#Drug cocktail might help diabetics make insulin Combining two different medications could help patients with Type 1 diabetes at least partially regain the ability to produce their own insulin.
For a new study, Michael Haller, an endocrinologist at University of Florida, looked for problematic cells of the immune system that could be behind a patient inability to produce insulin
a drug designed to improve the lives of people with certain forms of cancer, to stimulate the production of new
Haller treated 17 adult Type 1 diabetes patients for two weeks with the cocktail therapy and then followed them for a year.
Haller presented his findings this month at the annual meeting of the American Diabetes Association in San francisco. PROFOUND RESULTS Conventional diabetes wisdom says that within just a few months of the onset of Type 1 diabetes,
says Mark Atkinson, a co-investigator of the study and member of the department of pathology,
immunology, and laboratory medicine. That the treatment seemed to stimulate insulin production in people with established Type 1 diabetes made the researchers autiously optimistic,
Atkinson says. he results that Dr. Haller saw in his first study are profound. Another new aspect of the study is worked that it with patients who had been diagnosed long with the disease.
Typically, studies examine patients who are diagnosed newly and still have a reasonable number of beta cells producing insulin.
The patients in Haller study had been living with Type 1 diabetes between four months and two years. he model has mostly been to test therapies aimed at beta cell preservation in people who have just been diagnosed,
Haller says. ut obviously, the majority of patients living with the disease have been living with the disease for a long time,
so people become disenfranchised from the research process. Wee interested in making life better for these patients.
COMBINATION THERAPIES Atkinson began considering Thymoglobulin as a treatment for diabetes nearly a decade ago.
He and fellow co-investigator Desmond Schatz, associate chairman of the department of pediatrics, authored a paper advocating a combination approach to treating Type 1 diabetes.
Based on Schatz belief in combination therapies, the group began shepherding a cocktail of Thymoglobulin and Neulasta through early studies done with mouse models. espite tremendous strides in our understanding of the natural history of Type
1 diabetes we are as yet unable to cure and prevent the disease, Schatz says. his study is a step in that direction, toward a biological cure.
The patients in Haller study will be followed for three to five years to see if their bodies will preserve the insulin-producing beta cells.
The researchersnext step will be to recruit patients who have been diagnosed newly with the disease to conduct a larger trial.
Haller says he hopes the approach will help patients manage their disease more easily. f we can confirm the results in a larger effort,
the study could potentially be paradigm-shifting for our field in that it documents we should really be looking at combination therapies in treating Type 1 diabetes,
Haller says. ur ultimate goal is to prevent and cure this disease, but we have to crawl before we walk,
and walk before we run. This study is an important step forward in our efforts to make life easier for patients with Type 1 diabetes. k
#Starvation diet puts worm lifespan on pause Duke university rightoriginal Studyposted by Marla Broadfoot-Duke on June 20 2014the centuries-long search for the fountain of youth has yielded only a few promising leads one
A new study of the tiny nematode worm C. elegans begins to explain this marvel of calorie restriction
and hints at an easier way to achieve longevity. Researchers have found that taking food away from C. elegans triggers a state of arrested development:
while the organism continues to wriggle around foraging for food its cells and organs are suspended in an ageless quiescent state.
The results appear in PLOS Genetics. It is possible that low-nutrient diets set off the same pathways in us to put our cells in a quiescent state says David R. Sherwood an associate professor of biology at Duke university.
The trick is to find a way to pharmacologically manipulate this process so that we can get the antiaging benefits without the pain of diet restriction.
Over the last 80 years researchers have put a menagerie of model organisms on a diet
Outside the laboratory and in the real world organisms like C. elegans can experience bouts of feast or famine that no doubt affect their development and longevity.
Sherwood s colleague Ryan Baugh an assistant professor of medicine showed that hatching C. elegans eggs in a nutrient-free environment shut down their development completely.
Organisms have to monitor their environment and decide whether or not it is amenable to their development.
not only for aging but also for cancer says Sherwood. One of the biggest mysteries in cancer is how cancer cells metastasize early
and then lie dormant for years before reawakening. My guess is that the pathways in worms that are arresting these cells
and waking them up again are going to be the same pathways that are in human cancer metastases.
The American Cancer Society Postdoctoral Fellowship Award and the National institutes of health supported the research. Source: Duke Universityyou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license n
#Electronic eye sensor watches out for glaucoma Researchers have designed a high-tech, low-power sensor that can be placed permanently in a person eye to track hard-to-measure changes in pressure
and monitor for diseases like glaucoma. The sensor would be embedded with an artificial lens during cataract surgery
and would detect pressure changes instantaneously, then transmit the data wirelessly using radio frequency waves. o one has ever put electronics inside the lens of the eye,
so this is a little more radical, says Karl Böhringer, professor of electrical engineering at University of Washington. e have shown this is possible in principle.
If you can fit this sensor device into an intraocular lens implant during cataract surgery it won require any further surgery for patients.
The research team wanted to find an easy way to measure eye pressure for management of glaucoma,
a group of diseases that damage the eye optic nerve and can cause blindness. Right now there are two ways to check eye pressure,
but both require a visit to the ophthalmologist. At most, patients at risk for glaucoma may only get their pressure checked several times a year,
says Tueng Shen, a collaborator and professor of ophthalmology. MARTERLENSES But if ophthalmologists could insert a pressure monitoring system in the eye with an artificial lens during cataract surgeryow a common procedure performed on 3 million to 4 million people each year to remove blurry vision
or glare caused by a hazy lenshat could save patients from a second surgery and essentially make their replacement lens marterand more functional. he implementation of the monitoring device has to be well-suited clinically
and must be designed to be simple and reliable, Shen says. e want every surgeon who does cataract surgeries to be able to use this.
As reported in the Journal of Micromechanics and Microengineering, researchers built a prototype that uses radio frequency for wireless power and data transfer.
A thin, circular antenna spans the perimeter of the deviceoughly tracing a person irisnd harnesses enough energy from the surrounding field to power a small pressure sensor chip.
The chip communicates with a close-by receiver about any shifts in frequency which signify a change in pressure.
Actual pressure is calculated then and those changes are tracked and recorded in real-time. The chip processing mechanism is actually very simple,
leaving the computational heavy lifting to the nearby receiver, which could be a handheld device
or possibly built into a smartphone, Böhringer says. CHANGING EYE PRESSURE The current prototype is larger than it would need to be to fit into an artificial lens,
but the research team is confident it can be downscaled through more engineering. The team has tested successfully the sensing device embedded in the same flexible silicon material that used to create artificial lenses in cataract surgeries.
Similar to how a person blood pressure varies throughout the day with activity levels eye pressure is thought to behave similarly,
changing perhaps minute by minute. If the pressure in the eye is too high for the optic nerve to function,
however, damage to the eye can begin, often with no pain or warning signs. This increased intraocular pressure is the main factor in glaucoma,
which causes vision loss and ultimately blindness. ftentimes damage to vision is noticed late in the game,
and we can treat patients effectively by the time they are diagnosed with glaucoma, Shen says. r, if medications are given,
there no consistent way to check their effectiveness. As a result many patients with the disease aren diagnosed early enough
or aren on an accurate treatment plan. Both cataracts and glaucoma affect a similar aging population
so it seems a natural pairing to place a pressure monitoring device in a new lens during cataract surgery.
MAKING IT COST-EFFECTIVE The team is working on downscaling the prototype to be tested in an actual artificial lens.
Designing a final product that affordable for patients is the ultimate goal, Shen says. think
if the cost is reasonable and if the new device offers information that not measureable by current technology,
patients and surgeons would be really eager to adopt it. The researchers, including Brian Otis, associate professor of electrical engineering and also of Google Inc,
. and former doctoral students Cagdas Varel and Yi-Chun Shih, have filed patents on the pressure-monitoring device prototype l
#Bionic pancreas passes 5-day test in real life The latest version of a bionic pancreas device worked successfully in two five-day clinical trialsne with adults, the other with adolescentshat imposed
minimal restrictions on what patients could do. The device controls blood sugar in patients with type 1 diabetes using doses of both insulin
and the blood-sugar-raising hormone glucagon. n both of these studies this device far exceeded our expectations in terms of its ability to regulate glucose,
prevent hypoglycemia and automatically adapt to the very different needs of adultsome of whom were very insulin-sensitivend adolescents,
says principal investigator and senior author Edward Damiano of the Boston University department of biomedical engineering. here no current standard-of-care therapy that could match the results we saw. ne of the key virtues of this device is its ability to start controlling the blood sugar instantly,
adds co-lead author Firas El-Khatib, also of the department of biomedical engineering. Co-lead author Steven Russell of Massachusetts General Hospital (MGH
Damiano, and El-Khatib previously published a 2010 Science Translational Medicine report that described successful use of the first-generation system in controlling the blood sugar of adults for 27 hours.
But that study took place in a controlled hospital inpatient environment where participants essentially stayed in bed for the whole period
allowing participants to stay in something close to their usual environments, exercise, and eat whatever they want,
But developing a device that could be tested safely in an outpatient environment presented several challenges, first
explains Damiano, associate professor of biomedical engineering at BU. And even though the dosage needs of adults are more predictable,
contracting a typical illness like a cold or upset stomach can dramatically change the need for insulin over a period of days to weeks.
QUESTIONS FROM THE IPHONE APP Along with the software improvements that allow the device to adapt to widely varied individual dosage needs,
the new version also relies on improved hardware, including a smartphone (iphone 4s) capable of practical wireless communication with two pumps delivering doses of insulin and glucagon.
Every five minutes the smartphone receives a blood sugar reading from an attached continuous glucose monitor,
which it uses to calculate and administer a dose of either insulin or glucagon. The smartphone includes an application on
which the patient enters information immediately before eating. But instead of the complex calculation patients typically do to estimate their carbohydrate intake,
BETTER CONTROL Both of the studies reported in the New england Journal of Medicine paper compared data reflecting five days on the bionic pancreas system with five days of participantsusual care using their own insulin pumps.
which enabled constant wireless monitoring of the blood sugar levels by study staff. They were accompanied by a study nurse 24 hours a day
and slept in a hotel, but were otherwise free to do as they chose, including exercising at a gym and eating in restaurants.
The adolescent trial enrolled 32 participants, ages 12 to 20, attending a camp for young people with type 1 diabetes,
Study and camp staff monitored them closely and via wireless monitoring during their time on the bionic pancreas.
while the incidents of low blood sugar also dropped. he fear of hypoglycemia can limit attempts to bring the average blood sugar into the range that dramatically reduces the risk of long-term complications,
Fewer instances of hypoglycemia on the bionic pancreas also reduced the need for carbohydrate doses to raise blood sugar.
OT HAVING TO THINK ABOUT DIABETES 24/7damiano, whose 15-year-old son was diagnosed with type 1 diabetes at the age of 11 months,
explains what having a device like this could mean to patients. he most practical difference would be not having to think about diabetes 24/7,
not having to constantly make decisions about things that those of us without type 1 never have to think about. nother real problem that would be relieved is the fearear of going to bed at night
but still had significant episodes of hypoglycemia. nd another extremely frustrating aspect of diabetes that would be eliminated completely by this device is the enormous sense of failure
and provide a bridge to the often-promised but still elusive cure for type 1 diabetes.
THE NEXT CLINICAL TRIALS Two follow-up trials are in the works, one of which will be a true home study only requiring that participants stay within an hour drive of the study site.
That trial, which will compare 11 days on the bionic pancreas with 11 days of usual care,
the University of Massachusetts Medical center in Worcester, the University of North carolina at Chapel hill, and Stanford Universitynd will begin on June 16 at MGH.
and Camp Joslin in central Massachusetts, will enroll children ages 6 to 11 and is currently enrolling participants already registered at the camps.
Information on both of those trials and on the overall project is available at http://www. bionicpancreas. org/.
/The National Institute of Diabetes and Digestive and Kidney diseases, the Helmsley Charitable trust, and the Charlton Fund for Innovative Research in Diabetes supported the study.
Several members of the research team have been issues or applied for patents related to the development of the bionic pancreas.
#Telehealth consults improve child abuse exams Telehealth consultations for clinicians at rural hospitals improve their ability to provide forensic examinations for sexual abuse, according to new research.
Published in the journal Child abuse & Neglect, the study shows that clinicians with access to expert nurses provided more thorough
and to make an accurate diagnosis. roviding telehealth support really improves the quality of these forensic exams,
a forensic nurse practitioner and research nurse at the Betty Irene Moore School of nursing at University of California,
Davis."The assumption that hospital nurse staffing can be reduced to save money, without adversely affecting patient outcomes, may be foolish at best
Credit: istockphoto) University of Southampton Nurse staffing, education tied to hospital death rate ith this technology,
we can help children who might otherwise not receive this level of care. Provided by advanced practice nurse practitioners
and sexual assault nurse examiners with more than 10 years of experience evaluating abuse, telehealth consults offer tremendous benefits for rural communities.
In addition to improving quality, they ease the burden on families, who no longer need to travel many hours for expert care,
many examiners are prone to assess normal variations as injuries from trauma. n the other hand,
eliminating the added stress for children of having to testify in court. Telehealth offers support and built-in peer review for nurses, physicians,
and other clinicians practicing in relative isolation. The telehealth network uses secure teleconferencing equipment to link UC Davis nurses with rural clinicians.
The systems provide video and audio as well as images from colposcopes (magnifying devices used to examine genitalia) and other equipment.
This advanced technology essentially puts expert nurses in the room with examining clinicians. TELEHEALTH NETWORK To test whether telehealth improved care, the researchers brought in independent experts to review examinations from eight rural hospitals, five
of which had access to telehealth consults. The experts reviewed the health records for 183 patients, 101 of
whom were treated at telehealth hospitals, evaluating the thoroughness, accuracy, and overall quality of these exams.
The telehealth exams improved care in multiple areas, including examination findings, overall assessments completeness, and diagnostic accuracy.
and accuracy scores were all significantly higher in the telehealth hospitals. The team hopes these findings will spur other hospitals to expand their telehealth capabilities. f we create a statewide network,
we can really improve the quality of these exams in rural communities, says Miyamoto. e can provide a service for many children who don receive this level of care
Mark twain Medical center, Northern Nevada Medical center, and the California Department of public health Material, Child & Adolescent Health Program.
The Maternal and Child Health Bureau of Health Resources and Services Administration and the William Randolph Hearst Foundation supported the work F
#Handheld terahertz cameras could replace MRI Rice university rightoriginal Studyposted by Mike Williams-Rice on June 11 2014scientists have used carbon nanotubes to create compact terahertz sensors that operate at room temperature.
It also has the potential to inspect food and even scan for tumors. Junichiro Kono a physicist at Rice university says the potential to replace magnetic resonance imaging (MRI) technology in screening for cancer
and other diseases is one of the most exciting possible applications. The potential improvements in size ease cost and mobility of a terahertz-based detector are phenomenal Kono says.
With this technology you could conceivably design a handheld terahertz detection camera that images tumors in real time with pinpoint accuracy.
And it could be done without the intimidating nature of MRI technology. Because terahertz waves are much smaller in energy than visible light finding materials that absorb
and turn them into useful electronic signals has been a challenge Kono says. The scientific community has long been interested in the terahertz properties of carbon nanotubes says Franãois LÃNARD a scientist at Sandia National Laboratories.
But virtually all of the research to date has been theoretical or computer model-based. A handful of papers including several by Kono
and his team have investigated terahertz phenomena in carbon nanotubes but those have focused mainly on the use of one or a bundle of nanotubes.
The problem LÃNARD says is that terahertz radiation typically requires an antenna to achieve coupling into a single nanotube due to the relatively large size of terahertz waves.
The researchers however found a way to create a small detector that is visible to the naked eye.
The thin carbon nanotube film developed by Rice chemist Robert Hauge and graduate student Xiaowei He does not require an antenna
and is thus amenable to simple fabrication. It represents one of the team s most important achievements LÃNARD says.
Carbon nanotube thin films are extremely good absorbers of electromagnetic light he explains. In the terahertz range the film a mix of metallic
and semiconducting nanotubes soaks up all of the incoming terahertz radiation. rying to do that with a different kind of material would be nearly impossible
since a semiconductor and a metal couldn t coexist at the nanoscale at high density Kono says.
But that s what we ve achieved with the carbon nanotubes. The research was reported in the journal Nano Letters.
Additional researchers from the Rice Sandia National Laboratories Tokyo Institute of technology and Carnegie mellon University contributed to the project
which was funded by the Department of energy the National Institute for Nano Engineering at Sandia National Laboratories the Lockheed-martin Rice university LANCER program the National Science Foundation and the Robert A. Welch Foundation.
Source: Rice Universityyou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license c
#Marijuana may change sperm shape in young men Using cannabis appears to affect the size and shape of spermnd perhaps put young men fertility at riskccording to a new study.
In the world largest study to investigate how common lifestyle factors influence the size and shape of sperm (referred to as sperm morphology),
a research team from the Universities of Sheffield and Manchester also found that sperm size
249 men from 14 fertility clinics in the UK and asked them to fill out detailed questionnaires about their medical history and their lifestyle.
to have used cannabis in the three month period prior to ejaculation. ur knowledge of factors that influence sperm size
yet faced with a diagnosis of poor sperm morphology, many men are concerned to try and identify any factors in their lifestyle that could be causing this,
a senior lecturer in andrology at the University of Sheffield and the study lead author. t is
although our data suggests that cannabis users might be advised to stop using the drug if they are planning to try
The UK Health and Safety Executive, the UK Department of Environment, Transport and the Regions, the UK Department of health,
and it triggers stem cells from a dormant state to a state of self-renewal.
has major implications for healthier aging, in which immune system decline contributes to increased susceptibility to disease as we age.
By outlining how prolonged fasting cycleseriods of no food for two to four days at a time over the course of six monthsill older and damaged immune cells
professor of gerontology at the University of Southern California. STARVING KILLS DAMAGED CELLS hen you starve, the system tries to save energy,
and one of the things it can do to save energy is to recycle a lot of the immune cells that are needed not,
especially those that may be damaged, Longo says. hat we started noticing in both our human work
and animal work is that the white blood cell count goes down with prolonged fasting. Then when you re-feed, the blood cells come back.
So we started thinking, well, where does it come from? Prolonged fasting forces the body to use stores of glucose, fat,
During each cycle of fasting, this depletion of white blood cells induces changes that trigger stem cell-based regeneration of new immune system cells.
an effect previously discovered by the Longo team to extend longevity in simple organisms and
Prolonged fasting also lowered levels of IGF-1, a growth-factor hormone that Longo and others have linked to aging, tumor progression,
and cancer risk. KA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode.
Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally,
a new immune system. 72-HOUR FAST Prolonged fasting also protected against toxicity in a pilot clinical trial in
assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. ore clinical studies are needed,
The National Institute of Aging of the National institutes of health supported the study. The V Foundation and the National Cancer Institute of the National institutes of health funded the clinical trails I
#These neurons order stem cells to crank out new neurons Is it possible that your brain can repair itself from within?
explains Chay Kuo, an assistant professor of cell biology, neurobiology and pediatrics at Duke university. In a study with mice, his team found a previously unknown population of neurons within the subventricular zone (SVZ) neurogenic niche of the adult brain, adjacent to the striatum.
With optogenetic tools that allowed the team to tune the firing frequency of these Chat+neurons up and down with laser light,
and exciting to uncover this hidden gateway, a neural circuit that can directly instruct the stem cells to make more immature neurons,
as the mouse has a large amount of its brain devoted to process the sense of smell and needs these new neurons to support learning.
Kuo says. s it some kind of factory taking orders? Postdoctoral fellow Brent Asrican made a key observation that orders from the novel Chat+neurons were heard clearly by SVZ stem cells.
Studies of stroke injury in rodents have noted SVZ cells apparently migrating into the neighboring striatum.
They reported that interestingly in Huntington disease patients, this area seems to lack the newborn interneurons. his is a very important and relevant cell population that is controlling those stem cells,
These emerging threads have Kuo hopeful researchers will eventually be able to find the way to ngage certain circuits of the brain to lead to a hardware upgrade.
if you could upgrade the brain hardware to keep up with the new software? He says perhaps there will be a way to combine behavioral therapy
and stem cell treatments after a brain injury to rebuild some of the damage. The questions ahead are both upstream from the new Chat+neurons and downstream,
Kuo says. Upstream, what brain signals tell Chat+neurons to start asking the stem cells for more young neurons?
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