reading is displayed on the screen. When the LiveOne becomes commercially available,  the comparison with the Omron solution would be particularly interesting !


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MedTech

The Future of Portable Ultrasound Devices

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The medical field has been benefiting a lot from technological advancements. The diagnostic, monitoring, and treatment tools have been getting smaller in size with ubiquitous usage capabilities and smarter decision-making. Ultrasound technology uses sound frequencies outside the human audible band, that is, above 20 kilohertz.  These safe waves are reflected from body structures, and processed by a computer to produce a picture of the intended organ or structure. Recently, portable ultrasound devices have emerged in the market allowing a practical usage of this popular technology.  As is the case with wireless electroencephalogram (EEG)  headsets or most recently earbuds, and other continuous measurements techniques that rely on sensors placed in contact with the body, numerous benefits can be achieved through an accurate and close follow-up of various medical conditions. The democratization of healthcare is another important side-effect as costly services can now be available to the public at affordable prices.

Can I Do My Ultrasound at Home?

 The advances of technology will soon allow solutions at home that do not require a specialist operating the machine. Think about it in a similar way to blood pressure measurement devices that can be worn on the wrist, or even diabetes management devices that are placed on the body surface or subcutaneously under the skin. The more plausible question is whether the measurements would be reliable and accurate. The aforementioned question is answered through technologies that allow the development of small electronic devices, such as transducers, that will faithfully capture data, similarly to large traditional machines and devices.  There has indeed been much progress in that direction. In 2019, a group of researchers in the university of British Columbia in Canada, have developed a portable ultrasound transducer, the size of a plaster, that can be woven into clothes or even integrated into small machines. The cost of the device has been estimated at a mere USD 100. The possibility of personal use depends on the advanced processing and analytics algorithms that can be applied. Processing of the data is needed to produce accurate representation of the organ or structure being investigated while advanced artificial intelligence are needed to interpret the collected data and give the individual a preliminary decision regarding his medical status. Finally, wireless connectivity is needed to connect the sensing devices to a smartphone to process and display the required information.

 Do Portable Ultrasound Systems Exist?

 Many unique devices are emerging in the market for a multitude of applications. A few years ago, General Electric has launched a portable ultrasound scanner, the Vscan. The device has been subsequently employed to tackle child mortality in Africa. Several other notable products are available on the market.

 Butterfly iQ+

Butterfly iQ+ is a portable ultrasound scanner device that can be directly connected to a smartphone or tablet through a proprietary Apple Lightning connection or USB type-C connection. The package comes with a myriad of services including various imaging possibilities, unlimited cloud storage, and a possibility for telemedicine services. The features of the device, which is priced at around USD 2400 have been tested for a large number of medical applications including anesthesiology, cardiology, emergency medicine, obstetrics, and many more. Additional analytics provide insights directly on the smart device.

 iiSono Health

iSono Health has recently obtained the Food and Drug Administration (FDA) approval for its wearable breast ultrasound imaging apparatus, named ATUSA. The system can be comfortably worn by the subject and images can be obtained in less than two minutes. Two- and three-dimensional images can further be analyzed through an AI-based software than can assist the physician with the decision-making process. This device is of notable importance for individuals genetically predisposed or having breast cancer as it allows screening at increased interval. This will further improve the control of the disease.

Coso

Male contraception is another application where ultrasound portable devices are used. Traditional approaches to contraception include male contraceptive pills, vasectomy, or the traditional condom usage. What Coso does is halting sperm regeneration through an ultrasound-based mechanism. The designed device is filled with water, which is then heated by the device to the required temperature. The subject’s testicles are then placed in water and subject to ultrasound waves which will induce the contraceptive effects which temporarily last for a couple of months, two weeks after the treatment is given. This indeed could be a solution that replaces hormonal-based pills or surgical-based vasectomies, providing a temporary contraceptive effect.

 Sustained Acoustic Medicine

Sustained acoustic medicine (SAM) is a therapeutic approach that uses low intensity long duration ultrasounds to heal soft tissues. This biomodulation technique has been used to treat chronic pain and other musculoskeletal injuries, notably for athletes. Many products have been released that use this ultrasound-based technology and some are already available on the market. Among other, companies such as Kinex and Zetroz have developed such projects using specially designed patches that could be placed on the injury location. Zetroz research and development  is supported by entities such as the US Department of Defense.

Summary

Ultrasound based treatments are no longer confined to hospitals and specialized centers. The advances in technology have paved the way for portable ultrasound devices, that can be used at a relatively low cost, everywhere. The addition of AI-based analytics and wireless connectivity further helps in monitoring medical conditions while assisting in the assessment process.


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