The rate of hospital admissions for nine to 12-year-olds who self-injure has doubled in six years.
‘Concerning’ rise in pre-teens self-injuring
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Category Archives: Mind Building
‘Disturbing’ hallucinations increase during lockdown for blind people
Lockdown sees a “disturbing” rise in the number of blind people experiencing distressing hallucinations, a charity says.
Covid-19: PM urges ‘optimistic but patient approach’ to pandemic
Boris Johnson hails the success of the vaccine rollout but says we must keep our “foot to the floor”.
New surgery may enable better control of prosthetic limbs
MIT researchers have invented a new type of amputation surgery that can help amputees to better control their residual muscles and sense where their “phantom limb” is in space. This restored sense of proprioception should translate to better control of prosthetic limbs, as well as a reduction of limb pain, the researchers say.
In most amputations, muscle pairs that control the affected joints, such as elbows or ankles, are severed. However, the MIT team has found that reconnecting these muscle pairs, allowing them to retain their normal push-pull relationship, offers people much better sensory feedback.
“Both our study and previous studies show that the better patients can dynamically move their muscles, the more control they’re going to have. The better a person can actuate muscles that move their phantom ankle, for example, the better they’re actually able to use their prostheses,” says Shriya Srinivasan, an MIT postdoc and lead author of the study.
In a study that will appear this week in the Proceedings of the National Academy of Sciences, 15 patients who received this new type of surgery, known as agonist-antagonist myoneural interface (AMI), could control their muscles more precisely than patients with traditional amputations. The AMI patients also reported feeling more freedom of movement and less pain in their affected limb.
“Through surgical and regenerative techniques that restore natural agonist-antagonist muscle movements, our study shows that persons with an AMI amputation experience a greater phantom joint range of motion, a reduced level of pain, and an increased fidelity of prosthetic limb controllability,” says Hugh Herr, a professor of media arts and sciences, head of the Biomechatronics group in the Media Lab, and the senior author of the paper.
Other authors of the paper include Samantha Gutierrez-Arango and Erica Israel, senior research support associates at the Media Lab; Ashley Chia-En Teng, an MIT undergraduate; Hyungeun Song, a graduate student in the Harvard-MIT Program in Health Sciences and Technology; Zachary Bailey, a former visiting researcher at the Media Lab; Matthew Carty, a visiting scientist at the Media Lab; and Lisa Freed, a Media Lab research scientist.
Restoring sensation
Most muscles that control limb movement occur in pairs that alternately stretch and contract. One example of these agonist-antagonist pairs is the biceps and triceps. When you bend your elbow, the biceps muscle contracts, causing the triceps to stretch, and that stretch sends sensory information back to the brain.
During a conventional limb amputation, these muscle movements are restricted, cutting off this sensory feedback and making it much harder for amputees to feel where their prosthetic limbs are in space or to sense forces applied to those limbs.
“When one muscle contracts, the other one doesn’t have its antagonist activity, so the brain gets confusing signals,” says Srinivasan, a former member of the Biomechatronics group now working at MIT’s Koch Institute for Integrative Cancer Research. “Even with state-of-the-art prostheses, people are constantly visually following the prosthesis to try to calibrate their brains to where the device is moving.”
A few years ago, the MIT Biomechatronics group invented and scientifically developed in preclinical studies a new amputation technique that maintains the relationships between those muscle pairs. Instead of severing each muscle, they connect the two ends of the muscles so that they still dynamically communicate with each other within the residual limb. In a 2017 study of rats, they showed that when the animals contracted one muscle of the pair, the other muscle would stretch and send sensory information back to the brain.
Since these preclinical studies, about 25 people have undergone the AMI surgery at Brigham and Women’s Hospital, performed by Carty, who is also a plastic surgeon at the Brigham and Women’s hospital. In the new PNAS study, the researchers measured the precision of muscle movements in the ankle and subtalar joints of 15 patients who had AMI amputations performed below the knee. These patients had two sets of muscles reconnected during their amputation: the muscles that control the ankle, and those that control the subtalar joint, which allows the sole of the foot to tilt inward or outward. The study compared these patients to seven people who had traditional amputations below the knee.
Each patient was evaluated while lying down with their legs propped on a foam pillow, allowing their feet to extend into the air. Patients did not wear prosthetic limbs during the study. The researchers asked them to flex their ankle joints — both the intact one and the “phantom” one — by 25, 50, 75, or 100 percent of their full range of motion. Electrodes attached to each leg allowed the researchers to measure the activity of specific muscles as each movement was performed repeatedly.
The researchers compared the electrical signals coming from the muscles in the amputated limb with those from the intact limb and found that for AMI patients, they were very similar. They also found that patients with the AMI amputation were able to control the muscles of their amputated limb much more precisely than the patients with traditional amputations. Patients with traditional amputations were more likely to perform the same movement over and over in their amputated limb, regardless of how far they were asked to flex their ankle.
“The AMI patients’ ability to control these muscles was a lot more intuitive than those with typical amputations, which largely had to do with the way their brain was processing how the phantom limb was moving,” Srinivasan says.
In a paper that recently appeared in Science Translational Medicine, the researchers reported that brain scans of the AMI amputees showed that they were getting more sensory feedback from their residual muscles than patients with traditional amputations. In work that is now ongoing, the researchers are measuring whether this ability translates to better control of a prosthetic leg while walking.
Freedom of movement
The researchers also discovered an effect they did not anticipate: AMI patients reported much less pain and a greater sensation of freedom of movement in their amputated limbs.
“Our study wasn’t specifically designed to achieve this, but it was a sentiment our subjects expressed over and over again. They had a much greater sensation of what their foot actually felt like and how it was moving in space,” Srinivasan says. “It became increasingly apparent that restoring the muscles to their normal physiology had benefits not only for prosthetic control, but also for their day-to-day mental well-being.”
The research team has also developed a modified version of the surgery that can be performed on people who have already had a traditional amputation. This process, which they call “regenerative AMI,” involves grafting small muscle segments to serve as the agonist and antagonist muscles for an amputated joint. They are also working on developing the AMI procedure for other types of amputations, including above the knee and above and below the elbow.
“We’re learning that this technique of rewiring the limb, and using spare parts to reconstruct that limb, is working, and it’s applicable to various parts of the body,” Herr says.
The research was funded by the MIT Media Lab Consortia, the National Institute of Child Health and Human Development, the National Center for Medical Rehabilitation Research, and the Congressionally Directed Medical Research Programs of the U.S. Department of Defense.
Light used to detect quantum information stored in 100,000 nuclear quantum bits
Researchers have found a way to use light and a single electron to communicate with a cloud of quantum bits and sense their behaviour, making it possible to detect a single quantum bit in a dense cloud.
The researchers, from the University of Cambridge, were able to inject a ‘needle’ of highly fragile quantum information in a ‘haystack’ of 100,000 nuclei. Using lasers to control an electron, the researchers could then use that electron to control the behaviour of the haystack, making it easier to find the needle. They were able to detect the ‘needle’ with a precision of 1.9 parts per million: high enough to detect a single quantum bit in this large ensemble.
The technique makes it possible to send highly fragile quantum information optically to a nuclear system for storage, and to verify its imprint with minimal disturbance, an important step in the development of a quantum internet based on quantum light sources. The results are reported in the journal Nature Physics.
The first quantum computers — which will harness the strange behaviour of subatomic particles to far outperform even the most powerful supercomputers — are on the horizon. However, leveraging their full potential will require a way to network them: a quantum internet. Channels of light that transmit quantum information are promising candidates for a quantum internet, and currently there is no better quantum light source than the semiconductor quantum dot: tiny crystals that are essentially artificial atoms.
However, one thing stands in the way of quantum dots and a quantum internet: the ability to store quantum information temporarily at staging posts along the network.
“The solution to this problem is to store the fragile quantum information by hiding it in the cloud of 100,000 atomic nuclei that each quantum dot contains, like a needle in a haystack,” said Professor Mete Atatüre from Cambridge’s Cavendish Laboratory, who led the research. “But if we try to communicate with these nuclei like we communicate with bits, they tend to ‘flip’ randomly, creating a noisy system.”
The cloud of quantum bits contained in a quantum dot don’t normally act in a collective state, making it a challenge to get information in or out of them. However, Atatüre and his colleagues showed in 2019 that when cooled to ultra-low temperatures also using light, these nuclei can be made to do ‘quantum dances’ in unison, significantly reducing the amount of noise in the system.
Now, they have shown another fundamental step towards storing and retrieving quantum information in the nuclei. By controlling the collective state of the 100,000 nuclei, they were able to detect the existence of the quantum information as a ‘flipped quantum bit’ at an ultra-high precision of 1.9 parts per million: enough to see a single bit flip in the cloud of nuclei.
“Technically this is extremely demanding,” said Atatüre, who is also a Fellow of St John’s College. “We don’t have a way of ‘talking’ to the cloud and the cloud doesn’t have a way of talking to us. But what we can talk to is an electron: we can communicate with it sort of like a dog that herds sheep.”
Using the light from a laser, the researchers are able to communicate with an electron, which then communicates with the spins, or inherent angular momentum, of the nuclei.
By talking to the electron, the chaotic ensemble of spins starts to cool down and rally around the shepherding electron; out of this more ordered state, the electron can create spin waves in the nuclei.
“If we imagine our cloud of spins as a herd of 100,000 sheep moving randomly, one sheep suddenly changing direction is hard to see,” said Atatüre. “But if the entire herd is moving as a well-defined wave, then a single sheep changing direction becomes highly noticeable.”
In other words, injecting a spin wave made of a single nuclear spin flip into the ensemble makes it easier to detect a single nuclear spin flip among 100,000 nuclear spins.
Using this technique, the researchers are able to send information to the quantum bit and ‘listen in’ on what the spins are saying with minimal disturbance, down to the fundamental limit set by quantum mechanics.
“Having harnessed this control and sensing capability over this large ensemble of nuclei, our next step will be to demonstrate the storage and retrieval of an arbitrary quantum bit from the nuclear spin register,” said co-first author Daniel Jackson, a PhD student at the Cavendish Laboratory.
“This step will complete a quantum memory connected to light — a major building block on the road to realising the quantum internet,” said co-first author Dorian Gangloff, a Research Fellow at St John’s College.
Besides its potential usage for a future quantum internet, the technique could also be useful in the development of solid-state quantum computing.
The research was supported in part by the European Research Council (ERC), the Engineering and Physical Sciences Research Council (EPSRC) and the Royal Society.
New skin patch brings us closer to wearable, all-in-one health monitor
Engineers at the University of California San Diego have developed a soft, stretchy skin patch that can be worn on the neck to continuously track blood pressure and heart rate while measuring the wearer’s levels of glucose as well as lactate, alcohol or caffeine. It is the first wearable device that monitors cardiovascular signals and multiple biochemical levels in the human body at the same time.
“This type of wearable would be very helpful for people with underlying medical conditions to monitor their own health on a regular basis,” said Lu Yin, a nanoengineering Ph.D. student at UC San Diego and co-first author of the study published Feb. 15 in Nature Biomedical Engineering. “It would also serve as a great tool for remote patient monitoring, especially during the COVID-19 pandemic when people are minimizing in-person visits to the clinic.”
Such a device could benefit individuals managing high blood pressure and diabetes — individuals who are also at high risk of becoming seriously ill with COVID-19. It could also be used to detect the onset of sepsis, which is characterized by a sudden drop in blood pressure accompanied by a rapid rise in lactate level.
One soft skin patch that can do it all would also offer a convenient alternative for patients in intensive care units, including infants in the NICU, who need continuous monitoring of blood pressure and other vital signs. These procedures currently involve inserting catheters deep inside patients’ arteries and tethering patients to multiple hospital monitors.
“The novelty here is that we take completely different sensors and merge them together on a single small platform as small as a stamp,” said Joseph Wang, a professor of nanoengineering at UC San Diego and co-corresponding author of the study. “We can collect so much information with this one wearable and do so in a non-invasive way, without causing discomfort or interruptions to daily activity.”
The new patch is a product of two pioneering efforts in the UC San Diego Center for Wearable Sensors, for which Wang serves as director. Wang’s lab has been developing wearables capable of monitoring multiple signals simultaneously — chemical, physical and electrophysiological — in the body. And in the lab of UC San Diego nanoengineering professor Sheng Xu, researchers have been developing soft, stretchy electronic skin patches that can monitor blood pressure deep inside the body. By joining forces, the researchers created the first flexible, stretchable wearable device that combines chemical sensing (glucose, lactate, alcohol and caffeine) with blood pressure monitoring.
“Each sensor provides a separate picture of a physical or chemical change. Integrating them all in one wearable patch allows us to stitch those different pictures together to get a more comprehensive overview of what’s going on in our bodies,” said Xu, who is also a co-corresponding author of the study.
Patch of all trades
The patch is a thin sheet of stretchy polymers that can conform to the skin. It is equipped with a blood pressure sensor and two chemical sensors — one that measures levels of lactate (a biomarker of physical exertion), caffeine and alcohol in sweat, and another that measures glucose levels in interstitial fluid.
The patch is capable of measuring three parameters at once, one from each sensor: blood pressure, glucose, and either lactate, alcohol or caffeine. “Theoretically, we can detect all of them at the same time, but that would require a different sensor design,” said Yin, who is also a Ph.D. student in Wang’s lab.
The blood pressure sensor sits near the center of the patch. It consists of a set of small ultrasound transducers that are welded to the patch by a conductive ink. A voltage applied to the transducers causes them to send ultrasound waves into the body. When the ultrasound waves bounce off an artery, the sensor detects the echoes and translates the signals into a blood pressure reading.
The chemical sensors are two electrodes that are screen printed on the patch from conductive ink. The electrode that senses lactate, caffeine and alcohol is printed on the right side of the patch; it works by releasing a drug called pilocarpine into the skin to induce sweat and detecting the chemical substances in the sweat. The other electrode, which senses glucose, is printed on the left side; it works by passing a mild electrical current through the skin to release interstitial fluid and measuring the glucose in that fluid.
The researchers were interested in measuring these particular biomarkers because they impact blood pressure. “We chose parameters that would give us a more accurate, more reliable blood pressure measurement,” said co-first author Juliane Sempionatto, a nanoengineering Ph.D. student in Wang’s lab.
“Let’s say you are monitoring your blood pressure, and you see spikes during the day and think that something is wrong. But a biomarker reading could tell you if those spikes were due to an intake of alcohol or caffeine. This combination of sensors can give you that type of information,” she said.
In tests, subjects wore the patch on the neck while performing various combinations of the following tasks: exercising on a stationary bicycle; eating a high-sugar meal; drinking an alcoholic beverage; and drinking a caffeinated beverage. Measurements from the patch closely matched those collected by commercial monitoring devices such as a blood pressure cuff, blood lactate meter, glucometer and breathalyzer. Measurements of the wearers’ caffeine levels were verified with measurements of sweat samples in the lab spiked with caffeine.
Engineering challenges
One of the biggest challenges in making the patch was eliminating interference between the sensors’ signals. To do this, the researchers had to figure out the optimal spacing between the blood pressure sensor and the chemical sensors. They found that one centimeter of spacing did the trick while keeping the device as small as possible.
The researchers also had to figure out how to physically shield the chemical sensors from the blood pressure sensor. The latter normally comes equipped with a liquid ultrasound gel in order to produce clear readings. But the chemical sensors are also equipped with their own hydrogels, and the problem is that if any liquid gel from the blood pressure sensor flows out and makes contact with the other gels, it will cause interference between the sensors. So instead, the researchers used a solid ultrasound gel, which they found works as well as the liquid version but without the leakage.
“Finding the right materials, optimizing the overall layout, integrating the different electronics together in a seamless fashion — these challenges took a lot of time to overcome,” said co-first author Muyang Lin, a nanoengineering Ph.D. student in Xu’s lab. “We are fortunate to have this great collaboration between our lab and Professor Wang’s lab. It has been so fun working together with them on this project.”
Next steps
The team is already at work on a new version of the patch, one with even more sensors. “There are opportunities to monitor other biomarkers associated with various diseases. We are looking to add more clinical value to this device,” Sempionatto said.
Ongoing work also includes shrinking the electronics for the blood pressure sensor. Right now, the sensor needs to be connected to a power source and a benchtop machine to display its readings. The ultimate goal is to put these all on the patch and make everything wireless.
“We want to make a complete system that is fully wearable,” Lin said. This research was supported by the UC San Diego Center of Wearable Sensors and the National Institutes of Health (grant no. 1R21EB027303-01A1).
The 5 Major Transformations Creative People Want
Here’s an update on the new Amplify course on creative productivity that will be launching by the end of the month. I figured out the major transformations we’ll be working on together, so in this post I’ll share those with you.
First off, I appreciate all the generous feedback that people sent in response to the February 3rd email to my email list. I asked about people’s creative struggles, dreams, and desires regarding their creative flow, and the responses were super insightful.
I actually cried a few times while reading some of the emails. I felt honored by the authenticity and depth that people shared. In particular, this one line that someone shared really got to me emotionally:
The sad part is that with becoming older and having kids I quit my side project ideas earlier and earlier.
This reminds me of the saying, “Don’t die with your music still in you” that I learned from Dr. Wayne Dyer. It’s a powerful reminder of what’s at stake here.
Here’s another line that really stood out for me:
I want to be a safe space for people.
That’s such a beautiful and compact way of expressing caring for the people we serve.
It took me several days to read through all the feedback, including replying to everyone who responded. I took a ton of notes on this feedback, and my notes added up to almost 40K words – practically a book right there. Then I spent more time reviewing, pondering, and condensing the ideas to figure out the transformations that people wanted.
Initially I got it down to a list of 16 transformations, and then I was able to condense further to 5 major transformations. Would you like to know what they are? Here’s what it boiled down to:
1. Stressful resistance → Light-hearted, free-flowing play
- Feeling pressured, nagged, stressed, frustrated, guilty, disappointed, blocked, overwhelmed → relaxed confidence; having abiding trust in yourself as a creative pro
- Creating with stress, fear, anxiety, shame, perfectionism → creating with a light-hearted, free-flowing playfulness of spirit
- Impostor syndrome; doubts about value → confidence and certainty in value delivery
One of the most common desires people had was to change their relationships with their creative work. People are tired of stressing out with anxiety when they try to be creative, and they recognize that a dysfunctional relationship here is counter-productive. They want to ENJOY the experience of creating from start to finish, emphasis on JOY.
Notable Quotes From Feedback
- Long track record of creative blocks, frustrations, and procrastination
- I put my self-esteem on the line when approaching a new project.
- Frustrated that my productivity and creative projects are slaves to my emotional states and external circumstances
- I’m terrified of my creativity. I don’t know why. Maybe it feels like a force that, once unleashed, will be too wild and out of control.
- I often look at my creative work and worry that it’s complete rubbish.
- I was so disciplined and good at (unconsciously) forcing myself to do things that I’ve pushed myself into intense anxiety.
- These struggles are costing me my youth.
- The struggle of me being afraid to start is costing me the progress I could have been making all these years.
- I’ve found most projects immediately or eventually infused with anxious feelings.
- There’s a part of me that is pretty sure that my creative inclinations are self-indulgent and can’t possibly benefit anyone.
- Afraid of looking fake
- There seems to be a point where my enthusiasm about the project switches to loads of resistance.
- Scared it won’t be anything worth sharing so why begin in the first place
- I rarely feel satisfied with what I create.
- Feeling like whatever I create is never good enough for others to see
- Every time I write a chapter, I doubt myself or think why the hell would anyone take my advice.
- Change my mindset from feeling neediness, trying to be right and avoid making mistakes and being wrong to following through with the project, sense of lightness and engagement as opposed to resistance
- Less pushing and feel more pulled
- Less relying on accountability and more genuine excitement, satisfaction and confidence
- I want the whole damn wall to come crashing down and I want to be filled with creative inspiration and fire.
- Regular, sacred, and delightfully enjoyable time devoted to creative output during my week.
- Enjoy picking my instrument up again, the way I did when I skipped school to just jam, and write music all day.
- That level of connection, with the self, the instrument, music and the listener is the holy grail.
- Experience a joyful and playful relationship with the creative process.
- I want it to feel like play.
- Integrating ease into my creative process
2. Unstable or inconsistent progress → Reliable and consistent flow of creative output
- Not finishing what you start; fizzling out → finishing and shipping completed projects; capturing opportunities instead of letting them pass you by; a process that converges towards publishing
- Inconsistent, haphazard, or unbalanced workflow → stable, consistent, and reliable workflow you can trust; hitting your stride; maintaining momentum
- Low creative output → prolific output; seeing your collective work grow notably each year
- Confusion about priorities and process → clarity in priorities and process; reliable systems
- Insufficient time and energy → plenty of time and energy for creative projects
People are tired of piling up projects that die on the vine. One common refrain I heard was: “I have no shortage of ideas! The problem is that I’m not seeing enough of them through to completion.” People want to trust themselves to follow through and finish, but they’re clinging to approaches that degrade self-trust and build up self-doubt instead. Many could use help upgrading their systems and practices, so they can prioritize better and follow through with consistency. A lot of people struggle with dropping or switching projects partway through.
This transformation crosses between the mental and emotional space, and a lot of solutions you’ll find elsewhere don’t build this bridge very well, so the mind and heart remain in a constant tug of war. Your mind wants one thing, and your heart wants another. What we need here is to get them agreeing upon and committing to a common goal. I have a lot to share about how to do that – it has to do with choosing projects differently up front, before you begin.
Notable Quotes From Feedback
- Started, half-finished projects litter the house
- Subtly eroding the feelings of significance and importance I have in life
- The sad part is that with becoming older and having kids I quit my side project ideas earlier and earlier.
- My projects fail because I switch to other projects that are new and shiny and I quit my previous ones.
- I end up quitting when it stops being fun.
- Get pulled away and the pause becomes power off
- I’m fussing about ideas.
- I keep second guessing myself.
- Constantly second-guessing my choice of projects
- Hard time prioritizing and executing
- Interrupted almost daily by other obligations
- My energy is too limited.
- Not to get distracted by the shiny object syndrome
- A large part of my energy is already being used up by the discipline required to sit down and be productive.
- I never seem to have enough time or energy in a day.
- It’s a balancing act with everything else I have going on in my life.
- My funnel is more of a straw.
- Preserving the mental and physical energy to put towards creative projects when I have to devote so much time to a job
- Create something uniquely genuine that I can be proud of.
- Having a smooth content production mind-set and system that makes product creation pleasurable, productive, and profitable
- Get into that flow state when I want to.
- How to easily load and re-load my state of flow
- Step in and out of creativity without losing momentum.
- How best to balance making forward progress on business tasks and projects while at the same time allowing space for creative projects
- Sustainable habit of creative self-expression
- A creative, flowing, balanced, fun, challenging but easy-going life
- Generate creative outputs at will.
- I have so much light and love inside that’s been SCREAMING to GET OUT in a kind and gentle way.
- Lungs that long to express the depths of our universe and a soul who’d like to be felt and understood by other beings surrounding me
3. Unappreciated or ignored → Appreciated, respected, loved, and encouraged
- Feeling unappreciated; being ignored or forgotten; unsure if your art matters to people → being appreciated and valued; connecting with people’s hearts; belongingness; feeling at home here; having people encourage you to create
- No audience or misaligned audience → aligned audience of people who appreciate, respect, and love you; people you enjoy serving and who encourage, inspire, and motivate you
Many people struggle with a lack of connection to the people they could be serving. They either don’t have an audience yet, or they have a misaligned audience that doesn’t seem to care much. Life is very different when you attract an audience that appreciates your creative work and keeps encouraging you.
Some key mindset (and heartset) shifts we’ll work on in Amplify involve the relationship you develop with your audience. There’s a big difference between creating in a void and creating for real people that you care about.
What many people don’t realize that the audience matters more than the projects in most cases. When you have a strong connection with an aligned audience, that relationship can help carry you through many inspired projects. This is very different than creating something in a void all by yourself and then hoping to surprise some random audience with your brilliance… someday… eventually.
Notable Quotes From Feedback
- When it seems like no one notices or cares about what I’ve done, I get demotivated.
- I feel I cannot do it by myself in silence and be successful.
- Discouraging to think that a project I’m spending so much time on may never be seen
- Be OK with not everyone loving what I do.
- Have a reality that constantly inspires me.
4. Little or no impact → Bold contributions and ripples
- Little or no impact → making a rich and meaningful contribution; creating ripples that align with your values; putting a dent in the universe; making your mark on this world in a way that no one can take away from you; summoning courage and boldness
- No platform or outlet → stable platform that you like; ability to find or create new platforms
- Small scale projects only → ability to follow through on larger works and see them to completion; scaling up
- Lacking key skills → Developing, upgrading, and stretching your skills; providing value as you build your skills
Some people would really love to create more impact, especially by learning how to shift from short-form content like articles, YouTube videos, and social media updates to long-form content like books, albums, screenplays, and courses. Others want to build larger audiences, so they can positively impact the lives of more people. People recognize that it takes courage to set ambitious goals, and reliable follow-through is essential. It’s not enough to just think big and then fizzle out.
Notable Quotes From Feedback
- My biggest creative projects have been too overwhelming, resulting in quitting before completion.
- Easier to get into the flow while creating something but as soon as I need to market my project or share it with others, I fizzle out
- Realizing I don’t yet have the ability to do the project in the way I envisioned
- I feel like I just have to suck it up and grind through enough practice to become good enough at something that other people might possibly start to care.
- How to approach a big project like writing a book or starting a new business and sustaining motivation until completion
- Having the courage to pick a project that you feel is a little scary but you know you will figure out, and that really inspires you
- Deliver creative output that can create ripples across humanity.
- Trust that I can create something that can contribute to others while also helping me be the bold explorer of life that I want to be.
- Create boatloads of value.
- [Providing] Relief in knowing someone else out there recognizes their pain, sees them, puts their hearts longing into words on a page that they can read and feel less alone in the world
- I want to be a safe space for people.
- Consistently increase my skills and skill sets.
- Bring into reality what I imagine.
- Offering genuine value to others while at the same time clarifying my thoughts through my writing
5. Scarcity-driven income and caged lifestyle → Abundant income and enriching lifestyle
- Little or no income from creative work → abundant income for a comfortable or wealthy lifestyle
- Having an unwanted job or boss → making a good living as a creative pro; time freedom; location freedom; freedom to choose your own projects; knowing you can always make extra money from your creativity when you want
This one was no surprise. A lot of people want to step into a sustainable lifestyle of being a creative pro who earns an abundant living from their creative flow. Several people specifically mentioned they’d love to do something similar to what I do, either with the medium of blogging or with podcasting, videos, writing books, composing music, etc. People especially want time freedom.
Some people just want to complete some creative projects on the side, especially projects that can add supplemental income streams. They may want to write a novel or a screenplay because they feel they have an interesting story idea, but they don’t necessarily want to become a full-time writer.
Notable Quotes From Feedback
- A day job that was killing my soul
- The fact that I should make money from my art to keep my business afloat paralyzes me and stresses me out.
- Afraid of being some money-grubbing wannabe who wastes people’s time and dollars
- Costing me the amazing life I know I am capable of living
- How to create consistent, recurring income through creative projects
- Set up a side business to eventually turn it into my main source of income.
- Cool if this lifestyle paid for itself
- Publish a creative project in a way that creates lots of value for others that also allows me to be fairly/well compensated.
- Actually making my living as a writer
- I want to make art a foundation of my life.
- Remove the need to have a boss or work for an employer permanently.
- Find something that I really enjoy working on to the point that I can’t imagine doing anything else for work for the rest of my life.
- Pick projects and really let myself go and be immersed in them, without ever worrying about money.
- Get enough traction with my creative pursuit that I can make it my primary work.
- Lead a life centered around my curiosities and personal growth. I’d love my life to feel like one wild, grand adventure.
- What if I were known as an artist and creator?
So basically what people want here is: lightness, consistency, appreciation, contribution, and abundant support for their creative flow.
What do you think of these transformations?
I really like this list. It gives me tons of ideas for reframes, processes, and practices to cover in the course lessons.
Are these transformations possible? Yes, they are. They’re not easy though.
For many creative pros who are happy with their creative flow and enjoy great results, it took years or even decades to go through these transformations. For me personally it took more than a decade of full-time creative work before I really feel like I started hitting my stride – probably about 15 years if I’m honest about it. So much of this involved unlearning what I thought I knew about creativity and productivity. The models I picked up from elsewhere in society just didn’t serve me very well. I got better results from introspective analysis of my projects, results, motivations, and values. I began figuring out the patterns in my own behavior, so I could better predict which types of projects I’d finish. Then I knew when I could bet big and reliably follow through.
So don’t expect a 6-lesson mini-course that you can plow through in a day. A quickie isn’t going to get us there. There’s a lot to unpack here. We can take this journey together, but it won’t be a short one. The upside is that we can potentially shave years, maybe even decades, off your learning curve here.
I actually began compiling a list of lesson ideas as I read through the emails, and now I have 87 ideas on that list. Some of them could be condensed and combined, but it’s fair to say we can have at least 60 lessons for this course, on par with Submersion (60 lessons) and Stature (65 lessons). There are just so many juicy insights to cover here.
Format
Here’s what I can tell you regarding the course format.
Audio was the clear winner based on the feedback people shared, so we’ll go with audio for the core lessons – same as we did for the Submersion and Stature courses. Lots of people said they prefer audio lessons over video for flexibility reasons. People like to listen while walking, running, driving, cooking, cleaning, etc. It’s easier for people to immerse themselves in audio lessons, much like listening to a podcast, and the visual aspect isn’t really needed for this kind of topic.
We’ll provide text transcripts for all of the audio lessons too. Some people said they prefer reading to listening. We’ll publish the text transcripts as we go, so you’ll get a written version of the whole course too.
I’ll aim to keep the lessons fairly compact, around 15 minutes each, which is what we had for Stature. That way you can listen while having a meal or doing other tasks. A good pacing would be to listen to one lesson per day, but you can go through the course at whatever pacing works for you. Some people like to go through the courses at a slower pacing to really take the time to digest and practice the ideas in each lesson. Many people have told me they’ve gone through our courses more than once, and each time it’s a different experience. I love that feedback because I designed the courses with that intention in mind – I see them as courses for life that will still provide meaningful insights 10, 20, or 30+ years from now. They’re all anchored in timeless, universal ideas and solutions.
I’ll also provide a written Summary Guide, which will include a one-page bullet list summary of each lesson, just like we had with Stature and Submersion. I’m leaning towards including written exercises for each audio lesson (like journaling prompts) as we had with Stature too. Some people said they appreciated that extra invitation to go deeper into the ideas. I think this course would be a good fit for that as well. There are a lot of people in my audience who enjoy looking deep into themselves from different angles, which raises their self-awareness and self-understanding. This helps them to discover their own a-ha moments.
While some people only want to approach this course as a solo introspective journey (similar to Submersion and Stature), most people recognized that it would be good to have at least some kind of social element to this deep dive, so they can connect with other creatives as we go. Many people were gung-ho about that, recalling how much they enjoyed the social aspect of Deep Abundance Integration. Some people offered this suggestion while acknowledging some inner resistance to the idea, noting that it would very likely be good for them to engage with other creatives… while also admitting to a bit of anxiety about connecting in this way. I can understand that. People want to come out of their shells a bit more, but they also recognize that it may take some courage to do so.
So here’s what I’m thinking…
In addition to the audio lessons, we can provide some live Zoom calls too, perhaps one call per week for 1.5 to 2 hours each time. These calls will be optional for you. We’ll provide them for the people who see value in having a social element to this journey. So you’ll have a chance to engage with other creative types as we go through this deep dive together.
I imagine doing at least 6-8 of these calls as we go. I can keep hosting them for as long as it takes to build out the lessons.
So I won’t be using these video calls for the core lessons like we did in Deep Abundance Integration. I want the core material to be in the audio lessons. I’d like to make these calls more focused on you and the other people going through the course with you. So this could include opportunities to hear about other people’s creative journeys, how people are applying the ideas from the course, extra Q&A with me, and perhaps some breakout rooms where we can engage in smaller groups with focused sharing and discussion topics. I envision these calls as another way to engage with the material and each other.
We can co-creatively evolve how we structure these calls as we go. I also think the calls could help people improve their ability to create in a flowing and playful way without so much stress and anxiety. If you participated in Deep Abundance Integration, you could probably tell that I had fun creating the course, playfully cracking jokes with people as we went – and even growing a beard throughout the course after it was suggested. So I imagine these calls being light, fun, and playful.
I think this could be a really nice combo. We’ll have the depth, focus, and introspective nature of structured, compact audio lessons. And we’ll have the light, fun, and social engagement of the Zoom calls.
I still need to figure out the timing for the Zoom calls, but it will probably be around 10am Pacific time on a weekday.
We can record the Zoom calls and share the recordings for those who can’t make the live calls, but I do think they’ll be more beneficial to attend live for those who want a more social experience. We’ll also have open text chat on these calls, just like we did with DAI, and we’ll make the chat logs available to everyone. That way if someone shares something beneficial like a book recommendation, you’ll have a record of that. You can also keep the chat window closed if you don’t want to participate in it. Some people loved the open chat, especially the humor and playfulness of it, while others preferred not to even look at it because they found it distracting for them. You’re free to choose what sort of engagement works for you.
I might also use a different Zoom format for these calls. With the DAI course, we used the webinar format, so only Rachelle and me were on camera, and everyone else could communicate through the text chat (which was very active on every call!). I think that made sense back in 2018. But now that so many more people are familiar with Zoom, I’m leaning towards doing this new deep dive in a Zoom meeting format. That means we’ll all be able to see each other on video. People can easily hide their video if they don’t wish to be on camera, but for everyone who wants to be seen, we can all see each other. I think this would create a more social vibe. We’ll just have to be judicious about using the mute button since there could be hundreds of people on these calls. I think it could be fun though. Last month I emceed a Transformational Leadership Council event with 100+ people on the Zoom call, and it was nice to see everyone’s faces and visual reactions.
A few people suggested having a discussion forum or Facebook group. I deleted my Facebook account in January (and Instagram too), so I can rule out a Facebook group since I’m not interested in engaging more on Facebook. A lot of people in my audience are turned off by Facebook as well. A Slack channel wasn’t popular either.
We have a private forum for Conscious Growth Club, which is great for those who want to engage with the people who are most invested in this community, especially across multiple deep dives and courses. I don’t feel aligned with the idea of spinning up a new discussion group or forum for each deep dive course that we do. I leaned into that for previous deep dives, such as when someone else created a forum for DAI participants, and we had a Facebook group for Stature. In each case I don’t think it was really a great fit for the experience. There are a small number of people who always ask for something like this, but I don’t think it’s the right medium to really deliver and support the transformations we’re looking for. I prefer other approaches like live, in-person events (when we’re not in pandemic mode) and Conscious Growth Club for long-term support and engagement across multiple years. So I think we’ll skip having a forum or discussion group for this one. I think our focus will be better without it.
My aim here is to provide the ultimate creative productivity course, filled with rich and practical insights and practices that can permanently improve your creative flow. I’m putting a lot of thought into figuring out the right combination of pieces to encourage and support the transformations that people want to experience.
Pricing
This is still tentative, but I’m leaning toward $497 for the price with a launch week discount down to $297. I think for everything we can provide here, that’s pretty generous and should be nicely affordable for the majority of creatives in my audience who really want to engage with this deep dive.
I’m designing this to be a super high-value course, one that could easily warrant a $2K price. I think it will be better than most of the $2K+ courses and programs I’ve taken. Many $2K courses are no better than much less expensive courses in my opinion. The main difference is that they’re offered to different audiences, such as entrepreneurs or business owners.
I want this course to be more accessible since it can provide major benefits for people which will serve them well for life. If I price it at $2K, then I’m really targeting creative pros who will regard it as a career investment. That would be a different kind of audience than I’d like to serve with this deep dive. I’d like this course to provide strong value for established pros as well as for people who have creative leanings and want to really explore that in great depth. This includes people who feel they may have a book, a blog, a song, or a YouTube channel inside them, wanting to be expressed and shared.
I don’t want to go below $297 though. I think if we drop it below that, we’ll attract more dabblers who aren’t as serious about these transformations. More people would join for curiosity’s sake. And that won’t be as good for having quality interactions on the live calls. And for some pros the investment could begin to feel too trivial, so they’re not really bought into the experience as much.
I want there to be a high enough commitment such that most of the people engaging in this deep dive together really want to get their money’s worth. Having some positive pressure and anticipation is healthy for us. I also want to balance this with making the course highly accessible for the people who could really benefit from it, which isn’t only established creative pros but also people just starting on their creative journeys.
Offering $297 for the launch price and $497 for the long-term price just feels right to me. It seems like the right balancing point when I consider how invested people will feel. When people feel invested enough, they’re more likely to finish the course, and that’s the main key to extracting the gains.
For the first several weeks, we’ll be co-creating this course together. I like offering a substantial launch discount because we create these courses as we go, and it’s nice to have a bigger group going through the course as we build it. That benefits me too since then I get a lot of feedback and suggestions as I record new lessons each week. I also enjoy the extra social energy from knowing that people are listening to the lessons shortly after I record and publish them – I find that very motivating.
I think for someone who’s a good match for this course, $297 should be pretty irresistible. It’s hard to imagine a creatively inclined person not receiving many times that much value from this course. What is it worth to someone to finally get their books written and published, their albums created, their audiences built and expanded, and to have an enjoyable lifestyle as a creative pro if that’s their goal?
Incidentally, I also expect to record a lesson on pricing since it can be tricky to put a price on creative work.
The launch discount will be good for at least 5 days – maybe 7 or 10 days – after we invite people to start joining. I’ll let you know the sign-up deadline to get that discount when we launch.
My Feelings About the Upcoming Launch
A fellow Conscious Growth Club member recently asked me how I feel about the upcoming launch and course development since I’m clearly taking on a big creative responsibility here. She wondered if I was feeling anxious or stressed or excited about it. Here’s what I shared – to give you a glimpse of what my interior experience is like:
- curiosity
- intrigue
- a sense of adventure and discovery
- commitment
- resolve
- a sense of connection to the people involved
- teamwork
- cooperation
- a feeling of being gifted with a big responsibility
- willingness
- acceptance of the work ahead
- thinking of the laughs and tears and shifts people will have along the way
- imagining all the new creative works that will be spawned by this: books, blogs, albums, paintings, live events, etc.
- thinking about the people who really need this experience and how beautiful it will be for them
- caring and compassion for all the struggles and frustrations people have been dealing with
- appreciating this wonderful opportunity to help in a meaningful way
- imagining the ideas flowing together in a nice modular structure
- imagining meeting up with people in person, where they tell me about their transformations and I get to congratulate them and feel compersion for what they’ve accomplished
- feeling proud of the people who’ll soon be going through the course and the deep inner work they’re about to do
- feeling honored that I get to play this role and engage with such great spirits along the way
Much of the emotion I experience comes from thinking about the people who’ll be going through the course and what it will be like for them. I do get excited about that.
It’s an emotional journey for me to create a course like this. I will laugh and cry many times along the way. I’ll have a-ha moments as I figure out new pieces. And it will be fun to connect with people on live calls and see them engaging with each other. Several people mentioned that they don’t have anyone to connect with like this. I love that I can bring people together for such a noble purpose. Playing this role lights up my heart.
It’s a feeling of being called to serve a tremendous need and saying yes with an open heart and mind. It feels very right all around – right topic, right people, right timing.
I share this in case it helps you gain some extra insights on the framing that works for me when I’m engaging with a major new creative project
I think what gets a lot of creative people stuck is that they put their project first in their mind, and the people they’re serving are buried somewhere in the backs of their minds, almost like an afterthought. I find it much more productive and flowing to create with real people in mind. That’s been true for all the years I’ve been blogging. I didn’t just start writing into a void, hoping that people would show up. I actually began writing articles 5 years before I started my blog, always for specific groups of people, beginning with a group of software developers.
Helping you find the right audience is going to be a significant part of this course. I would say that this is even more important than helping you to complete any particular creative project. If you find the right audience and learn how to genuinely connect with them, those relationships can carry you across many creative projects for many years. That’s why I haven’t burned out after 16+ years of blogging. It’s not the medium or the content that keeps me going. It’s the people.
That’s why I can write a giant message on a weekend morning and enjoy the process. I know some people aren’t going to read this much. I know some people will unsubscribe at the sight of it. But the people who revel in these kinds of ideas are the ones I’m really here to serve and connect with – that’s where all the joy is.
When Is Amplify Launching?
We’ll launch the course as soon as we’re ready to go. I still need at least one more week to prepare everything. I’d like to record a few lessons up front, so people have something to listen to right away when they join. Then we’ll co-create the rest of the course as we go, adding more lessons each week till it’s done.
I follow a structured process for doing course launches, so I’m working from a detailed checklist, which converges on launching. In fact, I’m thinking of including that checklist as one of the course bonuses since it shows how I break a large project down into a step-by-step workflow that gives reliable results. I’ve been refining this process with each launch, so it’s pretty solid now. It would be relatively straightforward to adapt it to other types of projects as well.
I hope you enjoyed this update. If you’d like to share extra feedback about anything here, just send me a message to let me know. Otherwise I’ll invite you to join us in Amplify when we’re good to go, assuming you’re on the email list to get such invitations.
Also, if you know any other creative people who’d likely benefit from this course, please share this post with them, or tell them about the opportunity some other way. You could also invite them to join my email list, so they’ll be notified when the launch happens.
This will be a deep and fascinating journey for those who choose to experience it. Are you in yet? ❤️
Covid: Vaccine given to 15 million in UK as PM hails ‘extraordinary feat’
The PM calls it an “extraordinary feat”, reached just over two months after the first vaccine was delivered.
Immunotherapy — targeted drug combination improves survival in advanced kidney cancer
Patients with advanced kidney cancer, who received a targeted drug combined with a checkpoint-blocker immunotherapy agent had longer survival than patients treated with the standard targeted drug, said an investigator from Dana-Farber Cancer Institute, reporting results from a phase 3 clinical trial.
The survival benefit demonstrates that an immune checkpoint inhibitor together with a targeted kinase inhibitor drug “is important in the first-line treatment of patients with advanced renal cell carcinoma,” said the authors of a study published in The New England Journal of Medicine today and simultaneously presented during American Society of Clinical Oncology (ASCO) 2021 Genitourinary Cancers Symposium. The senior author is Toni Choueiri, MD, director of the Lank Center for Genitourinary Oncology at Dana-Farber.
The phase 3 CLEAR study results showed significant benefits from the combination comprised of lenvatinib, an oral kinase inhibitor that targets proteins involved in the formation of blood vessels supplying a tumor, and pembrolizumab, a checkpoint inhibitor given by infusion that helps the immune system attack the cancer. Another group of patients received a combination of lenvatinib and everolimus, a drug that targets a protein, mTOR.
The comparison drug was sunitinib, an inhibitor that targets multiple kinases and has been the standard treatment in these patients with advanced kidney cancer, which carries a poor prognosis. However, standard-of-care options now include treatment with immune checkpoint inhibitors, either as a combination of two checkpoint inhibitors or a checkpoint inhibitor plus a kinase inhibitor. These combinations have achieved improved outcomes for advanced kidney cancer patients compared with sunitinib.
The results of the CLEAR study showed that those receiving the combination of lenvatinib and pembrolizumab not only had longer overall survival but also longer progression-free survival — the period before their disease worsened — and a higher response rate. In addition to lenvatinib plus pembrolizumab, the clinical trial also tested the combination of lenvatinib and everolimus, which is approved for patients with advanced kidney cancer whose disease progresses following sunitinib treatment.
The primary endpoint of the trial was progression-free survival (PFS). Both combinations proved superior to sunitinib alone: lenvatinib/pembrolizumab achieved a median PFS of 23.9 months vs 9.2 for sunitinib; PFS for lenvatinib/everolimus was 14.7 months.
The 24-month overall survival rate was 79.2% with lenvatinib/pembrolizumab, 66.1% with lenvatinib/everolimus, and 70.4% with sunitinib.
The confirmed objective response rate (percentage of patients whose disease shrank) was 71% with lenvatinib/pembrolizumab, 53.5% with lenvatinib/everolimus, and 35.1% with sunitinib. The rate of complete responses — total tumor shrinkage — was 16.1% in patients receiving lenvatinib/pembrolizumab, 9.8% in the lenvatinib plus everolimus group, and 4.2% in the sunitinib group.
“The rate of responses and complete responses, and the progression-free survival were the longest we have seen to date in a phase 3 combination of a targeted VEGF inhibitor and an immune checkpoint inhibitor,” said Choueiri. The CLEAR trial is the last of the clinical trials that were launched to compare immunotherapy and targeted drug combinations to sunitinib, and sunitinib will not be the comparison drug in future trials because the combinations have proven superior in these advanced kidney cancer patients, said Choueiri.
Almost all patients in the CLEAR trial experienced some adverse events from treatment. The most frequent adverse events were diarrhea and hypertension. These side effects led to stopping the treatment in 37.2% of patients in the lenvatinib/pembrolizumab group, and dose reduction of lenvatinib in 68.5% of patients. “Although the combination of lenvatinib and pembrolizumab was associated with some notable side effects, these adverse events are often adequately managed” the researchers said.
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Materials provided by Dana-Farber Cancer Institute. Note: Content may be edited for style and length.
The pill could be sold in pharmacies without prescription
The contraception could be sold without prescription for the first time, following a public consultation.
