Robot therapist hits the spot with athletes

If you see a physiotherapist or a Chinese physician for a sprained back, do not be surprised if your therapist turns out to be a robot.

Meet Emma, unveiled today by a start-up incubated by Nanyang Technological University (NTU Singapore), which has been treating Singapore’s national athletes, such as national basketballer and Mediacorp actor Chase Tan.

Short for Expert Manipulative Massage Automation, Emma is now treating patients at the Singapore Sports Hub, using acupoint therapy to relieve muscle strains and injuries.

Developed by AiTreat, a start-up company founded by NTU graduate Albert Zhang, Emma is undergoing user trials at Kin Teck Tong’s Sports Science and Chinese Medicine Clinic at the Kallang Wave Mall.

Mr Zhang, the creator of Emma, said his creation, a robotic arm with a 3D-printed massage tip that runs on proprietary software, can resolve some of the challenges faced by sports therapy clinics, such as a shortage of trained therapists and a need to deliver high quality therapy consistently.

“We have designed Emma as a clinically precise tool that can automatically carry out treatment for patients as prescribed by a physiotherapist or Chinese physician,” said Mr Zhang, who graduated in 2010 from NTU’s Double Degree programme in Biomedical Sciences and Chinese Medicine.

“This is probably the first such robot in the world developed specifically for use by Traditional Chinese Medicine (TCM) physicians and sports therapists. Our aim is not to replace the therapists who are skilled in sports massage and acupoint therapy, but to improve productivity by enabling one therapist to treat multiple patients with the help of our robots.”

Emma, which has a user-friendly interface and recommended guidelines for various sports injuries, was designed by Mr Zhang based on his experience as a licensed TCM physician in Singapore for the past five years.

The robot consists of a single, 6-axis robotic arm capable of highly articulated movements, a 3D-stereoscopic camera for vision, and a customised, fully rotatable 3D-printed massage tip. Several safety features which work in tandem with advanced pressure sensors are also in-built, to ensure the comfort and the safety of its patients.

Since patient trials started last week at Kin Teck Tong, Emma has treated 50 patients with different conditions, such as tennis elbows, stiff neck and shoulders, lower back pain, as well as muscle pulls.

Integrating advanced sports science and traditional Chinese medicine, Kin Teck Tong is a modern medical institution with a chain of clinics that offer sports injury rehabilitation and pain management.

Executive Director of Kin Teck Tong, Ms Coco Zhang, said the new physiotherapy robot has the potential to be a disruptive innovation, especially in the TCM and sports science industry.

“Like many developed countries, Singapore has the problem of an aging population. Over the next decade, more people are going to suffer from physical ailments such as arthritis and will be seeking treatment,” Ms Zhang said.

“However, as the younger generation prefer knowledge-based jobs rather than physically intensive jobs such as massage therapists, there will likely be a shortage of trained therapists in future. In our trials with the robot, the experience has been very good, as it can perform most treatments as well as our therapists.”

Since Kin Teck Tong is the exclusive TCM Partner of the Singapore Athletic Association and Basketball Association of Singapore, delivering high quality therapy is extremely important for the athletes’ recovery, Ms Zhang added.

Physiotherapy meets the Cloud

To ensure a consistent quality of therapy, Emma has sensors and diagnostic functions that will measure the progress of the patient and the exact stiffness of a particular muscle or tendon.

These detailed diagnostics are uploaded to the cloud where the progress of each patient can be analysed and generated into a performance report. For the first time in TCM treatment, patients can accurately measure their recovery progress using precise empirical data.

This is extremely valuable for athletes, as their injuries, treatment and recovery can now be measured and monitored by their physician and therapists. In addition, the treatment programmes can be adjusted according to the progress of the patients’ recovery.

AiTreat’s propriety cloud intelligence is supported by Microsoft, after Mr Zhang and his teammates won the Microsoft Developer Day Start-up Challenge earlier this year.

Incubated at NTUitive, NTU’s innovation and enterprise arm, the one-year-old start-up spent six months developing their first prototype after receiving a grant from SPRING Singapore’s Ace Start-up grant.

After the clinical trials are completed, AiTreat will focus on developing its second-generation robot that is more compact and mobile.

“What we have demonstrated, is the possibility of having a tireless clinical massage therapist that always delivers high quality treatment,” added Mr Zhang.

Chief Executive Officer of NTU Innovation and NTUitive Dr Lim Jui said disruptive innovations like Emma are what the university hopes to achieve by nurturing an entrepreneurial and innovative culture amongst NTU students, graduates and professors.

“We are happy to support one of NTU’s promising graduates to turn his dream into reality that will benefit society,” Dr Lim said. “We hope to encourage more of our students to follow Albert’s footsteps, daring to dream and willing to plunge into uncharted waters to develop future solutions to benefit Singapore and the world.”

Full story can be found from NTU website by following this link.

Pneumonia discovery may offer way to boost body’s defenses

A molecule being targeted in cancer is also critical for the immune system’s ability to battle pneumonia, researchers at the School of Medicine have determined. The finding may offer a new way for doctors to boost patients’ ability to fight off the life-threatening infection as bacteria become more and more resistant to antibiotics.

“We’re interested in seeing if there are things we an do to strengthen the natural defenses of the host to help them fight the infection more effectively,” said Borna Mehrad, MBBS, of UVA’s Division of Pulmonary and Critical Care Medicine. “Potentially this would be the sort of thing you could do in addition to antibiotics to help patients with severe infections.”
Mysterious role

Mehrad and his team determined that the lack of the cytokine M-CSF (short for macrophage-colony stimulating factor) in infected mice worsened the outcome of bacterial pneumonia: Not having the protein resulted in 10 times more bacteria in the lungs, 1,000 times more bacteria in the blood and spread the infection to the liver, resulting in increased deaths.

Clearly M-CSF has an important role in battling pneumonia, but what exactly does it do? “M-CSF has previously been shown to help make a type of immune cell, called monocytes, so my idea was that if you take it away, infected hosts just stop making monocytes and that’s why they get sick,” Mehrad said, “and it turned out that was completely wrong.”

Instead, the researchers determined, M-CSF helped monocytes survive once they have arrived in the infected tissues. Mehrad credited a PhD student in his lab, Alexandra Bettina, with making key observations that completely changed the course of the research. “As I had expected, when we blocked the action of M-CSF … we saw fewer monocytes in the lung. And I thought, well, there you have it,” Mehrad said. “But what Alexandra did was look at the number of cells in the bone marrow, when they’re made, and the blood, which is how they get to the lung. And she found that, in the absence of M-CSF, the number of monocytes in the bone marrow and blood was completely unaffected … but was dramatically reduced in the lung.”

That meant the original hypothesis was wrong. The cells were being made despite the lack of the cytokine; they just weren’t surviving in the lungs to do their jobs. “To use an analogy, they are like soldiers mobilizing,” Mehrad said. “They’re being made in the right number, they’re arriving in the right number, but when they get there, they’re not very good soldiers.”

But by knowing more about M-CSF, doctors one day may be able to make them very good soldiers indeed. “If you take M-CSF away, the infections get worse, so that raises two important questions about therapy: Would more be better? It may be that during infection, the body is making the right amount of M-CSF and if we add extra, it won’t improve outcomes further,” he said. “The second possibility is that there is room for improvement: in the fight between monocytes and the bacteria, M-CSF may make monocytes live longer and give them an edge. In addition, some people with weakened immunity might not make enough of M-CSF. If that’s the case, you could augment that and improve their ability to fight the infection.”

More information can be found from University of Virginia website.

Boston Scientific Announces Acquisition of Cosman Medical

Boston Scientific Corporation announced that it has acquired Cosman Medical, Inc., a privately held Burlington, Mass. manufacturer of radiofrequency ablation (RFA) systems. The Cosman Medical team and products will become part of the Boston Scientific Neuromodulation business, which offers a range of Spinal Cord Stimulator (SCS) systems to treat patients with chronic pain, and Deep Brain Stimulation systems* for the treatment of Parkinson’s disease, dystonia and essential tremor.

“This acquisition is a natural extension of our current product portfolio and will help us provide physicians and patients more options to address chronic pain with non-opioid therapeutic treatments,” said Maulik Nanavaty, senior vice president and president, Neuromodulation, Boston Scientific. “The addition of the Cosman Medical product line, which is built on industry-leading technology and known for its high-quality, expands our capability to provide innovative solutions for the treatment of chronic pain.”

One in three Americans suffer from chronic pain and more than 100 million people are partially or totally disabled by pain. In the United States, it is the number one cause of disability in adults.1,2 RFA is a versatile outpatient procedure with a more than 50-year track record of providing relief for patients with chronic pain. It works by applying heat to small areas of nerve tissue to interrupt pain signals. SCS works by sending electrical signals to the spinal cord, masking pain signals from reaching the brain. In the continuum of care for pain, RFA is typically used prior to SCS. While many patients with chronic pain find effective relief from RFA, others progress to SCS to manage pain.

“We are pleased to join the Boston Scientific team and help expand access to leading treatments for chronic pain,” said Eric Cosman, Jr, PhD, scientific director, Cosman Medical. “This acquisition comes at a time when our society is recognizing the impact of relying extensively on opioids to treat pain and is looking for additional approaches. Our mutual commitment to innovation and quality will help us deliver solutions.”

The expansion into RFA follows the recent Boston Scientific launch of the Precision Montage™ MRI Spinal Cord Stimulator (SCS) System which offers customized relief to patients with chronic pain while also enabling safe access to full body magnetic resonance imaging (MRI) in a 1.5 Tesla environment when conditions of use are met. MultiWave™ Technology enables delivery of multiple waveforms, including burst and higher rates, intended to help respond to changes in pain over time. The launch expanded the suite of Boston Scientific products that leverage the Illumina 3D™ algorithm, a three-dimensional, anatomy-driven computer model designed for simple point-and-click pain targeting to support physicians in treating chronic pain. In addition to the new Precision Montage MRI SCS System, the portfolio includes the Precision Spectra™ System, which is designed to provide broad coverage for pain with 32 contacts, and the Precision Novi™ System, the smallest high-capacity non-rechargeable device.

Boston Scientific currently expects the net impact of this transaction on adjusted earnings per share to be break-even in 2016 and accretive thereafter and more dilutive on a GAAP basis as a result of acquisition-related net charges and amortization. Specific terms of the transaction were not disclosed.

A press release can be found from Boston Scientific website.

Withings launches non-contact smart phone connected thermometer

Withings launched a new thermometer – Thermo. A fast, simple, non-contact gesture yields the most precise temperature possible, and automatic sync with the dedicated app also allows users to track temperature readings, get reminders, and input related symptoms/medications right on smartphone.

    

Thermo measures from the temporal artery, considered the best place to detect temperature changes, as the blood that circulates there comes from the core of the body. As Thermo sweeps across the forehead, 16 infrared sensors take over 4,000 measurements to find the hottest point. This is the revolutionary advance, and is what we call HotSpot Sensor™ Technology.

An exceedingly simple scan across the forehead requires no contact with the skin. Unlike traditional methods, Thermo avoids any contact with saliva, earwax or other body fluids — making it the most sanitary way to take anyone’s temperature.

Readings appear illuminated on the device along with a color-coded LED indicator to tell you if the temperature is normal, elevated or high based on the age of the user.

Measurements sync automatically with your smartphone. Based on age, fever history, and symptoms, the Thermo app gives advanced health advice. In addition to tracking temperature and symptoms, users can enter comments, medications, and even photos in any user profile. This helps users see if the treatment is effective and allows users to have a complete history to share with a doctor.

More information can be found from Withings website.

Scientists develop painless microneedle system to monitor drugs

Researchers at UBC and the Paul Scherrer Institut (PSI) in Switzerland have created a microneedle drug monitoring system that could one day replace costly, invasive blood draws and improve patient comfort.

The new system consists of a small, thin patch that is pressed against a patient’s arm during medical treatment and measures drugs in their bloodstream painlessly without drawing any blood. The tiny needle-like projection, less than half a milimetre long, resembles a hollow cone and doesn’t pierce the skin like a standard hypodermic needle.

“Many groups are researching microneedle technology for painless vaccines and drug delivery,” said researcher Sahan Ranamukhaarachchi, a PhD student and Vanier scholar in UBC’s faculties of applied science and pharmaceutical sciences, who developed this technology during a research exchange at PSI. “Using them to painlessly monitor drugs is a newer idea.”

Microneedles are designed to puncture the outer layer of skin, which acts as a protective shield, but not the next layers of epidermis and the dermis, which house nerves, blood vessels and active immune cells.

The microneedle created by Ranamukhaarachchi and his colleagues was developed to monitor the antibiotic vancomycin, which is used to treat serious infections and is administered through an intravenous line. Patients taking the antibiotic undergo three to four blood draws per day and need to be closely monitored because vancomycin can cause life-threatening toxic side effects.

The researchers discovered that they could use the fluid found just below the outer layer of skin, instead of blood, to monitor levels of vancomycin in the bloodstream. The microneedle collects just a tiny bit of this fluid, less than a millionth of a millilitre, and a reaction occurs on the inside of the microneedle that researchers can detect using an optical sensor. This technique allows researchers to quickly and easily determine the concentration of vancomycin.

“This is probably one of the smallest probe volumes ever recorded for a medically relevant analysis,” said Urs Hafeli, associate professor in UBC’s faculty of pharmaceutical sciences.

“The combination of knowhow from UBC and PSI, bringing together microneedles, microfluidics, optics and biotechnology, allowed us to create such a device capable of both collecting the fluid and performing the analysis in one device,” said Victor Cadarso, a research scientist and Ambizione Fellow at PSI.

More information can be found from University of British Columbia website.

Researchers invent “smart” thread that collects diagnostic data when sutured into tissue

For the first time, researchers led by Tufts University engineers have integrated nano-scale sensors, electronics and microfluidics into threads – ranging from simple cotton to sophisticated synthetics – that can be sutured through multiple layers of tissue to gather diagnostic data wirelessly in real time, according to a paper published online July 18 in Microsystems & Nanoengineering. The research suggests that the thread-based diagnostic platform could be an effective substrate for a new generation of implantable diagnostic devices and smart wearable systems.

The researchers used a variety of conductive threads that were dipped in physical and chemical sensing compounds and connected to wireless electronic circuitry to create a flexible platform that they sutured into tissue in rats as well as in vitro. The threads collected data on tissue health (e.g. pressure, stress, strain and temperature), pH and glucose levels that can be used to determine such things as how a wound is healing, whether infection is emerging, or whether the body’s chemistry is out of balance. The results were transmitted wirelessly to a cell phone and computer.

The three-dimensional platform is able to conform to complex structures such as organs, wounds or orthopedic implants.

While more study is needed in a number of areas, including investigation of long-term biocompatibility, researchers said initial results raise the possibility of optimizing patient-specific treatments.

“The ability to suture a thread-based diagnostic device intimately in a tissue or organ environment in three dimensions adds a unique feature that is not available with other flexible diagnostic platforms,” said Sameer Sonkusale, Ph.D., corresponding author on the paper and director of the interdisciplinary Nano Lab in the Department of Electrical and Computer Engineering at Tufts School of Engineering. “We think thread-based devices could potentially be used as smart sutures for surgical implants, smart bandages to monitor wound healing, or integrated with textile or fabric as personalized health monitors and point-of-care diagnostics.”

Until now, the structure of substrates for implantable devices has essentially been two-dimensional, limiting their usefulness to flat tissue such as skin, according to the paper. Additionally, the materials in those substrates are expensive and require specialized processing.

“By contrast, thread is abundant, inexpensive, thin and flexible, and can be easily manipulated into complex shapes,” said Pooria Mostafalu, Ph.D., first author on the paper who was a doctoral student at Tufts when he worked on the project and is now a postdoctoral research fellow with the Harvard-MIT Division of Health Sciences and Technology, Brigham and Women’s Hospital, and the Wyss Institute for Biologically Inspired Engineering at Harvard University. “Additionally, analytes can be delivered directly to tissue by using thread’s natural wicking properties.”