Medtech to Thanos: We Have a Better Way to Save the Universe

The recent box office hit Avengers: Infinity War inspired us to explore the main villain's motivation for wiping out half the universe. Could medical technology solve these global problems in a more ethical way?

  • In the recent box office hit Avengers: Infinity War, the film's main villain, Thanos, is on a mission to wipe out half the world's population in an effort to restore balance to an overpopulated universe. While Thanos' methods are obviously immoral, overpopulation and distribution of resources are very real problems with consequences from a public health perspective.

    Fortunately, medical technology can address at least some of the problems caused by overpopulation, without resorting to mass destruction. 

  • Telemedicine

    Telemedicine solutions are one way that medtech is already addressing overpopulation, in a sense, because these technologies enable resources to be shared across distances and in places that are underserved. This tele-ultrasound system from Royal Philips is one example.

    Philips partnered with Innovative Imaging Technologies (IIT) to integrate IIT's Reacts collaborative platform with the Lumify portable ultrasound from Philips. The technology enables clinicians around the world to connect in real time by turning a smartphone or tablet into an integrated tele-ultrasound solution, combining two-way audio-visual calls with live ultrasound streaming.

  • Devices for Resource-Challenged Regions

    During a visit to a rural clinic in Uganda, an assistant professor of bioengineering at Stanford noticed an expensive centrifuge device being used as a doorstop. Upon further inquiry, Manu Prakash learned that the device was useless to the clinic because there was no electricity to run it.

    A centrifuge is a device that separates blood components and makes pathogens easier to detect, and the technology is especially important in developing countries where diseases like malaria, African sleeping sickness, HIV, and tuberculosis are most prevalent. A typical centrifuge spins fluid samples inside an electric-powered, rotating drum. As the drum spins, centrifugal forces separate fluids by density into layers within a sample tube. In the case of blood, heavy red cells collect at the bottom of the tube, watery plasma floats to the top, and parasites, like those that cause malaria, settle in the middle.

    "There are more than a billion people around the world who have no infrastructure, no roads, no electricity," Prakash said. "I realized that if we wanted to solve a critical problem like malaria diagnosis, we needed to design a human-powered centrifuge that costs less than a cup of coffee."

    Prakash and his team ended up building a new type of centrifuge using just 20 cents of paper, twine, and plastic. The design was inspired by classic spin toys such as yo-yos, tops, and whirligigs.

    "One night I was playing with a button and string, and out of curiosity, I set up a high-speed camera to see how fast a button whirligig would spin," Bhamla said. "I couldn't believe my eyes."

    The whirligig button rotated at 10,000 rpms to 15,000 rpms, he said.

    The researchers mounted a capillary of blood on a paper-disc whirligig and were able to centrifuge blood into layers. It was a definitive proof-of-concept, but before he went to the next step in the design process, they first had to study a whirligig to figure out how the toy actually worked.

    Bhamla recruited three undergraduate engineering students from MIT and Stanford to build a mathematical model of how devices work. The team created a computer simulation to capture design variables like disc size, string elasticity, and pulling force. They also borrowed equations from the physics of supercoiling DNA strands to understand how hand-forces move from the coiling strings to power the spinning disc.

    Next, the researchers were able to create a prototype with rotational speeds of up to 125,000 rpm, a magnitude significantly higher than their first prototypes.

    "From a technical spec point of view, we can match centrifuges that cost from $1,000 to $5,000," Prakash said.

    The team also tweaked the device's safety and began testing configurations that could be used to test live parasites in the field. From lab-based trials, they found that malaria parasites could be separated from red blood cells in 15 minutes. And by spinning the sample in a capillary pre-coated with acridine orange dye, glowing malaria parasites could be identified by placing the capillary under a microscope.

  • Smartphone-Enabled Diagnostic Devices

    A few years back, a team of researchers led by Samuel Sia, an assistant professor of biomedical engineering at Columbia University designed a new diagnostic device that works in tandem with a smartphone to detect major infectious disease markers like HIV from a single drop of blood in just 15 minutes.

    The device is designed to replicate all mechanical, optical, and electronic functions of a lab-based blood test. More specifically, it performs an enzyme-linked immunosorbent assay (ELISA) without requiring any stored energy, as all necessary power is drawn from a smartphone.

    The device performs a triplexed immunoassay in a single test format, testing for HIV antibodies, treponemal-specific antibodies for syphilis, and non-treponemal antibodies for active syphilis infections. The device was designed to be both small and cost-effective, partnering with either a smartphone or computer in an effort to make it more effective in areas with limited resources.

  • Nanotechnology Meets AI

    An Austin, TX-based molecular data company, Nano Global, is developing a chip in partnership with Arm, a leading semiconductor IP company. According to Nano, the technology will help redefine how global health challenges such as superbugs, infectious diseases, and cancer are conquered.

    The system-on-chip (SoC) will yield secure molecular data that can be used in the recognition and analysis of health threats caused by pathogens and other living organisms. Combined with the company's scientific technology platform, the chip leverages advances in nanotechnology, optics, artificial intelligence (AI), blockchain authentication, and edge computing to access and analyze molecular-level data in real time.

    “In partnership with Arm, we’re tackling the vast frontier of molecular data to unlock the unlimited potential of this universe,” said Steve Papermaster, chairman and CEO of Nano Global. “The data our technology can acquire and process will enable us to create a safer and healthier world.”

    Papermaster told MD+DI that the chip will present a way to turn the world into the laboratory, rather than taking samples of the world and sending them to the lab. "And that really is a fundamentally different approach to being able to access, monitor, analyze and even impact every form of life function from detecting and controlling infectious disease to chronic conditions and diseases like cancer ... but even into, eventually, areas like agriculture, crop management, and the basic environmental wellness of air and water," he said. "That's obviously a very broad reach, and it doesn't happen overnight."

    Because the scope of this technology is so broad, Papermaster said artificial intelligence is a necessary component of the chip. Training an AI engine on the chip is the only realistic way to be able to process and analyze what's happening at the point of contact with reality, he said. Over time, Papermaster envisions that the chip will be embedded into everyday objects like clothing, toys, and medical devices. Everything that today is still "dumb," he said, meaning anything that exists on its own and is not yet a connected device.

    "Over time our chip will light these things up and enable them to be smart," Papermaster said.

    For example, he said a product that comes into contact with a patient's skin could be enabled to detect an infection, identify what kind of infection it is, and determine how it should be treated. Perhaps, he said, there would be something embedded into a wound bandage that could be released based on the information the chip interprets. Such a product could be particularly useful in remote areas where healthcare resources are limited, he said.

    "This combination platform is really taking it to the world directly instead of sampling the world to bring it inside a lab," Papermaster said.

    Partnerships with organizations like Arm are a fundamental part of Nano's business model. Arm's IP is the basis for Nano to build on top of, according to Papermaster. 

    Despite a number of impressive developments being made to address antibiotic-resistant bugs and other major health challenges of our time, Papermaster said, "the reality is we're not winning."

    That's why, he said, Nano is trying to take a step back and think about new approaches and tools that could fight these large-scale problems.

  • Tech-Enabled Contraceptives

    Technology-enabled contraceptive devices, like this wireless remote-controlled contraceptive developed by MicroCHIPS with funding from the Gates Foundation, could go a long way toward addressing overpopulation.

    The proposed device is projected to deliver a daily dose of 30 micrograms of levonorgestrel, an already-approved female contraceptive, for 16 years.

    The company first demonstrated its individual microreservoir technology in a paper in the journal Science Translational Medicine, "First-in-Human Testing of a Wirelessly Controlled Drug Delivery Microchip." In that study, human parathyroid hormone fragment [hPTH(1-34)], the only approved anabolic osteoporosis treatment, was programmed to be delivered in escalating doses to osteoporotic postmenopausal women for 4 months. The controller was wirelessly programmed to release doses from the device once daily for up to 20 days. In the abstract, the authors reported that device dosing produced similar pharmacokinetics to multiple injections, and had lower coefficients of variation.

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