A paralyzed student walks again, with the help of a new technology



MIT Technology Review, May 24, 2011, by David Zax  — Last Saturday, at UC Berkeley’s commencement, something like a miracle happened. That, at least, is the way one’s tempted to describe it. Technology had enabled the sort of healing common to Biblical narratives or reports from the shrine at Lourdes. A paralyzed man walked again.

His name was Austin Whitney. The 22-year-old graduating senior had lost the use of his legs in the summer of 2007, when, after having a few drinks, he crashed his car into a tree, severing his spine above the hips. He later quit drinking, mustered the will to go to college, and by the time he reached Berkeley for his sophomore year, found himself to be in the right place at the right time, reports the San Francisco Chronicle.

At Berkeley, a professor of mechanical engineering, Homayoon Kazerooni, had been working with a team for several years on a robotic exoskeleton. At first, Kazerooni’s Robotics and Human Engineering Laboratory–“the Kaz-Lab,” it’s been dubbed–had been developing its technology for very different purposes: military ones. A 2004 story from UC Berkeley News announced a “breakthrough” from the Kaz-Lab (ushered in with the help of a boatload of DARPA funding) that would enable a solder to wear a 100-pound exoskeleton and 70-pound backpack “while feeling as if he were lugging a mere 5 pounds.” The 2004 project cleared many of the initial research hurdles that would eventually help Austin Whitney walk. Kazerooni et al. taught their exoskeleton to be able to work dynamically with the wearer: “the control algorithms in the computer are constantly calculating how to move the exoskeleton so that it moves in concert with the human,” he explained at the time.

In 2005, the following year, Kazerooni spun out some of his research into a company called Berkeley Bionics, and a few years after that, Austin Whitney first got in touch with the Kaz-Lab. Whitney worked with the team for several years, helping them hone a design for paraplegics. The Chronicle lists a host of influences Whitney had on the final design: flatter feet for greater stability; locks on the hand controls; crutches with telescoping legs. So integral was Whitney to the process, the roboticists even nicknamed the exoskeleton “Austin.”

Other companies have developed similar technology to Kazerooni and co’s. Robotic exoskeleton research is actually a burgeoning field, and not just one limited to the Iron Man films. In January, the FDA approved an Israeli-made device called “Rewalk,” invented by a quadriplegic named Amit Goffer. And just a few weeks ago, the New Zealand company Rex Bionics made its first sale of a custom-robotic exoskelton to a man with a spinal cord injury named Dave MacCalman–a man who “holds the current World Record for quadriplegic pentathlon.” The Berkeley device, though, is cheaper than these, running just $15,000, or the cost of a high-end wheelchair. (Rewalk, by contrast, runs $50,000.)

And on Saturday, it was finally time to debut the technology. Whitney climbed aboard the exoskelton, flicked a switch, and moved one leg forward, then the next, to the sound of the audience’s cheers. In attendance were his parents and younger sister. “Four years ago, doctors told me I’d never walk again,” he told the Chronicle. Never say never.

Credit: Technology Review



A $10 million prize would go to the first device that can diagnose a range of diseases with the same accuracy as a team of doctors



MIT Technology Review, May 24, 2011, by Katharine Gammon  —  Last week, the X Prize Foundation announced a new $10 million contest to develop a portable device that can diagnose a wide range of diseases with the same accuracy as a panel of board-certified physicians.


The details of the contest are still being worked out, but the goal is likely to be a device that can perform a number of diagnostic tests and combine these with artificial intelligence to determine whether a subject has a particular malady. Such a device could help those who lack access to traditional medical services—and streamline access to specialty care in traditional medical treatment.

“Imagine a world where people get funneled to the right part of a complex health system at the right time,” says Eileen Bartholomew, a senior director at the X Prize Foundation. Bartholomew is working on designing the exact parameters for the prize, which will be launched in 2012. “And when consumers get into the health system, they come with data, to understand and guide their treatment.”

Bartholomew says that the contest may involve diagnosing a particular disease or could start with less ambitious challenges, such as performing a single test for a prize in the $1 million range. Winning the whole prize, offered in collaboration with Qualcomm, would likely involve an entry that could combine several complex technologies.

The range of biomedical information that can be monitored quickly is increasing, says Eric Topol, director of the Scripps Translational Science Institute. “We can monitor glucose continuously and we can measure heart rate and rhythm remotely,” he says. But, he adds, “we don’t have good ways yet for remote sensing for blood pressure or oxygen saturation.”

Topol says such a prize won’t be won until there is a critical convergence of technology, perhaps involving genomic sequencing and advanced imaging. Nick van Terheyden, chief medical information officer at Nuance Healthcare, thinks that such a convergence might not be too far away.

Van Terheyden says that a doctor would always be involved in some way in patient diagnosis. “This technology wouldn’t be a replacement, but an adjunct: a third party in the room that’s prodding and nudging,” he says. “Clinicians are overwhelmed with the amount of information that is out there.”

The regulatory environment could present problems for any such device. “The Food and Drug Administration has stated that it will not certify tech that makes a diagnosis directly,” said Ross Mitchell, the author of a study published last week that shows that strokes can be diagnosed with the aid of a smart-phone application with the same degree of accuracy as with a hospital computer.

Bartholomew says that because of FDA restrictions, the contest could lead to innovations that might only be used outside the United States.

A Nightshirt to Monitor Sleep


Sweet dreams: The Somnus sleep shirt has embedded fabric electronics to monitor respiration.
Credit: Nyx Devices



A newly developed smart shirt detects the wearer’s stage of sleep via respiration patterns



MIT Technology Review, May 24, 2011, by Emily Singer  —  What if your pajamas could tell you how well you slept? That’s the dream of startup Nyx Devices, which has developed a nightshirt embedded with fabric electronics to monitor the wearer’s breathing patterns. A small chip worn in a pocket of the shirt processes that data to determine the phase of sleep, such as REM sleep (when we dream), light sleep, or deep sleep.

“It has no adhesive and doesn’t need any special setup to wear,” says Matt Bianchi, a sleep neurologist at Massachusetts General Hospital and co-inventor of the shirt with Carson Darling, Pablo Bello, and Thomas Lipoma. “It’s very easy—you just slip it on at night,” says Bianchi, who has no formal role with Nyx Devices.

When people with sleep disorders spend the night in a sleep lab, they are hooked up to a complex array of sensors that monitor brain activity, muscle activity, eye movement, and heart and breathing rate. Nyx’s Somnus shirt dramatically simplifies this by focusing only on respiration. “It turns out that you can tell if someone is awake or asleep and which stage of sleep they are in purely based on breathing pattern,” says Bianchi. “That’s a much easier signal to analyze than electrical activity from the brain.”

During REM sleep, the respiratory pattern is irregular, with differences in the size of breaths and the spacing between them. Breathing during deep sleep follows an ordered pattern, “like a sine wave,” says Bianchi. “And the breath-to-breath differences are very small.” The lighter stages of non-REM sleep fall somewhere in between. “The motivation behind the shirt is to allow repeated measurements over time in the home,” he adds. Users can log their habits, such as coffee or alcohol intake, exercise, or stress, and look for patterns in how those variables affect their quality of sleep.

Analyzing sleep stages based on respiration is still considered experimental. But Bianchi is now testing the device on patients who come to his sleep clinic who are also assessed using standard technology, known as polysomnography. The team will soon begin home tests of the shirts to further validate its use outside of the lab. The company hopes to have a commercial product available by summer of 2012 for less than $100.

The shirt is part of a growing number of devices that people can use to monitor sleep at home. The simplest, including an iPhone app, use accelerometers to measure movement, giving a rough gauge of when people fall asleep and wake up. A more sophisticated consumer device that monitors electrical activity from the brain and muscles, called the Zeo, came on the market two years ago.

While Nyx envisions the shirt as a consumer product, Bianchi wants to use it for his patients. Bianchi’s previous research has shown that people with insomnia often underestimate how much they sleep, so he wants to determine whether giving them an objective way to measure sleep will help them reassess their condition and improve quality of sleep. “It will be a game changer for my clinical practice,” he says. “There are zero objective tools available to physicians to assess insomnia.”