tag:theconversation.com,2011:/global/topics/prosthetics-2438/articles
Prosthetics – The Conversation
2023-09-25T15:03:20Z
tag:theconversation.com,2011:article/211090
2023-09-25T15:03:20Z
2023-09-25T15:03:20Z
Implants like pacemakers and insulin pumps often fail because of immune attacks − stopping them could make medical devices safer and longer-lasting
<figure><img src="https://images.theconversation.com/files/549651/original/file-20230921-21-b8f110.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Foreign body responses can cause insulin pumps to degrade.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-diabetic-patient-keeps-an-insulin-pump-in-the-royalty-free-image/1041117870">Click_and_Photo/iStock via Getty Images</a></span></figcaption></figure><p>Biomedical implants – such as pacemakers, breast implants and orthopedic hardware like screws and plates to replace broken bones – have improved patient outcomes across a wide range of diseases. However, <a href="https://doi.org/10.1002%2Fbtm2.10300">many implants fail</a> because the body rejects them, and they need to be removed because they no longer function and can cause pain or discomfort.</p>
<p>An immune reaction called the <a href="https://doi.org/10.1002/adfm.202007226">foreign body response</a> – where the body encapsulates the implant in sometimes painful scar tissue – is a key driver of implant rejection. Developing treatments that target the mechanisms driving foreign body responses could improve the design and safety of biomedical implants.</p>
<p>I am a <a href="https://scholar.google.com/citations?user=TG52tUAAAAAJ&hl=en">biomedical engineer</a> who studies why the body forms scar tissue around medical devices. Along with my colleagues <a href="https://scholar.google.com/citations?user=XMWljcMAAAAJ&hl=en">Dharshan Sivaraj</a>, <a href="https://scholar.google.com/citations?user=UcM7zG8AAAAJ&hl=en">Jagan Padmanabhan</a> and <a href="https://scholar.google.com/citations?user=zY_J9IQAAAAJ&hl=en">Geoffrey Gurtner</a>, we wanted to learn more about what causes foreign body responses. In our research, recently published in the journal Nature Biomedical Engineering, we <a href="https://www.nature.com/articles/s41551-023-01091-5">identified a gene</a> that appears to drive this reaction because of the increased stress implants put on the tissues surrounding them.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4h9nfYbov38?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Many implants need to be replaced because the immune system damages them over time.</span></figcaption>
</figure>
<h2>Mechanics of implant rejection</h2>
<p>Researchers hypothesize that foreign body responses are triggered by the chemical and material composition of the implant. Just as a person can tell the difference between touching something soft like a pillow versus something hard like a table, cells can tell when there are changes to the softness or stiffness of the tissues surrounding them as a result of an implant.</p>
<p>The <a href="https://doi.org/10.1096/fj.202101354">increased mechanical stress</a> on those cells sends a signal to the immune system that there is a foreign body present. Immune cells activated by mechanical pressure respond by building a capsule made of scar tissue around the implant in an attempt to shield it off. The more severe the immune reaction, the thicker the capsule. This protects the body from getting an infection from injuries like a splinter in your finger.</p>
<p>All biomedical implants cause some level of foreign body response and are surrounded by at least a small capsule. Some people have very strong reactions that result in a large, thick capsule that constricts around the implant, impeding its function and causing pain. <a href="https://doi.org/10.1002%2Fbtm2.10300">Between 10% to 30% of implants</a> need to be removed because of this scar tissue. For example, a neurostimulator could trigger the formation of a dense capsule of scar tissue that <a href="https://doi.org/10.1073/pnas.2115857119">inhibits electrical stimulation</a> from properly reaching the nervous system.</p>
<p>To understand why the immune systems of some people build thick capsules around implants while others do not, we gathered capsule samples from 20 patients whose breast implants were removed – 10 who had severe reactions, and 10 who had mild reactions. By genetically analyzing the samples, we found that a <a href="https://www.nature.com/articles/s41551-023-01091-5">gene called RAC2</a> was highly expressed in samples taken from patients with severe reactions but not in those with mild reactions. This gene is found <a href="https://doi.org/10.1128/mcb.22.21.7645-7657.2002">only in immune cells</a>, and it codes for a <a href="https://doi.org/10.1074/jbc.M306491200">member of a family of proteins</a> involved in cell growth and structure.</p>
<p>Because this protein seemed to be linked to a lot of the downstream reactions that lead to foreign body responses, we decided to explore how RAC2 affects the formation of capsules. We found that immune cells activate RAC2 along with other proteins <a href="https://www.nature.com/articles/s41551-023-01091-5">in response to mechanical stress</a> from implants. These proteins summon additional immune cells to the area that <a href="https://doi.org/10.3390%2Fma8095269">combine into a massive clump</a> to attack a large invader. These combined cells spit out fibrous proteins like collagen that form scar tissue.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clinician holding a silicone breast implant" src="https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549655/original/file-20230921-25-uccyoe.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The mechanical stress that medical devices like breast implants place on surrounding tissues can trigger a foreign body response.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/plastic-surgeon-holding-breast-silicone-implant-royalty-free-image/1300316377">megaflopp/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>To confirm RAC2’s role in foreign body responses, we artificially stimulated the mechanical signaling proteins surrounding silicone implants surgically placed in mice. This stimulation produced a severe and humanlike foreign body response in the mice. In contrast, blocking RAC2 resulted in an <a href="https://www.nature.com/articles/s41551-023-01091-5">up to threefold reduction</a> in foreign body responses.</p>
<p>These findings suggest that activating mechanical stress pathways triggers immune cells with RAC2 to generate severe foreign body responses. Blocking RAC2 in immune cells may significantly reduce this reaction.</p>
<h2>Developing new treatments</h2>
<p>Implant failure is conventionally treated by using <a href="https://doi.org/10.1186/s13036-019-0209-9">biocompatible materials</a> that the body can better tolerate, such as certain polymers. These don’t completely remove the risk of foreign body reactions, however.</p>
<p>My colleagues and I believe that treatments that target the pathways associated with RAC2 could potentially mitigate or prevent free body responses. Heading off this reaction would help improve the effectiveness and safety of medical implants.</p>
<p>Because <a href="https://doi.org/10.1128/mcb.22.21.7645-7657.2002">only immune cells express RAC2</a>, a drug designed to block only that gene would theoretically target only immune cells without affecting other cells in the body. Such a drug could also be administered via injection or even coated onto an implant to minimize side effects.</p>
<p>A complete understanding of the molecular mechanisms driving foreign body responses would be the final frontier in developing truly bio-integrative medical devices that could integrate with the body with no problems for the recipient’s entire life span.</p><img src="https://counter.theconversation.com/content/211090/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kellen Chen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
From breast implants to prosthetic knees, implants can trigger a foreign body response that results in your body rejecting them. Suppressing an immune cell gene could reduce this risk.
Kellen Chen, Assistant Professor of Surgery, University of Arizona
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/204439
2023-04-26T16:37:40Z
2023-04-26T16:37:40Z
Here’s what happened when we endowed volunteers with a sixth finger
<figure><img src="https://images.theconversation.com/files/522997/original/file-20230426-489-97um5.png?ixlib=rb-1.1.0&rect=5%2C14%2C1911%2C997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">This is not a _deepfake_ but a genuine sixth robotic finger.</span> <span class="attribution"><a class="source" href="https://www.youtube.com/watch?v=232jn-Vu6Rk">Yoichi Miyawaki Laboratory</a>, <span class="license">Author provided</span></span></figcaption></figure><p>Have you spotted what distinguishes this hand from those you see usually? Count the number of fingers…</p>
<p>The hand has a robotic “sixth finger” which we developed with <a href="https://www.lirmm.fr/ganesh-gowrishankar/">our collaborator</a>, Prof Yoichi Miyawaki of the University of Electro-Communications in Tokyo.</p>
<p>Users can control this sixth digit independently of the others. In fact, we can pinpoint, with an algorithm, muscle activity in the forearm which doesn’t contribute to normal finger movement, and use this signal to control the robot finger.</p>
<p>It’s also equipped with a haptic sensor (ie, concerned with the sense of touching): this feels what a real finger would feel, and offers “haptic feedback” – that is, light pressures applied on the palm of the hand, giving a tactile sensation.</p>
<p>The user can move around this extra digit with a minimum of training – for many people within less than an hour. One could put it to use by playing the piano!</p>
<p>What we have been studying is how, confronted with new digits, the body reacts. This is also what happens when the body is challenged to accept a prosthesis, for example.</p>
<h2>When the representation of the body changes</h2>
<p>Drawing on behavioural experiments and brain imagery, <a href="https://www.nature.com/articles/s41598-022-06040-x">our research</a> is focused on the way in which the user’s brain gels with the sixth finger. Changes in users’ bodily perceptions come very quickly.</p>
<p>More specifically, we’ve asked participants to touch a drawn line with their own little finger, without looking at their fingers. This experiment showed that people became uncertain about the positioning of their own little finger in space.</p>
<p>We’re pursuing these studies at the moment to directly observe using magnetic resonance imaging the extent of change to users’ brain activity, as this relates to representation of the robot sixth finger. For example, one could look to find out which zones of the brain are activated when the user moves their finger.</p>
<p>In neuroscience, the term <a href="https://www.sciencedirect.com/science/article/abs/pii/S0010027708000061">“embodiment”</a> of a limb refers to the human brain’s capacity to accept a prosthesis and believe it is part of one’s body. In French the expression is “incarnation”.</p>
<p>Another striking example is that of the <a href="https://www.youtube.com/watch?v=sxwn1w7MJvk">“rubber hand” illusion</a>, where the user thinks someone is tapping their hand, when their real arm is somewhere else.</p>
<h2>The human brain can accept foreign body parts</h2>
<p>This example and <a href="https://www.sciencedirect.com/science/article/pii/S2589004220309299">other scientific studies</a> over <a href="https://www.nature.com/articles/35784">recent decades</a>, including <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053810016303038">our own</a>, have shown that it’s actually quite easy to deceive our brain into thinking that artificial limbs are part of our bodies. The brain is very adaptable and flexible about what it defines and accepts as our body.</p>
<p>This flexibility is very useful, because the human body changes as we grow up and get old. Physical changes can also be caused by accidents or through paralysis, which people are potentially capable of adapting to as well.</p>
<p>This notion of “incarnation” is also what allows us to accept prostheses to replace or complete lost bodily functions.</p>
<h2>The limits of acceptance for a new limb</h2>
<p>In our study of extra body parts, like the sixth finger, we have been interested in the limits of this acceptance. Is it possible to add new integral body parts? And can we feel added elements as if they are part of our body?</p>
<p>A number of previous studies have tried to address these questions by attaching artificial limbs to their subjects, including <a href="https://www.mrc-cbu.cam.ac.uk/blog/2022/06/the-third-thumb-project-at-the-royal-society-summer-science-exhibition/">robot fingers</a>, <a href="https://ieeexplore.ieee.org/document/8612275">arms</a>, and a <a href="https://pubmed.ncbi.nlm.nih.gov/23428442/">virtual tail</a> for humans.</p>
<p>However, all these investigations are on the basis of a limb replacement, where the added part is animated by movements and haptic feedback of existing body parts – effectively substituting a new artificial limb for a flesh and bones one.</p>
<p>In our study, we’re trying to find out if our brains can accept a truly autonomous extra body part, which can be moved around independently of any other part and from which we can obtain haptic feedback, on which the flesh and bones body has no bearing. It seems that they can.</p>
<p>Thinking of the applications, our finding that additional limbs can be accepted by the brain is encouraging for the future development of wearable artificial limbs.</p>
<hr>
<p><em>This article was translated from French by <a href="https://twitter.com/JoshNeicho">Joshua Neicho</a></em>.</p><img src="https://counter.theconversation.com/content/204439/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This research was supported by JST ERATO Grant Number JPMJER1701, in Japan.</span></em></p>
Our body can adopt a sixth robotic finger, which we can move independently of the other fingers and with tactile sensations.
Ganesh Gowrishankar, Chercheur au Laboratoire d'Informatique, de Robotique et de Microelectronique de Montpellier, Université de Montpellier
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/196097
2023-01-23T13:24:48Z
2023-01-23T13:24:48Z
Cochlear implants can bring the experience of sound to those with hearing loss, but results may vary – here’s why
<figure><img src="https://images.theconversation.com/files/504991/original/file-20230117-14-1zs337.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A patient's age upon receiving a cochlear implant can influence the technology's effectiveness.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/yr-old-boy-with-cochlear-implant-studying-and-royalty-free-image/1203208092">Cavan Images/Cavan via Getty Images</a></span></figcaption></figure><p>Cochlear implants are among the most successful neural prostheses on the market. These artificial ears have allowed nearly <a href="https://doi.org/10.1121/10.0012825">1 million people globally</a> with severe to profound hearing loss to either regain access to the sounds around them or experience the sense of hearing for the first time.</p>
<p>However, the effectiveness of cochlear implants varies greatly across users because of a <a href="https://doi.org/10.1097%2FAUD.0b013e3182741aa7">range of factors</a>, such as hearing loss duration and age at implantation. Children who receive implants at a <a href="https://doi.org/10.1001/archotol.130.5.570">younger age may</a> may be able to acquire auditory skills similar to their peers with natural hearing.</p>
<p>I am a <a href="https://search.asu.edu/profile/3630640">researcher studying pitch perception with cochlear implants</a>. Understanding the mechanics of this technology and its limitations can help lead to potential new developments and improvements in the future.</p>
<h2>How does a cochlear implant work?</h2>
<p>In <a href="https://www.nidcd.nih.gov/health/how-do-we-hear">fully-functional hearing</a>, sound waves enter the ear canal and are converted into neural impulses as they move through hairlike sensory cells in the cochlea, or inner ear. These neural signals then travel through the auditory nerve behind the cochlea to the central auditory areas of the brain, resulting in a perception of sound.</p>
<p>People with severe to profound hearing loss often have damaged or missing sensory cells and are unable to convert sound waves into electrical signals. Cochlear implants bypass these hairlike cells by <a href="https://doi.org/10.1016/j.heares.2008.06.005">directly stimulating the auditory nerve</a> with electrical pulses.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Diagram of anatomy of hearing" src="https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=538&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=538&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=538&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=676&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=676&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505008/original/file-20230117-20-hub8am.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=676&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sound travels through the ear canal and is converted by hair cells in the cochlea into electrical signals that enter the brain.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/hearing-cross-section-of-humans-ear-with-royalty-free-illustration/1345828402">ttsz/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>Cochlear implants consist of an external part wrapped behind the ear and an internal part implanted under the skin. </p>
<p>The external unit, which includes a microphone, signal processor and transmitter, picks up and processes sound waves from the environment. It divides sounds into different frequency bands, which are like different channels on a radio, with each band representing a specific range of frequencies within an overall spectrum of sound. It also extracts information about amplitude, or loudness, from each frequency band.</p>
<p>It then transmits that information to the receiver in the internal unit implanted in the cochlea. The electrodes of the internal unit directly stimulate the auditory nerve with electrical pulses based on amplitude information. Electrodes at the base of the cochlea transmit electrical signals containing high-frequency auditory information while electrodes at the top transmit electrical signals containing low-frequency information to the brain, mimicking the frequency analysis in a fully-functioning ear.</p>
<h2>Where cochlear implants fall short</h2>
<p>While people with cochlear implants are able to detect sounds and perceive speech in quiet environments reasonably well, they often have great difficulty <a href="https://doi.org/10.1016/j.heares.2008.06.005">understanding speech in noisy environments</a>, <a href="https://doi.org/10.1177/108471380400800203">enjoying music</a> and <a href="https://doi.org/10.1121/1.2821965">localizing sounds</a>, that is, figuring out which direction a sound is coming from.</p>
<p>Cochlear implants are <a href="https://doi.org/10.1044/2020_JSLHR-19-00225">fundamentally limited</a> by their poor ability to tell the difference between sound frequencies and transmit rapid variations in sound amplitude over time. For example, current cochlear implant systems use only 12 to 22 electrodes to stimulate surviving auditory nerve fibers, whereas natural hearing has 30,000 auditory nerve fibers to encode detailed information about incoming sounds. Furthermore, electrode stimulation inside the cochlea excites a large group of auditory nerve fibers without much precision. </p>
<p>These factors result in poor frequency resolution. Picture it like painting with a thick brush that can show only an overall shape without the fine details, or only blurry details.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/xW4qfOkA4oc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The hearing experience from cochlear implants differs from that of natural hearing.</span></figcaption>
</figure>
<h2>Why cochlear implants work better for some</h2>
<p>It remains <a href="https://doi.org/10.1371/journal.pone.0048739%E2%80%8B">difficult to accurately predict</a> the performance of cochlear implants for each user. </p>
<p>There are <a href="https://doi.org/10.1177/000348949810701102">a variety of factors</a> that can affect the number of healthy auditory nerve fibers available to transmit acoustic information to the brain. Cochlear implant users with better survival of their auditory nerve fibers may have improved <a href="https://doi.org/10.1016/j.heares.2014.09.009">frequency and timing representations of sounds</a> represented by electrical stimulation, which can lead to better speech and pitch perception.</p>
<p>Neural health is not the only factor that contributes to variability in cochlear implant effectiveness. One 2012 study of 2,251 cochlear implant users found that <a href="https://doi.org/10.1371/journal.pone.0048739">speech recognition varied greatly</a>, and only 22% of the difference could be explained by clinical factors like length of experience with the implant and cause of hearing loss. Furthermore, it is <a href="https://doi.org/10.1007/s10162-022-00876-w">challenging to directly assess</a> the effects of neural survival on the performance of cochlear implants. This suggests that other factors also play a role in determining the success of speech recognition with cochlear implants.</p>
<p>For instance, research has found that <a href="https://doi.org/10.1097/MAO.0000000000002544">cognitive skills</a> like working memory can influence the extent to which a person can understand speech after implantation. Cochlear implants <a href="https://doi.org/10.1097/AUD.0000000000000145">increase cognitive load</a>, or the amount of mental effort required to perform a task, as the sound quality users hear is often lower than that of natural hearing. Aging may also negatively affect cognitive processing skills, including <a href="https://doi.org/10.1097/AUD.0b013e3182741aa7">attention deficits and slower processing speed</a> on listening tasks.</p>
<p>Furthermore, most of the implant’s electrode arrays don’t reach the top of the cochlea where low-frequency information is conveyed in natural hearing. This <a href="https://doi.org/10.1097%2FAUD.0000000000000163">leads to mismatches</a> between the frequencies conveyed by the implant and those of natural hearing, resulting in reduced sound quality.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Four cochlear implants of different colors." src="https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=512&fit=crop&dpr=1 600w, https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=512&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=512&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=644&fit=crop&dpr=1 754w, https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=644&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/504988/original/file-20230117-11104-w83z6d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=644&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The effectiveness of cochlear implants varies based on a number of factors.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/cohlear-implant-devices-royalty-free-image/490611153">Elizabeth Hoffmann/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<h2>Improving cochlear implants</h2>
<p>Scientists are investigating a number of potential ways to improve the effectiveness of cochlear implants.</p>
<p>Hearing sound through electrical stimulation is a new experience for those used to hearing without an implant. Auditory training exercises can help familiarize users with this new form of hearing and <a href="https://doi.org/10.1177/1084713807301379">may even enhance overall speech and music perception</a>. However, even with training, conventional cochlear implants may not fully replicate the rich experience of natural hearing.</p>
<p>Researchers are studying the potential <a href="https://spectrum.ieee.org/cochlear-implant">use of light beams</a> instead of electrical pulses to obtain better frequency resolution. This is done by genetically modifying the auditory nerve fibers to make them sensitive to light. Because light beams are able to more selectively stimulate auditory neurons compared to electrical pulses, this tactic may result in more precise frequency information. The research team behind this approach aims to start clinical trails in 2026.</p>
<p>Another approach involves <a href="https://twin-cities.umn.edu/news-events/university-minnesota-lead-97-million-nih-grant-improve-hearing-restoration">inserting electrodes directly into auditory nerve fibers</a> instead of the cochlea. By increasing the number of available electrodes, this strategy may enhance the sound frequency and timing information of the implant, and improve speech understanding in noisy environments and music perception.</p>
<p>Lastly, another development uses <a href="https://doi.org/10.7554/eLife.76682">magnetic stimulation</a> to transmit acoustic information via small, implantable microcoils. This approach allows for finer stimulation patterns than the widespread electrical activation of traditional electrodes, potentially leading to more precise sounds representation.</p>
<p>Research on new technologies may provide solutions to further improve the hearing experience for those struggling with hearing loss.</p><img src="https://counter.theconversation.com/content/196097/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Niyazi Arslan receives educational funding from the Republic of Türkiye.</span></em></p>
Researchers are exploring different ways to improve how cochlear implant users perceive speech and music in noisy environments.
Niyazi Arslan, Ph.D. Candidate in Speech and Hearing Science, Arizona State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/115418
2022-03-30T12:39:37Z
2022-03-30T12:39:37Z
Restoring touch through electrodes implanted in the human brain will require engineering around a sensory lag
<figure><img src="https://images.theconversation.com/files/454006/original/file-20220323-19-gkft50.jpg?ixlib=rb-1.1.0&rect=709%2C0%2C4832%2C2928&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The brain responds differently to natural touch on a finger versus a direct electrical stimulation.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/finger-reaching-for-a-brain-illustration-royalty-free-illustration/1215123867">Sebastian Kaulitzki/Science Photo Library</a></span></figcaption></figure><p>More than 5 million people in the United States are affected by <a href="https://doi.org/10.2105/AJPH.2016.303270">limb loss or paralysis</a>. Technological devices that directly interact with the brain, known as <a href="http://bci.cs.washington.edu/">brain-computer interfaces</a>, offer the potential to decode an individual’s thoughts and translate them into action <a href="https://www.youtube.com/watch?v=6h60UjIGGV4">using a robotic arm</a> or <a href="https://www.youtube.com/watch?v=9oka8hqsOzg">a cursor on a screen</a>. These neuroprosthetics can take the place of an amputated or paralyzed arm, for instance, helping the user take an action.</p>
<p>Much research in this field to date has focused on decoding brain signals – what is it that the person wants to do?</p>
<p>But there’s another equally important part of any real-world prosthetic system. It needs to be able to convey information in the other direction, too, back to the brain to provide feedback from the external world. Think about how challenging it would be to interact with the world in the absence of touch. Tasks such as lighting a match, picking up an egg and grasping a coffee cup become tremendously difficult.</p>
<p>At the University of Washington’s <a href="https://centerforneurotech.uw.edu/">Center for Neurotechnology</a>, our team is working out how best to <a href="https://www.youtube.com/watch?v=7t84lGE5TXA&t=13s">engineer stimulation to the brain</a> to restore tactile sensations that allow people to perform useful tasks. To this end, we are studying how people respond to sensation triggered by electrical stimulation of the brain. Our goal is to help devise a system that someday will allow someone who has lost the sense of touch to feel a loved one’s hand again.</p>
<h2>Speed of natural touch versus brain stimulation</h2>
<p>Collaborating with neurosurgeons <a href="https://scholar.google.com/citations?user=zQJMnscAAAAJ&hl=en&oi=ao">Jeffrey Ojemann</a> and <a href="https://scholar.google.com/citations?user=78GnqoAAAAAJ&hl=en&oi=ao">Andrew Ko</a>, we rely on patient volunteers who generously allow us to carry out research while they are undergoing treatment for epilepsy.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="patient with head immobilized in surgical suite" src="https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/454007/original/file-20220323-15-19jmijp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Many brain surgeries are performed with the patient awake and able to provide live feedback.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/photo-essay-at-the-regional-university-hospital-of-lille-news-photo/151046906">BSIP/Universal Images Group via Getty Images</a></span>
</figcaption>
</figure>
<p>To help localize the origin of a patient’s seizures prior to removing brain tissue to potentially help their epilepsy, Ojemann and Ko temporarily implant small, metal electrodes on top of and within the patient’s brain. These electrodes monitor the brain’s epileptic seizures so the neurosurgeons know where – and where not – to operate.</p>
<p>Our experiments use those same electrodes in two ways. We can record the electrical activity of the brain’s neurons. And we are also able to inject small amounts of electric current into specific parts of the brain. When we send a small burst of electricity to the touch-processing areas of the brain, the person experiences tactile sensations. In other words, when we activate particular neurons with electricity, the volunteer experiences it as if we were touching a particular part of their body.</p>
<p>In one study, we wanted to understand which tactile sensation <a href="https://doi.org/10.1038/s41598-019-38619-2">an individual would perceive faster</a> – artificial stimulation due to direct electrical stimulation of the brain via electrode, or natural tactile sensation due to a real touch on the patient’s hand?</p>
<p>We asked our subjects to press a button as quickly as possible using the hand opposite to where they felt the sensation. They were blindfolded to eliminate the potential for visual feedback that might confound our results.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Line drawing illustrates slower response time to direct electrical stimulation of the brain" src="https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=517&fit=crop&dpr=1 754w, https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=517&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/455100/original/file-20220329-21-1rzyey5.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=517&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Response times to direct stimulation of neurons in the brain were slower than response times to natural touch.</span>
<span class="attribution"><span class="source">Caldwell and Rao</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>What we discovered was surprising. Individuals responded <a href="https://www.nature.com/articles/s41598-019-38619-2#Sec2">more slowly to direct stimulation</a> of their brain’s primary somatosensory cortex compared to a natural touch to their fingers. Even though an electric signal directly from the electrode in the brain bypassed all the peripheral nerves between the hand and head, the signal that traveled the longer journey up the ascending sensory nerves registered first.</p>
<p>This result held up even when we tested subjects again after a short break, suggesting that it cannot be explained solely as a novel sensation that the subjects needed time to learn. </p>
<p>[<em>The Conversation’s science, health and technology editors pick their favorite stories.</em> <a href="https://memberservices.theconversation.com/newsletters/?nl=science&source=inline-science-favorite">Weekly on Wednesdays</a>.]</p>
<p><a href="https://doi.org/10.1088/1741-2560/11/4/046025">Previous studies in nonhuman primates</a> have found similar delays in reaction time relative to natural touch when researchers delivered electrical stimulation to a single location within somatosensory cortex. On the other hand, more recent research using multiple electrodes to stimulate somatosensory cortex in nonhuman primates found that such electrical stimulation could elicit response times <a href="https://doi.org/10.1088/1741-2552/ab5cf3">slightly faster than natural touch</a>.</p>
<p>Together, these studies demonstrate the complexities of stimulating the brain to replace natural tactile feedback. Future technologies and engineering strategies will need to take into account variability in touch sensation depending on how electrical stimulation is targeted in the brain.</p>
<h2>Engineering around a sensory lag</h2>
<p>By discovering a delay in how people respond to direct electrical stimulation of their brains, we have revealed potential limitations in how current engineered solutions perform. The delay might limit how well future sensory neuroprosthetic devices using these clinical electrodes can work.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="hand removes egg from carton" src="https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/454009/original/file-20220324-21-198dllb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Fine motor movements – like picking up an egg without crushing it – rely on calibrating the effort based on what your sense of touch tells you.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/hand-selected-egg-in-egg-box-royalty-free-image/1367295987">Jackyenjoyphotography/Moment via Getty Images</a></span>
</figcaption>
</figure>
<p><a href="https://www.youtube.com/watch?v=FUqgVHR6mpQ">Designers may need</a> to account for a significant lag in artificial sensation relative to natural touch. For instance, if a user doesn’t receive feedback from touch sensors on a robotic hand quickly enough, and the overall system does not account for this delay in perception, someone attempting to pick up an egg with a robotic hand could apply too much pressure and crush it.</p>
<p>To improve reaction times and more broadly to enhance the utility of direct brain stimulation, we will need to take into account ongoing brain activity and tailor the electrical stimulation patterns for each person’s brain and the task at hand.</p>
<p>To achieve this goal, we have recently proposed a <a href="https://www.youtube.com/watch?v=DH5HBQD69oI">new type of brain-computer interface</a> called a <a href="https://arxiv.org/abs/2012.03378">brain co-processor</a>, which uses artificial intelligence to compute the best stimulation patterns for a task given current brain activity. Such an approach allows multiple electrodes to be used, possibly targeting multiple regions, and relies on co-adaptation with the brain to better approximate natural sensations. </p>
<p>Can electrical stimulation meaningfully substitute for natural touch during a complex task in the real world? We believe so. It will require both understanding the intricacies of information processing in the brain and incorporating this knowledge into future brain co-processors and neuroprosthetic devices for restoring touch.</p><img src="https://counter.theconversation.com/content/115418/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Caldwell received funding from the National Science Foundation, National Institute of Health, University of Washington Institute for Neuroengineering, and the ARCS foundation. </span></em></p><p class="fine-print"><em><span>Rajesh P. N. Rao receives funding from the National Science Foundation, the Weill Neurohub Investigator program and a Cherng Jia & Elizabeth Yun Hwang Professorship.</span></em></p>
When designing neuroprosthetic devices for users to control with their thoughts, engineers must take into account the sensory information brains collect from the environment and how it gets processed.
David Caldwell, Neurological Surgery Resident, University of California, San Francisco
Rajesh P. N. Rao, Professor of Computer Science and Engineering and Director of the Center for Sensorimotor Neural Engineering, University of Washington
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/173484
2021-12-21T13:43:21Z
2021-12-21T13:43:21Z
Mechanical forces in a beating heart affect its cells’ DNA, with implications for development and disease
<figure><img src="https://images.theconversation.com/files/436506/original/file-20211208-23-3udfl3.png?ixlib=rb-1.1.0&rect=0%2C0%2C764%2C459&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Contracting heart cells exert forces on their genetic material that affect how they develop.</span> <span class="attribution"><a class="source" href="https://doi.org/10.1038/s41551-021-00823-9">Benjamin Seelbinder</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>Sometimes cells can forget what type of cell they are and stop functioning correctly. This commonly happens in <a href="https://doi.org/10.1016/j.devcel.2015.12.001">cancer</a>, in which mature cells lose aspects of their identity and become more susceptible to begin dividing uncontrollably.</p>
<p>Heart conditions like <a href="https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709">cardiomyopathy</a>, a disease that makes it harder to pump blood, affect the shape and function of affected heart cells. These changes can also occur in the nucleus of the cell, which houses genetic material that tells a cell how to function.</p>
<p>Because certain changes to nuclear structure can be early warning signals for heart problems, monitoring for such changes could help clinicians diagnose and treat disease before it gets worse. Researchers know that certain <a href="https://dx.doi.org/10.1172%2FJCI87491">changes in the physical forces exerted on heart cells</a>, including from their own contraction, can lead the cells to lose their heart cell identity and function poorly. But exactly how these physical forces work to change heart cell identity was unclear. </p>
<p>In <a href="https://doi.org/10.1038/s41551-021-00823-9">a 2021 study</a> my colleagues and I published in the journal Nature Biomedical Engineering, we found that mechanical forces can reorganize the genetic material inside the nucleus of heart cells and affect how they develop and function. Better understanding of how cells claim and maintain their identities may help advance treatments to repair heart damage from cardiovascular disease and create new prosthetic tissues.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/AONaH_oi3wQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Heart cells in a petri dish change the structure of their nuclei with each beat.</span></figcaption>
</figure>
<h2>Pushing cell development in another direction</h2>
<p>Early in human development, the external pressures surrounding immature cells influence what type of cell they eventually become when they <a href="https://doi.org/10.1016/j.cell.2006.06.044">differentiate</a>, or fully mature. These external forces also help maintain <a href="https://doi.org/10.1146/annurev-bioeng-071114-040829">tissue health as people age</a>. </p>
<p>During differentiation, cells move around and restructure a mixture of proteins and DNA called <a href="https://www.genome.gov/genetics-glossary/Chromatin">chromatin</a> that’s located in their nuclei. Cells use chromatin as a way to package and organize their genetic code. Knowing that external physical pressures can affect how cells mature, <a href="https://www.colorado.edu/lab/neulab/">my research lab</a> and I wanted to explore how mechanical forces can reorganize chromatin and what that might tell us about how heart cells develop and sometimes stop working.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Diagram of chromosome unwinding to show chromatin, histones and DNA" src="https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=515&fit=crop&dpr=1 600w, https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=515&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=515&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=648&fit=crop&dpr=1 754w, https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=648&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/438277/original/file-20211217-27-ca80jb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=648&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Chromatin consists of DNA tightly coiled around proteins called histones.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/chromation-biological-diagram-vector-royalty-free-illustration/1205309579">VectorMine/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>To do this, we looked at adult heart cells as they contracted under a microscope to see how their nuclei change shape. We then compared these images with the nuclei of embryonic heart cells as they normally change during early development. We found that areas in the nucleus with high tension tended to organize chromatin into specific shapes known to influence cell behavior. When we changed the tension in those areas of the nucleus, we were able to prevent cells from developing into normal heart cells. This meant that tension may play a key role in guiding heart cells on how to develop.</p>
<p>We then examined how mechanical stress changed the chromatin structure of heart cells from patients with cardiovascular disease and mice with reduced heart performance. Compared with healthy cells, heart cells from both patients and mice lost their chromatin organization and identity as heart cells. This meant that mechanical tension could influence how well mature cells function and their likelihood of developing into cardiovascular disease.</p>
<h2>Mechanical forces matter in medicine</h2>
<p>While our study explores the role that chromatic reorganization plays in early development, additional research is needed to understand exactly what triggers cells to develop into specific cell types. Further insight into how the mechanical environment surrounding a cell affects how it matures will help researchers better understand the process of human development.</p>
<p>Understanding what triggers a collection of cells to transition to a fully functional organ may also help researchers learn how to mimic these developmental processes and create new prosthetic devices. For example, accounting for the mechanical forces that affect how well <a href="https://doi.org/10.1038/nm1394">tissue grafts for failing hearts</a> and <a href="https://doi.org/10.1073/pnas.1402723111">muscles</a> work may help biomedical engineers design even more effective artificial implants. It may also set the stage for more <a href="https://doi.org/10.1038/s41573-020-0079-3">organ-on-chip models</a> that can be used instead of animals to screen potential drugs.</p><img src="https://counter.theconversation.com/content/173484/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Corey Neu receives funding from the National Institutes of Health, National Science Foundation, and the Department of Defense. </span></em></p>
Heart disease can change the genetic structure of heart cells. Understanding the role that mechanical forces play in these changes could lead to improvements in artificial tissue design.
Corey Neu, Professor of Mechanical and Biomedical Engineering, University of Colorado Boulder
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/166896
2021-09-03T03:49:23Z
2021-09-03T03:49:23Z
From bespoke seats to titanium arms, 3D printing is helping paralympians gain an edge
<p>Major sporting events like the Paralympics are a breeding ground for technological innovation. Athletes, coaches, designers, engineers and sports scientists are constantly looking for the next improvement that will give them the edge. Over the past decade, <a href="https://www.hubs.com/guides/3d-printing/">3D printing</a> has <a href="https://doi.org/10.1177/1754337120971521">become a tool</a> to drive improvements in sports like running and cycling, and is increasingly used by paralympic athletes.</p>
<p>The Paralympics features athletes with a diverse range of abilities, competing in a wide range of different <a href="https://www.paralympic.org/classification">categories</a>. Many competitors use prosthetics, wheelchairs or other specialised components to enable them to perform at their best.</p>
<p>One interesting question is whether 3D printing widens or narrows the divide between athletes with access to specialised technologies, and those without. To put it another way, does the <a href="https://doi.org/10.4018/978-1-5225-8491-9.ch012">widespread availability</a> of 3D printers — which can now be found in many homes, schools, universities and <a href="https://www.makerspaces.com/what-is-a-makerspace/">makerspaces</a> — help to level the playing field?</p>
<h2>Forget mass production</h2>
<p>Mass-manufactured equipment, such as gloves, shoes and bicycles, is generally designed to suit typical able-bodied body shapes and playing styles. As such, it may not be suitable for many paralympians. But one-off, bespoke equipment is expensive and time-consuming to produce. This can limit access for some athletes, or require them to come up with their own “do-it-yourself” solutions, which may not be as advanced as professionally produced equipment.</p>
<p>3D printing can deliver bespoke equipment at a more affordable price. Several former paralympians, such as British triathlete <a href="https://all3dp.com/4/paralympic-athlete-3d-prints-adaptive-sports-equipment/">Joe Townsend</a> and US track athlete <a href="https://www.startribune.com/how-a-wheelchair-athlete-s-invention-led-to-a-growing-business/562872182/">Arielle Rausin</a>, now use 3D printing to create personalised gloves for themselves and their fellow wheelchair athletes. These gloves fit as if they were moulded over the athlete’s hands, and can be printed in different materials for different conditions. For example, Townsend uses stiff materials for maximum performance in competition, and softer gloves for training that are comfortable and less likely to cause injury.</p>
<p>3D-printed gloves are inexpensive, rapidly produced, and can be reprinted whenever they break. Because the design is digital, just like a photo or video, it can be modified based on the athlete’s feedback, or even sent to the nearest 3D printer when parts are urgently needed.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/paralympians-still-dont-get-the-kind-of-media-attention-they-deserve-as-elite-athletes-166879">Paralympians still don’t get the kind of media attention they deserve as elite athletes</a>
</strong>
</em>
</p>
<hr>
<h2>Harder, better, faster, stronger</h2>
<p>An elite athlete might be concerned about whether 3D-printed parts will be strong enough to withstand the required performance demands. Fortunately, materials for 3D printing have come a long way, with many 3D printing companies developing their own formulas to suit applications in various industries - from medical to aerospace.</p>
<p>Back in 2016, we saw the <a href="https://www.reuters.com/article/uk-olympics-rio-germany-paralympics-idUKKCN0XV2AQ">first 3D-printed prosthetic leg used in the Paralympics</a> by German track cyclist Denise Schindler. Made of polycarbonate, it was lighter than her previous carbon-fibre prosthetic, but just as strong and better-fitting. </p>
<p>With research showing <a href="https://commons.nmu.edu/cgi/viewcontent.cgi?article=1290&context=isbs">sprint cyclists can generate more than 1,000 Newtons of force</a> during acceleration (the same force you would feel if a 100-kilogram person were to stand on top of you!), such prosthetics need to be incredibly strong and durable. Schindler’s helped her win a bronze medal at the Tokyo games.</p>
<p>More advanced materials being 3D printed for Paralympic equipment include carbon fibre, with Townsend using it to produce the <a href="https://all3dp.com/4/paralympic-athlete-3d-prints-adaptive-sports-equipment/">perfect crank arms</a> for his handbike. 3D printing allows reinforced carbon fibre to be placed exactly where it is needed to improve the stiffness of a part, while remaining lightweight. This results in a better-performing part than one made from aluminium.</p>
<p>3D-printed titanium is also being used for <a href="https://www.ge.com/news/reports/a-quantum-leap-this-paralympic-athlete-is-harnessing-the-power-of-personalized-training-equipment-built-with-the-latest-3d-printing-technology">custom prosthetic arms</a>, such as those that allow New Zealand paralympian Anna Grimaldi to securely grip 50kg weights, in a way a standard prosthetic couldn’t achieve.</p>
<h2>Different technologies working together</h2>
<p>For 3D printing to deliver maximum results, it needs to be used in conjunction with other technologies. For example, <a href="https://sportstechnologyblog.com/2018/03/02/customising-what-athletes-wear-and-use-3d-scanning-and-other-tech/">3D scanning</a> is often an important part of the design process, using a collection of photographs, or dedicated 3D scanners, to digitise part of an athlete’s body.</p>
<p>Such technology has been used to <a href="https://www.mercedes-benz.com.au/passengercars/experience/mercedes-me-magazine/performance/articles/science-technology-super-athlete/story-content.module.html">3D-scan a seat mould</a> for Australian wheelchair tennis champion Dylan Alcott, allowing engineers to manufacture a seat that gives him maximum comfort, stability and performance.</p>
<p>3D scanning was also used to create the <a href="https://createdigital.org.au/engineers-helping-aussie-athletes-to-paralympic-gold/">perfect-fitting grip</a> for Australian archer Taymon Kenton-Smith, who was born with a partial left hand. The grip was then 3D-printed in both hard and soft materials at the <a href="https://www.theguardian.com/sport/2021/aug/20/bespoke-bows-and-specialised-seats-the-engineering-propelling-paralympians-to-new-levels">Australian Institute of Sport</a>, providing a more reliable bow grip with shock-absorbing abilities. If the grip breaks, an identical one can be easily reprinted, rather than relying on someone to hand-craft a new one that might have slight variations and take a long time to produce.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/3-reasons-why-paralympic-powerlifters-shift-seemingly-impossible-weights-166824">3 reasons why Paralympic powerlifters shift seemingly impossible weights</a>
</strong>
</em>
</p>
<hr>
<p>All these technologies are increasingly accessible, meaning more non-elite athletes can experiment with unique parts. Amateurs and professionals alike can already buy <a href="https://www.carbon3d.com/resources/case-study/adidas/">running shoes</a> with 3D-printed soles, and <a href="https://www.bastioncycles.com/experience/">3D-printed custom bike frames</a>. For those with access to their own 3D printer, <a href="https://edditiveblog.wordpress.com/category/kitesurfing-and-sup/">surf fins</a>, <a href="https://all3dp.com/2/3d-printed-bike-parts-accessories/">cycling accessories</a> and more can be downloaded for free and printed for just a few dollars.</p>
<p>However, don’t expect your home 3D printer to be making titanium parts anytime soon. While the technology is levelling the playing field to a certain extent, elite athletes still have access to specialised materials and engineering expertise, giving them the technological edge.</p>
<hr>
<p>_This article was coauthored by Julian Chua, a sports technology consultant at <a href="https://www.reengineeringlabs.com/">ReEngineering Labs</a> and author of the <a href="https://sportstechnologyblog.com/">Sports Technology Blog</a>.</p><img src="https://counter.theconversation.com/content/166896/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This article was written in collaboration with Dr Julian Chua, who is affiliated with ReEngineering Labs, a sports technology consultancy, as well as the Sports Technology Blog (<a href="https://sportstechnologyblog.com/">https://sportstechnologyblog.com/</a>).</span></em></p><p class="fine-print"><em><span>Andrew Novak does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Most sporting equipment is designed with typical able-bodied athletes in mind, whereas custom equipment to meet a particular Paralympian’s needs can be expensive. 3D printing offers a third way.
James Novak, Senior Research Fellow and Adjunct Lecturer, The University of Queensland
Andrew Novak, Senior Research Fellow, University of Technology Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/159714
2021-04-28T20:06:09Z
2021-04-28T20:06:09Z
DNA-inspired ‘supercoiling’ fibres could make powerful artificial muscles for robots
<figure><img src="https://images.theconversation.com/files/397483/original/file-20210428-13-1dt2wbv.jpg?ixlib=rb-1.1.0&rect=0%2C29%2C4992%2C3764&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The double helix of DNA is one of the most iconic symbols in science. By imitating the structure of this complex genetic molecule <a href="http://robotics.sciencemag.org/lookup/doi/10.1126/scirobotics.abf4788">we have found a way</a> to make artificial muscle fibres far more powerful than those found in nature, with potential applications in many kinds of miniature machinery such as prosthetic hands and dextrous robotic devices.</p>
<h2>The power of the helix</h2>
<p>DNA is not the only helix in nature. Flip through any biology textbook and you’ll see helices everywhere from the <a href="https://en.wikipedia.org/wiki/Alpha_helix">alpha-helix</a> shapes of individual proteins to the “coiled coil” helices of fibrous protein assemblies like <a href="https://en.wikipedia.org/wiki/Alpha-keratin">keratin</a> in hair. </p>
<p>Some bacteria, such as <a href="https://en.wikipedia.org/wiki/Spiral_bacteria">spirochetes</a>, adopt helical shapes. Even the <a href="https://www.doitpoms.ac.uk/tlplib/wood/structure_wood_pt1.php">cell walls of plants</a> can contain helically arranged cellulose fibres. </p>
<p>Muscle tissue too is composed of helically wrapped proteins that form thin filaments. And there are many other examples, which poses the question of whether the helix endows a particular evolutionary advantage. </p>
<p>Many of these naturally occurring helical structures are involved in making things move, like the <a href="https://science.sciencemag.org/content/333/6050/1726">opening of seed pods</a> and the twisting of trunks, tongues and tentacles. These systems share a common structure: helically oriented fibres embedded in a squishy matrix which allows complex mechanical actions like bending, twisting, lengthening and shortening, or coiling. </p>
<p>This versatility in achieving complex shapeshifting may hint at the reason for the prevalence of helices in nature. </p>
<h2>Fibres in a twist</h2>
<p>Ten years ago my work on artificial muscles brought me to think a lot about helices. My colleagues and I discovered a simple way to make powerful <a href="https://science.sciencemag.org/content/334/6055/494.abstract">rotating artificial muscle fibres</a> by simply twisting synthetic yarns. </p>
<p>These yarn fibres could rotate by untwisting when we expanded the volume of the yarn by heating it, making it absorb small molecules, or by charging it like a battery. Shrinking the fibre caused the fibres to re-twist. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/show-us-your-carbon-nanotube-artificial-muscles-3821">Show us your (carbon nanotube artificial) muscles!</a>
</strong>
</em>
</p>
<hr>
<p>We <a href="https://science.sciencemag.org/content/338/6109/928.abstract">demonstrated</a> that these fibres could spin a rotor at speeds of up to 11,500 revolutions per minute. While the fibres were small, we showed they could produce about as much torque per kilogram as large electric motors. </p>
<p>The key was to make sure the helically arranged filaments in the yarn were quite stiff. To accommodate an overall volume increase in the yarn, the individual filaments must either stretch in length or untwist. When the filaments are too stiff to stretch, the result is untwisting of the yarn. </p>
<h2>Learning from DNA</h2>
<p>More recently, I realised DNA molecules behave like our untwisting yarns. Biologists studying <a href="https://academic.oup.com/nar/article/38/19/6526/2409166">single DNA molecules</a> showed that double-stranded DNA unwinds when treated with small molecules that insert themselves inside the double helix structure. </p>
<p>The backbone of DNA is a stiff chain of molecules called sugar phosphates, so when the small inserted molecules push the two strands of DNA apart the double helix unwinds. Experiments also <a href="https://pubs.acs.org/doi/10.1021/acs.nanolett.6b02213">showed</a> that, if the ends of the DNA are tethered to stop them rotating, the untwisting leads to “supercoiling”: the DNA molecule forms a loop that wraps around itself.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fishing-for-artificial-muscles-nets-a-very-simple-solution-23417">Fishing for artificial muscles nets a very simple solution</a>
</strong>
</em>
</p>
<hr>
<p>In fact, special proteins induce <a href="https://www.nature.com/scitable/topicpage/dna-packaging-nucleosomes-and-chromatin-310/">coordinated supercoiling</a> in our cells to pack DNA molecules into the tiny nucleus. </p>
<p>We also see supercoiling in everyday life, for example when a garden hose becomes tangled. Twisting any long fibre can produce supercoiling, which is known as “snarling” in textiles processing or “hockling” when cables become snagged. </p>
<h2>Supercoiling for stronger ‘artificial muscles’</h2>
<p>Our latest results show <a href="http://robotics.sciencemag.org/lookup/doi/10.1126/scirobotics.abf4788">DNA-like supercoiling</a> can be induced by swelling pre-twisted textile fibres. We made composite fibres with two polyester sewing threads, each coated in a hydrogel that swells up when it gets wet and then the pair twisted together.</p>
<p>Swelling the hydrogel by immersing it in water caused the composite fibre to untwist. But if the fibre ends were clamped to stop untwisting, the fibre began to supercoil instead. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=616&fit=crop&dpr=1 600w, https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=616&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=616&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=774&fit=crop&dpr=1 754w, https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=774&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/397284/original/file-20210427-15-x2wvqm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=774&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">An untwisted fibre (left) and the supercoiled version (right).</span>
<span class="attribution"><span class="source">Geoff Spinks</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>As a result, the fibre shrank by up to 90% of its original length. In the process of shrinking, it did mechanical work equivalent to putting out 1 joule of energy per gram of dry fibre. </p>
<p>For comparison, the muscle fibres of mammals like us only shrink by about 20% of their original length and produce a work output of 0.03 joules per gram. This means that the same lifting effort can be achieved in a supercoiling fibre that is 30 times smaller in diameter compared with our own muscles. </p>
<h2>Why artificial muscles?</h2>
<p>Artificial muscle materials are especially useful in applications where space is limited. For example, the latest motor-driven <a href="https://www.ottobockus.com/prosthetics/upper-limb-prosthetics/solution-overview/bebionic-hand/">prosthetic hands</a> are impressive, but they do not currently match the dexterity of a human hand. More actuators are needed to replicate the full range of motion, grip types and strength of a healthy human. </p>
<p>Electric motors become much less powerful as their size is reduced, which makes them less useful in prosthetics and other miniature machines. However, artificial muscles maintain a high work and power output at small scales. </p>
<p>To demonstrate their potential applications, we used our supercoiling muscle fibres to open and close miniature tweezers. Such tools may be part of the next generation of non-invasive surgery or robotic surgical systems.</p>
<p>Many new types of artificial muscles have been introduced by researchers over the past decade. This is a very active area of research driven by the need for miniaturised mechanical devices. While great progress has been made, we still do not have an artificial muscle that completely matches the performance of natural muscle: large contractions, high speed, efficiency, long operating life, silent operation and safe for use in contact with humans. </p>
<p>The new supercoiling muscles take us one step closer to this goal by introducing a new mechanism for generating very large contractions. Currently our fibres operate slowly, but we see avenues for greatly increasing the speed of response and this will be the focus for ongoing research.</p><img src="https://counter.theconversation.com/content/159714/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Geoff Spinks does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Fibres that imitate the double helix of DNA can make artificial muscles more powerful than those found in nature.
Geoff Spinks, Senior Professor, Australian Institute for Innovative Materials, University of Wollongong, University of Wollongong
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/146906
2020-10-09T12:28:23Z
2020-10-09T12:28:23Z
More penises are appearing on TV and in film – but why are nearly all of them prosthetic?
<figure><img src="https://images.theconversation.com/files/362230/original/file-20201007-14-ijqgh6.png?ixlib=rb-1.1.0&rect=202%2C3%2C869%2C504&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">'Euphoria' is one of many premium cable TV shows to feature an abundance of prosthetic penises.</span> <span class="attribution"><a class="source" href="https://preview.redd.it/20xysq8yfm631.jpg?width=1920&format=pjpg&auto=webp&s=e35414d051b88b125e005186b66bb4b236cd826e">HBO</a></span></figcaption></figure><p>If you’ve noticed an uptick of male frontal nudity in TV and in movies in recent years, you’re onto something.</p>
<p>In 1993, I studied patterns of male nudity in my book “<a href="https://www.wsupress.wayne.edu/books/detail/running-scared">Running Scared: Masculinity and the Representation of the Male Body</a>.” After the old <a href="https://daily.jstor.org/end-american-film-censorship/">Motion Picture Production Code</a> was replaced by a new ratings system in 1968, frontal male nudity in Hollywood movies in certain contexts was permitted. “<a href="https://www.imdb.com/title/tt0068509/?ref_=nv_sr_srsg_1">Drive, He Said</a>,” directed by Jack Nicholson in 1971, was an early film to include such a scene, while Richard Gere’s <a href="https://foxwilmington.com/headlines/american-gigolo-star-carole-cook-recalls-working-with-richard-gere-he-was-carrying-the-mother-lode/">nude scene</a> in 1980’s “<a href="https://www.imdb.com/title/tt0080365/?ref_=nv_sr_srsg_0">American Gigolo</a>” helped to transform the young actor into an international sex symbol.</p>
<p>Yet female nudity remained far more common in movies, and there was no frontal male nudity on mainstream television as of 1993.</p>
<p>Since then, a lot has changed. Directors and audiences are becoming more and more comfortable showing male nudity. </p>
<p>But nowadays, while we’re much more likely to see penises in mainstream film and television, they’re seldom real. Prosthetic penises – once used for exaggerated effect – have become the norm. </p>
<p>To me, this says something about the unusual significance we continue to grant the penis, along with our cultural need to carefully regulate its representation. In a way, the use of prosthetic penises maintains a certain mystique about masculinity, preserving the power of the phallus. </p>
<h2>Skirting the production code</h2>
<p>There are a number of factors fueling the current wave of frontal male nudity. </p>
<p>In the 1990s, premium cable television channels like HBO became more popular, while streaming platforms like Amazon and Netflix took off in the 21st century. </p>
<p>These channels and platforms aren’t governed by the Motion Picture Association’s <a href="https://www.motionpictures.org/film-ratings/">ratings system</a>, which strictly limits the circumstances under which the penis can be shown. </p>
<p>According to the ratings – which still regulate theater releases – penises can be shown in nonsexual situations, such as when they appear during a concentration camp scene in “<a href="https://www.imdb.com/title/tt0108052/">Schindler’s List</a>.” But if a scene involves sex and frontal male nudity, the actors have to be a certain distance apart. So when Bruce Willis’ penis briefly appeared during an underwater swimming pool lovemaking scene in the “<a href="https://www.imdb.com/title/tt0109456/?ref_=nv_sr_srsg_0">The Color of Night</a>,” the MPAA objected, citing his proximity to the woman, and the shot had to be cut. Uncensored versions of the film are now available on DVD. </p>
<p>Premium cable TV channels are not governed by these guidelines, and the HBO show “<a href="https://www.imdb.com/title/tt0118421/?ref_=fn_al_tt_1">Oz</a>,” which aired from 1997 to 2003, marked a major turning point. Set in a prison, it was notable for the sheer quantity of full frontal male nudity, with characters shown in a variety of contexts, including showering and in their cells, fully naked. </p>
<p>Another reason for the trend in male nudity has to do with justifiable criticism of the ways women <a href="https://rb.gy/fzbhdt">have been sexually objectified</a> on TV and in film. Female nudity has been much more common than male nudity, and most of it tends to involve young, attractive women being showcased in a variety of erotic contexts, with an emphasis on their breasts and buttocks. </p>
<p>Some filmmakers, such as <a href="https://slate.com/culture/2019/08/the-righteous-gemstones-male-nudity-hbo-series-review.html">Judd Apatow</a> and <a href="https://www.buzzfeednews.com/article/manuelbetancourt/penises-euphoria-nudity-hbo-game-of-thrones">Sam Levinson</a>, have said they’ve wanted to level the playing field by featuring more male nudity.</p>
<h2>The proliferation of the prosthetic</h2>
<p>Like “Oz,” Starz’s “<a href="https://www.imdb.com/title/tt1442449/">Spartacus</a>,” which premiered in 2010, was full of frontal male nudity. </p>
<p>However, there was a key difference: all the penises were prosthetic, which are made to be worn by the actors and look realistic when filmed. </p>
<p>One of the most famous prosthetic penises appeared in Paul Thomas Anderson’s 1997 film “<a href="https://www.imdb.com/title/tt0118749/?ref_=nv_sr_srsg_0">Boogie Nights</a>,” which is about a porn star, played by Mark Wahlberg. At the end of the film, viewers see a closeup shot of the actor’s extremely large prosthetic penis. </p>
<p>Prosthetics were used on and off through the years. But after “Spartacus,” their use became the norm. Now in shows like HBO’s “<a href="https://www.imdb.com/title/tt4998350/?ref_=nv_sr_srsg_0">The Deuce</a>” and “<a href="https://www.imdb.com/title/tt8772296/?ref_=nv_sr_srsg_0">Euphoria</a>,” they’re everywhere. Sometimes they’re even digital. In “<a href="https://www.imdb.com/title/tt1937390/?ref_=nv_sr_srsg_0">Nymphomaniac: Vols. I and II</a>,” director Lars von Trier digitally replaced the actors’ penises with those from body doubles.</p>
<p>Whether they’re tangible or digital they tend to have one thing in common: they’re big. </p>
<h2>The obsession with size</h2>
<p>The prosthetic penis gives filmmakers total control over its representation, and some have used its flexibility to directly address this issue of size. </p>
<p>Take the 2015 romantic comedy “<a href="https://www.imdb.com/title/tt3844362/?ref_=nv_sr_srsg_0">The Overnight</a>.” </p>
<p>Penis size is first introduced in the opening scene, when a couples has awkward sex due to the husband’s small penis. Later at a dinner party with another couple, penis size becomes the big issue again when a wife swap between the two couples is discussed. </p>
<p>The other man, played by Jason Schwartzman, has an extremely large one, while the man from the opening scene, played by Adam Scott, has a much smaller one, and becomes uncomfortable with the idea of being “exposed.” During a protracted skinny dipping scene, viewers get to see each actor’s prosthetic penis. Within the conventions of the romantic comedy, both couples are united at the end and committed to saving their marriages. </p>
<p>“The Overnight” attempts to deflate the myth that penis size matters. But at the same time that it tackles the obsession with size, it ends up reinforcing the notion – in part because of the opening scene – that bigger is better. </p>
<p>Similarly, “Euphoria,” a bold, experimental high school drama, also explores penis size, connecting the fixation on size to toxic masculinity. It shows how girls are also complicit by dwelling on size themselves – and assuming that it’s linked to sexual performance and masculinity. </p>
<h2>Toward a more honest representation</h2>
<p>“The Overnight” and “Euphoria” strive to critique our culture’s obsession with the penis, as do movies like “Boogie Nights” and TV shows like “The Deuce,” both of which are serious explorations of the pornography industry. </p>
<p>Yet by making the penis a central theme, these films and TV shows continue to grant it an aura of mystique and power that existed long before prosthetics and weaker regulations. </p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>.]</p>
<p>In the end, the use of prosthetics comes at the expense of the most mature thing filmmakers could do: show diverse, real penises in a manner that holds no special meaning for the character or plot.</p>
<p>While “Spartacus” would lead you to believe otherwise, all gladiators did not have big penises. Nor did their penis size and shape have anything to do with their strength, power, masculinity or sexuality. </p>
<p><a href="https://historycollection.com/10-of-the-most-famous-quotes-never-said-or-misattributed/3/">Although apocryphal</a>, Sigmund Freud supposedly remarked, “Sometimes a cigar is just a cigar,” which was meant to suggest that cigars are not always phallic symbols.</p>
<p>It’d be nice if, on screen, sometimes a penis were just a penis.</p><img src="https://counter.theconversation.com/content/146906/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Lehman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Directors and audiences are becoming more comfortable with male frontal nudity. But what message does it send when almost all of the penises shown aren’t real?
Peter Lehman, Emeritus Professor, Film and Media Studies in English, Arizona State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/144181
2020-09-08T12:16:34Z
2020-09-08T12:16:34Z
How the Civil War drove medical innovation – and the pandemic could, too
<figure><img src="https://images.theconversation.com/files/354135/original/file-20200821-18-1jj8kww.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Bernard Tobey, a double amputee, and his son, wearing Union sailor uniforms, standing beside a small wagon displaying Secretary of War Edwin Stanton's dispatch on the fall of Fort Fisher.</span> <span class="attribution"><a class="source" href="https://www.loc.gov/pictures/item/2017659614/"> Fetter's New Photograph Gallery/Library of Congress</a></span></figcaption></figure><p>The current COVID-19 pandemic, the largest public health crisis in a century, threatens the health of people across the globe. The U.S. has had the most diagnosed cases – <a href="https://www.worldometers.info/coronavirus/">surpassing 6 million</a> – and <a href="https://www.worldometers.info/coronavirus/">more than 180,000 deaths</a>. </p>
<p>But six months into the pandemic, the U.S. still faces <a href="https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/faqs-shortages-surgical-masks-and-gowns-during-covid-19-pandemic">shortages</a> of personal protective equipment for both front-line medical workers and the general public. There is also great need for widely available <a href="https://theconversation.com/will-the-new-15-minute-covid-19-test-solve-us-testing-problems-145285">inexpensive, rapid tests</a>; the infrastructure to administer them; and most importantly, safe, effective vaccines. </p>
<p>Moving forward, medical innovation can play a substantial role in controlling and preventing infection – and treating those who have contracted the virus. But what’s the best way to catalyze and accelerate public health developments? Research and history show that the federal government can play a major role in spurring private-sector innovation.</p>
<h2>Lessons from the Civil War</h2>
<p>Governments play far-reaching roles in health care. The U.S. Food and Drug Administration approves new treatments. Public and private insurance administrators determine what treatments to cover. The Medicare program sets prices that have <a href="https://www.journals.uchicago.edu/doi/pdfplus/10.1086/689772">effects across the heath care system</a>. By determining if and when competitors can enter the market, the U.S. patent system shapes pharmaceutical prices, which impacts companies’ financial returns. The National Institutes of Health and the National Science Foundation allocate funding for both basic and applied medical research.</p>
<p>Taken together, the government has substantial influence on medical innovation. That’s because private industry requires well-defined quality standards and clear financial incentives to speed forward – performance depends critically on the government agencies that often make the rules and set the payments.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=280&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=280&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=280&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=352&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=352&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354137/original/file-20200821-16-tujihc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=352&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Portraits of Civil War veteran amputees, Left to right: G.L. Burnette, Richard D. Dunphy and Henry A. Seaverns.</span>
<span class="attribution"><a class="source" href="https://www.loc.gov/pictures/resource/bellcm.15657">Library of Congress</a></span>
</figcaption>
</figure>
<p>In my <a href="https://scholar.google.com/citations?user=wFv_COwAAAAJ&hl=en">research as an economist</a>, I investigate the effects of government insurance programs on patient care, pricing and innovation across the health system. My colleague Parker Rogers and I recently <a href="https://econweb.ucsd.edu/%7Ej1clemens/pdfs/ProstheticsPaperLatest">analyzed</a> innovations in the design and manufacture of artificial limbs during the U.S. Civil War. The example resonates because wars, like pandemics, create dramatic, unanticipated needs for medical innovations. </p>
<p>With advances in weaponry, destructive Minié bullets and a lack of surgical experience among doctors, many Civil War soldiers with leg or arm wounds required amputation. Roughly <a href="https://www.rehab.research.va.gov/jour/07/44/4/Gailey.html">70,000 veterans</a> who survived the bloody, four-year conflict lost limbs.</p>
<p>As disabled veterans returned home, the government launched the “Great Civil War Benefaction” to provide prostheses. Officials <a href="http://www.siupress.com/books/978-0-8093-3131-4">examined and certified</a> inventors’ prototypes, and wounded veterans then chose from approved products, which the government then acquired at preset prices: US$75 per leg and $50 per arm. </p>
<p>The program’s cost-conscious approach shaped inventors’ efforts, leading them to emphasize simplicity in design and low-cost production. While prosthetic arms and legs remained quite primitive by modern standards, inventors emphasized improvements in comfort and modest gains in functionality. In total, 87 patents for prostheses were granted from 1863 through 1867, compared with 15 new patents between 1858 and 1862.</p>
<p>Production responded dramatically to the unprecedented needs. Just prior to the war, in 1860, <a href="https://econweb.ucsd.edu/%7Ej1clemens/pdfs/ExpandingHealthSystemCapacity.pdf">five manufacturers</a> sold an estimated 350 prostheses in the U.S. By 1865, production had increased tenfold. That year, the Union Army <a href="http://www.siupress.com/books/978-0-8093-3131-4">furnished</a> some 2,020 artificial legs and 1,441 artificial arms to its soldiers. By 1870, there were <a href="https://econweb.ucsd.edu/%7Ej1clemens/pdfs/ExpandingHealthSystemCapacity.pdf">24 manufacturers</a> in the industry. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354738/original/file-20200825-23-kyneen.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A researcher holding vials of COVID-19 vaccine that will be used in clinical trials.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/healthcare-professional-in-protective-gloves-royalty-free-image/1254511513">Tang Ming Tung/GettyImages</a></span>
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<h2>The economics of medical innovation</h2>
<p>Most research into the economics of medical innovation has focused on pharmaceuticals. This research has showcased the power of incentives. </p>
<p>For example, with the introduction of guidelines, mandates or other government policies that increased projected profits, <a href="https://economics.mit.edu/files/7894">vaccine development</a> accelerated. Clinical trial activity increased during the years immediately following these changes. </p>
<p>Additional evidence has shown that the introduction of <a href="https://doi.org/10.1016/j.jpubeco.2012.10.003">Medicare’s drug benefit</a> (passed in 2003 and enacted in 2005) sped pharmaceutical research for diseases that impact the elderly. Diseases that offer robust or expanding drug <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1756-2171.12113">markets</a> <a href="https://economics.mit.edu/files/4464">receive particular attention</a>. Economists have also found that drug development responds to incentives created by the <a href="https://pubs.aeaweb.org/doi/pdfplus/10.1257/aer.20131176">patent system</a>. Finally, when insurers begin to exclude drugs for a particular disease, <a href="https://cpb-us-e1.wpmucdn.com/sites.dartmouth.edu/dist/c/1998/files/2020/07/Agha-Kim-Li-Insurance-Design-Innovation-_-July-2020.pdf">R&D for that disease tends to slow</a>. </p>
<h2>Failures during the COVID-19 pandemic</h2>
<p>During the COVID-19 pandemic the U.S. government has, unfortunately, not provided the sort of certainty required for medical innovation to flourish as well as it could. By creating uncertainty, the federal government discouraged both states and private companies from acting on their own initiative, which has delayed our national response. </p>
<p>Early on, for example, the federal government equivocated over contractual commitments to companies that came forward to <a href="https://www.nytimes.com/2020/03/26/us/politics/coronavirus-ventilators-trump.html">produce ventilators</a>. State officials who prudently expanded stocks of <a href="https://www.vanityfair.com/news/2020/05/how-the-federal-government-took-control-of-the-ppe-pipeline">personal protective equipment</a> were unsure whether supplies would be commandeered by the federal government. </p>
<p>Federal actions also impacted testing. The FDA thwarted efforts to implement <a href="https://medium.com/@rzadek/unprepared-government-failure-at-the-cdc-fda-e157d2ca25c">new testing infrastructure</a> supported by <a href="https://www.businessinsider.com/bill-gates-backed-coronavirus-testing-program-stopped-by-fda-2020-5">the Gates Foundation</a>. The error was compounded by the <a href="https://www.sciencemag.org/news/2020/02/united-states-badly-bungled-coronavirus-testing-things-may-soon-improve">botched early rollout</a> of testing kits and rejection of tests manufactured in other countries. The result: Months into the pandemic, tests can still be difficult to obtain, and <a href="https://www.nytimes.com/2020/08/04/us/virus-testing-delays.html">results are often backlogged</a> to the point of uselessness.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/355171/original/file-20200827-16-j71bs4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Catrina Rugar, 34, a traveling nurse from Florida, responded first to hospitals in New York City, then to Texas’ Rio Grande Valley, where she was treating COVID-19 patients. Rather than coordinate purchases of PPE to help drive innovation in the field, the federal government created uncertainty among states and other purchasers.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/july-20-2020-catrina-rugar-a-traveling-nurse-from-florida-news-photo/1227737165">Carolyn Cole/Getty Images</a></span>
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<h2>A recipe for progress</h2>
<p>So what is the best way forward for spurring private industry to fight the pandemic? To me it’s clear that the government has a straightforward role to play in setting the stage. </p>
<p>As a narrow example, governments can increase demand for masks by issuing clear guidance and informing the public. The resulting demand creates strong financial incentives for companies to innovate and expand production.</p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p>Further, the federal government can propel the development and distribution of <a href="https://www.nytimes.com/2020/07/03/opinion/coronavirus-tests.html">tests</a> and vaccines through “<a href="https://www.nytimes.com/2020/05/04/opinion/coronavirus-vaccine.html">advance purchase commitments</a>” that guarantee a market for newly approved products. The U.S. government has <a href="https://www.nytimes.com/2020/07/22/upshot/vaccine-coronavirus-government-purchase.html">taken a major step</a> in this direction by committing to purchase large quantities of COVID-19 vaccines upon approval.</p>
<p>While the science of medical innovation is difficult, policy is relatively simple: Set clear standards, establish clear incentives and let the scientists and entrepreneurs do their work. Vaccine development, rapid testing and widely available protective gear all have important roles to play in saving lives and getting the economy back on its feet.</p><img src="https://counter.theconversation.com/content/144181/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jeffrey Clemens does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Lessons from history make clear that the federal government can spur medical innovation in a crisis, including this pandemic. Providing certainty and clarity is critical.
Jeffrey Clemens, Associate Professor of Economics, University of California, San Diego
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/145386
2020-09-02T03:57:06Z
2020-09-02T03:57:06Z
Pain-sensing electronic silicone skin paves the way for smart prosthetics and skin grafts
<figure><img src="https://images.theconversation.com/files/355754/original/file-20200901-22-yivt65.jpg?ixlib=rb-1.1.0&rect=36%2C0%2C3507%2C2478&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Ella Maru Studio</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Skin is our largest organ, made up of complex sensors constantly monitoring for anything that might cause us pain. Our new technology replicates that – electronically.</p>
<p>The electronic artificial skin we’ve developed reacts to pain stimuli just like real skin, and paves the way for better prosthetics, smarter robotics and non-invasive alternatives to skin grafts.</p>
<p>Our prototype device mimics the body’s near-instant feedback response and can react to painful sensations with the same lighting speed at which nerve signals travel to the brain.</p>
<p>Our new technology, details of which are <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202000094">published in Advanced Intelligent Systems</a>, is made of silicone rubber with integrated electronics. It mimics human skin, both in texture and in how it responds to pressure, temperature and pain.</p>
<p>Human skin senses things constantly, but our pain response only kicks in at a certain threshold. Once this threshold is breached, electric signals are sent via the nervous system to the brain to initiate a pain response.</p>
<p>You don’t notice when you pick up something at a comfortable temperature. But touch something too hot, and you’ll almost instantly recoil. That’s our skin’s pain-sensing system in action. </p>
<h2>Helping hand</h2>
<p>Our new pain-sensing electronic skin is a crucial step towards the development of “smart prosthetics” featuring sophisticated feedback systems. We want to develop medical devices and components that show similar pain sensing responses to the human body.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Sample of silicone skin" src="https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/355936/original/file-20200902-16-1vvqtxv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Stretchable, smart silicone skin.</span>
<span class="attribution"><span class="source">RMIT University</span>, <span class="license">Author provided</span></span>
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<p>Prosthetics significantly improve an amputee’s quality of life, but they still lack the ability to sense danger. A prosthetic hand does not sense when it’s placed on a hot surface, while someone with a prosthetic arm might lean on something sharp but won’t realise the damage being caused.</p>
<p>Technology that provides a realistic skin-like response can make a prosthetic much more like a natural limb. </p>
<p>With further development, our electronic skin could also potentially be used for skin grafts, in cases where the traditional approach is not viable.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Hand with silicone skin overlaid" src="https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/355937/original/file-20200902-18-1wgbpqd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The new silicone skin could pave the way for smarter skin grafts.</span>
<span class="attribution"><span class="source">RMIT University</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>Skin in the game</h2>
<p>We created our electronic skin by building on our research group’s previous breakthroughs in <a href="https://www.rmit.edu.au/news/all-news/2017/aug/eureka-moment-for-unbreakable-electronic-skin">stretchable electronics</a>, <a href="https://www.rmit.edu.au/news/newsroom/media-releases-and-expert-comments/2018/feb/clever-coating-opens-door-to-smart-windows">temperature-sensitive materials</a>, and <a href="https://www.rmit.edu.au/news/all-news/2015/october/nano-memory-cell-mimics-brains-longterm-memory">brain-mimicking electronics</a>.</p>
<p>For example, we used our process for integrating temperature-sensitive vanadium oxide, a material that can change its electronic behaviour in reaction to temperatures above a particular threshold (65°C in this case). </p>
<p>This material then triggers electrical signals similar to those generated by our nerve endings when we touch something hot. The electrical signal from the sensing part of the system (which is temperature- or pressure-sensitive) goes to a brain-mimicking circuit which processes the input and makes a decision based on threshold values. </p>
<p>The electrical output from the brain-mimicking circuit is like the nerve signals that initiate a motor response (such as moving your hand away) in the human pain response. </p>
<p>In our experiment, we measured the current generated. To use the silicone skin for real, this would need to be connected to nerve endings or apparatus that could initiate a motor response.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-not-easy-to-give-a-robot-a-sense-of-touch-118111">It's not easy to give a robot a sense of touch</a>
</strong>
</em>
</p>
<hr>
<p>Our material responds just as fast as a real human pain response, mimicking the entire process from stimulus to response triggers from the brain – or in our case, the brain-mimicking circuit. The response is stronger depending on both the intensity and time of stimulation – just like a real human pain response.</p>
<p>The electronic skin brings to reality the threshold-based responses to pain, both in the way the skin reacts differently to pain above a certain threshold and how it takes longer for skin to “recover” from something that’s more painful. This is because stronger stimuli generate more voltage across the brain-mimicking circuit.</p>
<p>We can also modify this threshold in our devices to mimic the way injured skin (such as sunburnt skin) can have a lower pain threshold than normal skin. The electronic skin can also be used to increase sensitivity, which could be particularly useful in sports and defence as well as for skin grafts. </p>
<p>Another unique application could be smart gloves that could provide precise feedback from a surgeon’s hands when palpating tissue.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/prosthetic-limbs-affect-our-attitudes-to-disability-expressive-design-might-change-things-for-the-better-140796">Prosthetic limbs affect our attitudes to disability – expressive design might change things for the better</a>
</strong>
</em>
</p>
<hr>
<p>Our silicone skin will need further development to integrate the technology into biomedical applications. But the fundamentals – biocompatibility and skin-like stretchability – are already there.</p>
<p>The next steps are working with medical researchers to make this even more “skin-like”, and to figure out how best to integrate it with the human body.</p><img src="https://counter.theconversation.com/content/145386/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Madhu Bhaskaran receives funding from Australian Research Council. </span></em></p>
A new silicone ‘skin’ contains electronics that mimic the human body’s lightning-fast response to pain, potentially paving the way for smart prosthetics that can detect painful sensations.
Madhu Bhaskaran, Professor, Electronic and Communications Engineering, RMIT University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/140796
2020-07-10T12:21:27Z
2020-07-10T12:21:27Z
Prosthetic limbs affect our attitudes to disability – expressive design might change things for the better
<p>Amputation can have a devastating effect on a person’s body image and sense of self. The use of prosthetic limbs may help, but when it comes to their appearance, options are often limited. </p>
<p>The choice, if there is one, usually comes down to either a prosthesis with a realistic appearance that helps users hide the limb loss, or a mechanical version which offers greater functionality, but is more easily noticeable. </p>
<p>To address this gap between function and appearance, <a href="https://limb-art.com/">some companies</a> and <a href="http://www.thealternativelimbproject.com/">designers</a>) are now working on “expressive prostheses”. These are prosthetic limbs where the design focuses on the appearance, with the aim of highlighting the user’s identity. </p>
<p>The idea is that by transforming prostheses into accessories, expressive versions can help users make positive statements about themselves. They may also be able to question notions of normalcy about the human body, and help eliminate stigmatisation. </p>
<p>A <a href="http://radar.gsa.ac.uk/6990/3/Aesthetics%20of%20Prosthetic%20Greaves.pdf">recent research project</a> explored the effects of a “co-design” approach between prosthetic makers and users in developing personalised covers. The project reported that amputees found involvement in the design process a positive experience, and the benefits extended beyond an “expression of identity, supporting confidence and a potential to create a positive image of disability”. </p>
<p><a href="https://strathprints.strath.ac.uk/52964/1/Sansoni_etal_IJD2015_aesthetic_appeal_of_prosthetic_limbs.pdf">Another study</a> looked into preferences towards prosthetic limbs with a realistic or non-realistic appearance. It found that prostheses with a high level of human likeness were considered by non-users to be more attractive than those with a more mechanical appearance. </p>
<p>But the reverse was true for the prosthetic users themselves, who preferred prostheses with robotic designs, perhaps because of their <a href="https://www.uwlax.edu/globalassets/offices-services/urc/jur-online/pdf/2010/grames-leverentz.pdfprostheses">greater functionality</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=486&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=486&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=486&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345553/original/file-20200703-33922-17nnr6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Expressive prosthetic cover designed and produced by Limb-Art.</span>
<span class="attribution"><span class="source">Limb-Art</span></span>
</figcaption>
</figure>
<p>This is where expressive prostheses can come in. Researchers have <a href="https://www.tandfonline.com/doi/abs/10.2752/175693813X13559997788682">also argued</a> that such prostheses could help to alter society’s attitudes towards prosthetic users, where notions of disability and impairment can have negative connotations. </p>
<p><a href="https://www.academia.edu/17319692/Attitudes_towards_disabilities_in_a_multicultural_society">We know</a> culture plays a major role in people’s attitudes towards disability. Specifically, research shows that in <a href="https://blog.bham.ac.uk/business-school/2020/04/22/how-societies-respond-to-social-distancing-orders/">individualistic societies</a> like the US and the UK, where people tend to value personal identity and individual goals, attitudes towards disabilities are less stigmatised than in collectivist societies like China and Greece, where the emphasis is on maintaining group harmony. </p>
<h2>Talking points</h2>
<p><a href="https://www.tandfonline.com/doi/full/10.1080/24735132.2020.1727699">My own study</a> aimed to explore the effects of the appearance of prostheses in different cultures. To do this, I spoke to users in the UK as an individualistic culture, and in Greece as a collectivist one.</p>
<p>All participants stated that expressive prostheses were more attractive than conventional ones, and improved their self-confidence. They also mentioned that expressive prostheses were useful as conversation starters with non-users, providing an opportunity to discuss limb loss with other people. </p>
<p>James, for example, a 56-year-old British man who uses two lower replacement limbs, said that an expressive version “allows the user to make a statement” and “would be a good talking point”.</p>
<p>A common experience of a certain awkwardness around approaching people with limb loss also emerged. Margaret, a 19-year-old Greek woman who has an upper limb prosthetic said: “I think (expressive prostheses) might help people who are more open minded feel more comfortable to open themselves to others who present a difference”. </p>
<p>Sebastian, a 47-year-old British lower limb prosthetic user, pointed out that the use of expressive prostheses had a “fundamental difference” on people’s reactions towards him and his prosthesis. He said they had the potential to provoke a more positive response compared to other types of prosthetic. </p>
<p>The interviews also highlighted the importance of culture on the formation of people’s attitudes. Two of the Greek participants for example, suggested that expressive prostheses may actually increase stigmatisation as they may be perceived as being used by people with limb loss to draw attention to themselves. </p>
<p>One thing my research demonstrates is the need to take culture into account during the design of prostheses (and other medical products, such as wheelchairs or hearing aids) to avoid increased stigmatisation. </p>
<p>But it also provides evidence of the largely positive effects of expressive prostheses on users’ self-confidence and how they are treated in society. The next step, I hope, is that great design – and talented designers – will be more widely valued in the manufacture of medical products, for everyone’s benefit.</p><img src="https://counter.theconversation.com/content/140796/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anna Vlachaki does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Appearance, functionality and culture should all be considered.
Anna Vlachaki, PhD Candidate in Design, Loughborough University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/136831
2020-04-22T18:45:02Z
2020-04-22T18:45:02Z
A smart second skin gets all the power it needs from sweat
<p><em>The Research Brief is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>Skin is the largest organ of the human body. It conveys a lot of information, including temperature, pressure, pleasure and pain. Electronic skin (e-skin) mimics the properties of biological skin. Recently developed e-skins are capable of wirelessly monitoring physiological signals. They could play a crucial role in the next generation of robotics and medical devices. </p>
<p><a href="http://www.gao.caltech.edu/">My lab at Caltech</a> is interested in studying human biology and monitoring human health by using advanced bioelectronic devices. The e-skin we have developed not only analyzes the chemical and molecular composition of human sweat, it’s <a href="http://robotics.sciencemag.org/lookup/doi/10.1126/scirobotics.aaz7946">fully powered by chemicals in sweat</a>.</p>
<h2>Why it matters</h2>
<p>Existing e-skins and wearable devices primarily focus on monitoring physiological parameters like heart rate and can’t assess health information at the molecular level. Moreover, they typically require batteries to power them, and the batteries need to be recharged frequently.</p>
<p>Despite recent efforts to harvest energy from the human body, there are no reports of self-powered e-skins that are able to perform biosensing and transmit the information via standard Bluetooth wireless communications. This comes down to the lack of power efficiency. There is a need for a self-powered device that can continuously collect molecular as well as physical information and wirelessly transmit the information to other devices.</p>
<h2>How we do this work</h2>
<p>The approach we take to harvesting energy from the human body is based on biofuel cells. Fuel cells convert chemical energy to electricity. The biofuel cells we developed for our e-skin convert the lactic acid in human sweat to electricity. In addition to the biofuel cells, the e-skin contains biosensors that can analyze metabolic information like glucose, urea and pH levels, to monitor for diabetes, ischaemia another health conditions, as well as physical information like skin temperature. The e-skin, made of soft materials and attached to a person’s skin, performs real-time biosensing, powered solely by sweat.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=403&fit=crop&dpr=1 600w, https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=403&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=403&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/329621/original/file-20200422-82699-uzmg0b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The sweat-powered biofuel cells in this electronic skin provide enough electricity to power biological sensors and transmit the information wirelessly to other devices.</span>
<span class="attribution"><span class="source">Yu et al., Sci. Robot. 5, eaaz7946 (2020)</span></span>
</figcaption>
</figure>
<p>Previously developed wearable biofuel cells <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/elan.201600019">don’t produce a lot of power</a> and aren’t very stable. We greatly improved the power output and stability of the biofuel cells by using novel nanomaterials for the cell’s two electrodes. The cathode of our biofuel cell is composed of a mesh of carbon nanotubes decorated with nanoparticles containing platinum and cobalt. The anode is a nanocomposite material that contains an enzyme that breaks down lactic acid. </p>
<p>The biofuel cells can generate a continuous, stable output as high as several milliwatts per square centimeter over multiple days in human sweat. That’s enough to power the biosensors as well as wireless communication. We demonstrated our e-skin by monitoring glucose, pH, ammonium ions and urea levels in studies using human subjects. We also used our e-skin as a human-machine interface to control the motion of a robotic arm and a prosthetic leg.</p>
<h2>What’s next</h2>
<p>We plan to further improve the power output of the biofuel cells and integrate different biosensors. The development of fully self-powered e-skin opens the door to numerous robotic and wearable health care possibilities. Wearable sensor arrays could be used for health monitoring, early disease diagnosis and potentially nutritional intervention. In addition, self-powered e-skin could be used to design and optimize next generation prosthetics.</p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p><img src="https://counter.theconversation.com/content/136831/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Wei Gao receives funding from the National Institute of Health. </span></em></p>
Lightweight, flexible materials can be used to make health-monitoring wearable devices, but powering the devices is a challenge. Using fuel cells instead of batteries could make the difference.
Wei Gao, Assistant Professor of Medical Engineering, California Institute of Technology
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/122358
2019-08-28T11:48:28Z
2019-08-28T11:48:28Z
Blinking lights don’t make a better knee brace – fighting cognitive biases in testing orthopedic devices
<figure><img src="https://images.theconversation.com/files/289470/original/file-20190826-8864-1dnc3rd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">How do you know if a brace is better versus the patient just believing it is?
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/therapist-fitting-knee-brace-patient-leg-736234591?src=39kf0EXcQ3kusGJX8wiKWA-1-0">Praisaeng/Shutterstock.com</a></span></figcaption></figure><p>As a researcher in a health-care-related field, I am keenly aware of how frequently economics enters the discussion these days. <a href="https://scholar.google.com/citations?user=C7j3KnYAAAAJ&hl=en&oi=ao">I am a biomedical engineer</a> who works with patients using orthopedic devices: prosthetics, such as an artificial limb; and orthotics, which help improve the function of an intact limb, like a knee brace or custom shoe insert. In recent years, these devices have become far more <a href="http://www.opcareers.org/what_is_op/technology/">complex and technologically advanced</a>, to the point where they can sense walking patterns and modify their function accordingly. Others contain motorized components to add power. </p>
<p>With increased complexity comes increased cost, so it has become important from a health-care economics perspective to measure and document improved outcomes related to more expensive devices. Those of us who do this research know there’s an added layer of scrutiny. If my lab research determines that patients have a more biomechanically sound walking pattern with knee brace A versus brace B, not only are clinicians interested, but so are insurance companies. </p>
<h2>The comment that made me question everything</h2>
<p>Several years ago, I had helped organize a group of experts to assess the state of the science in microprocessor-controlled prosthetic knees, which adjust the stiffness in the knee joint depending on what the user is doing. A comment from one orthopedic surgeon on the panel made me realize I’d been missing part of the equation in my own studies. </p>
<p>He raised the potential for something called confirmation bias – the tendency for a person to actually experience what he or she expects – when a user is wearing an advanced prosthetic knee. The remark made me aware just how possible it is for a patient using an advanced, expensive orthopedic device to report that it’s better just because it’s more advanced – regardless of its actual function. Patients might even move differently while using it, all because they think it is better. Suddenly, I questioned the way I measure outcomes in my own research.</p>
<h2>When in doubt, test</h2>
<p>Of course, as a researcher, my solution to a question like this is to launch a study. Along with a master’s student in our lab, Brittany Balsamo, I decided to find out what would happen if people thought they were wearing an advanced orthopedic device when, actually, it was just a standard knee brace. I’d never done a project involving deception before, so I was, perhaps perversely, more than a little excited. </p>
<p>We <a href="https://doi.org/10.1016/j.jbiomech.2018.04.028">tested confirmation bias in 18 healthy young adults</a> wearing two identical, standard, off-the-shelf hinged knee braces to see whether biases might affect their perception and their movement. Though the two braces were the same, we jazzed up the appearance of one of them and added an LED circuit, switch and USB port. </p>
<p>We told the healthy volunteers that we were testing a prototype of a new knee brace designed to dynamically alter its stiffness based on the wearer’s movement patterns. We showed them a mock-up flyer (entirely false) showing some baseline data on the new brace and listing its benefits. We gave them an idea of how much more it would cost, and told them we’d be measuring their walking in the new brace compared to the same manufacturer’s standard model. Then, we gave them a survey to assess their expectations. </p>
<p>Before using the braces, the majority of the subjects expressed a preference for the so-called “computerized” brace. They expected it to be better in appearance, stabilization, comfort and function in various types of sports. Next, we measured their walking in the lab in both braces using a multi-camera system that gives detailed information about 3D movement. After the trial, the subjects expressed an even stronger preference for the “computerized” brace, even though, unbeknownst to them, both braces were functionally identical.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289513/original/file-20190826-8868-zvo9xy.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">3D motion capture.</span>
</figcaption>
</figure>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=428&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=428&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=428&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=538&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=538&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289515/original/file-20190826-8841-qmljke.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=538&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Knee focus.</span>
</figcaption>
</figure>
<h2>But did they walk differently?</h2>
<p>When we analyzed the gait data, we found that despite their perceptions, the subjects walked remarkably similarly in both types of braces. I was shocked with how identical the walking patterns were. Average stride length was exactly the same – to the millimeter. The amount of knee bending was only one-tenth of one degree different. </p>
<p>Because the subjects were healthy young adults, we did not expect major differences in gait. What was most interesting was that 83% of subjects thought the “computerized” brace performed better, even though they had walked identically in both. Moreover, subjects were less concerned with the purported increased cost of the “computerized” brace after they used it, thinking the benefits were worth it, even when there were none.</p>
<p>In the end, I realized just how important it is to consider cognitive biases when testing advanced orthopedic devices, particularly if I’m using patient-reported outcomes. Established techniques like placebos and blinding are challenging to implement with these devices, but it helps to know that confirmation bias may be present with orthopedic devices. And as complexity grows, it will be more important to find ways to avoid it.</p><img src="https://counter.theconversation.com/content/122358/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Geil does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Are more technologically advanced prosthetics and orthotics actually better for improving health? Or do we just think they are better? And most importantly, how do we figure it out?
Mark Geil, Professor and Chair, Kennesaw State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/90314
2018-02-08T18:11:51Z
2018-02-08T18:11:51Z
Proposed new regulations for 3D printed medical devices must go further
<figure><img src="https://images.theconversation.com/files/204790/original/file-20180205-19944-1jpif2q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Advances in technology mean it's now possible to 3D print everything from prosthetic limbs to skin, bones and organs.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/armymedicine/14441713519/in/photolist-MbxEc2-o1ayhF-Aj615U-Q1tCyL-Q4brC2-NX3Tz5-NX3RnE-QbavUU-NZQnyt-PuVTAw">armymedicine/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>3D printing has rapidly increased in quality and popularity over the past decade. In the medical sector, it has evolved from the creation of relatively simple prosthetics, to a silicon prototype of a functioning human heart.</p>
<p>Unfortunately regulation hasn’t kept pace with technological progress. </p>
<p>As the costs of 3D printing have reduced, patients are now able to manufacture their own prosthetics at home – <a href="http://enablingthefuture.org/2017/08/04/e-nable-in-education-st-gabriel-catholic-school/">or school</a> – under the “custom made” definition of the Therapeutic Goods Administration frameworks. Soon we will be able to print our own <a href="https://www.computerworld.com/article/3048823/3d-printing/this-is-the-first-3d-printed-drug-to-win-fda-approval.html">medicines</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-3d-printing-and-whats-it-for-9456">Explainer: what is 3D printing and what's it for?</a>
</strong>
</em>
</p>
<hr>
<p>But who should be legally responsible as the manufacturer when 3D printed devices fail? </p>
<p>In what could serve as a watershed moment for additive manufacturing, the TGA is now proposing changes to the <a href="https://www.tga.gov.au/consultation/consultation-proposed-regulatory-changes-related-personalised-and-3d-printed-medical-devices">personalised and 3D printed medical devices</a> regulatory framework that have the potential to settle that question. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"960911440365355008"}"></div></p>
<h2>Access versus safety</h2>
<p>In January 2013, the US medical device company, DePuy, recalled their <a href="http://www.abc.net.au/radionational/programs/healthreport/artificial-knee-gone-wrong/2986700">knee and hip replacement systems</a>. The devices were made from layers of metal, and shavings had come loose – potentially harming the patient. There is a high possibility of similar problems occurring (called layer separation) in 3D printed parts.</p>
<p>The TGA’s <a href="https://www.tga.gov.au/consultation/consultation-proposed-regulatory-changes-related-personalised-and-3d-printed-medical-devices">proposed amendments</a> are part of an effort to increase oversight and prevent these kinds of issues. In doing so, the TGA must balance ease of access for patients with the need to protect the public from the harm posed by devices that are manufactured without adequate oversight and testing. All this within a medical system <a href="http://www.news.com.au/lifestyle/health/public-hospitals-already-failing-surgery-and-emergency-targets-face-60-billion-in-federal-funding-cuts/news-story/8ccee41f823f7ee5aed8df139a9f4fb4">already under pressure financially</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/3d-printers-a-revolutionary-frontier-for-medicine-83031">3D printers: A revolutionary frontier for medicine</a>
</strong>
</em>
</p>
<hr>
<p>The current TGA framework breaks therapeutic goods into three areas: medicines, biologicals and medical devices. </p>
<p>Medicines are the pharmacological items we get from a chemist and biologicals are anything containing human cells. </p>
<p>Medical devices are ranked on a scale from Class I to Class III according to the <a href="https://www.tga.gov.au/product-regulation-according-risk">level of harm they may pose to a patient</a>. These devices are already subject to strict regulation and range from <a href="https://www.sculpteo.com/blog/2017/08/02/3d-printed-glasses-taking-the-eyewear-industry-to-the-next-level/">eye glasses</a> (Class I) to <a href="http://www.mccormick.northwestern.edu/news/articles/2016/10/3d-printing-customized-vascular-stents.html">custom vascular stents</a> (Class III). </p>
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<h2>The “custom made” exemption</h2>
<p>While a 3D printed prosthetic may be classified as Class I, or low risk, the technology has progressed to enable more advanced implants and tools to be produced that encompass Class III, or high risk, medical devices. </p>
<p>For example, <a href="https://link.springer.com/article/10.1007%2Fs00268-016-3814-5">full surgical intrument sets for space missions</a>, umbilical cord clamps for <a href="https://link.springer.com/content/pdf/10.1007/978-3-319-16247-8_4.pdf">disaster relief efforts</a> and new implantable medical devices to help <a href="https://www.adelaide.edu.au/news/news84742.html">heal fractured bones</a>.</p>
<p>If such devices are mass produced on a 3D printer, then high level, third party oversight of safety, quality and performance applies. However, if they fall under the custom made definition, third party oversight does not apply. </p>
<p>Devices made for a specific patient under the current framework are considered under the “custom made” definition. Historically, this made sense since custom made items were typically low risk and few in number. But as the number and complexity of custom made devices grows, we need to ensure they are subject to the same high level scrutiny as mass produced devices.</p>
<h2>Shifting definitions</h2>
<p>The custom made loophole isn’t the only issue with the current framework. There remains an ambiguity about who is legally responsible for the manufacture of a device.</p>
<p>Under the <a href="https://www.tga.gov.au/custom-made-medical-devices">existing rules</a>, </p>
<blockquote>
<p>“it is important to note that the person who adapts a medical device for an individual patient is not considered to be a manufacturer of a medical device if the adaptation does not alter its intended purpose… However, the device that requires modification is also required to be included on the Australian Register of Therapeutic Goods (ARTG) before it is supplied.” </p>
</blockquote>
<p>This is fine for items such as the raw material used for making dental crowns.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"874229841842798592"}"></div></p>
<p>But what about TGA approved filaments and other raw materials for 3D printing? </p>
<p>There is a risk that once raw materials are approved and included on the ARTG then any device could be printed and circumvent the definition of being a manufacturer. </p>
<p>For example, if a filament impregnated with copper was approved, we could print a custom made copper IUD contraceptive based on 3D scans <a href="https://www.ronen-kadushin.com/bearina-iud-concept/">similar in concept to this already open source device</a>. Given personal scans of the patient were integrated into the design it would meet the custom made definition, so paperwork related to it would only be required to be kept for five years. But a copper IUD can last anywhere from five to 12 years. Therefore, the risk of such a device causing permanent infertility would not be properly managed. </p>
<h2>Who is the manufacturer?</h2>
<p>This is proposed to be changed by including the <a href="https://www.tga.gov.au/sites/default/files/consultation-proposed-regulatory-changes-related-personalised-and-3d-printed-medical-devices.pdf">following addition in the framework</a>:</p>
<blockquote>
<p>“…the assembly or adaptation must be in accordance with validated instructions provided by the manufacturer of the device to be adapted; and that, if an individual modifies a device … in such a way that compliance with the essential principles may be affected, they shall assume the obligations incumbent on manufacturers…” </p>
</blockquote>
<p>This goes some way towards fixing the problem.</p>
<p>But if a hospital were to print devices for their patients by strictly following the instructions from the supplier, they would not be considered the manufacturer under this change.</p>
<p>So who would be responsible for the device? How do we treat the designs of products and their associated 3D files – the digital blueprints of a medical device?</p>
<p>Traditional definitions of manufacture do not encompass the designer. Generally speaking, we assume the business that designs an item will manufacture the item. That is not always going to be the case with the democratisation of 3D printing technology. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"917389233781960704"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/speaking-with-mia-woodruff-about-using-3d-printing-to-replace-body-parts-75769">Speaking with: Mia Woodruff about using 3D printing to replace body parts</a>
</strong>
</em>
</p>
<hr>
<h2>Future regulation</h2>
<p>I have previously <a href="https://theconversation.com/the-legal-minefield-of-3d-printed-guns-71878">written about</a> the Australian laws surrounding 3D Printed Firearms. I drew the conclusion that we need a unified approach to legislation that specifically speaks to the capabilities of 3D printers, and the digital blueprints devices are based on. </p>
<p>The TGA is beginning to address this by ensuring items that are now enabled by this technology are suitably captured by the existing legislation. What still isn’t clear is how digital blueprints will be treated in this new age of fabrication. </p>
<p>Comments submitted during the consultation process of the regulatory changes are now being reviewed by the TGA. If the TGA is serious about preventing harms caused by 3D medical devices, they must ensure these loopholes are closed.</p><img src="https://counter.theconversation.com/content/90314/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Richard Matthews is an elected member of The University of Adelaide Council, is an Additive Manufacturing consultant with the Entrepreneurship, Commercialisation and Innovation Centre at the University of Adelaide and is a current member of the South Australian branch of the Labor Party.</span></em></p>
Who should be legally responsible when 3D printed devices fail? Proposed changes to the Therapeutic Goods Administration’s regulatory framework have the potential to settle that question.
Richard Matthews, PhD Candidate, University of Adelaide
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/87920
2017-11-24T12:09:29Z
2017-11-24T12:09:29Z
Jonnie Peacock’s Strictly experience highlights the need to rethink how disability is represented on TV
<figure><img src="https://images.theconversation.com/files/196181/original/file-20171123-18006-b7baxl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">BBC/Guy Levy</span></span></figcaption></figure><p>Paralympic sprinter <a href="http://www.mirror.co.uk/3am/celebrity-news/who-jonnie-peacock-strictly-contestant-11498349">Jonnie Peacock</a> recently appeared as a guest on Channel 4’s <a href="http://www.channel4.com/programmes/the-last-leg">The Last Leg</a>, a late-night comedy chat show which aims to challenge the representation of disability on television. Adam Hills, the host, raised the question of whether it is fair to judge Peacock on the same criteria as the rest of the contestants on Strictly Come Dancing. </p>
<p>Hills asked Peacock <a href="https://twitter.com/hashtag/isitok?lang=en">#isitokay?</a> that in week three of the competition, he was criticised for sticking his bottom out when such a posture is a common result of wearing a prosthetic leg? Peacock agreed that it was difficult for him to dance in the desired posture and suggested that his incorrect posture was potentially due to the way he has to distribute his weight when using his prosthetic leg. </p>
<p>Although Peacock downplays any sense of being at a disadvantage, Hills raised an important issue. If reality shows want to increase the visibility of disabilities to their audience, there are some factors they must consider. It is worth discussing whether disabled competitors should be judged on the same criteria as their able-bodied competitors. The type of disability and/or prosthetic could also be taken into consideration when scoring these contestants. And perhaps most importantly, does marking disabled and able-bodied competitors on the same criteria lead to equality or exclusion?</p>
<h2>Disability on reality TV</h2>
<p>While Jonnie Peacock is the first paralympian to appear on Strictly Come Dancing, he is not the first disabled person to compete on a reality talent dancing show. In 2015, the US version of the show, <a href="http://abc.go.com/shows/dancing-with-the-stars">Dancing with the Stars</a> featured an Iraq War veteran amputee, Sergeant Noah Galloway. And in the same year, Royal Marine veteran Lance Corporal Cassidy Little – who lost his leg in Afghanistan – appeared on <a href="http://www.bbc.co.uk/programmes/profiles/14WxTJYynG31SvcLTtVTvc7/cassidy-little">The People’s Strictly</a> . </p>
<p>Galloway and Cassidy were both presented as “wounded heroes” – highlighting their veteran identities. In many instances their prosthetics were deliberately foregrounded in the routines and their video introductions each week focused on the practical and emotional difficulties of training for each dance. Most importantly, the judges’ comments acknowledged the difficulties they faced in performing the dances and took this into account when scoring. </p>
<p>In contrast, although Peacock has talked about his disability, he has generally downplayed any sense that it should hinder his performance. The only dance so far in which Peacock’s prosthetic has been visible is the jive, after which he was hailed as a <a href="http://www.mirror.co.uk/tv/tv-news/strictly-jonnie-peacock-blade-video-11267832">“hero”</a>“ by the media. In his <a href="http://www.huffingtonpost.co.uk/author/jonnie-peacock/">Huffpost blog</a> , Peacock wrote:</p>
<blockquote>
<p>I love reading that my prosthetic has got households across the UK talking about disability. I’m on this programme to show everyone that there is ability in disability and that if you put your mind to it, and work hard, then anything is possible.</p>
</blockquote>
<h2>Equality or exclusion?</h2>
<p>Peacock’s ability to compensate for his disability has meant that the narrative set up by Strictly rarely refers to his disability and the judges don’t appear to take it into account in their scoring of his performances. After he was voted out of the competition, Peacock thanked the judges for treating him the same as everybody else. </p>
<p>But having repeatedly drawn attention to an issue caused by his disability without acknowledging the reasons, can the judges really claim to have treated Peacock equally? </p>
<p>Ignoring Peacock’s disability potentially put him at a disadvantage in relation to his fellow competitors. This made it less likely that he would fulfil his hopes of demonstrating that, if we work hard enough, "anything is possible”.</p>
<p>Peacock’s inability to achieve the correct posture is a result of his disability – so, surely awarding him lower scores on this basis inevitably resulted in him being unable to progress beyond a certain point in the competition. His performance on Saturday night was given a standing ovation by the audience in Blackpool’s Tower Ballroom. But the judges’ comments repeatedly focused on Peacock’s incorrect posture and he found himself voted off the programme. </p>
<p>Peacock hopes that his appearance has paved the way for more contestants with disabilities to come forward and take part. But if this is to be the case, the programme will need to consider how this will work. As sporting organisations and academics begin to scrutinise the categorisation systems used in the Paralympics, perhaps it’s time for reality talent shows to consider how people with disabilities should be represented in order to ensure fairness and inclusivity.</p><img src="https://counter.theconversation.com/content/87920/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jenna Pitchford-Hyde does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Should disabled competitors be judged on the same criteria as their able-bodied rivals when it comes to dance competitions?
Jenna Pitchford-Hyde, Lecturer in Humanities, University of East Anglia
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/83031
2017-09-19T22:34:39Z
2017-09-19T22:34:39Z
3D printers: A revolutionary frontier for medicine
<figure><img src="https://images.theconversation.com/files/186440/original/file-20170918-8236-1rpfbpm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Surgeons at the University of Saskatchewan use a 3D printed human brain to plan complex neurosurgical procedures for patients with movement disorders.</span> <span class="attribution"><span class="license">Author provided</span></span></figcaption></figure><p>Mission control on earth receives an urgent communication from Mars that an astronaut has fractured his shinbone. Using a handheld scanning device, the crew takes images of his damaged tibia and transmits them to earth. </p>
<p>Orthopedic surgeons then use a 3D printer to create an exact replica of the astronaut’s leg from medical imaging files obtained before the voyage. Surgeons on earth use a robot to stabilize the bone with a metal plate on the 3D replica. The data is transmitted back to Mars, where surgical instruments, a personalized plate and screws are 3D printed. Finally, a surgical robot operates on the injured astronaut. </p>
<p>As a neurosurgeon and a researcher in remote presence robotics, I offer you this vision of the future. I am also a member of the Expert Group on the Potential Healthcare and Biomedical Roles for Deep Space Human Spaceflight of the Canadian Space Agency. Though <a href="https://www.nasa.gov/content/international-space-station-s-3-d-printer">3D printing in space</a> is still <a href="http://www.engineering.com/3DPrinting/3DPrintingArticles/ArticleID/15623/Recyclable-3D-Printing-Preps-for-the-Space-Station.aspx">in early development</a>, a revolution in 3D printing is already occurring closer to home. And it has transformative implications for the future of health care.</p>
<h2>What is 3D printing?</h2>
<p>Additive manufacturing, <a href="https://en.wikipedia.org/wiki/3D_printing">or 3D printing</a>, uses a digital model to build an object of any size or shape — by adding successive layers of material in a single continuous run. This layering capability allows the manufacturing of complex shapes, such as the intricate structure of bones or vascular channels, that would be impossible to create by other methods. </p>
<p>Advances in computer design and the ability to translate medical imaging — such as X-rays, computerized tomography (CT), magnetic resonance imaging (MRI) or ultrasound — to digital models that can be read by 3D printers are expanding its applications in health care. 3D printing is opening a horizon of amazing possibilities, such as <a href="http://www.nature.com/nbt/journal/v32/n8/full/nbt.2958.html?foxtrotcallback=true">bioprinting</a> living tissues with “biological ink”. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/186446/original/file-20170918-8300-lzobot.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">More than 64,000 people have been killed or injured by landmines in Cambodia since 1979. 3D printing significantly lowers the costs of prosthetic hands and arms, helping landmine victims such as this teenage boy in Phnom Phen.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>An advantage of 3D printing technology is that it allows for personalization of health care — customized prostheses and tailor-made drugs and <a href="http://www.mercurynews.com/2017/09/17/early-stage-the-startup-3d-printing-human-organs-save-lives/">organs</a>, for example. This technology may also decrease costs by disrupting supply chains and lowering the production costs of medical devices, surgical instruments and other health-care products. </p>
<h2>Hearing aids and dentures</h2>
<p>At present, 3D printing is being widely used in the manufacture of <a href="http://www.forbes.com/sites/rakeshsharma/2013/07/08/the-3d-printing-revolution-you-have-not-heard-about/#2ca7b85f21e1">hearing aids</a> and in <a href="https://www.dentalproductsreport.com/3d-printing/11614">dentistry</a>. </p>
<p>In 2013, there were 10 million 3D-printed hearing aids in circulation worldwide. This huge impact in the hearing aid industry has been called the “quiet revolution” as it has gone almost unnoticed. Before 3D printing, it took one week to manufacture a hearing aid; now it takes only a few hours.</p>
<p>The development of sophisticated and accurate 3D oral scanners and new 3D printing dental materials has also catapulted 3D printing as a disruptive technology in dentistry. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/zXqPnl7NB54?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A time-lapse video of a 3D printed full denture base.</span></figcaption>
</figure>
<p>In 2016, the Food and Drug Administration Agency (FDA) approved <a href="http://www.dentalproductsreport.com/dental/article/fda-approves-3d-printable-denture-base-material">3D printing denture material</a> and this set the stage for dentists to introduce 3D-printing manufacturing laboratories into their offices. The idea of producing crowns, orthodontic appliances or removable dentures with a push of a button in your dentist’s office is not far from reality.</p>
<h2>Prostheses for land-mine victims</h2>
<p>Perhaps the biggest impact of 3D printing globally could be in helping to narrow inequality in health-care delivery by producing inexpensive health-care products for low income regions. Prostheses for landmine victims is a good example.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/lZ4sKdV1P0A?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Mick Ebeling, CEO of Not Impossible Labs, travels to the Nuba Mountains of Sudan to teach locals how to make prosthetic arms for landmine victims.</span></figcaption>
</figure>
<p>Landmines in conflict zones in Africa and Asia have <a href="http://www.aljazeera.com/indepth/inpictures/2017/08/beating-odds-clearing-landmines-cambodia-170830073311964.html">devastating consequences</a> for the populations living in those areas. Inexpensive 3D-printed prostheses, customized to the person and printed in one day, have greatly benefited landmine amputees. Networks of volunteers such as <a href="http://enablingthefuture.org/">e-NABLE</a> and <a href="http://www.notimpossible.com/">NotImpossible</a> working with open source collaborations have had a positive impact on the design and provision of affordable 3D-printed prostheses. </p>
<p>In 2017 alone, these projects have created 300 prosthetic hands that have directly benefited war victims and the disabled poor.</p>
<h2>Face transplants and spine surgery</h2>
<p>Surgical applications of 3D printing are evolving rapidly from the production of models for surgical planning to <a href="https://www.nature.com/nbt/journal/v34/n3/full/nbt.3413.html">biological active implants</a> for craniofacial reconstruction. </p>
<p>At the University of Saskatchewan, we have 3D-printed a <a href="https://3dprint.com/104305/first-realistic-brain-model/">human brain replica</a> from MRI data. And we use it to plan complex neurosurgical procedures for treating patients with movement disorders. The surgery involves implanting electrodes that target pea-sized structures in the depths of the brain. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=374&fit=crop&dpr=1 600w, https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=374&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=374&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=469&fit=crop&dpr=1 754w, https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=469&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/185527/original/file-20170911-1368-1no1ugn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=469&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">3D printed brain for deep brain stimulation (DBS) surgical planning.</span>
<span class="attribution"><span class="source">University of Saskatchewan, Department of Surgery</span></span>
</figcaption>
</figure>
<p>Surgeons have used similar 3D printed models to plan complex surgeries ranging from a <a href="http://ko.3dsystems.com/blog/2015/11/virtual-surgical-planning-assists-full-face-transplant">full-face transplant</a> to <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1703-1">spine surgery</a>. Implantable surgical devices such as the recently FDA-approved and 3D-printed <a href="http://ijssurgery.com/10.14444/4016">titanium bone implant</a> coated with bioactive agents that promote bone growth are also starting to reach the clinic. </p>
<h2>Printing living organs</h2>
<p>An exciting area with huge potential for the future is the manufacturing of 3D-printed drugs. The first 3D-printed drug approved by the FDA is the anti-seizure medication <a href="http://www.computerworld.com/article/3048823/3d-printing/this-is-the-first-3d-printed-drug-to-win-fda-approval.html"><em>Sprintam</em></a>. The 3D printing process enables the creation of a highly porous structure that can load a large dosage of the active compound into a rapidly dissolvable pill. </p>
<p>This possibility of highly personalized drugs, which optimize beneficial effects while reducing side effects, made in real-time using digital recipes could radically change the pharmaceutical industry.</p>
<p>One of the most promising 3D printing technological advances is the bioprinting of living tissue. Great strides have been made in manufacturing <a href="https://www.nature.com/nbt/journal/v34/n3/full/nbt.3413.html">tissue constructs</a> that could eventually be used for organ transplants.</p>
<p>The clinical manufacturing of biologically active complex structures such as functional skeletal muscle or liver tissue is promising. The recent commercialization of functional human liver or kidney constructs — the so-called “<a href="http://ir.organovo.com/phoenix.zhtml?c=254194&p=irol-newsArticle&ID=2295198">lab on a chip organ</a>” — will have a huge impact on medical research, drug discovery and toxicology. It could possibly reduce the need to use experimental animal models. </p>
<p>Although we may be far away from surgery in Mars using 3D printing technology, the advances on earth are already changing health care.</p><img src="https://counter.theconversation.com/content/83031/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ivar Mendez does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
From cheap prosthetic arms for landmine victims in Sudan to the promise of surgery on astronauts in space — 3D printing is sparking a healthcare revolution.
Ivar Mendez, Fred H. Wigmore Professor and Unified Head of the Department of Surgery, University of Saskatchewan
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/78538
2017-07-31T04:19:56Z
2017-07-31T04:19:56Z
Super-intelligence and eternal life: transhumanism’s faithful follow it blindly into a future for the elite
<figure><img src="https://images.theconversation.com/files/173109/original/file-20170609-32437-9sfejw.jpg?ixlib=rb-1.1.0&rect=0%2C1%2C998%2C738&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Distant Earth. </span> </figcaption></figure><p>The rapid development of so-called NBIC technologies – nanotechnology, biotechnology, information technology and cognitive science – are giving rise to possibilities that have long been the domain of science fiction. Disease, ageing and even death are all human realities that these technologies seek to end. </p>
<p>They may enable us to enjoy greater “morphological freedom” – we could take on new forms through prosthetics or genetic engineering. Or advance our cognitive capacities. We could use <a href="https://theconversation.com/melding-mind-and-machine-how-close-are-we-75589">brain-computer interfaces</a> to link us to advanced artificial intelligence (AI). </p>
<p><a href="https://singularityhub.com/2016/05/16/nanorobots-where-we-are-today-and-why-their-future-has-amazing-potential/">Nanobots</a> could roam our bloodstream to monitor our health and enhance our emotional propensities for joy, love or other emotions. Advances in one area often raise new possibilities in others, and this “convergence” may bring about radical changes to our world in the near-future.</p>
<p>“Transhumanism” is the idea that humans should transcend their current natural state and limitations through the use of technology – that we should embrace self-directed human evolution. If the history of technological progress can be seen as humankind’s attempt to tame nature to better serve its needs, transhumanism is the logical continuation: the revision of humankind’s nature to better serve its fantasies. </p>
<p>As <a href="https://ieet.org/index.php/IEET2/print/2201">David Pearce</a>, a leading proponent of transhumanism and co-founder of <a href="http://humanityplus.org/">Humanity+</a>, says: </p>
<blockquote>
<p>If we want to live in paradise, we will have to engineer it ourselves. If we want eternal life, then we’ll need to rewrite our bug-ridden genetic code and become god-like … only hi-tech solutions can ever eradicate suffering from the world. Compassion alone is not enough.</p>
</blockquote>
<p>But there is a darker side to the naive faith that Pearce and other proponents have in transhumanism – one that is decidedly dystopian.</p>
<p>There is unlikely to be a clear moment when we emerge as transhuman. Rather technologies will become more intrusive and integrate seamlessly with the human body. Technology has long been thought of as an <a href="https://en.wikibooks.org/wiki/Living_in_a_Connected_World/Technology_as_an_Extension_of_Self">extension of the self</a>. Many aspects of our social world, not least our <a href="http://time.com/4471451/cathy-oneil-math-destruction/">financial systems</a>, are already largely machine-based. There is much to learn from these evolving human/machine hybrid systems.</p>
<p>Yet the often Utopian language and expectations that surround and shape our understanding of these developments have been under-interrogated. The profound changes that lie ahead are often talked about in abstract ways, because evolutionary “advancements” are deemed so radical that they ignore the reality of current social conditions. </p>
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<p><em>Listen to the audio version of this article in The Conversation’s In Depth Out Loud podcast:</em></p>
<iframe src="https://player.acast.com/5e29c8205aa745a456af58c8/episodes/5e29c8365aa745a456af58cd?theme=default&cover=1&latest=1" frameborder="0" width="100%" height="110px" allow="autoplay"></iframe>
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<p>In this way, transhumanism becomes a kind of “techno-anthropocentrism”, in which transhumanists often underestimate the complexity of our relationship with technology. They see it as a controllable, malleable tool that, with the correct logic and scientific rigour, can be turned to any end. In fact, just as technological developments are dependent on and reflective of the environment in which they arise, they in turn feed back into the culture and create new dynamics – often imperceptibly. </p>
<p>Situating transhumanism, then, within the broader social, cultural, political, and economic contexts within which it emerges is vital to understanding how ethical it is.</p>
<h2>Competitive environments</h2>
<p><a href="http://www.extropy.org/">Max More</a> and Natasha Vita-More, in their edited volume <a href="http://eu.wiley.com/WileyCDA/WileyTitle/productCd-1118334299.html">The Transhumanist Reader</a>, claim the need in transhumanism “for inclusivity, plurality and continuous questioning of our knowledge”.</p>
<p>Yet these three principles are incompatible with developing transformative technologies within the prevailing system from which they are currently emerging: advanced capitalism. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173113/original/file-20170609-20873-1qsbqci.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Perpetual doper or evolutionary defunct?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/broken-red-capsule-white-powdery-contents-602428577?src=srhG0rIC-eKuRulTj27QZA-1-23">Shutterstock</a></span>
</figcaption>
</figure>
<p>One problem is that a highly competitive social environment doesn’t lend itself to diverse ways of being. Instead it demands increasingly efficient behaviour. Take students, for example. If some have access to pills that allow them to achieve better results, can other students afford not to follow? This is already a quandary. Increasing numbers of students <a href="https://theconversation.com/fair-play-how-smart-drugs-are-making-workplaces-more-competitive-61818">reportedly pop performance-enhancing pills</a>. And if pills become more powerful, or if the enhancements involve genetic engineering or intrusive nanotechnology that offer even stronger competitive advantages, what then? Rejecting an advanced technological orthodoxy could potentially render someone socially and economically moribund (perhaps evolutionarily so), while everyone with access is effectively forced to participate to keep up. </p>
<p>Going beyond everyday limits is suggestive of some kind of liberation. However, here it is an imprisoning compulsion to act a certain way. We literally have to transcend in order to conform (and survive). The more extreme the transcendence, the more profound the decision to conform and the imperative to do so.</p>
<p>The systemic forces cajoling the individual into being “upgraded” to remain competitive also play out on a geo-political level. One area where technology R&D has the greatest transhumanist potential is defence. DARPA (the US defence department responsible for developing military technologies), which is attempting to create “<a href="https://www.wired.com/2012/12/andrew-herr/">metabolically dominant soldiers</a>”, is a clear example of how vested interests of a particular social system could determine the development of radically powerful transformative technologies that have destructive rather than Utopian applications.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175422/original/file-20170623-12623-6inkwn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Designing super-soldiers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-woman-soldier-member-ranger-squad-329042594?src=nwTGhl200zehgLapCMS7Bw-1-3">Shutterstock</a></span>
</figcaption>
</figure>
<p>The rush to develop super-intelligent AI by globally competitive and mutually distrustful nation states could also become an arms race. In <a href="http://www.penguinrandomhouse.com/books/58429/radical-evolution-by-joel-garreau/9780767915038/">Radical Evolution</a>, novelist Verner Vinge describes a scenario in which superhuman intelligence is the “ultimate weapon”. Ideally, mankind would proceed with the utmost care in developing such a powerful and transformative innovation.</p>
<p>There is quite rightly a <a href="http://observer.com/2015/08/stephen-hawking-elon-musk-and-bill-gates-warn-about-artificial-intelligence/">huge amount of trepidation</a> around the creation of super-intelligence and the emergence of “<a href="https://en.wikipedia.org/wiki/Technological_singularity">the singularity</a>” – the idea that once AI reaches a certain level it will rapidly redesign itself, leading to an explosion of intelligence that will quickly surpass that of humans (<a href="http://spectrum.ieee.org/computing/software/humanlevel-ai-is-right-around-the-corner-or-hundreds-of-years-away">something that will happen by 2029</a> according to futurist Ray Kurzweil). If the world takes the shape of whatever the most powerful AI is programmed (or reprograms itself) to desire, it even opens the possibility of evolution taking a turn for the entirely banal – could an AI destroy humankind <a href="http://www.salon.com/2014/08/17/our_weird_robot_apocalypse_why_the_rise_of_the_machines_could_be_very_strange/">from a desire to produce the most paperclips</a> for example?</p>
<p>It’s also difficult to conceive of any aspect of humanity that could not be “improved” by being made more efficient at satisfying the demands of a competitive system. It is the system, then, that determines humanity’s evolution – without taking any view on what humans are or what they should be. One of the ways in which advanced capitalism proves extremely dynamic is in its ideology of moral and metaphysical neutrality. As philosopher <a href="https://www.penguin.co.uk/books/181796/what-money-can-t-buy/">Michael Sandel</a> says: markets don’t wag fingers. In advanced capitalism, maximising one’s spending power maximises one’s ability to flourish – hence <a href="https://theconversation.com/into-a-bizarre-future-why-the-liberal-promise-of-true-liberty-is-a-lie-71395">shopping could be said</a> to be a primary moral imperative of the individual. </p>
<p>Philosopher Bob Doede rightly suggests it is <a href="http://www.academia.edu/2636472/TRANSHUMANISM_TECHNOLOGY_AND_THE_FUTURE_">this banal logic of the market</a> that will dominate: </p>
<blockquote>
<p>If biotech has rendered human nature entirely revisable, then it has no grain to direct or constrain our designs on it. And so whose designs will our successor post-human artefacts likely bear? I have little doubt that in our vastly consumerist, media-saturated capitalist economy, market forces will have their way. So – the commercial imperative would be the true architect of the future human. </p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175419/original/file-20170623-12614-g7qu4s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">System-led evolution.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/using-modern-technologies-work-closeup-young-534465139">Shutterstock</a></span>
</figcaption>
</figure>
<p>Whether the evolutionary process is determined by a super-intelligent AI or advanced capitalism, we may be compelled to conform to a perpetual transcendence that only makes us more efficient at activities demanded by the most powerful system. The end point is predictably an entirely nonhuman – though very efficient – technological entity derived from humanity that doesn’t necessarily serve a purpose that a modern-day human would value in any way. The ability to serve the system effectively will be the driving force. This is also true of natural evolution – technology is not a simple tool that allows us to engineer ourselves out of this conundrum. But transhumanism could amplify the speed and least desirable aspects of the process.</p>
<h2>Information authoritarianism</h2>
<p>For bioethicist Julian Savulescu, the main reason humans must be enhanced is for our species to survive. He says we face a <a href="https://www.youtube.com/watch?v=6pAMuFZRzyo">Bermuda Triangle of extinction</a>: radical technological power, liberal democracy and our moral nature. As a transhumanist, Savulescu extols technological progress, also deeming it inevitable and unstoppable. It is liberal democracy – and particularly our moral nature – that should alter.</p>
<p>The failings of humankind to deal with global problems are increasingly obvious. But Savulescu neglects to situate our moral failings within their wider cultural, political and economic context, instead believing that solutions lie within our biological make up. </p>
<figure>
<iframe src="https://player.vimeo.com/video/7515623" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe>
</figure>
<p>Yet how would Savulescu’s morality-enhancing technologies be disseminated, prescribed and potentially enforced to address the moral failings they seek to “cure”? This would likely reside in the power structures that may well bear much of the responsibility for these failings in the first place. He’s also quickly drawn into revealing how relative and contestable the concept of “morality” is:</p>
<blockquote>
<p>We will need to relax our commitment to maximum protection of privacy. We’re seeing an increase in the surveillance of individuals and that will be necessary if we are to avert the threats that those with antisocial personality disorder, fanaticism, represent through their access to radically enhanced technology.</p>
</blockquote>
<p>Such surveillance allows corporations and governments to access and make use of extremely valuable information. In <a href="http://www.simonandschuster.com/books/Who-Owns-the-Future/Jaron-Lanier/9781451654974">Who Owns the Future</a>, internet pioneer Jaron Lanier explains: </p>
<blockquote>
<p>Troves of dossiers on the private lives and inner beings of ordinary people, collected over digital networks, are packaged into a new private form of elite money … It is a new kind of security the rich trade in, and the value is naturally driven up. It becomes a giant-scale levee inaccessible to ordinary people.</p>
</blockquote>
<p>Crucially, this levee is also invisible to most people. Its impacts extend beyond skewing the economic system towards elites to significantly altering the very conception of liberty, because the authority of power is both radically more effective and dispersed. </p>
<p>Foucault’s notion that we live in a <a href="http://dm.ncl.ac.uk/courseblog/files/2011/03/michel-foucault-panopticism.pdf">panoptic society</a> – one in which the sense of being perpetually watched instils discipline – is now stretched to the point where today’s incessant machinery <a href="http://eu.wiley.com/WileyCDA/WileyTitle/productCd-0745613969.html">has been called</a> a “superpanopticon”. The knowledge and information that transhumanist technologies will tend to create could strengthen existing power structures that cement the inherent logic of the system in which the knowledge arises.</p>
<p>This is in part evident in the <a href="https://www.theguardian.com/technology/2017/apr/13/ai-programs-exhibit-racist-and-sexist-biases-research-reveals">tendency of algorithms toward race and gender bias</a>, which reflects our already existing social failings. Information technology tends to interpret the world in defined ways: it privileges information that is easily measurable, such as GDP, at the expense of unquantifiable information such as human happiness or well-being. As invasive technologies provide ever more granular data about us, this data may in a very real sense come to define the world – and intangible information may not maintain its rightful place in human affairs. </p>
<h2>Systemic dehumanisation</h2>
<p>Existing inequities will surely be magnified with the introduction of highly effective psycho-pharmaceuticals, genetic modification, super intelligence, brain-computer interfaces, nanotechnology, robotic prosthetics, and the possible development of life expansion. They are all fundamentally inegalitarian, based on a notion of limitlessness rather than a standard level of physical and mental well-being we’ve come to assume in healthcare. It’s not easy to conceive of a way in which these potentialities can be enjoyed by all. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175420/original/file-20170623-12653-1ytx2ly.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Will they come along for the ride?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/lesvos-greece-october-12-2015-refugee-375252433">Shutterstock</a></span>
</figcaption>
</figure>
<p>Sociologist Saskia Sassen <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674599222">talks of</a> the “new logics of expulsion”, that capture “the pathologies of today’s global capitalism”. The expelled include the more than <a href="https://publications.iom.int/system/files/fataljourneys_vol2.pdf">60,000 migrants who have lost their lives</a> on fatal journeys in the past 20 years, and the victims of the <a href="https://www.theguardian.com/us-news/2016/jun/18/mass-incarceration-black-americans-higher-rates-disparities-report">racially skewed</a> profile of <a href="https://www.nap.edu/read/18613/chapter/4">the increasing prison population</a>. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175423/original/file-20170623-12633-1neek5d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Grenfell Tower, London, 2017.</span>
<span class="attribution"><a class="source" href="http://www.epa.eu/disasters-photos/fire-photos/fire-at-lancaster-west-estate-in-london-photos-53584044">EPA/Will Oliver</a></span>
</figcaption>
</figure>
<p>In Britain, they include the <a href="http://www.ox.ac.uk/news/2017-02-20-30000-excess-deaths-2015-linked-cuts-health-and-social-care">30,000 people whose deaths</a> in 2015 were linked to health and social care cuts and the many who perished in <a href="https://theconversation.com/after-grenfell-local-authorities-must-break-the-link-between-fire-and-inequality-79707">the Grenfell Tower fire</a>. Their deaths can be said to have resulted from systematic marginalisation. </p>
<p>Unprecedented <a href="http://www.oxfam.org.uk/media-centre/press-releases/2017/01/eight-people-own-same-wealth-as-half-the-world">acute concentration of wealth</a> happens alongside these expulsions. Advanced economic and technical achievements enable this wealth and the expulsion of surplus groups. At the same time, <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674599222">Sassen writes</a>, they create a kind of nebulous centrelessness as the locus of power:</p>
<blockquote>
<p>The oppressed have often risen against their masters. But today the oppressed have mostly been expelled and survive a great distance from their oppressors … The “oppressor” is increasingly a complex system that combines persons, networks, and machines with no obvious centre.</p>
</blockquote>
<p>Surplus populations removed from the productive aspects of the social world may rapidly increase in the near future as improvements in AI and robotics potentially result in significant <a href="https://www.theguardian.com/sustainable-business/2017/mar/31/the-robot-debate-is-over-the-jobs-are-gone-and-they-arent-coming-back">automation unemployment</a>. Large swaths of society may become productively and economically redundant. For historian <a href="http://ideas.ted.com/the-rise-of-the-useless-class/">Yuval Noah Harari</a> “the most important question in 21st-century economics may well be: what should we do with all the superfluous people?”</p>
<p>We would be left with the scenario of a small elite that has an almost total concentration of wealth with access to the most powerfully transformative technologies in world history and a redundant mass of people, no longer suited to the evolutionary environment in which they find themselves and entirely dependent on the benevolence of that elite. The dehumanising treatment of today’s expelled groups shows that prevailing liberal values in developed countries don’t always extend to those who don’t share the same privilege, race, culture or religion. </p>
<p>In an era of radical technological power, the masses may even represent a significant security threat to the elite, which could be used to justify aggressive and authoritarian actions (perhaps enabled further by a culture of surveillance).</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=391&fit=crop&dpr=1 600w, https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=391&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=391&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=491&fit=crop&dpr=1 754w, https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=491&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/176931/original/file-20170705-24525-47w93n.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=491&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Life in the Hunger Games.</span>
<span class="attribution"><span class="source">© Lionsgate</span></span>
</figcaption>
</figure>
<p>In their transhumanist tract, <a href="http://www.palgrave.com/gb/book/9781137302977">The Proactionary Imperative</a>, Steve Fuller and Veronika Lipinska argue that we are obliged to pursue techno-scientific progress relentlessly, until we achieve our god-like destiny or infinite power – effectively to serve God by becoming God. They unabashedly reveal the incipient violence and destruction such Promethean aims would require: “replacing the natural with the artificial is so key to proactionary strategy … at least as a serious possibility if not a likelihood [it will lead to] the long-term environmental degradation of the Earth.”</p>
<p>The extent of suffering they would be willing to gamble in their cosmic casino is only fully evident when analysing what their project would mean for individual human beings: </p>
<blockquote>
<p>A proactionary world would not merely tolerate risk-taking but outright encourage it, as people are provided with legal incentives to speculate with their bio-economic assets. Living riskily would amount to an entrepreneurship of the self … [proactionaries] seek large long-term benefits for survivors of a revolutionary regime that would permit many harms along the way. </p>
</blockquote>
<p>Progress on overdrive will require sacrifices.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175421/original/file-20170623-12648-1r1ghrn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">God-like elites.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/floating-woman-200385053?src=S2Ck47xViOHicruTKd9-EQ-1-15">Shutterstock</a></span>
</figcaption>
</figure>
<p>The economic fragility that humans may soon be faced with as a result of automation unemployment would likely prove extremely useful to proactionary goals. In a society where vast swaths of people are reliant on handouts for survival, market forces would determine that less social security means people will risk more for a lower reward, so “proactionaries would reinvent the welfare state as a vehicle for fostering securitised risk taking” while “the proactionary state would operate like a venture capitalist writ large”. </p>
<p>At the heart of this is the removal of basic rights for “Humanity 1.0”, Fuller’s term for modern, non-augmented human beings, replaced with duties towards the future augmented Humanity 2.0. Hence the very code of our being can and perhaps must be monetised: “personal autonomy should be seen as a politically licensed franchise whereby individuals understand their bodies as akin to plots of land in what might be called the ‘genetic commons’”. </p>
<p>The neoliberal preoccupation with privatisation would so extend to human beings. Indeed, the <a href="https://data.oecd.org/hha/household-debt.htm">lifetime of debt that is the reality</a> for most citizens in developed advanced capitalist nations, <a href="http://www.palgrave.com/gb/book/9781137302977">takes a further step</a> when you are born into debt – simply by being alive “you are invested with capital on which a return is expected”.</p>
<p>Socially moribund masses may thus be forced to serve the technoscientific super-project of Humanity 2.0, which uses the ideology of market fundamentalism in its quest for perpetual progress and maximum productivity. The only significant difference is that the stated aim of godlike capabilities in Humanity 2.0 is overt, as opposed to the undefined end determined by the infinite “progress” of an ever more efficient market logic that we have now.</p>
<h2>A new politics</h2>
<p>Some transhumanists are beginning to understand that the most serious limitations to what humans can achieve are social and cultural – not technical. However, all too often their reframing of politics falls into the same trap as their techno-centric worldview. They commonly argue the new political poles are not left-right but techno-conservative or techno-progressive (and even <a href="https://transpolitica.org/publications/envisioning-politics-2-0/">techno-libertarian and techno-sceptic</a>). Meanwhile Fuller and Lipinska argue that the new political poles will be up and down instead of left and right: those who want to dominate the skies and became all powerful, and those who want to preserve the Earth and its species-rich diversity. It is a false dichotomy. Preservation of the latter is likely to be necessary for any hope of achieving the former. </p>
<p>Transhumanism and advanced capitalism are two processes which value “progress” and “efficiency” above everything else. The former as a means to power and the latter as a means to profit. Humans become vessels to serve these values. Transhuman possibilities urgently call for a politics with more clearly delineated and explicit humane values to provide a safer environment in which to foster these profound changes. Where we stand on questions of social justice and environmental sustainability has never been more important. Technology doesn’t allow us to escape these questions – it doesn’t permit political neutrality. The contrary is true. It determines that our politics have never been more important. Savulescu is right when he says radical technologies are coming. He is wrong in thinking they will fix our morality. They will reflect it.</p><img src="https://counter.theconversation.com/content/78538/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexander Thomas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The quest for technology to be the salvation of humankind neglects to consider some darker truths that lead to dystopia.
Alexander Thomas, PhD Candidate, University of East London
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/75769
2017-05-11T02:00:15Z
2017-05-11T02:00:15Z
Speaking with: Mia Woodruff about using 3D printing to replace body parts
<p>3D printing is fundamentally changing the way we make many objects – from construction materials to toys and even food. </p>
<p>And being able to 3D-scan the environment, even our own bodies, means that tools and prosthetics that were once mass-produced can now be custom-made for the people they’re designed to help, at a low cost.</p>
<p>What if one of the most essential items in the hospital of the future is a 3D printer?</p>
<p>William Isdale speaks with Queensland University of Technology’s Mia Woodruff about the work she and her team are doing to explore the use of 3D-printed bio-gels and scaffolds in healing cartilage and bone injuries, and looking to a future where biological functions for those currently on organ donor lists might be fulfilled by bio-compatible machines created in a lab.</p>
<hr>
<p><em><a href="https://itunes.apple.com/au/podcast/speaking-with.../id934267338">Subscribe</a> to The Conversation’s Speaking With podcasts on iTunes, or <a href="http://tunein.com/radio/Speaking-with---The-Conversation-Podcast-p671452/">follow</a> on Tunein Radio.</em></p>
<p><strong>Additional Audio</strong></p>
<ul>
<li><p>Fox News, <a href="http://video.foxnews.com/v/3453568864001/?#sp=show-clips">Scientists trying to create human heart with 3D printer</a></p></li>
<li><p>Associated Press, <a href="https://www.youtube.com/watch?v=1RTFuThFED8">Obama announces new manufacturing hubs</a></p></li>
<li><p>New China TV, <a href="https://www.youtube.com/watch?v=hnkauL9qh3c">Man recovers after 3D-printed prosthetic skull replacement</a></p></li>
<li><p>My Angel Foundation, <a href="https://www.youtube.com/watch?v=UqB0HfmduSY">The Power of Yes - organ donation myths vs facts</a></p></li>
<li><p>730, ABC News – <a href="http://www.abc.net.au/7.30/content/2015/s4377381.htm">Why are Australia’s organ donation rates so low?</a></p></li>
</ul>
<p><strong>Music</strong></p>
<ul>
<li><p>Free Music Archive: <a href="http://freemusicarchive.org/music/Scott_Holmes/Music_for_TV__Film/Rise_And_Fall_1777">Scott Holmes - Fall and Rise</a></p></li>
<li><p>Free Music Archive: <a href="http://freemusicarchive.org/music/Blue_Dot_Sessions/The_Contessa/When_The_Guests_Have_Left">Blue Dot Sessions - When The Guests Have Left</a></p></li>
<li><p>Free Music Archive: <a href="http://freemusicarchive.org/music/Psychadelik_Pedestrian/Nocturnia/07_-_Psychadelik_Pedestrian_-_Pacific">Psychadelik Pedestrian - Pacific</a></p></li>
<li><p>Free Music Archive: <a href="http://freemusicarchive.org/music/Kai_Engel/Chapter_One__Cold/Kai_Engel_-_Chapter_One_-_Cold_-_07_February">Kai Engel - February</a></p></li>
<li><p>Free Music Archive: <a href="http://freemusicarchive.org/music/johnny_ripper/lesprit_descalier/03_gael">Johnny_Ripper - Gaël</a></p></li>
</ul><img src="https://counter.theconversation.com/content/75769/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>William Isdale does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
What if one of the most essential items in the hospital of the future is a 3D printer?
William Isdale, Research Assistant, Melbourne Law School, The University of Melbourne
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/71086
2017-02-28T19:09:47Z
2017-02-28T19:09:47Z
Stronger, faster and more deadly: the ethics of developing supersoldiers
<figure><img src="https://images.theconversation.com/files/158254/original/image-20170224-21964-7mo177.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The future soldier may be enhanced.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Enhancing a soldier’s capacity to fight is nothing new. Arguably one of the first forms of enhancement was through improving diet. The phrase “an army marches on its stomach” goes back at least to <a href="http://www.oxfordreference.com/view/10.1093/oi/authority.20110803095425331">Napoleon</a>, and speaks to the belief that being well fed enhances the soldier’s chances of winning a battle. </p>
<p>But recent research has gone well beyond diet to <a href="http://www.nextbigfuture.com/2009/05/super-soldier-2030.html">enhance the capabilities of soldiers</a>, like purposefully <a href="https://goo.gl/z8mr57">altering the structure and function of a soldier’s digestive system</a> to enable them to digest cellulose, meaning that they can use grass as a food.</p>
<p>Perhaps their cognitive capabilities could be substantially altered so they can make more rapid decisions during conflict. Or their sensitivity to pain could be diminished, or even the severity and likelihood of post traumatic stress disorder (PTSD) reduced. Or even the direct <a href="http://www.darpa.mil/news-events/2015-09-11">wiring of prostheses to their brain</a>.</p>
<p>This kind of biological and technological enhancement is often referred to as developing “supersoldiers”. It’s not science-fiction; research is underway around the world. And it brings with it a host of ethical concerns.</p>
<h2>Ethical dimensions</h2>
<p>One concern revolves around the capacity for a soldier – or any other member of a military force – to give meaningful <a href="https://plato.stanford.edu/entries/informed-consent/">informed consent</a> to partake in clinical research or undergo enhancement. </p>
<p>The concern here is twofold. First, some of these interventions would be confidential; a military might justifiably want to keep new technologies top secret. This need for secrecy can impact how much information the subjects of enhancement receive, thus impacting the “informed” part of informed consent. </p>
<p>Second, we might have concerns about whether a soldier can actively consent to enhancement. That is, the hierarchical command structures and training in the military may impact the soldier’s capacity to refuse enhancement. Given the prominence of <a href="https://plato.stanford.edu/entries/clinical-research/">informed consent to medical ethics</a>, this is a core issue for enhancement before we even get to conflict.</p>
<p>Numerous forms of enhancement look at ways of indirectly or directly impacting the soldier’s cognitive capacities. One example is <a href="http://ethics.calpoly.edu/Greenwall_report.pdf">countering the need for sleep</a> through the use of drugs like amphetamines or <a href="https://theconversation.com/modafinil-the-smart-drug-leading-the-charge-towards-a-future-of-neuroenhancement-46477">Modafinil</a>, or other longer-lasting neurological interventions. Another is enhancing a soldier’s <a href="http://www.practicalethics.ox.ac.uk/moralenhancement2">capacity to make moral decisions</a>. </p>
<p>Another concern is what might happen if we reduce a soldier’s capacity to experience trauma with a drug like <a href="http://apt.rcpsych.org/content/15/2/159.2">propranolol</a>, which is being investigated for its ability to dampen the emotional force of particular memories. If administered rapidly after a particularly traumatic military activity – say, killing a teenage combatant to protect a school full of children – this pharmaceutical intervention could reduce the likelihood or severity of the soldier developing post traumatic stress disorder (<a href="http://www.medscape.com/viewarticle/729444">PTSD</a>). </p>
<h2>Moral obligation</h2>
<p>The ethical worries here turn on whether such interventions negatively impact a soldier’s capacity to follow the laws of war. However, if these enhancements don’t increase the chances of the soldier committing <a href="https://www.researchgate.net/publication/5286661_Performance-Enhancing_Technologies_and_Moral_Responsibility_in_the_Military">war crimes</a>, then perhaps there is even a moral obligation to enhance soldiers in such situations.</p>
<p>Conversely, there are reasons to be worried that enhancing soldiers can make their opponents, or even civilians, treat those soldiers immorally. For example, if it is believed that enemy soldiers are enhanced so that they don’t feel <a href="http://www.nextbigfuture.com/2008/07/3-billion-super-soldier-program-10.html">pain</a>, some might be more inclined to torture them.</p>
<p>Treating the enemy as inhuman or subhuman is sadly all too common <a href="http://yalebooks.com/book/9780300087000/humanity">through history</a>. Enhancements may exacerbate this process, particularly if opposing groups can classify their enemies as inhuman mutant supersoldiers.</p>
<p>Another concern is around the soldier’s life after conflict ceases or they leave the military. For instance, does an enhancement have to be <a href="http://ethics.calpoly.edu/Greenwall_report.pdf">reversible</a>? And if not, what special responsibilities does the military have to care for veterans, above and beyond existing supports? Similar issues have already been <a href="http://www.imdb.com/title/tt0708801/">explored in science-fiction</a>.</p>
<p>In a sense, none of these ethical concerns are specially new. Informed consent, limiting war crimes and a responsibility to care for veterans are hardly novel ideas. </p>
<p>What enhancement technologies do is shine a light on existing behaviour. And though we don’t need to worry about enhanced soldiers becoming mutant superheroes quite yet, there is value in considering the ethical aspects of such technologies before they are used rather than after the fact.</p><img src="https://counter.theconversation.com/content/71086/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adam Henschke receives support from the Brocher Foundation to look at the ethics of supersoldiers: <a href="http://www.brocher.ch/en">http://www.brocher.ch/en</a>.
</span></em></p>
Armed forces around the world are exploring technological and biological enhancements to their soldiers. But this raises a number of serious ethical concerns, before, during and after conflict.
Adam Henschke, Lecturer, Australian National University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/66622
2016-10-06T16:54:53Z
2016-10-06T16:54:53Z
Shape-shifting materials could be crucial in tight spaces – such as inside our bodies
<figure><img src="https://images.theconversation.com/files/140738/original/image-20161006-14726-1uj9lcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">cybrain/shutterstock.com</span></span></figcaption></figure><p>The rise of 3D printing means it’s now easy to create objects to any design we like from scratch, something that’s already finding particular use in medicine, with 3D printed <a href="http://3dprint.nih.gov/collections/prosthetics">customised prosthetics</a> or even <a href="http://www.bbc.co.uk/news/uk-england-hampshire-27436039">replacement bones such as hip joints</a>. Going one step further is to create so-called “<a href="https://theconversation.com/explainer-what-is-4d-printing-35696">4D printed materials</a>” that once created can change their shape.</p>
<p>Following decades of research by chemists, engineers, physicists and biologists this promising field of “smart materials” includes polymer-based (plastic) materials that can drastically change their properties if <a href="http://www.nature.com/nmat/journal/v9/n2/abs/nmat2614.html">triggered by changing environmental factors</a> such as heat, moisture or pH. Now, in a recently published paper, US researchers have demonstrated novel smart materials that can be pre-programmed to shape-shift in specific ways, without the need for an external stimulus to trigger the change.</p>
<p>Smart polymers have been put to many uses. For example, as nanoparticles that only form when a <a href="http://pubs.rsc.org/en/Content/ArticleLanding/2014/CC/c4cc04139a#!divAbstract">solution is shaken</a>, or dissolve to release a pharmaceutical when the nanoparticle is taken up by a <a href="http://pubs.acs.org/doi/abs/10.1021/acs.chemrev.5b00346">living cell</a>. Or nanoparticles that shape-shift into a different type of nanoparticle when the temperature changes, and <a href="http://pubs.acs.org/doi/abs/10.1021/ja3024059">shape-shift back again</a> when the temperature change is reversed. On a much larger scale, smart materials have been used to create <a href="https://application.wiley-vch.de/books/sample/3527318291_c01.pdf">self-healing systems</a>, where the mechanical forces that cause breakages also initialise chemical reactions that glue two broken pieces back together. </p>
<p>What all these smart materials have in common is that they only react to external stimulation. Being able to “program” smart materials to shape-shift without a trigger, as demonstrated in the new paper, is a new achievement.</p>
<h2>Pitting physical against chemical</h2>
<p>Published in Nature Communications, the <a href="http://www.nature.com/articles/ncomms12919">study</a> focuses on the preparation of cylinder-shaped polymer hydrogels: soft pieces of plastic that contain water, similar to the material soft contact lenses are made from. </p>
<p>The usual mechanical behaviour of these plastic cylinders relies on its chemical structure, made up of two sets of bonds between individual chains of polymers. The first type of bonds that hold the cylinder material together are known as chemical crosslinks, which are permanent and do normally not break. The second are the many physical hydrogen bonds that hold the plastic cylinder together. Crucially, while initially stable, these hydrogen bonds can be broken under sufficient stress, becoming soft and then reforming in a different configuration.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=434&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=434&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=434&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=545&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=545&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140723/original/image-20161006-14709-1isj1rh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=545&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Diagram showing how polymer chains (top) break and reform in new shapes as time progresses (bottom).</span>
<span class="attribution"><a class="source" href="http://www.naure.com/articles/ncomms12919#f1">Xiaobo Hu et al/Nature</a></span>
</figcaption>
</figure>
<p>Left for enough time – perhaps days – this material will eventually assume the shape in which the strong chemical crosslinks are least strained. This is just the same as how a rubber band returns to its original resting shape after having been stretched (only a rubber band moves much faster). </p>
<p>In the study, the researchers forced one of their smart material cylinders into a specific shape for a period of time. While deformed, the material’s chemical structure attempts to reform into its original shape, just as a rubber band does. However, depending on how long the cylinder is bent out of shape, the physical hydrogen bonds inside the material will break and reform in a way that actually favours the new, bent, shape. </p>
<p>When released, an internal struggle begins inside the cylinder during which its chemical structure attempts to revert to its original shape, but to do so requires the physical network of hydrogen bonds to revert to its original form, which can take some time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=308&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=308&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=308&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=387&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=387&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140711/original/image-20161006-14719-ihf11k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=387&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Rose petals made from shape-shifting materials, programmed to open one after the other, with the bud opening into a flower.</span>
<span class="attribution"><a class="source" href="http://www.nature.com/articles/ncomms12919#f4">Xiaobo Hu et al/Nature</a></span>
</figcaption>
</figure>
<h2>Timing is crucial</h2>
<p>The authors demonstrated that the time the material requires to revert to its original shape depends on how long it is held bent out of shape. The longer it spends deformed, the more the physical connections become accustomed to the new change and the longer it takes for the cylinder to relax back. </p>
<p>Impressively, this means the researchers were able to show that one of their smart material cylinders could be programmed to perform a specific routine by applying several bends, each held for different lengths of time. They were also able to program a time lag, applying a thin water-soluble coating to the cylinder which prevents the cylinder from starting its shape-shifting until the coating becomes soft from immersion in water.</p>
<p>Given the large and growing interest in smart materials, this research offers an interesting new approach to their design and manipulation. Adding the element of timing and trigger-free activation into the design of smart materials offers all sorts of uses, for example home products that adapt to heat or moisture. And of course there’s enormous potential for biomedical treatments, such as minimally invasive surgical procedures, autonomous actuators, slow-release methods for drugs, or physical implants that respond to environmental changes, even within the body.</p><img src="https://counter.theconversation.com/content/66622/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Roth does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Programmable materials that can change shape could have all manner of potential uses.
Peter Roth, Lecturer in Applied Organic Chemistry, University of Surrey
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/65399
2016-09-16T02:55:54Z
2016-09-16T02:55:54Z
Technology matters in the Paralympics, but the athlete matters more
<figure><img src="https://images.theconversation.com/files/137891/original/image-20160915-30575-14h5azb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Technology makes an impact on various events, but the key is to let the athlete's ability shine through.</span> <span class="attribution"><span class="source">OIS</span></span></figcaption></figure><p>The role of technology in sports is always a hot issue, but is perhaps more present when it comes to the Paralympics because of the more visible connection between person and <a href="https://www.fastcodesign.com/3027334/innovation-by-design/the-winter-paralympics-are-the-worlds-best-showcase-of-sports-technolog">machine</a>. </p>
<p>With amputation, there is a “blank slate” on which to build. And with today’s technological advancements, the possibilities seem limitless, even to the point of creating <a href="http://www.wired.co.uk/article/techno-fetish-prosthetic-bionic-envy">techno-envy</a>.</p>
<p>So after the Rio Paralympics, what are the technological innovations in prosthetics that we may see at the next Paralympics in Tokyo 2020? And, perhaps more importantly, how should we view technology’s role in the Paralympics in view of the fundamental principles of the International Paralympic Committee (IPC)? </p>
<p>Many new technologies coming out are enhancing the lives of people with all disabilities, including limb loss. </p>
<p>It is not hard to find articles about <a href="http://biomech.media.mit.edu/portfolio_page/cseaknee/">powered limbs</a>, <a href="https://www.youtube.com/watch?v=_qUPnnROxvY">robotic arms</a>, <a href="http://qz.com/500572/this-mind-controlled-prosthetic-robot-arm-lets-you-actually-feel-what-it-touches/">mind-control of limbs</a> and <a href="http://www.forbes.com/sites/tjmccue/2014/08/31/3d-printed-prosthetics/#35f4e0a2543e">3D printing</a> and how these technologies revolutionise the integration of a person with the prosthesis. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/_qUPnnROxvY?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Nigel Ackland demonstrates his carbon fibre bebionic3 myoelectric hand.</span></figcaption>
</figure>
<p>However, out of these four innovations, only <a href="https://theconversation.com/au/topics/3d-printing-2359">3D printing</a> seems to be poised to make a substantial difference on how prostheses are used in the next Paralympics. </p>
<p>3D printing provides a manufacturing system that makes it easier to model and refine a design, like for the <a href="http://www.reuters.com/article/us-olympics-rio-germany-paralympics-idUSKCN0XV29F">aerodynamics of a bicycle</a>, than traditional methods. </p>
<p>This allows designs that might reduce drag during racing, much as has been done in the <a href="http://www.telegraph.co.uk/sport/othersports/cycling/10461757/British-cycling-team-develop-new-drag-resistant-clothing-and-helmet.html">Olympics</a>. </p>
<p>The biggest contributing factor that 3D printing makes perhaps is two-fold: it allows us to fail much more in the design process than traditional methods, and therefore will allow these innovative designs to become readily adoptable to all in a more accelerated manner. </p>
<p>3D printing will also advance the use of different materials, making prostheses lighter, stronger and potentially more comfortable. </p>
<p>However, we should see these processes more akin to the tweaking of performance and design of equipment done in the Olympics than in enabling individuals to become Paralympians. </p>
<p>Instead, the success of the Paralympians in achieving improved performance is the same attributed to the improved performance in many sports: knowledge of the sport, training, nutrition and dedication. </p>
<p>So, just as “buying” speed will not get one into the the Tour de France, the use of a “blade” prosthesis does not guarantee entrance into the Paralympics. Technology may improve performance, but does not create it without human effort.</p>
<h2>It’s all about the athlete</h2>
<p>Safety, fairness, universality and physical prowess. These are the <a href="https://www.paralympic.org/sites/default/files/document/160428154029551_2015_12+IPC+Athletics+Rules+and+Regulations_A4_WEB2.pdf">four fundamental principles</a> of the IPC regarding the use of technology and equipment in the Paralympics. </p>
<p>This rule mainly applies to wheelchairs and prostheses, the latter lately becoming linked to imagery of <a href="https://www.technologyreview.com/s/602105/first-cyborg-olympics-will-celebrate-how-technology-can-help-disabled-people/">cyborgs</a>, <a href="https://techcrunch.com/2015/09/14/future-transhumanist-tech-may-soon-change-the-definition-of-disability/">trans-humanism</a> and even debates regarding its “<a href="http://www.scientificamerican.com/article/scientists-debate-oscar-pistorius-prosthetic-legs-disqualify-him-olympics/">fairness</a>” in even the Olympics. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/137893/original/image-20160915-30587-zlzknb.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The ‘blade’ features prominently in many athletics events.</span>
<span class="attribution"><span class="source">OIS</span></span>
</figcaption>
</figure>
<p>The essence of the Paralympics is that technology must be reasonably available to all, safe, fair and, most importantly, must not “<a href="https://www.paralympic.org/sites/default/files/document/160428154029551_2015_12+IPC+Athletics+Rules+and+Regulations_A4_WEB2.pdf">enhance performance beyond the natural physical ability of the athlete</a>”. </p>
<p>This means that externally powered sources and large springs are prohibited. And while they may impact the ability of the athletes to improve <a href="http://www.stuff.co.nz/sport/other-sports/83529854/technoathletes-riobound">daily performance and training</a>, many of the advances in prosthetics are at odds with the IPC ruling. </p>
<p>Prostheses are a tool; an extension of the person, more akin currently to the interaction of an athlete with a bicycle or kayak where the design is purpose specific. </p>
<p>Improvements will come in the form of new materials, improved design characteristics and advanced manufacturing techniques before the next Olympics in 2020. However, the vast improvement in performance will more likely stem from <a href="http://www.tandfonline.com/doi/full/10.1080/02640410903062019?src=recsys">general athletic improvement</a>. </p>
<p>For example, the carbon “blade”, or “<a href="http://www.nytimes.com/2008/07/02/sports/olympics/02cheetah.html?_r=0">Cheetah</a>”, was first introduced around 30 years ago and has not significantly changed in that time. Yet <a href="http://www.mdpi.com/2075-4663/3/1/30">100-metre sprint times in the Paralympics</a> have continued to improve over that time. </p>
<p>This vast improvement is starting to decay, much like in the Olympics. This seems to imply that although the blade is “<a href="http://bjsm.bmj.com/content/44/3/215.full">essential for performance</a>”, it is not the only factor. It still relies on the human element to drive it and any new technology must still have the person at the centre.</p>
<p>The Olympics and Paralympics both have issues of how to deal with technology and the “<a href="http://www.sportscoachuk.org/blog/technology-enhances-paralympic-athletes-where-will-it-stop">purity of the sport</a>”, especially in sports that rely on the athlete using an extension of themselves, such as cycling.</p>
<p>But just as we tend to celebrate the indomitable spirit and fortitude of those who reach that pinnacle without focusing on how technology got them there in the Olympics, maybe we should also focus on those same traits of the Paralympian and realise that the technology is part of the sport, but it is really the person that got them there. </p>
<p>We as spectators should focus on the own merits of the <a href="http://www.insidethegames.biz/articles/16560/sir-philip-craven-athletes-must-be-given-full-credit-in-paralympic-sport-not-their-technology">athlete</a> and not the technology.</p><img src="https://counter.theconversation.com/content/65399/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ben Lucas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Technology has had a particularly visible impact on the Paralympics. But the the most important thing is to let the athlete’s ability come to the fore.
Ben Lucas, Senior Lecturer in Prosthetics and Orthotics, University of the Sunshine Coast
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/65009
2016-09-12T14:18:54Z
2016-09-12T14:18:54Z
Here’s how to convince the brain that prosthetic legs are real
<figure><img src="https://images.theconversation.com/files/137355/original/image-20160912-3807-1w92mwl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Forgetting limitations</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The carbon fibre legs or “blades” used by lower limb amputee runners have arguably become one of the most iconic symbols of the Paralympic Games. Although different lower-limb sports prostheses are used for <a href="https://theconversation.com/forget-about-the-olympics-its-the-paralympics-where-the-true-super-humans-perform-62860">running, jumping and other activities</a>, they share a single common aim: they are designed to help Paralympians run faster, jump higher or further <a href="http://www.scientificamerican.com/article/blade-runners-do-high-tech-prostheses-give-runners-an-unfair-advantage/">than other competitors</a>. Form follows function. </p>
<p>For those who have prostheses for more everyday uses, however, their replacement limbs need to be able adapt to different scenarios and perform a variety of functions, not just excel in one discipline – just like an actual leg. So how can we make prostheses feel more like the real thing rather than a specialist tool? </p>
<p>Whereas modern running blades have a distinctive hook shape, one of the most promising engineering approaches for everyday prostheses is to closely model the biological design of a leg, ankle and foot. This approach is referred to as “<a href="http://rsta.royalsocietypublishing.org/content/367/1893/1445">biomimicity</a>”.</p>
<p>A “passive” ankle-foot prosthesis generally uses elastic like a spring to replicate the behaviour of the Achilles tendon, storing elastic energy and releasing it before ankle push-off. “Active” prostheses additionally use an actuator or motor to make up for the power previously provided by the calf muscle <a href="https://www.youtube.com/watch?v=RJrYcPNLhKo&feature=youtu.be">at every step</a>. Such prostheses have been shown to help users <a href="http://rspb.royalsocietypublishing.org/content/279/1728/457.long">walk more like a non-amputee</a> and improve symmetry between the biological and the artificial limb. At the moment, this mainly applies to walking overground at steady speeds rather than activities such as climbing stairs.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/137354/original/image-20160912-3799-1r4cmhr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Maximum comfort.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Simple design, advanced technology</h2>
<p>Other ways to make a prosthesis more like a biological leg and improve the user’s comfort are more simple. They also illustrate how important it is to involve the amputee in the design process. One user of the most advanced bionic ankle currently available told me its greatest feature was not that it provided a powered push-off or that it allowed them to walk more like a non-amputee. Instead it was that the <a href="http://www.ottobock.co.uk/prosthetics/lower_limb_prosthetics/prosthetic-product-systems/triton-smart-ankle/">foot dropped flat</a> <a href="http://www.bionxmed.com/patients/the-biom-advantage/">on the ground</a> when sitting with an outstretched leg, rather than sticking up awkwardly at a 90-degree angle (as is the case for the majority of prosthetic feet).</p>
<p>Another issue is how the prosthesis is controlled. Active prostheses now include <a href="https://hackaday.io/project/5765-flexsea-wearable-robotics-toolkit">on-board computers</a> to control the motors and emulate human walking. Prostheses are effectively becoming more and more like wearable robots. What’s more, we can even use interfaces that read signals from the brain <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1300126#t=article">or muscles</a> so that the user can operate the prosthesis like a real leg just by thinking and <a href="http://ieeexplore.ieee.org/document/6943925/?arnumber=6943925">moving in their normal way</a>. The next step being trialled is the use of implantable electrodes that send signals to the brain to give the user tactile feedback so they can <a href="http://stm.sciencemag.org/content/6/222/222ra19.full">feel the contact on the prosthesis as if it were their biological limb</a>, closing the human-machine loop.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Ebd_Yc0oDZI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>These technological and scientific advances connect the amputee more intimately with their prosthetic limb, meaning we can now focus more on how the prosthesis is embodied. In other words, to what extent does the prosthetic limb feel like part of the biological body? Does your brain treat it as such?</p>
<p>We have a good understanding of how our body is mapped in our brain. Both our motor cortex – the movement control centre, if you like – and the somatosensory cortex where we process a wide range of touch sensations are <a href="http://brain.oxfordjournals.org/content/60/4/389">organised somatotopically</a>. This means each area of our body corresponds to a specific area of the primary motor and sensory cortices. Importantly, this mapping does not disappear after the loss of a limb.</p>
<p>This means we have an opportunity to connect prostheses, through muscles and peripheral nerves, to the parts of the brain that would have controlled and sensed the biological body part. But it may also allow us to <a href="http://www.sciencedirect.com/science/article/pii/S1571064516000129">measure embodiment</a>, how successfully the brain accepts the prosthesis as part of the body.</p>
<p>Ultimately this line of research, bringing together cognitive neuroscience and biomedical engineering, is not only important for designing better prostheses. It is a unique window for understanding how our brain creates and maintains the image of our bodies – mechanisms that apply equally to amputees and <a href="http://www.oliversacks.com/books-by-oliver-sacks/leg-stand/">non-amputees</a>.</p><img src="https://counter.theconversation.com/content/65009/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Oliver Alan Kannape received funding from the Swiss National Science Foundation and the US Department of Defense while working at the Massachusetts Institute of Technology. </span></em></p>
The best prosthetics feel more like the real thing.
Oliver Alan Kannape, Assistant Lecturer, University of Central Lancashire
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/64451
2016-09-06T08:16:42Z
2016-09-06T08:16:42Z
World War I to the age of the cyborg: the surprising history of prosthetic limbs
<figure><img src="https://images.theconversation.com/files/136458/original/image-20160902-20238-1d3an2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">AltLimbPro</span></span></figcaption></figure><p>People have long dreamed of being smarter, stronger, faster. But now it seems that cutting edge technologies are out there, or in development, that might enable us truly to enhance our cognitive and physical capabilities. At the Paralympics, sprinters will be bounding down the tracks on running blades. Students are taking “<a href="https://theconversation.com/fair-play-how-smart-drugs-are-making-workplaces-more-competitive-61818">smart drugs</a>” and using <a href="https://theconversation.com/regulate-brain-boosting-devices-so-everyone-can-have-a-go-26409">cognitive enhancement devices</a> in order to achieve better academic performance. </p>
<p>These recent advances in science and technology have led to much discussion on the ethics of human enhancement, giving the impression that this is an era-defining moment, one in which the very definition of what it is to be “human” is being challenged. But such concerns over human enhancement are not new. Consider, for instance, the design and mass production of prosthetic limbs 100 years ago.</p>
<p>As thousands of soldiers returned from World War I with severe physical disabilities, engineers, physicians and politicians had to figure out how to enable the ex-combatants to return to the workforce. Germany and France did so via the mass production and large-scale distribution of prosthetic limbs. The public discussion on the benefits of mass production of prosthetic limbs was so intense in Europe, and the sight of men with prosthetic limbs so ubiquitous, that some historians speak of the emergence of a symbolic figure during the interwar years: “<a href="http://www.jstor.org/stable/488659">homo prostheticus</a>”. Many people were confident that a new generation of prosthetic limbs would enable amputees to resume their working lives, and perhaps even make them more productive than before.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=696&fit=crop&dpr=1 600w, https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=696&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=696&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=874&fit=crop&dpr=1 754w, https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=874&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/135624/original/image-20160826-17872-jl039m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=874&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘Reconstructing the Crippled Soldier’ McMurtrie, 1918.</span>
</figcaption>
</figure>
<p>A booklet published by the Red Cross in 1918, aptly entitled <a href="https://catalog.hathitrust.org/Record/005112764">Reconstructing the Crippled Soldier</a>, shows several pictures of amputees sporting their tool-like prosthetic limbs. Its author is optimistic, declaring: “There are no more cripples!” Another article on the new approach to prostheses, published in a Brazilian newspaper in 1918, went as far as to suggest that thanks to the scientific achievements of the modern age a healthy man could be turned into a “<em>super-homem</em>” – superman.</p>
<h2>Supermen?</h2>
<p>The prosthetic limbs developed and mass produced during the interwar period did not purport to imitate the anatomy of the human body, but were conceived to function as tools. The French engineer Jules Amar was one of the leading figures behind this new approach. In 1917, <a href="https://archive.org/stream/organisationphy00amargoog/organisationphy00amargoog_djvu.txt">he argued</a> that the purpose of a prosthetic limb was not to “substitute” an amputated leg or arm, but to perform a specific function. The prosthesis might indeed “copy” the natural anatomy of the human body, but it should not be a “slave to nature”. </p>
<p>But Amar also recognised that aesthetics were sometimes important. A salesman, for instance, was expected to have a good appearance. He should have both hands, even if he could not grab anything with them. For this reason, the “scientific prosthesis” Amar developed came with different attachments, depending on the task to be completed. It was, however, supplied with a wooden hand that could be attached to the socket depending on the social setting: the wooden hand was unnecessary in the factories, where the aesthetic function of the human body was irrelevant and other tools were more practical.</p>
<p>Amar’s functional approach was later adopted in Germany, where the engineer Georg Schlesinger was responsible for supervising the mass production and distribution of prosthetic limbs to a huge contingent of disabled men. Schlesinger <a href="http://www.transcript-verlag.de/978-3-8376-2351-2/koerper-2.0">argued</a> that as long as the prosthetic limb was able to function as a human arm, it didn’t matter whether it looked like one. The Red Cross <a href="https://catalog.hathitrust.org/Record/005112764">booklet</a> also made this point very clearly. The caption for one of the pictures says: “The working arm is designed for practical ends – not for appearance.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=560&fit=crop&dpr=1 600w, https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=560&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=560&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=704&fit=crop&dpr=1 754w, https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=704&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/135622/original/image-20160826-17851-1kqfroz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=704&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Reconstructing the Crippled Soldier, McMurtrie, 1918.</span>
</figcaption>
</figure>
<p>Schlesinger was <a href="http://bod.sagepub.com/content/16/3/93">so enthusiastic</a> about the prosthetic limbs of the interwar years that he tried to convince prospective employers that the “homo prostheticus” was actually better than the unenhanced man.</p>
<h2>… or automatons?</h2>
<p>But not everyone was so optimistic about this new approach to prosthetic limbs. The Austrian artist Raoul Hausmann, for instance, expressed concerns over the plight of the amputees. He argued that the supposedly enhanced workers would not benefit from their new condition, but would be exploited. </p>
<p>In a short article entitled “The Prosthetic Economy”, published in 1920, Hausmann sarcastically predicted that because the “prosthetic limb never gets tired”, the “25-hour workday” would become the norm. “The prosthetic man is therefore a better man, raised to a superior class thanks to the world war,” he went on. <a href="http://link.springer.com/referenceworkentry/10.1007%2F978-94-007-4707-4_168">Similar concerns</a> are still being raised today in debates on the ethics of human enhancement. </p>
<p>Other German speaking artists also reacted against the rise of “homo prostheticus”. They saw the new prosthetic limbs not as symbols of scientific progress, but as a clear sign of the dehumanisation of human beings. For painters such as <a href="https://www.nga.gov/exhibitions/2006/dada/images/artwork/202-108-2.shtm">Otto Dix</a>, <a href="https://en.wikipedia.org/wiki/File:Republican_Automatons_George_Grosz_1920.jpg">George Grosz</a>, Heinrich Hoerle, and <a href="http://paintingdb.com/art/xl/10/9621.jpg">Rudolf Schlichter</a>, the functional approach to prosthetic limbs was turning ex-combatants into machines rather than fully human beings.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=486&fit=crop&dpr=1 600w, https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=486&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=486&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=611&fit=crop&dpr=1 754w, https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=611&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/135617/original/image-20160826-17865-1hyw1c8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=611&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Heinrich Hoerle, ‘Monument of the Unknown Prostheses’ (Denkmal der unbekannten Prothesen), 1930.</span>
</figcaption>
</figure>
<p>Several paintings from the 1920s and 1930s depict grotesque men trying to get to grips with their artificial body parts. The idea was to critique the prospect of “rebuilding” war veterans, and to call into doubt the assumption that science and technology had all the answers for amputees. </p>
<h2>21st century enhancement</h2>
<p>Back to the current debate. Some philosophers consider human enhancement morally objectionable because they, too, believe that the attempt to extend our physical and cognitive capacities beyond “normal” limits is unnatural. For philosophers such as <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674036383">Michael Sandel</a>, <a href="http://us.macmillan.com/ourposthumanfuture/francisfukuyama">Francis Fukuyama</a>, and <a href="http://www.polity.co.uk/book.asp?ref=9780745629865">Jürgen Habermas</a>, human enhancement is a threat to our shared human nature. But do we really dehumanise ourselves when we give our bodies new, unnatural functions?</p>
<p>After all, the functional approach of a century ago, which was criticised by artists and intellectuals of the time, is on the rise again. Many of the latest, state-of-the-art prosthetic limbs do not purport to emulate the anatomy of the human body. They look quite unnatural. But today, unlike a century ago, the reception seems to be more positive. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/135620/original/image-20160826-17884-1unv648.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Prosthetic arm with LEGO developed by Colombian designer Carlos Torres.</span>
<span class="attribution"><span class="source">© Carlos Torres</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Flex-Foot Cheetah prosthetic legs, or “blades” developed by Van Phillips, don’t look like human limbs – and make amputees <a href="http://goo.gl/tpIoCR">run even faster</a> than many non-enhanced athletes – but no one would say that they dehumanise the paralympic athletes who use them. The <a href="https://goo.gl/xlrRh2">prosthetic arms designed by Carlos Torres</a> have been designed to function as a LEGO toy, but no one would suggest that they dehumanise children. And next October, Switzerland is going to host the <a href="http://www.cybathlon.ethz.ch/en/">Cybathlon</a> – the first cyborg Olympics. The participants will have to steer their machine-like bodies through a series of challenging tasks. They call themselves <a href="http://www.nature.com/news/welcome-to-the-cyborg-olympics-1.20353?WT.ec_id=NATURE-20160804&spMailingID=51981319&spUserID=MTY1NTE3Nzk5NjExS0&spJobID=980509994&spReportId=OTgwNTA5OTk0S0">pilots rather than athletes</a> – but they do not seem less human for that. </p>
<p>It is very unlikely that contemporary artists will feel tempted to portray “pilots”, or paralympic athletes, or children with a LEGO prosthetic arm in a grotesque fashion. Quite the opposite. Some have already raised prosthetic limbs to the status of works of art.</p>
<p>Consider, for instance, the prostheses developed by Sophie de Oliveira Barata for her company, <a href="http://www.thealternativelimbproject.com/">Altlimbpro</a>. They deliberately depart from the natural anatomy of the human body. Amar may have recognised in the past that our limbs also have an aesthetic function. But Altlimbpro goes far beyond. Why should we remain content with a good-looking artificial hand, if we can have a work of art instead? Why not have a <a href="http://www.thealternativelimbproject.com/project/floral-porcelain-leg/#prettyPhoto">floral porcelain leg</a>, or a <a href="http://www.thealternativelimbproject.com/project/stereo-leg/">leg with functioning stereo speakers</a> encrusted with diamonds? What about a <a href="http://www.thealternativelimbproject.com/project/snake-arm/">snake arm</a>? These <a href="http://www.thealternativelimbproject.com/">prostheses</a> are unique. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/136461/original/image-20160902-20224-dsyjmk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Kiera Roche wearing the Floral Porcelain Leg.</span>
<span class="attribution"><span class="source">© Altlimbpro. Photography by Rosemary Williams and Nadav Kander</span></span>
</figcaption>
</figure>
<p>Indeed, one of the greatest advantages of the functional approach is the fact that such prosthetic limbs do not look like fake body parts. When people look at conventional prosthetic limbs they may feel pity for the amputee. But with alternative prostheses today, people are likely to think twice before calling users “disabled”. It may not be long before people start to feel a bit of envy, too. As technology has advanced, our perception of the human body has changed. Artificial body parts are not seen as such a threat to our common humanity.</p>
<p>Future developments will likely further change the way we perceive and assess how technological innovations can modify and improve human capacities. The emergence of the “homo prostheticus” in the 1920s sparked the first wave of discussion on the ethics of human enhancement, a debate in which the idea of the “natural” eventually won. But now the functional approach is back, enabling us to realise in a new light that something being “unnatural” is not a reason to reject the prospect of using new technologies to augment human capacities.</p><img src="https://counter.theconversation.com/content/64451/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marcelo de Araujo currently receives funding from the CNPq (Council for Scientific and Technological Development). Previous research on this topic was funded by the Alexander von Humboldt Foundation.</span></em></p>
A tool in place of your arm or a stereo for your leg? How our attitudes towards human enhancement have changed.
Marcelo de Araujo, Professor of Ethics, Political Philosophy, and Philosophy of Law, Universidade Federal do Rio de Janeiro (UFRJ)
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/54760
2016-03-01T13:53:53Z
2016-03-01T13:53:53Z
Cybathlon will showcase what bionics could do for millions with disabilities
<figure><img src="https://images.theconversation.com/files/112133/original/image-20160219-25855-13eaye3.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Groundbreaking new technologies are finally leaving the lab.</span> <span class="attribution"><span class="source">Alessandro Della Bella/ETH Zurich</span></span></figcaption></figure><p>Following the Olympic Games and Paralympic Games, this year will see the arrival of the <a href="http://www.cybathlon.ethz.ch/">Cybathlon</a>, the world’s first competition for parathletes and people with severe disabilities who compete with the aid of bionic implants, prosthetics and other assistive technology. </p>
<p>The Cybathlon will include six disciplines, each one specialised to the competitors’ type of physical need. Agility courses test those with bionic arms and legs, while races for powered wheelchairs and <a href="http://fortune.com/2014/08/27/exoskeletons-wearable-robotics/">powered wearable exoskeletons</a> include tackling obstacles such as flights of stairs. There is also a bike race for paralysed competitors using <a href="https://www.mstrust.org.uk/a-z/functional-electrical-stimulation-fes">electronic muscle stimulation</a> to move their legs, and a competition for those who have lost the ability to move their bodies but who are put back in control by means of a brain-computer interface.</p>
<p>It’s true that the Cybathlon is unlikely to feature the sort of athletic prowess found at the Olympics or Paralympics. But it will demonstrate what the technology is capable of, instead of it staying hidden in research labs, and focus effort and enthusiasm on improving it in order to revolutionise the lives of those with severe disabilities and life changing injuries. Organisers <a href="https://www.ethz.ch/en.html">ETH Zurich</a>, the Swiss Federal Institute of Technology, will bring together 80 teams of users, researchers, and the tech manufacturing industry to think about what is really needed to make technology that solves the everyday problems those living with disabilities face.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Rx9I_hYqQcM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>It’s this focus on practical problems that has informed the design of the challenges. For example, the prosthetic arm race includes a station where the parathletes must slice a loaf of bread or pour a cup of coffee, and another where they must walk through a door while carrying a tray of objects. These are everyday activities taken for granted by most of us, but for the <a href="http://www.who.int/mediacentre/factsheets/fs352/en/">15m people</a> the World Health Organisation estimates are living with disabilities, they may be difficult or impossible.</p>
<p>While examples of technology such as bionic arms may be familiar, the brain-computer interface competition will be a surprise to most. A brain-computer interface is a system that interprets a person’s brain activity into one of several possible commands for equipment fitted to the competitor. This allows severely paralysed people whose cognitive and sensitive abilities are nevertheless intact to control equipment that can help them move or communicate.</p>
<p>It’s rare such interface systems leave a research lab, and many exist only in theory on the pages of research journals. They may seem like science fiction, yet they have existed in one form or another for decades. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/112140/original/image-20160219-25894-9hia8n.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Paralysed racers use electrical stimulation to move their legs to power reclining cycles.</span>
<span class="attribution"><span class="source">Alessandro Della Bella/ETH Zurich</span></span>
</figcaption>
</figure>
<h2>Brain as machine controller</h2>
<p>There are several components to a brain-computer interface. The first one is of course the brain of the person. Electrical impulses in the brain are detected through electroencephalogram (<a href="http://www.nhs.uk/conditions/eeg/pages/introduction.aspx">EEG</a>) sensors attached non-invasively to the scalp, very much as they are in a hospital setting. These signals quite often include interference from muscular movement such as from the eyes, so the first step is to isolate the useful signal from the noise.</p>
<p>The signals are then processed in a step known as feature extraction. Approaches vary, but a common technique is for the user to imagine he or she is performing a movement, such as clasping and opening a hand. This mental imagery generates a particular pattern in the brain’s motor cortex which appears as an EEG signal that is easily recognisable and distinct from the background EEG activity.</p>
<p>The EEG signals are processed during feature extraction to make them more easily understood by the next component, the classifier, which identifies the intention of the user. A classifier identifies how the signal patterns differ when the user thinks of moving their left or their right hand, for example, or how these differ from signals generated as the user makes mental calculations. A good classifier learns these differences and identifies the most likely intention the user had, achieved through pattern matching and machine learning algorithms.</p>
<figure>
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</figure>
<p>The Cybathlon race will test competitors of the brain-computer interface race by means of a video game, in which the participants will map up to four different actions from the brain that need to be understood by the classifier of the system. The competitors must send the correct decision at the right time in order to race each others’ avatars represented in the game. The best system will be the one that most accurately recognises and quickly responds to its user’s brain activity, selects the right command and so allows he or she to win the race.</p>
<p>The appearance of brain-computer interfaces at Cybathlon is a rare opening outside the lab, that requires the systems’ developers to considerably improve them over those that need only function in lab experiments, for example by making them more reliable and able to cope with the user getting distracted.</p>
<p>Current systems aren’t yet ready for those whose lives they could so radically change. But the new developments of the last few years, which Cybathlon is encouraging further, will not only improve this technology but make it more suited to use by people living outside the lab – finally closing the loop on a technology that has been in the making for over 20 years.</p><img src="https://counter.theconversation.com/content/54760/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ana Matran-Fernandez is leader of BrainStormers, a team that will compete in the Brain-Computer Interface race at Cybathlon on behalf of Essex University.</span></em></p>
After the Olympics and the Paralympics come the Cyberolympics – bionic men and women are coming to competitive sports.
Ana Matran-Fernandez, PhD researcher, University of Essex
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/45309
2015-08-30T20:06:29Z
2015-08-30T20:06:29Z
From science fiction to reality: the dawn of the biofabricator
<figure><img src="https://images.theconversation.com/files/92882/original/image-20150825-17783-1bizp8w.jpg?ixlib=rb-1.1.0&rect=163%2C159%2C2325%2C1493&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Biofabrication takes place at the intersection of biology and technology.</span> <span class="attribution"><span class="source">Vern Hart/Flickr</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><blockquote>
<p>We can rebuild him. We have the technology.
<br>- The Six Million Dollar Man, 1973</p>
</blockquote>
<p>Science is catching up to science fiction. Last year a paralysed man walked again after cell treatment <a href="http://www.bbc.com/news/health-29645760">bridged a gap</a> in his spinal cord. Dozens of people have had <a href="http://www.gizmodo.com.au/2014/12/bionic-eyes-can-already-restore-vision-soon-theyll-make-it-superhuman/">bionic eyes</a> implanted, and it may also be possible to augment them to see into the infra-red or ultra-violet. Amputees can control bionic limb implant with <a href="http://www.reuters.com/article/2015/05/20/us-iceland-mind-controlled-limb-idUSKBN0O51EQ20150520">thoughts alone</a>. </p>
<p>Meanwhile, we are well on the road to <a href="http://www.nature.com/news/the-printed-organs-coming-to-a-body-near-you-1.17320">printing body parts</a>.</p>
<p>We are witnessing a reshaping of the clinical landscape wrought by the tools of technology. The transition is giving rise to a new breed of engineer, one trained to bridge the gap between engineering on one side and biology on the other. </p>
<p>Enter the “biofabricator”. This is a role that melds technical skills in materials, mechatronics and biology with the clinical sciences.</p>
<h2>21st century career</h2>
<p>If you need a new body part, it’s the role of the biofabricator to build it for you. The concepts are new, the technology is groundbreaking. And the job description? It’s still being written. </p>
<p>It is a vocation that’s already taking off in the US though. In 2012, Forbes rated <a href="http://www.forbes.com/pictures/lmj45jgfi/no-1-biomedical-engineering/">biomedical engineering</a> (equivalent to biofabricator) number one on its list of the 15 most valuable college majors. The following year, CNN and <a href="http://www.payscale.com/">payscale.com</a> called it the “<a href="http://money.cnn.com/pf/best-jobs/2013/full_list/">best job in America</a>”. </p>
<p>These conclusions were based on things like salary, job satisfaction and job prospects, with the US Bureau of Labour Statistics projecting a <a href="http://www.bls.gov/ooh/architecture-and-engineering/biomedical-engineers.htm">massive growth</a> in the number of biomedical engineering jobs over the next ten years. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/92999/original/image-20150826-16668-1ll5606.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Cochlear implant has brought hearing to many people.</span>
<span class="attribution"><span class="source">Dick Sijtsma/Flickr</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Meanwhile, Australia is blazing its own trail. As the birthplace of the multi-channel <a href="http://www.cochlear.com/wps/wcm/connect/au/home/understand/hearing-and-hl/hl-treatments/cochlear-implant">Cochlear implant</a>, Australia already boasts a worldwide reputation in biomedical implants. Recent clinical breakthroughs with an implanted titanium <a href="http://www.csiro.au/en/News/News-releases/2014/3D-Heel-In-World-First-Surgery">heel</a> and <a href="http://www.abc.net.au/news/2015-06-20/melbourne-man-receives-titanium-3d-printed-prosthetic-jaw/6536788">jawbone</a> reinforce Australia’s status as a leader in the field.</p>
<p>I’ve recently helped establish the world’s first international <a href="http://www.electromaterials.edu.au/biofab-masters-degree/">Masters courses for biofabrication</a>, ready to arm the next generation of biofabricators with the diverse array of skills needed to 3D print parts for bodies. </p>
<p>These skills go beyond the technical; the job also requires the ability to communicate with regulators and work alongside clinicians. The emerging industry is challenging existing business models. </p>
<h2>Life as a biofabricator</h2>
<p>Day to day, the biofabricator is a vital cog in the research machine. They work with clinicians to create a solution to clinical needs, and with biologists, materials and mechatronic engineers to deliver them. </p>
<p>Biofabricators are naturally versatile. They are able to discuss clinical needs pre-dawn, device physics with an electrical engineer in the morning, stem cell differentiation with a biologist in the afternoon and a potential financier in the evening. Not to mention remaining conscious of regulatory matters and social engagement.</p>
<p>Our research at the ARC Centre of Excellence for Electromaterials Science (<a href="http://www.electromaterials.edu.au/">ACES</a>) is only made possible through the work of a talented team of biofabricators. They help with the conduits we are building to regrow severed nerves, to the electrical implant designed to sense an imminent epileptic seizure and stop it before it occurs, to the 3D printed cartilage and bone implants fashioned to be a perfect fit at the site of injury. </p>
<p>As the interdisciplinary network takes shape, we see more applications every week. Researchers have only scratched the surface of what is possible for wearable or implanted sensors to keep tabs on an outpatient’s vitals and beam them back to the doctor. </p>
<p>Meanwhile, stem cell technology is developing rapidly. Developing the cells into tissues and organs will require prearrangement of cells in appropriate 3D environments and custom designed bioreactors mimicking the dynamic environment inside the body.</p>
<p>Imagine the ability to arrange stem cells in 3D surrounded by other supporting cells and with growth factors distributed with exquisite precision throughout the structure, and to systematically probe the effect of those arrangements on biological processes. Well, it can already be done. </p>
<p>Those versed in 3D bioprinting will enable these fundamental explorations. </p>
<h2>Future visions</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=543&fit=crop&dpr=1 600w, https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=543&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=543&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=682&fit=crop&dpr=1 754w, https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=682&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/92878/original/image-20150825-17765-165uzrm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=682&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The 1970s TV show, Six Million Dollar Man, excited imaginations, but science is rapidly catching up to science fiction.</span>
<span class="attribution"><span class="source">Joe Haupt/Flickr</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>Besides academic research, biofabricators will also be invaluable to medical device companies in designing new products and treatments. Those engineers with an entrepreneurial spark will look to start spin-out companies of their own. The more traditional manufacturing business model will not cut it.</p>
<p>As 3D printing evolves, it is becoming obvious that we will require dedicated printing systems for particular clinical applications. The printer in the surgery for cartilage regeneration will be specifically engineered for the task at hand, with only critical variables built into a robust and reliable machine.</p>
<p>Appropriately trained individuals will also find roles in the public service, ideally in regulatory bodies or community engagement.</p>
<p>For this job of tomorrow, we must train today and new opportunities are emerging <a href="http://www.electromaterials.edu.au/biofab-masters-degree/">biofab-masters-degree</a>. We must cut across the traditional academic boundaries that slow down such advances. We must engage with the community of traditional manufacturers that have skills that can be built upon for next generation industries.</p>
<p>Australia is also well placed to capitalise on these emerging industries. We have a traditional manufacturing sector that is currently in flux, an extensive advanced materials knowledge base built over decades, a dynamic additive fabrication skills base and a growing alternative business model environment.</p><img src="https://counter.theconversation.com/content/45309/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gordon Wallace receives funding from the Australian Research Council via the Centres of Excellence and Australian Laureate Fellowship schemes. With colleagues at QUT, Utrecht and Wurzberg they have established an International Masters in BioFabrication Course. </span></em></p><p class="fine-print"><em><span>Cathal D. O'Connell does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
At the nexus of medical science, engineering, computer science and 3D printing is the biofabricator, a new career for the 21st century.
Gordon Wallace, Executive Director of the ARC Centre of Excellence for Electromaterials Science and Director of the Intelligent Polymer Research Institute, University of Wollongong
Cathal D. O'Connell, Associate Research Fellow in 3D Bioprinting, University of Wollongong
Licensed as Creative Commons – attribution, no derivatives.