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Ray Kurzweil – The noted futurist says that exponential advances will allow us to intervene in the aging process 

Submitted in response to Technology Review’s interview with Leonard Hayflick. See “Can Aging Be Solved?”

MIT Technology Review, July 2009, by Ray Kurzweil  —  Entropy is not the most fruitful perspective from which to view aging. There are varying error rates in biological information processes depending on the cell type, and this is part of biology’s paradigm. We have means already of determining error-free DNA sequences even though specific cells will contain DNA errors, and we will be in a position to correct those errors that matter.

The most important perspective in my view is that health, medicine, and biology is now an information technology, whereas it used to be hit or miss. We not only have the (outdated) software that biology runs on (our genome), but we have the means of changing that software (our genes) in a mature individual with such technologies as RNA interference and new forms of gene therapy that do not trigger the immune system. (I am a collaborator with a company that performs gene therapy outside the body, replicates the modified cell a million-fold, and reintroduces the cells to the body, a process that has cured a fatal disease–pulmonary hypertension–and is undergoing human trials.)

We can design interventions on computers and test them out on increasingly sophisticated biological simulators. One of my primary themes is that information technology grows exponentially, in sharp contrast to the linear growth of hit or miss approaches that have characterized medicine up until recently. As such, these technologies will be a million times more powerful in 20 years (by doubling in power and price performance each year). The genome project, incidentally, followed exactly this trajectory.

Hayflick cites the automobile as an example to support his thesis that you cannot stop aging. Yes, automobiles will wear out if you don’t maintain them adequately. However, we do have the knowledge to perfectly maintain automobiles and completely prevent aging. There are century-old automobiles around in vintage (perfect) condition that are still driven around. That is because the maintenance was sufficiently aggressive for those cars. Most people don’t think it’s worth the trouble with regard to an automobile, but it will be worth the trouble for our bodies. With regard to automobiles, we have all of the knowledge and tools needed to completely stop aging. We do not yet have all of the knowledge and tools to do this with the human body, but that knowledge is growing exponentially.

As for the implications of radical life extension, Hayflick assumes that nothing else would change. But the same technologies that will bring radical life extension will also bring radical expansion of resources (nanoengineered solar panels, water and food technologies) and radical life expansion (merging with the intelligent machines that we are creating, virtual reality from within the nervous system, etc.). We have already democratized the tools of creativity so that kids in their dorm room can create a full-length high-definition motion picture or write software that results in disruptive change (e.g., Google). Hayflick has not considered the implications of these recent developments. We don’t have to do any of these things perfectly (and there is no such thing as perfection in the real world)–just well enough to stay ahead of the curve.

Our intuition is linear, so many scientists, such as Hayflick, think in linear terms and expect that the slow pace of the past will characterize the future. But the reality of progress in information technology is exponential, not linear. My cell phone is a billion times more powerful per dollar than the computer we all shared when I was an undergrad at MIT. And we will do it again in 25 years. What used to take up a building now fits in my pocket, and what now fits in my pocket will fit inside a blood cell in 25 years.

With regard to Hayflick’s own limit, he acts as if that limit is impossible to engineer. Just in recent years we have discovered that just one enzyme controls the telomeres and that cancer cells use telomerase to become immortal. Now, I realize that it is not a simple matter to just apply telomerase to overcome this particular aging limit, as we have to figure out how to administer it, and we don’t want to encourage cancer, but these are all solvable engineering problems.

By Peter Diamandis, June/July 2009  —  This week marks the launch of a new University. It’s rare to launch a new University these days, so I’m very honored and pleased to have given birth to Singularity University (www.singularityU.org) along with fellow X PRIZE Trustee Ray Kurzweil. Singularity University (or “SU”) aims to assemble, educate and inspire a cadre of leaders who strive to understand and facilitate the development of exponentially advancing technologies and apply, focus and guide these tools to address humanity’s grand challenges. SU is located on the campus of NASA Ames/Moffett Field. It has been founded with the support of Corporate Founders of Google and ePlanet Ventures, as well as a dozen Associate Founders (Moses Znaimer, Keith Kleiner, Barney Pell, Klee Irwin, Sonia Arrison, Dan Stoicescu, Georges Harik, Reese Jones, David S. Rose, Sabiha Malik Foster, Peter L. Bloom, Geoffrey Shmigelsky).

SU has just completed the first of nine weeks of the Graduate Student Program (GSP’09) and I’m extremely pleased and proud of what we have created. It is real, off and running, and here to stay.

From the student perspective, we have pulled together an incredible group of brilliant and dedicated graduate students who are all entrepreneurs, driven and passionate about taking on the world’s grand challenges (this year’s class is 40 in size from 13 nations, the program will expand to 120 graduate students next year). When we selected our students based upon the criteria of academic excellence, demonstrated entrepreneurship and big-picture thinking, we did not know we’d be attracting fun, high-spirited and good natured individuals as well. I’m pleased the traits matched up!

Equally rewarding is the faculty from 10 different disciplines including a half-dozen exponentially growing fields. Going from a lecture by Vint Cerf on the Internet’s origin to Ralph Merkle on the basics of nanotech to astronaut Dan Barry on high-risk scenarios in space exploration, all in the span of four hours, is an intellectual feast. Having Trustees Bob Richards, and Michael Simpson present for the opening week, as well as my co-Founder Ray Kurzweil, was fantastic. We all greatly enjoyed the screening of Transcendent Man — a truly beautiful film.

Our home at NASA Ames, courtesy of Dr. Pete Worden and NASA HQ is tremendous. The facilities are excellent and the setting could not be better. As Pete said in the opening ceremony…Welcome to Starfleet Academy!

SU runs 24×7, and the nickname “sleepless university” has its merits… hopefully things will settle down shortly. As the first week of “getting to know each other” and “introductory lectures” is behind us, the real work of focusing on the curriculum and figuring out how to bring life to the “10 to the 9th plus” design project (10^9+) is our next challenge. How can all of the students, staff and faculty work together to design technologies, systems or programs that can positively affect one billion people within a decade?

As I mentioned in my opening remarks, SU is special in what and how it teaches. Homo Sapiens have evolved as a species to think “locally” and “linearly” and SU is focused on teaching how to think “globally” and “exponentially.” This is not an institution which seeks to compete with the MITs, Stanfords, or Oxfords of the world, but rather has been founded to complement those existing programs in a meaningful and unique fashion. Most importantly to build a cadre of future leaders who are connected and empowered to take on humanity’s grand challenges in a significant fashion.

It is my fervent hope that the Graduates of SU will be the leadership that pursues X PRIZEs in the decades ahead.

For those of you not able to participate in SU this summer, there will be two options for you going forward. Consider applying for the GSP-2010 program which will take place in late June through August 2010. Next year we will be accepting ~120 students into the program. Also, for the Executives interested in SU, we will be launching our 3-Day and 10-Day Executive Programs starting this November 2009. They are limited in size so please let us know of your interest ASAP.

I’d like to close by saying thank you to our super-star staff and teaching fellows who are working 48×7 to make this program happen. Special thanks to Susan Fonseca-Klein, Bruce Klein, Emeline Paat-Dahlstrom and our Executive Director, Salim Ismail for all that you are doing.

June/July 2009  —  A new institution of higher learning aims to solve grand challenges related to space science and down-to-earth issues facing humanity.

NASA announced today a new narrowly focused graduate studies program that will be a cooperative effort between the space agency and a group of big thinkers.

The Singularity University (SU) plans to offer a nine-week graduate studies program, as well as three-day chief executive officer-level and 10-day management-level programs, starting in June. It will be located at the NASA Ames Research Center, Moffett Field, Calif.

According to a NASA statement, the SU curriculum will provide a broad, interdisciplinary exposure to ten fields of study: future studies and forecasting; networks and computing systems; biotechnology and bioinformatics; nanotechnology; medicine, neuroscience and human enhancement; artificial intelligence, robotics, and cognitive computing; energy and ecological systems; space and physical sciences; policy, law and ethics; and finance and entrepreneurship.

Singularity University was founded by S. Pete Worden, Ames Center Director; Ray Kurzweil, author and futurist; Peter Diamandis, space entrepreneur and chairman of the X PRIZE Foundation; Robert Richards, co-founder of the International Space University; Michael Simpson, president of the International Space University; and a group of SU associate founders who have contributed time and capital.

“With its strong focus on interdisciplinary learning, Singularity University is poised to foster the leaders who will create a uniquely creative and productive future world,” Kurzweil said.

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SAN DIEGO–(BUSINESS WIRE), July 21, 2009 — Researchers led by a team at AntiCancer, Inc. have demonstrated that stem cells derived from human hair follicles can repair severed nerves in mice. After stem cells from the hair follicle are injected into the injured nerve they differentiate into Schwann cells which promote nerve growth allowing the nerve to rejoin. The repaired nerve regains function allowing the mouse to walk normally. This work was done in collaboration with Kitasato University School of Medicine in Sagamihara, Kanagawa in Japan.

Previously, AntiCancer and Kitasato scientists showed that hair follicle stem cells are pluripotent and can differentiate into many cell types, including neurons, and named them hfPS (hair follicle pluripotent stem) cells.

“hfPS cells have important advantages for regenerative medicine over embryonic stem (ES) cells and induced pluripotent stem (iPS) cells in that they are easily accessible from any patient and don’t cause immunological problems, they don’t cause tumors and they don’t have ethical problems,” said Charlene M. Cooper, Vice President and Chief Operating Officer of AntiCancer. The current study was published in the current issue of the Journal of Cellular Biochemistry.

AntiCancer, founded in 1984 and based in San Diego, has developed the leading mouse models of cancer including MetaMouse® and AngioMouse®. These models are made imageable with AntiCancer’s OncoBrite® technology using fluorescent proteins. AntiCancer is also developing new cancer drugs based on genetic engineering that target cancer-specific metabolic defects. The company is also developing recombinant-enzyme-based diagnostics for cancer and cardiovascular disease. AntiCancer is developing tumor-targeting bacteria. AntiCancer also offers the Histoculture Drug Response Assay (HDRA) for individualized cancer treatment. AntiCancer pioneered hair follicle gene therapy and is now pioneering the use of pluripotent hair-follicle stem cells for regenerative medicine.

For further information, contact Charlene M. Cooper, AntiCancer, Inc., via e-mail: all@anticancer.com.

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GoogleNews.com, MedCityNews.com, July 21, 2009, by Chris Seper  —  ROCHESTER, Minnesota – A batch of re-engineered, personalized stem cells has helped repair heart damage, according to new research from the Mayo Clinic.

It’s an important discovery beyond the area of heart treatment. The broader application of these cells – known as induced pluripotent stem cells (iPS) – is they could steer scientists away from controversial issues around stem-cell science. The cells are not created from nor do they rely on human embryos, which must be destroyed to do some embryonic stem cell research.

Scientists create iPS cells by reprogramming adult non-stem cells. The approach has worked in treating Parkinson’s disease, sickle-cell anemia and hemophilia A. But it also was thought the cells would have limited use because altering them increased risks for infection and other diseases.

The drawbacks of using the cells is declining. Researchers recently showed they can use iPS cells without increasing the risk of cancer.

Mayo physicians, in a proof-of-concept study performed on mice, reprogrammed fibroblasts – connective tissues that can create the scars that lead to a heart attack. Instead, the fibroblasts were turned into stem cells that in less than a month fixed and strengthened a damaged heart.

Researchers say that using the body’s cells as part of a transplant could eliminate the risk of rejection and the use of anti-rejection drugs and, further down the line, cut the need for some transplants.

“This iPS innovation lays the groundwork for translational applications,” Dr. Andre Terzic, the Mayo Clinic senior author on the study, stated in a release. “Through advances in nuclear reprogramming, we should be able to reverse the fate of adult cells and customize ‘on demand’ cardiovascular regenerative medicine.”

Michael Werner, an organizer of the new Alliance for Regenerative Medicine that advocates for stem-cell research, applauded the breakthrough but warned about overvaluing potential of innovations like iPS cells to supplant the need for embryonic stem cell research.

“This whole field is so new, we don’t know what technologies will be the most fruitful,” said Werner, a biotech attorney and partner at the Washington, D.C., law firm Holland & Knight. “There are big advantages to embryonic stem cell research. It’s not just the research value in cell differentiation, but in drug development and discovery and other areas.

“We may get to a point where we don’t need embryonic stem cells,” Werner said. “But I don’t think we’re anywhere near that place yet.”

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Customized knees: A depiction of a knee implant designed to cover one part of the knee joint –   Credit: ConforMIS

A startup company uses medical imaging and rapid prototyping to create customized knee implants.

MIT Technology Review, July 20, 2009, by Courtney Humphries  —  A startup company is taking a customized approach to knee replacement surgery, creating knee implants on demand that exactly match a patient’s anatomy. The company, ConforMIS, based in Burlington, MA, is bringing the technology of rapid prototyping, which converts a three-dimensional computer design into a physical object, into the field of orthopedics. The company believes that such custom-made implants can make knee replacement surgery faster, more accurate, and less traumatic to the patient.

Knee replacement surgery repairs damage and relieves pain in patients with severe osteoarthritis or knee injury. Total knee replacement involves removing diseased cartilage and bone from the surfaces of the knee joint–the thigh bone, shin bone, and kneecap–and replacing them with an artificial joint made from a combination of metal and plastic. A partial knee replacement can also be performed on one part of the joint.

Typically, a surgeon chooses an artificial joint from several options of different sizes. ConforMIS, however, creates a custom implant based on imaging data of a patient’s knee joint, a technology that the company calls iFit. ConforMIS transforms images from CT or MRI scans into a three-dimensional computer model using computer-aided design (CAD) software, which serves as a template for manufacturing the implant.

Philipp Lang, president and CEO of ConforMIS, says that typically, surgeons must shape the patient’s bone to fit the implant. Because the bone-facing side of ConforMIS’s implant is matched to the patient’s anatomy, it can reduce the amount of bone that the surgeon must cut. On the joint-facing side of the implant, Lang says, “we want to re-create the geometry that the patient had before he or she developed arthritis.” He says that the ability to fit the implant to the patient without removing excess bone will speed recovery time and lessen pain.

Andrew Freiberg, an orthopedic surgeon who heads the joint replacement services at Massachusetts General Hospital and is not involved with the company, says that ConforMIS is an early example of an approach that has the potential to be important in the orthopedic field. However, he adds, “I’m not aware of any study that shows that custom-made implants give a better outcome” than traditional ones do. Lang says that the company is working with medical centers to conduct studies that will gather data about their outcomes.

Freiberg says that the ability to model what a knee replacement would look like before it’s performed could have advantages, although he notes that many surgeons prefer to actually see and measure the patient’s anatomy before making decisions. He says that replacing a knee properly is a geometrically complex task that requires a great deal of precision, and companies have been looking for ways to eliminate guesswork with technology.

Along with the implants, ConforMIS also creates customized instruments, called iJig, which assist surgeons in placing the implant. Because the knee joint must be precisely aligned to function properly, surgeons use cutting and placement guides to ensure that any cuts to the bone are made at the correct angles so that the implant is placed in proper alignment. ConforMIS uses the imaging data from the patient to create disposable instruments that are calibrated to the patient’s specific implant and anatomy. Lang says that the instrumentation will enable surgeons to perform the operation more quickly and easily, and it will also reduce time spent sterilizing reusable equipment.

ConforMIS announced today that it has raised $50 million in funding from investors worldwide in its latest round of fund-raising. Currently, the company has released three products for partial knee replacements, along with instrumentation, and it plans to make an implant available for a total knee replacement in 2010. Lang says that it takes about six weeks to create the implant, from imaging to shipping, and ConforMIS hopes to reduce that time to four weeks.

One concern about such a customized approach is the cost. As volume grows, the company hopes to provide its customized products at the same price as that of a standard implant.

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WebMD.com, by Bill Hendrick, July 20, 2009 – U.S. News & World Report has released its annual “honor roll” of America’s best medical centers, and Johns Hopkins Hospital in Baltimore is at the top of the list for the 19th straight year.

The top 21 hospitals all earned high scores in at least six of 16 specialties, ranging from cancer and geriatric care to orthopaedics and urology.

Scores were based on both objective measures — such as mortality rates, patient safety, and other care-related factors — and subjective measures, such as reputation.

“I think these rankings are extremely meaningful to an extremely small number of patients, relatively speaking, who represent a very small piece of the patient population but whose need for a very high quality of care is extreme,” Avery Comarow, the U.S. News & World Report statistician who compiled and analyzed the data, tells WebMD. “These rankings are not at all intended for those who need relatively routine procedures.”

The ‘Best Hospitals’ for 2009

Hospitals are listed below by total points. Here are the 21 hospitals that made the magazine’s honor roll (two are tied for 10th place):

  1. Johns Hopkins Hospital, Baltimore
  2. Mayo Clinic, Rochester, Minn.
  3. Ronald Reagan UCLA Medical Center, Los Angeles
  4. Cleveland Clinic
  5. Massachusetts General, Boston
  6. New York-Presbyterian University Hospital of Columbia and Cornell
  7. University of California-San Francisco Medical Center
  8. Hospital of the University of Pennsylvania, Philadelphia
  9. Barnes-Jewish Hospital/Washington University, St. Louis
  10. Brigham and Women’s Hospital, Boston
  11. Duke University Medical Center, Durham, N.C.
  12. University of Washington Medical Center, Seattle
  13. UPMC-University of Pittsburgh Medical Center
  14. University of Michigan Hospitals and Health Centers, Ann Arbor
  15. Stanford Hospital and Clinics, Stanford, Calif.
  16. Vanderbilt University Medical Center, Nashville, Tenn.
  17. New York University Medical Center
  18. Yale-New Haven Hospital, New Haven, Conn.
  19. Mount Sinai Medical Center, New York
  20. Methodist Hospital, Houston
  21. Ohio State University Hospital, Columbus

 

Top Hospitals by Specialty

Here are the No. 1 hospitals in each specialty, according to U.S. News and World Report:

  • Cancer: M.D. Anderson Center, University of Texas, Houston
  • Diabetes and endocrine disorders: Mayo Clinic, Rochester, Minn.
  • Digestive disorders: Mayo Clinic
  • Ear, nose, throat: Johns Hopkins Hospital, Baltimore
  • Geriatric care: Ronald Reagan UCLA Medical Center, Los Angeles
  • Gynecology: Brigham and Women’s Hospital, Boston
  • Heart and heart surgery: Cleveland Clinic
  • Kidney disorders: Brigham and Women’s Hospital
  • Neurology and neurosurgery: Mayo Clinic
  • Ophthalmology: Bascon Palmer Eye Institute, University of Miami
  • Orthopaedics: Mayo Clinic
  • Psychiatry: Massachusetts General, Boston
  • Rehabilitation: Rehabilitation Institute of Chicago
  • Respiratory disorders: National Jewish Hospital, Denver
  • Rheumatology: Johns Hopkins Hospital
  • Urology: Johns Hopkins Hospital

Best Hospital Lists: How Useful Are They?

American Hospital Association Senior Vice President Rick Wade tells WebMD that hospitals that made the honor roll and those that were ranked in the 16 specialty groups were generally teaching hospitals “with the most cutting-edge research and technology.”

Wade says that hospitals that didn’t score enough points to make a list should be avoided.

“You can investigate on your own,” he says. “For people who don’t live near a Hopkins, there are many community hospitals that have very good records.”

Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania, tells WebMD that lists for most people “are almost useless. The only data of value is on specific doctors, treating cases analogous to your own.”

Rankings “are a quality perspective from 75,000 feet when what the prospective patient needs is precision at ground level about particular doctors doing particular things in situations close to the one the patient has,” Caplan says.

SOURCES:

News release, U.S. News & World Report.

U.S. News & World Report: “America’s Best Hospitals.”

Avery Comarow, health rankings editor, U.S. News & World Report.

Arthur Caplan, PhD, director, Center for Bioethics, University of Pennsylvania.

Rick Wade, senior vice president, American Hospital Association.