Tech

Puschel Sorensen undergoing physical therapy using Cyberdyne's hybrid assistive limb, left, and with her grandson while still in a wheelchair.

(Photo Credit: Brooks Rehabilitation Hospital)


Puschel Sorensen first noticed something was wrong when her fingertips began to tingle. Later that day, she grew weak and fell.

It picked up small electrical impulses on her skin's surface and turned them into full movement in her legs.

Her family rushed her to the doctor, where she received the devastating diagnosis of Guillain-Barré Syndrome -- a rare and rapidly progressing autoimmune disorder that attacks the myelin sheath covering nerves.

Sorensen, a once-spry grandmother in her late fifties, spent 54 days in intensive care in 2018. When she was finally transferred to a rehab facility near her home in Florida, she was still on a feeding tube and ventilator, and was paralyzed from the neck down. Progress with traditional physical therapy was slow.

Sorensen in the hospital after her diagnosis of Guillain-Barré syndrome.

(Photo Credit: Brooks Rehabilitation Hospital)

And then everything changed. Sorensen began using a cutting-edge technology called an exoskeleton to relearn how to walk. In the vein of Iron Man's fictional power suit, it confers strength and mobility to the wearer that isn't possible otherwise. In Sorensen's case, her device, called HAL – for hybrid assistive limb -- picked up small electrical impulses on her skin's surface and turned them into full movement in her legs while she attempted to walk on a treadmill.

"It was very difficult, but super awesome," recalls Sorensen, of first using the device. "The robot was having to do all the work for me."

Amazingly, within a year, she was running. She's one of 38 patients who have used HAL to recover from accidents or medical catastrophes.

Cyberdyne's hybrid assistive limb technology.

(Photo Credit: Brooks Rehabilitation Hospital)

"How do you thank someone for giving them back the ability to walk, the ability to live your life again?" Sorensen asks effusively.

It's still early days for such exoskeleton devices, which number perhaps a few thousand worldwide, according to data from the handful of manufacturers who create them with any scale. But the devices' ability to dramatically rehabilitate patients like Sorensen highlights their potential to extract untold numbers of people from wheelchairs, and even to usher in a new paradigm for caregiving – one of the fastest growing segments of the U.S. economy.

"I've been a physical therapist for 16 years, and (these devices) help teach patients the right way to move in rehabilitation," says Robert McIver, director of clinical technology at the Brooks Cybernic Treatment Center, part of the Brooks Rehabilitation Hospital in Jacksonville, Fla, where Sorensen recovered.

Another patient there, a 17-year-old named George with a snowboarding injury that paralyzed his legs, was getting around with a walker within 20 sessions.

As patients progress in their recoveries, so does exoskeleton technology. Jack Peurach, CEO of Ekso, one of the leaders in the space, believes within a decade they could resemble an article of clothing (a "magic pair of pants" is his phrase). They also may become inexpensive and reliable enough to transition from a medical to a consumer device. McIver sees them eventually being used in the home on an ongoing basis as a personal assistive device, much like a walker or cane, to prevent falls in elderly people.

Such a transition "certainly could eventually lessen the need for caregivers," says Sharona Hoffman, a professor of law at Case Western University in Cleveland who has written extensively on aging and bioethics. "We have a real shortage of caregivers, so that would be a good thing."

Of course, having an aging and disabled population using exoskeletons in much the same way as an Apple Watch raises issues of its own.

Dr. Elizabeth Landsverk, a California-based geriatrician and founder of a company that performs house calls for elderly patients, believes the tech holds some promise in easing the burden on caregivers, who sometimes have to lift or move patients without assistance. But she also believes exoskeletons could become overhyped.

"I don't see robotics as completely replacing the caregiver," she says. And even if exoskeletons became akin to articles of clothing, she is skeptical of how convenient they could become.

"It's hard enough to get into support hose. Would an older person be able to get in and out of it on their own?" she asks, noting that a patient's cognitive levels could pose a huge barrier to donning such a device without assistance.

If personal exoskeletons did wildly succeed, Hoffman wonders whether they would leave the elderly more physically mobile yet also more socially isolated, since caregivers or even residing in an assisted living facility may no longer be required. Or, if they were priced in the hundreds or thousands of dollars, he worries that the cost would exacerbate social inequalities among the elderly and disabled.

"It's almost like a bad dream that [my illness] happened."

With any technology that confers superhuman ability, there's also the question of appropriate usage. Even the fictional Power Loader in the movie Alien required an operator's license. In the real world, such an approach would likely pay dividends.

"We would have to make sure physicians are well-trained in these devices, and patients have a way of getting training to operate them that is thorough and responsible," Hoffman says.

But despite some unresolved questions, it is a remarkable achievement to be able to give people back their lives thanks to new technology.

"It's almost like a bad dream that [my illness] happened," says Sorensen, who managed to walk in her daughter's wedding after her recovery. "Because now everything is pretty much back to normal and it's awesome."

Ron Shinkman
Ron Shinkman is a veteran journalist whose work has appeared in the New England Journal of Medicine publication Catalyst, California Health Report, Fierce Healthcare, and many other publications. He has been a finalist for the prestigious NIHCM Foundation print journalism award twice in the past five years. Shinkman also served as Los Angeles Bureau Chief for Modern Healthcare and as a staff reporter for the Los Angeles Business Journal. He has an M.A. in English from California State University and a B.A. in English from UCLA.
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Artificial avatars for hire and sophisticated video manipulation carry profound implications for society.

Image by Rostyslav Savchyn on Unsplash

This article is part of the magazine, "The Future of Science In America: The Election Issue," co-published by LeapsMag, the Aspen Institute Science & Society Program, and GOOD.

Alethea.ai sports a grid of faces smiling, blinking and looking about. Some are beautiful, some are oddly familiar, but all share one thing in common—they are fake.

Alethea creates "synthetic media"— including digital faces customers can license saying anything they choose with any voice they choose. Companies can hire these photorealistic avatars to appear in explainer videos, advertisements, multimedia projects or any other applications they might dream up without running auditions or paying talent agents or actor fees. Licenses begin at a mere $99. Companies may also license digital avatars of real celebrities or hire mashups created from real celebrities including "Don Exotic" (a mashup of Donald Trump and Joe Exotic) or "Baby Obama" (a large-eared toddler that looks remarkably similar to a former U.S. President).

Naturally, in the midst of the COVID pandemic, the appeal is understandable. Rather than flying to a remote location to film a beer commercial, an actor can simply license their avatar to do the work for them. The question is—where and when this tech will cross the line between legitimately licensed and authorized synthetic media to deep fakes—synthetic videos designed to deceive the public for financial and political gain.

Deep fakes are not new. From written quotes that are manipulated and taken out of context to audio quotes that are spliced together to mean something other than originally intended, misrepresentation has been around for centuries. What is new is the technology that allows this sort of seamless and sophisticated deception to be brought to the world of video.

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Jeanette DePatie
Jeanette DePatie describes herself as a professional “techsplainer”--taking complicated technologies and technological concepts and breaking them down into everyday language that everyone can understand. She has shared her entertaining and educational views on technology trends with companies like, McDonalds, Reynolds, Meredith, Better Homes and Gardens, Facebook and 20th Century Fox. She also proudly boasts that she once raised several million dollars in venture capital for a technology company with a presentation featuring two pieces of PVC pipe, a plastic funnel and a rubber chicken. She has been hired to describe technology by a host of Fortune 500 companies including Adobe, Apple, Intel, Microsoft, Monsanto, NTT Electronics, Panasonic, Pulitzer Samsung and Sony. She has spoken at CES, NAB, SMPTE CEATECH The Lean Startup Conference and a variety of Colleges and Universities.

On the left, a picture of the Mojo lens smart contact; and a simulated image of a woman with low vision who is wearing the contact to highlight objects in her field of vision.

(Photo Credit: Mojo Vision)

Imagine a world without screens. Instead of endlessly staring at your computer or craning your neck down to scroll through social media feeds and emails, information simply appears in front of your eyes when you need it and disappears when you don't.

"The vision is super clear...I was reading the poem with my eyes closed."

No more rude interruptions during dinner, no more bumping into people on the street while trying to follow GPS directions — just the information you want, when you need it, projected directly onto your visual field.

While this screenless future sounds like science fiction, it may soon be a reality thanks to the new Silicon Valley startup Mojo Vision, creator of the world's first smart contact lens. With a 14,000 pixel-per-inch display with eye-tracking, image stabilization, and a custom wireless radio, the Mojo smart lens bills itself the "smallest and densest dynamic display ever made." Unlike current augmented reality wearables such as Google Glass or ThirdEye, which project images onto a glass screen, the Mojo smart lens can project images directly onto the retina.

A current prototype displayed at the Consumer Electronics Show earlier this year in Las Vegas includes a tiny screen positioned right above the most sensitive area of the pupil. "[The Mojo lens] is a contact lens that essentially has wireless power and data transmission for a small micro LED projector that is placed over the center of the eye," explains David Hobbs, Director of Product Management at Mojo Vision. "[It] displays critical heads-up information when you need it and fades into the background when you're ready to continue on with your day."

Eventually, Mojo Visions' technology could replace our beloved smart devices but the first generation of the Mojo smart lens will be used to help the 2.2 billion people globally who suffer from vision impairment.

"If you think of the eye as a camera [for the visually impaired], the sensors are not working properly," explains Dr. Ashley Tuan, Vice President of Medical Devices at Mojo Vision and fellow of the American Academy of Optometry. "For this population, our lens can process the image so the contrast can be enhanced, we can make the image larger, magnify it so that low-vision people can see it or we can make it smaller so they can check their environment." In January of this year, the FDA granted Breakthrough Device Designation to Mojo, allowing them to have early and frequent discussions with the FDA about technical, safety and efficacy topics before clinical trials can be done and certification granted.

For now, Dr. Tuan is one of the few people who has actually worn the Mojo lens. "I put the contact lens on my eye. It was very comfortable like any contact lenses I've worn before," she describes. "The vision is super clear and then when I put on the accessories, suddenly I see Yoda in front of me and I see my vital signs. And then I have my colleague that prepared a beautiful poem that I loved when I was young [and] I was reading the poem with my eyes closed."

At the moment, there are several electronic glasses on the market like Acesight and Nueyes Pro that provide similar solutions for those suffering from visual impairment, but they are large, cumbersome, and highly visible. Mojo lens would be a discreet, more comfortable alternative that offers users more freedom of movement and independence.

"In the case of augmented-reality contact lenses, there could be an opportunity to improve the lives of people with low vision," says Dr. Thomas Steinemann, spokesperson for the American Academy of Ophthalmology and professor of ophthalmology at MetroHealth Medical Center in Cleveland. "There are existing tools for people currently living with low vision—such as digital apps, magnifiers, etc.— but something wearable could provide more flexibility and significantly more aid in day-to-day tasks."

As one of the first examples of "invisible computing," the potential applications of Mojo lens in the medical field are endless.

According to Dr. Tuan, the visually impaired often suffer from depression due to their lack of mobility and 70 percent of them are underemployed. "We hope that they can use this device to gain their mobility so they can get that social aspect back in their lives and then, eventually, employment," she explains. "That is our first and most important goal."

But helping those with low visual capabilities is only Mojo lens' first possible medical application; augmented reality is already being used in medicine and is poised to revolutionize the field in the coming decades. For example, Accuvein, a device that uses lasers to provide real-time images of veins, is widely used by nurses and doctors to help with the insertion of needles for IVs and blood tests.

According to the National Center for Biotechnology Information, augmentation of reality has been used in surgery for many years with surgeons using devices such as Google Glass to overlay critical information about their patients into their visual field. Using software like the Holographic Navigation Platform by Scopsis, surgeons can see a mixed-reality overlay that can "show you complicated tumor boundaries, assist with implant placements and guide you along anatomical pathways," its developers say.

However, according to Dr. Tuan, augmented reality headsets have drawbacks in the surgical setting. "The advantage of [Mojo lens] is you don't need to worry about sweating or that the headset or glasses will slide down to your nose," she explains "Also, our lens is designed so that it will understand your intent, so when you don't want the image overlay it will disappear, it will not block your visual field, and when you need it, it will come back at the right time."

As one of the first examples of "invisible computing," the potential applications of Mojo lens in the medical field are endless. Possibilities include live translation of sign language for deaf people; helping those with autism to read emotions; and improving doctors' bedside manner by allowing them to fully engage with patients without relying on a computer.

"[By] monitoring those blood vessels we can [track] chronic disease progression: high blood pressure, diabetes, and Alzheimer's."

Furthermore, the lens could be used to monitor health issues. "We have image sensors in the lens right now that point to the world but we can have a camera pointing inside of your eye to your retina," says Dr. Tuan, "[By] monitoring those blood vessels we can [track] chronic disease progression: high blood pressure, diabetes, and Alzheimer's."

For the moment, the future medical applications of the Mojo lens are still theoretical, but the team is confident they can eventually become a reality after going through the proper regulatory review. The company is still in the process of design, prototype and testing of the lens, so they don't know exactly when it will be available for use, but they anticipate shipping the first available products in the next couple of years. Once it does go to market, it will be available by prescription only for those with visual impairments, but the team's goal is to bring it to broader consumer markets pending regulatory clearance.

"We see that right now there's a unique opportunity here for Mojo lens and invisible computing to help to shape what the next decade of technology development looks like," explains David Hobbs. "We can use [the Mojo lens] to better serve us as opposed to us serving technology better."

Addison Nugent
Addison Nugent is a professional freelance journalist based out of Paris, France. Like so many Americans before her, she fell in love with the French capital at a young age and never left. She graduated from the Sorbonne's Master of the Arts literary research program with honors in 2016, and has since pursued a career in journalism. She has accumulated a diverse portfolio of published work that includes investigative pieces, in-depth profiles, historical deep dives, and tech news. Her work has been featured in such publications as OZY, Vice Motherboard, Atlas Obscura, Dazed Digital and Messy Nessy Chic.