e-HealthExpert.org - Primum non nocere

BBC News Magazine has an interesting interactive article that attempts to demonstrate how chance can make or break a reputation of a hospital or a surgeon in respect to their morbidity and mortality outcomes. In a special calculator, simply by selecting the percentage chance of someone dying, and clicking repeatedly, you can get a recalculated variance in outcome results between hospitals. We get the point, but it's not clear what the practical or political use this story is serving. BBC News Mag: Can chance make you a killer?... Michael

Wolfram|Alpha, the popular data search engine, has recently upgraded its medical capabilities even further with a drug guide that can help patients find out pharmaceutical options for various conditions. Simply by searching for something like "diabetes drug treatment", you will get the categories of drugs prescribed, and related pharma data. More at Wolfram|Alpha blog: Ask Wolfram|Alpha about Medical Drug Treatments... Link: Wolfram|Alpha Flashbacks: WolframAlpha Imports WHO Numbers; Wolfram|Alpha Beefs Up Its Medical Capabilities; Wolfram Alpha and Its Medical Powers... Michael

Berci Meskó over at ScienceRoll points out QuizMD, a service developed by med students for med students to prepare for exams. There are question answer sections, case reviews, links to further information online and a lot more. Berci uses it to stay fresh on his medical knowledge since graduating with an MD himself, and that's a pretty good endorsement as far as we're concerned. It was created to help students help each other succeed, to collectively scratch each others' backs. Education doesn't need to be difficult. Take control and make it yours. It is an entirely student developed and supported venture, independent of association with any university or post-secondary institution. Thank you for your continued contributions and support. Link: QuizMD ScienceRoll: Medical school e-learning... Michael

A team from Northeastern University and Harvard Medical School has been analyzing words used in tweets by American users in an attempt to gauge the public mood around the country. What they discovered was that users on the West Coast seem to be quite a bit jollier than those on the East Coast. It is not clear whether the data was collected during the summer or winter months and accordingly adjusted, for that surely would affect the readings. Researchers were able to infer the mood of each tweet using a psychological word-rating system developed by the National Institute of Mental Health’s Center for the Study of Emotion and Attention. The system ranks words based on how they make people feel. Tweets containing words such as “love,” or triumph,” for example, received high mood scores, whereas messages with words such as “hell,” or “death” earned low marks. Researchers then calculated an hour-by-hour average mood score for users in each state, and geographically represented the data using a density-equalizing map in which each region is scaled to represent its number of tweets as opposed to its land area. Here's a day's worth of tweets and how our mood changes throughout the day: Press release: What's in a tweet?... Michael

HealCam, our free no registration video chat service for people with medical conditions, continues to generate excitement among bloggers, journalists, twitterers, and other people. The site has now been profiled on a Dutch medical magazine Zorgvisie, a popular Croatian blog tehnoklik, as well as on Shiny Shiny. We also thank individual bloggers like Zara Rabinowicz for spreading the word around. The site is also creating a constant buzz on Twitter. In other news, we signed up for a service at GetSatisfaction, to help us manage software bugs. So if you notice a bug, there is a link on the bottom of HealCam to report it. So please help us spread the word around! Think of yourself, your elderly relatives and others, and tell them to visit HealCam.com. Thanks!... Michael

Kevin Stone is an orthopedic surgeon who's been working on developing non-artificial, biological tissue replacement material for joint conditions. Here's his talk from TED 2010: Link @ TED: The bio-future of joint replacement...... Michael

Cambridge Consultants (Cambridge, MA) and XenBio Fluidics (San Diego, CA) just announced a new platform that may bring rapid diagnostic testing to the bedside. Some details from the press release: The new immunoassay platform is based on a novel time-resolved florescence (TRF) label and low-cost portable detection technology, providing the precision, accuracy and sub-pM sensitivity expected of a clinical laboratory in a cost effective near-patient setting, better enabling earlier diagnosis and the detection of a wider range of biomarkers. Cambridge Consultants' platform is based on the combination of a TRF reader and label that achieve high sensitivity by using a temporal, rather than spectral separation of excitation and detection light. At the core of the new platform is an innovative TRF label that offers far greater levels of sensitivity compared to existing gold labels. The new label, when integrated with Cambridge Consultants' sophisticated detection unit, can deliver over four orders of magnitude improved sensitivity compared to gold labels. Using an NT-proBNP assay, Cambridge Consultants has demonstrated that the new platform is capable of detecting the biomarker in concentrations of less than 1pM and under certain conditions as low as 0.01pM. Cambridge Consultants and XenBio's new platform can be applied to a number of substrates, arrays and planar surfaces as well as being capable of being retrofitted to a range of existing lateral flow assays. As a result new tests can quickly be brought to market. Press release: Development opens potential for earlier detection and treatment of major diseases...... Michael

Tan Le, co-founder and president of Emotiv Systems, a company that's bringing novel EEG technology to the consumer market, recently gave a TED talk that included a demonstration of the company's headset. Emotiv is working on bringing its technology to video games and, hopefully, to disabled people for direct interaction with computers and assistive devices. Link @ TED: Tan Le: A headset that reads your brainwaves... Flashback: Telekinetic Video Games...... Michael

Researchers from the University of Buffalo have created a hybrid method of monitoring apoptosis. The technique should help us to understand the programmed cell death process and to perhaps aid in the development of techniques that will allow clinicians to program self annihilation of cancer cells. More from U. of Buffalo press statement: To capture the cellular images, the interdisciplinary UB team of biologists, chemists and physicists, led by Prasad [Paras N. Prasad, PhD, executive director of the UB Institute for Lasers, Photonics and Biophotonics (ILPB) and SUNY Distinguished Professor in the departments of Chemistry, Physics, Electrical Engineering and Medicine], utilized an advanced biophotonic approach that combines three techniques: a nonlinear, optical imaging system (CARS or Coherent anti-Stokes Raman scattering), TPEF (two-photon excited fluorescence), which images living tissue and cells at deep penetration and Fluorescence Recovery after Photobleaching to measure dynamics of proteins. The resulting composite image integrates in one picture the information on all four types of biomolecules, with each type of molecule represented by a different color: proteins in red, RNA in green, DNA in blue and lipids in grey, as shown on the PNAS cover. Multiplex imaging provided new information on the rate at which proteins diffuse through the cell nucleus, the UB scientists say. Before apoptosis was induced, the distribution of proteins was relatively uniform, but once apoptosis develops, nuclear structures disintegrate, the proteins become irregularly distributed and their diffusion rate slows down, says Artem Pliss, PhD, research assistant professor at the ILPB and co-author on the paper. Press release: How Do Cells Die? Biophotonic Tools Reveal Real-Time Dynamics in Living Color... Abstract in PNAS: Biophotonic probing of macromolecular transformations during apoptosis...... Michael

A team of researchers from Wake Forest University Baptist Medical Center announced yesterday that they have improved the targeting of laser-induced thermal therapy (LITT), an experimental cancer treatment. In LITT, nanoparticles are introduced to the area around a tumor, and then laser treatment is used to heat up the nanoparticles and destroy the cancerous tissue. The Wake Forest researchers improved the treatment by using iron-containing multi-walled carbon nanotubes (MWCNTs), which can be tracked within the patient's body through the use of MRI, thereby allowing more precise delivery of laser treatment and better targeting of neoplastic tissue. From the Wake Forest press release: LITT works by virtue of the fact that certain nanoparticles like MWCNTs can absorb the energy of a laser and then convert it into heat. If the nanoparticles are zapped while within a tumor, they will boil off the energy as heat and kill the cancerous cells. The problem with LITT, however, is that while a tumor may be clearly visible in a medical scan, the particles are not. They cannot be tracked once injected, which could put a patient in danger if the nanoparticles were zapped away from the tumor because the aberrant heating could destroy healthy tissue. Now the team from Wake Forest Baptist has shown for the first time that it is possible to make the particles visible in the MRI scanner to allow imaging and heating at the same time. By loading the MWCNT particles with iron, they become visible in an MRI scanner. Using tissue containing mouse tumors, they showed that these iron-containing MWCNT particles could destroy the tumors when hit with a laser. Link: Researchers Use Nanoparticles as Destructive Beacons to Zap Tumors...... Smit

The Defense Advanced Research Projects Agency (DARPA) will soon begin testing thought-controlled prosthetic arms on human subjects. Although this isn't the first mind-controlled arm we have seen, this is the first one that will directly interface with the brain instead of relying on peripheral nerves to transmit signals from the brain. Micro-arrays will be implanted into the brain that will capture neuronal signals and transmit them to the device. Over the next two years, the device will be tested in five patients while development will continue to focus on adding haptic pressure and touch capabilities and improving the implant lifespan. Wired: Human Trials Next for Darpa's Mind-Controlled Artificial Arm...... Wouter Stomp

The Today Show on NBC highlighted the story of Michael Waldron, a recent high school graduate born with a thumb but no fingers on his right hand. He was one of the first in the US to receive a ProDigits prosthesis and the video below shows him acclimating to it and using it to shake hands at his high school graduation. The ProDigits was approved for use in the US in December, when we wrote about it originally. Product page: Touch Bionics ProDigits... Flashback: ProDigits, World's First Powered Bionic Fingers, Coming to Market... Dan Buckland

Following FDA approval for the SoftView technology from Riverain Medical (Miamisburg, Ohio), Siemens has annouced that it will offer the product on their Yiso platform, or as an upgrade on their other products. SoftView enables the physician to acquire a soft tissue image faster and without any additional radiation dose for the patient. "Patient positioning, radiation dose and inspiration can make the interpretation of a chest X-ray challenging. SoftView suppresses the ribs and clavicles on a chest X-ray to improve the clarity of the image, even when image quality is low," explains Dr. Stefan Palmers, Ghent Hospital, Belgium, who is already working with the technology. Siemens: SoftView technology from Riverain Medical extends digital radiography systems from Siemens... Riverain: SoftView... Flashback: Riverain Medical Receives FDA Clearance for SoftView Enhanced Chest Imaging...... Dan Buckland

Chinese scientists at Shanghai Institute of Applied Physics have shown that graphene, a material which is a sheet of carbon exactly one atom thick, does not allow the growth of bacteria on its surface. This is in contrast to mammalian cells which seem to do just fine when in contact with the graphene. From the article abstract in ACS NANO: In this work, we report the antibacterial activity of two water-dispersible graphene derivatives, graphene oxide (GO) and reduced graphene oxide (rGO) nanosheets. Such graphene-based nanomaterials can effectively inhibit the growth of E. coli bacteria while showing minimal cytotoxicity. We have also demonstrated that macroscopic freestanding GO and rGO paper can be conveniently fabricated from their suspension via simple vacuum filtration. Given the superior antibacterial effect of GO and the fact that GO can be mass-produced and easily processed to make freestanding and flexible paper with low cost, we expect this new carbon nanomaterial may find important environmental and clinical applications. Abstract in ACS NANO: Graphene-Based Antibacterial Paper Press statement by the American Chemical Society: New antibacterial material for bandages, food packaging, shoes ...... Michael

In a press release filed today, a company called PositiveID claims it has developed a breath-based glucometer technology that should be ready for clinical testing by the end of the year. The portable Easy Check Breath Glucose Detection Device would be based on single use cartridges featuring the firm's own reagents. Paint us skeptical, but one day this technology might, just might, shake up the blood prick market for diabetics. The Company believes this device could eliminate a patient's need to prick his or her finger multiple times per day in order to get a blood sugar reading. The Company plans to begin conducting side-by-side comparisons of the handheld device versus the standard "finger stick" earlier than originally anticipated. The compact, portable, battery operated and easy to use design includes an advanced laser optical sensor, a state-of-the-art microprocessor and the Company's patent pending chemical sensors. By loading the reagent capsule into the cartridge chamber and exhaling into the device, the Company hopes that a user will be able to test blood sugar levels without the drop of blood presently required by existing glucose measuring devices. Press release: PositiveID Corporation Completes Design and Launches Development of Handheld, Non-Invasive Easy Check Breath Glucose Detection Device ... Link: PositiveID Corp.... Michael

Identifying autistic kids as early as possible is very important, so that appropriate clinical interventions and upbringing can have the most beneficial effect. Now a new study in the Proceedings of The National Academy of Sciences has shown that analyzing the unique signature of children's pre-speech vocalizations can be a pretty good way to identify potential cases of autism. This is done using a fairly simple voice recorder called LENA that kids wear in their clothing for all day recording. The data is then uploaded to a central server where it is analyzed for specific vocal signatures. Interestingly, although the study was conducted on American kids, the same software should be able to work with kids from other languages and cultures. Researchers analyzed 1,486 all-day recordings from 232 children (or more than 3.1 million automatically identified child utterances) through an algorithm based on the 12 acoustic parameters associated with vocal development. The most important was targeted syllabification—the ability of children to produce well-formed syllables with rapid movements of the jaw and tongue during vocalization. Infants show voluntary control of syllabification and voice in the first months of life and refine this skill as they acquire language. The autistic sample showed little evidence of development on the parameters as indicated by low correlations between the parameter values and the children’s ages (from 1 to 4 years). On the other hand, all 12 parameters showed statistically significant development for both typically developing children and those with language delays. LENA is digital language processor and language analysis software. The processor fits into the pocket of specially designed children’s clothing and records everything the child vocalizes but can reliably distinguish child vocalizations from its cries and vegetative sounds, other voices and extraneous environmental sounds. Recordings with the device have been collected since 2006. Parents responded to advertisements and indicated if their children had been diagnosed with autism or language delay. A speech-language clinician employed by the project also evaluated many of the children with a reported diagnosis of language delay. Many of the parents of children with language delay and all of the children with autism supplied documentation from the diagnosing clinicians, who were independent of the research. The recordings were made by the parents at home and in the other natural environments of the children, by simply turning the recorder on and placing in the special children's clothing, and then worn all... Michael

PEAK Surgical has received FDA clearance for its PlasmaBlade 3.0S dissection device. The PlasmaBlade 3.0S has a 3.0mm wide blade with integrated suction, and a telescoping shaft that extends from 5.5 cm to 15 cm for reaching all those places deep away in the human body. PlasmaBlades are disposable dissection devices that use pulsed waveforms that produce short plasma-mediated electrical discharges to cut through tissue, resulting in the radiofrequency being delivered in short on-and-off pulses with low duty cycle. According to studies performed by the manufacturer, use of the PlasmaBlades results in reductions in thermal injury depth, inflammation and postoperative narcotic consumption and a stronger healed incision strength when compared to the "standard of care", whatever that may have been. Press release: PEAK Surgical Introduces PEAK PlasmaBlade 3.0S... Product page: PlasmaBlade Family...... Wouter Stomp

By using 3-D ultrasound and artificial intelligence, engineers at Duke University have shown that a robot can sample simulated human prostate tissue without assistance. This could lead to automated procedures in the future, sooner than later as Stephen Smith, the director of the Duke University Ultrasound Transducer Group, points out since all of the hardware used in the technology development is already commercially available. The video below shows the system in action. The Duke team combined a “souped-up” version of an existing robot arm with an ultrasound system of its own design. The ultrasound serves as the robot’s “eyes” by collecting data from its scan and locating its target. The robot is “controlled” not by a physician, but by an artificial intelligence program that takes the real-time 3-D information, processes it and gives the robot specific commands to perform. The robot arm has a mechanical “hand” that can manipulate the same biopsy plunger device that physicians use to reach a lesion and take samples. In the latest series of experiments, the robot guided the plunger to eight different locations on the simulated prostate tissue in 93 percent of its attempts. Duke University: Next Gen Surgical Robots Could Steer Themselves...... Dan Buckland

Well, the above statement seems to be true at least in urology. Two studies presented this week at the 2010 American Urological Association (AUA) Annual Meeting have shown that removing larger biopsy samples using Cook Medical's BIGopsy forceps can lead to better identification of the nature of suspicious ureteral or kidney lesions. From Cook's press release: One study, conducted by Shaun Wason, Alan Schned, John Seigne and Vernon Pais Jr. at Dartmouth Medical School, compared the diagnoses resulting from tissue samples taken with the BIGopsy forceps versus the market-leading forceps. Researchers used ex vivo nephroureterectomy specimens to obtain tissue samples for biopsy. The BIGopsy samples were significantly larger than those obtained with the other biopsy forceps (average sample size of 31.2 +/- 34.6 mm2 vs 3.5 +/- 2.8 mm2). Unlike the competitor device, the BIGopsy specimens were accurately identified in all pathology reports. The market’s leading biopsy forceps were used to obtain a total of six biopsy samples from three different specimens. The samples ranged in size from 1 to 8 mm2 with an average size sample size of 3.5 +/- 2.8 mm2. Using the same three specimens, BIGopsy was used to obtain five samples with sizes ranging from 6 to 80 mm2 with an average sample size of 31.2 +/- to 34.6 mm2, resulting in an average size that was about nine times larger than market leading biopsy forceps. In all three cases, the test results derived from BIGopsy agreed with the final pathological report. Unlike BIGopsy, samples from the other biopsy device agreed in two cases but disagreed in the third. The smaller sample resulted in the tissue being misassigned as malignant. In addition to their pathological conclusions, the researchers found the BIGopsy tissue specimens were less distorted and fragmented, making them easier for pathologists to interpret. The researchers concluded that improved biopsy quality may translate into improved ability to diagnose ureteral and renal pelvic mucosa lesions endoscopically.1 A second study2 presented at AUA by Saeed Al-Qahtani, Dorian Legraverand, Sixtina Gil-Diez de Medina, Malthilde Sibony and Prof. Olivier Traxer conducted at the Hôpitol Tenon in Paris, France, also compares the biopsy sample quality of the BIGopsy biopsy forceps to the market leader for upper-tract urothelial tumors. A total of 14 patients were biopsied using both types of forceps and a single pathologist then analyzed the blinded samples. The histopathology results of the biopsies performed with BIGopsy were... Michael

Following up on a recent study by a Yale team that has shown effective gas exchange in transplanted bioengineered rat lungs, researchers from Harvard Medical School and Boston University now claim to have created the world's first functional bioartificial lung. Harvard Bioscience, a Holliston, Massachusetts company has proudly announced to have provided the bioreactor in which the lungs were grown. Some details of the study from an abstract in Nature Medicine: We decellularized lungs by detergent perfusion and yielded scaffolds with acellular vasculature, airways and alveoli. To regenerate gas exchange tissue, we seeded scaffolds with epithelial and endothelial cells. To establish function, we perfused and ventilated cell-seeded constructs in a bioreactor simulating the physiologic environment of developing lung. By day 5, constructs could be perfused with blood and ventilated using physiologic pressures, and they generated gas exchange comparable to that of isolated native lungs. To show in vivo function, we transplanted regenerated lungs into orthotopic position. After transplantation, constructs were perfused by the recipient's circulation and ventilated by means of the recipient's airway and respiratory muscles, and they provided gas exchange in vivo for up to 6 h after extubation. Press release: Harvard Bioscience Novel Bioreactor Helps Grow First Functional Lung for Successful Transplant in Collaboration With Dr. Harald Ott and Massachusetts General Hospital ... Abstract in Nature Medicine: Regeneration and orthotopic transplantation of a bioartificial lung Flashback: Engineered Mouse Lungs Function Well in Laboratory Study... Michael