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Orthopedics, Technology

“Intelligent” liner may improve prosthetic limb fit and function

0984-FieldsRuns200.jpgWhen I lived in the triathlete town of San Diego and tagged along for fun with a group who trained, a kind young man always gave me an encouraging word or high-five as he zoomed past me while running or cove swimming. He has a prosthetic leg, and although the device that helps him move around was clearly functional, and even sounded springy on the pavement, I wondered if a small shift in alignment could cause a great deal of discomfort.

This thought came back today as I came across news about an “intelligent” liner for better-fitting prostheses. A prototype of the device, which is being developed by researchers at the University of Southampton, uses sensors to detect pressure and forces at the point of contact between a patient’s stump and the prosthesis. Information on limb loading could lead to a better fitting and perhaps self-adjusting prosthesis, according to a release, which also notes:

There are 50,000 lower-limb amputees in the UK, most of whom use artificial limbs that are attached to the residual limb through a socket. No two stumps are exactly the same shape and size and even an individual’s stump can change shape over the course of a single day.

Pain, discomfort and ulceration are frequently experienced at the socket interface due to poor fit. This stems from the excessive build-up of pressure within the limb socket (causing high ‘loads’ on the stump).

Synthetic liners, worn like a sock over the stump, provide some cushioning against the hard socket, but at present there is no convenient way to accurately measure the critical loads at this interface in the clinic. Without this information, prosthetists face difficulty in fitting replacement limbs and the outcomes for patients are variable.

According to the non-profit Amuptee Coalition, nearly two million people in the United States live with limb loss.

Previously: Stanford graduates partner with clinics in developing countries to test low-cost prostheticBiotech start-up builds artful artificial limbs and Two Stanford students’ $20 device to treat clubfoot in developing countries
Photo by U.S. Army

Science, Technology

Survey says: Americans split on the future of science

Mechanics of Time TravelIf you’re feeling sciencey, check out a Pew Research Center survey completed with Smithsonian Magazine and released yesterday. You’ll see the percentage of Americans surveyed who would welcome or dismiss personal robots servants, driverless cars or other futuristic possibilities, given the options.

piece published on the blog re/code reports:

Asked what inventions they most want to take advantage of themselves, participants repeatedly landed on three themes: Medical strides that extend human longevity, flying cars or personal space crafts, and time travel.

On the other hand, nearer realities like robot caregivers, face computers, genetic engineering and drones seem to give a lot of people the heebie-jeebies. Among the findings:

  • 65 percent think it would be a change for the worse if lifelike robots become the primary caregivers for the elderly and people in poor health.
  • 63 percent think it would be a change for the worse if personal and commercial drones are given permission to fly through most U.S. airspace.
  • 53 percent think it would be a change for the worse if most people wear implants or other devices that constantly show them information about the world around them.

What do you think?

Previously: Using personal robots to overstep disabilityHelping the public make sense of scientific research and Hey, president-to-be: What are your views on science?
Via Kara Swisher
Photo by Bob Owen

Events, Medicine and Literature, Medicine and Society

Intersection of arts and medicine a benefit to both, report finds

Intersection of arts and medicine a benefit to both, report finds

An article today on Cleveland.com notes that, at least in Northeast Ohio, collaboration between medicine and the arts benefits both camps as well as the region’s economic health. A preliminary report from the non-profit Community Partnership for Arts and Culture looks at ways art and medicine enrich one another in Cleveland and provides recommendations for enhancing those partnerships. From the news piece:

The report identifies four principal ways in which the art and medicine intersect productively:

• The use of arts and culture in medical settings;

• Participatory programs that involve patients and communities in activities and therapies that promote positive medical outcomes and general wellness;

• The potential shown by arts and culture to serve as a rallying point from which public health and social equity can be addressed; and

• The enrichment of medical training.

Meanwhile, at Stanford, art and science lovers prepare for this evening’s Medicine and the Muse symposium, featuring author Khaled Hosseini, MD. Stay tuned for a recap on Scope next week.

Previously: Stanford’s Medicine and the Muse symposium features author of “The Kite Runner”, Literature and medicine at life’s end and Thoughts on the arts and humanities in shaping a medical career

In the News, Neuroscience, Technology

Facial expression recognition software could predict student engagement in learning

Facial expression recognition software could predict student engagement in learning

bored faceTest day approaching? Get your game face on. A study of a computer program that recognizes and interprets facial expressions has found that identifying students’ level of engagement while learning may predict their performance in the class. Computer scientists at the University of California, San Diego and Emotient, a San Diego-based company that developed the facial-recognition software used in the study, teamed with psychologists at Virginia Commonwealth and Virginia State universities to look at “when and why students get disengaged,” study lead author Jacob Whitehill, PhD, researcher in UC San Diego’s Qualcomm Institute and Emotient co-founder, said in a release.

The authors write in the study, which was published in an early online version in the journal IEEE Transactions on Affective Computing:

In this paper we explore approaches for automatic recognition of engagement from students’ facial expressions. We studied whether human observers can reliably judge engagement from the face; analyzed the signals observers use to make these judgments; and automated the process using machine learning.

“Automatic engagement detection provides an opportunity for educators to adjust their curriculum for higher impact, either in real time or in subsequent lessons,” Whitehill said in the release. ”Automatic engagement detection could be a valuable asset for developing adaptive educational games, improving intelligent tutoring systems and tailoring massive open online courses, or MOOCs.”

Previously: Looks of fear and disgust help us to see threats, study showsProviding medical, educational and technological tools in Zimbabwe and Whiz Kids: Teaching anatomy with augmented reality
Photo by Jesús Gorriti

Autism, In the News, Pediatrics, Research

Using theater’s sensory experiences to help children with autism

Using theater's sensory experiences to help children with autism

Gesamkunstwerk, my favorite German word and a term commonly associated with the operas of Richard Wagner, can be translated as a “total work of art” playing to many of the senses and synthesizing numerous art forms. The word came to mind as I read about a pilot study using theater as an environment for children with autism-spectrum disorders  to explore “communication, social interaction, and imagination skills – the ‘triad of impairments’ seen in autism,” a New Scientist piece notes, “engaging all the children’s senses at once.”

Twenty-two children ages 7-12 attended one weekly 45-minute session for 10 weeks involving improvisation exercises led by trained performers in enclosed make-believe environments such as a forest or outer space.

From the piece:

As well as looking at whether behaviours used to diagnose autism changed after the drama sessions, the researchers also assessed emotion recognition, imitation, IQ and theory of mind – the ability to infer what others are thinking and feeling. Subjective ratings were also gathered from parents and teachers and follow-up assessments were conducted up to a year later.

At the early assessments, all children showed some improvement. The most significant change was in the number of facial expressions recognised, a key communication skill. Nine children improved on this. Six children improved on their level of social interaction. The majority of these changes were also seen at the follow-up assessments.

The project’s lead psychologist, David Wilkinson, PhD, at the University of Kent, told New Scientist, ”It’s an opportunity for children to create their own narratives in an unconstrained, unfamiliar environment.” He continued, “They find this empowering, and we know from the psychology literature that individuals who are empowered enjoy increased attention skills and an improved sense of well-being.”

Previously: Making museums more inviting for autistic children and their familiesStanford study reveals why human voices are less rewarding for kids with autismDirector of Stanford Autism Center responds to your questions on research and treatment and A mother’s story on what she learned from her autistic son

Behavioral Science, Ethics, Medicine and Society, Research, Stanford News

Breaking down happiness into measurable goals

Breaking down happiness into measurable goals

sunflowersSo you want to be happy. Can you be more specific? A study published in the Journal of Experimental Social Psychology found that concrete, rather than abstract, goals for happiness tend to be more successful. Jennifer Aaker, PhD, Stanford social psychologist and marketing professor, and colleagues performed six field and laboratory experiments and found that participants who performed specific acts of kindness – such as recycling or making someone smile – reported greater happiness than participants whose prosocial goals were less precise – such as helping the environment or people more broadly.

From a Stanford News article:

The reason is that when you pursue concretely framed goals, your expectations of success are more likely to be met in reality. On the other hand, broad and abstract goals may bring about happiness’ dark side – unrealistic expectations.

Acting directly and specifically in service to others brings greater happiness to the giver, the study found. The piece continues:

For example, an experiment involving bone marrow transplants focused on the whether giving those who need bone marrow transplants “greater hope” – the abstract goal – or giving those who need bone marrow transplants a “better chance of finding a donor” – the concrete goal – made a giver more happy.

The answer: Helping someone find a donor resulted in more happiness for the giver. This, the researchers wrote, was driven by givers’ perceptions that their actual acts better met their expectations of accomplishing their goal of helping another person.

Previously: Study shows happiness and meaning in life may be different goalsAre you happy now? Stanford Roundtable spotlights the science of happiness and wellbeing and Stanford faculty and students launch social media campaign to expand bone marrow donor registry
Photo by Iryna Yeroshko

Aging, Stanford News, Technology

Stanford Center of Longevity announces dementia-care design challenge winners

Stanford Center of Longevity announces dementia-care design challenge winners

Winners have been announced for Stanford Center on Longevity‘s first Design Challenge, which launched last fall. As previously written about on Scope, 52 teams representing 31 universities in 15 countries submitted entries, all of them centered on improving the daily lives for people with dementia as well as their families and caregivers.

Stanford News reports:

There were seven finalists, including one student team from Stanford.

Sha Yao from the Academy of Art University in San Francisco won the $10,000 first place prize for her project, “Eatwell,” which involved the design of tableware specifically for people with Alzheimer’s.

For example, blue was chosen as the color of the insides of bowls because dementia sufferers can become confused when food and bowl have similar colors, according to Smith. As spills are common when bowls are tipped to get the final bits out, Yao designed a slanted bottom that eliminates the need to tip. The cups have low centers of gravity and are difficult to knock over.

The piece describes runner-up prize winners and the center’s new design contest, themed “enabling personal mobility across the life span.”

Previously: Finalists announced for Stanford Center on Longevity’s Design Challenge and Soliciting young minds to help older adults

Grand Roundup

Grand Roundup: Top posts for the week of April 6

The five most-read stories this week on Scope were:

Stanford bioengineer develops a 50-cent paper microscopeManu Prakash, PhD, assistant professor of bioengineering, has developed an ultra-low-cost paper microscope to aid disease diagnosis in developing regions. The device is further described in a technical paper.

Music box inspires a chemistry set for kids and scientists in developing countries: Manu Prakash has also developed a chemistry set that can be built with materials costing about $5. The device won a contest from the Gordon and Betty Moore Foundation and the Society for Science & the Public to “Reimagine the chemistry set for the 21st century.”

Blood will tell: In Stanford study, tiny bits of circulating tumor DNA betray hidden cancers: A blood sample may one day be enough to diagnose many types of solid cancers, or to monitor the amount of solid cancer in a patient’s body, researchers in the labs of Stanford radiation oncologist Maximilian Diehn, MD, PhD, and hematologist and oncologist Ash Alizadeh, MD, PhD, have shown.

Art and anatomy: Decades-old collaboration brings augmented reality into the hands of Rodin: Stanford’s Cantor Arts Center launched a first-of-its-kind exhibit, “Inside Rodin’s Hands: Art, Technology, and Surgery,” which uses 21st Century technology to look inside the works of Rodin’s 19th Century sculptures.

Bad news for pill poppers? Little clear evidence for Vitamin D efficacy, says Stanford’s John Ioannidis: A large study of vitamin D led by John Ioannidis, MD, DSc, found that more well-designed studies and trials are necessary before firm conclusions can be drawn about its efficacy.

And still going strong – the most popular post from the past:

What are the consequences of sleep deprivation?: Brandon Peters, MD, an adjunct clinical faculty member at the Stanford Center for Sleep Sciences and Medicine, explains how lack of sleep can negatively affect a person’s well-being in this Huffington Post piece.

Humor, Neuroscience, Research, Stanford News

Looking at how a child’s sense of humor takes its shape

Looking at how a child's sense of humor takes its shape

girl2Where does a child’s sense of humor come from? That depends on how you define humor and where you look to find it. A recent blog post from the Cognitive Neuroscience Society reports:

Humor can be a very complex and hard concept for some kids to grasp, said [Jessica Black, PhD,] of the Graduate School of Social Work Boston College, speaking yesterday about her poster on this new work at the CNS meeting in Boston. It requires people to both detect and resolve incongruities and to find amusement – involving many regions of the brain, including those that process cognitive computations and those that process emotions.

Black and others, including Allan Reiss, MD, the study’s director, and Pascal Vrticka, PhD, both of Stanford, studied how different brain regions were activated as children watched a video with funny, positive or neutral content. Twenty-two children ages 6 to 13 were asked to rate their ability to create and appreciate humor. Then, researchers examined their brain activity using fMRI scans.

The CNS blog post continues:

In general, the researchers found greater brain activity in children who rated themselves low on the sense of humor scale. The systems related to detecting incongruities and those involved in language and working memory had to ramp up to process the funny videos, as did the arousal network that is usually more active when processing negative emotional information. Interestingly, the brain activity related to social processing was lower in these children, suggesting perhaps more difficulty in being able to think about the mental state of others.

Their results suggest that children with a low sense of humor may require more cognitive effort to process humor, Black said. The data also imply that children with a low sense of humor may experience stress and increased levels of arousal during social interactions involving humor.

Previously: A closer look at the way our brains process humorHumor as a mate selection strategy for women? and Making kids laugh for science: Study shows how humor activates children’s brains
Photo by Maria del Carmen Gomez

Medical Education, Medicine and Society, Stanford News

Studying the humanities to address “the messiness of human life”

Studying the humanities to address "the messiness of human life"

Life’s problems and people are often complex, ambiguous and soft to the touch. This holds true even in the medical sciences and professions that require precision in data collection and analysis; critical thinking skills and a broad, flexible world view are therefore necessary components of a balanced education. The School of Medicine‘s dean, Lloyd Minor, MD, explains in a recent op-ed for the Stanford Daily why anyone invested or even interested in medicine should pay attention to the humanities.

From the piece:

Consider the child with autism or the adult with Alzheimer’s disease. A physician can make a diagnosis but cannot offer a cure or a satisfying answer to the question “why?” Even for conditions that we can prevent or treat, patient behavior can significantly impact the success or failure of an intervention. For the hypertensive patient, no amount of prescribed medication will impact the social factors that may be inhibiting lifestyle modification. The specificity of scientific interventions does not account for the messiness of human life.

We as physicians heal best when we listen to and communicate with our patients and seek to understand the challenges they face in their lives. The perspectives on illness, emotions and the human condition we gain from literature, religion and philosophy provide us with important contexts for fulfilling these roles and responsibilities.

Previously: Becoming Doctors: Stanford med students reflect and share experiences through podcastsThoughts on the arts and humanities in shaping a medical careerEncouraging alternative routes to medical school and Stanford dean discusses changing expectations for medical students

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