The Smart Magazine About Medical Technology Innovations
The Next Generation Training
In this issue, you’ll read about how integrating augmented and virtual reality into medical training can be tremendously helpful for trainees. With healthcare training becoming increasingly high-tech, medical simulation centers are the new classrooms of the 21st century.
Smart bed, smart pad, smart pillow, smart headband… The “sleep tech” market is booming. In this edition, we also go over the burgeoning range of ever-smarter devices that is now available to help users manage their levels of “vitamin Z.” And to keep you up-to-date on the latest industry trends, we’re giving you a taste of what happened at the recent HIMSS conference in Las Vegas and the ECR congress in Vienna.
Integrating virtual reality (VR) and augmented reality (AR) into medical training means trainees can practice procedures over and over again and achieve a superior surgical outcome.
In medical training, certain practices become so familiar it’s hard to imagine an alternative. A cadaver on a slab that students study...
The “sleep tech” market is booming. A growing array of gadgetry targets sleep-conscious consumers.
Most of us understand the importance of a good night’s sleep. Yet in today’s constantly connected world, filled with demands, deadlines, and drama, getting enough pillow time can be a real challenge. It is therefore not surprising that the so-called “sleep tech” market is booming. With New York-based research outfit Persistence Market Research valuing the global sleep aid market at $31 billion by 2025, a burgeoning range of ever-smarter devices is now available to help users manage their levels of “vitamin Z”.
With subtle differences between our varying sleep stages, accurately tracking sleep is no easy task. Yet personal sleep devices now go way beyond a smartphone equipped with an app and accelerometer.
Nokia has just unveiled Nokia Sleep, described as an “advanced sensor” incorporated into a smart pad. The pad, which connects via Wi-Fi, is inserted under the mattress and records the user’s sleep patterns. This data is then relayed to Nokia’s Health Mate app for analysis and the generation of a so-called “sleep score”. With the sensor’s algorithms trained on clinical data from polysomnography tests, it can also track snoring patterns.
Nokia Sleep is an “advanced sensor” incorporated into a smart pad. (Courtesy of Nokia)
One of the most useful features of Nokia Sleep is that it also integrates with the automation app IFTTT, allowing other connected domestic devices to be customized to the user’s sleeping habits. “The system can be configured so that lights dim and the room temperature lowers once the user falls asleep, or the blinds open on waking,” said Audrey Rampazzo, UK brand and channel marketing specialist at Nokia Health.
“The system can be configured so that lights dim and the room temperature lowers once the user falls asleep.”
Mattress pads might seem like a more comfortable way to monitor sleep than wristbands, but critics point out that restless sleepers could receive inaccurate data if they lose contact with the pad during the night. Placed under the side of the mattress at chest level, the Nokia Sleep can supposedly distinguish the user’s movements and vital signs from anyone else sharing the bed.
Those who don’t want to use bracelets or pads to keep tabs on their snoozing can choose from a plethora of other options. The iX21 smartpillow from German company ADVANSA incorporates sensors which monitor the user’s sleep cycles.
“Sensor data is sent to a smartphone app which then offers ‘personalised coaching’ on how to improve sleep quality,” said Etienne Fradin-Beaugerie, a technical leader overseeing the iX21 Smart pillow project. “An intelligent wake-up system also rouses the user at the best possible time within their sleep cycle.”
Levels of “Vitamin Z”
A growing range of sleep tech now boasts active sleep management as well as passive monitoring. Sleep Number’s 360 smart bed, which is equipped with an array of pressure sensors, adapts to the user’s every move, automatically modifying the contours and firmness of the bed during the night, while an adjustable base inclines the head upwards if snoring is detected. There are automated foot warmers and under-bed lights, while each night over 4 million biometric data points are sent to an app for analysis.
Sleep Number’s 360 smart bed is equipped with an array of pressure sensors. (Courtesy of Sleep Number)
“In the near future we envision that such analysis will allow the identification of flu and other diseases, and enable remote medical monitoring outside of hospitals,” explained Pete Bils, Sleep Number’s Vice President of Sleep Science and Research.
Studies suggest that deep (or slow wave) sleep plays a key role in determining how alert and focused the human brain is. The SmartSleep headband from Philips uses two sensors to detect periods of deep sleep, then plays fixed frequency tones to extend their duration.
“We use advanced algorithms, developed with leading sleep experts and neurologists, to generate these audio tones,” said John Frank, CEO of Philips Sleep and Respiratory Care. “In trials 70 percent of chronically sleep-deprived users who tried SmartSleep for just two weeks reported feeling less tired during the day.”
The Dreem headband emits subtle sounds into the user’s inner ear to boost deep sleep. (Courtesy of Dreem)
The Philips device will be competing with the Dreem headband from San Francisco-based startup Rythm, which uses electroencephalography electrodes and an in-built computer to monitor and analyze brain activity. The device then emits subtle, precise sounds directly into the user’s inner ear to boost deep sleep. The company claims that Dreem can enhance deep sleep quality by 32% and leave users feeling 88% more rested and alert when they wake up.
A Rest Revolution
The influence of smart gadgetry on human sleep is likely to continue its upward trend. Many experts predict that advances in artificial intelligence, technology, biology and neurology will one day enable us to “sleep hack”, enhancing our rest time to boost wellbeing and productivity. And as the role of such digital devices increases, so sleep will become an increasingly personal, micro-managed affair.
Healthcare training is becoming increasingly high-tech and medical simulation centers are the classrooms of the 21st century.
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Medication didn’t help. Talk therapy didn’t help. But a digital avatar did. For a group of schizophrenic patients suffering from voice hallucinations for years, a new type of therapy seems to have helped.
In a clinical trial, researchers from King’s College London created a digital avatar in collaboration with each patient to represent the voice they heard in their head. Using computer software, they were able to create a voice that resembled the one the patient heard and put a face to it. Over the course of six sessions, the therapist then gave voice to the avatar and was able to converse with the patient in a Skype-like conversation as if the patient were talking to the voice.
“At first, the patient is usually very frightened of the voice and will curl up in the chair and look away from the avatar,” explained professor Tom Craig, one of the study’s authors. However, as the patients got more comfortable with the avatars they were able to confront the voices.
Do You Hear What I Hear?
The avatar therapy was able to reach a level of understanding that therapists weren’t achieving with traditional therapy. “You see the patient interacting with the thing they’re afraid of in an immediate way, right in the moment, and as a therapist that gives you tremendous new insight,” Tom Craig added.
Many patients told researchers that it was the first time anyone had been able to hear what they heard, and that they felt it was the first time a doctor really understood them. It also meant the therapist could see how each patient interacted with the voices and in later sessions make the voice seem less powerful so the patient could stand up to it. “The idea that the voice no longer has that power is something you’d never achieve just by talking to the patient,” Tom Craig said.
Digital avatars (Courtesy of King’s College London)
Eventually, the therapist was able to formulate what the voice meant to the person, and often the voice stemmed from a traumatic experience in their life. For one patient, the voice resembled a demeaning relationship with his parents, always putting him down. During one session, the therapist had the voice apologize for its behavior and that seemed to break the spell for the patient who was finally able to stand up to the voice and say how much it had hurt him. After that breakthrough, the voices decreased then stopped.
More Research Needed
Eighteen months later the therapist ran into the patient who said he never heard the voices again. Remarkably, the majority of the 75 patients who received avatar treatment reported a significant reduction in the frequency of hearing voices and the amount of stress it put on them. Six months later the patients remained improved. However, the control group who simply received supportive counseling experienced similar improvement which is something the researchers wanted to look more into.
The majority of the 75 patients who received avatar treatment reported a significant reduction in the frequency of hearing voices.
Al Powers, a clinical instructor in psychiatry at Yale University specializing in schizophrenia and psychosis, found the avatar trial interesting. “It’s an encouraging finding because it means that there could be a way to take a non-functioning group and help them not only decrease the frequency of the voices but also the stress and the feeling that the voices are omnipotent,” he said.
Avatars have also been used by researchers from Montpellier University in the treatment of schizophrenia, though their study focused on creating a full-body avatar of the patients themselves. Other studies are using virtual reality games to put the therapist in the mind of someone suffering from psychosis. “Avatar therapy is a novel approach that hasn’t yet been tested rigorously. It’s the first positive trial and a lot more work needs to be done,” said Al Powers.
Not for Everyone
Avatar treatment is not for everyone though. Some patients were too scared of their voices and declined to participate, while some therapists were too uncomfortable having to criticize the patient using the avatar’s voice to realistically replicate the experience. But for a group of patients, the avatar treatment improved their lives.
“When I hear the voice now, I talk back to it. Before, I didn’t know I could do that,” one of the patients, who wished to remain anonymous, said after the study. “The voices are still there but I have more fight. I can’t ignore them but I can suppress them and they accept it when I say ‘piss off’.”
The Norwegian company No Isolation created what is believed-to-be the world’s first telepresence robot in order to overcome the forced isolation of children undergoing medical treatment.
When three young Norwegian engineers decided to put their skills together to build a company, they thought it should contribute to making “the world a little bit better with the help of technology.” Cue the idea of No Isolation: “to help vulnerable groups living in social isolation,” explained Anna Holm Heide, the company’s chief communications officer.
The engineers imagined an avatar who could sit in the classroom instead of the sick children.
In August 2016, they launched their first product, AV1, “the world’s first telepresence robot.” AV1 allows children to remain socially engaged in their daily life despite their illness.
Engineers sat with children for several sessions to understand their needs and adjust their responses. “User experience is a huge part of our process,” added Heide. Children mentioned that they really missed school. So the engineers imagined an avatar who could sit in the classroom instead of the sick children.
AV1 is operated by standard tablet. With a swipe to the tablet, the robot’s head turns 360 degrees so the user can see and hear everything going on around it. The child speaks through the proxy to interact with the class, and a light indicates when the robot wants to “raise its hand.”
The device weighs 900 grams and can fit in a backpack. It comes with 4G and WiFi to allow the sick child’s friends to take it with them everywhere. It is made entirely of hard plastic. “I sort of wished that we had more broken robots coming back to us because that would mean that kids were bringing it around a lot,” said Heide. “[Kids] seem to respect [the robot]. They are very responsible, they are good at picking it up and including it.”
AV1 with student (Courtesy of No Isolation)
The robot allows users to have full control over something in their lives at a time when they are losing control. The target group, however, is both broad and complex. From immune system deficiency, or cerebral palsy, to chemotherapy treatments, the groups all suffer from different conditions. This is why the robot’s degree of interaction can be modified. The patient can also decide to remain passively present—he or she can let the class know by simply turning on a blue light on top of AV1’s head.
“The robot was designed to fully respect the user’s privacy and safety.”
In addition, “the kids using the device were very clear that they did not want to be visible, they did not want others to see if they were having a bad day,” clarified Heide. The robot was designed to fully respect the user’s privacy and safety, with live streaming and encryption on both ends. Only the children concerned have access to the activation code. And “the kids and the parents agree that only the kid will look at the screen,” added Heide.
In countries where No Isolation is present—Norway, Sweden, Denmark, the Netherlands and the UK— the machine is also available to rent. More than 350 robots are currently being used.
“Our new product is a communication tool targeting senior citizens with no technical or digital skills,” explained Heide. This tool, KOMP, was launched in December 2017. No Isolation intends to propose a new solution every year to fight isolation, each time for a different target group. They also want to become a global company and expand into North and South America. “We see that this issue is so universal,” said Heide.
Wheelchair users who endure overheating problems when sitting in their chairs for long periods of time can now relax with a new cooling cushion that just arrived on the market.
It’s an all too common problem for wheelchair users: their bodies become overheated when sitting for long periods of time with little air circulation around their backs. However, a solution that regulates body temperature has been introduced thanks to the efforts of Belgian-born Corien Staels.
With the aid of the fan the cushion not only cools the back, but reduces the user’s core temperature.
In 2015 Staels first developed her wheelAir cushion after seeing how her Glasgow University supervisor, who used a wheelchair, become overheated. She started her company Staels Design in 2016 to further develop the product and has received significant funding to bring it to production.
After witnessing the problem of overheating, Staels also discovered that those with spinal cord injuries had to cool themselves off in drastic and unforgiving ways. This included having to strap ice packs to their bodies or spray themselves with water hoses post-exercise. Soon it became apparent to her that overheating was not just a problem for those with immobilizing spinal cord injuries, but for all wheelchair users.
The patent pending wheelAir product is a specially designed supportive cushion that uses battery-operated inbuilt fan technology. Layers of breathable viscoelastic foam make up the cushion itself which is machine-washable and fits all self-propelled wheelchairs.
Taking Away Excess Heat and Moisture
The cushion fits heights from 300 mm to 450 mm and is available in a number of widths including 290 mm, 330 mm, 360 mm and 400 mm. The lithium battery lasts for up to 20 hours and is rechargeable via a micro USB charger. With the aid of the fan the cushion not only cools the back, but reduces the user’s core temperature by removing excess heat and moisture. This, according to the manufacturer, allows for instant comfort and better temperature control.
The wheelAir’s lithium battery lasts for up to 20 hours. (Courtesy of wheelAir)
So far, the product has generated a great deal of interest among wheelchair users and especially with Paralympic athletes. “We have already sold our first batch of 500 cushions in ten countries. They are all manufactured in Dunfermline, Scotland and retail for £650 each (740 euros),” Staels indicated.
Also for Truck or Taxi Drivers
There are four settings on the airflow system within the cushion to suit all situations and people. “We developed the cushion primarily for users of self-propelled wheelchairs. But they can also be used for truck or taxi drivers sitting long hours behind the wheel or indeed office workers,” Staels explained.
“However, at the moment, we are concentrating on the mobility market and have a number of new products coming that will help a lot more people. One of these is a higher tech version of the wheelAir cushion,” she added without revealing too many details about the cooling products to come.