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科技醫療:戰勝疾病的巧妙新技術

The ingenious new tricks to beat disease
科技醫療:戰勝疾病的巧妙新技術

According to the World Health Organization, so-called Neglected Tropical Diseases (NTDs) affect more than one billion people and cost developing economies billions of dollars every year.

據世界衛生組織(World Health Organization)稱,所謂“被忽視熱帶病”(NTDs)的這類疾病影響著全世界10多億人,每年給發展中國家造成數十億美元的損失。

Populations living in poverty, without adequate sanitation and in close contact with infectious vectors such as livestock are most affected by these communicable illnesses, which prevail in tropical conditions. To complicate matters, diseases like measles and tuberculosis, which were nearly eradicated a century ago, are again on the rise. And more common, eminently treatable infectious diseases – norovirus and flu, for example – are responsible for thousands of preventable deaths each year.

生活貧困、缺乏足夠的衛生設施,以及與牲畜等傳染媒介有密切接觸的人群,最容易感染這些在熱帶環境中流行的傳染病。令問題更為復雜的是,一個世紀前幾乎已經滅絕的麻疹和肺結核又呈上升趨勢。更常見的、完全可治療的傳染病,比如諾羅病毒和流感,每年都造成數千例本可以避免的死亡。

Fortunately, new medical technology has vast potential to control infection, contain outbreak, even deliver life-saving supplies to remote regions affected by these diseases. From antimicrobial paint to powdered vaccines to drone-delivered organs, these innovations are fast becoming a clinical reality.

幸運的是,新的醫療技術在預防感染、控制疫情,甚至在向受到這些疾病影響的偏遠地區運送醫療物資方面,都有非常巨大的潛力。從抗菌涂料、粉狀疫苗到無人機運送器官,這些創新技術正迅速成為臨床手段。

In the short-term, such tools can improve survival rate for patients affected by a host of maladies; long-term, they may help us understand pathogen epidemiology, essential to the development of global disease control programs.

在短期內,這些手段可以提高多種疾病患者的存活率;從長期來看,或許有助于我們了解病原體流行病學,這對全球疾病控制規劃的發展至關重要。

Ouchless insulin

免注射的口服胰島素


Certain medicines can only be delivered by injection. The constant pinprick of needles is painful for patients and cumbersome for healthcare providers, while a shortage of sterile hypodermic needles in some areas can lead to infection. Now, researchers from MIT’s Koch Institute for Integrative Cancer Research and Harvard’s Brigham and Women's Hospital have engineered a coating that they claim can safely carry insulin beyond the obstacles of the digestive system and into the bloodstream – a kind of edible Swiss Army knife that can deliver life-saving medicine without the pain of needle injection.

有些藥物的接受只能通過注射。但長期打針對患者來說是痛苦的,對醫療保健提供方也是很麻煩,在有些地區,因為缺乏無菌皮下注射針頭有可能讓接受注射者感染細菌?,F在,麻省理工學院柯克綜合癌癥研究所(Koch Institute for Integrative Cancer Research)和哈佛大學布里格姆婦科醫院(Brigham and Women's Hospital)的研究人員設計了一種涂層,他們聲稱此技術可以安全地攜帶胰島素穿過消化系統的障礙物,進入人體血液,這就像一種可以食用的瑞士刀,可以提供救命藥,又沒有藥物注射的痛苦。

Once swallowed, the pill issues a spring-activated dart of insulin directly into the wall of the stomach. Patients with type 1 diabetes – the version of the disease in which the immune system attacks pancreatic cells that produce blood sugar-regulating insulin – might soon be able to manage their condition with the help of this pea-sized device.

這種藥片一旦吞下肚,就能夠在胃壁上“打一針”,釋放胰島素直接進入血液。有了這種豌豆大小的裝置,就能幫助1型糖尿病患者迅速控制病情。

The researchers reported their findings in the journal Science, explaining that they were “inspired by the leopard tortoise’s ability to passively reorient”: the pill’s applicator knows how to position itself so that its microscopic needle is trained directly toward stomach tissue, without perforating any gastric organs along the way.

這些研究人員在《科學》(Science)雜志上發表了他們的發現,并且解釋說,他們是受到“豹紋陸龜”的啟發:這種藥丸的微型裝置知道如何調整自己的位置,這樣顯微針頭就可以直接對準胃組織,而不會刺穿胃部。

The antimicrobial paint that can kill ‘superbugs’

殺死“超級細菌”的抗菌涂料


About 10% of hospital patients contract a new illness during their stay – often after coming into contact with germ-laden equipment and surfaces. This results in about 100,000 deaths annually in the US alone; globally, 700,000 people die each year as a result of drug-resistant infections, including tuberculosis, HIV and malaria. The World Health Organization recently described antibiotic resistance as a “global health emergency”.

大約10%的住院病人會感染一種新疾病,通常是因為接觸了醫院的帶菌的設備和物體表面。僅在美國,每年因此造成約10萬人死亡。全球每年有70萬人死于耐藥感染,包括結核病、艾滋病毒和瘧疾等。世界衛生組織最近將抗生素耐藥性形容為“全球健康危機”。

In response, the US Food and Drug Administration and several leading paint companies have teamed up to develop a variety of antimicrobial coatings that can be applied to medical equipment and supplies. These additives are first introduced into a paint, ink or lacquer during the manufacturing process; the paint is then applied to a surface, which, once dried, becomes resistant to microbes, mould, and fungi. One company, BioCote, produces antimicrobial paint for purchase commercially, offering a promising mechanism for fighting so-called “superbugs”: the antibiotic-resistant bacteria that can infect hospital surfaces and harm patients who are already immunocompromised.

為此,美國食品和藥物管理局(US Food and Drug Administration)和幾家領先的涂料公司合作開發了多種可用于醫療設備和用品的抗菌涂料。這種抗菌添加劑在生產過程中加入到涂料、油墨或者油漆當中,然后將這種涂料覆蓋在設備表面,干燥之后,就能抵御微生物、霉菌和真菌。一家名為BioCote的公司生產用于商業采購的抗菌涂料,為抵御所謂的“超級細菌”提供了一個充滿希望的機制。這種耐藥性細菌可以感染醫院建筑或設備的表面,對免疫功能已經受損的病人會造成進一步的傷害。

Ironically, the same chemicals in antibacterial products – gels, antiseptics and hand sanitisers – used to scour hospitals and clean equipment are known to actually promote these antibacterial strains, killing off good and bad bacteria alike. Since their advent in the early 20th Century, antibiotics have saved countless lives, eradicating diseases caused by harmful bacteria; but, just as overuse of the drugs has weakened their efficacy, antimicrobial paint isn’t a fail-safe measure.

具有諷刺意味的是,用于醫院和清潔設備的凝膠、防腐劑和洗手液等抗菌產品中所添加的同樣的化學物質,實際上卻能促進這些抗菌菌株的生長,不管細菌是好是壞全部殺死??股刈?0世紀初問世以來,挽救了無數生命,根除有害細菌引起的疾??;但是,正如藥物濫用會削弱藥效一樣,抗菌涂料也不是萬無一失的措施。
 

抗生素使用的增加,意味著一些細菌對許多常用抗生素品種產生了抗藥性

It’s safe to say that, as long as they don’t rely exclusively on one method, hospitals can now add antibacterial paint to their disease-fighting toolbox.

可以肯定地說,只要不完全依賴于一種方法,醫院現在就可以在他們的抗病手段中加入抗菌涂料。

Crypto-anchors may put an end to counterfeit pharmaceuticals

加密錨定機制(crypto-anchors)可能從此杜絕假藥


Fraud costs the global economy more than £3tn a year. From corporate corruption to fake electronics to identity theft, double-dealing is pervasive in almost every industry, and that includes healthcare: in some countries, nearly 70% of certain drugs are counterfeit.

欺詐使得全球經濟每年的損失超過3萬億英鎊。從企業腐敗到假冒電子產品,再到身份盜竊,幾乎所有行業都存在不誠信的行為,其中也包括醫療保健行業:在有些國家,近70%的藥品都是假藥。

Earlier in February, the World Health Organization reported that fake leukemia medicine, packaged for the UK market to look like the genuine drug Iclusig, was circulating in Europe and the Americas. And physicians have found traces of ecstasy and Viagra ingredients in pills posing as antimalarial medicine.

2月初,世界衛生組織報告說,假冒的白血病藥物正在歐洲和美洲傳播,英國市場上架的普納替尼(Iclusig)包裝與正品看起來一樣。醫生們在假冒的抗瘧疾藥物中還發現了搖頭丸和偉哥的成分。

It turns out that ensuring the authenticity of medicine is nearly as difficult as monitoring bank accounts or consumer electronics, for a few reasons. Complex supply chains, comprised of dozens of suppliers in multiple countries, make it difficult to prevent bad actors from tampering with drugs. The market for legal medicine has surpassed that of illegal narcotics, a fact not lost on drug dealers; and when a patient doesn’t blossom back to health after taking a (counterfeit) drug, doctors generally blame the illness, and not the pill.

事實證明,出于幾個原因,確保藥品的真實性與對銀行賬戶或消費電子產品進行監控幾乎一樣困難。由多個國家數十個供應商組成的復雜供應鏈,使得阻止不法之徒對藥品動手腳變得非常困難。合法藥品的市場的利潤已經超過了非法假藥市場,對此假藥販子不會視而不見。而且當病人因服用假藥而無法痊愈,醫生通常會認為是疾病的原因,不會想到是藥有問題。

That may all soon change, thanks to a team of IBM researchers who are developing crypto-anchors: tamper-proof digital fingerprints that can be embedded into products and linked to a blockchain to prove their authenticity (the blockchain is a growing list of digital records called blocks, which are linked through encrypted code).

因為IBM的一個研究小組正在開發加密錨定機制,上述狀況可能很快就會改變。所謂加密錨定機制是將防篡改數字指紋嵌入到產品中,并與區塊鏈相聯,以證明藥品的真實性(區塊鏈是一長串數字記錄,稱之為區塊,通過加密的代碼相連)。

Smaller than a grain of sand, these crypto-anchors can take many forms: tiny edible computers or optical codes that can be put on pills to separate them from fake meds, in much the same way that diamonds are measured and marked to distinguish them from imitation stones.

加密錨比一粒沙子還小,可以采用多種形式,例如置于藥片之上的光學編碼,可以區別真藥與假藥,這與給鉆石做測量和標記,以區別于真假鉆石是一個道理。

Researchers offered the example of embedding a crypto-anchor in an edible shade of magnetic ink, which could then be used to dye a malaria pill. A drop of water would visibly activate the code, assuring consumers the pill is both authentic and safe to consume.

研究人員舉了一個例子,他們將一個加密錨嵌入一種可食用的磁性墨水,這種墨水可以用來給瘧疾藥片上色。一滴水就能顯現密碼,從而向消費者確保該藥的真實性和食用安全性。

Since their identifying codes cannot be duplicated or copied, crypto-anchors are highly secure, offering patients, doctors and healthcare providers added security in an increasingly fraudulent pharmaceutical landscape.

由于識別碼無法復制,加密錨非常安全,在造假越來越多的制藥領域為患者、醫生和醫療保健提供商提供了額外的安全保障。

BRCK: free public Wifi

BRCK:免費公共Wifi


We take internet connectivity for granted, but many lack reliable access to a network connection. Breakdowns in digital communication during a health crisis can have devastating consequences: missed dosages, inaccurate records, poor decision-making, medical errors, and incomplete information regarding disease outbreaks.

我們認為互聯網連接是理所當然的,但許多地區缺乏可靠的網絡連接。如發生健康危機,數字通信的中斷可能會帶來災難性的后果,如劑量記錄丟失、記錄不準確、決策失誤、醫療錯誤以及關于疾病爆發的信息不完整之類。

In Africa, a continent whose 1.1 billion inhabitants rely mostly on mobile internet, connectivity is notoriously bad; the problem is compounded by the fact that users are often trying to access content that sits on a remote server somewhere in the United States or Europe.

在非洲大陸,11億居民主要依靠連接性能很不理想的移動互聯網,而用戶又需要經常瀏覽位于美國或歐洲某個遠程服務器提供的信息,這使得問題變得更加復雜。

Enter Moja, a free public Wifi device created by the BRCK team designed to be used in areas with limited internet access. More than just a hardware router, this content delivery network (CDN) effectively replaces spotty – and expensive –cellular data, allowing users to browse the internet and social media at no additional cost, since anyone within range of Moja’s signal can connect to the internet for free.

解決方法是連接到Moja。這是一個由BRCK團隊設計的免費公共Wifi設備,專門為互聯網接入受限的地區所設計。Moja不僅僅是一個硬件路由器,這個信息傳送網絡(CDN)有效地取代了不穩定和昂貴的蜂窩數據,用戶無需額外成本,就可以瀏覽互聯網和社交媒體,因為在Moja信號范圍內的所有人都可以免費連接到互聯網。

Moja’s network of servers hosts content for Facebook, Netflix and Youtube, but it’s easy to see how this improved connection might have tremendous impact for disease management: remote users will be able to message one another and share information in real time, thereby streamlining communication between doctors, patients, hospitals and healthcare volunteers.

Moja的服務器網絡托管Facebook、Netflix和Youtube的內容,但很容易看出這種上網連接的改進,可能會對疾病防治管理產生巨大影響:遠程用戶能夠相互發送并實時分享信息,從而簡化醫生、患者、醫院和醫療志愿者之間的溝通。

Plus, BRCK’s hardware is designed to stand up to the challenges of weather and environment: Moja runs through sturdy, waterproof aluminium routers with multiple power ports, ensuring that applications run smoothly even when conditions are tough.

此外,BRCK的硬件設計還考慮到了天氣和環境的挑戰:Moja采用堅固的防水鋁制路由器,帶有多個電源端口,確保應用程序即使在惡劣環境下也能順利運行。
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