The future of medicine

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BIONIC PROSTHETIC

A bionic eye sounds like science fiction, but a 3D printer created this prototype in an hour, bringing the promise of a seeing prosthetic that much closer to reality.

PHOTOGRAH BY REBECCA HALE

USEFUL DNA ORIGAMI

Bioengineers have made nanoscale tetrahedrons, bunnies, and more by folding DNA into origami. They enter the desired shape into an algorithm that determines how to bend a long DNA strand, or scaffold, into twoand three-dimensional shapes held together by shorter DNA pieces. Other molecules studded along the scaffold’s surface give it its function, like ferrying medicine or gene editing tools to a particular part of the body. MIT’s Mark Bathe says the “holy grail” of DNA origami would be a structure that can cross the bloodbrain barrier that now keeps many drugs from reaching the brain. —Theresa Machemer

PHOTOGRAPH BY ERIK BENSON AND BJÖRN HÖGBERG, KAROLINSKA INSTITUTET

KEEPING AN EYE ON HEALTH

Forget the finger-prick blood test. The race is on to create contact lenses that track glucose levels from tears. South Korean researchers have been able to attach transparent, flexible electronics that won’t block vision while wirelessly relaying electricity to run glucose sensors. —Eve Conant

PHOTOGRAPH BY KIM KYOUNG CHAE, UNIST

ROBOT UNFOLDS, GOES TO WORK

A new wrinkle in origami robots is rectangular, packs a tiny magnet, and folds accordion-style to fit in a pill-size case perfect for swallowing. Now in testing, the robot unfurls in the gut to grab and remove an ingested button battery or patch tissue harmed by its presence. —Lori Cuthbert

PHOTOGRAPH BY JASON DORFMAN, MIT CSAIL

A PATCH THAT READS DEEP

This wearable patch, smaller than a postage stamp, keeps the beat—heartbeat, that is. It measures blood pressure deep within the body by emitting ultrasonic waves that pierce the skin and bounce off tissues and blood, feeding data back to a laptop. —Eve Conant

PHOTOGRAPH BY CHONGHE WANG AND SHENG XU, UC SAN DIEGO

A MUSICAL MILESTONE

In most nations, premature births—at or before 37 weeks—have risen in the past 20 years. Leaving the nourishing confines of the womb too early can result in complications and often leads to a stay in a hospital’s neonatal intensive care unit (NICU).

At University Hospital in Geneva, Switzerland, music is folded into the care plan for some preemies. But unlike other NICU music programs, this novel project features three specific songs, which babies listen to through special headphones made for tiny, fragile heads. The songs are part of an ongoing study that aims to understand how music affects a preterm newborn’s brain and how well it can recognize melody, tempo, and pitch—skills likely related to language processing.

Developed by neonatologist Petra Huppi, researcher Manuela Filippa, and composer Andreas Vollenweider, the project involves scanning babies’ brains via MRI as they listen and comparing the scans to those of babies who were not exposed to the music. The songs—short and “much simpler than Mozart,” says Huppi—were composed to help the infants fall asleep, wake up, or interact.

Further research will assess the full benefit of this therapy, but early findings are promising. MRI scans reveal improved brain connectivity, and the songs appear to support the daily rhythm of sleeping and waking—key to thriving in a noisy NICU and the world beyond. —Catherine Zuckerman

PHOTOGRAPH BY CRAIG CUTLER

POWER THERAPY FOR THE BRAIN

The use of electricity as medicine has come far since the first cardiac pacemaker. Implanted electrodes, visible in this x-ray, deliver electric pulses known as deep brain stimulation (DBS). These “brain pacemakers” have effectively treated conditions including obsessivecompulsive disorder and Parkinson’s disease and are being tested in Alzheimer’s patients to improve focus, memory, and judgment. A Cleveland Clinic study of DBS to spur stroke recovery has shown promising results. A 2015 stroke robbed a patient of function on her left side—but after months of physical and occupational therapy and DBS, she plays catch with her grandkids and even threw the opening pitch at a Cleveland Indians game. —Patricia Edmonds

PHOTOGRAPH BY OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER

READING THE WHITES OF OUR EYES

A smartphone app in development at the University of Washington could help diagnose pancreatic cancer by checking the whites of the eyes for signs of jaundice. Snap a selfie and the app would use it to spot elevated bilirubin levels, a possible sign of the disease. —Lori Cuthbert

PHOTOGRAPH BY REBECCA HALE

3D PRINT REMEDIES

Many artificial limbs still begin with a plaster cast. Transforming that mold into a socket that comfortably fits the residual limb is an expensive and halting process—if you’re lucky enough to live near a trained prosthetist. Many amputees worldwide don’t have access to prosthetic limbs. Mobile phones and 3D printing may offer a solution, says Albert Yu-Min Lin, a National Geographic explorer who lost part of his leg in 2016. Phone cameras could scan residual limbs, providing measurements to professionals with 3D printers, who would produce matching low-cost sockets to be shipped to amputees all over the world. —Christina Nunez

PHOTOGRAPH BY BRUNA BORTOLATO

BETTER PROSTATE CANCER ANALYSIS

High-grade prostate cancers can be lethal, low-grade cases may need only monitoring—and both may benefit from recent advances at the Cleveland Clinic. One research team found that patients with a testosterone-based genetic anomaly had different responses to certain drugs, which could open the way to personalized treatments. Other researchers developed a new blood test that predicts prostate cancer risk more accurately than existing tests; it could dramatically reduce the need for biopsies and the treatment of cases unlikely to be lethal. —Patricia Edmonds

 

FLUORESCENCE DELINEATES THE PARTS OF THESE PROSTATE CANCER CELLS. THREE-COLOR CONFOCAL IMAGE: JAMES HAYDEN, WISTAR INSTITUTE

THE SHARP EYES OF AI

Correctly identifying the cancer cells in a lung tissue sample (left) is key to successful treatment. It’s also an ideal diagnostic use of artificial intelligence. In one study, the same AI that Google uses to identify objects online was trained to recognize forms of cancer. It then found two forms in a tissue sample (right) as accurately as a human could, in seconds. AI also has been used to model the precise dosage of a cancer drug to shrink tumors but cause minimal toxic side effects. —Lori Cuthbert

For the sample at left, AI produced the analysis at right, showing normal lung tissue (gray) and two forms of cancer: adenocarcinoma (red) and squamous cell carcinoma (blue).

TISSUE IMAGE BY CANCER GENOME ATLAS

ROBOTIC SUPPORT

For patients with severe mobility problems such as partial paralysis, scientists are developing robotics that enfold and support like an exoskeleton. The devices are programmed to guide the body through motions—such as helping a stroke victim walk—that can rebuild posture and strength. —Natasha Daly

PHOTOGRAPH BY MARCEL VAN DEN BERGH

MAGAZINETHE FUTURE OF MEDICINE

12 innovations that will revolutionize the future of medicine

Analytics-enabled, individualized attention will not just treat disease, but increasingly, prevent it.

8 MINUTE READ

BY DANIEL KRAFT

This story appears in the January 2019 issue of National Geographic magazine.

I WOULD NEVER have met Harriett were it not for our mutual friend, Linda. I’m a physician in Northern California; Harriett’s a communications executive in New York City. Linda co-founded an online personal genomics company, to which Harriett and I each sent our genetic information for analysis.

Linda introduced us after she saw that Harriett and I had something in common: a rare type of mitochondrial DNA, which meant we were distantly related. It turns out that we also share that genealogy with a prehistoric celebrity: Ötzi the Iceman, whose 5,300-year-old frozen corpse was discovered in the Alps in 1991. For fun, I even started a Facebook group for people with the same DNA variant as Ötzi and Harriett and me.

USEFUL DNA ORIGAMI

Bioengineers have made nanoscale tetrahedrons, bunnies, and more by folding DNA into… Read More

PHOTOGRAPH BY ERIK BENSON AND BJÖRN HÖGBERG, KAROLINSKA INSTITUTET

I tell this story to make a point. Harriett and I met over a feat of biomedical science—mass-market, low-cost gene analysis—that once was unimaginable and now is commonplace. The convergence of digital technologies and social platforms made it possible for us to learn our genotypes and share what we found out with the online universe.

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Since then, we’ve seen an explosion of tech-driven gains and innovations that have the potential to reshape many aspects of health and medicine. All around us, technologies from artificial intelligence (AI) to personal genomics and robotics are advancing exponentially, giving form to the future of medicine.

The innovations I describe here—many of which are still in early stages—are impressive in their own right. But I also appreciate them for enabling the shift away from our traditional compartmentalized health care toward a model of “connected health.” We have the opportunity now to connect the dots—to move beyond institutions delivering episodic and reactive care, primarily after disease has developed, into an era of continuous and proactive care designed to get ahead of disease. Think of it: ever present, analytics-enabled, real-time, individualized attention to our health and well-being. Not just to treat disease, but increasingly, to prevent it.

BLINK AND THERE’LL BE A BIONIC EYE

Building a bionic eye has many challenges, but researchers may have just solved one of… Read More

PHOTOGRAPH BY REBECCA HALE

In the old model of medicine, patients’ health data was collected only intermittently, primarily in clinic visits, and scattered among paper files and siloed electronic medical record systems. Today there’s a far better option: personal technology that can monitor vital signs continuously and record health data comprehensively.

AN EXPLOSION OF HEALTH DATA

Just how fast is the growth of health-related data? A report from the Stanford University School of Medicine put it this way: “The sheer volume of health care data is growing at an astronomical rate: 153 exabytes (one exabyte = one billion gigabytes) were produced in 2013 and an estimated 2,314 exabytes will be produced in 2020, translating to an overall rate of increase [of] at least 48 percent annually.”

Just a decade after the first Fitbit launched the “wearables” revolution, health tracking devices are ubiquitous. Most are used to measure and document fitness activities. In the future these sensing technologies will be central to disease prevention, diagnosis, and therapy. They’ll measure health objectively, detect changes that may indicate a developing condition, and relay patients’ data to their clinicians.

Flexible, electronic medical tattoos and stick-on sensors can take an electrocardiogram, measure respiratory rate, check blood sugar, and transmit results seamlessly via Bluetooth. It’s mobile vital sign tracking, but at a level once found only in an intensive care unit.

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Hearing aids or earbuds with embedded sensors will not only amplify sound but also track heart rate and movement. Such smart earpieces also could be integrated with a digital coach to cheer on a runner, or a guide to lend assistance to dementia patients.

Smart contact lenses in the future will be packed with thousands of biosensors, and engineered to pick up early indicators of cancer and other conditions. Lenses now in development may someday measure blood sugar values in tears, to help diabetics manage diet and medications.

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