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It’s stories like this that really bring home how much progress we’ve made in medical research. There were immensely innovative studies in brain research all o

It’s stories like this that really bring home how much progress we’ve made in medical research. There were immensely innovative studies in brain research all over the past 50-60 years, but this is still breathtaking.

spicybright 4y ago
It really is. I see too often wins like this get overlooked by the general pessimism everyone seems to have about the world. But through a lot of hard work, we gave someone living in a black mirror-style horror the start of being able to communicate again. Give it 20 years and I'm sure we'll have a standard box to stick on someone's head to let them communicate reasonably well (or at least enough to order a cold beer).
- TaupeRanger 4y ago
  Well part of the pessimism comes from overstatements of the effects of such research, as evidenced by your comment. There is basically zero evidence that this device provides better quality of life than the systems that already existed. This is essentially a fluff piece, likely financed by the company that made the system. Real breakthroughs are few and far between, and it's been like this for decades.
  - filoleg 4y ago
    > There is basically zero evidence that this device provides better quality of life than the systems that already existed. IMO it is less about which purpose this specific device is used for, and more about what this breakthrough has the potential to enable us to do in the future, using this tech as the basis to build on top of (assuming it is proven a success and all the kinks are worked out). If there was a standardized "smart hat" that I could put on my head that would allow me to control my AR glasses in an efficient way, that would be crazy. Because right now, that's one specific concern regarding AR usability, since current solutions with buttons and touch surfaces and voice controls and making hand gestures are awkwardly inconvenient and feel clunky. UI/UX paradigm for certain consumer device categories completely shifts. A lot of accessibility problems get resolved. Hardware itself on a lot of consumer devices can become much simpler and more robust, since there is no need for much hand-driven interaction. And that's just a singular the most obvious example I could've thought of. There are plenty of potential amazing things that could be enabled by this tech, even if the specific use case for it that was presented in the article might not "provide better quality of life".
  - goodells 4y ago
    I'd offer some pushback, from someone with hands-on experience. I'm a paramedic and work alongside other medics, nurses, and physicians who have seen a wave of change in evidence-based medicine over just the course of a few decades. Not everything is flashy and glamorous like a brain-computer interface. No press release that makes it to the top of HN is going to talk about the choice of isotonic crystalloids or sedation agents on intracranial pressure, but we're making great strides, even if by definition "marginal" ones. Modern resuscitation is like nothing I have ever seen before. Over the past 100 years, we have gained an almost complete understanding of cardiac electrophysiology, acid-base balance, hematology. In the worst-case scenario that you get hit by a car in a major US city, you will likely have TXA forced into your bloodstream through an intravenous catheter within 13 minutes to counteract the body's incorrect hyperfibrinolytic reaction. Your heart rhythm will be constantly analyzed and treated according to ACLS which has essentially been studied and modified to death by the AHA in a gradient descent pattern - we're stuck in a local minimum where the antidysrhythmic of choice alternates between amiodarone and lidocaine. When you arrive at the hospital, a FAST ultrasound scan will be performed where the culmination of materials science and informatics comes together to quickly identify blood in the retroperitoneal space without incurring the logistics of getting a trauma patient into a CT scanner. All this while a neurologist checks 12 of your cranial nerves and someone checks the tone of your rectal sphincter - because evidence shows us this is an important sign. In the case that you have an intracranial bleed, you'll be followed with MRI (which I'm convinced is the closest we've gotten to Star Trek scanner technology) to identify the penumbra of a stroke based on the deoxygenation of hemoglobin. We can now scan a variety of elements with magnetic resonance spectroscopy besides just precessing hydrogen atoms, which is helpful in identifying neoplastic lesions without the daunting task of a brain biopsy. Not everything is gloom-and-doom at the financing of some big company.
    - manholio 4y ago
      That contains so much jargon that it has to be 100% legit. The rectal sphincter tone though.
      - goodells 4y ago
        I can try to break it down for an uninitiated audience. "isotonic crystalloids" - Solutions such as normal saline used to restore volume proportionally to the bloodstream and intracellular spaces (as opposed to hypotonic or hypertonic, isotonic solutions just match the normal blood's osmolality) "sedation agents" - The patient is out, you keep 'em out, ideally without tanking their blood pressure. Different than paralysis. "electrophysiology" - Electrical conduction through the heart. "acid-base balance" - Various chemical processes and enzymes in the body only work well within a certain pH range, and long-term, only a narrow pH range is compatible with life. "hematology" - Blood and its components, including the cascade of enzymes and clotting factors involved in coagulation. "TXA" - Tranexamic acid - An anti-anti-clotting agent, which stops the body from breaking down blood clots. In the context of trauma, it allows your body to form the needed clots to avoid imminent exsanguination. "ACLS" - Advanced Cardiac Life Support - The AHA algorithm for identifying and treating life-threatening heart rhythms that most paramedics, RTs, nurses, etc. and above are trained on. In practice, this means that an unresponsive patient or code situation can be run to a certain standard with the staff who are immediately summoned in any clinical area of any hospital within about 30 seconds. "antidysrhythmic" - In the ACLS algorithms, it's a drug (usually a potassium channel blocker or sodium channel blocker or both) that acts on the cardiac action potential to do something that tends to make lethal dysrhythmias stop and return to a normal sinus rhythm. How exactly, you'd need to ask a cardiologist or specialized pharmacist. "FAST [ultrasound] scan" - Focused assessment with sonography for trauma - it's just an ultrasound of the flank area to detect blood around the kidneys ("retroperitoneal space") which has a high mortality rate and usually requires emergency surgery. "cranial nerves" - Your brain can communicate with the rest of your body either through your spinal cord, or through the cranial nerves which are direct interfaces for things like smell, sight, tongue movement, etc. Checking these is an important part of determining of a brain injury or spinal cord injury is present. "rectal sphincter tone" - If it's present, then it's unlikely that spinal cord injury above a certain level has occurred. "intracranial bleed" - It's bleeding, in your brain. "magnetic resonance spectroscopy" - The original MRI technique was based on spinning all the hydrogen atoms in your body such that they aligned head to toe, then detecting electromagnetic induction in a coil as they were jarred back and forth at a megahertz frequency. Nowadays, we can do this with other atoms like phosphorus in the same way. "precessing" - The pattern of relaxation of an atom similar to a spinning top where it goes from the aforementioned align orientation (forced by a strong magnet to align head to toe), and gradually relaxes to its random orientation while spinning at the Larmor frequency (megahertz frequency of the corresponding type of atom). "penumbra" - The border between healthy living brain tissue and dead brain tissue at the outside territory of a brain injury post-stroke. "neoplastic" - Uncontrolled cell growth, similar to cancer except not all neoplasms are cancer, some are benign tumors which will never be able to metastasize/spread to other parts of the body.
TaupeRanger 4y ago
Not much. This probably only marginally improves a patient's quality of life beyond what we were already capable of providing with existing systems. It's better than nothing of course, since you made a general point about medical research, the life expectancy of the average American has only gone up 5 years over the past 40 years (excluding declines due to COVID).
- uniqueuid 4y ago
  I would strongly disagree. The decreasing life expectancy in the US is probably, ahem, largely attributed to a medical system that is not particularly well-optimized for boosting mass life expectancy (despite being world-class in absolute quality of care, I assume). If you look closely, past decades have brought immense breakthroughs such as - the first completely synthetic new antibiotic - dramatic improvements in spatial and temporal resolution of imaging systems (MRI, PET etc.) - actually useful robotic assistance for surgery - easy, simple, and widespread techniques that are nevertheless life-saving, including a broad awareness for important events such as cardiac arrest and stroke - much better, faster and more accurate laboratory work, down to the DNA level And that's only a fraction of it which a layman such as myself can come up with from the top of my head!
  - TaupeRanger 4y ago
    Unless those things help people live longer or better (with scientific evidence to show such an effect) they are interesting developments with no actual impact on patients. Do people treated with surgical robots live longer or better? Has the synthetic antibiotic helped average patients live longer or better? So far, we only see very marginal improvements, and at massive, constantly increasing costs.
- sterlind 4y ago
  I'm struggling to understand what you mean. Finally being able to communicate strikes you as "only marginally" improved? You really don't think that being able to talk to family, say that you're in pain, ask for an audiobook, helps much at all? And then you mention life expectancy, which is quantity of life.

spicybright 4y ago

It really is. I see too often wins like this get overlooked by the general pessimism everyone seems to have about the world. But through a lot of hard work, we gave someone living in a black mirror-style horror the start of being able to communicate again. Give it 20 years and I'm sure we'll have a standard box to stick on someone's head to let them communicate reasonably well (or at least enough to order a cold beer).

TaupeRanger 4y ago
Well part of the pessimism comes from overstatements of the effects of such research, as evidenced by your comment. There is basically zero evidence that this device provides better quality of life than the systems that already existed. This is essentially a fluff piece, likely financed by the company that made the system. Real breakthroughs are few and far between, and it's been like this for decades.
- filoleg 4y ago
  > There is basically zero evidence that this device provides better quality of life than the systems that already existed. IMO it is less about which purpose this specific device is used for, and more about what this breakthrough has the potential to enable us to do in the future, using this tech as the basis to build on top of (assuming it is proven a success and all the kinks are worked out). If there was a standardized "smart hat" that I could put on my head that would allow me to control my AR glasses in an efficient way, that would be crazy. Because right now, that's one specific concern regarding AR usability, since current solutions with buttons and touch surfaces and voice controls and making hand gestures are awkwardly inconvenient and feel clunky. UI/UX paradigm for certain consumer device categories completely shifts. A lot of accessibility problems get resolved. Hardware itself on a lot of consumer devices can become much simpler and more robust, since there is no need for much hand-driven interaction. And that's just a singular the most obvious example I could've thought of. There are plenty of potential amazing things that could be enabled by this tech, even if the specific use case for it that was presented in the article might not "provide better quality of life".
- goodells 4y ago
  I'd offer some pushback, from someone with hands-on experience. I'm a paramedic and work alongside other medics, nurses, and physicians who have seen a wave of change in evidence-based medicine over just the course of a few decades. Not everything is flashy and glamorous like a brain-computer interface. No press release that makes it to the top of HN is going to talk about the choice of isotonic crystalloids or sedation agents on intracranial pressure, but we're making great strides, even if by definition "marginal" ones. Modern resuscitation is like nothing I have ever seen before. Over the past 100 years, we have gained an almost complete understanding of cardiac electrophysiology, acid-base balance, hematology. In the worst-case scenario that you get hit by a car in a major US city, you will likely have TXA forced into your bloodstream through an intravenous catheter within 13 minutes to counteract the body's incorrect hyperfibrinolytic reaction. Your heart rhythm will be constantly analyzed and treated according to ACLS which has essentially been studied and modified to death by the AHA in a gradient descent pattern - we're stuck in a local minimum where the antidysrhythmic of choice alternates between amiodarone and lidocaine. When you arrive at the hospital, a FAST ultrasound scan will be performed where the culmination of materials science and informatics comes together to quickly identify blood in the retroperitoneal space without incurring the logistics of getting a trauma patient into a CT scanner. All this while a neurologist checks 12 of your cranial nerves and someone checks the tone of your rectal sphincter - because evidence shows us this is an important sign. In the case that you have an intracranial bleed, you'll be followed with MRI (which I'm convinced is the closest we've gotten to Star Trek scanner technology) to identify the penumbra of a stroke based on the deoxygenation of hemoglobin. We can now scan a variety of elements with magnetic resonance spectroscopy besides just precessing hydrogen atoms, which is helpful in identifying neoplastic lesions without the daunting task of a brain biopsy. Not everything is gloom-and-doom at the financing of some big company.
  - manholio 4y ago
    That contains so much jargon that it has to be 100% legit. The rectal sphincter tone though.
    - goodells 4y ago
      I can try to break it down for an uninitiated audience. "isotonic crystalloids" - Solutions such as normal saline used to restore volume proportionally to the bloodstream and intracellular spaces (as opposed to hypotonic or hypertonic, isotonic solutions just match the normal blood's osmolality) "sedation agents" - The patient is out, you keep 'em out, ideally without tanking their blood pressure. Different than paralysis. "electrophysiology" - Electrical conduction through the heart. "acid-base balance" - Various chemical processes and enzymes in the body only work well within a certain pH range, and long-term, only a narrow pH range is compatible with life. "hematology" - Blood and its components, including the cascade of enzymes and clotting factors involved in coagulation. "TXA" - Tranexamic acid - An anti-anti-clotting agent, which stops the body from breaking down blood clots. In the context of trauma, it allows your body to form the needed clots to avoid imminent exsanguination. "ACLS" - Advanced Cardiac Life Support - The AHA algorithm for identifying and treating life-threatening heart rhythms that most paramedics, RTs, nurses, etc. and above are trained on. In practice, this means that an unresponsive patient or code situation can be run to a certain standard with the staff who are immediately summoned in any clinical area of any hospital within about 30 seconds. "antidysrhythmic" - In the ACLS algorithms, it's a drug (usually a potassium channel blocker or sodium channel blocker or both) that acts on the cardiac action potential to do something that tends to make lethal dysrhythmias stop and return to a normal sinus rhythm. How exactly, you'd need to ask a cardiologist or specialized pharmacist. "FAST [ultrasound] scan" - Focused assessment with sonography for trauma - it's just an ultrasound of the flank area to detect blood around the kidneys ("retroperitoneal space") which has a high mortality rate and usually requires emergency surgery. "cranial nerves" - Your brain can communicate with the rest of your body either through your spinal cord, or through the cranial nerves which are direct interfaces for things like smell, sight, tongue movement, etc. Checking these is an important part of determining of a brain injury or spinal cord injury is present. "rectal sphincter tone" - If it's present, then it's unlikely that spinal cord injury above a certain level has occurred. "intracranial bleed" - It's bleeding, in your brain. "magnetic resonance spectroscopy" - The original MRI technique was based on spinning all the hydrogen atoms in your body such that they aligned head to toe, then detecting electromagnetic induction in a coil as they were jarred back and forth at a megahertz frequency. Nowadays, we can do this with other atoms like phosphorus in the same way. "precessing" - The pattern of relaxation of an atom similar to a spinning top where it goes from the aforementioned align orientation (forced by a strong magnet to align head to toe), and gradually relaxes to its random orientation while spinning at the Larmor frequency (megahertz frequency of the corresponding type of atom). "penumbra" - The border between healthy living brain tissue and dead brain tissue at the outside territory of a brain injury post-stroke. "neoplastic" - Uncontrolled cell growth, similar to cancer except not all neoplasms are cancer, some are benign tumors which will never be able to metastasize/spread to other parts of the body.

TaupeRanger 4y ago

Not much. This probably only marginally improves a patient's quality of life beyond what we were already capable of providing with existing systems. It's better than nothing of course, since you made a general point about medical research, the life expectancy of the average American has only gone up 5 years over the past 40 years (excluding declines due to COVID).

uniqueuid 4y ago
I would strongly disagree. The decreasing life expectancy in the US is probably, ahem, largely attributed to a medical system that is not particularly well-optimized for boosting mass life expectancy (despite being world-class in absolute quality of care, I assume). If you look closely, past decades have brought immense breakthroughs such as - the first completely synthetic new antibiotic - dramatic improvements in spatial and temporal resolution of imaging systems (MRI, PET etc.) - actually useful robotic assistance for surgery - easy, simple, and widespread techniques that are nevertheless life-saving, including a broad awareness for important events such as cardiac arrest and stroke - much better, faster and more accurate laboratory work, down to the DNA level And that's only a fraction of it which a layman such as myself can come up with from the top of my head!
- TaupeRanger 4y ago
  Unless those things help people live longer or better (with scientific evidence to show such an effect) they are interesting developments with no actual impact on patients. Do people treated with surgical robots live longer or better? Has the synthetic antibiotic helped average patients live longer or better? So far, we only see very marginal improvements, and at massive, constantly increasing costs.
sterlind 4y ago
I'm struggling to understand what you mean. Finally being able to communicate strikes you as "only marginally" improved? You really don't think that being able to talk to family, say that you're in pain, ask for an audiobook, helps much at all? And then you mention life expectancy, which is quantity of life.