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藏在纹身里的随身医院 – 译学馆
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藏在纹身里的随身医院

A temporary tattoo that brings hospital care to the home | Todd Coleman

【启点字幕组】
Light up the world
她叫简
Please meet Jane.
她是一名高危产妇
She has a high-risk pregnancy.
她怀孕才24周
Within 24 weeks,
就要在医院里卧床观察
she’s on bed rest at the hospital,
被密切监测着早产宫缩情况【宫缩 有规则的子宫收缩 临产的特征】
being monitored for her preterm contractions.
她看起来没那么开心
She doesn’t look the happiest.
原因之一是她必须靠技师和专家
That’s in part because it requires technicians and experts
给她绑上笨重的带子以监测宫缩情况
to apply these clunky belts on her to monitor her uterine contractions.
另一个原因是简很担忧
Another reason Jane is not so happy is because she’s worried.
担忧着这十天住院观察结束之后
In particular, she’s worried about what happens
可能发生的种种状况
after her 10-day stay on bed rest at the hospital.
回家之后 她会遇到什么情况呢
What happens when she’s home?
假如胎儿现在早产 可能会很危险
If she were to give birth this early it would be devastating.
作为一名非裔美国妇女
As an Africa-American woman,
她早产或死产的几率【死产 胎儿在分娩过程中死亡】
she’s twice as likely to have a premature birth
是其他产妇的两倍
or to have a stillbirth.
所以简其实只有两个选择
So Jane basically has one of two options:
继续住院观察
stay at the hospital on bed rest,
被高科技仪器束缚 直到分娩
a prisoner to the technology until she gives birth,
然后还一辈子医院账单
and then spend the rest of her life paying for the bill;
或者出院回家 祈祷好运降临
or head home after her 10-day stay and hope for the best.
两个都不是什么好选择
Neither of these two options seems appealing.
我不断听说这样的事例
As I began to think about stories like this
开始反复思考
and hear about stories like this,
常常自问
I began to ask myself and imagine:
是否还有别的解决方法呢
Is there an alternative?
有没有办法 可以保证患者
Is there a way we could have the benefits of high-fidelity monitoring
受到跟在医院一样的精确监测
that we get with our trusted partners in the hospital
又让他们能在家正常地生活
while someone is at home living their daily life?
抱着这样的想法
With that in mind,
我鼓励我的研究团队人员
I encouraged people in my research group
去和一些聪明的材料学家合作
to partner with some clever material scientists,
我们一起进行头脑风暴
and all of us came together and brainstormed.
经过长时间的努力
And after a long process,
我们有了初步的想法
we came up with a vision, an idea,
设想了一种可穿戴系统
of a wearable system that perhaps you could wear like a piece of jewelry
能像首饰或创可贴一样放在身上
or you could apply to yourself like a Band-Aid.
经过多年艰苦尝试和探索
And after many trials and tribulations and years of endeavors,
我们最终研制出了这种柔性电子贴片
we were able to come up with this flexible electronic patch
它的生产流程
that was manufactured using the same processes
与电脑芯片无异
that they use to build computer chips,
只是电子元件被从半导体晶片上转移到
except the electronics are transferred from a semiconductor wafer
一种能够附着于人体的柔性材料上
onto a flexible material that can interface with the human body.
这些电子贴片只有一根头发那么薄
These systems are about the thickness of a human hair.
却能够监测我们想要的各种数据
They can measure the types of information that we want,
比如说
things such as:
肢体运动
bodily movement,
体温
bodily temperature,
身体的电节律
electrical rhythms of the body
诸如此类
and so forth.
我们也可以使这些电子贴片
We can also engineer these systems,
能够利用能源
so they can integrate energy sources,
进行无线传输
and can have wireless transmission capabilities.
开发此类电子贴片时
So as we began to build these types of systems,
我们在研究人员身上进行测试
we began to test them on ourselves in our research group.
此外 我们也联络了圣地亚哥的
But in addition, we began to reach out to some of our clinical partners
一些临床合作伙伴
in San Diego,
在不同的临床条件下 不同的病人身上进行测试
and test these on different patients in different clinical conditions,
其中也包括像简这样的准妈妈
including moms-to-be like Jane.
这张照片是一个孕妇在我们大学附属医院的实验室
Here is a picture of a pregnant woman in labor at our university hospital
用传统的带子检测的宫缩
being monitored for her uterine contractions with the conventional belt.
同时
In addition,
她身上也有我们研制的柔性电子贴片
our flexible electronic patches are there.
这幅图展示的是胎儿心率的波形
This picture demonstrates waveforms pertaining to the fetal heart rate,
红色部分是
where the red corresponds to what was acquired
用传统方法获得的数据
with the conventional belts,
而蓝色部分则是
and the blue corresponds to our estimates
用贴片和我们的算法所得的估计数据
using our flexible electronic systems and our algorithms.
看到这个结果的一刻
At this moment,
我们倍受鼓舞
we gave ourselves a big mental high five.
我们的一些设想逐步实现
Some of the things we had imagined were beginning to come to fruition,
并在临床环境下得到验证
and we were actually seeing this in a clinical context.
但是仍有一个问题
But there was still a problem.
那就是 我们生产这些贴片的方式
The problem was, the way we manufactured these systems
是很低效的
was very inefficient,
产量很低
had low yield
还非常容易出错
and was very error-prone.
另外
In addition,
在我们与医护人员的交流中
as we talked to some of the nurses in the hospital,
他们鼓励我们把电子设备
they encouraged us to make sure
与医院常用的医用粘合剂
that our electronics worked with typical medical adhesives
相结合
that are used in a hospital.
我们突然顿悟
We had an epiphany and said, “Wait a minute.
与其让它们用粘合剂粘合
Rather than just making them work with adhesives,
不如让它们融入粘合剂
let’s integrate them into adhesives,
这样也可以解决我们的生产问题
and that could solve our manufacturing problem.”
请看这张图片
This picture that you see here
只用轻轻一撕 就能将感应器
is our ability to embed these censors inside of a piece of Scotch tape
从晶片剥离 嵌入胶带
by simply peeling it off of a wafer.
此外 研究团队正在尝试
Ongoing work in our research group allows us to, in addition,
将集成电路嵌入柔性粘合剂
embed integrated circuits into the flexible adhesives
以放大信号并将其数字化
to do things like amplifying signals and digitizing them,
对其进行处理
processing them
和编码 以便无线传输
and encoding for wireless transmission.
所有这些都能融入
All of this integrated into the same medical adhesives
医院真正在用的常见粘合剂中
that are used in the hospital.
到了这一步
So when we reached this point,
我们又遇到了新的挑战
we had some other challenges,
要同时从工程学和可用性的角度
from both an engineering as well as a usability perspective,
保证电子贴片能实际使用
to make sure that we could make it used practically.
在很多关于数字化医疗的讨论中
In many digital health discussions,
人们深信 我们可以简单地将数据
people believe in and embrace the idea that we can simply digitize the data,
数字化 再用无线传输
wirelessly transmit it,
传到云端
send it to the cloud,
然后在云端
and in the cloud,
提取有用信息并进行破译
we can extract meaningful information for interpretation.
事实上 如果不考虑能源问题
And indeed, you can do all of that,
这些都能办得到
if you’re not worried about some of the energy challenges.
考虑一下简的情况
Think about Jane for a moment.
她不住在帕洛阿尔托
She doesn’t live in Palo Alto,
也不住在比弗利山庄
nor does she live in Beverly Hills.
那意味着
What that means is,
我们必须仔细考虑她的数据计划
we have to be mindful about her data plan and how much it would cost
以及不间断传输数据的成本
for her to be sending out a continuous stream of data.
还有另一个挑战
There’s another challenge
这个问题可能会让一些医疗人员感到不快
that not everyone in the medical profession is comfortable talking about.
那就是 简对医疗机构
And that is, that Jane does not have the most trust
没有绝对的信任
in the medical establishment.
她 像她那样的人 她的祖先
She, people like her, her ancestors, have not had the best experiences
都对医生 医院 以及保险公司
at the hands of doctors and the hospital
没有好印象
or insurance companies.
这意味着我们必须谨慎处理隐私问题
That means that we have to be mindful of questions of privacy.
简可能并不愿意
Jane might not feel that happy
让自己的数据在云端处理
about all that data being processed into the cloud.
而且简可不好忽悠
And Jane cannot be fooled;
她会看新闻
she reads the news.
她明白 连联邦政府
She knows that if the federal government can be hacked,
和500强公司的系统都可以被入侵
if the Fortune 500 can be hacked,
医疗数据又岂能绝对安全呢
so can her doctor.
所以考虑到这一点
And so with that in mind,
我们突然想到
we had an epiphany.
我们不可能比世上所有的黑客都聪明
We cannot outsmart all the hackers in the world,
但或许我们能把可能遭受攻击的目标变小
but perhaps we can present them a smaller target.
我们是否可以
What if we could actually,
不让那些算法
rather than have those algorithms that do data interpretation
在云端处理数据
run in the cloud,
可不可以就在那些嵌入粘合剂的
what if we have those algorithms run on those small integrated circuits
小型集成电路中处理数据
embedded into those adhesives?
所以当我们将数据监测和处理都整合起来
And so when we integrate these things together,
这意味着现在我们可以想象这样一种未来
what this means is that now we can think about the future
像简这样的人可以一边过日常生活
where someone like Jane can still go about living her normal daily life,
一边实现医疗监测
she can be monitored,
她也无需兼职赚钱
it can be done in a way where she doesn’t have to get another job
来为她的数据计划支付高昂成本
to pay her data plan,
同时 她对隐私方面的一些顾虑也得到了妥善处理
and we can also address some of her concerns about privacy.
所以此时
So at this point,
我们自我感觉良好
we’re feeling very good about ourselves.
我们取得了成果
We’ve accomplished this,
也已开始解决一些隐私问题
we’ve begun to address some of these questions about privacy
我们觉得 这件事差不多告一段落了
and we feel like, pretty much the chapter is closed now.
大家都会幸福地生活下去 对吧
Everyone lived happily ever after, right?
可惜 没那么快
Well, not so fast.
还有一点难以忽视 正如我之前提到的
One of the things we have to remember, as I mentioned earlier,
简对医疗机构没有绝对的信任
is that Jane does not have the most trust in the medical establishment.
我们必须记住
We have to remember
健康差距在不断扩大
that there are increasing and widening health disparities,
医疗管理中也存在不平等
and there’s inequity in terms of proper care management.
这意味着什么呢
And so what that means is that this simple picture
想想简和她的数据
of Jane and her data —
即使她不介意将数据传到云端
even if her being comfortable being wirelessly transmitted to the cloud,
愿意在必要时让医生干预
letting a doctor intervene if necessary —
这也还不够
is not the whole story.
所以我们开始考虑
So what we’re beginning to do
如何让可信赖的第三方
is to think about ways to have trusted parties serve as intermediaries
成为像简一样的人和医疗机构间的中介
between people like Jane and her health care providers.
例如 我们已开始与教会合作
For example, we’ve begun to partner with churches
教会深受人们信赖
and to think about nurses that are church members,
我们让出身教会的护士
that come from that trusted community,
为像简这样的人们提供支持和咨询
as patient advocates and health coaches to people like Jane.
另一个值得关注的情况是
Another thing we have going for us
保险公司渐渐地
is that insurance companies, increasingly,
也被我们的一些想法吸引
are attracted to some of these ideas.
他们逐步意识到
They’re increasingly realizing
或许现在花1美金
that perhaps it’s better to pay one dollar now
买可穿戴健康设备 请健康咨询师
for a wearable device and a health coach,
好过以后花10美元
rather than paying 10 dollars later,
为早产的婴儿
when that baby is born prematurely
支付住新生儿监护室的费用
and ends up in the neonatal intensive care unit —
那可是医院里最烧钱的病房之一
one of the most expensive parts of a hospital.
这对我们来说是一个漫长的学习过程
This has been a long learning process for us.
我们解决了一个问题
This iterative process of breaking through and attacking one problem
但又觉得不够完美
and not feeling totally comfortable,
于是就发现了下一个问题
and identifying the next problem,
这种情况反复出现 促使我们
has helped us go along this path
不仅用技术进行创新
of actually trying to not only innovate with this technology
也要确保它被用于最需要的人身上
but make sure it can be used for people who perhaps need it the most.
我们从这个过程中学到的另一件事
Another learning lesson we’ve taken from this process
也让我们时刻保持谦恭
that is very humbling,
那就是 在技术加速前进的同时
is that as technology progresses and advances at an accelerating rate,
我们必须牢记 使用技术的是人
we have to remember that human beings are using this technology,
我们必须明白
and we have to be mindful
每一个人 都有脸面
that these human beings — they have a face,
有名有姓
they have a name
有自己的生活
and a life.
希望简的这些基本的人性化需求
And in the case of Jane,
也都能被得到尊重和照顾
hopefully, too.
谢谢
Thank you.

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