#Can Technology Fix Medicine? After decades as a technological laggard, medicine has entered its data age.
Mobile technologies, sensors, genome sequencing, and advances in analytic software now make it possible to capture vast amounts of information about our individual makeup and the environment around us.
The sum of this information could transform medicine, turning a field aimed at treating the average patient into one that customized to each person while shifting more control and responsibility from doctors to patients.
The question is: can big data make health care better? here is a lot of data being gathered. That not enough, says Ed Martin,
interim director of the Information Services Unit at the University of California San francisco School of medicine. t really about coming up with applications that make data actionable.
and the challenges they will face as they push to remake health care. The groups that control the most medical data today are insurance companies and care providers,
and their data analysis is already beginning to change health care. Express Scripts which manages pharmacy benefits for 90 million members in the U s
. and processes 1. 4 billion prescriptions a year, has scoured its data from doctorsoffices, pharmacies, and laboratories to detect patterns that might alert doctors to potential adverse drug interactions and other prescription issues.
Doctors can now know 12 months in advance, with an accuracy rate of 98 percent, which of their patients may fail to take their medicine.
Taking steps to avert that problem could improve patientshealth and reduce the $317 billion spent in the United states each year on unnecessary ER visits and other treatment.
Today many companies and health-care providers are adding other layers of information to create an increasingly precise
patient-specific brand of medicine. New mobile technologies, for example, could provide information about a patient everyday behaviors
or how they might react to treatments. e want to believe that most of the things we do in medicine are based on evidence,
is that medicine could become more analytical and evidence-based. Data is also changing the role of patients,
and even stress. And companies like Apple are hoping to become repositories for all this information,
but it can become essential for the millions living with chronic conditions like diabetes, heart disease, and depression.
and provides the patient doctor with treatment recommendations based on the data and established medical guidelines.
Over time, both companies will aggregate this information to help doctors study and improve treatment overall. t like one of the largest clinical trials in history,
Families affected by Phelan-Mcdermid syndrome, a rare condition in which a deletion on chromosome 22 causes problems such as learning and memory deficits, are building a database of information from genomic tests, clinical medical records, extensive family surveys and histories,
That increasingly important as researchers begin to see connections between Phelan-Mcdermid, autism, and other conditions.
#Mathematicians Explain Why Social Epidemics Spread Faster in Some Countries Than Others Psychologists have puzzled always over why people in Sweden were slower to start smoking and slower to stop.
Treating smoking like an epidemic in this way finally reveals what going on. They say their results can explain the rate of change of smoking in various industrialized countries.
That an interesting result with significant implications for government health policies. It shows that differences in culture affect the dynamics of social spreading processes in a measurable way.
and hopes to sell them to manufacturers of wearable electronics, medical devices, smart labels, and environmental sensors.
While gene drives may have commercial and public health uses, 10 scientists published an editorial today in the journal Science calling for more public discussion,
and researchers have been developing gene drive approaches to alter mosquitoes to slow the spread of malaria and dengue fever.
with the idea of releasing them in the wild to cause a population crash, thereby reducing malaria.
For the health-care industry it complies with medical privacy laws. For legal and financial clients it integrates with electronic signature services.
and the few materials researchers have been able to develop with good thermoelectric properties have been rare, expensive, or toxic.
The U k. project will focus on people with cancer, as well as adults and children with rare diseases.
Because all Britons are members of the National Health service, the project expects to be able to compare DNA data with detailed centralized health records (see hy the U k. Wants a Genomic National Health service.
While the number of genomes to be sequenced is 100 000, the total number of Britons participating in the study is smaller, about 70,000.
That is because for cancer patients Genomics England intends to obtain the sequence of both their inherited DNA as well as that of their cancers.
Genomics England began talking early this year to potential bidders, including Chinese company and Illumina rival BGI (see nside China Genome Factory.
#3-D Mammography Shown to Improve Detection of Invasive Breast cancer A new 3-D imaging technology that typically isn covered by health insurance allows radiologists to detect more cases of invasive breast cancer than traditional mammography,
In an analysis of nearly half a million women published in the June 25 issue of the Journal of the American Medical Association,
was linked to a 41 percent increase in the detection of invasive cancers as well as a 15 percent drop in the recall rate,
Daniel Kopans, who founded the breast imaging division at Massachusetts General Hospital and developed tomosynthesis, says the latest evidence could push hospitals to move toward the new screening method. ltimately,
radiologists will recognize that if they miss a cancer because they weren using tomosynthesis, they could end up being sued by someone who said,
hy didn you use tomosynthesis? Why did you do my screening as a 2-D mammogram??
he says. Currently in the United states, doctors recommend that women over 40 get screened for breast cancer every year,
but some researchers argue that the rate of false positives causes patients undue anxiety and creates a burden on the health system.
Some medical groups say screening is overused and should instead occur every two years starting at age 50.
Traditional mammography uses side-to-side and top-to-bottom x-rays of the breast. Such 2-D mammograms can create superimposed shadows that look like cancer,
and they sometimes fail to detect cancer lesions behind normal tissue. In tomosynthesis approved by the FDA in 2011, a series of x-ray images are taken in an arc across the breast,
resulting in pictures from multiple angles. A computer algorithm then creates a stack of thin layers that a radiologist can read, much like the pages of a book.
The JAMA study was funded by Hologic, which is currently the only company to have approved an FDA tomosynthesis system in the U s. General electric sells a system in Europe).
Etta Pisano, dean of the College of Medicine at the Medical University of South carolina, says there still isn enough evidence to say
or even how often women should be screened. aybe radiologists should have a mixture of technologiesomo might just make sense for women with dense breasts,
Some doctors say 2-D mammography isn going to be retired, since it better at detecting the tiny calcium deposits that are evidence of ductal carcinoma in situ (DCIS), one of the earliest forms of breast cancer.
so radiologists can more accurately analyze the size, shape, and location of any abnormalities and judge whether the tumors are invasive. ight now the prohibitive issue is the costatients can afford to pay for this expensive technology,
and there no reimbursement to the health-care system, says Emily Conant, professor and chief of the breast imaging division at the Hospital of the University of Pennsylvania
and senior author of the JAMA study. think the data supports implementing tomosynthesis for screening,
or disease could change the impedance properties of the wearer wrist, requiring the device to be recalibrated,
and the stress this can put on the power grid. But Solar City believes that if building huge factories to produce advanced solar panels can bring down costs,
First Emotion-Reading Apps for Kids with Autism The first mobile apps that use emotion-reading software to help kids with autism are nearing release,
Though the early academic research focused on applications such as helping people with autism, so far the technology has been used commercially to help marketers understand
We started out with research on autism, and we went out and did this commercial stuff.
and apply it back to autism again. The advertising work helped make the software more accurate by rainingit
to use brain implants to read, and then control, the emotions of mentally ill people. This week the Defense Advanced Research Projects Agency,
or DARPA, awarded two large contracts to Massachusetts General Hospital and the University of California, San francisco,
to create electrical brain implants capable of treating seven psychiatric conditions, including addiction, depression, and borderline personality disorder.
The project builds on expanding knowledge about how the brain works; the development of microlectronic systems that can fit in the body;
The U s. faces an epidemic of mental illness among veterans, including suicide rates three or four times that of the general public.
But drugs and talk therapy are limited of use which is why the military is turning to neurological devices,
says Justin Sanchez, manager of the DARPA program, known as Subnets, for Systems-Based Neurotechnology for Emerging Therapies. e want to understand the brain networks in neuropsychiatric illness,
develop technology to measure them, and then do precision signaling to the brain, says Sanchez. t something completely different and new.
Companies including the medical device giant Medtronic and startup Cortera Neurotechnologies a spin out from UC Berkeley wireless laboratory,
More recently, doctors have used such stimulators to treat severe cases of obsessive-compulsive disorder (see rain Implants Can Reset Misfiring Circuits.
the U s. Food & Drug Administration approved Neuropace, the first implant that both records from the brain and stimulates it (see apping Seizures Away.
It is used to watch for epileptic seizures and then stop them with electrical pulses. Altogether, U s. doctors bill for about $2. 6 billion worth of neural stimulation devices a year, according to industry estimates.
Researchers say they are making rapid improvements in electronics, including small, implantable computers. Under its program, Mass General will work with Draper Laboratories in Cambridge, Massachusetts,
who have created several prototypes of miniaturized brain implants. Michel Maharbiz, a professor in Berkeley electrical engineering department, says the Obama brain initiative,
wee trying to build the next generation of psychiatric brain stimulators, says Alik Widge, a researcher on the Mass General team.
a psychiatrist who directs Mass General division of neurotherapeutics, says one aim could be to extinguish fear in veterans with posttraumatic stress disorder, or PTSD.
Fear is generated in the amygdala part of the brain involved in emotional memories. But it can be repressed by signals in another region,
like relaxation or anxiety, using implants he called timoceivers. But Delgado, also funded by the military,
Psychiatric implants would in fact control how mentally ill people act, although in many cases indirectly, by changing how they Feel for instance,
Dougherty says a brain implant would only be considered for patients truly debilitated by mental illness, and who can be helped with drugs
let do surgery, says Dougherty. t going to be for people who don respond to the other treatments. o
#Genome Editing to Reverse Bubble Boy Syndrome Researchers used an emerging technique to correct the gene behind a fatal immune system disorder in an infant.
Genome editing technology is considered a promising new tool for curing disease. For decades gene therapy has meant that a virus delivers a functional copy of a gene that is dysfunctional in a patient.
and the therapeutic version typically remains separate from the rest of the genome. The technology has drawbacks.
First, by sitting outside of the genome, the activity of therapeutic gene isn regulated properly.
In some cases, the therapeutic copy is delivered by a retrovirus the plunks the new gene down near randomly in the patients genome,
Second, some diseases, such as Huntington can be treated this way because the broken copy of the gene causes harm.
Using genome editing to repair genes could circumvent these issues (see enome Surgery. In the new study, published today in the journal Nature,
researchers in Milan treated a condition known as Severe Combined Immunodeficiency Syndrome, or SCID (this condition is referred sometimes to as ubble boy diseasebecause children afflicted may live in protected environments
because the risk of death from infectious disease is extremely likely). Children with this genetic condition have been treated with the additive gene therapy method in the past,
and some suffered leukemia-like diseases as a side effect (see he Glimmering Promise of Gene therapy.
Scientists used zinc fingers to engineer the immune cells of patients with HIV to resist the virus (see an Gene therapy Cure HIV?.
#DNA-Based Research May have unveiled Long-Sought Diabetes Treatment A synthetic drug that controls blood sugar in obese mice demonstrates the potential of a DNA-dependent method for developing new chemical compounds.
By Susan Young Rojahn on May 23, 2014 WHY IT MATTERS The World health organization predicts that diabetes will be the seventh-leading cause of death by 2030.
and treat diabetes. Researchers have known long that the body carries an enzyme that breaks down insulin inside cells
and helps regulate the body response to sugars process that goes awry in type 2 diabetes.
Genetic studies have shown that people with type 2 diabetes are more likely to have mutations in the gene that encodes a protein called insulin-degrading enzyme, or IDE.
Patients with type 2 diabetes either have an insufficient amount of insulin in their blood
Researchers have speculated for decades that a drug that could inhibit IDE might help some type 2 diabetes patients.
which make up the majority of medicines, are compounds far smaller than less common biological medicines like antibodies.
They are developed using libraries of thousands or millions of known chemical substances. Each compound is screened to see
or other protein known to be involved in a disease. Pharmaceutical companies may use robotics to test many chemical reactions in parallel.
The newly identified IDE inhibitor could be the starting point for developing a powerful new drug for type 2 diabetes.
#Nerve-Stimulating Implant Could Lower Blood pressure An implantable device that reduces blood pressure by stimulating a nerve in the neck could someday be an alternative to drugs for controlling hypertension.
The device is one of the latest efforts to use a nerve-stimulating implant to treat a medical condition.
Such implants might offer new hope to those with extreme hypertension. Up to 30 percent of people with high blood pressure cannot be treated fully with medication
The researchers tested their implant in five adult rats and found that a certain stimulation pattern could reduce the rodents blood pressure by 40 percent without any major side effects.
Plachta says the procedure for implanting the device in humans would be similar to one used in an existing technique that uses vagal-nerve stimulation to treat epilepsy.
which a surgeon would gently wrap the electrodes around the nerve. The device would then be connected to a capsule containing the pulse generator
The whole surgery should take an hour and a half or less says Plachta. The president-elect of the American Society of Hypertension John Bisognano says the work is an impressive and promising application of recent advances in miniaturized electronics and microsurgery.
Bisognano a cardiologist who runs a resistant-hypertension clinic at the University of Rochester Medical center in New york knows well the need for more treatment options.
He says all his patients are on several blood pressure medications and some find that side effects make the drug regimens difficult to maintain.
which means they are at high risk for stroke heart failure and kidney failure he says. Implanted electrical devices that control bodily functions have been used for many years.
but electrical devices are used also to control Parkinson s disease and experimentally some psychiatric conditions (see Brain Pacemakers
and Brain Implants Can Rest Misfiring Circuits). They may be helpful even for such unlikely conditions as bladder dysfunction
and rheumatoid arthritis (see Implanted Device Controls Rheumatoid arthritis). Kristoffer Famm vice president of bioelectronics research and development at Glaxosmithkline coauthored a paper last year on the emergence of the field that he and his academic colleagues call electroceuticals.
Bisognano has reduced successfully blood pressure with experimental implants that stimulate the carotid artery directly an entirely different design from the implant developed by the German group.
Whereas drugs cannot adapt to patient activities an intelligent implant can he says which could offer a way to treat hypertension on demand d
In medical examinersoffices around the United states alone, some 25,000 unidentified human skulls, many of homicide victims, await identification.
Haptic styluses and similar hardware have been used for years for niche applications and for high-end 3-D design and medical trainingor example,
#Implant Lets Patients Regrow Lost Leg Muscle Five people who suffered serious leg injuries have been able to regrow muscle tissue in their legs thanks to a new regenerative medicine treatment.
The new treatment requires intensive surgery to remove scar tissue, after which a biological scaffold is sutured in.
Within two days, the patients began an intensive physical therapy regimen that helps direct the development of stem cells in the body that are drawn to the implant.
Once the stem cells reach the implant, they start making new muscle tissue. The aggressive physical therapy is demanding but critical
two of these injuries were the result of IED blasts. The other two participants were injured in skiing accidents.
Each injury had taken between 60 and 90 percent of thigh muscle or lower leg muscles,
and the participants had undergone already multiple surgeries and physical therapy to try to repair their damaged limbs. rankly,
Although the body has a natural ability to regenerate some muscle after injury, extreme trauma can create gaps that are too large for normal processes to fill,
Such injuries which can be caused by motorcycle accidents, bomb blasts, and more, lead to debilitating condition with limited treatment options, says Andrés García,
The new treatment, described in Science Translational Medicine on Wednesday, is imple yet with significant translational potential,
Biopsies taken six to eight months after the procedure indicated that at least some muscle tissue grew in all five patients
The material is used widely as a passive structural support for abdominal wall hernias, breast reconstruction, and chest wall defects.
As the scaffold starts to break down over several months, it releases biochemical signals that attract the body stem cells to the implant.
The researchers have started treating patients with upper body injuries, and are seeing similar results n
#Cochlear Implant Also Uses Gene therapy to Improve Hearing More than 300,000 people worldwide have cochlear implants.
Cochlear implants use up to 22 platinum electrodes to stimulate the auditory nerve; the devices make a tremendous difference for people
but they restore only a fraction of normal hearing. ochlear implants are very effective for picking up speech,
and dynamics, says Gary Housley, a neuroscientist at the University of New south wales in Sydney, Australia, who led development of the new implant.
So there a physical gap between these atrophied neurons and the electrodes in the cochlear implant.
distributed electrodes of the cochlear implant could be used to achieve the effect. Housley group used deafened guinea pigs
During surgery to place the cochlear implant, they injected the cochlea with a neurotrophin gene vector.
Once the implant was placed, they applied an electroporation voltage using the electrodes. The process, which took only a few seconds during surgery,
resulted in nerve regeneration in the animals. And weeks after implantation, the nerves of treated animals showed stronger responses to signals from the implant,
which suggests they are able to hear more. This research is described this week in the journal Science Translational Medicine. learly this worksn a guinea pig
says Lawrence Lustig, director of the Cochlear Implant Center at the University of California, San francisco Medical center.
Lustig group and others have been exploring gene therapy, but they use a virus to deliver the neurotrophin gene.
whether it for deep-brain stimulation in Parkinson disease, or retinal implants for the blind, there is already neural damage,
a major maker of cochlear implants headquartered in Sydney, to test the electrode and gene therapy combination in a clinical trial i
to prevent serious injury to humans (or worse), these robots are normally shut down when anyone enters their workspace.
in fact, a lot of what we know about cancer genetics comes from research on our fungal friends.
creating living factories for medicines, biofuels, and more (see icrobes Can Mass-produce Malaria Drugand iofuel Plant Opens in Brazil.
The report of the first artificial, designer yeast chromosome suggests ways for researchers to produce new chemicals in the microbes
She not being paranoid. Documents leaked last June by former U s. intelligence contractor Edward Snowden revealed a global surveillance operation coördinated by the U s. National security agency and its counterpart in Britain
my first reaction was had that we discovered junk that would be said highly toxic microbiologist Kim Lewis, director of Northeastern Antimicrobial Discovery Center.
or Streptococcus pneumonia survived and showed no signs of toxicity pleasant surprise to Lewis and his colleagues.
That the antibiotic can kill M. tuberculosis s a major breakthrough because it is virtually certain to be effective for the multi-resistant strains that are now all but impossible to treat,
said Richard Novick, a microbiologist at New york University Langone Medical center who was involved not in the work.
Although further studies are needed before the antibiotic can be tested in humans animal efficacy models are often predictive of a drug effects in humans,
said Gerard Wright, director of the Institute for Infectious disease Research at Mcmaster University in Hamilton, Canada,
drug like this must be reserved for serious diseases and not given to general practitioners to spread around like aspirin
#One-jab universal flu shot in offing MELBOURNE: Scientists have uncovered how human immune cells remember previously encountered strains of influenza,
a discovery that may pave the way for a single universal flu shot to immunize people for their entire lives.
and nobody had immunity. Thankfully, we did manage to contain the virus but we knew we had come face-to-face with a potential pandemic that could kill millions of people around the world
if the virus became able to spread between humans, "she said.""After collecting samples from infected patients we found that people who couldn't make these T cell flu assassins were dying.
These findings lead to the potential of moving from vaccines for specific influenza strains towards developing a protection,
we're talking about a history-altering event on the Spanish flu scale. As it turns out,
"Our extraordinary breakthrough could lead to the development of a vaccine component that can protect against all new influenza viruses, with the potential for future development of a one-off universal flu vaccine shot,
Experts find proof In a major medical breakthrough, scientists at the National Brain Research Centre (NBRC) have reported clinical evidence supporting the role of a novel biomarker in diagnosing Alzheimer's disease.
Glutathione (GSH), the biomarker, is a natural antioxidant that protects the brain from damage. Researchers claim that those suffering from the disease have reduced GSH as compared to the healthy individuals."
"The conventional methods for diagnosis of Alzheimer's depend mostly on clinical symptoms or biopsy which is an invasive procedure.
However, the new biomarker can be assessed by MRI-like imaging tests. Also, it can help predict the disease much before its onset,
"said Dr Pravat Mandal, a professor at NBRC and associate professor (adjunct) at the John Hopkins University, Maryland, USA.
"Several animal studies conducted at NBRC have showed the utility of this biomarker in diagnosing Alzheimer's disease previously also.
The findings have been accepted by the international journal'Biological Psychiatry'for publication.""A total 130 people0 Alzheimer's patient, 41 patients suffering from mild cognitive impairment and 49 healthy individualsarticipated in the study.
the patients were recruited through referral from neurologists at AIIMS, the researchers said. They claimed GSH estimation in Hippocampi,
a region of the brain, yielded 100%specificity and sensitivity for distinguishing Alzheimer's disease and healthy controls."
"We propose that estimation of GSH affords a crucial noninvasive measure of Alzheimer's disease progression that could
not only provide clinical insight about the disease's pathophysiology but also expedite the drug development process,
Dr Kameshwar Prasad, professor and head of neurology at AIIMS, said the findings are preliminary."
"If it succeeds to become a practical solution for early diagnosis of Alzheimer's. Early identification can help in giving drug therapy to slow the degeneration process
and develop strategies to enhance the patient's living environment, "he said. Alzheimer's is one of the common brain disorders that affects nearly 35 million people worldwide.
By 2050, experts said, about one in 85 individuals over the age of 65 years will suffer from the disease s
#Created: First artificial molecular pump WASHINGTON: Scientists have developed the first man-made molecular pump, which transports key proteins that cells need to function,
#Researchers find new way to treat diabetic blindness WASHINGTON: US researchers said they have found a new way to restore the eyesight in patients who have a blinding eye disease caused by diabetes.
The key is to block a second blood vessel growth protein, along with one that is already well-known,
and preventing diabetic retinopathy, the most common diabetic eye disease, they reported in the US journal Proceedings of the National Academy of Sciences, Xinhua news agency reported.
Diabetic retinopathy occurs when the normal blood vessels in the eye are replaced over time with abnormal,
damaging the light-sensitive retina and causing blindness. Forty to 45 percent of Americans with diabetes have diabetic retinopathy, according to the US National Eye Institute.
Laser-sealing eye blood vessels can save central vision, but this often sacrifices peripheral and night vision, according to the researchers at the Johns hopkins university and the University of Maryland.
But studies have shown that although these drugs slow progression to proliferative diabetic retinopathy, it does not reliably prevent it,
said lead author Akrit Sodhi, an assistant professor of ophthalmology at the Johns hopkins university School of medicine. To find an explanation,
people with diabetes who did not have diabetic retinopathy and people with diabetic retinopathy of varying severity were tested.
While levels of VEGF tended to be higher in those with proliferative diabetic retinopathy some of their fluid had less VEGF than did the healthy participants.
But even the low-VEGF fluid from patients with proliferative diabetic retinopathy stimulated blood vessel growth in lab-grown cells."
"The results suggested to us that although VEFG clearly plays an important role in blood vessel growth,
and angiopoietin-like 4 in fluid from the eyes of people with proliferative diabetic retinopathy, it markedly reduced blood vessel growth in lab-grown cells.
it might be combined with the anti-VEGF drugs to prevent many cases of proliferative diabetic retinopathy.
whether angiopoietin-like 4 might also play a role in other eye diseases, such as macular degeneration,
US researchers said they have found a new way to restore the eyesight in patients who have a blinding eye disease caused by diabetes.
and preventing diabetic retinopathy, the most common diabetic eye disease, they reported in the US journal Proceedings of the National Academy of Sciences, Xinhua news agency reported.
Diabetic retinopathy occurs when the normal blood vessels in the eye are replaced over time with abnormal,
damaging the light-sensitive retina and causing blindness. Forty to 45 percent of Americans with diabetes have diabetic retinopathy, according to the US National Eye Institute.
Laser-sealing eye blood vessels can save central vision, but this often sacrifices peripheral and night vision, according to the researchers at the Johns hopkins university and the University of Maryland.
But studies have shown that although these drugs slow progression to proliferative diabetic retinopathy, it does not reliably prevent it,
said lead author Akrit Sodhi, an assistant professor of ophthalmology at the Johns hopkins university School of medicine. To find an explanation,
people with diabetes who did not have diabetic retinopathy and people with diabetic retinopathy of varying severity were tested.
While levels of VEGF tended to be higher in those with proliferative diabetic retinopathy some of their fluid had less VEGF than did the healthy participants.
But even the low-VEGF fluid from patients with proliferative diabetic retinopathy stimulated blood vessel growth in lab-grown cells."
"The results suggested to us that although VEFG clearly plays an important role in blood vessel growth,
and angiopoietin-like 4 in fluid from the eyes of people with proliferative diabetic retinopathy, it markedly reduced blood vessel growth in lab-grown cells.
it might be combined with the anti-VEGF drugs to prevent many cases of proliferative diabetic retinopathy.
whether angiopoietin-like 4 might also play a role in other eye diseases, such as macular degeneration,
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