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Students at Harvard Medical School have just launched Third Space, a quarterly literary magazine for the university community that highlights medically related creative work from students and faculty alike. The first edition is spectacular and full of intelligent humor and quality writing. The magazine also features an Art section. A sample from their comedy advice column, Chief Complaints: Do you think if I ask more questions in lecture everyone will know how smart I am? I'm worried that people don't know I read ahead last night! SmartEPants Dear SmartEPants, You have good reason to be worried. For all you know, your fellow students think you're an idiot, someone accepted to medical school because of political gaming or a computer glitch in the admissions office. Prove them wrong. When you use big words in section, don't just say them; spell them. If someone offers you a hat, politely accept it, then make a dramatic showing of struggling to fit it on your massive, knowledge-filled head. I'm not saying you should write your MCAT score on your forehead. That would be absurd, as no one will be able to see it there when you're busy at the front of the class. Instead, tattoo it to your neck, or have it screen-printed on the back of all the science competition t-shirts you should be wearing. In lecture, raise your hand, but not to ask questions — those are a sign of knowledge weakness. Instead, correct the professor, or provide semi-related or even unrelated scientific facts that you Googled the night before. No one will expect your comments to be relevant, because you should be sleeping in lecture, a sign that you have nothing to learn from class and need rest from the hours of studying you did the night before. Also, if you rub sand in your eyes they turn red so everyone knows you were working too hard for sleep. You'll thank us later. Third Space Link: Third Space...... Sean Duffy www.medgadget.com

Just when we thought auscultation couldn't get any more sophisticated than with the Littmann 3200 bluetooth stethoscope and the heart sounds analyzed by the Cardioscan software, Zargis Medical proves us wrong. They have just launched the ZargisTelemed platform, which streams the heart and lung sounds to anywhere in the world. The sounds are transmitted in real-time either over the internet or a private network allowing for remote diagnosis and expert opinions. It can be installed on a private server or accessed from Zargis' servers. The software is integrated with the Cardioscan heart sounds analysis software and the Zargis StethAssist heart and lung sounds visualization software. Press release: Zargis Launches Telemedicine System with Real-Time Transmission of Stethoscope Sounds... Product page: ZargisTelemed...... Wouter Stomp

2 years ago we reported on a protein folding game called foldit. In brief, the program is a game that allows you to manipulate a protein, and gives you more points the more "correct" your protein 3D structure is. The game then shares your results with other players so they can try and improve your protein structure and earn points themselves. At Games for Health 2010, one of the foldit concept designers presented a retrospective on how the game has fared over the past couple of years. When looking at the demographics of the user base, a large percentage of players had either no biochemistry training or just a class in high school. Surprisingly, many users are in the business and financial sectors. But the ultimate question lies in if all this gaming and protein folding is even worth it. That question was answered resoundingly in last year's CASP8 competition. In this competition protein sequences are handed out to various groups who then have to try and determine their 3D structure. The structures of these proteins are already known, so it is a great way to determine which protein folding methods are the best. At the end of the day foldit users beat automated protein-folding computer programs most of the time. Despite the non-scientific backgrounds of most users, foldit has led to correct protein folding solutions even when computers failed. Looking ahead, the designers want to expand the functionality of the program while streamlining its usage. To hasten the folding process, strategies that are used frequently by human users will be boiled down into "recipes" to automate certain parts of the folding process. In terms of widening the scope, the designers are toying with the idea of DNA binding, and the synthesis of enzymes, drugs, and vaccines. Download foldit and give it a try!... jhbarad

Serious game development company Grendel Games presented a very unique product today at Games for Health: A laparoscopy training game that has almost nothing to do with laparoscopy. To paint a clearer picture, last time we checked there weren't any mad scientists, robots, or goop that turn into monsters in laparoscopic procedures. However, this is exactly the point. The speaker, Tim Laning, boldly proclaimed "This is not a simulator, this is a seriously entertaining game." He went on to say while ultra-realistic laparoscopy simulators are effective and impressive pieces of technology, they are expensive and more importantly, they aren't fun. Residents don't seem to train as much on simulators as they should be. His solution is to create a game that gives the user the psychomotor training he needs to be an effective minimally invasive surgeon, while also being fun and interesting. The game is in an early prototype phase, and while it will be available for the Wii and the PS3 Move, only the Wii version was demonstrated. As shown in the picture, the hardware utilizes the Wii controllers to translate the motion of the laparoscopy tools to the game on-screen. In order to prove its effectiveness Grendel Games is piloting a study to compare people using their software, people using 3D simulators, and people with no training at all. While Grendel Games wants surgeons to train using their software, they are also targeting the retail market. They figure that young budding surgeons-to-be can get a head start and would be willing to shell out a little bit of extra dough for the unique hardware set-up. This idea is definitely an astonishingly unique take in the highly active field of minimally invasive surgery training. While the prototype is still too early to make any judgments, we worry that it might be a bit too out there for established surgeons and residents, and might be a little too complex for the average retail customer. We hope for the best for Grendel and will continue to follow this brilliant and innovative technology. Unfortunately, the demo wasn't working quite right. See a video of the simulator in action (somewhat) below: Link: Grendel Games... jhbarad

Chronically ill pediatric patients, such as kids with cystic fibrosis, are often overwhelmed by frequent and multiple tests and treatments. To cope with such stress, these patients sometimes turn to video games for relief. Dr. Peter Bingham, a pediatric neurologist, wondered if it would be possible to combine these tests and treatments with the fun and stress relief value of video games. With the help of the Robert Wood Johnson Foundation, he has developed two games for cystic fibrosis patients. A specific forced expiration, "huffing," is a valuable therapeutic technique that cystic fibrosis patients can use to clear their airways. The problem is that it is generally not carried out. Not only that, but sometimes these patients do not correctly perform pulmonary function tests, making it difficult to monitor their disease. Two pilot games were developed by his team to address this problem. The games are on a laptop connected to a spirometer. One game is called "Creep Frontier," where players wander around to collect treasure, but they have to "huff" to get obstructive and dangerous purple slime out of the way. The other game was a racing game where "huffing" refills the car's gas tank. Both of the games did not deal with the subject of cystic fibrosis directly to try and make the game feel less clinical. In a pilot study, more patients preferred the games over simple on screen instructions. The team is continuing to analyze data from the study to see long term effects, but the results look promising. Read the abstract in Clinical Pediatrics: A Breath Biofeedback Computer Game for Children With Cystic Fibrosis.... jhbarad

Medics in the Marine Corps and Navy have a new way to train with the Tactical Combat Casualty Care (TC3) simulator developed by Engineering & Computer Simulations of Orlando, Florida. The simulator complements course training in reinforcing the lessons learned. The simulator puts the user in the shoes of a medic in Afghanistan and presents various scenarios from a first-person perspective. In the demonstration, the medic was following behind his team when they came under attack. The threat was neutralized, at which point the user had to come in to survey the scene. One man was spurting blood rather alarmingly from his neck. A pressure dressing was applied, and after checking his pulse an IV was started. The next patient had a traumatic amputation of his forearms and was screaming and writhing in pain. After some calming words from the the user, the patient calmed down and a tourniquet was applied. Eventually, after all friendly and enemy combatants were accounted for and somewhat stable transport was called in, the mission ended. Feedback at the end of the mission let's you know if you did an adequate job, or it chastises you for actions you either did or didn't commit, and the system also refers you to the appropriate educational material for review. The simulator looked pretty cool and seemed like it could actually be fun. Early research has shown that the simulator was more effective that simple multimedia presentations in younger users. More research studies are on the way. An included mission editor allows instructors to tailor simulations and lessons to their curriculum. Product page: Tactical Combat Casualty Care (TC3)... jhbarad

As the imaging community rushes headlong into the effort to acquire 3D, or volumetric data, in real-time, considerably less effort is going into determining the best way to display that data in a way usable to physicians. Most displays simply mimic the 2D images most physicians are comfortable with, pulling those images from the 3D data sets. However, a group at the University of Arizona has been working on updatable holographic images that can display full 3D volumes. The team just published an analysis of the performance of these devices. From PhysOrg: In 2008, researchers from the University of Arizona created a holographic 3D display that could write and erase images, making it the first updatable (or rewritable) holographic 3D display ever demonstrated. The key to the display was a photorefractive polymer material, which enabled the researchers to take advantage of the potential of holography to a greater extent than previously allowed. Now, in a follow-up study, the researchers have reported the results of their analysis on the performance of the display, including how the polymer enables display enhancements and what more needs to be done before such displays can be widely used. More from PhysOrg: Researchers analyze performance of first updatable holographic 3D display... Abstract from IEEE/OSA Journal of Display Technology: Materials for an Updatable Holographic 3D Display... Dan Buckland

St. Jude Medical has just announced European approval of its Epiducer lead delivery device. The system is designed for use in the implantation of paddle leads, which are used in neurostimulation therapy to treat patients suffering from chronic pain. By making lead implantation possible through a single, minimally invasive incision, the Epiducer system improves on traditional, more invasive methods of lead delivery. From the press release: The Epiducer system allows physicians to efficiently place neurostimulation S-Series perc-paddle leads and/or multiple lead arrays utilized in spinal cord stimulation (SCS) therapy for the management of chronic pain. Before the Epiducer system, the placement of paddle leads was only possible through a laminotomy, a more invasive surgical procedure, which typically requires removal of part of the vertebral bone. Press release: St. Jude Medical Announces European Approval for Industry-First Neurostimulation Lead Delivery System for the Management of Chronic Pain...... Smit

Abbott has received the CE Mark and is now launching the TREK and the smaller TREK-MINI coronary balloon dilation catheters in Europe. The company is touting the ground-up redesign of the catheters, emphasizing the continuous smoothness of their surface that should help in getting the balloon to target. From the announcement: "The TREK system has a more seamless, transitionless design that allows for successful navigation to hard-to-access lesions, which is an important factor in treating patients with complex anatomy. In contrast, the designs of many balloon catheter systems include more abrupt junction points that can create resistance while trying to access complex lesions," said Julinda Mehilli, M.D., director of Clinical Research and Data Coordinating, Intracoronary Stenting and Antithrombosis Research (ISAR) Center, German Heart Center in Munich. "With the TREK system, blockages may be crossed smoothly and reliably even in vessels that are tight and challenging; lesions which were previously thought to be some of the most challenging may now be reached." The TREK family is a completely re-engineered line of balloon catheters, incorporating many advanced design and technology changes. The TREK system is available in two catheter designs, including the specialty catheter MINI-TREK™ for accessing smaller vessels. TREK is available in 77 sizes and in a wide variety of diameters (from 1.2 mm to 5 mm) and lengths (from 6 mm to 30 mm). It currently is available on a rapid exchange delivery system, and Abbott plans to launch a high-pressure version called NC TREK™ later this year. The TREK dilatation catheter is the delivery platform for Abbott's future generations of stent technology. Press release: Abbott Announces European Launch of TREK™ Catheter System, Representing an Advancement in Balloon Technology...... Michael

Covidien has globally launched the V-Loc 90 device, the newest in its line of V-Loc knotless wound closure devices. The first one, the V-Loc 180 was launched late last year. The devices use a uni-directional barbed thread which fixates itself in the tissue, with a loop at the start of the thread which anchors it securely at the beginning of the incision. Standard suturing techniques can be used, but without the need to tie knots to fixate the suture. This way tension is distributed more evenly and wounds can be closed more quickly than with conventional sutures. The V-Loc 180's suture material is completely absorbed in 180 days, while the V-Loc 90's thread is absorbed in 90 to 110 days. Press release: Covidien Expands V-Loc Family of Absorbable Wound Closure Devices for Knotless Tissue Repair... Product page: Covidien V-Loc...... Wouter Stomp

Boston Scientific has announced that its NC Quantum Apex coronary balloon catheter has received regulatory approval in both US and Europe. The company is releasing the product in Europe this week and in America next month. From the press release: The NC Quantum Apex Catheter is a high-performance, post-dilatation balloon catheter developed specifically to address physicians' needs in optimizing coronary stent deployment. It represents the next generation of balloon catheter technology, and is designed to deliver enhanced performance through the use of a new Bi-Segment™ Inner Shaft for improved trackability and a re-designed tip for greater flexibility(1). It is available in a wide array of balloon diameters from 2.0 to 5.0 mm, with balloon lengths ranging from 6 to 30 mm. The Monorail® catheter platform will be available worldwide and both the Monorail and Over-the-Wire (OTW) catheter platforms will be available in the U.S. Bruce Brodie, M.D., Interventional Cardiologist, Moses Cone Heart and Vascular Center, and Chairman, LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina, and Principal Investigator of the POSTIT study was one of the first physicians in the U.S. to use the NC Quantum Apex Catheter. "Results from the POSTIT clinical study showed that more than 70 percent of coronary stents are not optimally deployed by a stent delivery balloon alone," said Dr. Brodie. "The use of IVUS with an adjunctive post-dilatation balloon makes it twice as likely that a stent will be optimally deployed. The NC Quantum Apex Catheter is a great addition to the available post-dilatation balloons, making it easier for physicians to achieve optimal stent deployment." Press release: Boston Scientific Announces CE Mark and FDA Approval of NC Quantum Apex® Balloon Catheter...... Michael

Abbott Diabetes Care has announced 510(k) clearance of their new FreeStyle Lite blood glucose test strips, designed for use with the company's existing FreeStyle Lite monitors. The strips improve the safety of at-home blood glucose monitoring by eliminating the possibility of interference from non-glucose sugars in readings, which according to the FDA has resulted in hundreds of cases of insulin overdose due to erroneously high glucose readings. From the press release: The new FreeStyle Lite test strips do not use the GDH-PQQ enzyme, which can be affected by common non-glucose sugars. The new FreeStyle Lite test strips use a GDH-FAD enzyme which is unaffected by common non-glucose sugars, such as maltose or galactose, and minimizes the potential for other interference. The new FreeStyle Lite test strips are compatible with all FreeStyle Lite blood glucose monitoring systems, eliminating the need to switch meters. The FreeStyle Lite strips feature a new, easier-to-use ZipWik design tapered test strip that offers a better blood glucose testing experience. The new strips are designed to ensure faster blood application and to reduce the number of error messages and wasted test strips. Press release: Abbott Receives FDA Clearance for New, Easier-to-Use FreeStyle Lite® Test Strips... Product page: FreeStyle Lite® Blood Glucose Monitoring System...... Smit

Douglas Hart, a mechanical engineering professor at MIT, adapted technology he originally developed for dentistry to scan the shape of the ear canal. Because the procedure is relatively fast and easy compared to traditional silicone method, it may not only improve the fitting of hearing aids but may also lead to customized ear buds for your audio player. From MIT press office: With the new MIT system, a very stretchy, balloon-like membrane is inserted into the ear canal and inflated to take the shape of the canal. The membrane is filled with a fluorescent dye that can be imaged with a tiny fiber-optic camera inside the balloon. Scanning the canal takes only a few seconds, and the entire fitting process takes only a minute or two. Because the camera captures 3-D images so quickly, it can measure how much the surface of the ear canal deforms when the pressure changes, or how the canal shape changes when the wearer chews or talks. That could help hearing-aid manufacturers design devices that keep their tight seal in those situations. The researchers have built a prototype scanner to demonstrate the proof of concept, and are now working on a handheld version of the device. Once it’s ready, they plan to do a study comparing the fit of hearing aids built with the new scanner to that of traditional hearing aids. Press release: MIT researcher develops new way of scanning the ear canal with 3-D imaging technology...... Michael

Medtronic has just announced the results of the RESOLUTE All Comers study, which compared the performance of its Resolute drug eluting stent to that of Abbott's XIENCE V. The results, which were announced at the ongoing 2010 EuroPCR meeting in Paris, show that the Resolute stent matches XIENCE V in both safety and efficacy. While the Resolute stent is currently approved for sale in Europe, the stent is still classified as an investigational device in the US. More details about the study from the press release: At one year, the Resolute DES was shown to be as effective as the Xience DES in reducing the need for repeat procedures, and both second-generation stents were associated with low and similar rates of death from cardiac causes and heart attacks attributed to the treated vessel. The primary endpoint of the study was target lesion failure (TLF) - a composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularization. The Resolute DES posted TLF rates of 8.2 percent versus 8.3 percent for the Xience DES (non-inferiority p= Press release: Medtronic's Resolute® Drug-Eluting Stent Matches Market-Leading Rival in Large Head-to-Head Study... Flashbacks: Medtronic Improves Its Driver Bare-Metal Stent System; Abbott XIENCE V Drug Eluting Stent Outperforms Boston Scientific's TAXUS Express2 in Trial; FDA Approves Abbott's Everolimus Eluting Stent; New Xience Abbot Stent Gets EU OK... Smit

That's right: we are now syndicating our content on Facebook. So, you can follow us there and let your friends know where medical technology makes headlines every day. Link: Medgadget on Facebook...... Michael

Optovue has received 510(k) FDA clearance for its iVue compact SD-OCT (spectral-domain optical coherence tomography). Optical coherence tomography uses the scattering of light in tissue to create high resolution 3D images, but is limited to visualizing tissue 1 to 2 mm below the surface. The iVue system can image both the cornea and retina. It is the successor to the RTVue system from the same company offering a more compact system with similar scanning capabilities. Press release: Optovue Announces FDA 510(k) Clearance for iVue SD-OCT... Product page: Optovue iVue...... Wouter Stomp

Researchers from University of Leeds, Durham University and GlaxoSmithKline (GSK) are working on technology that would permit the printing of pharmaceutical ingredients directly onto tablets, currently only possible for a small set of drugs. The technology would allow precise regulation of the quantity of active ingredients in each pill and may even permit doctors to set individual doses based on the unique nature of each patient. GSK has developed a way of printing active pharmaceutical ingredients onto tablets - but the process can only currently be applied to just 0.5 per cent of all medicines used in tablet form. The researchers hope the new project will see this increase this to 40 per cent. "Some active ingredients can be dissolved in a liquid, which then behaves like normal ink, so then the process is fairly straightforward," explains Dr Kapur. "However, when you're working with active ingredients that don't dissolve, the particles of the drug are suspended in the liquid, which creates very different properties and challenges for use within a printing system. "For some tablets, you may also need higher concentrations of active ingredients to create the right dose, and this will affect how the liquid behaves." A medicine droplet is 20 times larger than an ink droplet in a standard ink-jet system, so the challenges facing the researchers include the numbers of drops that each tablet can hold, and how to increase the level of active ingredient in each drop. The research will also look at the properties and behaviour of the suspension, the shape and size of the printing nozzle and ways to pump the suspension through the printing equipment. University of Leeds press release: New research into safer drugs puts pills through the printer... Image: sparktography... Michael

Mayo Clinic Hospital in Phoenix, Arizona earlier this month discharged the first patient in the US to go home with an artificial heart. This was possible due to a recent Investigational Device Exception (IDE) FDA approval of the Freedom Driver that powers the patient's Syncardia Total Artificial Heart. Here's video from CBS with Charles Okeke, the 43 year old patient, showing off his power system. Press release: Mayo Clinic First in U.S. to Send Patient Home with Artificial Heart Flashbacks: Syncardia's Freedom Artificial Heart Driver Going to Trial in US; Syncardia's Freedom Mobile Artificial Heart Driver Gets CE Mark; A New Driver System for CardioWest Artificial Heart; Mobile Driver for CardioWest Artificial Heart Gets EU OK (hat tip: Gizmodo)... Michael

Presentation is important when instructing people how to do something. Here's a video demonstrating how to perform CPR that should stick in the minds of many. This one may not be safe for playing at work. On the other hand it may serve as an excellent mandatory instructional video for lesbian bar employees. The Super Sexy Abdominal Thrusts video is next in the series. Really. Link: Super Sexy CPR... Michael

Having just published Craig Venter and company's work describing the creation of a synthetic cells, the journal Nature asked eight very different academics what they thought the new scientific breakthrough will lead to. The scientists, in the published editorial, included physicists, philosophers, geneticists, and other specialists, and they provide a variety of angles to look at the new reality of creating artificial life. Read here: Life after the synthetic cell... Download the PDF directly from Nature... Related: One of the study authors answering relevant questions on Reddit...... Michael