Category Archives: Health Online

Beware of Politics

Who thought science was free from politics? Science consumes millions of tax payers’ money each year. Often based on polished applications, on decision from people inexperienced in the field. Ideally, the best scientific proposals should be funded. In reality, it is often about who knows who and who can market the proposal the best. Sadly, approving successful science can be a step up the career ladder in politics. A situation which can lead to projects based on shaky but eye-catching scientific evidence being put forward. Good science makes for good publicity.

The other side of the same coin is that bad publicity can lead to science being rejected. Even good science. One of the projects suffering collateral damage from the ongoing crisis at Karolinska Institutet is the joint biobank effort, BBMRI, which suddenly had its funding suspended, pending investigation of how funds have been used.

One beneficial outcome of the KI crisis is a more sceptic position among funding bodies, and stricter oversight of scientific funding. Let’s hope BBMRI can support its spending, and save us from Politics in Science!

New Accelerator for eHealth

Health2b, a new accelerator has started in Lund in collaboration with Lund Life Science Incubator, Startup Studio Malmö and Healthy Habits. During three months the participants will take part in an intense series of activities lead by a team of mentors.

Lund has a previous high focus on IT and life Science, so eHealth is a natural step for focused activities.

The Worlds Largest Imaging Project – Take2

UK Biobank has now launched the second phase of its imaging study.

In a £43m project, 100.000 of the 500.000 previous participants will be contacted again and asked to undergo a set of scans of their internal organs. The UK Biobank imaging facilities consists of a DEXA (Dual Echo Ray Absorptiometry)scan, ultrasound and two MRI cameras, or 3 and 1.5 Tesla, respectively. Conventional X-Ray and CT scans are not taken, to avoid exposing healthy people to unnecessary radiation.

The pre-study for the imaging project (already the largest imaging study in the world) took part in the imaging facilities in the main headquarter in Stockport, but for the large study, two more imaging facilities will be used.


The study is planned to take at least six years to complete. The largest expected benefit is the possibility to combine information from the imaging scans with data previously taken; blood, urine and saliva, and with patient records for the years to come. Having scans available from before a person caught on a decease is a rare opportunity when it comes to analyzing causes and risk factors.

What if a yearly scanning procedure would be available from your GP as a part of a standard health check-up – perhaps in combination with a one-off genetic screening?
What if it would be possible to use the results of such a scan, in combination with conventional medical tests to predict the risk of coronary heart decease or stroke with some certainty?

The future seem not far beyond the horizon.

Stand Up for Science

standupforscience  A number of Societies and Organizations, together with a few universities helped Voice of Young Science (VOYS) and Sense About Science sponsor the “Standing Up for Science Media Workshop” today, April 8 2016. Among the sponsors was my old acquaintance, the Biochemical Society and so it happened I had an occasional notification on mail a few weeks back. I was in the need of some new material for the blog, But busy as one is during the last months of an education, I still hesitated to go. Another workshop? As if I hadn’t got enough excuses to avoid writing on my thesis already. Then after some days decision anxiety, I put in the application. After all there are worse ways to waste one’s time. At the very least, it would give me the opportunity to clear my brain among fellow scientists. I also recently got involved as a mentor to two engaging end very inquisitive students from the
British Science Association journalism competition, frequently picking my brain over mail. But sometimes I felt that their questions and my answers were not always on the same course. I could not help thinking I could use some help in how to better explain my research to a journalist. So I went. If nothing else, there would be a free lunch…

It turned out to be a day way above expectations.

The event took place at Manchester University and attracted young scientists from both UK and the rest of Europe. The workshop itself consisted of a combination of workshop and panelist discussion with both scientists, experienced in media communication, and with science journalists.

Personally for me as a young scientist, I found the straight forward advice from the scientists to be the most useful take-home of the day. (After the free lunch of course!) The overall message is really quite simple:

  1. Don’t be afraid of media or public contact. Any publicity is good publicity and the general public has a short memory for your failures – even if you don’t.
  2. Be prepared to be harassed. If in a hostile environment, prepare your message in advance, focus on that and say only what you came there to say.
  3. Answer questions truthfully and to the best of your ability, but only if you want to. Learn to deflect ignorant/unwanted/irrelevant/provocative questions. You are not obliged to answer anything!
  4. Remember – you are the expert!

A full list of the advice compiled by Chris Peters (Sense about science) can be found at the bottom of this page, and also check out these tips in The Guardian. All good and sound advice, not only for communicating science .

The need to communicate science efficiently is certainly not a new issue. Popular Science journalism plays a large part in communicating science to a wider audience and indirectly plays a large part in promoting the interest in STEM (Science, Technology, engineering and Math) subjects. Just a few days ago,  The Wellcome Trust launched the second phase in their project to investigate the effects in Informal Science Learning, Science Learning+.

Let’s hope they are aware of projects like VOYS and Sense About Science, whose staff had the excellent habit of keeping the participants updated both before and after the workshop, filling my mail box with a bunch of useful links to projects, both their own and others, and tips of how to get involved.

See this page for some pictures, this page for some more pictures and a short summary of the day. Sense About Science Media Workshops are open to all postgraduates, are free to attend and are a recurring event since 2011. Do you want to attend of find out more – Click here!


 Speak about science in the media cheat sheet

–        Pick the message you want to get across and don’t be afraid to repeat yourself

–        Keep it brief & simple

–        Have your notes handy

–        Know when to say “I don’t know”

–        Avoid over-extrapolating too far beyond what the data say (in a paper).

–        Talk to your press office

–        Ask politely for recognition of your institute/team etc

–        Ensure the facts are conveyed (e.g. evolution) even if they’re obvious to you

How a Squid Can Improve Your Health

Neurosquid

It is advertised as the first “Neurosquid Review Conference“. The First of what I wonder? The First in the World? In the country? The First to be advertised by the MedTechWest perhaps? There is no way of telling. I am not an expert on Neurosquids, but I check out some of the illustrations on the ad. It looks scientific enough. With lots of body cut-throughs displaying inner organs and sketchy drawings of human bodies with cables sticking out of them in strategic places. Not just scientific. Medical Science. Yummy – this is right up my alley. And there will be lunch – that settles it – I’m going! At the very least, I will get to satisfy my curiosity and find out what a Neurosquid is.

Said and done, at the date in question, feb 9 2016, I step into the Sahlgrens Aula at the Sahlgrenska University Hospital in Gothenburg, trying my best to look as if I belong. Scanning the room for the lunch buffet, while at the same time keeping an eye on the far corners, hoping to spot The Squid.

There is no squid and my disappointment is almost total. It turns out a neurosquid is just a little measuring gadget for small magnetic currents. how cool is that? But as the day passes by with one presentation after the next, my fascination for the subject increases. The conference seem to be largely a club for internal admiration: almost everybody know each other, even though the participants come from research groups all over the world. Some of the talks go way over my head, but a few of them have a more digestible approach. All of them have one thing in common: They all work way beyond the research front.

  • Where do you regularly come in contact with quantum mechanics in your everyday life?
  • What is one of the most common use of nanotechnology today?
  • Why does most hospital machines measuring your bodies magnetism have to be so bulky?The answer is not The Matrix. The NeuroSQUID answers all of those questions.

SQUID stands for Superconducting Quantum Interference Device and is the most common detector of weak magnetic fields that exists. It was invented in 1964 and is in use today in hospitals in MRI cameras and MEG (magnetic encephalogram). The SQUID itself consists of a superconducting loop, interrupted by a thin insulating layer, which is called a Jospehson Junction. In the absence of an external magnetic field, electrons will tunnel through the insulating layer, creating a small base current, equally divided between the two branches of the loop. But in the presence of an external magnetic field, an additional current will flow through the loop, slightly changing the base current. The change can be measured as an electric signal and voila – we have measured the magnetic field. Today, SQUIDS are routinely used in hospital environment to measure brain activity of for magnetic imaging of the body or brain, using MRI (Magnetic Resonance Imaging). It can be used for schizophrenia research, diagnosis of epilepsy and for evaluation of neural damage after stroke of physical trauma.

So back to the topic of the day – why do those machines have to be so big that the patient needs to crawl into the machine instead of having the sensor placed on or inside the body? After all a SQUID is small – about half a millimeter across the loop. What do you remember from physics class about super conductors? The have to be cryogenically refrigerated! So, in addition to the sensor, we also need a huge cooling system, with fumigating and expensive storage tanks, safety procedures to keep liquid nitrogen from escaping, not to imagine the cost of producing and delivering and administering the coolant. Is there not a better way? This is the questions these groups were trying to answer – using the phenomenon of high critical temperature superconductors. There are a few elements, which experience superconducting properties at room temperature. Why they do so is still an open question in physics, but if we could make sensors out of those instead, science would have a whole new way to approach neurological measurements. They could be done in your home, on the move, of maybe (and why not), implanted in your scull.

No, we are still not talking about The Matrix. For starters, REAL scientists have much cooler outfits – AND they get free lunch.

Journals coming online!

Writers Cramp

The time of Miracles has not yet passed. In 2016, swedish medical journals are coming online, accessible for patients, doctors or caretakers through the e-Health portal 1177.se. By coincidence (or maybe not?) the region first to offer this service – Norrbotten – has among the lowest population density in the country. When performing a risky experiment, to limit the risk by exposing a small subset of individuals, before targeting the entire population. Good thinking, Norrbotten! Worst case, a substantial part of medical staff may end up in Forensic Psychiatry – one way or the other … at least if we are to believe Jeanette:

Source: eHealth Innovation Centre, Luleå University of Technology & Norrbotten County Council

Doctors – get online!

Medica 2015 has now come to an end. Among the activites was the Medica Connected Healthcare Forum, where (among other things) a mobile app competition took place. Out of 10 apps, 1 were for improved monitoring of severe medical conditions, 2 for communication in different forms for people with disabilities, and 7 were for patient-doctor communication and general health improvement purposes, such as SmokeWatchers and Oviva Coach.

Apps for purposes midway between entertainment, sports and healthcare have exploded in the last few decades – As useful and fun as they may be, how many of those do we actually need today, when 1 out of 3 people in this world lack even the most basic form of healthcare? Apart from being unworthy of a world with both global satellite systems, global communications systems and global transportation system, a global thinking in health systems is an economic issue. WHO estimates that better use of preventive measures [in healthcare] could reduce the global burden of disease by as much as 70%.

One of the apps in the competition stands out, from a global health perspective: The Doctome, developed by MedTrix. It is a mobile app which facilitates communication between patient and healthcare personel, at any time, any day, from any part of the world. For now, this app is limited to areas with electronic health record systems, that is – the industrially developed part of the world.

In developing countries, even in areas where copper-line phone contact is not available, mobile phones are the main connection with the outside world. Imagine then, if a global use of mobile phone connection could be implemented, to provide increased contact with basic healthcare. Instead of providing leasure care for the part of the world which allready has excellent health systems, there is a possibility of providing a reasonable level of medical care for many more. Technicians – Let’s get together to get ALL the world online!

Intensive Care

Information Exchange Medical Software

Tuesday, November 3, 2015, 20 representatives for a number of companies with interests in medical technology gathered in Jonsered, Sweden for to exchange what we knew about managing software projects in this environment, a meeting facilitated by Mediteq Forum
(mediteq.se/mediteq_forum.html)
.

The site for the venue was the beautifully located Jonsereds Herrgård, now operated by Gothenburg University. The day was not the best, with the fantastic view from the front porch somewhat diminished by heavy rain clouds, and the water in the taps being unsuitable for drinking due to an incident at the nearby waterworks. Luckily, the participants were all informed of this fact upon arrival, and adequate replacements in the form of tea and coffee were provided.

jonsered
Art by: Anna Leida

Some of the questions we wanted to discuss were:
In what way is software a part of the companies products?
How is the process managed and what problems are faced?
What tools are used?
What can we learn from each other?

The majority of the participants were software developers or project managers from companies providing medtech solutions, where software is only part of the deliverables. A few came from pure software companies, who also provide solutions for medtech. The structure of the meeting was a short update on latest information from representatives for Mediteq, after which a discussion between the participants followed, with some opportunity for mingling. The discussion focused on points of IT security, testing procedures, tools, risk and requirements analysis and the fulfillment of governmental requirements and international standards.

One point of major interest was the latest information on the standards IEC 62304:2015
and TR 80002-1:2009, and the latest on the not yet published IEC 82304. Some discussion take place along the system definition and classification of medical software, where the 2015 addition to 62304 is helpful in its definition. Most participants agreed that it is very hard to classify any software, used in a medical environment as A, C being the most common. The reason for this is that probability is not included in the risk classification, only the severity. In other words, if an application can cause severe injury to a patient, it will always be classified as C, no matter how unlikely the incident is, and even if the system requires failure on several levels in order to cause that injury.Sometimes it may be possible to separate systems into parts, after which the least critical parts could be classified as A. But in practice, the extra effort in separating the system is questionable, if the majority of the software is in any case undergoing scrutiny as class C. (A useful explanation by the classification system is given by Mitch).

One of the more useful outcomes was a survey among the participants resulting in a list of the most popular tools for process management (published below). The general opinion was that this meeting was very useful, both as an opportunity to exchange tips-and-tricks and to network. For many of the participants, this was a rare opportunity to exchange information with colleagues in the same field, and an opportunity which, sadly, does not come around often enough through other channels.


 

Most popular tools among the participants

For Requirement Management we used:
– Jira
– TFS
– DOORS
– Caliber

For Implementation we used:
– LabView
– TFS/Visual Studio
– GIT
– SVN
– StarTeam
– Enterprise architecture

For Verification we used:
– PC-Lint (statical code analysis)
– CppUnit (unit test)
– NUnit (automatic systemtest)
– TFS/Test Manager

For Release we used:
– GIT
– SVN
– StarTeam

For Change Management we used:
– StarTeam
– Jira
– PDMlink
– TFS

A New Medical Landscape

sickbed
The medical field is by tradition and necessity a highly conservative business, and as such has been one of the last to adopt highly integrated computerized solutions. Probably with good reason given the critical systems involved. Robust systems of high quality does not come about by themselves, but are a product of adequate resources, efficiently put to use.

Both Sweden and the UK are countries where a discussion around these issues has started to yield concrete results. A new law on biobanking and an action plan for the implementation of an e-health system in the former, a strategy for Life Science in the latter. In 2014, three Swedish institutes, LIF, Swedish Medtech and Sweden BIO, concluded that quality in individual systems was usually sufficient, but that coordination between systems and organizations was missing. An action plan was devised. In UK, the situation is somewhat improved by the presence of a national healthcare system, the NHS, making it possible to launch nation wide research and healthcare collaborations such as the UK Biobank.

Clear is that the new technological environment will bring a new possibilities in healthcare, but also changes in how we work. How does this new environment patient, the researcher, the medical personnel and the provider of technical services? The technician will suddenly be an important part in a traditionally non-technological field. What will that require in terms of people skills, risk assessment and ethical thinking?

As a Swedish citizen, working for several years in the UK on the fence between medicine, biology and technology, I take a particular interest in some of the differences between their respective national systems, against the backdrop of European and Global policies, trying to bring to light some of the opportunities and challenges facing us. At the same time, I will try to share my knowledge in this field.