A May 4, 2021 news item on ScienceDaily announced work that may result the restoration of nasal cartilage for skin cancer patients,
A team of University of Alberta researchers has discovered a way to use 3-D bioprinting technology to create custom-shaped cartilage for use in surgical procedures. The work aims to make it easier for surgeons to safely restore the features of skin cancer patients living with nasal cartilage defects after surgery.
The researchers used a specially designed hydrogel — a material similar to Jell-O — that could be mixed with cells harvested from a patient and then printed in a specific shape captured through 3-D imaging. Over a matter of weeks, the material is cultured in a lab to become functional cartilage.
“It takes a lifetime to make cartilage in an individual, while this method takes about four weeks. So you still expect that there will be some degree of maturity that it has to go through, especially when implanted in the body. But functionally it’s able to do the things that cartilage does,” said Adetola Adesida, a professor of surgery in the Faculty of Medicine & Dentistry.
“It has to have certain mechanical properties and it has to have strength. This meets those requirements with a material that (at the outset) is 92 per cent water,” added Yaman Boluk, a professor in the Faculty of Engineering.
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Who would have thought that nose cartilage would look like a worm?
Caption: 3-D printed cartilage is shaped into a curve suitable for use in surgery to rebuild a nose. The technology could eventually replace the traditional method of taking cartilage from the patient’s rib, a procedure that comes with complications. Credit: University of Alberta
Adesida, Boluk and graduate student Xiaoyi Lan led the project to create the 3-D printed cartilage in hopes of providing a better solution for a clinical problem facing many patients with skin cancer.
Each year upwards of three million people in North America are diagnosed with non-melanoma skin cancer. Of those, 40 per cent will have lesions on their noses, with many requiring surgery to remove them. As part of the procedure, many patients may have cartilage removed, leaving facial disfiguration.
Traditionally, surgeons would take cartilage from one of the patient’s ribs and reshape it to fit the needed size and shape for reconstructive surgery. But the procedure comes with complications.
“When the surgeons restructure the nose, it is straight. But when it adapts to its new environment, it goes through a period of remodelling where it warps, almost like the curvature of the rib,” said Adesida. “Visually on the face, that’s a problem.
“The other issue is that you’re opening the rib compartment, which protects the lungs, just to restructure the nose. It’s a very vital anatomical location. The patient could have a collapsed lung and has a much higher risk of dying,” he added.
The researchers say their work is an example of both precision medicine and regenerative medicine. Lab-grown cartilage printed specifically for the patient can remove the risk of lung collapse, infection in the lungs and severe scarring at the site of a patient’s ribs.
“This is to the benefit of the patient. They can go on the operating table, have a small biopsy taken from their nose in about 30 minutes, and from there we can build different shapes of cartilage specifically for them,” said Adesida. “We can even bank the cells and use them later to build everything needed for the surgery. This is what this technology allows you to do.”
The team is continuing its research and is now testing whether the lab-grown cartilage retains its properties after transplantation in animal models. The team hopes to move the work to a clinical trial within the next two to three years.
Here’s a link to and a citation for the paper,
Bioprinting of human nasoseptal chondrocytes-laden collagen hydrogel for cartilage tissue engineering by Xiaoyi Lan, Yan Liang, Esra J. N. Erkut, Melanie Kunze, Aillette Mulet-Sierra, Tianxing Gong, Martin Osswald, Khalid Ansari, Hadi Seikaly, Yaman Boluk, Adetola B. Adesida. The FASEB Journal Volume 35, Issue 3 March 2021 e21191 DOI: https://doi.org/10.1096/fj.202002081R First published online: 17 February 2021
An April 30, 2021 news item on Nanowerk announced research from a joint team at Northwestern University (located in Chicago, Illinois, US) and University of Hong Kong of researchers in the field of neuromorphic (brainlike) computing,
Researchers have developed a brain-like computing device that is capable of learning by association.
Similar to how famed physiologist Ivan Pavlov conditioned dogs to associate a bell with food, researchers at Northwestern University and the University of Hong Kong successfully conditioned their circuit to associate light with pressure.
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The device’s secret lies within its novel organic, electrochemical “synaptic transistors,” which simultaneously process and store information just like the human brain. The researchers demonstrated that the transistor can mimic the short-term and long-term plasticity of synapses in the human brain, building on memories to learn over time.
With its brain-like ability, the novel transistor and circuit could potentially overcome the limitations of traditional computing, including their energy-sapping hardware and limited ability to perform multiple tasks at the same time. The brain-like device also has higher fault tolerance, continuing to operate smoothly even when some components fail.
“Although the modern computer is outstanding, the human brain can easily outperform it in some complex and unstructured tasks, such as pattern recognition, motor control and multisensory integration,” said Northwestern’s Jonathan Rivnay, a senior author of the study. “This is thanks to the plasticity of the synapse, which is the basic building block of the brain’s computational power. These synapses enable the brain to work in a highly parallel, fault tolerant and energy-efficient manner. In our work, we demonstrate an organic, plastic transistor that mimics key functions of a biological synapse.”
Rivnay is an assistant professor of biomedical engineering at Northwestern’s McCormick School of Engineering. He co-led the study with Paddy Chan, an associate professor of mechanical engineering at the University of Hong Kong. Xudong Ji, a postdoctoral researcher in Rivnay’s group, is the paper’s first author.
Caption: By connecting single synaptic transistors into a neuromorphic circuit, researchers demonstrated that their device could simulate associative learning. Credit: Northwestern University
An April 30, 2021 Northwestern University news release (also on EurekAlert), which originated the news item, includes a good explanation about brainlike computing and information about how synaptic transistors work along with some suggestions for future applications,
Conventional, digital computing systems have separate processing and storage units, causing data-intensive tasks to consume large amounts of energy. Inspired by the combined computing and storage process in the human brain, researchers, in recent years, have sought to develop computers that operate more like the human brain, with arrays of devices that function like a network of neurons.
“The way our current computer systems work is that memory and logic are physically separated,” Ji said. “You perform computation and send that information to a memory unit. Then every time you want to retrieve that information, you have to recall it. If we can bring those two separate functions together, we can save space and save on energy costs.”
Currently, the memory resistor, or “memristor,” is the most well-developed technology that can perform combined processing and memory function, but memristors suffer from energy-costly switching and less biocompatibility. These drawbacks led researchers to the synaptic transistor — especially the organic electrochemical synaptic transistor, which operates with low voltages, continuously tunable memory and high compatibility for biological applications. Still, challenges exist.
“Even high-performing organic electrochemical synaptic transistors require the write operation to be decoupled from the read operation,” Rivnay said. “So if you want to retain memory, you have to disconnect it from the write process, which can further complicate integration into circuits or systems.”
How the synaptic transistor works
To overcome these challenges, the Northwestern and University of Hong Kong team optimized a conductive, plastic material within the organic, electrochemical transistor that can trap ions. In the brain, a synapse is a structure through which a neuron can transmit signals to another neuron, using small molecules called neurotransmitters. In the synaptic transistor, ions behave similarly to neurotransmitters, sending signals between terminals to form an artificial synapse. By retaining stored data from trapped ions, the transistor remembers previous activities, developing long-term plasticity.
The researchers demonstrated their device’s synaptic behavior by connecting single synaptic transistors into a neuromorphic circuit to simulate associative learning. They integrated pressure and light sensors into the circuit and trained the circuit to associate the two unrelated physical inputs (pressure and light) with one another.
Perhaps the most famous example of associative learning is Pavlov’s dog, which naturally drooled when it encountered food. After conditioning the dog to associate a bell ring with food, the dog also began drooling when it heard the sound of a bell. For the neuromorphic circuit, the researchers activated a voltage by applying pressure with a finger press. To condition the circuit to associate light with pressure, the researchers first applied pulsed light from an LED lightbulb and then immediately applied pressure. In this scenario, the pressure is the food and the light is the bell. The device’s corresponding sensors detected both inputs.
After one training cycle, the circuit made an initial connection between light and pressure. After five training cycles, the circuit significantly associated light with pressure. Light, alone, was able to trigger a signal, or “unconditioned response.”
Future applications
Because the synaptic circuit is made of soft polymers, like a plastic, it can be readily fabricated on flexible sheets and easily integrated into soft, wearable electronics, smart robotics and implantable devices that directly interface with living tissue and even the brain [emphasis mine].
“While our application is a proof of concept, our proposed circuit can be further extended to include more sensory inputs and integrated with other electronics to enable on-site, low-power computation,” Rivnay said. “Because it is compatible with biological environments, the device can directly interface with living tissue, which is critical for next-generation bioelectronics.”
I stumbled across this event on my Twitter feed (h/t @katepullinger; Note: Kate Pullinger is a novelist and Professor of Creative Writing and Digital Media, Director of the Centre for Cultural and Creative Industries [CCCI] at Bath Spa University in the UK).
Anyone who visits here with any frequency will have noticed I have a number of articles on technology and the body (you can find them in the ‘human enhancement’ category and/or search fro the machine/flesh tag). Boddington’s view is more expansive than the one I’ve taken and I welcome it. First, here’s the event information and, then, a link to her open access paper from February 2021.
This year’s CCCI Public Lecture will be given by Ghislaine Boddington. Ghislaine is Creative Director of body>data>space and Reader in Digital Immersion at University of Greenwich. Ghislaine has worked at the intersection of the body, the digital, and spatial research for many years. This will be her first in-person appearance since the start of the pandemic, and she will share with us the many insights she has gathered during this extraordinary pivot to online interfaces much of the world has been forced to undertake.
With a background in performing arts and body technologies, Ghislaine is recognised as a pioneer in the exploration of digital intimacy, telepresence and virtual physical blending since the early 90s. As a curator, keynote speaker and radio presenter she has shared her outlook on the future human into the cultural, academic, creative industries and corporate sectors worldwide, examining topical issues with regards to personal data usage, connected bodies and collective embodiment. Her research led practice, examining the evolution of the body as the interface, is presented under the heading ‘The Internet of Bodies’. Recent direction and curation outputs include “me and my shadow” (Royal National Theatre 2012), FutureFest 2015-18 and Collective Reality (Nesta’s FutureFest / SAT Montreal 2016/17). In 2017 Ghislaine was awarded the international IX Immersion Experience Visionary Pioneer Award. She recently co-founded University of Greenwich Strategic Research Group ‘CLEI – Co-creating Liveness in Embodied Immersion’ and is an Associate Editor for AI & Society (Springer). Ghislaine is a long term advocate for diversity and inclusion, working as a Trustee for Stemette Futures and Spokesperson for Deutsche Bank ‘We in Social Tech’ initiative. She is a team member and presenter with BBC World Service flagship radio show/podcast Digital Planet.
Date and time
Thu, 24 June 2021 08:00 – 09:00 [am] PDT
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@GBoddington
@bodydataspace
@ConnectedBodies
Boddington’s paper is what ignited my interest; here’s a link to and a citation for it,
The Weave—virtual physical presence design—blending processes for the future
Coming from a performing arts background, dance led, in 1989, I became obsessed with the idea that there must be a way for us to be able to create and collaborate in our groups, across time and space, whenever we were not able to be together physically. The focus of my work, as a director, curator and presenter across the last 30 years, has been on our physical bodies and our data selves and how they have, through the extended use of our bodies into digitally created environments, started to merge and converge, shifting our relationship and understanding of our identity and our selfhood.
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One of the key methodologies that I have been using since the mid-1990s is inter-authored group creation, a process we called The Weave (Boddington 2013a, b). It uses the simple and universal metaphor of braiding, plaiting or weaving three strands of action and intent, these three strands being:
1. The live body—whether that of the performer, the participant, or the public;
2. The technologies of today—our tools of virtually physical reflection;
3. The content—the theme in exploration.
As with a braid or a plait, the three strands must be weaved simultaneously. What is key to this weave is that in any co-creation between the body and technology, the technology cannot work without the body; hence, there will always be virtual/physical blending. [emphasis mine]
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Cyborgs
Cyborg culture is also moving forward at a pace with most countries having four or five cyborgs who have reached out into media status. Manel Munoz is the weather man as such, fascinated and affected by cyclones and anticyclones, his back of the head implant sent vibrations to different sides of his head linked to weather changes around him.
Neil Harbisson from Northern Ireland calls himself a trans-species rather than a cyborg, because his implant is permanently fused into the crown of his head. He is the first trans-species/cyborg to have his passport photo accepted as he exists with his fixed antenna. Neil has, from birth, an eye condition called greyscale, which means he only sees the world in grey and white. He uses his antennae camera to detect colour, and it sends a vibration with a different frequency for each colour viewed. He is learning what colours are within his viewpoint at any given time through the vibrations in his head, a synaesthetic method of transference of one sense for another. Moon Ribas, a Spanish choreographer and a dancer, had two implants placed into the top of her feet, set to sense seismic activity as it occurs worldwide. When a small earthquake occurs somewhere, she received small vibrations; a bigger eruption gives her body a more intense vibration. She dances as she receives and reacts to these transferred data. She feels a need to be closer to our earth, a part of nature (Harbisson et al. 2018).
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Medical, non medical and sub-dermal implants
Medical implants, embedded into the body or subdermally (nearer the surface), have rapidly advanced in the last 30 years with extensive use of cardiac pacemakers, hip implants, implantable drug pumps and cochlear implants helping partial deaf people to hear.
Deep body and subdermal implants can be personalised to your own needs. They can be set to transmit chosen aspects of your body data outwards, but they also can receive and control data in return. There are about 200 medical implants in use today. Some are complex, like deep brain stimulation for motor neurone disease, and others we are more familiar with, for example, pacemakers. Most medical implants are not digitally linked to the outside world at present, but this is in rapid evolution.
Kevin Warwick, a pioneer in this area, has interconnected himself and his partner with implants for joint use of their personal and home computer systems through their BrainGate (Warwick 2008) implant, an interface between the nervous system and the technology. They are connected bodies. He works onwards with his experiments to feel the shape of distant objects and heat through fingertip implants.
‘Smart’ implants into the brain for deep brain stimulation are in use and in rapid advancement. The ethics of these developments is under constant debate in 2020 and will be onwards, as is proved by the mass coverage of the Neuralink, Elon Musk’s innovation which connects to the brain via wires, with the initial aim to cure human diseases such as dementia, depression and insomnia and onwards plans for potential treatment of paraplegia (Musk 2016).
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Given how many times I’ve featured art/sci (also know as, art/science and/or sciart) and cyborgs and medical implants here, my excitement was a given.
For anyone who wants to pursue Boddington’s work further, her eponymous website is here, the body>data>space is here, and her University of Greenwich profile page is here.
For anyone interested in the Centre for Creative and Cultural Industries (CCCI), their site is here.
The topics of human enhancement and human augmentation have been featured here a number of times from a number of vantage points, including that of a video game seires with some thoughtful story lines known under the Deus Ex banner. (My August 18, 2011 posting, . August 30, 2011 posting, and Sept. 1, 2016 posting are three, which mention Deus Ex in the title but there may be others where the game is noted in the posting.)
A March 19, 2021 posting by Timothy Geigner for Techdirt offers a more fulsome but still brief description of the games along with a surprising declaration (it’s too real) by the game’s creator (Note: Links have been removed),
The Deus Ex franchise has found its way onto Techdirt’s pages a couple of times in the past. If you’re not familiar with the series, it’s a cyberpunk-ish take on the near future with broad themes around human augmentation, and the weaving of broad and famous conspiracy theories. That perhaps makes it somewhat ironic that several of our posts dealing with the franchise have to do with mass media outlets getting confused into thinking its augmentation stories were real life, or the conspiracy theories that centered around leaks for the original game’s sequel were true. The conspiracy theories woven into the original Deus Ex storyline were of the grand variety: takeover of government by biomedical companies pushing a vaccine for a sickness it created, the illuminati, FEMA [US Federal Emergency Management Agency] takeovers, AI-driven surveillance of the public, etc.
And it’s the fact that such conspiracy-driven thinking today led Warren Spector, the creator of the series, to recently state that he probably wouldn’t have created the game today if given the chance. [See pull quote below]
Deus Ex was originally released in 2000 but took place in an alternate 2052 where many of the real world conspiracy theories have come true. The plot included references to vaccinations, black helicopters, FEMA, and ECHELON amongst others, some of which have connotations to real-life events. Spector said, “Interestingly, I’m not sure I’d make Deus Ex today. The conspiracy theories we wrote about are now part of the real world. I don’t want to support that.”
… I’d like to focus on how clearly this illustrates the artistic nature of video games. The desire, or not, to create certain kinds of art due to the reflection such art receives from the broader society is exactly the kind of thing artists operating in other artforms have to deal with. Art imitates life, yes, but in the case of speculative fiction like this, it appears that life can also imitate art. Spector notes that seeing what has happened in the world since Deus Ex was first released in 2000 has had a profound effect on him as an artist. [See pull quote below]
Earlier, Spector had commented on how he was “constantly amazed at how accurate our view of the world ended up being. Frankly it freaks me out a bit.” Some of the conspiracy theories that didn’t end up in the game were those surrounding Denver Airport because they were considered “too silly to include in the game.” These include theories about secret tunnels, connections to aliens and Nazi secret societies, and hidden messages within the airport’s artwork. Spector is now incredulous that they’re “something people actually believe.”
It was possible for Geigner even back to an Oct. 18, 2013 posting to write about a UK newspaper that confused Deus Ex with reality,
… I bring you the British tabloid, The Sun, and their amazing story about an augmented mechanical eyeball that, if associated material is to be believed, allows you to see through walls, color-codes friends and enemies, and permits telescopic zoom. Here’s the reference from The Sun.
Oops. See, part of the reason that Sarif Industries’ cybernetic implants are still in their infancy is that the company doesn’t exist. Sarif Industries is a fictitious company from a cyberpunk video game, Deus Ex, set in a future Detroit. …
There’s more about Spector’s latest comments at a 2021 Game Developers Conference in a March 15, 2021 article by Riley MacLeod for Kotaku. There’s more about Warren Spector here. I always thought Deus Ex was developed by Canadian company, Eidos Montréal and, fter reading the company’s Wikipedia entry, it seems I may have been only partially correct.
Getting back to Deus Ex being ‘too real’, it seems to me that the line between science fiction and reality is increasingly frayed.
I wrote about some brain computer interface (BCI) work out of Stanford University (California, US), in a Sept. 17, 2020 posting (Turning brain-controlled wireless electronic prostheses into reality plus some ethical points), which may have contributed to what is now the first demonstration of a wireless brain-computer interface for people with tetraplegia (also known as quadriplegia).
In an important step toward a fully implantable intracortical brain-computer interface system, BrainGate researchers demonstrated human use of a wireless transmitter capable of delivering high-bandwidth neural signals.
Brain-computer interfaces (BCIs) are an emerging assistive technology, enabling people with paralysis to type on computer screens or manipulate robotic prostheses just by thinking about moving their own bodies. For years, investigational BCIs used in clinical trials have required cables to connect the sensing array in the brain to computers that decode the signals and use them to drive external devices.
Now, for the first time, BrainGate clinical trial participants with tetraplegia have demonstrated use of an intracortical wireless BCI with an external wireless transmitter. The system is capable of transmitting brain signals at single-neuron resolution and in full broadband fidelity without physically tethering the user to a decoding system. The traditional cables are replaced by a small transmitter about 2 inches in its largest dimension and weighing a little over 1.5 ounces. The unit sits on top of a user’s head and connects to an electrode array within the brain’s motor cortex using the same port used by wired systems.
For a study published in IEEE Transactions on Biomedical Engineering, two clinical trial participants with paralysis used the BrainGate system with a wireless transmitter to point, click and type on a standard tablet computer. The study showed that the wireless system transmitted signals with virtually the same fidelity as wired systems, and participants achieved similar point-and-click accuracy and typing speeds.
“We’ve demonstrated that this wireless system is functionally equivalent to the wired systems that have been the gold standard in BCI performance for years,” said John Simeral, an assistant professor of engineering (research) at Brown University, a member of the BrainGate research consortium and the study’s lead author. “The signals are recorded and transmitted with appropriately similar fidelity, which means we can use the same decoding algorithms we used with wired equipment. The only difference is that people no longer need to be physically tethered to our equipment, which opens up new possibilities in terms of how the system can be used.”
The researchers say the study represents an early but important step toward a major objective in BCI research: a fully implantable intracortical system that aids in restoring independence for people who have lost the ability to move. While wireless devices with lower bandwidth have been reported previously, this is the first device to transmit the full spectrum of signals recorded by an intracortical sensor. That high-broadband wireless signal enables clinical research and basic human neuroscience that is much more difficult to perform with wired BCIs.
The new study demonstrated some of those new possibilities. The trial participants — a 35-year-old man and a 63-year-old man, both paralyzed by spinal cord injuries — were able to use the system in their homes, as opposed to the lab setting where most BCI research takes place. Unencumbered by cables, the participants were able to use the BCI continuously for up to 24 hours, giving the researchers long-duration data including while participants slept.
“We want to understand how neural signals evolve over time,” said Leigh Hochberg, an engineering professor at Brown, a researcher at Brown’s Carney Institute for Brain Science and leader of the BrainGate clinical trial. “With this system, we’re able to look at brain activity, at home, over long periods in a way that was nearly impossible before. This will help us to design decoding algorithms that provide for the seamless, intuitive, reliable restoration of communication and mobility for people with paralysis.”
The device used in the study was first developed at Brown in the lab of Arto Nurmikko, a professor in Brown’s School of Engineering. Dubbed the Brown Wireless Device (BWD), it was designed to transmit high-fidelity signals while drawing minimal power. In the current study, two devices used together recorded neural signals at 48 megabits per second from 200 electrodes with a battery life of over 36 hours.
While the BWD has been used successfully for several years in basic neuroscience research, additional testing and regulatory permission were required prior to using the system in the BrainGate trial. Nurmikko says the step to human use marks a key moment in the development of BCI technology.
“I am privileged to be part of a team pushing the frontiers of brain-machine interfaces for human use,” Nurmikko said. “Importantly, the wireless technology described in our paper has helped us to gain crucial insight for the road ahead in pursuit of next generation of neurotechnologies, such as fully implanted high-density wireless electronic interfaces for the brain.”
The new study marks another significant advance by researchers with the BrainGate consortium, an interdisciplinary group of researchers from Brown, Stanford and Case Western Reserve universities, as well as the Providence Veterans Affairs Medical Center and Massachusetts General Hospital. In 2012, the team published landmark research in which clinical trial participants were able, for the first time, to operate multidimensional robotic prosthetics using a BCI. That work has been followed by a steady stream of refinements to the system, as well as new clinical breakthroughs that have enabled people to type on computers, use tablet apps and even move their own paralyzed limbs.
“The evolution of intracortical BCIs from requiring a wire cable to instead using a miniature wireless transmitter is a major step toward functional use of fully implanted, high-performance neural interfaces,” said study co-author Sharlene Flesher, who was a postdoctoral fellow at Stanford and is now a hardware engineer at Apple. “As the field heads toward reducing transmitted bandwidth while preserving the accuracy of assistive device control, this study may be one of few that captures the full breadth of cortical signals for extended periods of time, including during practical BCI use.”
The new wireless technology is already paying dividends in unexpected ways, the researchers say. Because participants are able to use the wireless device in their homes without a technician on hand to maintain the wired connection, the BrainGate team has been able to continue their work during the COVID-19 pandemic.
“In March 2020, it became clear that we would not be able to visit our research participants’ homes,” said Hochberg, who is also a critical care neurologist at Massachusetts General Hospital and director of the V.A. Rehabilitation Research and Development Center for Neurorestoration and Neurotechnology. “But by training caregivers how to establish the wireless connection, a trial participant was able to use the BCI without members of our team physically being there. So not only were we able to continue our research, this technology allowed us to continue with the full bandwidth and fidelity that we had before.”
Simeral noted that, “Multiple companies have wonderfully entered the BCI field, and some have already demonstrated human use of low-bandwidth wireless systems, including some that are fully implanted. In this report, we’re excited to have used a high-bandwidth wireless system that advances the scientific and clinical capabilities for future systems.”
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Brown has a licensing agreement with Blackrock Microsystems to make the device available to neuroscience researchers around the world. The BrainGate team plans to continue to use the device in ongoing clinical trials.
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Here’s a link to and a citation for the paper,
Home Use of a Percutaneous Wireless Intracortical Brain-Computer Interface by Individuals With Tetraplegia by John D Simeral, Thomas Hosman, Jad Saab, Sharlene N Flesher, Marco Vilela, Brian Franco, Jessica Kelemen, David M Brandman, John G Ciancibello, Paymon G Rezaii, Emad N. Eskandar, David M Rosler, Krishna V Shenoy, Jaimie M. Henderson, Arto V Nurmikko, Leigh R. Hochberg. IEEE Transactions on Biomedical Engineering, 2021; 1 DOI: 10.1109/TBME.2021.3069119 Date of Publication: 30 March 2021
This paper is open access.
If you don’t happen to be familiar with the IEEE, it’s the Institute of Electrical and Electronics Engineers. BrainGate can be found here, and Blackrock Microsystems can be found here.
The Mutant Project is both a book (The Mutant Project: Inside the Global Race to Genetically Modify Humans) and an event about gene editing with special reference to the CRISPR (clustered regularly interspaced short palindromic repeats) twins, Lulu and Nana. The event is being held by Toronto’s ArtSci Salon. Here’s more from their March 3, 2021 announcement (received via email),
The Mutant Project
A talk and discussion with Eben Kirksey
Discussants:
Dr. Elizabeth Koester, Postdoctoral fellow, Department of History, UofT [University of Toronto]
Vincent Auffrey, PhD student, IHPST [Institute for the History and Philosophy of Science and Technology], UofT
Fan Zhang, PhD student, IHPST, UofT
This event will be streamed on Zoom and on Youtube
At a conference in Hong Kong in November 2018, Dr. He Jiankui announced that he had created the first genetically modified babies—twin girls named Lulu and Nana—sending shockwaves around the world. A year later, a Chinese court sentenced Dr. He to three years in prison for “illegal medical practice.”
As scientists elsewhere start to catch up with China’s vast genetic research program, gene editing is fueling an innovation economy that threatens to widen racial and economic inequality. Fundamental questions about science, health, and social justice are at stake: Who gets access to gene editing technologies? As countries loosen regulations around the globe, from the U.S. to Indonesia, can we shape research agendas to promote an ethical and fair society?
Join us to welcome Dr. Kirksey, who will discuss key topics from his book “The Mutant Project”.
The talk will be followed by a Q&A
EBEN KIRKSEY is an American anthropologist who finished his latest book as a Member of the Institute for Advanced Study in Princeton, New Jersey. He has been published in Wired, The Atlantic, The Guardian and The Sunday Times. He is sought out as an expert on science in society by the Associated Press, The Wall Street Journal, The New York Times, Democracy Now, Time and the BBC, among other media outlets. He speaks widely at the world’s leading academic institutions including Oxford, Yale, Columbia, UCLA, and the International Summit of Human Genome Editing, plus music festivals, art exhibits, and community events. Professor Kirksey holds a long-term position at Deakin University in Melbourne, Australia. For more information, please visit https://eben-kirksey.space/.
Elizabeth Koester currently holds a SSHRC [Social Science and Humanities Research Council of Canada] Postdoctoral Fellowship in the Department of History at the University of Toronto. After practising law for many years, she undertook graduate studies in the history of medicine at the Institute for the History and Philosophy of Science and Technology at the University of Toronto and was awarded a PhD in 2018. A book based on her dissertation, In the Public Good: Eugenics and Law in Ontario, will be published by McGill-Queen’s University Press and is anticipated for Fall 2021.
Vincent Auffrey is pursuing his PhD at the Institute for the History of Philosophy of Science and Technology (IHPST) at the University of Toronto. His focus is set primarily on the social history of medicine and the history of eugenics in Canada. Secondary interests include the histories of scientific racism and of anatomy, and the interplay between knowledge and power.
Fan Zhang is a PhD student at the History of Philosophy of Science and Technology (IHPST) at the University of Toronto
What a great image of bones! This December 3, 2020 University of Arkansas news release (also on EurekAlert) by Matt McGowan features research focused on bone material looks exciting. The date for the second study citation and link that I have listed (at the end of this posting) suggests the more recent study may have been initially overlooked in the deluge of COVID-19 research we are experiencing,
University of Arkansas researchers Marco Fielder and Arun Nair have conducted the first study of the combined nanoscale effects of water and mineral content on the deformation mechanisms and thermal properties of collagen, the essence of bone material.
The researchers also compared the results to the same properties of non-mineralized collagen reinforced with carbon nanotubes, which have shown promise as a reinforcing material for bio-composites. This research aids in the development of synthetic materials to mimic bone.
Using molecular dynamics — in this case a computer simulation of the physical movements of atoms and molecules — Nair and Fielder examined the mechanics and thermal properties of collagen-based bio-composites containing different weight percentages of minerals, water and carbon nanotubes when subjected to external loads.
They found that variations of water and mineral content had a strong impact on the mechanical behavior and properties of the bio-composites, the structure of which mimics nanoscale bone composition. With increased hydration, the bio-composites became more vulnerable to stress. Additionally, Nair and Fielder found that the presence of carbon nanotubes in non-mineralized collagen reduced the deformation of the gap regions.
The researchers also tested stiffness, which is the standard measurement of a material’s resistance to deformation. Both mineralized and non-mineralized collagen bio-composites demonstrated less stability with greater water content. Composites with 40% mineralization were twice as strong as those without minerals, regardless of the amount of water content. Stiffness of composites with carbon nanotubes was comparable to that of the mineralized collagen.
“As the degree of mineralization or carbon nanotube content of the collagenous bio-composites increased, the effect of water to change the magnitude of deformation decreased,” Fielder said.
The bio-composites made of collagen and carbon nanotubes were also found to have a higher specific heat than the studied mineralized collagen bio-composites, making them more likely to be resistant to thermal damage that could occur during implantation or functional use of the composite. Like most biological materials, bone is a hierarchical – with different structures at different length scales. At the microscale level, bone is made of collagen fibers, composed of smaller nanofibers called fibrils, which are a composite of collagen proteins, mineralized crystals called apatite and water. Collagen fibrils overlap each other in some areas and are separated by gaps in other areas.
“Though several studies have characterized the mechanics of fibrils, the effects of variation and distribution of water and mineral content in fibril gap and overlap regions are unexplored,” said Nair, who is an associate professor of mechanical engineering. “Exploring these regions builds an understanding of the structure of bone, which is important for uncovering its material properties. If we understand these properties, we can design and build better bio-inspired materials and bio-composites.”
Here are links and citations for both papers mentioned in the news release,
There have been only two people who have tested the device from Australia but the research raises hope, from an Oct, 28, 2020 news item on ScienceDaily,
A tiny device the size of a small paperclip has been shown to help patients with upper limb paralysis to text, email and even shop online in the first human trial.
The device, Stentrode™, has been implanted successfully in two patients, who both suffer from severe paralysis due to amyotrophic lateral sclerosis (ALS) — also known as motor neuron disease (MND) — and neither had the ability to move their upper limbs.
Published in the Journal of NeuroInterventional Surgery, the results found the Stentrode™ was able to wirelessly restore the transmission of brain impulses out of the body. This enabled the patients to successfully complete daily tasks such as online banking, shopping and texting, which previously had not been available to them.
The Royal Melbourne Hospital’s Professor Peter Mitchell, Neurointervention Service Director and principal investigator on the trial, said the findings were promising and demonstrate the device can be safely implanted and used within the patients.
“This is the first time an operation of this kind has been done, so we couldn’t guarantee there wouldn’t be problems, but in both cases the surgery has gone better than we had hoped,” Professor Mitchell said.
Professor Mitchell implanted the device on the study participants through their blood vessels, next to the brain’s motor cortex, in a procedure involving a small ‘keyhole’ incision in the neck.
“The procedure isn’t easy, in each surgery there were differences depending on the patient’s anatomy, however in both cases the patients were able to leave the hospital only a few days later, which also demonstrates the quick recovery from the surgery,” Professor Mitchell said.
Neurointerventionalist and CEO of Synchron – the research commercial partner – Associate Professor Thomas Oxley, said this was a breakthrough moment for the field of brain-computer interfaces.
“We are excited to report that we have delivered a fully implantable, take home, wireless technology that does not require open brain surgery, which functions to restore freedoms for people with severe disability,” Associate Professor Oxley, who is also co-head of the Vascular Bionics Laboratory at the University of Melbourne, said.
The two patients used the Stentrode™ to control the computer-based operating system, in combination with an eye-tracker for cursor navigation. This meant they did not need a mouse or keyboard.
They also undertook machine learning-assisted training to control multiple mouse click actions, including zoom and left click. The first two patients achieved an average click accuracy of 92 per cent and 93 per cent, respectively, and typing speeds of 14 and 20 characters per minute with predictive text disabled.
University of Melbourne Associate Professor Nicholas Opie, co-head of the Vascular Bionics Laboratory at the University and founding chief technology officer of Synchron said the developments were exciting and the patients involved had a level of freedom restored in their lives.
“Observing the participants use the system to communicate and control a computer with their minds, independently and at home, is truly amazing,” Associate Professor Opie said.
“We are thankful to work with such fantastic participants, and my colleagues and I are honoured to make a difference in their lives. I hope others are inspired by their success.
“Over the last eight years we have drawn on some of the world’s leading medical and engineering minds to create an implant that enables people with paralysis to control external equipment with the power of thought. We are pleased to report that we have achieved this.”
The researchers caution that while it is some years away before the technology, capable of returning independence to complete everyday tasks is publicly available, the global, multidisciplinary team is working tirelessly to make this a reality.
The trial recently received a $AU1.48 million grant from the Australian commonwealth government to expand the trial to hospitals in New South Wales and Queensland, with hopes to enrol more patients.
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About Stentrode™
Stentrode™ was developed by researchers from the University of Melbourne, the Royal Melbourne Hospital, the Florey Institute of Neuroscience and Mental Health, Monash University and the company Synchron Australia – the corporate vehicle established by Associate Professors Thomas Oxley (CEO) and Nicholas Opie (CTO) that aims to develop and commercialise neural bionics technology and products. It draws on some of the world’s leading medical and engineering minds
Researchers demonstrated the success of a fully implantable wireless medical device, the Stentrode™ brain-computer interface (BCI), designed to allow patients with severe paralysis to resume daily tasks — including texting, emailing, shopping and banking online — without the need for open brain surgery. The first-in-human study was published in the Journal of NeuroInterventional Surgery™, the leading international peer-reviewed journal for the clinical field of neurointerventional surgery.
The patients enrolled in the study utilized the Stentrode neuroprosthesis to control the Microsoft Windows 10 operating system in combination with an eye-tracker for cursor navigation, without a mouse or keyboard. The subjects undertook machine learning-assisted training to control multiple mouse-click actions, including zoom and left click.
“This is a breakthrough moment for the field of brain-computer interfaces. We are excited to report that we have delivered a fully implantable, take home, wireless technology that does not require open brain surgery, which functions to restore freedoms for people with severe disability,” said Thomas Oxley, MD, PhD, and CEO of Synchron, a neurovascular bioelectronics medicine company that conducted the research. “Seeing these first heroic patients resume important daily tasks that had become impossible, such as using personal devices to connect with loved ones, confirms our belief that the Stentrode will one day be able to help millions of people with paralysis.”[1]
Graham Felstead, a 75-year-old man living at home with his wife, has experienced severe paralysis due to amyotrophic lateral sclerosis (ALS). He was the first patient enrolled in the first Stentrode clinical study and the first person to have any BCI implanted via the blood vessels. He received the Stentrode implant in August 2019. With the Stentrode, Felstead was able to remotely contact his spouse, increasing his autonomy and reducing her burden of care. Philip O’Keefe, a 60-year-old man with ALS who works part time, was able to control computer devices to conduct work-related tasks and other independent activities after receiving the Stentrode in April 2020. Functional impairment to his fingers, elbows and shoulders had previously inhibited his ability to engage in these efforts.
The Stentrode device is small and flexible enough to safely pass through curving blood vessels, so the implantation procedure is similar to that of a pacemaker and does not require open brain surgery. Entry through the blood vessels may reduce risk of brain tissue inflammation and rejection of the device, which has been an issue for techniques that require direct brain penetration. Implantation is conducted using well-established neurointerventional techniques that do not require any novel automated robotic assistance.
Here’s a link to and a citation for the paper,
Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience by Thomas J Oxley, Peter E Yoo, Gil S Rind, Stephen M Ronayne, C M Sarah Lee, Christin Bird, Victoria Hampshire, Rahul P Sharma, Andrew Morokoff, Daryl L Williams, Christopher MacIsaac, Mark E Howard, Lou Irving, Ivan Vrljic, Cameron Williams, Sam E John, Frank Weissenborn, Madeleine Dazenko, Anna H Balabanski, David Friedenberg, Anthony N Burkitt, Yan T Wong, Katharine J Drummond, Patricia Desmond, Douglas Weber, Timothy Denison, Leigh R Hochberg, Susan Mathers, Terence J O’Brien, Clive N May, J Mocco, David B Grayden, Bruce C V Campbell, Peter Mitchell, Nicholas L Opie. Journal of Neurointerventional Surgery, DOI: http://dx.doi.org/10.1136/neurintsurg-2020-016862 Published Online First: 28 October 2020
Another boost is the the free and virtual, upcoming 2020 Gairdner Ontario International Symposium “Breaking Through: Delivering on the Promise of Gene Therapy“; an international symposium on gene therapy research and practice, which will feature a presentation on the CCA’s report,
Breaking Through brings together Canadian and international leaders to explore the past, present, and future of somatic gene therapy research and practice. This two-day virtual event will examine the successes, challenges and opportunities from the bench to the bedside. It will also feature:
Speaker sessions from Canadian and international researchers at the forefront of gene therapy research.
A panel discussion exploring the opportunities and challenges facing Canadian scientists, regulators, clinicians, decision-makers, and patients (Presented by NRC).
A presentation and Expert Panel discussion on the Council of Canadian Academies’ latest report, From Research to Reality, and a closing panel discussion about the future of gene therapies and gene editing (Presented by Genome Canada).
The title for the CCA report bears an uncanny resemblance to the name for a Canadian initiative highlighting science research, Research2Reality (R2R). (If you’re curious, you can check out my past postings on R2R by using ‘Research2Reality’ as the term for the blog’s search engine.
Glybera
This name stood out: Michael Hayden (scroll down to his name and click), one of the featured speakers for this Dec. 2 – 3, 2020 event, reminded me of the disturbing Glybera story,
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Dr. Hayden identified the first mutations underlying lipoprotein lipase (LPL) deficiency and developed gene therapy approaches to treat this condition, the first approved gene therapy (Glybera) in the western world.
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Kelly Crowe’s Nov. 17, 2018 story for the Canadian Broadcasting Corporation (CBC) lays it out,
It is one of this country’s great scientific achievements.
The first drug ever approved that can fix a faulty gene.
It’s called Glybera, and it can treat a painful and potentially deadly genetic disorder with a single dose — a genuine made-in-Canada medical breakthrough.
But most Canadians have never heard of it.
A team of researchers at the University of British Columbia spent decades developing the treatment for people born with a genetic mutation that causes lipoprotein lipase defficiency (LPLD).
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If you have the time, do read Crowe’s Nov. 17, 2018 story but as I warned in another post, it’s heartbreaking.
Fora brief summary, the company which eventually emerged with the licensing rights to Glybera, charged $1m per dose and a single dose is good for 10 years. It seems governments are reluctant to approve the cost and for many individuals, it’s an impossible price to meet, every 10 years. So, the drug is dead. Or perhaps not? Take a look at the symposium’s agenda (scroll down) for description,
GLYBERA REINVENTED: A WINDING STORY OF COMMITMENT, CREATIVITY, AND INNOVATION
Michael Hayden, MB, ChB, PhD, FRCP(C), FRSC, C.M., O.B.C University Killam Professor, Senior Scientist, Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics,
University of British Columbia (Vancouver, BC)
Money issues
One theme from the agenda jumped out at me: money. The focus seems to be largely on accessibility and costs. The Nov. 3, 2020 CCA news release (also on EurekAlert) about the report also prominently featured costs,
Gene therapies are being approved for use in Canada, but could strain healthcare budgets and exacerbate existing treatment inequities [emphasis mine] across the country. However, there are opportunities to control spending, streamline approvals and support fair access through innovation, coordination and collaboration, according to a new expert panel report from the Council of Canadian Academies (CCA).
“Rapid scientific advances mean potentially life-changing treatments are approaching the clinic at an accelerated pace,” said Janet Rossant, PhD, C.C., FRSC, and Chair of the Expert Panel. “These new therapies, however, pose a number of challenges in terms of their introduction into the Canadian healthcare system and ensuring access to those who would most benefit.”
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Gene therapies and gene editing
Before moving on, you might find it useful to know (if you don’t already) that gene therapy can be roughly divided into somatic cell gene therapy and germline gene therapy as per the Gene Therapy entry in Wikipedia.
Two other items on the symposium’s agenda (scroll down) drew my attention,
Genome editing and the promise for future therapies
Ronald Cohn, MD, FACMG, FCAHS President and CEO, The Hospital for Sick Children (SickKids) (Toronto, ON)
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COMING SOON: THE FUTURE OF GENE EDITING AND GENE THERAPIES
Presented by: Genome Canada
Rob Annan, PhD President and CEO, Genome Canada (Ottawa, ON)
R. Alta Charo, J.D. Warren P. Knowles Professor of Law & Bioethics, University of Wisconsin Law School (Madison, USA)
Jay Ingram, C.M. Science broadcaster and writer, Former Co-Host, Discovery Channel’s “Daily Planet” (Calgary, AB)
Vardit Ravitsky, PhD, FCAHS Full Professor, Bioethics Program, Department of Social and Preventative Medicine, School of Public Health, Université de Montréal; President, International Association of Bioethics (Montréal, QC)
Janet Rossant, PhD, C.C., FRSC President, Gairdner Foundation (Toronto, ON) [also a member of the CCA expert panel for report on somatic cell therapies ‘From research to reality …’)
Genome editing, by the way and if you don’t know, is also known as gene editing. The presence of the word ‘future’ in both the presentations has my antennae quivering. Could they be hinting at germline editing possibilities? At this time, the research is illegal in Canada.
If you don’t happen to know, somatic gene editing, covered in the CCA report, does not affect future generations as opposed to germline gene editing, which does. Should you be curious about the germline gene editing discussion in Canada, I covered as much information as I could uncover in an April 26, 2019 posting on topic.
Jay Ingram’s presence on the panel sponsored by Genome Canada is a bit of a surprise.
I saw him years ago as the moderator for a panel presentation sponsored by Genome British Columbia. The discussion was about genetics and ethics, which was illustrated by clips from the television programme, ReGenesis (from its IMDB entry),
[Fictional] Geneticist David Sandstrom is the chief scientist at the prestigious virology/micro-biology NORBAC laboratory, a joint enterprise between the USA, Canada and Mexico for countering bio-terrorism.
Ingram (BA in microbiology and an MA that’s not identified in his Wikipedia entry) was a television science presenter for a number of years and has continued to work in the field of science communication. He didn’t seem all that knowledgeable about genetics when he moderated the ReGenesis panel but perhaps his focus will be about the communication element?
For anyone interested in attending the free and virtual “Breaking Through” event, you can register here.
CAR-T cell therapies (a type of somatic cell therapy)
One final note, the first week of December seems to be gene therapy week in Canada. There is another free and virtual event, the second session of the Summit for Cancer Immunotherapy: 2020 Speaker Series (Hosted by BioCanRx, Canada’s Immunotherapy Network), Note: I made a few changes to make this excerpt a bit easier to read,
Session Two: Developing better CAR T-Cell Therapies by engaging patients, performing systematic reviews and assessing real-world and economic evidence Wednesday, December 9, 1:30 pm – 3:15pm EST [emphasis mine]
Chimeric Antigen Receptor T-cell (CAR-T) therapy is a personalized immunotherapy, currently being assessed in a Canadian Phase I/II clinical trial to test safety and feasibility for relapsed/refractory blood cancer (CD19+ Acute Lymphoblastic Leukemia and non-Hodgkin’s Lymphoma).
This virtual seminar will provide an overview of a multidisciplinary team’s collaborative efforts to synthesize evidence for the development of this clinical trial protocol, using a novel approach (the ‘Excelerator’ model). This approach involved the completion of a systematic review (objective review of existing trial data), engagement of patients and clinicians, and drawing from real world and economic evidence.
Dr. Fergusson will provide a brief introduction. Dr. Kednapa Thavorn will discuss the team’s use of economic modelling to select trial factors to maximize economic feasibility of the therapy, and Mackenzie Wilson (HQP) will discuss the current efforts and future directions to engage diverse stakeholders to inform this work. Gisell Castillo (HQP) will speak about the interviews that were conducted with patients and hematologists to identify potential barriers and enablers to participation and recruitment to the trial.
The team will also discuss two ongoing projects which build on this work. Dr. Lalu will provide an overview on the team’s patient engagement program throughout development of the trial protocol and plans to expand this program to other immunotherapy trials. Joshua Montroy (HQP) will also discuss ongoing work building on the initial systematic review, to use individual participant data meta-analysis to identify factors that may impact the efficacy of CAR-T cell therapy.
Dr. Justin Presseau will moderate the question and answer period.
And there’s this,
Who should attend?
Scientific and health care community including researchers, clinicians and HQP along with patients and caregivers. Note: There will be a plain language overview before the session begins and an opportunity to ask questions after the discussion.
If you want to know more about CAR T-cell therapy, sometimes called gene or cell therapy or immune effect cell therapy, prior to the Dec., 9, 2020 event, this page on the cancer.org website should prove helpful.
Researchers at Stanford University (California, US) believe they have a solution for a problem with neuroprosthetics (Note: I have included brief comments about neuroprosthetics and possible ethical issues at the end of this posting) according an August 5, 2020 news item on ScienceDaily,
The current generation of neural implants record enormous amounts of neural activity, then transmit these brain signals through wires to a computer. But, so far, when researchers have tried to create wireless brain-computer interfaces to do this, it took so much power to transmit the data that the implants generated too much heat to be safe for the patient. A new study suggests how to solve his problem — and thus cut the wires.
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Caption: Photo of a current neural implant, that uses wires to transmit information and receive power. New research suggests how to one day cut the wires. Credit: Sergey Stavisky
Stanford researchers have been working for years to advance a technology that could one day help people with paralysis regain use of their limbs, and enable amputees to use their thoughts to control prostheses and interact with computers.
The team has been focusing on improving a brain-computer interface, a device implanted beneath the skull on the surface of a patient’s brain. This implant connects the human nervous system to an electronic device that might, for instance, help restore some motor control to a person with a spinal cord injury, or someone with a neurological condition like amyotrophic lateral sclerosis, also called Lou Gehrig’s disease.
The current generation of these devices record enormous amounts of neural activity, then transmit these brain signals through wires to a computer. But when researchers have tried to create wireless brain-computer interfaces to do this, it took so much power to transmit the data that the devices would generate too much heat to be safe for the patient.
Now, a team led by electrical engineers and neuroscientists Krishna Shenoy, PhD, and Boris Murmann, PhD, and neurosurgeon and neuroscientist Jaimie Henderson, MD, have shown how it would be possible to create a wireless device, capable of gathering and transmitting accurate neural signals, but using a tenth of the power required by current wire-enabled systems. These wireless devices would look more natural than the wired models and give patients freer range of motion.
Graduate student Nir Even-Chen and postdoctoral fellow Dante Muratore, PhD, describe the team’s approach in a Nature Biomedical Engineering paper.
The team’s neuroscientists identified the specific neural signals needed to control a prosthetic device, such as a robotic arm or a computer cursor. The team’s electrical engineers then designed the circuitry that would enable a future, wireless brain-computer interface to process and transmit these these carefully identified and isolated signals, using less power and thus making it safe to implant the device on the surface of the brain.
To test their idea, the researchers collected neuronal data from three nonhuman primates and one human participant in a (BrainGate) clinical trial.
As the subjects performed movement tasks, such as positioning a cursor on a computer screen, the researchers took measurements. The findings validated their hypothesis that a wireless interface could accurately control an individual’s motion by recording a subset of action-specific brain signals, rather than acting like the wired device and collecting brain signals in bulk.
The next step will be to build an implant based on this new approach and proceed through a series of tests toward the ultimate goal.
As I found out while investigating, ethical issues in this area abound. My first thought was to look at how someone with a focus on ability studies might view the complexities.
My ‘go to’ resource for human enhancement and ethical issues is Gregor Wolbring, an associate professor at the University of Calgary (Alberta, Canada). his profile lists these areas of interest: ability studies, disability studies, governance of emerging and existing sciences and technologies (e.g. neuromorphic engineering, genetics, synthetic biology, robotics, artificial intelligence, automatization, brain machine interfaces, sensors) and more.
I can’t find anything more recent on this particular topic but I did find an August 10, 2017 essay for The Conversation where he comments on technology and human enhancement ethical issues where the technology is gene-editing. Regardless, he makes points that are applicable to brain-computer interfaces (human enhancement), Note: Links have been removed),
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Ability expectations have been and still are used to disable, or disempower, many people, not only people seen as impaired. They’ve been used to disable or marginalize women (men making the argument that rationality is an important ability and women don’t have it). They also have been used to disable and disempower certain ethnic groups (one ethnic group argues they’re smarter than another ethnic group) and others.
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A recent Pew Research survey on human enhancement revealed that an increase in the ability to be productive at work was seen as a positive. What does such ability expectation mean for the “us” in an era of scientific advancements in gene-editing, human enhancement and robotics?
Which abilities are seen as more important than others?
The ability expectations among “us” will determine how gene-editing and other scientific advances will be used.
And so how we govern ability expectations, and who influences that governance, will shape the future. Therefore, it’s essential that ability governance and ability literacy play a major role in shaping all advancements in science and technology.
One of the reasons I find Gregor’s commentary so valuable is that he writes lucidly about ability and disability as concepts and poses what can be provocative questions about expectations and what it is to be truly abled or disabled. You can find more of his writing here on his eponymous (more or less) blog.
Ethics of clinical trials for testing brain implants
In 2003, neurologist Helen Mayberg of Emory University in Atlanta began to test a bold, experimental treatment for people with severe depression, which involved implanting metal electrodes deep in the brain in a region called area 25 [emphases mine]. The initial data were promising; eventually, they convinced a device company, St. Jude Medical in Saint Paul, to sponsor a 200-person clinical trial dubbed BROADEN.
This month [October 2017], however, Lancet Psychiatry reported the first published data on the trial’s failure. The study stopped recruiting participants in 2012, after a 6-month study in 90 people failed to show statistically significant improvements between those receiving active stimulation and a control group, in which the device was implanted but switched off.
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… a tricky dilemma for companies and research teams involved in deep brain stimulation (DBS) research: If trial participants want to keep their implants [emphases mine], who will take responsibility—and pay—for their ongoing care? And participants in last week’s meeting said it underscores the need for the growing corps of DBS researchers to think long-term about their planned studies.
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… participants bear financial responsibility for maintaining the device should they choose to keep it, and for any additional surgeries that might be needed in the future, Mayberg says. “The big issue becomes cost [emphasis mine],” she says. “We transition from having grants and device donations” covering costs, to patients being responsible. And although the participants agreed to those conditions before enrolling in the trial, Mayberg says she considers it a “moral responsibility” to advocate for lower costs for her patients, even it if means “begging for charity payments” from hospitals. And she worries about what will happen to trial participants if she is no longer around to advocate for them. “What happens if I retire, or get hit by a bus?” she asks.
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There’s another uncomfortable possibility: that the hypothesis was wrong [emphases mine] to begin with. A large body of evidence from many different labs supports the idea that area 25 is “key to successful antidepressant response,” Mayberg says. But “it may be too simple-minded” to think that zapping a single brain node and its connections can effectively treat a disease as complex as depression, Krakauer [John Krakauer, a neuroscientist at Johns Hopkins University in Baltimore, Maryland] says. Figuring that out will likely require more preclinical research in people—a daunting prospect that raises additional ethical dilemmas, Krakauer says. “The hardest thing about being a clinical researcher,” he says, “is knowing when to jump.”
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Brain-computer interfaces, symbiosis, and ethical issues
This was the most recent and most directly applicable work that I could find. From a July 24, 2019 article by Liam Drew for Nature Outlook: The brain,
“It becomes part of you,” Patient 6 said, describing the technology that enabled her, after 45 years of severe epilepsy, to halt her disabling seizures. Electrodes had been implanted on the surface of her brain that would send a signal to a hand-held device when they detected signs of impending epileptic activity. On hearing a warning from the device, Patient 6 knew to take a dose of medication to halt the coming seizure.
“You grow gradually into it and get used to it, so it then becomes a part of every day,” she told Frederic Gilbert, an ethicist who studies brain–computer interfaces (BCIs) at the University of Tasmania in Hobart, Australia. “It became me,” she said. [emphasis mine]
Gilbert was interviewing six people who had participated in the first clinical trial of a predictive BCI to help understand how living with a computer that monitors brain activity directly affects individuals psychologically1. Patient 6’s experience was extreme: Gilbert describes her relationship with her BCI as a “radical symbiosis”.
Symbiosis is a term, borrowed from ecology, that means an intimate co-existence of two species for mutual advantage. As technologists work towards directly connecting the human brain to computers, it is increasingly being used to describe humans’ potential relationship with artificial intelligence.
Interface technologies are divided into those that ‘read’ the brain to record brain activity and decode its meaning, and those that ‘write’ to the brain to manipulate activity in specific regions and affect their function.
Commercial research is opaque, but scientists at social-media platform Facebook are known to be pursuing brain-reading techniques for use in headsets that would convert users’ brain activity into text. And neurotechnology companies such as Kernel in Los Angeles, California, and Neuralink, founded by Elon Musk in San Francisco, California, predict bidirectional coupling in which computers respond to people’s brain activity and insert information into their neural circuitry. [emphasis mine]
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Already, it is clear that melding digital technologies with human brains can have provocative effects, not least on people’s agency — their ability to act freely and according to their own choices. Although neuroethicists’ priority is to optimize medical practice, their observations also shape the debate about the development of commercial neurotechnologies.
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Neuroethicists began to note the complex nature of the therapy’s side effects. “Some effects that might be described as personality changes are more problematic than others,” says Maslen [Hannah Maslen, a neuroethicist at the University of Oxford, UK]. A crucial question is whether the person who is undergoing stimulation can reflect on how they have changed. Gilbert, for instance, describes a DBS patient who started to gamble compulsively, blowing his family’s savings and seeming not to care. He could only understand how problematic his behaviour was when the stimulation was turned off.
Such cases present serious questions about how the technology might affect a person’s ability to give consent to be treated, or for treatment to continue. [emphases mine] If the person who is undergoing DBS is happy to continue, should a concerned family member or doctor be able to overrule them? If someone other than the patient can terminate treatment against the patient’s wishes, it implies that the technology degrades people’s ability to make decisions for themselves. It suggests that if a person thinks in a certain way only when an electrical current alters their brain activity, then those thoughts do not reflect an authentic self.
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To observe a person with tetraplegia bringing a drink to their mouth using a BCI-controlled robotic arm is spectacular. [emphasis mine] This rapidly advancing technology works by implanting an array of electrodes either on or in a person’s motor cortex — a brain region involved in planning and executing movements. The activity of the brain is recorded while the individual engages in cognitive tasks, such as imagining that they are moving their hand, and these recordings are used to command the robotic limb.
If neuroscientists could unambiguously discern a person’s intentions from the chattering electrical activity that they record in the brain, and then see that it matched the robotic arm’s actions, ethical concerns would be minimized. But this is not the case. The neural correlates of psychological phenomena are inexact and poorly understood, which means that signals from the brain are increasingly being processed by artificial intelligence (AI) software before reaching prostheses.[emphasis mine]
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But, he [Philipp Kellmeyer, a neurologist and neuroethicist at the University of Freiburg, Germany] says, using AI tools also introduces ethical issues of which regulators have little experience. [emphasis mine] Machine-learning software learns to analyse data by generating algorithms that cannot be predicted and that are difficult, or impossible, to comprehend. This introduces an unknown and perhaps unaccountable process between a person’s thoughts and the technology that is acting on their behalf.
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Maslen is already helping to shape BCI-device regulation. She is in discussion with the European Commission about regulations it will implement in 2020 that cover non-invasive brain-modulating devices that are sold straight to consumers. [emphases mine; Note: There is a Canadian company selling this type of product, MUSE] Maslen became interested in the safety of these devices, which were covered by only cursory safety regulations. Although such devices are simple, they pass electrical currents through people’s scalps to modulate brain activity. Maslen found reports of them causing burns, headaches and visual disturbances. She also says clinical studies have shown that, although non-invasive electrical stimulation of the brain can enhance certain cognitive abilities, this can come at the cost of deficits in other aspects of cognition.
Regarding my note about MUSE, the company is InteraXon and its product is MUSE.They advertise the product as “Brain Sensing Headbands That Improve Your Meditation Practice.” The company website and the product seem to be one entity, Choose Muse. The company’s product has been used in some serious research papers they can be found here. I did not see any research papers concerning safety issues.
… He [Gilbert] is now preparing a follow-up report on Patient 6. The company that implanted the device in her brain to help free her from seizures went bankrupt. The device had to be removed.
… Patient 6 cried as she told Gilbert about losing the device. … “I lost myself,” she said.
“It was more than a device,” Gilbert says. “The company owned the existence of this new person.”
It’s easy to forget that in all the excitement over technologies ‘making our lives better’ that there can be a dark side or two. Some of the points brought forth in the articles by Wolbring, Underwood, and Drew confirmed my uneasiness as reasonable and gave me some specific examples of how these technologies raise new issues or old issues in new ways.
What I find interesting is that no one is using the term ‘cyborg’, which would seem quite applicable.There is an April 20, 2012 posting here titled ‘My mother is a cyborg‘ where I noted that by at lease one definition people with joint replacements, pacemakers, etc. are considered cyborgs. In short, cyborgs or technology integrated into bodies have been amongst us for quite some time.
Interestingly, no one seems to care much when insects are turned into cyborgs (can’t remember who pointed this out) but it is a popular area of research especially for military applications and search and rescue applications.
I’ve sometimes used the term ‘machine/flesh’ and or ‘augmentation’ as a description of technologies integrated with bodies, human or otherwise. You can find lots on the topic here however I’ve tagged or categorized it.
Amongst other pieces you can find here, there’s the August 8, 2016 posting, ‘Technology, athletics, and the ‘new’ human‘ featuring Oscar Pistorius when he was still best known as the ‘blade runner’ and a remarkably successful paralympic athlete. It’s about his efforts to compete against able-bodied athletes at the London Olympic Games in 2012. It is fascinating to read about technology and elite athletes of any kind as they are often the first to try out ‘enhancements’.
Gregor Wolbring has a number of essays on The Conversation looking at Paralympic athletes and their pursuit of enhancements and how all of this is affecting our notions of abilities and disabilities. By extension, one has to assume that ‘abled’ athletes are also affected with the trickle-down effect on the rest of us.
Regardless of where we start the investigation, there is a sameness to the participants in neuroethics discussions with a few experts and commercial interests deciding on how the rest of us (however you define ‘us’ as per Gregor Wolbring’s essay) will live.
This paucity of perspectives is something I was getting at in my COVID-19 editorial for the Canadian Science Policy Centre. My thesis being that we need a range of ideas and insights that cannot be culled from small groups of people who’ve trained and read the same materials or entrepreneurs who too often seem to put profit over thoughtful implementations of new technologies. (See the PDF May 2020 edition [you’ll find me under Policy Development]) or see my May 15, 2020 posting here (with all the sources listed.)
As for this new research at Stanford, it’s exciting news, which raises questions, as it offers the hope of independent movement for people diagnosed as tetraplegic (sometimes known as quadriplegic.)
