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Slide#29
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The human genome project is expected to cause an explosion in the number
of laboratory tests that will be medically useful for diagnosis. The 30,000
anticipated single nucleotide polymorphisms will result in the discovery
of many proteins associated with disease. Many of these tests will appear
in hand held analytical systems such as this device (pictured) from Clinical
Microsensors and Motorola life sciences. The analytical testing paradigm
will change from single SNP and protein analysis to panels of analytical
tests. This graph simply shows an upward trend but is not intended to be
a forecast of actual numbers. |
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Slide#30
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The human genome project has taught us that the relationship between genes
and proteins is not going to be as simple as we originally envisioned.
A typical separated plasma specimen will require the clinical laboratory
to determine the pattern of protein distribution in order to diagnose protein
based diseases and to diagnose complex disease states with multiple etiology.
Genomics will be used to predict the response to medications by allowing
us to phenotypically stratify patient populations. The examination of multiple
genes and gen-gene interaction (or epistasis) will provide statistical
predictions of disease. |
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Slide#31
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Recently we published papers in Hypertension and the Proceedings of the
National Academy of Sciences (PNAS) that describe the identification of
multilocus genotypes that associate with high-risk and low-risk of hypertension.
We found, using disequilibria methods, that interactions of genes at different
loci are more important than any single gene in isolation as risk factors
for hypertension. These multilocus genotypes can be compared using a new
mathematical method ? multifactor dimensionality reduction. |
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Slide#32
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In order to rapidly perform multigene interactions, we are creating a biochip
array that combines the hybridization surface with a built in spectrofluorimeter
to allow high throughput analysis in a clinical setting. |
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Slide#33
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In the Medical Automation Research Center (MARC), we are developing some
new technologies to supply specific laboratory needs in the molecular genetics
and proteomics field. For example, we have completed the construction of
an automated freezer that allows automated retrieval of 93,000 specimens
in a standard ?80C freezer. In order to prepare specimens for freezing,
we are developing a pre-analytical processor. We have also developed a
biorepository robot that automates many of the tasks associated with preparing,
storing, retrieving, and analyzing specimens. The freezer and processor
will become components of the biorepository. |
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Slide#34
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The challenges faced by our medical system is to maintain the safety, quality
of life, general health, and the dignity of our elders. One can maintain
a high quality of life by preserving the social group and maintaining mobility
(driving and walking). Good general health is a result of preserving a
sense of well being and monitoring for the onset of chronic illness. |
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Slide#35
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The MARC eldercare program is focusing on technologies that preserve mobility,
personal health, and provide enriched socialization. We feel that smart
habitats will allow us to integrate many of these technologies into a working
system. |
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Slide#36
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To aid in mobility enhancement, Dr. Wasson in the MARC has developed a
smart walker equipped with a laser scanner that instructs the front wheel
how to steer away from dangerous obstacles, and instructs the walker when
to apply the brakes. Handle sensors determine the user’s level of anxiety
and desired path. The walker will only help the patient when it senses
that assistance is needed. |
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Slide#37
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Many elder focused health care technologies are complicated and too difficult
to use for most elders. For example, the CyberCare portable teleconferencing
system allows real time consultation with health professionals from within
the home. When a vital sign has to be monitored, then the CyberCare device
accepts a number of physiologic monitoring devices. |
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Slide#38
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These technologies require a sophisticated user to properly apply and calibrate
the equipment, for example the thermometer, blood pressure monitor, stethescope,
and pulse oximeter. The unit also accepts input from an electronic scale. |
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Slide#39
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Integrated health sites will allow the patient and health professional
to converse and examine health data together at a lower cost than an office
visit. However this interface is not simple enough for the average elderly
person to use. |
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Slide#40
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The home based diagnostics market will require a novel technology. In the
MARC, we are developing a passive self directed health and quality of life
monitor that passively gathers physiologic data. This system is coupled
to a data interpretation system that allows for personal health improvement
and ultimately health intervention only if necessary. |
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Slide#41
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Here is an example of a proximity monitoring system that determines daily
movement activities. Seven sensors are placed in a typical home that can
detect the subjects motion over time. |
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Slide#42
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The motion data is gathered automatically and send to a centralized computer.
Data mining algorithms detect normal patterns and compare these to abnormal
patterns over many weeks and months. |
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Slide#43
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If the system detects the possibility of arthritis in the knee, the user
is presented a simplified interface to self diagnose the problem. |
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Slide#44
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The future challenge for successful deployment of automation in either
the laboratory, hospital, or home will be an affordable price, standardized
mechanics and electronic interfaces, availability of quality service and
support. For the elderly in particular, reliable operation requiring no
supervision, and ease of use will be important. If technology is not cost
justified with adequate clinical trials to determine health outcome measures,
it will not succeed in the marketplace. |
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Slide#45
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I would like to thank all the professional 30 members of the MARC team
for their dedication to the projects in the MARC and to the field of medical
automation.
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