Michael Barbella , Managing Editor09.11.14
“...in a lot of cases it’s seeing two things and having them come together in some new and interesting way, and then adding the question, ‘What if?’ ‘What if?’ is always the key question.”
—Stephen King
It began, as most great ideas do, with a simple query.
For days, or maybe weeks back in 2012 (the memory is now a blur), Jay F. Whitacre pondered the feasibility of supersized batteries. Is it possible, he wondered, to make such large-scale devices?
Whitacre wracked his brain for answers but continually came up empty. Thinking about it, in fact, only led to more questions: Are there size limitations to batteries? Could they be made as big as a car or garage? A house? How difficult would it be to make a mega-battery? What would it cost? Are they even practical?
Lots of unanswered questions. And no Eureka! moment.
The proverbial “aha!” light bulb eventually flickered in the hallowed fourth-floor corridor of Carnegie Mellon University’s Wean Hall. The building’s north wing houses Whitacre’s office and those of several other Materials Science and Engineering faculty, including Christopher J. Bettinger, Ph.D., director of CMU’s Biomaterials-based Microsystems and Electronics laboratory.
Whitacre quickly found a confidante in Bettinger upon his arrival at CMU two years ago. Connected by fate (their offices are only four rooms apart), the pair quickly forged a friendship based on common interests: Both men hold doctorate degrees in materials science; both teach materials science and engineering courses at CMU (Bettinger also is a biomedical engineering instructor); and both spawned companies from their scientific passions (Whitacre’s Aquion Energy develops sodium ion batteries and energy storage systems while Bettinger’s AnCure designs brain aneurysm treatment devices).
As CMU neighbors, Whitacre and Bettinger often discussed their work and respective research. It was one of those conversations that led to an epiphany about batteries, though it was radically different from anything Whitacre had previously considered.
“Because we work in close proximity, we’ve thought about this [battery] idea a lot,” explained Bettinger, recipient of the National Academy of Sciences Award for Initiatives in Research. “He [Whitacre] develops batteries for large-scale energy storage. Rather than use expensive materials to build batteries, his idea is to use a simple, inexpensive material. It turns out that aqueous electrolytes, or salt water-based electrolytes, are pretty important in moving ions around. Our bodies are made up of mostly salt water, so we started asking ‘what if?’ What if we used aqueous electrolytes from the body as a component of this battery? That could be interesting.”
Not exactly an Archimedes-like breakthrough for Whitacre’s big battery brainstorm, but a Eureka! moment nonetheless. The light bulb was on—and shining brightly on the opposite end of the battery size spectrum. Human electrolytes may not be practicable for supersized batteries but they’re an ideal power source for miniscule electronic devices. Making these batteries suitable for implantation inside the body, however, has proved challenging.
Most energy storage systems that power automated medical devices use potentially toxic electrode materials and electrolytes that compromise their safety. To become eligible for implantation, these storage systems must be composed of benign materials and able to operate in hydrated environments.
Last spring, Bettinger and Whitacre created edible power sources for medical devices using materials found in a daily diet. Their initial design involved a flexible polymer electrode and a sodium ion electrochemical cell that was folded into an edible pill encapsulating the tiny device.
Since then, the pair has improved upon their original design by using cuttlefish ink melanins. The naturally occurring melanins (pigment) in the mollusk’s ink have a higher charge storage capacity compared to other synthetic melanin derivatives when used as anode materials. And pigment-based anodes are an essential component of sodium-ion batteries, the technology Whitacre has pioneered through his company.
“We discovered that melanin—the pigment in your eyes, your skin and your hair—has an interesting cross-section of properties that make it ideal for powering an ingestible electronic device. One of the more interesting aspects of melanin is the nanoscale structures that occur naturally,” Bettinger told Medical Product Outsourcing. “This nanoscale structure found in nature is very similar to the structure you might find in a battery that powers your cell phone or laptop. There’s a consequential structural conformity between melanins and high-performance batteries. We took that idea and ran with it, using melanin to make batteries that could power edible electronic devices in the future.”
Ingestible electronics, mite-sized robots, microscopic sensors and tiny biomimetic scaffolds are just a few of the probable treatment options in that future as nanotechnology further ingrains itself in the medical device and pharmaceutical industries. Industry experts predict the global nanomedicine market to achieve a compound annual growth rate of 12.3 percent through 2019, reaching a total net worth of $177.6 billion, according to Transparency Market research statistics.
Nanobot Power
Researchers are close to turning science fiction into science fact with millimeter-wide robots that crawl through human veins to treat arterial blockage or deliver targeted medication. Former CMU professors Metin Sitti, Ph.D. (now a director at the Max Planck Institute for Intelligent Systems in Stuttgart, Germany), and Eric Diller, Ph.D. (currently a University of Toronto professor), have created magnetic micro-robots, or “nanobots” controllable through a magnetic field. Initial experiments proved the nanobots capable of transporting small objects and building bridges from Y-shaped rods, raising hopes that future injectible versions could construct an entire medical device while floating within the bloodstream.
“We need to make things smaller to get inside the body easier, but if they are too small, they are not really useful,” Sitti noted to New Scientist in April. “You want to assemble the robot inside the body.”
While at CMU, Sitti also was developing a pill camera that significantly improves upon most current models that lack their own propulsion system and move through the body naturally without a doctor’s help. Sitti’s therapeutic capsule endoscope, by contrast, has two magnets on either end, allowing clinicians to twist, spin and otherwise manipulate it from outside the body. Its flexible elastomer composition also would enable physicians to change its shape, making it easier to load drugs or tiny tools for site-specific treatment.
Magnets also are the power source for the OctoMag, a microbot designed by scientists at the Multi-Scale Robotics Lab at ETH Zurich (Switzerland). The magnetically guided device allows doctors to wirelessly navigate microbots during ophthalmic surgery, releasing magnetic forces and torques in three directions using electromagnetic coils.
The OctoMag is cylindrical and can move a needle forward or back. Just over a quarter-millimeter in diameter, or about four human hairs, the microbot surpasses even the thinnest of scalpel blades. The needle, which is ground to a point almost atomically sharp, also matches well against surgical industry standards for blade sharpness, according to published reports.
The robot contains no power source nor means of locomotion; it’s simply a metal rod with a retractable needle. The OctoMag team has worked on other means of nanobot locomotion, including a system of artificial flagellar movement inspired by the locomotion of bacteria, but this particular robot moves solely with the help of magnets.
Although prior experiments with magnetically controlled eye surgery have used dead pig eyes, advances in the practical physical design of the OctoMag hardware have allowed studies to begin in live rabbits. The scale still is too small to accommodate an animal much larger than that, and certainly too small for a human head, but the potential nevertheless exists.
Nanotechnology, and nanobots specifically, are likely to play an increasingly important role in diagnosing and treating diseases in the future. Chemists at New York University, for example, have created a nanoscale robot from DNA fragments that walks on two legs measuring 10 nanometres long. This robot took its first steps (two forward and two reverse) in 2004 with the help of psoralen molecules attached to the ends of its “feet.” With some fine-tuning, researchers hope the nanobot could one day become part of an infinitesimal production line, regulating molecular chemistry where needed (much like “spot-welding” on automotive assembly lines).
Harvard University scientists are tinkering with DNA-based robots as well, having created an “origami nanorobot” that can transport molecular payloads. According to the journal Science, the barrel-shaped nanobot can carry molecules containing instructions that make cells behave in a particular way. In their study, the team successfully demonstrated the delivery of molecules that trigger cell suicide in leukemia and lymphoma cells.
This programmable nanotherapeutic approach was modeled on the body’s own immune system in which white blood cells patrol the bloodstream for any signs of trouble. These infection fighters hone in on specific cells in distress, bind to them, and transmit comprehensible signals directing them to self-destruct. The DNA nanorobot emulates this level of specificity through the use of modular components in which different hinges and molecular messages can be switched in and out of the underlying delivery system, much as different engines and tires can be placed on the same chassis. The programmable power of this type of modularity means the system potentially can be used to treat various diseases.
“We can finally integrate sensing and logical computing functions via complex, yet predictable, nanostructures—some of the first hybrids of structural DNA, antibodies, aptamers and metal atomic clusters—aimed at useful, very specific targeting of human cancers and T-cells,” said George Church, Ph.D., a Wyss core faculty member and genetics professor at Harvard Medical School, who is principal investigator on the project.
Because DNA is a natural, biocompatible and biodegradable material, DNA nanotechnology is widely recognized for its potential as a delivery mechanism for drugs and molecular signals. But there have been significant challenges to its implementation, such as the type of structure to create; the manner in which that structure is opened, closed, and reopened to insert, transport and deliver a payload; and ways to program this type of nanoscale robot.
Nanobots are being created from other materials, too. Northwestern University investigators crafted their cancer-chasing “nanostars”from gold while German researchers built their sperm-based biobots from iron and titanium.
Northwestern’s nanostar is, as its name implies, shaped much like a star, with five to 10 points (a nanostar is roughly 25 nanometers wide). The star’s large surface area holds a high concentration of drug molecules, though a much lower amount than current therapeutic approaches is required because the pharmaceutical is stabilized on the surface of the nanoparticle.
Bound to the nucleolin, the drug-loaded gold nanostars take advantage of the protein’s role as a shuttle within human cervical and ovarian cancer cells and hitchhike their way to the cell nucleus. The researchers then direct ultrafast pulses of light— similar to that used in LASIK surgery—at the cells. The pulsed light cleaves the bond attachments between the gold surface and the thiolated DNA aptamers, which then can enter the nucleus.
The German biobots conceived at the Institute for Integrative Nanosciences in Dresden, Germany, ride solo, modelling themselves after one of Mother Nature’s best swimmers. The biobots are a microtube-sperm hybrid, composed of hollow cylinders 50 microns long by 5 to 8 microns in diameter. The tube’s lobster trap-like design (one end narrower than the other) easily captures live bull sperm head-first, leaving their flagella free to move and propel the entire compound forward.
Institute scientists used external magnetic fields to control the tubes’ direction, similar to the way a compass needle aligns with Earth’s magnetic field. Lead scientist Oliver Schmidt said the sperm cells make ideal drug delivery tools because they are self-powered, biologically safe and can successfully steer through thick liquids.
“The real promise of nanotech is that you can affect things at a nanoscale, which is where most biological processes happen,” said Venkat Rajan, advanced medical technologies principal analyst at global market research firm Frost & Sullivan. “A lot of these technologies have been more theoretical or proof-of-concept over the last decade but now they are moving into animal model testing phases or they are close to commercialization. The sci-fi type of nanobot technology is still in the very early phase; it’s probably more than a decade away. The nanotechnology we’re likely to see now is more along the lines of sensing capabilities, biomimetic protection for implants and diagnostics.”
One of the sensing capabilities currently under development involves tiny implantable chips that can detect an impending heart attack. Last spring, Swiss scientists unveiled a 14-millimeter-long chip that measures molecules in the bloodstream and transmits the results wirelessly to a smartphone or tablet app. Investigators claim their IronIC system can detect heart attacks several hours in advance.
“There is a molecule called troponin that is released by the heart muscle just three to four hours before the heart attack, once the heart muscle starts malfunctioning,” Sandro Carrara, a team leader at the Swiss Federal Institute of Technology in Lausanne told The Verge. “Our system could detect this molecule three to four hours in advance of the fatal event.”
The device is powered by a patch that sticks onto a patient’s skin like a nicotine patch, but contains a battery rather than drugs. The chip sends information through radio waves to the battery patch, which in turn, transmits it via Bluetooth to a mobile app. Carrara and his colleagues have tested a prototype device in mice for detection of five different blood-borne substances. So far, the results have been equal to the reliability of traditional blood tests, which involve drawing blood from a patient and analyzing it with separate lab equipment. The researchers estimate commercialization to be about four years away, though at that point, they believe mass production would allow them to make the chips for less than a dollar each.
The injectible chip developed by Scripps Health Chief Academic Officer Eric Topol, M.D., and Axel Scherer, a Neches professor of physics, electrical engineering, and applied physics at the California Institute of Technology, works in a similar way, using chips measuring 90 microns (smaller than a grain of sand) to prowl for endothelial cells that are sloughed off an artery wall in the precursory period before a heart attack. The sensors, which also could be used to forewarn of strokes, currently are being tested for glucose detection in animals. Humal trials soon will follow.
“A nanosensor in the bloodstream that is smaller than a grain of sand will pick up a signal when you have cells coming off the artery lining, which is a precursor to a heart attack,” Topol explained to NBC last winter. “... then you’ll get on your phone a special heart attack ring tone, which will warn you that within the week or two weeks that you are very liable to have a heart attack. I know it sounds a little invasive putting this tiny, smaller than a grain of sand in your blood, but what that will do is have your body under continual surveillance talking to your phone—that is the future of medicine.”
—Stephen King
It began, as most great ideas do, with a simple query.
For days, or maybe weeks back in 2012 (the memory is now a blur), Jay F. Whitacre pondered the feasibility of supersized batteries. Is it possible, he wondered, to make such large-scale devices?
Whitacre wracked his brain for answers but continually came up empty. Thinking about it, in fact, only led to more questions: Are there size limitations to batteries? Could they be made as big as a car or garage? A house? How difficult would it be to make a mega-battery? What would it cost? Are they even practical?
Lots of unanswered questions. And no Eureka! moment.
The proverbial “aha!” light bulb eventually flickered in the hallowed fourth-floor corridor of Carnegie Mellon University’s Wean Hall. The building’s north wing houses Whitacre’s office and those of several other Materials Science and Engineering faculty, including Christopher J. Bettinger, Ph.D., director of CMU’s Biomaterials-based Microsystems and Electronics laboratory.
Whitacre quickly found a confidante in Bettinger upon his arrival at CMU two years ago. Connected by fate (their offices are only four rooms apart), the pair quickly forged a friendship based on common interests: Both men hold doctorate degrees in materials science; both teach materials science and engineering courses at CMU (Bettinger also is a biomedical engineering instructor); and both spawned companies from their scientific passions (Whitacre’s Aquion Energy develops sodium ion batteries and energy storage systems while Bettinger’s AnCure designs brain aneurysm treatment devices).
As CMU neighbors, Whitacre and Bettinger often discussed their work and respective research. It was one of those conversations that led to an epiphany about batteries, though it was radically different from anything Whitacre had previously considered.
“Because we work in close proximity, we’ve thought about this [battery] idea a lot,” explained Bettinger, recipient of the National Academy of Sciences Award for Initiatives in Research. “He [Whitacre] develops batteries for large-scale energy storage. Rather than use expensive materials to build batteries, his idea is to use a simple, inexpensive material. It turns out that aqueous electrolytes, or salt water-based electrolytes, are pretty important in moving ions around. Our bodies are made up of mostly salt water, so we started asking ‘what if?’ What if we used aqueous electrolytes from the body as a component of this battery? That could be interesting.”
Not exactly an Archimedes-like breakthrough for Whitacre’s big battery brainstorm, but a Eureka! moment nonetheless. The light bulb was on—and shining brightly on the opposite end of the battery size spectrum. Human electrolytes may not be practicable for supersized batteries but they’re an ideal power source for miniscule electronic devices. Making these batteries suitable for implantation inside the body, however, has proved challenging.
Most energy storage systems that power automated medical devices use potentially toxic electrode materials and electrolytes that compromise their safety. To become eligible for implantation, these storage systems must be composed of benign materials and able to operate in hydrated environments.
Last spring, Bettinger and Whitacre created edible power sources for medical devices using materials found in a daily diet. Their initial design involved a flexible polymer electrode and a sodium ion electrochemical cell that was folded into an edible pill encapsulating the tiny device.
Since then, the pair has improved upon their original design by using cuttlefish ink melanins. The naturally occurring melanins (pigment) in the mollusk’s ink have a higher charge storage capacity compared to other synthetic melanin derivatives when used as anode materials. And pigment-based anodes are an essential component of sodium-ion batteries, the technology Whitacre has pioneered through his company.
“We discovered that melanin—the pigment in your eyes, your skin and your hair—has an interesting cross-section of properties that make it ideal for powering an ingestible electronic device. One of the more interesting aspects of melanin is the nanoscale structures that occur naturally,” Bettinger told Medical Product Outsourcing. “This nanoscale structure found in nature is very similar to the structure you might find in a battery that powers your cell phone or laptop. There’s a consequential structural conformity between melanins and high-performance batteries. We took that idea and ran with it, using melanin to make batteries that could power edible electronic devices in the future.”
Ingestible electronics, mite-sized robots, microscopic sensors and tiny biomimetic scaffolds are just a few of the probable treatment options in that future as nanotechnology further ingrains itself in the medical device and pharmaceutical industries. Industry experts predict the global nanomedicine market to achieve a compound annual growth rate of 12.3 percent through 2019, reaching a total net worth of $177.6 billion, according to Transparency Market research statistics.
Nanobot Power
Researchers are close to turning science fiction into science fact with millimeter-wide robots that crawl through human veins to treat arterial blockage or deliver targeted medication. Former CMU professors Metin Sitti, Ph.D. (now a director at the Max Planck Institute for Intelligent Systems in Stuttgart, Germany), and Eric Diller, Ph.D. (currently a University of Toronto professor), have created magnetic micro-robots, or “nanobots” controllable through a magnetic field. Initial experiments proved the nanobots capable of transporting small objects and building bridges from Y-shaped rods, raising hopes that future injectible versions could construct an entire medical device while floating within the bloodstream.
“We need to make things smaller to get inside the body easier, but if they are too small, they are not really useful,” Sitti noted to New Scientist in April. “You want to assemble the robot inside the body.”
While at CMU, Sitti also was developing a pill camera that significantly improves upon most current models that lack their own propulsion system and move through the body naturally without a doctor’s help. Sitti’s therapeutic capsule endoscope, by contrast, has two magnets on either end, allowing clinicians to twist, spin and otherwise manipulate it from outside the body. Its flexible elastomer composition also would enable physicians to change its shape, making it easier to load drugs or tiny tools for site-specific treatment.
Magnets also are the power source for the OctoMag, a microbot designed by scientists at the Multi-Scale Robotics Lab at ETH Zurich (Switzerland). The magnetically guided device allows doctors to wirelessly navigate microbots during ophthalmic surgery, releasing magnetic forces and torques in three directions using electromagnetic coils.
The OctoMag is cylindrical and can move a needle forward or back. Just over a quarter-millimeter in diameter, or about four human hairs, the microbot surpasses even the thinnest of scalpel blades. The needle, which is ground to a point almost atomically sharp, also matches well against surgical industry standards for blade sharpness, according to published reports.
The robot contains no power source nor means of locomotion; it’s simply a metal rod with a retractable needle. The OctoMag team has worked on other means of nanobot locomotion, including a system of artificial flagellar movement inspired by the locomotion of bacteria, but this particular robot moves solely with the help of magnets.
Although prior experiments with magnetically controlled eye surgery have used dead pig eyes, advances in the practical physical design of the OctoMag hardware have allowed studies to begin in live rabbits. The scale still is too small to accommodate an animal much larger than that, and certainly too small for a human head, but the potential nevertheless exists.
Nanotechnology, and nanobots specifically, are likely to play an increasingly important role in diagnosing and treating diseases in the future. Chemists at New York University, for example, have created a nanoscale robot from DNA fragments that walks on two legs measuring 10 nanometres long. This robot took its first steps (two forward and two reverse) in 2004 with the help of psoralen molecules attached to the ends of its “feet.” With some fine-tuning, researchers hope the nanobot could one day become part of an infinitesimal production line, regulating molecular chemistry where needed (much like “spot-welding” on automotive assembly lines).
Harvard University scientists are tinkering with DNA-based robots as well, having created an “origami nanorobot” that can transport molecular payloads. According to the journal Science, the barrel-shaped nanobot can carry molecules containing instructions that make cells behave in a particular way. In their study, the team successfully demonstrated the delivery of molecules that trigger cell suicide in leukemia and lymphoma cells.
This programmable nanotherapeutic approach was modeled on the body’s own immune system in which white blood cells patrol the bloodstream for any signs of trouble. These infection fighters hone in on specific cells in distress, bind to them, and transmit comprehensible signals directing them to self-destruct. The DNA nanorobot emulates this level of specificity through the use of modular components in which different hinges and molecular messages can be switched in and out of the underlying delivery system, much as different engines and tires can be placed on the same chassis. The programmable power of this type of modularity means the system potentially can be used to treat various diseases.
“We can finally integrate sensing and logical computing functions via complex, yet predictable, nanostructures—some of the first hybrids of structural DNA, antibodies, aptamers and metal atomic clusters—aimed at useful, very specific targeting of human cancers and T-cells,” said George Church, Ph.D., a Wyss core faculty member and genetics professor at Harvard Medical School, who is principal investigator on the project.
Because DNA is a natural, biocompatible and biodegradable material, DNA nanotechnology is widely recognized for its potential as a delivery mechanism for drugs and molecular signals. But there have been significant challenges to its implementation, such as the type of structure to create; the manner in which that structure is opened, closed, and reopened to insert, transport and deliver a payload; and ways to program this type of nanoscale robot.
Nanobots are being created from other materials, too. Northwestern University investigators crafted their cancer-chasing “nanostars”from gold while German researchers built their sperm-based biobots from iron and titanium.
Northwestern’s nanostar is, as its name implies, shaped much like a star, with five to 10 points (a nanostar is roughly 25 nanometers wide). The star’s large surface area holds a high concentration of drug molecules, though a much lower amount than current therapeutic approaches is required because the pharmaceutical is stabilized on the surface of the nanoparticle.
Bound to the nucleolin, the drug-loaded gold nanostars take advantage of the protein’s role as a shuttle within human cervical and ovarian cancer cells and hitchhike their way to the cell nucleus. The researchers then direct ultrafast pulses of light— similar to that used in LASIK surgery—at the cells. The pulsed light cleaves the bond attachments between the gold surface and the thiolated DNA aptamers, which then can enter the nucleus.
The German biobots conceived at the Institute for Integrative Nanosciences in Dresden, Germany, ride solo, modelling themselves after one of Mother Nature’s best swimmers. The biobots are a microtube-sperm hybrid, composed of hollow cylinders 50 microns long by 5 to 8 microns in diameter. The tube’s lobster trap-like design (one end narrower than the other) easily captures live bull sperm head-first, leaving their flagella free to move and propel the entire compound forward.
Institute scientists used external magnetic fields to control the tubes’ direction, similar to the way a compass needle aligns with Earth’s magnetic field. Lead scientist Oliver Schmidt said the sperm cells make ideal drug delivery tools because they are self-powered, biologically safe and can successfully steer through thick liquids.
“The real promise of nanotech is that you can affect things at a nanoscale, which is where most biological processes happen,” said Venkat Rajan, advanced medical technologies principal analyst at global market research firm Frost & Sullivan. “A lot of these technologies have been more theoretical or proof-of-concept over the last decade but now they are moving into animal model testing phases or they are close to commercialization. The sci-fi type of nanobot technology is still in the very early phase; it’s probably more than a decade away. The nanotechnology we’re likely to see now is more along the lines of sensing capabilities, biomimetic protection for implants and diagnostics.”
One of the sensing capabilities currently under development involves tiny implantable chips that can detect an impending heart attack. Last spring, Swiss scientists unveiled a 14-millimeter-long chip that measures molecules in the bloodstream and transmits the results wirelessly to a smartphone or tablet app. Investigators claim their IronIC system can detect heart attacks several hours in advance.
“There is a molecule called troponin that is released by the heart muscle just three to four hours before the heart attack, once the heart muscle starts malfunctioning,” Sandro Carrara, a team leader at the Swiss Federal Institute of Technology in Lausanne told The Verge. “Our system could detect this molecule three to four hours in advance of the fatal event.”
The device is powered by a patch that sticks onto a patient’s skin like a nicotine patch, but contains a battery rather than drugs. The chip sends information through radio waves to the battery patch, which in turn, transmits it via Bluetooth to a mobile app. Carrara and his colleagues have tested a prototype device in mice for detection of five different blood-borne substances. So far, the results have been equal to the reliability of traditional blood tests, which involve drawing blood from a patient and analyzing it with separate lab equipment. The researchers estimate commercialization to be about four years away, though at that point, they believe mass production would allow them to make the chips for less than a dollar each.
The injectible chip developed by Scripps Health Chief Academic Officer Eric Topol, M.D., and Axel Scherer, a Neches professor of physics, electrical engineering, and applied physics at the California Institute of Technology, works in a similar way, using chips measuring 90 microns (smaller than a grain of sand) to prowl for endothelial cells that are sloughed off an artery wall in the precursory period before a heart attack. The sensors, which also could be used to forewarn of strokes, currently are being tested for glucose detection in animals. Humal trials soon will follow.
“A nanosensor in the bloodstream that is smaller than a grain of sand will pick up a signal when you have cells coming off the artery lining, which is a precursor to a heart attack,” Topol explained to NBC last winter. “... then you’ll get on your phone a special heart attack ring tone, which will warn you that within the week or two weeks that you are very liable to have a heart attack. I know it sounds a little invasive putting this tiny, smaller than a grain of sand in your blood, but what that will do is have your body under continual surveillance talking to your phone—that is the future of medicine.”