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Using Google Glass, Augmedix has developed a platform for doctors to collect, update and recall patient and other medical data in real time, technology website TechCrunch reported on Tuesday.

Google Glass is no longer available for consumers but its enterprise business continues to rise especially in the health care sector.

“When you are with doctors without Glass, they are charting and clicking on computers for a lot of the time and not focusing on their patients,” Ian Shakil, CEO of Augmedix was quoted as saying.

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New project underway to find answers.


The Allen Institute for Brain Science has announced major updates to its online resources available at “brain-map.org” brain-map.org, including a new resource on Aging, Dementia and Traumatic Brain Injury (TBI) in collaboration with UW Medicine researchers at the University of Washington, and Group Health. The resource is the first of its kind to collect and share a wide variety of data modalities on a large sample of aged brains, complete with mental health histories and clinical diagnoses.

“The power of this resource is its ability to look across such a large number of brains, as well as a large number of data types,” says Ed Lein, Ph.D., Investigator at the Allen Institute for Brain Science. “The resource combines traditional neuropathology with modern ‘omics’ approaches to enable researchers to understand the process of aging, look for molecular signatures of disease and identify hallmarks of brain injury.”

The study samples come from the Adult Changes in Thought (ACT) study, a longitudinal research effort led by Dr. Eric B. Larson and Dr. Paul K. Crane of the Group Health Research Institute and the University of Washington to collect data on thousands of aging adults, including detailed information on their health histories and cognitive abilities. UW Medicine led efforts to collect post-mortem samples from 107 brains aged 79 to 102, with tissue collected from the parietal cortex, temporal cortex, hippocampus and cortical white matter.

This makes me a little nervous because pathways are very fragile and just the smallest change can result is some very bad/ even devastating results in other areas of the brain/ body.


Alzheimer’s remains one of the costliest yet most mysterious conditions in the United States, where an estimated 5.1 million Americans are living with the incurable, progressive disease. But researchers at The Rockefeller University have found that manipulating a protein pathway linked with Alzheimer’s helped improve memory impairment in mice— a finding that offers hope for new treatment in humans. Memory loss is the hallmark symptom of the disease.

Scientists with the Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University used a complex set of imaging technologies and experiments to identify an early trafficking protein pathway (COPI) that affects amyloid precursor protein (APP), which precedes the formation of amyloid plaques. Previous research on Alzheimer’s have targeted this plaque, but scientists haven’t successfully identified a way to halt its progression. There is currently no cure or effective treatment for the disease.

Alzheimer’s Disease Mortality by State | HealthGrove.

Nice


The consumer version of Google Glass smart wearable probably won’t be coming to the market anytime soon, but it seems like the project is far from dead. Namely, one of the startups which came to being after Google originally revealed its hi-tech headset several years ago is now raising new capital in order to bring Google’s optical head-mounted display into more hospitals and other health care facilities. The company in question is Augmedix, one of the ten official “Google Glass for Work” partners. Its main activity is developing software for wearable devices utilized in the medical industry, i.e. co-developing inventions which should make doctors’ lives easier. As Augmedix’s CEO Ian Shakil puts it, the doctors are “engaging with patients in front of them” while his company’s inventions are taking care of the “burdensome work in the background”.

Augmedix managed to raise $17 million of strategic investment capital from five institutions: TriHealth Inc., Sutter Health, Catholic Health Initiatives, Dignity Health, and a fifth, yet unnamed entity. This is the second round of funding the Silicon Valley company managed to secure in just over a year after raising $16 million in 2015. In total, the groups which financed Augmedix’s endeavors represent more than 100,000 health care providers. Naturally, the company can’t yet aim to deliver 100,000 of smart wearables designed for the medical industry, but it’s slowly getting there. Specifically, it’s currently providing equipment and services to hundreds of physicians and surgeons and is hoping to do the same with “thousands” more by 2017. No concrete figures have been provided by Augmedix, though the startup did confirm that it’s currently achieving a “multi-million dollar revenue” on a yearly basis.

What does this all mean for Google Glass? Well, despite the plans for the consumer version of the headset being momentarily dropped by Google, the Work program designed to deliver the said piece of hardware to various industries around the world is still going strong, and Augmedix is one of Google’s key partners in this business endeavor. Google Glass 2.0, officially called Project Aura is currently in development for enterprise applications and it seems like it has a very bright future in the medical industry as Augmedix claims its internal study concluded that close to 100 percent of patients are completely fine with their doctors using augmented reality (AR) headsets. In addition to that, it’s worth noting that Glass is the dominant platform Augmedix sells its services on, so it makes sense that this latest round of funding will see it end up in more heath care facilities in the very near future.

I learn useful life lessons from each patient I meet. Some are positive messages, reminding me of the importance of maintaining balance between family, work, and leisure activities, but more frequently I witness examples of the remarkable resilience of the human spirit when facing the reality and risks of a major surgical procedure and a diagnosis of cancer. Rarely, patients and their family members utter remorseful or simply sad remarks when they are faced with a grim prognosis and the emotions associated with an onrushing date with mortality. These comments invariably involve an inventory of regrets in life, including, “I should have spent more time with my kids,” “I wish I had told my father (or mother, brother, sister, child, or some other person) that I loved them before they died,” and “I have spent my entire life working, I never took time for anything else.” I wince when I hear these openly expressed remonstrations, I recognize that I am hearing painful and heartfelt truths. Not a week goes by that I am not reminded that I do not one day want to look back at my life with a long list of regrets, should have dones, and what ifs.

I was blessed to meet a great teacher in the guise of a patient early in my academic career. He came to my clinic in my first year after completing a Fellowship in Surgical Oncology, my first year as an Assistant Professor of Surgery. My patient was a 69 year-old Baptist Minister from a small town in Mississippi. He was referred to me by his medical oncologist who called me and said, “I don’t think there is anything you can do for him, but he needs to hear that from you because he doesn’t believe me.” This tall, imposing man had colon cancer that had metastasized (spread) to his liver. The malignant tumor in his colon was removed the year before I met him, and he had received chemotherapy to treat several large tumors found in his liver. The chemotherapy had not worked and the tumors grew. At the point I met him, the medical oncologist told him he would live no more than 6 months, and because he was an avid fisherman when not preaching or helping others in his community , the doctor suggested that he go out and enjoy his remaining time by getting in as much fishing as possible. I learned two invaluable lessons from this patient and his family. First, never deny or dismiss hope from a patient or their family, even when from a medical perspective the situation seems hopeless and the patient is incurable. Second, quoting the minister directly, “Some doctors think of themselves as gods with a small ‘g’, but not one of you is God”.

When I first walked into the examining room, this man was slouched on the examining table in the perfunctory blue and white, open-backed, always unflattering hospital gown. He made eye contact with me briefly, then looked down to the floor. In that momentary meeting of our eyes, I saw no sparkle, no life, no hope in his eyes. He responded to my initial questions with a monotonic and quiet voice. Several times I had to ask him to repeat an answer because his response was so muted. Mid-way through our first visit, the patient’s wife told me he had been very depressed by his diagnosis of untreatable metastatic colon cancer. She reported, despite his occasional side-long warning glances requesting her silence, that while he was eating well, he was spending most of his time sitting in a chair or laying in bed, and that the active, gregarious man with the quick wit and booming voice she had married was gone.

After I interviewed and examined the Minister I left the room so he could dress and sit in a chair next to his wife. I reviewed the results of the lab tests and CT scans we had performed on him, and then returned to the examining room. I explained to them that I believed it was possible to perform a difficult operation that would remove approximately 80% of his liver. The operation would be risky, it was possible he would require blood transfusions, and as a worst-case scenario the small amount of remaining liver might not be sufficient to perform necessary functions. If I pushed the surgical envelope too far and removed too much normal liver, following the operation he could develop liver failure leading rapidly to his death. I also stated, assuming he survived a major operation and the recovery period, that I could not predict his long-term outcome or survival. I emphasized that even if the operation was successful, it was possible that the cancer would recur in the remaining liver or in some other organ. I even attempted to raise his spirits a bit by injecting some puerile surgical word play when I said, “This operation will leave you with little more than a sliver of liver, but God willing it will be enough!” At the conclusion of my very direct monologue, he looked up from the floor and once again his eyes met mine. I remember blinking several times in surprise at how different his eyes now appeared. With his eyes bright and twinkling he asked, “Are you saying there is hope?” I replied that I believed there was hope, albeit small and impossible to measure, but hope nonetheless. An unforgettable and immediate transformation occurred in his demeanor and as his wife smiled at me and mouthed the words, “He’s back”; he reverted instantaneously to what I would come to learn was his former garrulous self.

The spiritually-resuscitated Minister sat upright, grasped my right hand with both of his hands, and launched into a memorable diatribe. “Never deny someone hope doctor, no matter how hopeless you know the situation to be. Humans need hope, without it comes depression, despair, and death. Why do you think the Jewish defenders at Masada held out against an overwhelming Roman force for so long? Because they had hope, and they had faith. Why do people let you cut them open? Hope. Never deny a human being hope doctor, without it we have no humanity, we are only another animal.” He was a forceful and eloquent speaker. With his Mississippi drawl, he could alternatively be plain spoken or pedantic. He was a well-read and educated man and he loved to display his extensive etymologic armamentarium. Not infrequently after our conversations I would seek out a dictionary to learn the meaning of a word or two. I had no difficulty visualizing him preaching from a pulpit in his Baptist church, like a yo-yo dropping his parishioners to the floor with the fear of eternal damnation, and then pulling them back up into his hands with a message of redemption and salvation.

I walked out of the examination room enthralled and scheduled the operation for the next week. I was amazed by the sudden change I had witnessed in this man’s posture and overall demeanor. As with all who provide care for patients with debilitating and serious medical conditions, I have seen patients lapse into a state of abject, deep despair and complete hopelessness. Like an autumn leaf falling from a tree branch, their spiritual demise leads to a rapid downward spiral of their physical condition. These patients fulfill the expectations of medical practitioners who have told them their survival will be a matter of only weeks or months, in fact I have seen several patients die much more rapidly than I would have predicted when darkness and despair overwhelmed them.

I had the Minister’s “sermon” on my mind throughout his operation. As I expected, the operation was technically difficult. He was a robust, barrel-chested man and had four large tumors in his liver. Two of these were right lobe of the liver only, but the other two extended from the right lobe of his liver into portions of the left lobe of the liver. One of these latter two tumors also extended down to involve two of the three large veins that drain blood from the liver into the large vein, called the inferior vena cava, that carries blood back to the heart. To assure that I had completely removed all of the tumor around these two veins, I removed a portion of the wall of the inferior vena cava and replaced it with a patch from another vein. It was a liver surgery tour-de-force, and at the conclusion of the operation the surgical fellow who performed the operation with me and I quietly congratulated one another on a job well done. Nonetheless, I admit to my own negative sentiments and relative paucity of optimism at the end of the operation. I remarked to the surgical fellow working with me that while the operation had been technically challenging and a great lesson in surgical anatomy, I doubted that we had cured this patient because I was concerned his aggressive cancer would return.

“Never deny someone hope doctor.” If I ever had a crystal ball to predict the future, I obviously dropped it in the mud a long time ago. I was wrong about the Minister. His cancer never returned. He spent only one week in the hospital after his operation and his sliver of liver performed and regenerated beautifully. For the first five years after the operation I saw him every three to six months with lab tests and CT scans to check for return of malignant tumors. For the next six years I saw him only for an annual visit. This man survived and enjoyed life for eleven years after being told that he only had only six months to live. He died as many of us would wish to die, in his sleep from a stroke. He gave his last sermon from the pulpit of his church three days before he died. His cancer never returned to prey upon his mind and hunt down his hope.

After thinking about it, I realize I learned one additional lesson from this patient. He taught me that it was acceptable to express a little clean, righteous anger and then laugh and move on. The Minister and I developed a ritual that was repeated with each of his visits after passage of the initial six months he was told he would live by his medical oncologist. After I reviewed the results of his tests and CT scans and confirmed that all was well and that cancer had not returned, he would smile and say, “Let’s do it!” From the examining room, I would dial the phone number of the medical oncologist in Mississippi who had referred him to me. The Minister admitted to me he was angry that this doctor had needlessly denied him hope. When the medical oncologist came to the phone, I would hand it to the Minister, who would identify himself to the doctor, and then he would say the same exact words, “Hey doc, you want to go fishing?” As a surgeon, I confess I enjoyed witnessing the surgical precision with which the preacher inserted this verbal blade, deftly turning it to maximize the impact of his statement. When I passed the phone to the Minister, he always had an impish, perhaps even devilish grin on his face. Each time after he asked the doctor in Mississippi if he would care to join him for a fishing expedition, he would hand the phone back to me and a look of beatific serenity would come to his face. The ritual was completed when I would take the phone and speak to the doctor in Mississippi. In my first few conversations with this physician, I apologized for my obvious and indecorous breach in professional behavior, but to the credit of this man being regularly taunted by a Baptist Minister who wasn’t entirely forgiving, he would tell me that no apology was necessary and that he believed he deserved and benefited from these brief but poignant verbal reminders. As the years passed, he would be laughing when I put the phone to my ear and tell me that he really enjoyed those calls and that his whole office staff looked forward to this annual event.

Two years before the Minister finally died at the age of 80, the doctor in Mississippi told me that because of this patient, he never answered the question asked to him by patients about their expected longevity with a diagnosis of advanced cancer. Instead, he would inform the patients and their families that he really couldn’t make such a prediction because of marked individual differences in responses to treatment, along with the immeasurable will to live even in individuals no longer receiving treatment for their cancer. Together, he and I learned the importance of leaving no treatment stone unturned; to engage in multidisciplinary management and to consider all options for our patients. Great lessons from a great spiritual teacher, taught to a couple of hard-headed doctors.

“Hey doc, you want to go fishing?”

hope

Whether it’s hay fever, food allergies, or asthma that plagues you, there’s no denying that our immune system can be a real punishment when it’s not working properly.

Which is why it’s so exciting to hear that researchers might have just come up with a system that could, in theory, put an end to all allergies — simply by forcing our bodies to recognise harmless objects, such as peanuts or pollens, as friend, rather than foe.

I know what you’re thinking — that sounds too good to be true, right? Because scientists have been trying to find a way to stop our immune system freaking out over harmless things, such as cat hair and pollen, for decades, and so far, nothing’s really stuck.

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Bioquark, Inc., (http://www.bioquark.com) a company focused on the development of novel biologics for complex regeneration and disease reversion, and Revita Life Sciences, (http://revitalife.co.in) a biotechnology company focused on translational therapeutic applications of autologous stem cells, have announced that they have received IRB approval for a study focusing on a novel combinatorial approach to clinical intervention in the state of brain death in humans.

This first trial, within the portfolio of Bioquark’s Reanima Project (http://www.reanima.tech) is entitled “Non-randomized, Open-labeled, Interventional, Single Group, Proof of Concept Study With Multi-modality Approach in Cases of Brain Death Due to Traumatic Brain Injury Having Diffuse Axonal Injury” (https://clinicaltrials.gov/ct2/show/NCT02742857?term=bioquark&rank=1), will enroll an initial 20 subjects, and be conducted at Anupam Hospital in Rudrapur, Uttarakhand India.

brainimage

“We are very excited about the approval of our protocol,” said Ira S. Pastor, CEO, Bioquark Inc. “With the convergence of the disciplines of regenerative biology, cognitive neuroscience, and clinical resuscitation, we are poised to delve into an area of scientific understanding previously inaccessible with existing technologies.”

Death is defined as the termination of all biological functions that sustain a living organism. Brain death, the complete and irreversible loss of brain function (including involuntary activity necessary to sustain life) as defined in the 1968 report of the Ad Hoc Committee of the Harvard Medical School, is the legal definition of human death in most countries around the world. Either directly through trauma, or indirectly through secondary disease indications, brain death is the final pathological state that over 60 million people globally transfer through each year.

While human beings lack substantial regenerative capabilities in the CNS, many non-human species, such as amphibians, planarians, and certain fish, can repair, regenerate and remodel substantial portions of their brain and brain stem even after critical life-threatening trauma.

operation

Additionally, recent studies on complex brain regeneration in these organisms, have highlighted unique findings in relation to the storage of memories following destruction of the entire brain, which may have wide ranging implications for our understanding of consciousness and the stability of memory persistence.

“Through our study, we will gain unique insights into the state of human brain death, which will have important connections to future therapeutic development for other severe disorders of consciousness, such as coma, and the vegetative and minimally conscious states, as well as a range of degenerative CNS conditions, including Alzheimer’s and Parkinson’s disease,” said Dr. Sergei Paylian, Founder, President, and Chief Science Officer of Bioquark Inc.

Over the years, clinical science has focused heavily on preventing such life and death transitions and made some initial progress with suspended animation technologies, such as therapeutic hypothermia. However, once humans transition through the brain death window, currently defined by the medical establishment as “irreversible”, they are technically no longer alive, despite the fact that human bodies can still circulate blood, digest food, excrete waste, balance hormones, grow, sexually mature, heal wounds, spike a fever, and gestate and deliver a baby. It is even acknowledged by thought leaders that recently brain dead humans still may have residual blood flow and electrical nests of activity in their brains, just not enough to allow for an integrated functioning of the organism as a whole.

coolbrain

“We look forward to working closely with Bioquark Inc. on this cutting edge clinical initiative,” said Dr. Himanshu Bansal, Managing Director of Revita Life Sciences.

About Bioquark, Inc.

Bioquark Inc. is focused on the development of natural biologic based products, services, and technologies, with the goal of curing a wide range of diseases, as well as effecting complex regeneration. Bioquark is developing both biological pharmaceutical candidates, as well as products for the global consumer health and wellness market segments.

About Revita Life Sciences

Revita Life Sciences is a biotechnology company focused on the development of stem cell therapies that target areas of significant unmet medical need. Revita is led by Dr. Himanshu Bansal MD, PhD. who has spent over two decades developing novel MRI based classifications of spinal cord injuries as well as comprehensive treatment protocols with autologous tissues including bone marrow stem cells, dural nerve grafts, nasal olfactory tissues, and omental transposition.