Acceleration

On September 14, 2004, in Acceleration

Not long ago, digital
cameras were exotic, expensive, produced poor pictures, and easily dismissed.
Now, they are cheap, everywhere, as good as film at the high end, and many
double as video cameras. Think of this example as you read in Health Futures
Digest
about other exotic, expensive, and currently rather limited
technologies now emerging�hydrogen-powered cars, for instance,
Pessimists maintain it will take 20 years before they are in production, yet
Honda�s 2005 model FCX fuel-cell car has much more power, fuel efficiency, and
range than its current model, and it does all that with only half the
components. Is it really likely that the world�s automobile and technology
superpower, which has no natural oil reserves of its own, will not maintain this
level of acceleration in fuel-cell vehicle development? And if it does, that a
future version of the FCX will not be in widespread demand�and production�within
five years, or ten at the most?

Japanese (and German, and other countries�) development of fuel cell
technologies contributes to a brewing �perfect storm� whose outer edge is
already enveloping the auto industry as increasing competition, costs,
regulation, and other factors combine with �the accelerating velocity of
change.� It provides some unnerving parallels for the healthcare industry.

Genetic modification may
be as disruptive a technology in healthcare as fuel cells will be in energy and
transportation, and the cat may already be out of the bag. By the next Olympics,
we predict superhuman feats of athletics prowess. The benefits�and the
pitfalls�could accrue too to medicine. The issue is framed by some in normative
and even religious terms; objectively, however, the real world will inevitably
act, as it always has and always will, in positive terms.

There will be speed bumps in technology�s accelerating advance, of course. In
healthcare, the discovery that colon cancer anti-angiogenic drug Avastin can cause stroke and heart
attack is a reminder. But speed bumps do not stop the advances, they only spur
the driver to go faster. And if one driver cannot maintain the pace alone, find
some co-drivers, as four leading cancer institutes have done in order to
accelerate toward a cure for multiple
myeloma
.

Other signs of acceleration last month:

 

  • Non-engineers can now design a widget and have it manufactured in a machine
    shop via the Internet. The 3-D printers (a.k.a. fabricators, replicators) we
    wrote about in November
    2003
    will probably soon find their way into Internet-connected machine shops,
    followed by copy shops, and finally by the home. 

     

  • Video imaging at the cellular level dramatically (literally) improves
    scientists ability to understand viruses. With
    that understanding comes an improvement in learning to harness viruses for
    therapy. 

     

  • The Japanese are testing the science fiction idea of solar-sail-powered spaceships for
    intergalactic travel, in space. 
Disposable Digital Cameras

US pharmacy chain CVS Corporation is offering customers a disposable digital
color camera for US$19.99. A similar model will be offered by Ritz Camera and
Walt Disney Co. resorts. Consumers return the camera for processing and receive
film-quality prints and a compact disc that allows pictures to be stored or
e-mailed. It holds 25 pictures and can be recycled.

Reference: Unknown (2004). �Drugstore
Offers New Wave of Disposable Cameras
.� Reuters, August 19.

Hydrogen Cars Have Truly Arrived

Honda Motor Co.�s 2005 FCX fuel cell vehicle has been certified by the US
Environmental Protection Agency and the California Air Resources Board for
on-road use. The vehicle is the first to be powered by a Honda-designed and
built fuel cell stack.

The new model boasts a 33 percent gain in peak power (107 hp vs. 80 hp), an
EPA rating of 57 miles per kilogram�62 city, 51 highway�nearly 20 percent more,
and it has 50 percent fewer components and is easier to produce than earlier
prototypes. It is also cheaper, simpler, and works at startup temperatures as
low as -20�C.

Honda has delivered nine of its current fuel cell vehicles to government
fleets in California for testing. In addition to other California applications,
the company will place the 2005 four-seater with a customer in the northeastern
United States later this year.

Reference: Unknown (2004). �Honda FCV gets
certified.� Item in the Great Lakes IT Report, July 30, citing AutoTech Daily.

Perfect Storm

A recent conference brochure stated that �an unusual confluence of factors
[is] creating an extraordinarily turbulent and dangerous period in [the
automobile manufacturing] industry.� The factors include:

  • Hyper-competition;
  • Rapid global integration, from global sourcing to global operations;
  • The accelerating velocity of change;
  • New and �very competent� (read: intelligent?) tools;
  • Exploding peripheral costs, such as healthcare and litigation, that divert
    company resources;
  • Accelerating global regulation;
  • Growing threats and opportunities from China, India, and other aggressively
    developing nations; and
  • �Inappropriate profitability of the industry as a whole.��The only hope for survival,� says the brochure, �is a new and improved
    [cooperative] business model for this great and important industry.� It seems to
    us that these same factors, and the same conclusion, can be applied to the
    healthcare industry.

    Reference: Unknown (2004). �Automotive: The Perfect
    Storm
    .� Brochure description of a Management Briefing Seminars conference
    session, August 2-6.

    Superhumans

    What the Christian Science Monitor�s Gregory Lamb calls the �emerging
    science [of] gene modification or gene enhancement� is �going to turn sports
    into a . . . freak show,� said a sports doping researcher. DNA injections would
    replace training, producing the muscle without the sweat. �Somebody who�s not
    athletic at all could be transformed into something superhuman,� said a trainer.
    The same technology could also, of course, transform someone with muscular
    dystrophy into someone without muscular dystrophy, or a frail elder into a
    frisky kid.

    How far has the science emerged? More than enough to make the leap from
    animal lab to human bodies, it seems. H. Lee Sweeney, a University of
    Pennsylvania researcher, reported in March this year that mice injected with a
    gene gained up to 50 percent muscle growth. More recently, writes Kristen
    Philipkoski in Wired, �marathon mice� genetically modified by Howard
    Hughes Medical Institute researchers were able to run twice the distance of an
    unmodified control group.

    While these respectable scientists would not dream of moving from mice to men
    without following scientific process�not to mention the law�others probably not
    only will make the move, but may already be doing so. �The technology is
    available now for athletes to use,� according to a bioethicist who has written a
    book on the topic, and in light of its illegal, underground, and dangerous but
    inevitable application in sports, on the one hand, and its promise for helping
    humanity, on the other, he proposes that its use in sports be legalized and
    regulated, rather than banned.

    The problem, as one of Lamb�s other expert sources put it, is that �All bets
    are off when you start playing with genetic engineering … in terms of system
    function, organ function, and long-term effects. If you put in superfast muscle,
    are you going to alter function in a way that the tendons and the bones might
    not be able to support the loads?… You might start to snap tendons and bones.
    There might be deleterious health effects. We really don�t know.�

    We do know, however, that the genetic modifications are transgenic�they
    become part of the organism�s genome and are passed on to future generations,
    says Philipkoski. We also know, in the case of the marathon mice, that they
    became more resistant to weight gain, �even when fed a high-fat diet that caused
    obesity in other mice.�

    In fact, above-board science may not be all that far behind the underground.
    According to Philipkoski, GlaxoSmithKline is developing an oral drug that
    activates the same protein in humans (called PPAR-delta) that was stimulated in
    the marathon mice, and has already completed phase I clinical trials of the drug
    for use as a good cholesterol, or HDL, booster. The company was apparently
    surprised�but elated�to discover from the Hughes research that its drug might
    also combat obesity and work as an insulin sensitizer (by lowering levels of the
    intramuscular triglycerides associated with insulin resistance and diabetes in
    obese people), not to mention improve muscle performance. The fact that multiple
    outcomes were effected by altering just one gene was the biggest surprise of
    all. �The world,� said one of Philipkoski�s sources, �is about to change
    dramatically.�

    Reference: Lamb, Gregory M. (2004). �Will gene-altered
    athletes kill sport? Soon, animal DNA could make us faster and stronger – no
    training needed
    .� Christian Science Monitor, August 23.

    Reference: Philipkoski, Kristen (2004). �Scientists Breed a
    Tougher Mouse
    .� Wired News, August 23.

    Anti-angiogenic Hits a Speed Bump

    It has been discovered that Avastin, the first approved angiogenesis
    inhibitor used to treat colorectal cancer, increases the risk of stroke and
    heart attacks. A Genentech spokeswoman said some patients who took the drug had
    died from heart ailments, and that a single fatality during the drug�s clinical
    trials had not been enough to establish a clear relationship between the drug
    and the fatality. The company is informing health care providers by letter and
    is adding warning information to the drug�s label. The clinical trials showed
    that the sickest colon-cancer patients taking Avastin survived on average
    five months longer than those receiving standard care. The problem, said one
    expert, is that the targets of biologic drugs such as Avastin could be
    present in tissues or organs besides the one being treated.

    Reference: Henderson, Diedtra (2004). �FDA,
    Genentech Warn Doctors About Avastin
    .� Associated Press via Yahoo News,
    August 13.

    Joining Forces to Fight Cancer

    Four leading, and hitherto competitive, cancer centers are now coordinating
    clinical trials and sharing resources and findings on multiple myeloma.
    Participants in the Multiple Myeloma Research Consortium are the Mayo Clinic,
    the Dana Farber Cancer Institute, the H. Lee Moffitt Cancer Center and Research
    Institute, and the Ontario Cancer Institute.

    �Progress against the disease has been slow because researchers studying the
    disease rarely communicated, often duplicating each other�s findings and hitting
    dead ends,� writes Anahad O�Connor in the New York Times.

    Reference: O�Connor, Anahad (2004). �Joining
    Forces to Combat Multiple Myeloma
    .� New York Times, August 17.

    Toward the Home Manufactory

    �The Internet Revolution meets the Industrial Revolution� is how the AP�s
    Peter Svensson concisely captures the significance of eMachineShop, a free
    program that lets even non-engineers design �car parts and door knobs . . . door
    signs, motorcycle seats, robot frames, car engine covers, guitar plates and
    camera parts��and other small objects�on the Web, to then be manufactured by a
    �real world� machine shop.

    Key to eMachineShop�s success is that it incorporates �the knowledge of a
    machinist,� which prevents the designer from designing things a machinist would
    know to be impossible or inadvisable.

    Ten sandblasted copper door knobs of your design will cost you US$143. The
    most expensive item made since beta testing began last year is a $4,011 aluminum
    part for a laboratory magnet. The customers range from large companies that make
    prototypes, to hobbyists; one of whom told Svensson: �Being able to sit at you
    home computer, draw up some parts, submit them and 30 days later they are on
    your doorstep, all without human contact, is mind-blowing.�

    Reference: Svensson, Peter (2004). �Program
    Lets People Design 3-D Objects
    .� AP via Yahoo News, August 18.

    Understanding Viral Processes

    Using crystallography, cryoelectron microscopy, and imaging software, Purdue
    University researchers have made detailed pictures of a common bacteriophage
    (bacteria-eating virus) called T4, and a video showing how it attaches to a cell
    surface, infects it, and replicates. The work, reports Kristen Philipkoski in
    Wired, could �elucidate the secrets of viral infection and possibly
    improve gene-therapy techniques.� For instance, said one of the researchers: �By
    changing the receptor molecule at the ends of the long tail fibers, you may be
    able to target specific cells or add to the genome of the virus to get it to
    insert additional genes into target cells.�

    Bacteriophages have long been used in Eastern Europe in place of antibiotics,
    and given the problem of growing antibiotic resistance, could have important
    significance in the West.

    Reference: Philipkoski, Kristen (2004). �When
    Viruses Attack.� Wired News, August 30.

    Solar Sails Into the Sunset of Science
    Fiction

    The Japanese Institute of Space Astronautical Science has tested two solar
    sails aboard a rocket in space. The idea (popular in science fiction) is that
    photons from the Sun impart a small force when they strike the sail, giving the
    spacecraft to which the sail is attached increasing momentum. Though it starts
    off slowly, the cumulative acceleration leads, in theory, to astronomical speed
    and enables travel to distant planets.

    Reference: Unknown (2004). �Japan
    unfurls solar sail in space
    .� BBC News, August 11.

 

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