NASA's mini lab may change testing

NASA to launch mini lab, test for cancer and disease in space -- Engadget
engadget.com by Steve Dent on August 26, 2012



It’s hard to find a good specialist on earth, let alone when you’re floating 240 miles above it. That’s why NASA will test the Microflow, a breadbox-sized device that instantly detects cancer and infectious diseases, and can even sense the presence of rotten food. The Canadian-made device is a “flow cytometer,” which works by analyzing microparticles in blood or other fluids and replaces hospital versions weighing hundreds of pounds. Here on Earth, the device could let people in remote communities be tested more quickly for disease, or permit on-site testing of food quality, for instance. It will be particularly advantageous in space, however, where Canadian astronaut Chris Hadfield will test it during his six-month ISS mission, allowing crew to monitor, diagnose and treat themselves without outside help. Now, if we could just get it down to a hand size, and use some kind of radio waves instead — oh wait, that’s not until Stardate -105352.



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New non-invasive method for diagnosing epilepsy

New non-invasive method for diagnosing epilepsy | ScienceBlog.com
Science Blog by sb on August 26, 2012

A team of University of Minnesota biomedical engineers and researchers from Mayo Clinic published a groundbreaking study today that outlines how a new type of non-invasive brain scan taken immediately after a seizure gives additional insight into possible causes and treatments for epilepsy patients. The new findings could specifically benefit millions of people who are unable to control their epilepsy with medication.

The research was published online today in Brain, a leading international journal of neurology.

The study’s findings include:

Important data about brain function can be gathered through non-invasive methods, not only during a seizure, but immediately after a seizure.
The frontal lobe of the brain is most involved in severe seizures.
Seizures in the temporal lobe are most common among adults. The new technique used in the study will help determine the side of the brain where the seizures originate.
“This is the first-ever study where new non-invasive methods were used to study patients after a seizure instead of during a seizure,” said Bin He, a biomedical engineering professor in the University of Minnesota’s College of Science and Engineering and senior author of the study. “It’s really a paradigm shift for research in epilepsy.”

Epilepsy affects nearly 3 million Americans and 50 million people worldwide. While medications and other treatments help many people of all ages who live with epilepsy, about 1 million people in the U.S. and 17 million people worldwide continue to have seizures that can severely limit their lives.

The biggest challenge for medical researchers is to locate the part of the brain responsible for the seizures to determine possible treatments. In the past, most research has focused on studying patients while they were having a seizure, or what is technically known as the “ictal” phase of a seizure. Some of these studies involved invasive methods such as surgery to collect data.

In the new study, researchers from the University of Minnesota and Mayo Clinic used a novel approach by studying the brains of 28 patients immediately after seizures, or what is technically know as the “postictal” phase of a seizure. They used a specialized type of non-invasive EEG with 76 electrodes attached to the scalp for gathering data in contrast to most previous research that used 32 electrodes. The researchers used specialized imaging technology to gather data about the patient. The findings may lead to innovative means of locating the brain regions responsible for seizures in individual patients using non-invasive strategies.

“The imaging technology that we developed here at the University of Minnesota allowed us to tackle this research and gather several thousand data points that helped us determine our findings,” He said. “The technical innovation was a big part of what helped us make this discovery.”

He, who was recently appointed the director of the University of Minnesota’s Institute for Engineering in Medicine, said this study was also a good example of a true partnership between engineering and medicine to further medical research.

“The innovations in engineering combined with collaborations with clinicians at Mayo Clinic made this research a reality,” He said.

In addition to He, members of the research team included University of Minnesota biomedical engineering Ph.D. student Lin Yang; Gregory A. Worrell, Mayo Clinic, Neurology and Division of Epilepsy; Cindy Nelson, Mayo Clinic, Neurology; and Benjamin Brinkmann, Mayo Clinic, Neurology. The research was funded by the National Institutes of Health.


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What health care can learn from the military

What health care can learn from the military
KevinMD.com by John Lee on August 26, 2012

While the typical physician is now accepting of the IT changes that are intruding into their work environment, he often does not understand the reasons or the strategic underpinnings for the push for the digitalization of healthcare. Being a typical modern consumer, he understands smartphones, online shopping and email, but doesn’t understand concepts such as clinical data repositories, data warehouses, decision support and business intelligence. Analogies can help, but carts, horses, sticks and carrots are a bit tired.

Being an amateur historian, I realized that the modern military is rife with models that can be used to make the point. These analogies are not meant to be comprehensive of the broad strategic goals of health information technology, but they do help the rank and file physician understand why there is such a push to integrate information technology into the healthcare world.

Carpet bombing

One example highlights the broad “high level” view in more ways than one. In World War II, the US Air Force generally relied on eyeballs on target to bomb surface targets. Objectives previously were targeted with squadrons of bombers, risking the lives of the pilots and also creating all sorts of collateral damage. It was terror in the air and on the ground. Then in Vietnam, the Air Force began utilizing “smart bombs,” or precision guided munitions. The contrast was illustrated by the Air Force’s campaign against the Thanh Hoa bridge in Vietnam. It was the target of 800 unsuccessful sorties with unguided munitions, but was finally successfully dispatched by a single flight of 12 planes with microchip enhanced bombs.

If you think about how we practice medicine now, we are essentially carpet bombing our patients. This sort of approximated, empiric “targeting” occurs when we treat pneumonias with broad spectrum antibiotics, tumors with chemotherapy, and asthma with steroids and leukotriene inhibitors. These treatments are quite effective, most of the time. Relative to the alternatives, they are also safe, most of the time. However, physicians frequently encounter the “collateral damage” of well-intended treatment such as C. difficile, allergic reactions and drug interactions which are certainly not intended, but occur because we clinicians are constantly barraged by so much data that there is no possible way to avoid all such incidents.

So how do we “smart-bomb” illness and injury? The modern bomber flying at 30,000 feet hitting a small target miles away on the ground does not do this in isolation. It relies on huge amounts of data that is processed by multiple entities from satellites in space to targeting resources on the ground and complex systems within the plane and munitions themselves. We in medicine also rely on large amounts of data that we are required to apply at the point of care. Unfortunately, more often than not, this data is difficult to access (ie. locked as text on paper) and even more difficult to aggregate so that it can be usable and the time and point of care. We need to collect this data, put it together, and use it in real time to affect our clinical decisions. Examples of this are using allergy and medication interaction information to reduce the risks of medication.

However, such information is just the low hanging fruit because medication information is easy to store as discrete data. The vast majority of medical knowledge is locked as unusable data. We need to codify this bulk of clinical data so that is usable by digital systems and patterns can be dredged, enabling our therapies to be more nuanced and accurate.

Integrated systems

There are anecdotes describing how Navy destroyers saved the day at the Omaha beach landing on D-Day. The planned landing Omaha Beach on D-Day was a failure. The infantry that had landed on the beach were in chaos and impotently pinned by German firepower in protected positions. However, despite not being part of the plan, these smaller ships were able to move in close to shore and noticed that a lone Sherman tank was pounding in vain against a German gun battery encased in concrete. They were able to provide tactical fire support using their larger 5 inch guns and neutralized the battery.

Noticing this, the tank went on to “target” other batteries and the destroyers apparently were happy to use this information. Despite not having direct communications, resourceful soldiers and sailors cobbled together a makeshift communication system. It didn’t occur to the US military that facilitating tactical communications between the branches (in this case, the Navy and Army) would amplify their effectiveness. Today, the military has embraced the concept of combined arms and integrated systems. Well known example are the AWACS and Aegis combat systems that coordinates various military assets. Such coordination allows military command and control to see data from multiple sources, allowing them to direct their forces efficiently and in a time sensitive manner.

Likewise, our healthcare environment is currently a victim of information isolation. It is quite common to have patient information from separate sources inaccessible to the providers who are actively taking care of a patient. A patient can be hospitalized with much of his data locked in a doctor’s office or vice versa. Obstructions to information flow can even occur in the same physical plant. It is quite common for doctors, nurses, and other ancillary providers to record and document information in different ways and on separate parts of the chart or even separate physical charts. Because of this, it is even common for the patient to go through their inpatient clinical course without doctors even looking at any nursing documentation. The eventual goal is a single common electronic patient document. The patient information then is simultaneously available to all providers as a single merged source of truth, allowing a coordinated approach to the care of the patient rather than multiple strategies that are blinded to other practitioners.

Force multipliers

The US military uses Special Forces teams (typically 12 men) to train a larger size (100-200) of indigenous fighters to engage in guerrilla warfare. Thus, the Special Force unit has multiplied their effective size. The GPS technology we now take for granted in our cars allowed the US led coalition forces to outmaneuver the Iraqi forces in the first Gulf War, allowing the Allied forces to choose when and where they wanted to fight, again, making a fighting force more potent than their pure numbers. These tactics and technology were force multipliers, amplifying the strength of a single unit or soldier.

We often hear about the silos of data and information in health care. However, we also have silos of knowledge. It took 15 years for 50% of patients to receive beta-blockers after myocardial infarction and 25 years to reach 90%. The studies and knowledge that beta-blockers improved outcomes was readily available, but the academics failed to reach the trenches of real world medicine. If this clinical knowledge had been presented at the appropriate times, compliance would have reached 90+% much sooner. Reading about evidence based recommendations and filing them away is one thing.

Trying to remember and implement them during the chaos of the real world medicine is more difficult. Decision support allows such recommendations and reminders to be delivered at the point of care, where we wage the real fight. Discovering evidence based practices is not enough. We must use technology enhanced decision support to amplify and accelerate evidence based academic findings when and where the clinician needs them, not locked up in a journal.

Our healthcare environment and national economic circumstances dictate that we take care of patients better with fewer resources. Although it may seem odd to relate strategies used by an organization to exert physical power to the healing purposes of healthcare, the US military has evolved its technology and tactics to be a leaner but more potent force. Healthcare can learn from their evolution to be leaner and more potent as well.


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A High-Tech Fix for Broken Schools

I know this blog is pointed towards technological changes in healthcare, however this article by Juan Williams looks at the changes technology is bringing to our schools. These changes will eventually bring these students into the entrepreneurial world.

A High-Tech Fix for Broken Schools

By JUAN WILLIAMS
WSJ

Mooresville, N.C., is best known as "Race City, U.S.A.," home of Nascar. But these days Mooresville is leading the nation in a different way—by using digital technology to improve public education.

"Fixing Our Schools," a documentary I am hosting for the Fox News Channel this Sunday, looks at how digital learning is being used by schools like those in Mooresville to help fix our broken education system.

Our schools are undoubtedly in crisis. Prize-winning documentaries such as "Waiting for 'Superman'" have revealed the terrible cost of losing young minds to failing schools. Dropout rates are particularly high among minority children in urban schools. But even parents in the best suburban schools are alarmed by the fact that the U.S. now ranks 30th world-wide in math, 23rd in science, and 17th in literacy.

This is why the modestly funded schools in Mooresville are drawing national attention. The school district ranks 100th out of 115 school districts in North Carolina on per-pupil spending. But in the last 10 years, its test scores have pushed it from a middling rank among North Carolina's school districts to a tie for second place.

Three years ago, 73% of Mooresville's students tested as proficient in math, reading and science. Today, 89% are proficient in those subjects.

The big change in Mooresville began when Superintendent Mark Edwards took the radical step of cutting back on teachers and using the money to give every student from third grade through high school a laptop computer.

All of their textbooks, notes, learning materials and assignments are computerized, allowing teachers and parents to track their progress in real time. If a student is struggling, their computer-learning program can be adjusted to meet their needs and get them back up to speed. And the best students no longer wait on slow students to catch up. Top students are constantly pushed to their limits by new curricular material on their laptops.

Nearly every phase of students' education is a data-point that can be tracked, analyzed and compared with their peers. Thanks to the data system, Mr. Edwards says, "our teachers are better informed, our parents are better informed, and our students are understanding what they're doing and why they're doing it." He notes, by the way, that digital learning hasn't increased costs.

Some 600 miles north of Moorseville, New York City's "School of One" in Brooklyn has had similar success with a digital-learning program. The mathematics-centered middle school has reported significant gains in the test scores of its students since it was founded in 2009. Joel Klein, the former chancellor of the New York City public schools, helped initiate the program and is now one of the leading proponents for digital learning. (Mr. Klein is CEO of Amplify, News Corp.'s educational division. News Corp. owns The Wall Street Journal.)

"Think about how different the world is today in terms of the media, in terms of medicine, in terms of the way people really experience their lives, and education is stuck in a 19th-century model," Mr. Klein explains. "So I'm convinced that we can [use computers to] change the way we educate our kids." He adds that the computers don't remove the need for good teachers but help "teachers do their work in a much more effective way."

In Florida, former Gov. Jeb Bush pioneered large-scale digital learning as part of his education-reform efforts. "If you want to take an [advanced placement] class, you can do this online, and people flock to that opportunity. So, it has improved learning and they don't get paid unless the course is complete," Mr. Bush says. "Imagine if the public schools accepted that idea. You would have a lot more children gaining the power of knowledge."

Some critics charge that digital learning is a boondoggle, a way for the private companies that make the technology to profit by selling their products to school districts. Messrs. Klein and Bush respond that we must support new ideas and budding solutions that show promise to fix schools—regardless of their origins.

Mr. Bush puts it this way: "If it's for-profit or not-for-profit or it's developed by the schools inside a district or by teachers inside of schools, does it matter?"

The bottom line is that bringing more technology into the classroom shows tremendous promise to improve schools. And any doubters should take a look at the little school district now speeding along in Mooresville.


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Hi speed camera may help early Cancer Testing

Snap Judgment: Ultrafast Camera Renews Promise of Blood Test for Early Cancer Detection: Scientific American
Scientific American by Larry Greenemeier


Cells that break away from a cancerous tumor and circulate in the bloodstream are a serious threat to helping cancer spread, or metastasize, throughout the body. Finding these circulating tumor cells (CTCs), however, can be like searching for a particular needle in a stack of needles. One milliliter of blood contains about five billion red blood cells, 10 million white blood cells and only 10 tumor cells.

Yet early cancer detection and treatment is a person's best chance of survival, And because metastasis is responsible for 90 percent of cancer deaths, researchers have spent decades trying to develop blood tests that can effectively spot CTCs before they can form new tumors. The biggest challenge has been quickly examining billions of rapidly moving blood cells in a sample at a resolution high enough to identify the cancerous intruders.

Researchers at the University of California, Los Angeles, (U.C.L.A.), are developing a system that combines an optical microscope with a device for counting and studying cells, along with a high-speed image processor they say can take blur-free images of fast-moving cells, a significant step toward catching CTCs in the act. The researchers described the system last month in Proceedings of the National Academy of Sciences (PNAS).

The heart of the U.C.L.A. system is an ultrafast microscopic camera the researchers introduced in 2009 that captures images at about six million frames per second. This "serial time-encoded amplified microscopy" (STEAM) camera creates each image using a very short laser pulse—a flash of light only a billionth of a second long. The STEAM camera's shutter speed is 27 picoseconds, about a million times faster than a current digital camera. (A picosecond it one trillionth of a second.)

An instrument must meet two major requirements to detect CTCs in a blood sample. Of course, it must have a high sensitivity or signal-to-noise ratio to identify the signals, says lead author Keisuke Goda, a U.C.L.A. program manager in electrical engineering and bioengineering. "And it must be high speed, otherwise it would take a ridiculously long time [to find a cancer cell] because the background cell count is huge." The STEAM flow analyzer is an automated microscope 100 times faster than the automated microscopes hospitals sometimes use for disease identification, he adds.

The U.C.L.A. camera converts each laser pulse into a data stream from which a high-speed image can be assembled. The team used this technology to identify breast cancer cells in a blood sample. "We look at the cell's shape, size and texture as well as its surface biochemistry," Goda explains. "We can tell through high-speed imaging that cancer cells tend to be larger than white or red blood cells. And we know that a cancer cell's shape is ill-defined compared to red and white blood cells."

The researchers are now doing clinical testing on breast, lung, stomach, prostate and intestinal cancer patients' blood samples. Longer term, they want to quickly diagnose additional cancer types, including ovarian and pancreatic cancers, which are fast-spreading and require early detection for a patient to survive, says Goda, who was recently appointed as a chemistry professor at the University of Tokyo but will continue his research with U.C.L.A. He adds that a relatively noninvasive blood test would encourage people to get screened frequently.

Such a blood test could provide a safer and more accurate alternative to mammographies and other imaging tests as well as painful biopsies. MRI and computed tomography (CT) scans can be effective in finding larger tumors, but a patient's prognosis is poor by the time a tumor is detected.

There is already one diagnostic tool on the market for identifying and counting CTCs in blood samples, but it is not optimized for early detection. The U.S. Food and Drug Administration (FDA) in 2004 approved the CellSearch system, made by Johnson & Johnson's Veridex unit, for identifying and counting CTCs in patients with metastatic breast cancer. The FDA has since cleared CellSearch to help guide treatment of metastatic forms of prostate and colorectal cancer as well. Last year Johnson & Johnson said it would invest $30 million in a partnership with Massachusetts General Hospital to further develop CellSearch.

Despite these planned upgrades, "the U.C.L.A. work has promise as an advance over what is currently available," says Leon Esterowitz, a program director at the National Science Foundation (NSF). CellSearch is used primarily to check the progress of cancer treatment, whereas U.C.L.A.'s imaging technology could find cancerous cells at an earlier stage, before they can form a new tumor. "They've greatly improved the sensitivity and speed of the techniques that are being used for instance by Johnson & Johnson," Esterowitz says.

Researchers at New York City's Weill Cornell Medical College and Cornell University College of Engineering in Ithaca are also developing a cancer blood test, although theirs uses a "geometrically enhanced differential immunocapture" (GEDI) silicon chip that can identify and collect cancer cells from a patient's blood sample. The chip works in a device that can determine when patients have a high concentration of rare cancer cells from metastatic prostate cancer, according to the researchers, who described their work in the April 2012 issue of PLoS ONE. GEDI, like CellSearch, would be used to determine the efficacy of the patients' chemotherapy rather than finding early-stage cancer cells.

Esterowitz notes that all these blood tests are effective only after cells have become cancerous. He points to a Northwestern University project that aims to illuminate precancerous cells. Northwestern researchers are analyzing tissue at the nano—as opposed to the micro—scale to root out cells whose nuclei have greatly expanded or otherwise show irregularities that could be signs of impending malignancy.

Northwestern's approach, led by biomedical engineer Vadim Backman, involves shining light on tissue either inside a patient's body or taken from it. The researchers use a combination of microscopy and spectroscopy to examine how that light is reflected. Fluctuations in the reflections indicate possible abnormalities in the sampled tissue's micromolecular density and may flag the presence of unhealthy cells, Backman says.

"Most effort in the past has been studying cancer cells and tumors themselves, but we're focusing on what precedes the tumor," Backman says. "The tumor is the tip of the iceberg. We want to look below the waterline."

Backman and his team claim to have already tested their technology on 2,000 patients with a high degree of accuracy. The next step is to develop a compact, easy-to-use version that could be commercialized, and then conduct additional tests to earn FDA approval for what could be an even more effective cancer early warning system.


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Nanotechnology Holds Promise for Heart Patients

Nanotechnology Holds Promise for Heart Patients - WSJ.com
The Wall Street Journal by GAUTAM NAIK


Scientists have used nanotechnology materials to repair vital tissues damaged by heart attacks in animals, suggesting a new way to treat the same ailment in people.

The experiments, done in rats and pigs, led to the growth of fresh blood vessels and improved heart function without harmful side effects, the scientists said Wednesday in the journal Science Translational Medicine.


“Currently, there are no approved therapies in regenerative medicine for heart failure,” said Karen Christman, assistant professor of bioengineering at the University of California, San Diego, who wasn’t involved in the latest experiments. “These results are quite exciting.”

The World Health Organization estimates that more than 17 million people died from cardiovascular diseases in 2008. In the U.S., about 785,000 people will have new heart attacks this year and 470,000 will suffer recurrent ones. While more patients are surviving such events, about two-thirds don’t make complete recoveries and are vulnerable to heart failure.

Some researchers hope to treat patients by transplanting cells into the heart to promote the growth of new tissues. Animal tests have yielded promising results, and large-scale human trials are expected to kick off in coming months. But some of the early data suggest this approach may yield only small improvements in cardiac function.

An alternative technique is to deliver a protein called vascular endothelial growth factor, or VEGF, to promote blood-vessel growth in the heart. This method hasn’t worked well so far because the heart’s blood circulation tends to rapidly wash away the VEGF.

In their newly published experiments, researchers described an engineering fix for the problem. They made fibers from bits of protein and then assembled them into a lattice-like structure. Each fiber is just five nanometers wide and 100 nanometers long. (A nanometer is the length of three to six atoms placed side by side.)

The lattice structure is in the form of a sticky gel. The scientists mixed it with the VEGF and injected the combination into the hearts of two groups of test animals, rats and pigs, in which they had induced heart attacks. (Pig hearts bear significant similarities to human ones.) In both cases, instead of being washed away, the VEGF stayed on the lattice and slowly got released over several weeks.

Bone-marrow stem cells normally circulate in the blood and are part of the “repair crew” for damaged tissue. In the animal experiments, when those cells sensed the release of VEGF, they relocated to the heart and began to grow tiny blood vessels known as capillaries.

“The nanofibers create a special microenvironment in the heart for recruiting stem cells,” said Patrick Hsieh, a cardiac surgeon at the National Cheng Kung University in Taiwan and lead author of the paper.

However, fresh capillary formation isn’t enough to help a failing heart. For regeneration to continue, stem cells from both the bone marrow and the heart itself must be coaxed to grow a second layer of tissue that is necessary for the formation of arteries, which are bigger and thicker than capillaries.

To the scientists’ surprise, the prolonged release of VEGF achieved that result.

“This is the most striking finding of our approach,” said Dr. Hsieh. “We saw more than fivefold artery growth compared with the controls,” which included one group of animals that only got VEGF and another that got the nanofibers without the VEGF. The new artery growth contributed to improved heart function in the animals, Dr. Hsieh said.

The researchers also detected the creation of fresh heart muscle. This, too, is significant because the “scarring” tissue that naturally forms after a heart attack is thin and can get stretched in ways that alter the shape of the heart. In the latest experiments, the nanofiber gel appeared to strengthen these weak areas of the heart.

While the beneficial results in pig hearts were particularly important due to their resemblance to human ones, two challenges remain before the same technique can be safely attempted in people.

“We need to determine the long-term effect in animals, and we need to determine the optimal time window” when the VEGF nanofibers need to be administered, said Dr. Hsieh.

The researchers said they treated the rats and pigs immediately after a heart attack. When it comes to people, said Dr. Hsieh, it might be similarly effective to give the therapy in the first week after a heart attack, when stem-cell activity is highest.

The exact timing will now have to be pinned down. “While this therapy is promising,” said Dr. Christman, “it is important to see if the positive effect on cardiac function is maintained over the long term.”



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See the magic a 3D printer can do for a youngster

Not only read this but watch the video

http://allthingsd.com/20120804/3-d-printer-brings-magic-arms-to-a-two-year-old/?mod=mailchimp


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