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Milos Prvulovic and Alenka Zajic. Credit: Allison Carter, Georgia Tech

Researchers at the Georgia Institute of Technology have gotten very good at eavesdropping — but not in the traditional sense. Recently, computer science professors Milos Prvulovic and Alenka Zajic discovered that they could steal encryption keys from a major mobile security package by listening in to smartphone vibrations and electromagnetic signals with a portable device.

Zajic told Healthcare Analytics News™ that the exploit takes less than one second to complete. The device, which can be bought for less than $1,000, analyzes signal variations around a given device’s processor clock — basically measuring when its signal is changing to accommodate for the added burden of running encryption &mdash; and then sorts them into zeroes and ones, using that to extrapolate the encryption key.

READ: Cybersecurity Is Undervalued. But That Might Change Soon

Their work, which was supported by the National Science Foundation, Defense Advanced Research Projects Agency and the U.S. Air Force Research Laboratory, was recently presented at the USENIX Security Symposium in Baltimore. The researchers notified software developers of the exploit before it was published, but Zajic said it’s unclear whether any malicious actors found and used the exploit before her team caught it.

“It is hard to tell since bad actors do not advertise their success,” Zajic said.

Side-channel exploits aren’t new, but the specific exploit the Georgia team found completely changes the game.

“What is unique about our finding is that only one recording of the signal is sufficient to recover the full key,” Zajic said.

Prior side-channel attacks on encryption needed “thousands of observations” of a device’s signals or key to extract it, a process that wasn’t as viable for hackers because encryption keys change frequently.

“By needing only one recording, it makes the attack more practical and dangerous,” Zajic said. “Both electronic designers and software engineers need to worry about this problem and try to minimize side-channel leakage.”

The researchers tested the exploit on Android devices, but Zajic said that Apple devices are also susceptible to the same vulnerability “in principle.”

Zajic said hackers using a side-channel exploit would only need the encryption key to perform more sophisticated crimes. The exploit can also extract actual data — the encrypted information itself &mdash; but Zajic said that would be largely unnecessary if a hacker has the user’s personal key.

“Once you have a key, there are probably better ways to steal the data or pretend you are someone else (since you have their private key) than side channels,” Zajic told 

in an email, “But it is possible to get data through side-channels too.”

In the healthcare system, Zajic said, encryption is often used to verify user identity and which data said user can access.

“If attackers obtain access to administrator's device, they could pretend to be an administrator and dispense the wrong medicine. Similarly, attackers could penetrate network protection (by having a key) and change many settings in a hospital network,” Zajic said. “We all operate under assumption that encryption will protect us from wrong persons having information about our identity or having our data, and this is mostly true, except when an unauthorized person gets the key to all that info.”

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Articles

Why the finding is significant in healthcare and elsewhere.

Researchers Stop Dramatic New Side-Channel Exploit That Cracks Encryption in 1 Second

For all the advancements of modern medicine, doctors still struggle to decipher the human brain. But a new machine-learning algorithm could drastically simplify the complicated calculus that psychiatrists go through to diagnose conditions such as bipolar disorder and major depressive disorder (MDD), giving them a far easier way to fine-tune medication and treatment.

Researchers at the Lawson Health Research Institute, the Mind Research Network and the Brainnetome Center recently designed an artificial intelligence (AI) system purpose-built to analyze brain scans and pick apart the subtle differences in mood disorders. The algorithm — 

— could help doctors prescribe and predict a patient’s response to a given medication, lessening the period of tortuous trial-and-error before a patient can get the help they need.

READ: mHealth Might Solve Our Prisons’ Mental Health Problem

The researchers used brain scans from 78 young adult patients at the London Health Sciences Center in Ontario, Canada. Of those, 66 patients had already been diagnosed and treated for either major depressive disorder or bipolar type 1. The researchers also used 33 participants with no history of mental illness as a control group for their data set, which was compiled using fMRI scans. Under an fMRI, brains exhibiting MDD and bipolar 1 look different next to each other and compared to the group with no history of mental illness, which the researchers designed the algorithm to identify. They set the AI loose on the data and checked its work based on the patients with an existing diagnosis. All told, the AI was promising — classifying illnesses correctly 92.4 percent of the time.

“The technique can always be improved, and we have lots of ideas there,” Vince Calhoun, Ph.D., president of the Mind Research Network and a professor of neuroscience, computer science and psychiatry at the University of New Mexico, told Healthcare Analytics News™ in an email. “But given the performance was very good for the current algorithm, I think the next steps include scaling up.”

Researchers want to scale the program up to see how it runs on different kinds of MRI machines, and to further automate how the AI processes data and comes to a conclusion (the “analysis pipeline,” as Calhoun put it). They also want to develop a protocol that can help human doctors to perform similar analysis to the algorithm, looking for the same distinctions that the computer does.

Down the line, the technique still needs much more data from additional studies, as well as some way of certifying imaging facilities to do the scans correctly. Calhoun said a widespread implementation would also need cloud-based tools to process the data.

For now, the program is still in its infancy.

“This is not ready for ‘prime time’ or routine clinical care yet,” Elizabeth Osuch, M.D., a clinician-scientist at Lawson Health Research Institute and medical director at the First Episode Mood and Anxiety Program (FEMAP) at the London Health Sciences Center, told HCA News in an email. “But advances in technology may lead to cheaper proxies for an fMRI scan.”

And in any case, Osuch said the AI is designed to be used in cases where traditional DSM diagnoses fails, not on every patient who comes through the door.

But, if implemented properly, it could make the difficult job of distinguishing a patient’s particular mood disorder much easier. The researchers said they already have algorithms that can differentiate bipolar disorders from schizophrenia and classify forms of dementia, and they are working toward applying the approach to everything from autism to ADHD — any disorder that the standard DSM diagnostic approach struggles to nail down.

, “suggests that we may one day have an objective measure of psychiatric illness through brain imaging that would make diagnosis faster, more effective and more consistent across health care providers."

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Photo: Abbas Furniturewalla, Rutgers University.

Over the past few years, wearable technology has become ubiquitous among fitness freaks and many other people, too. Having an easy piece of tech that monitors heart rate, calories burned and activities is useful, but the next generation of the technology could do a lot more than that.

Researchers at Rutgers University—New Brunswick are working on a new system of wearable tech that expands the smartwatch into a far more functional medical device. In new research published in 

the researchers described a smart wristband capable of diagnosing everything from blood cancers to toxins in the air around the wearer.

READ: Digital Health Isn’t a Technological Revolution. It’s a Cultural One.

The “smart wristband,” as it’s called, isn’t as sleek and polished as a Fitbit, but researcher Mehdi Javanmard, Ph.D., told Healthcare Analytics News™ that further miniaturization is the next step. Right now, it’s a wide wrap of circuitry and sensors that connects wirelessly to a smartphone via Bluetooth, like its commercial predecessors. The difference is, the new wristband packs a lot more hardware. With a standard lancet prick (the wristband doesn’t have needles embedded in it, yet), people can use the wearable technology to analyze their blood cell counts, test for certain blood cancers, quantify bacteria and analyze proteins.

Before that happens, though, researchers have more work to do.

“Extensive assessments need to be performed, testing the device on large numbers of patients,” Javanmard said, emphasizing that they must make the device “more rugged.”

The device’s uses are an interesting combination of clinical and commercial.

On one hand (literally), a commercial user could wear a bracelet to monitor insulin levels or check the air quality outdoors when stepping out of the house for a run.

On a clinical level, the device could be put on discharged patients who need further testing, to provide immediate, up-to-date information to doctors without another visit to the hospital. Blood samples are fed into a small plastic channel on the device that’s embedded with tiny gold electrodes and analyzed by a micro-controller.

The researchers tested and developed the device for Android phones, but there’s nothing stopping it from being adapted to iOS or other operating systems.

“Current wearables can measure only a handful of physical parameters such as heart rate and exercise activity,” said Abbas Furniturewalla, the study’s lead author and former undergraduate researcher in the Department of Electrical and Computer Engineering, said in a 

. “The ability for a wearable device to monitor the counts of different cells in our bloodstream would take personal health monitoring to the next level.”

Javanmard mentioned in the release that a whole host of professions could benefit from the device, which could become a next-generation canary for miners to measure poisonous gases in their environment. And, of course, they’d also let every fitness-focused consumer fine-tune their body’s chemistry as well.

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A few times a month, Johnny Kung, Ph.D., and his colleagues sit down with groups of people to tell them about all the different ways they could have been born. Kung works for Harvard University’s Personal Genetics Education Project (pgEd), an outreach group that talks to classrooms, churches and healthcare professionals about the potential of gene-editing technology — and about the ethical dilemmas it presents.

When Kung approaches a class, he can’t shy away from the transformative, and possibly transgressive, nature of his field. Gene editing could give doctors the ability to change the building blocks of human life, overhauling everything from our susceptibility to diseases to our physical strength and stamina. It promises cures for cancer, hereditary disease and any number of genetic flaws that cause hardships. But like our bodies, the world is an imperfect place, and some groups think altering our fundamental code is problematic, for many reasons.

READ: Handling the Headaches of At-Home Genetic Testing

Our understanding of the human genome, and what editing it might produce, remains far from complete, and opponents worry that beginning to change it will have unforeseen and disastrous side effects. Others worry that creating a system in which humans can enhance themselves will further societal divides between the haves and have-nots, allowing only the rich to change their genes and futures.  

Kung accepts this. But he also realizes that personal genetics are only going to play a larger role in personal health and society in the future — and the only way to maximize their potential and minimize their pitfalls is to empower the public to make thoughtful, informed decisions. Techniques like CRISPR/Cas9, short for clustered regularly interspaced short palindromic repeats, and chimeric antigen receptor T-cell (CAR T) therapy are still in their infancy but have already shown groundbreaking results in animal and human trials. As these innovations develop, healthcare providers must learn how to counsel patients, navigating the ethical intricacies of changing the human body among different groups, races and religions.

“For many of the communities we engage with, genetics is so closely tied to questions of health, identity, autonomy and privacy, informed consent and history,” Kung says. “We believe that having these difficult conversations early and frankly is important for our audience to be informed.”

Kung says his team’s goal is to “spark conversations about what ways these communities can ensure that current research in these areas can lead to benefits for their communities while preventing the negative history from repeating.” Usually, Kung goes into a classroom or a community center with a short lecture, orienting people to the basics of what gene editing is. After some PowerPoint slides, he likes to pose different scenarios or ethical dilemmas to the group and have them sort themselves into smaller groups based on their stance. This helps them solidify arguments and process why they hold their own views and why others might feel differently. Trying to decide the future of the human race can get thorny, and for many historically marginalized groups, the scientific advancements have often come at the expense of violence to their communities. Many communities just don’t trust scientists who promise miracles.

In 1932, the U.S. Public Health Service performed a 

nonconsensual study on hundreds of black syphilis patients in the South

, using them as a control population to examine the effects of the disease without treatment. The patients were not told they had syphilis or about the nature of the experiment.

In 2016, Kung met with a group of black pastors in Baltimore for a conference co-organized by the 

Minority Coalition for Precision Medicine

 and the Health Ministries Network to discuss religious and cultural objections to gene editing. Kung had high hopes for the meeting, and more than 100 prominent clergy had signed up to attend. But when the date arrived, after the conference was postponed during protests over a court’s decision to 

drop charges for the officers indicted in the killing of Baltimore resident Freddie Gray

, only a handful of clergy showed up. Kung asked why.

“One of the pastors who was in attendance told us bluntly that, to many of them, Harvard [where the pgEd is based] carries the same connotations as their local medical powerhouse, Johns Hopkins — a history of mistrust, the story of Henrietta Lacks,” Kung says.

Much of modern cancer treatment stems from the cell line of Lacks, a black woman whose biopsied cancerous cells were immortalized by doctors at Johns Hopkins in 1951. Lacks never consented to the procedure nor received any compensation for the invaluable research that resulted from her genetic material. Though her body has saved countless lives and changed the way we understand humanity’s most dangerous disease, she was effectively used as a laboratory specimen by doctors entrusted with her care. Lacks, the Tuskegee experiment and a 

long legacy of eugenics in the U.S. disproportionately targeting minorities

 have all left an indelible legacy in many communities, felt today in an entire demographic’s trepidation toward researchers who promise new cures.

Citing the history of eugenics, critics of gene editing warn that editing of individual human embryos could quickly become a tool of oppression. They fear that bad faith actors wielding complete control of the human genome could carry out genocide or systematic oppression on an unprecedented scale.

Even in a best-case scenario, the ability to edit embryos, like 

, would be reserved for those fortunate enough to afford it. This concern isn’t new — in the ’90s, when cloning first entered the scientific dialogue, 

Princeton microbiologist Lee Silver warned

 that specialized genetic selection could quickly widen the gap between rich and poor. In his book “Remaking Eden: Cloning and Beyond in the Brave New World

Silver explained that privileged classes would have the resources and ability to edit out undesirable traits at will.

Marcy Darnovsky, executive director of the Center for Genetics and Society and one of the most outspoken critics of gene editing of most forms, says that CRISPR technology and other epigenetic procedures could quickly make Silver’s dystopia possible.

READ: Forensic Genealogy Is Neat. Is It Ethical, Though?

This fear is particularly pronounced in one specific kind of epigenetics, a process called germline editing. Germline gene editing changes the genetic makeup of something while it is still in embryo, ensuring that the resultant life form will pass on those changes to their own offspring. In humans, germline editing immediately changes a person’s genome, and thus their life, before they are a conscious being capable of consent or awareness of what’s happening. With a germline change, doctors or scientists could, for example, eliminate the chance that a baby would be born with Huntington’s disease or another hereditary condition. But the fear is that things go further: that genetic treatments become an expensive luxury that one class of people can afford so that all children born to the wealthy will be stronger, taller, smarter and healthier than those who cannot afford treatments.

“This kind of thing could take us to some very ugly places,” Darnovsky says. “We already tolerate pretty huge levels of inequality and unfairness in this society that we have. And I think that to try to add to that, exacerbate that, just seems wrong.”

Make no mistake: Gene-editing technology is here. Public and private labs across the country are throwing money and resources into genetic research and CRISPR trials, and it’s inevitable that, eventually, many of the changes that critics worry about will become possible. But that doesn’t mean this scientific evolution has to play out the way that Darnovsky and others fear.

CRISPR technology can be used both for germline editing and somatic editing, which refers to changing the genes of living cells in a fully formed organism to fight cancer or genetic disease or to provide other enhancements.

Somatic gene editing with CRISPR most recently 

played a semiaccurate role in Dwayne Johnson’s summer blockbuster “Rampage

,” in which Johnson’s gorilla friend is juiced up with edited genes to become enormous and angry, and a gigantic wolf grows bat wings. This sort of Frankenstein-like power is not one of the chief concerns of gene-editing opponents, although Chinese researchers have managed to make 

several species of dogs extremely muscular

. In humans, somatic gene editing has the potential to cure or treat hundreds, if not thousands, of diseases and conditions.

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Germline and somatic editing are being widely researched in both humans and animals despite the ongoing debate. Even so, in 2015, the National Institutes of Health (NIH), a major government source of funding for scientific trials, announced that it would not fund germline gene-editing experiments on human embryos.

“The concept of altering the human germline in embryos for clinical purposes has been debated over many years from many different perspectives and has been viewed almost universally as a line that should not be crossed,” NIH Director Francis S. Collins, M.D., Ph.D., 

. “Advances in technology have given us an elegant new way of carrying out genome editing, but the strong arguments against engaging in this activity remain. These include the serious and unquantifiable safety issues, ethical issues presented by altering the germline in a way that affects the next generation without their consent and a current lack of compelling medical applications justifying the use of CRISPR/Cas9 in embryos.”

Germline editing of human embryos is legal but must be privately funded, a regulation that has been on the books well before CRISPR became prominent: The 1996 Dickey-Wicker Amendment prohibits the creation or destruction of human embryos during any research that uses federal funding. Other countries, such as the U.K. and China, have less restrictive laws: Chinese researchers reportedly used CRISPR to genetically modify human embryos as far back as 2015.

Still, experts say that it’s unlikely germline-editing techniques will make it into a clinical setting in the near future. 

, is an assistant professor at Columbia University who did his doctorate under Jennifer Doudna, one of the first scientists to propose that CRISPR could be used for gene editing. Sternberg says that modern research efforts in the U.S. are largely focused on somatic editing rather than germline editing, and even those studies are in their infancy.

“We don’t even know how well CRISPR is going to work as a way to treat disease in living patients, so it’s really too early to think about doing this clinically in embryos,” Sternberg says.

CRISPR technology is not without risks, and with a scarcity of human trials, it’s still too early to tell how soon they’ll be clinically viable. In June, two studies 

linked CRISPR treatments with an increased risk for cancer in edited cells

. This isn’t necessarily a deal breaker for the technology — it’s more of a risk to study or an eventual problem to fix &mdash; but findings like it will change the ethical risk calculations for doctors who are deciding whether to prescribe a somatic gene-editing procedure in the future. And Darnovsky says we can expect more side effects of gene editing down the line.

“We are at a very early stage of our understanding of how changing one genetic sequence might have biological and health consequences,” she says. “We just learned how to read the human genome a few years ago. If we try to rewrite it now, to rewrite the code, we’re likely to have some bugs.”

For doctors and scientists working on genetic treatments for disease, Sternberg explained that there’s an ethical difference between exposing a living patient to the risk of a procedure going wrong and exposing a future person to an unforeseen host of effects. A living patient may consent to a CRISPR treatment, knowing there’s a chance they’ll contract cancer, because they think it will give them the best shot at life. But an embryo and future offspring can’t consent to having their genetic code completely altered.

Fortunately, in our current medical system, germline editing is largely unnecessary to treat medical conditions.

“I think it’s going to be very rare that you’ll have medical needs that would justify germline editing,” Sternberg says. Instead, major companies pursuing CRISPR technologies on a clinical, commercial level — 

— will “completely avoid the germline issue,” Sternberg adds, bypassing the difficult ethics of modifying embryos to focus on somatic-editing therapies to treat medical conditions in living patients.

The solution to this, and to some of the more ideological critiques of gene editing, Sternberg says, is to treat gene editing as any other medical procedure.

READ: Lost in the CRISPR Hype, a Gene-Editing Giant Is Fighting Back

“I think it’s often mentioned in this way as being a very profound thing,” Sternberg notes. “I don’t actually see intervention at the genetic level as something we should do any more or less seriously than intervention at a surgical level or in a way that might modify the genome of certain cells. The question is, can some intervention address medical needs? Can it be offered in an equitable, socially responsible way, and are there any safety concerns that may be intended or unintended that we need to address?”

And right now, somatic gene editing shows great potential to help. Novartis’ 

groundbreaking CAR T cancer treatment, Kymriah

already met Food and Drug Administration approval

, and doctors and hospital administrators are starting to include it in their budget analyses. A single dose of the treatment is $475,000, which means the cost-benefit analysis for administrators is going to be heavily driven by how effective it really is — something we won’t know until it’s been used many, many more times.

What focusing on somatic, clinical applications of gene-editing technology doesn’t solve, however, is the social ethics component of the conversation. The applications for CRISPR tech are varied, from a cure to cancer to enhanced muscle tone. As the medical science community gains further understanding of the human genome, more solutions will present themselves and more cures will become available. Darnovsky worries that gene editing will become like cosmetic surgery, which was first proposed as a treatment for patients with disfiguring wounds but then became a luxury for those who could afford it. Except gene editing could create differences even more drastic than those of personal appearance — it could weed out diseases, improve life expectancies and change bodies. Those who will miss out on these advancements are the populations of people the existing medical system in the U.S. often overlooks: the uninsured or underinsured, the poor, ethnic minorities and rural populations living far from well-equipped, metropolitan healthcare networks.

Sternberg mentioned the case of sickle cell anemia, a chronic genetic condition that predominantly affects African-Americans. Sickle cell is virtually incurable, but there are treatments that have improved the life expectancy for many affected patients. And yet hydroxyurea, the most effective treatment for sickle cell, is 

 by doctors, and many patients in the developing world have no access to it at all.

“If that isn’t available today, then what is going to be the landscape with a new, highly priced drug named CRISPR that’s even more difficult for most of these people to access or pay for?” Sternberg asks. “None of that excitement [about CRISPR] addresses these underlying problems with access and insurance.”

Sickle cell is one of many diseases that 

CRISPR (combined with stem cell therapies) has the potential to cure,

 but Sternberg points out that its mere existence doesn’t guarantee the tech will get to where it needs to go.

Kung covered this on the second day of his meeting with church leaders last year. He was invited back to one of the pastors’ churches to speak more about the coming revolution of personal genetics. The pastors told Kung to focus on the technology’s potential to deliver patients from suffering rather than its comparisons to “playing God.” In Tuskegee, with Henrietta Lacks, researchers were playing God, with unwitting subjects unable to consent. With gene editing, that possibility is on the table, particularly if the technology is deployed in a way that only some have the means to use it.

Speaking to the pastors, Kung says, “showed us how wide the gap is between the biomedical research community and some of the communities it’s supposed to serve. And how much work still needs to be done to narrow this gap.”

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The Complicated Ethics of Gene Editing

For Jill Steinberg, the take-home genetic test was meant to be fun. Her husband saw a sale on 23andMe kits, discounted for 2010 World DNA Day, and bought two on a whim, for himself and for his then-30-year-old wife, who was recovering at home after delivering their second child. Steinberg had no reason to suspect anything was wrong—she was young and in good health&mdash;but thought that diving into the genome she’d just passed down to another child could be interesting. Her sister, 4 years older, had recently battled breast cancer, but Steinberg’s latest trip to her obstetrician/gynecologist raised no red flags. She figured she’d spit in the tube, send it off, and maybe learn a bit more about her ancestry and genes.

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Five months later, Steinberg was in the hospital again, this time for a double mastectomy. The 23andMe kit had identified her as positive for mutations for the 

 genes, a condition that almost invariably results in aggressive, malignant breast cancer.

“I’m like 99.6 percent Ashkenazi Jew,” she said, referring to an ethnic group that the 

 mutation is particularly common in. “I should be having this test, and my doctor told me it wasn’t necessary.”

(After getting her 23andMe results, there wasn’t friction with her doctor—he welcomed the new information and immediately set her on the path to confirming the information and providing care.) The take-home test started a medical journey that the Steinbergs never expected. At the time, 23andMe’s genetic results weren’t official, as the tests lived in a certification gray area that wasn’t under the control of federal standards. A few weeks after getting her results, Steinberg went to a traditional genetic counseling unit, which re-ran her genome at Myriad Genetics, a molecular diagnostics company, and confirmed that she did have the 

“I didn’t want to sit around and wait for cancer,” Steinberg told 

™. “I have these two babies, and I didn’t want to sit around and wait, and all of a sudden, when they’re 13 or older, I have cancer. I couldn’t go through what my sister went through.”

Eight years later, Steinberg is cancer free, and 23andMe’s methods have gone legit: In March, the company received the first FDA approval to test for 

 mutations for a direct-to-consumer product. But beyond that, these tests have become a cultural fad. Similar direct-to-consumer genetics services such as Color and Ancestry all contribute to a growing industry that analysts for the market consulting firm Credence Research predict will be worth $340 million by 2022. On Facebook, friends swap stories of shared Neanderthal genetics or forgotten family heritage, even delving into details like their genetically-predisposed wine preferences or DNA-compatible dating partners. Users like Steinberg say genetic testing should be as easy to access as a take-home pregnancy test, but doctors and other medical professionals worry that a direct-to-consumer model is no substitute for genetic services performed in a clinical setting inside the normal healthcare apparatus.

“There’s a lot of information and a lot of nuanced discussion that happens in the clinic, and that is the role of the genetic counselor,” said Ophira M. Ginsberg, MD, the director of the high-risk cancer genetics program at NYU Langone’s Perlmutter Cancer Center. “It’s much more than just revealing information.”

How Direct-to-Consumer Genetic Tests Get It Wrong

Direct-to-consumer tests, such as those offered by 23andMe, often provide users with raw readouts of their genetic markers, which they take to third-party services that can “interpret” the data. These outside vendors, like StrateGene and LiveWello, offer to interpret the raw data from 23andMe or Ancestry for an additional fee, transforming that data into easier-to-understand tidbits such as whether a customer is genetically resistant to getting norovirus or how that individual metabolizes caffeine.

In the messier economy of scale that these products inhabit (23andMe alone claims to have genotyped at least 2 million customers), physicians worry that false positives and overconfidence in the test’s results will cause patients to slip through the cracks. One study, published this past spring in 

, noted that an aggregated sample of direct-to-consumer tests resulted in a 40 percent false positive rate when judging raw data from the various services. Although that appears to be an alarming figure, Inverse notes that the false positive rate is based on mistakes made by third-party services analyzing the raw data from take-home genetics tests.

READ: Genetic Databases Bump Up Against Privacy Concerns

Going that far into the fringe, the study’s authors warned, should never be a supplement for actual medical advice.

“While having access to raw genotyping data can be informative and empowering for patients, this type of information can also be inaccurate and misinterpreted,” the authors wrote. “Genetic testing needs to be interpreted by a qualified healthcare professional in the context of several other factors, such as personal and family medical history.”

But as direct-to-consumer genetic tests continue to proliferate, doctors will undoubtedly have to grapple with worry that some will see them as a replacement for modern medicine.

“Tools like this have really put the power and knowledge in the individuals,” a friend of mine from college told me, as I asked around about people’s personal experiences with the service. He said he’d used 23andMe specifically for the medical section and analyzed his data with a third-party service, hoping to “remove doctors from his life as much as possible.” “In my opinion, at this point, people should become knowledgeable themselves and take their health into their own hands unless it is an emergency or life-or-death situation,” he said.

“We certainly wouldn’t consider it advisable for somebody to interpret their own [genetic data] or have not commercial non-CLIA [Clinical Laboratory Improvement Amendments]-certified laboratory tell you whether or not you have a serious communicable disease, for example, which may have all kinds of implications,” Ginsberg said. (23andMenow uses CLIA-certified labs to perform its genetic tests, after New York and California told the company it couldn’t operate in their states without using verified labs; other direct-to-consumer kits may not have made the leap yet.) Still, outside of the raw data, take-home kits don’t offer any of the wealth of services that a clinical setting does.

“The main thing here that we’re concerned about is the lack of real kind of honest description of what the test can and cannot do,” Ginsberg said. “We feel they’re sort of misrepresenting what they are able to provide to the

How Health Systems Can Clear the Confusion

Lee Ann McCoy, MS, a certified cancer genetic counselor at NYU Langone said the role of a clinical genetic counselor is part interpreter, part doctor, and part therapist. When patients receive their diagnostics from the lab, genetic counselors are there to talk them through the results and follow up on any additional testing, including on other family members who might be at risk.

“A lot of our patients who come in for genetic counseling may have taken a really long time to face, or decide to face, their risk,” McCoy said. “The idea behind just quietly doing this in your own private home could be appealing, but it defeats the purpose. We really work through what the implications of these tests can mean for [the patient] and their family.”

Kristin Platt, for instance, was in the middle of a dinner with her mother when she got her 23andMe results. She opened the email and skimmed through the data, noticing that she had tested positive for an alpha-one antitrypsin deficiency, something she’d never heard of before. At first, she thought she was just a carrier of some genetic trait, but when she got back to her parents’ house, she took a closer look. The kit’s results repeatedly urged her to see her doctor about the abnormality, and it occurred to her that she might be up against something serious.

READ: Why Consumers Could Drive the Genomic Revolution

Alpha-one is a dangerous mutation that causes long-term loss in lung capability and, if untreated, can take decades off an otherwise healthy person’s life expectancy. Platt, who’s now 43, had been diagnosed with adult-onset asthma at 35 and had been struggling with her lungs for years. As she learned more about the disease, she felt herself going through the stages of grief, signs she recognized from her own career as a drug and alcohol counselor.

“One day when I was cleaning house, I just sat down on the kitchen floor and started sobbing,” Platt said. “I really worked my way through it, but I realized that, you know, this is the way I was going to die.”

She said the 23andMe data were presented well and clearly indicated that she needed to take additional steps. Within a couple of weeks, she was in touch with her doctor and a genetic counselor from the AlphaOne Foundation, a nonprofit company focused on promoting research into the condition and improving quality of life for patients. This, Ginsberg and McCoy told me, is a vital step to reconciling the disorganization of direct-to-consumer model genetic testing and the traditional healthcare apparatus. If patients do use the tests—which they inevitably will&mdash;it’s important to confirm and absorb that data in a clinical treatment plan.

In Platt’s case, that’s exactly what happened. She’s a good case study for a possible future in which take-home tests can coexist with clinical services. Her doctors confirmed her diagnosis and caught her condition early. With augmentation therapy—regular injections of the protein her body struggles to produce&mdash;she can hope to lead a relatively normal life.

The analogy that advocates for take-home tests always return to is the pregnancy test. They give families a quick and easy way to alleviate fears or celebrate a new life-to-be. They’re not perfect—false positives and negatives are known to happen&mdash;which is why they’re almost always followed up by a visit to a doctor’s office. But pregnancy tests only look at a single variable: Are you pregnant? Genetic tests, on the other hand, examine millions of combinations of genetic factors and try to extrapolate real-life data from them. The importance of a follow-up visit, therefore, is amplified exponentially. Ginsberg doesn’t like direct-to-consumer genetic tests, but she conceded that anything that raises awareness of hereditary conditions, such as 

“It was information that I was able to use to change my life and save my own life,” Steinberg, the mother who underwent a double mastectomy after receiving her 23andMe test results, said. “Why wouldn’t everyone else want to have access to that?”

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Image has been cropped and resized. Courtesy of Brian Long/UCSB.

Cybersecurity is a constant arms race between bad actors and security researchers. As quickly as new programs or techniques come out, it seems, hackers find exploits around them. Recently, researchers at University of California, Santa Barbara (UCSB) announced that they may have an unorthodox method to prevent devices from cloning, a common hacking practice that creates a digital replication of a network and uses it to sabotage the original system.

The fix is called a memristor, and it’s not a program or code. Instead, it’s a physical object—a new format for computer chips that introduces a level of randomness to its design that makes any device using it very difficult to replicate. The paper, which was 

, refers to memristors as a kind of “black box,” impenetrable to cloning, hijacking, or replication.

The term itself, according to Dimitri Strukov, PhD, a computer science professor at UCSB and one of the paper’s authors, is a combination of the words “memory” and “resistor.” Strukov explained in a 

 that memristors are a physical type of electrical resistance switch (a core component of any given computer circuit) that’s capable of “remembering” its state of resistance based on the history of voltage and current passing through it. Because of their unique structure, memristors can change how much current and voltage they output, adding another variable to the process. The more variables a computer network has, the harder it is to replicate.

"The idea is that it's hard to predict, and because it's hard to predict, it's hard to reproduce," Strukov said in the news release. Essentially, the unique memristors in a device would make it so difficult for a hacker to replicate (because they’d have to nail every unique variable in the system, not just figure out one pattern), it probably wouldn’t be time efficient to try to clone it.

It’s also particularly effective in beating machine-learning algorithms designed to clone or hijack complicated systems. In traditional systems, a hacker would only need to observe a portion of the inputs and outputs of a system, and a machine-learning algorithm could extrapolate the model and pattern being used to clone the device, as if it were guessing the next numbers in a simple 2, 4, 6, X pattern. With memristors, there are way too many variables to fill in those blanks.

The problem, lead study author Hussein Nili explained, is that memristors aren’t quite ready for widespread adoption yet. Nili told 

that major chip-making companies would have to put a lot of effort behind designing and fabricating integrated memristor circuits into their devices, scaling the technology and creating optimized, integrated arrays that link memristor systems to one another, forging “robust security primitives.”

“The big hurdle (as with any emerging technology), is to get large industry partners to commit resources to adopting the technology and creating systems around them,” Nili said in an email.

But when they do, it could completely change the landscape of personal and professional computing.

“The big idea is to have these circuits embedded in devices, chips, [etc.], to give them unique keys (or fingerprints) that are only theirs and can't be easily replicated,” Nili said.

Memristor devices would certify that the phone or computer you’re buying isn’t a counterfeit, or that the device accessing a wifi network is authorized (as opposed to a clone or impostor).

Nili said there’s a lot of research and development still to come. His team has filed several patents, but it’ll take a lot more resources and time before the technology is widespread.

“This is not a trivial task, but it is achievable,” Nili said. And in the future, it could make consumer and professional technology, like the systems every modern hospital network runs on, look much different.

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Eating disorders can be some of the most difficult mental conditions to treat. Unlike other anxiety or compulsion disorders, the main trigger for an eating disorder—food&mdash;is unavoidable. But a new paper suggests that visual exposure in virtual reality (VR) might help patients battle their eating disorder in a physician-controlled environment, complemented with traditional cognitive behavioral therapy (CBT).

A team of researchers led by Sofian Berrouiguet, MD, at France’s University Hospital of Brest 

culled through more than 300 studies on virtual reality's

 use in treating eating disorders, and concluded that the technology was a promising therapeutic tool. Barbara Peran, another author of the paper, told 

A new study suggests the tech deftly complements cognitive behavioral therapy.

Jack Crosbie

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