A team led by electrical engineer Krishna Shenoy developed technology that detects brain signals to move a cursor. Animals trained to copy text using the technology were able to type at a rate of up to 12 words per minute.
That technology, developed by Stanford Bio-X scientists Krishna Shenoy, a professor of electrical engineering at Stanford, and postdoctoral fellow Paul Nuyujukian, directly reads brain signals to drive a cursor moving over a keyboard. In an experiment conducted with monkeys, the animals were able to transcribe passages from the New York Times and Hamlet at a rate of up to 12 words per minute.

Earlier versions of the technology have already been tested successfully in people with paralysis, but the typing was slow and imprecise. This latest work tests improvements to the speed and accuracy of the technology that interprets brain signals and drives the cursor.

‘Our results demonstrate that this interface may have great promise for use in people,’ said Nuyujukian, who will join Stanford faculty as an assistant professor of bioengineering in 2017. ‘It enables a typing rate sufficient for a meaningful conversation.’

Other approaches for helping people with movement disabilities type involve tracking eye movements or, as in the case of Stephen Hawking, tracking movements of individual muscles in the face. However, these have limitations, and can require a degree of muscle control that might be difficult for some people. For example, Hawking wasn’t able to use eye-tracking software due to drooping eyelids and other people find eye-tracking technology tiring.

Directly reading brain signals could overcome some of these challenges and provide a way for people to communicate their thoughts and emotions.

The technology developed by the Stanford team involves a multi-electrode array implanted in the brain to directly read signals from a region that ordinarily directs hand and arm movements used to move a computer mouse.

It’s the algorithms for translating those signals and making letter selections that the team members have been improving. They had tested individual components of the updated technology in prior monkey studies but had never demonstrated the combined improvements in typing speed and accuracy.

‘The interface we tested is exactly what a human would use,’ Nuyujukian said. ‘What we had never quantified before was the typing rate that could be achieved.’ Using these high-performing algorithms developed by Nuyujukian and his colleagues, the animals could type more than three times faster than with earlier approaches.

The monkeys testing the technology had been trained to type letters corresponding to what they see on a screen. For this study, the animals transcribed passages of New York Times articles or, in one example, Hamlet. The results show that the technology allows a monkey to type with only its thoughts at a rate of up to 12 words per minute.

People using this system would likely type more slowly, the researchers said, while they think about what they want to communicate or how to spell words. People might also be in more distracting environments and in some cases could have additional impairments that slow the ultimate communication rate.

‘What we cannot quantify is the cognitive load of figuring out what words you are trying to say,’ Nuyujukian said.

Despite that, Nuyujukian said even a rate lower than the 12 words per minute achieved by monkeys would be a significant advance for people who aren’t otherwise able to communicate effectively or reliably.

Stanford University news.stanford.edu/2016/09/12/typing-brain-sensing-technology/

In science, sometimes the best discoveries come when you’re exploring something else entirely. That’s the case with recent findings from the National Institute of Standards and Technology (NIST), where a research team has come up with a way to build safe, nontoxic gold wires onto flexible, thin plastic film. Their demonstration potentially clears the path for a host of wearable electronic devices that monitor our health.
The finding might overcome a basic issue confronting medical engineers: How to create electronics that are flexible enough to be worn comfortably on or even inside the human body-without exposing a person to harmful chemicals in the process-and will last long enough to be useful and convenient.
‘Overall this could be a major step in wearable sensor research,’ said NIST biomedical engineer Darwin Reyes-Hernandez.

Wearable electronics would permit the wearer to monitor not only familiar vital signs, but a host of other biomarkers in the body – potentially catching the signs of disease well before symptoms appear.

Wearable health monitors are already commonplace; bracelet-style fitness trackers have escaped mere utility to become a full-on fashion trend. But the medical field has its eye on something more profound, known as personalized medicine. The long-term goal is to keep track of hundreds of real-time changes in our bodies-from fluctuations in the amount of potassium in sweat to the level of particular sugars or proteins in the bloodstream. These changes manifest themselves a bit differently in each person, and some of them could mark the onset of disease in ways not yet apparent to a doctor’s eye. Wearable electronics might help spot those problems early.

First, though, engineers need a way to build them so that they work dependably and safely-a tall order for the metals that make up their circuits and the flexible surfaces or ‘substrates’ on which they are built.

Gold is a good option because it does not corrode, unlike most metals, and it has the added value of being nontoxic. But it’s also brittle. If you bend it, it tends to crack, potentially breaking completely- meaning thin gold wires might stop conducting electricity after a few twists of the body.
‘Gold has been used to make wires that run across plastic surfaces, but until now the plastic has needed to be fairly rigid,’ said Reyes-Hernandez. ‘You wouldn’t want it attached to you; it would be uncomfortable.’

Reyes-Hernandez doesn’t work on wearable electronics. His field is microfluidics, the study of tiny quantities of liquid and their flow, typically through narrow, thin channels. One day he was exploring a commercially available porous polyester membrane-it feels like ordinary plastic wrap, only a lot lighter and thinner-to see if its tiny holes could make it useful for separating different fluid components. He patterned some gold electrodes onto the membrane to create a simple device that would help with separations. While sitting at his desk, he twisted the plastic a few times and noticed the electrodes, which covered numerous pores as they crisscrossed the surface, still conducted electricity. This wasn’t the case with nonporous membranes.
‘Apparently the pores keep the gold from cracking as dramatically as usual,’ he said. ‘The cracks are so tiny that the gold still conducts well after bending.’

Reyes-Hernandez said the porous membrane’s electrodes show even higher conductivity than their counterparts on rigid surfaces, an unexpected benefit that he cannot explain as yet. The next steps, he said, will be to test changes in conductivity over the long term after many bends and twists, and also to build some sort of sensor out of the electrode-coated membrane to explore its real-world usability.

NIST www.nist.gov/news-events/news/2016/11/wearable-electronic-devices-nist-shows-plastic-holes-are-golden

Researchers at ETH Zurich have developed a new marker substance for positron emission tomography (PET) that will allow them to monitor the progression of the degenerative muscle disease amyotrophic lateral sclerosis (ALS) in a patient’s brain. Many people will remember the Ice Bucket Challenge back in the summer of 2014. This social media campaign helped patient support groups to promote public awareness of the rare, but debilitating and incurable muscle disease, amyotrophic lateral sclerosis (ALS). The challenge involved one person nominating three others through social media, creating a snowball effect, to make a financial donation to an ALS support group, or – as a forfeit – to pour a bucket of ice-cold water over their heads. This action was supposed to give participants a brief insight into one of the symptoms experienced by someone suffering from degenerative muscle disease.
ALS induces progressive degeneration of the motor neurons that control the muscles. The patient suffers from muscular atrophy and paralysis, accompanied by symptoms such as difficulty walking, speaking and swallowing. At best, drugs can delay the progression of the disease, but oft en life expectancy is only a few years after the initial diagnosis. Very little is known about the causes of the disease.
A new marker substance developed by ETH researchers in collaboration with specialists at St. Gallen Cantonal Hospital and University Hospital Zurich could potentially make a vital contribution to ALS research. The new substance could perhaps make it possible to monitor the progression of ALS in patients using positron emission tomography (PET). The PET imaging technique renders specific molecules on the cell surface visible within the body tissue. The scan uses marker substances, known as PET ligands, that adhere to these molecules via the lock-and-key principle. The radiation emitted by the radioactive markers is very short lived, with a half-life between several minutes and a few hours. This radiation is measured during the PET scan.
The newly developed PET ligand binds to a receptor molecule in the body’s neurotransmitter system for cannabis-based substances, known as the cannabinoid receptor 2 (CNR2). This is very common in inflamed nerve tissue, and is also found in the central nervous system of patients suffering from ALS.
‘The big challenge we faced was to develop a PET ligand that only binds to CNR2, but not to the related cannabinoid receptor 1 (CNR1),’ explains Simon Ametamey, a professor at the Institute of Pharmaceutical Sciences at ETH Zurich. CNR1 occurs naturally in the human brain, where it elicits the pain-relieving and intoxicating effect of cannabis.
The researchers in Professor Ametamey’s group synthesized a series of molecules and performed an in vitro study to measure their ability to bind to the receptors CNR2 and CNR1. The team went on to successfully test the molecule with the most obvious preference for CNR2 in rats and mice with inflamed nerve tissue. Th e scientists have filed a patent for this molecule. The next step will be to perform clinical trials in humans.
‘The new PET ligand could help us to research ALS more effectively and to understand how the disease progresses,’ says Professor Ametamey. It could also improve the early diagnosis of the disease. It might also be potentially interesting for research and diagnosis of other neurological disorders such as Alzheimer’s, Parkinson’s or multiple sclerosis.

ETHZ http://tinyurl.com/gvnvsy5

Carestream Health’s focus on the radiology profession has earned it the No. 1 market position for its DRYVIEW Laser Imaging Film, resulting in the production of more than one billion square meters of this and other specialty films at its White City, Oregon facility – enough film to circle the Earth 70 times. CARESTREAM DRYVIEW film for medical imaging use is sold in more than 140 countries. It contains more than 25 different components, including nanoparticles, with four layers coated simultaneously on the top of a PET film base and two layers on the back. The six-layer DRYVIEW film is coated in one pass at a rate of hundreds of feet per minute with in-line quality inspection to meet FDA-regulated Class 1 medical device requirements. The company’s manufacturing capabilities include its Contract Manufacturing operations that apply specialized manufacturing processes using high-technology coating assets to help contract-coating customers and partners develop better products at a competitive cost using coated or cast filmbased advanced materials. Carestream Contract Manufacturing offers optimal product design, technology integration, manufacturing support, distribution, and finishing (slitting and packaging) capabilities with facilities in Asia and North America. The company can create structures of up to 20 precision-coated layers in a single pass, with options for two-sided coating, radiation cure, on-line inspection and lamination. Carestream adheres to top global standards for quality and certification including ISO 9001, ISO 13485 and ISO 14001.

www.carestream.com

‘Addressing the challenge of patient-centred care and safety’ was the theme addressed in the International Hospital Federation (IHF) 40th World Hospital Congress held in Durban, South Africa, 31 October to 3 November 2016, attended by national and international healthcare leaders and organizations from 50 countries.

Discussions on the challenges being encountered by different countries when it comes to making patients the centre of quality and affordable healthcare services and management, as well as the solutions on how to improve hospitals’ delivery of quality care and the healthcare status of each country were tackled.
Quality of Care, Capacity Building in Leadership and Management, Governance and Accountability, Ethics and Medical Legal Issues, Financing and Universal Health Coverage, Health Technology, and Service Delivery were some of the tracks explored during the Congress.
Dr. Aaron Motsoaledi, the Honourable Minister of Health of the host country, Republic of South Africa, mentioned in his welcome message the two objectives of the South African National Development Plan that are needed to be comprehended not only by African healthcare leaders and personnel, but by all healthcare leaders internationally: ‘(1) The quality of services in the public health system must be improved (2) The relative cost of private healthcare must be reduced.’
These two important points were emphasized and tackled in detail in the three-day congress through member, free paper and special sessions as well as the pre-congress meetings, which included the African Regional meeting, hosted by the National Department of Health of South Africa.
Erik Normann, IHF President, in his opening remarks, expressed his delight at the fact that the Durban Congress was the first to be hosted by IHF on the African continent since the creation of the IHF in 1929.
Apart from addressing the challenges and delivering interesting and trending healthcare topics, the congress has also made sure that all the events and activities held would make a difference in patient-centred care by featuring cutting-edge delivery approaches and inventive management practices.
Aligned with those innovative healthcare management practices, IHF members and delegates had unique opportunities to exhibit and share their accomplishments and practices in hospital leadership to the global healthcare community through expositions.
The IHF CEO Circle, the exclusive professional network for senior healthcare executives was also highlighted in the congress through meetings.

IHF 2016 International Awards
The IHF 2016 International Awards attracted many excellence entries from 19 countries. The Awards, given to hospitals, not individuals, because healthcare is acknowledged as a team endeavour, recognize achievements in several areas, such as quality and patient safety, corporate social responsibility, innovations in service delivery at affordable costs, and healthcare leadership and management practices.

In the last day of the event, the delegates were also given the chance to visit and tour some of the distinguished hospitals and healthcare facilities in Durban, South Africa which included: KZN Children’s Hospital, Ethekwini Hospital and Heart Centre, Inkosi Albert Luthuli Central Hospital, King Dinuzulu Hospital, and Prince Mshiyeni Memorial Hospital.
All the mentioned activities and events of this year’s World Hospital Congress show its key unique features on how it can contribute and respond to the needs in the global healthcare nowadays.
Delegates were already looking forward to attending next year’s congress, the IHF 41st World Hospital Congress, which will take place 7-9 November 2017 in Taipei, Taiwan, with the theme ‘Patient-friendly and Smarter Healthcare’.
The IHF World Hospital Congress, being held annually, is a unique global forum’ and a one-stop shop’ for the healthcare professionals in quest of an unparalleled environment to exchange insights, experiences, and expertise in the sector of health management and service delivery.
IHF having as a mission to enhance knowledge that can translate into practice for those having the responsibilities to lead healthcare organizations is making available all the resources that were shared during this congress.
A selection of Congress presentations appears on pages 15-17 of this issue of International Hospital.

www.ihf-fih.org