Saturday, December 25, 2010

A Doctor's Disdain for Medical 'Googlers' - NYTimes.com

A Doctor's Disdain for Medical 'Googlers' - NYTimes.com

November 19, 2007, 11:06 AM

A Doctor’s Disdain for Medical ‘Googlers’

(Jason Lee/Reuters)

Can a patient ever show up at the doctor’s office with too much information?

A doctor’s essay about medical “Googlers” — patients who research their symptoms, illness and doctors on the Web before seeking treatment — suggests they can. The report, which appeared in Time magazine, was written by Dr. Scott Haig, an assistant clinical professor of orthopedic surgery at Columbia University College of Physicians and Surgeons. He begins with a description of a patient he calls Susan, who seems to be clicking on a keyboard as she speaks to him on the phone. “I knew she was Googling me,” he writes.

Dr. Haig’s disdain for her information-seeking ways becomes quickly evident. He describes the woman’s child, whom she brings to the office, as “a little monster” and notes that the woman soon “launched into me with a barrage of excruciatingly well-informed questions.” Every doctor knows patients like this, he writes, calling them “brainsuckers.”

Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived. It was a little too much — as if she knew how stinky and snorey I was last Sunday morning. Yes, she was simply researching important aspects of her own health care. Yes, who your surgeon is certainly affects what your surgeon does. But I was unnerved by how she brandished her information, too personal and just too rude on our first meeting.

The problem, Dr. Haig notes, is that patients can have too much information and often don’t have the expertise to make sense of it. “There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore,” Dr. Haig writes.

Dr. Haig’s essay, however, has riled patient advocates, who believe patients need to arm themselves with information and take charge of their own medical care. Mary Shomon, who runs a popular thyroid disease blog on About.com, recently highlighted the essay on her site, generating angry responses from readers. Ms. Shomon said she thinks many physicians like Dr. Haig are threatened by patients who use Google and other Internet resources to research their own health questions.

“By condemning Googlers, he made it clear that he’s threatened by empowered, educated and assertive patients who do their own research,” said Ms. Shomon. “He can’t handle a patient who talks and doesn’t just listen. Good patients…are seen and not heard, right?”

Dr. Haig concludes his essay by confessing that he decided not to treat the woman, whom he described as “the queen of all Googlers.”

I couldn’t even get a word in edgewise. So, I cut her off. I punted. I told her there was nothing I could do differently than her last three orthopedists, but I could refer her to another who might be able to help.

Friday, December 24, 2010

New From Google: The Body Browser - NYTimes.com

New From Google: The Body Browser - NYTimes.com

RESEARCH FITNESS & NUTRITION MONEY & POLICY VIEWS HEALTH GUIDE

December 23, 2010, 3:52 PM
New From Google: The Body Browser
By SINDYA N. BHANOO

Six years ago, I took a hard fall while playing soccer and tore a ligament in my knee.

As I weighed my treatment options in confusion, I searched on the Internet for images and videos to help me better understand how the knee works.

I wish I’d had access to Google’s Body Browser, a new, free 3-D tool that lets users rotate the body, peel back layers of it, and zoom in and zoom out, all from within an Internet browser window. There’s a search feature, so I typed in “anterior cruciate ligament” and it zoomed into the part of the knee that I’d injured.

It’s like a Gray’s Anatomy coloring book, come to life. I was curious, though, about what medical practitioners think about it. Is it something that medical students might use, or that doctors might use to educate patients?

When I talked to doctors who have played around with Body Browser, they said that isn’t nearly as detailed or sophisticated enough for a medical student. But, many told me, it may end up being an excellent teaching tool for patients.

“I could well imagine that this could replace the innumerable line drawings I’ve done on paper and on endless pairs of scrubs,” said Dr. Ziv Haskal, the chief of vascular and interventional radiology at the University of Maryland Medical Center. “If I could put it up on my iPad or local computer in front of them, that could be very useful.”

Keith Walker, a chiropractor in England, is already using the tool in his clinic. And so far, it’s been a hit.

“As a patient education tool, it’s one of the best I’ve seen,” he said. “There are other things like this on the Web, and they tend to be not as usable, or on medical university Web sites and directed at students.”

Mr. Walker wishes that the 3-D model had limbs that rotated. For example, users can’t lift the wrists of the model, which happen to block a portion of the hip.

The browser also lacks the sort of detail a serious student would need, he said. “If you look at the shoulder, you can’t peel off the layers,” he said. “There are some really important muscles under the deltoid, and you can’t see those.”

Dr. Haskal, too, had a couple of requests. “If we could modify or customize to demonstrate certain diseases, the way you can lay your own map on Google Maps, it would be wonderful,” he said.

Dr. Roni Zeiger, Google’s chief health strategist and an urgent-care physician, was reluctant to share too many details about what’s to come with the Body Browser, but he welcomes suggestions.

“We love all kinds of information, including visual information. And we built this to let anyone who’s curious about anatomy explore it,” he said. “We’ve gotten wonderful feedback from students, patients, teachers, physical therapists and doctors at all levels of training.”

He did say that Google plans to introduce a male model soon. Currently, the browser displays only a female body.

My own request? For the search bar to handle colloquial terms for body parts. Right now, you need to type in medical terms like “gastrocnemius” or “scapula” rather than commonly used ones like “calf” or “shoulder.”

I’m also wondering if one day I’ll be able to map my electronic health record directly to a 3-D model, so that I can visually track any ailments I might have. I reported on a similar technology in Denmark earlier this year.

Try it out if you’d like, and then please join the discussion below. What do you think of Body Browser? What works? What’s lacking?

Note: To use it, you’ll have to install the beta version of the Google Chrome browser, Mozilla Firefox 4 beta or another browser that supports WebGL, which allows for 3-D graphics to be displayed within a browser’s window. You can find those on the Google Body page.
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Monday, November 29, 2010

New Electric Car Pays For Itself : Discovery News

New Electric Car Pays For Itself : Discovery News

Toyota Scion xB

Researchers converted a Scion xB to feed electricity directly into the power grid.
AP Photo


THE GIST:

  • A converted Scion is the first electric car to be linked to the power grid.
  • The car utilizes vehicle-to-grid (V2G) technology, which uses electricity and gas to store energy and feed it back into the grid.
  • V2G is still a new concept, but it is gaining ground in the U.S. and Europe.



U.S. researchers unveiled a vehicle Thursday that earns money for its driver instead of guzzling it up in gasoline and maintenance costs.

The converted Toyota Scion xB, shown at the annual meeting of the American Association for the Advancement of Science here, is the first electric car to be linked to a power grid and serve as a cash cow.

"This is the first vehicle that's ever been paid to participate in the grid -- the first proof of concept vehicle," Ken Huber, who oversees technological development at wholesale electricity coordinator PJM Interconnection, told AFP.

The presentation of the box-like, unassuming looking Scion was the researchers' way of introducing the "vehicle-to-grid" (V2G) concept as it begins to gain momentum in the United States and around the world.

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V2G projects with hybrid cars that use electricity and gas to store energy in their batteries and feed it back into the power grid are up and running in the United States, and the drive now is to produce all electric vehicles to plug into the power grid.

"This makes the car useful not only when it's being driven, but also when it's parked, as long as you remember to plug it in," said Willett Kempton, who is leading a V2G project at the University of Delaware.

A V2G car is connected via an Internet-over-powerline connection that sends a signal from inside the car's computer to an aggregator's server.

The aggregator acts as the middleman between the car owner and power grid management companies, which are constantly trying to keep electricity output at a constant level.

When the grid needs more power due to a surge in demand, power companies usually draw from traditional power plants, which in the United States are often coal-fired and leave a large carbon footprint.

When V2G becomes more widespread, the power could be drawn from millions of vehicles plugged into sockets in home garages or from commercial fleets, such as the U.S. Postal Service's vans, for a much smaller footprint than that of the power plants.

Grid management companies like PJM Interconnection currently pay around 30 dollars an hour when taking power from a car.

V2G is still a new concept, but it is gaining ground in the United States and Europe.

"Ten years ago, this was just a plan. Today, it's a real project and in 10 years, we'll be producing tens of megawatts of power this way," said Kempton, adding that V2G will readily find applications in countries that are rapidly ramping up reliance on wind and solar energy, such as Denmark and Britain.

Huber said he will be meeting in the coming weeks in Paris with heads of European grid management companies about V2G.

"We're going to try to determine how we can work together on this. It's a technology that is very good at meeting a need we have, and there's growing interest among auto companies to develop V2G vehicles," he added.

AC Propulsion of California has designed an electric drive system for V2G, and car manufacturers including Renault/Nissan, Mitsubishi and BMW are producing all-electric vehicles with an eye on the V2G market.

'Sky Pod' to Offer Personalized Ride : Discovery News


'Sky Pod' to Offer Personalized Ride : Discovery News


sky pod
A California firm has created a new technology that personalizes public transportation. 
Courtesy of Unimodal Systems

'SKY POD' TO OFFER PERSONALIZED RIDE

A public transportation scheme includes individual cars that will take riders directly to their destination.

Fri Sep 18, 2009 08:18 AM ET 7 Comments | Leave a Comment
sky pod
A California firm has created a new technology that personalizes public transportation.
Courtesy of Unimodal Systems
A California firm thinks it has figured out how to get the masses moving on public transportation: Give them their own pods.
"If you look at what we've done in last 100 years in terms of how we've had the most market buy-in for personal mobility, we need look no further than the car," said Christopher Perkins, co-founder of Unimodal Systems.
"With a car, it's essentially one person, or so, and one destination. We don't have to stop at all our friends' houses to get to the store. Likewise, when you use public transit, the concept here is you don't want to have to go to a bunch of stops on the way to wherever you're going."
The company this month signed an agreement with NASA's Ames Research Center in Moffett Field, Calif., to see if software developed to control robots will help development of a personal rapid transportation system known as SkyTran.
The system uses small vehicles that run on elevated, magnetically levitated rails.
Each computer-controlled pod holds up to three people. Riders type in their destination and leave the navigating to SkyTran's intelligent software to transport the pod, non-stop and without interrupting traffic flow.
Perkins envisions SkyTran feeding into other regional and local transit systems, such as the San Francisco Bay Area Rapid Transit, known as BART, and high-speed rail.
A demonstration system is planned for the NASA Research Park at Ames, a hub for innovative technology that has attracted 15 universities and about 40 businesses, including Google.
"What we see as a beginning is to serve areas that have high traffic that need to get to one point, like downtown to the airport. That would form the backbone," Perkins told Discovery News.
"All networks have humble beginnings," he added.
The pods can be mass produced in factories, which helps to cut costs. Unimodal expects the concept will be so appealing that it could be supported commercially, as opposed to public transportation systems, which typically operate at a loss.
"Based on our projects, we think this is a viable business model. The next step will be show in a series of demonstration projects that the technology is viable," Perkins said.
The pods are designed to hang beneath an elevated guideway. They are propelled by the interaction of electromagnetic fields. Unimodal expects the pods to eventually be capable of traveling at speeds of up to 150 mph.
For its part, NASA wants to know if its software created for aerospace projects has applications in other fields. It also is interested in the ergonomics of the pod itself.
"Having people see this built to scale is a major step forward," said Michael Marlaire, who oversees the NASA Research Park at Ames. "If this works and you sell the popularity, it's a huge impact on society."

Monday, November 8, 2010

Chevy Volt to Get 230 MPG Rating...Maybe - Auto - FOXNews.com

Chevy Volt to Get 230 MPG Rating...Maybe - Auto - FOXNews.com

WARREN, Mich. — General Motors said Tuesday its Chevrolet Volt electric car could get 230 mpg in city driving, making it the first American vehicle to achieve triple-digit fuel economy if that figure is confirmed by federal regulators.

But when the four-door family sedan hits showrooms late next year, its efficiency will come with a steep sticker price: $40,000.

Still, the Volt's fuel efficiency in the city would be four times more than the popular Toyota Prius hybrid, the most efficient car now sold in the U.S.

Most automakers are working on similar designs, but GM would offer the first mainstream plug-in with the Volt, which seats four and was introduced at the 2007 Detroit auto show.

The Volt will join a growing fleet of cars and trucks powered by systems other than internal combustion engines.

Unlike the Prius and other traditional hybrids, the Volt is powered by an electric motor and a battery pack with a 40-mile range. After that, a small internal combustion engine kicks in to generate electricity for a total range of 300 miles. The battery pack can be recharged from a standard home outlet.

Hybrids use a small internal combustion engine combined with a high-powered battery to boost fuel efficiency. Toyota's Prius — which starts at about $22,000 — gets 51 mpg in the city and 48 mpg on the highway.

The number of all-electric vehicles available to U.S. consumers remains limited. The Tesla Roadster, a high-end sports car with a range of 224 miles, is perhaps the best known. But its $100,000-plus price tag keeps it out of reach of all but the wealthiest drivers.

The company is working on an electric family sedan that will be priced considerably less.

Nissan Motor Co. unveiled its first electric car, the Leaf, earlier this month. Nissan said the vehicle will go on sale in Japan, the U.S. and Europe next year.

Edmunds.com, an auto Web site, cast doubt on whether drivers can expect 230 mpg from the Volt since fuel efficiency also depends on driving style.

Volt drivers who cruise sensibly on smooth roads without much cargo — and who avoid exceeding 20 or 30 miles between charges — might fill up only rarely. But "for most people, it is not realistic to expect that kind of mileage in real-world driving," said Michelle Krebs, a senior analyst with the Web site.

General Motors Co. is touting the 230 mpg figure following early tests that used draft guidelines from the Environmental Protection Agency for calculating the mileage of extended-range electric vehicles.

The EPA guidelines, developed with help from automakers, figure that cars such as the Volt will travel more on straight electricity in the city than on the highway. If drivers operate the Volt for less than 40 miles, in theory they could do so without using a drop of gasoline.

Highway mileage estimates for the Volt based on the EPA's methodology have yet to be released.

"We are confident the highway (mileage) will be a triple-digit," GM CEO Fritz Henderson said.

The EPA conducts testing to determine the mileage posted on new car stickers. The agency said in a statement Tuesday that it has not tested a Volt "and therefore cannot confirm the fuel economy values claimed by GM."

The EPA is working with the Society of Automotive Engineers and state and federal officials to develop testing procedures to measure the fuel efficiency of advanced vehicles, according to a draft outline of the proposal obtained by The Associated Press.

The plan could be released later this year.

It was not immediately clear how GM reached the 230 mpg in city driving, but industry officials estimated the automaker's calculation took into consideration the Volt traveling 40 miles on the electric battery and then achieving about 50 mpg when the engine kicked in.

Although Henderson would not give details on pricing, the first-generation Volt is expected to cost nearly $40,000, making it cost-prohibitive to many people even if gasoline returns to $4 per gallon.

The price of the sporty-looking sedan is expected to drop with future generations of the Volt, but GM has said government tax credits of up to $7,500 and the savings on fuel could make it more affordable, especially at 230 mpg.

"We get a little cautious about trying to forecast what fuel prices will do," said Tony Posawatz, GM's vehicle line director for the Volt. "We achieved this number, and if fuel prices go up, it certainly does get more attractive even in the near-term generation."

The mileage figure could vary as the guidelines are refined and the Volt gets further along in the manufacturing process, Posawatz said.

Chrysler Group, Ford Motor Co. and Daimler AG are all developing plug-ins and electric cars, and Toyota Motor Corp. is working on a plug-in version of its gas-electric hybrid system.

GM has produced about 30 test Volts so far and is making 10 a week, Henderson said during a presentation at the company's technical center in the Detroit suburb of Warren.

Henderson said charging the Volt will cost about 40 cents a day, at about 5 cents per kilowatt hour.

GM is nearly halfway through building about 80 test Volts that will look and behave like the production model, and testing is running on schedule, Posawatz said.

Two critical areas — battery life and the electronic switching between battery and engine power — are still being refined, but the car is on schedule to reach showrooms late in 2010, he said.

GM is simulating tests to make sure the new lithium-ion batteries last 10 years, Posawatz said, as well as testing battery performance in extremely hot and cold climates.

"We're further along, but we're still quite a ways from home," he said. "We're developing quite a knowledge base on all this stuff. Our confidence is growing."

The other area of new technology, switching between battery and engine power, is proceeding well, he said, with engineers just fine-tuning the operations.

"We're very pleased with the transition from when it's driving EV (electric vehicle) to when the engine and generator kick in," he said.

GM also is finishing work on the power cord, which will be durable enough that it can survive being run over by the car. The Volt, he said, will have software on board so it can be programmed to begin and end charging during off-peak electrical use hours.

It will be easy for future Volt owners living in rural and suburban areas to plug in their cars at night, but even Henderson recognized the challenge urban, apartment dwellers, or those who park their cars on the street might have recharging the Volt. There could eventually be charging stations set up by a third-party to meet such a demand, Henderson said.