Digitization of Pathology Specimens Allows for Improved Workflow and Incorporation of Advanced Techniques

MedicalResearch.com Interview with:|
Dr. Wendy L. Frankel, MD. Kurtz Chair and Distinguished Professor and
Dr. Anil Parwani, MD, PhD, MBA, Associate Professor
Wexner Medical Center
The Ohio State University

MedicalResearch.com: What is the background for this work? How does digital pathology differ from traditional H/E specimens?  Is there is different processing method?  Difference in prep time or costs?

Response: Traditional pathology involves patient tissue coming to the lab and being processed. The end result is a glass slide with a stained tissue that pathologists use under a microscope. The process in digital pathology is the same, up until the point right after when the glass slide is made. In digital pathology, we put the glass slide under a scanner instead of under a microscope. The scanner creates a large file image that can be reviewed remotely by pathologists around the world.

The advantage of digital pathology, and the reason we are doing this at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), is because when the slide is digitized, the image can be rapidly shared with an expert for review, or another institute that the patient may be going to. In addition, I can look at the image and ask the computer to quantitate different types of features that are present in the sample. While this has historically been done manually with a microscope, it’s been a more subjective process that is open to human error.

On top of that, we now have computer programs that allow us to ask very specific questions about the sample. For example, we can ask how many nuclei are in the field, how many of the nuclei show signs of cancer, and the size and color of the nucleus. These programs make the whole diagnostic process more objective and standardized. This is something we just can’t do by looking at a glass slide under a microscope.

Finally, you can also use these images for presentations at clinical conferences or for teaching residents, fellows or other pathologists. You now have the means to create an archive of patient slides and have it instantaneously available.

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Waiting Room App Uses Selfies To Show Patients Effects of Sun Damage

MedicalResearch.com Interview with:
Startup Screen Dermatology APPDr. med. Titus Brinker
Head of App-Development // Clinician Scientist
Department of Translational Oncology
National Center for Tumor Diseases (NCT)
Department of Dermatology
University Hospital Heidelberg
Heidelberg

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: ​While everyone in the dermatologic community appears to agree on the importance of UV-protection for skin cancer prevention, busy clinicians often lack time to address it with their patients.

Thus, the aim of this study was to make use of waiting rooms that almost every patient visiting a clinic spends time in and address this topic in this setting by the means of modern technology rather than clinicians time.

We used our free photoaging app “Sunface” which shows the consequences of bad UV protection vs. good UV protection on the users’ own 3D-animated selfie 5 to 25 years in the future and installed it on an iPad. The iPad was then centrally placed into the waiting room of our outpatient clinic on a table and had the Sunface App running permanently. The mirroring of the screen lead to a setting where every patient in the waiting room would see and eventually react to the selfie taken by one individual patient which was altered by the Sunface App.

Thus, the intervention was able to reach a large proportion of patients visiting our clinic: 165 (60.7%) of the 272 patients visiting our waiting room in the seven days the intervention was implemented either tried it themselves (119/72,12%) or watched another patient try the app (46/27,9%) even though our outpatient clinic is well organized and patients have to wait less than 20 minutes on average. Longer waiting times should yield more exposure to the intervention. Of the 119 patients who tried the app, 105 (88.2%) indicated that the intervention motivated them to increase their sun protection (74 of 83 men [89.2%]; 31 of 34 women [91.2%]) and to avoid indoor tanning beds (73 men [87.9%]; 31 women [91.2%]) and that the intervention was perceived as fun (83 men [98.8%]; 34 women [97.1%]).

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Machine Learning Can Help Identify First Episodes of Schizophrenia, As Well As Treatment Response

MedicalResearch.com Interview with:

Bo Cao, Ph.D. Assistant Professor Department of Psychiatry Faculty of Medicine & Dentistry University of Alberta Edmonton

Dr. Bo Cao

Bo Cao, Ph.D.
Assistant Professor
Department of Psychiatry
Faculty of Medicine & Dentistry
University of Alberta
Edmonton

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Schizophrenia is a severe psychiatric disorder that comes with delusions, hallucinations, poor motivation, cognitive impairments.

The economic burden of schizophrenia was estimated at $155.7 billion in 2013 alone in the United States. Schizophrenia usually emerges early in life and can potentially become a lifetime burden for some patients. Repeated untreated psychotic episodes may be associated with irreversible alterations of the brain. Thus, it is crucial to identify schizophrenia early and provide effective treatment. However, identifying biomarkers in schizophrenia during the first episode without the confounding effects of treatment has been challenging. Limited progress has been made in leveraging these biomarkers to establish diagnosis and make individualized predictions of future treatment responses to antipsychotics.

In a recent study by Dr. Cao and his colleagues, they successfully identified the first-episode drug-naïve schizophrenia patients (accuracy 78.6%) and predict their responses to antipsychotic treatment (accuracy 82.5%) at an individual level by using a machine learning algorithm and the functional connections of a brain region called the superior temporal cortex.  Continue reading

Thousands of Students Sneak JUUL To Use School Hours

MedicalResearch.com Interview with:

Jon-Patrick Allem, Ph.D., M.A. Research Scientist Keck School of Medicine of USC

Dr. Allem

Jon-Patrick Allem, Ph.D., M.A.
Research Scientist
Keck School of Medicine of USC

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by JUUL? 

Response: The JUUL vaporizer is the latest advancement in electronic cigarette technology, delivering nicotine to the user from a device about the size and shape of a thumb drive.

JUUL has taken the electronic cigarette market by storm experiencing a year-over-year growth of about 700 percent.

In our most recent study, we wanted to document and describe the public’s initial experiences with JUUL. We collected posts to Twitter containing the term “Juul” from April 1, 2017 to December 14, 2017. We analyzed over 80,000 posts representing tweets from 52,098 unique users during this period and used text classifiers (automated processes that find specified words and phrases) to identify topics in posts.

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CRISPR-Gold Has Potential To Edit Brain Genes

MedicalResearch.com Interview with:

Niren Murthy PhD Professor of Bioengineering University of California at Berkeley

Prof. Murthy

Niren Murthy PhD
Professor of Bioengineering
University of California at Berkeley

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this paper we delivered Cas9 RNP in the brain using a delivery vehicle termed CRISPR-Gold.  We were able to knock out the mGluR5 gene and rescue mice from autism using CRISPR-Gold.  The background here is that there is a great need for safe and effective CRISPR delivery vehicles, and that brain gene editing has great therapeutic potential.  This paper demonstrates for the first time that non-viral delivery of Cas9 RNP into the brain can have therapeutic effects.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Brain gene editing has tremendous therapeutic potential, and can be achieved with non-viral Cas9 RNP delivery

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response:   We need to be able to edit the brains of large animals.  The particles will need to be modified for this, we are currently working on this.  GenEdit, a start-up company spun out from our lab, is also working on this.

Disclosures: I was a co-founder of GenEdit, but now have no equity in GenEdit, there should be no conflict of interest

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Bumwhee Lee, Kunwoo Lee, Shree Panda, Rodrigo Gonzales-Rojas, Anthony Chong, Vladislav Bugay, Hyo Min Park, Robert Brenner, Niren Murthy, Hye Young Lee. Nanoparticle delivery of CRISPR into the brain rescues a mouse model of fragile X syndrome from exaggerated repetitive behaviours. Nature Biomedical Engineering, 2018; DOI: 10.1038/s41551-018-0252-8

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

 

 

Enabling Angioplasty-Ready “Smart” Stents to Detect In-Stent Restenosis and Occlusion

MedicalResearch.com Interview with:

Kenichi Takahata, Ph.D., P.Eng. Associate Professor Department of Electrical & Computer Engineering Faculty of Applied Science University of British Columbia Vancouver, B.C., Canada

Dr. Takahata

Kenichi Takahata, Ph.D., P.Eng.
Associate Professor
Department of Electrical & Computer Engineering
Faculty of Applied Science
University of British Columbia
Vancouver, B.C., Canada

MedicalResearch.com: What is the background for this technology and study? 

Response: Cardiovascular disease (CVD) is the number one cause of mortality globally. One of the most common and proven treatments for CVD is stenting. Millions of stents are implanted annually worldwide. However, the most common complication called in-stent restenosis, re-narrowing of stented arteries, still poses a significant risk to patients.

To address the current lack of diagnostic technology to detect restenosis at its early stage, we are developing “smart” stents equipped with microscale sensors and wireless interface to enable continuous monitoring of restenosis through the implanted stent. This electrically active stent functions as a radio-frequency wireless pressure transducer to track local hemodynamic changes upon a re-narrowing condition. We have reported a new smart stent that has been engineered to fulfill clinical needs for the implant, including its applicability to current stenting procedure and tools, while offering self-sensing and wireless communication functions upon implantation.

The stent here has been designed to function not only as a typical mechanical scaffold but also as an electrical inductor or antenna. To construct the device, the custom-designed implantable capacitive pressure sensor chip, which we developed using medical-grade stainless steel, are laser-microwelded on the inductive antenna stent, or “stentenna”, made of the same alloy. This forms a resonant circuit with the stentenna, whose resonant frequency represents the local blood pressure applied to the device and can be wirelessly interrogated using an external antenna placed on the skin.

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Watson for Clinical Trial Matching Increases Enrollment in Breast Cancer Trials

MedicalResearch.com Interview with:

Alexandra Urman, MPH Clinical Research Manager Clinical Development IBM Watson Health 

Alexandra Urman

Alexandra Urman, MPH
Clinical Research Manager
Clinical Development
IBM Watson Health 

MedicalResearch.com: What is the background for this study? 

Response: Cancer statistics show only 3-5% of cancer patients participate in clinical trials although up to 20% may be eligible.

Dr. Tufia Hadad, a medical Oncologist at the Mayo Clinic in Rochester, Minnesota sought to address this issue and spearheaded a project conducted at the Rochester facility in collaboration with IBM Watson Health. The objective was to determine if the use of cognitive computing increased clinical trial enrollment and screening efficiency in the breast cancer clinic.

Watson for Clinical Trial Matching (CTM) is a cognitive system which utilizes natural language processing to derive patient and tumor attributes from unstructured text in the electronic health record that can be further used to match a patient to complex eligibility criteria in trial protocols.

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Virtual Reality Improves Recall

MedicalResearch.com Interview with:

University of Maryland researchers conducted one of the first in-depth analyses on whether people recall information better through virtual reality, as opposed to desktop computers. Credit: John T. Consoli / University of Maryland

A picture of Eric Krokos, UMIACS graduate student, using the EEG Headset while on the computer.

Eric Krokos
5th-year Ph.D. student in computer science
Augmentarium visualization lab

augmentarium.umiacs.umd.edu
University of Maryland 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I am interested in exploring the use of virtual and augmented reality in high-impact areas like education, medicine, and high-proficiency training. For VR and AR to excel as a learning tool, we felt there needed to be a baseline study on whether people would perceive information better, and thus learn better, in an immersive, virtual environment as opposed to viewing information on a two-dimensional desktop monitor or handheld device.

Our comprehensive user-study showed initial results that people are able to recall information using virtual reality—there was an 8.8 percent improvement in recall ability from our study participants using VR. Continue reading

Blackcurrant Extract Developed As New Natural Hair Dye

MedicalResearch.com Interview with:

Dr. Richard S. Blackburn

Dr. Blackburn

Dr. Richard S. Blackburn
BSc (Leeds), PhD (Leeds), CCol FSDC
Associate Professor in Coloration Technology
Head of Sustainable Materials Research Group
University of Leeds

MedicalResearch.com: What is the background for this study?

Response: I’ve been working with my colleague Professor Chris Rayner at The University of Leeds for over 10 years in the field of anthocyanins, which are pigments that provide colour to most berries, flowers, and many other fruits and vegetables. We have developed techniques to isolate these compounds from food waste, characterise the chemistry of the extracts, and use these natural pigments in various applications. In this work, anthocyanins extracted from blackcurrant waste created during the manufacture of blackcurrant cordial (Ribena) have for the first time been used in an effective new hair dyeing technology.

Why hair dyeing? The global hair coloration industry is worth more than $10 billion a year, with the number of people colouring their hair in professional salons and at home on the increase, but some of the ingredients found in commonly-used synthetic hair dyes, are known irritants and can trigger severe allergic reactions. There is also much debate about whether these ingredients also cause cancer. Dyes that some may consider ‘natural’ – such as those including henna – usually escape scrutiny when it comes to health concerns, but the main natural colorant in henna is lawsone, which the EU Scientific Committee on Consumer Safety states is toxic. What is more, it is thought up to 95% of all dyes end up washed down the drain; their effect on the environment is unknown.

Because of issues and concerns around conventional dyes, we wanted to develop sustainable, biodegradable alternatives using green chemistry processes that minimise potential risks to health and offer consumers a different option.

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Developing a Pill That Mimics Effects of Gastric Bypass Surgery

MedicalResearch.com Interview with:

Jeff Karp B.Eng. PhD. Professor of Medicine Center for Nanomedicine and Division of Engineering in Medicine Brigham and Women’s Hospital, Harvard Medical School Boston MA

Prof. Karp

Jeff Karp B.Eng. PhD.
Professor of Medicine
Center for Nanomedicine and Division of Engineering in Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston MA

MedicalResearch.com: How would you briefly explain the most important findings and conclusions of this study to a non-expert?

  • The type-2 diabetes (T2D) epidemic will affect over 642 million people worldwide by 2040. As a result, diabetes costs the US healthcare over $174 billion dollars annually and is the leading cause of blindness, amputations, renal failure, and poor cardiovascular outcomes. Recently, bariatric surgery, bypassing stomach and intestine from the food stream, has shown promising results and shown to be superior to pharmaceuticals in managing T2D. However, the risks of surgery along with permanent changes to gastrointestinal anatomy deters many suitable patients from surgery, with less than 1-2% of Americans who qualify for weight loss surgery actually undergoing the procedure. Therefore, there is an urgent need for a safe, non-invasive and effective treatment for wider diabetic patient population.
  • We envisioned a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery. During the past 8 years, we’ve been working on this idea and have developed a safe gut-coating material that can potentially mimic the beneficial effects of gastric bypass procedures in the form a pill.
  • LuCI can be activated in any part of gastrointestinal tract (e.g. stomach, duodenum, intestine, colon) to form a temporary physical barrier that isolates that part of gastrointestinal tract. In our pre-clinical models, LuCI coated the duodenum to modulate glucose responses in oral glucose tolerance tests.
  • These beneficial effect are observed without any evidence of systemic absorption of the drug.
  • We believe that LuCI could be a new therapeutic approach for T2D that is based on Roux-en-Y gastric bypass surgery, but is safer, associated with significantly less complications, and thus can potentially help a wide T2D patient population.
  • In a separate set of studies, we also showed that luCi allows delivery of certain proteins and drugs, which would normally be degraded by the gastric acid, to the GI tract, protecting it from gastric acid digestion and prolonging their luminal exposure.

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Painless Laser Reduces Sweating in Axillary Hyperhidrosis

MedicalResearch.com Interview with:

Bruce E. Katz, M.D.  Clinical Professor Icahn School of Medicine at Mt Sinai Director, Juva Skin & Laser Center Past Director, Cosmetic Surgery & Laser Clinic Mt Sinai Hospital New York, N.Y. 10022

Dr. Katz

Bruce E. Katz, M.D. 
Clinical Professor
Icahn School of Medicine at Mt Sinai
Director, Juva Skin & Laser Center
Past Director, Cosmetic Surgery & Laser Clinic
Mt Sinai Hospital
New York, N.Y. 10022 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Axillary hyperhidrosis  is estimated to affect 1.4% of the U.S. population.  Newer treatments such as microwave technology, botulinum toxin injections and lasers have emerged as effective methods.

In this pilot study we examine the use of a non-invasive 1060nm diode laser, SculpSure,  for the treatment of axillary hyperhidrosis. SculpSure focuses energy at the level of the sweat glands so we believed it would work for hyperhidrosis. After two SculpSure treatments, there was a long lasting resolution of hyperhidrosis.

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airRx App Improves Physicians’ Ability To Manage In-Flight Emergencies

MedicalResearch.com Interview with:
Dr. Raymond E. Bertino, MD
airRx lead developer and
Clinical Professor of Radiology and Surgery at UICOMP

MedicalResearch.com: What is the background for the airRX app and study?

Response: With increasing air travel, in-flight medical emergencies have increased and physicians on commercial airline flights are routinely asked to volunteer assistance. A study presented this week at the annual meeting of The Society for Academic Emergency Medicine (SAEM) examined physician performance during practice simulations of in-flight medical emergencies with use of a smartphone app, airRx.

In the unique study, cases based on commonly occurring in-flight medical emergencies were portrayed in a mockup of the airline cabin setting. Actors portrayed patients, family members, seat neighbors and flight attendants. Resident physicians in non-emergency specialties were asked to assist as if they were volunteering in actual medical emergencies.

The study utilized airRx, the mobile app developed to help physicians and other medical personnel volunteering during in-flight medical events. The airRx app enables healthcare professionals to access 23 scenarios of the most common medical emergencies, with concise treatment algorithms and reference information to help evaluate and treat the patient.  Continue reading

Automated Bone Scan Index Correlates with Survival in Metastatic Prostate Cancer

MedicalResearch.com Interview with:

Andrew J. Armstrong, MD ScM FACP Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology Associate Director for Clinical Research in Genitourinary Oncology Duke Cancer Institute Divisions of Medical Oncology and Urology Duke University

Dr. Armstrong

Andrew J. Armstrong, MD ScM FACP
Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology
Associate Director for Clinical Research in Genitourinary Oncology
Duke Cancer Institute
Divisions of Medical Oncology and Urology
Duke University

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Men with prostate cancer commonly develop bone metastases and undergo nuclear medicine bone scans. However, these scans are non-quantitative, and disease burden has been challenging to assess over time and to relate to clinical outcomes.

We developed a software program and measurement called the automated bone scan index that essentially reads a standard of care nuclear bone scan, provides a quantitative metric, and demonstrate in a phase 3 trial that this aBSI is highly associated with clinical outcomes including survival, time to symptomatic progression, and prostate cancer specific survival.

We accomplished this within a prospective phase 3 international trial of men with metastatic hormone resistant prostate cancer who were followed over a long period of time.  All bone scans were read and measured using the aBSI at baseline, and we found that the aBSI was highly prognostic.  This work validates prior smaller phase 2 BSI studies, and demonstrates both the feasibility and clinical utility for incorporating the aBSI into clinical practice to provide this important prognostic information to patients and providers.

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Can a Pill Plus Infrared Light Replace Mammograms?

MedicalResearch.com Interview with:

Greg Thurber, PhD Assistant Professor Department of Chemical Engineering Assistant Professor Department of Biomedical Engineering University of Michigan 

Dr. Thurber

Greg Thurber, PhD
Assistant Professor
Department of Chemical Engineering
Assistant Professor
Department of Biomedical Engineering
University of Michigan 

MedicalResearch.com: What is the background for this study?

Response: Most current disease screening strategies rely on either blood tests, where the physician can obtain information on specific disease molecules but has no idea where they originated in the body, or anatomical imaging, where the physician can see changes in the structure of tissues but doesn’t have any molecular information. We wanted to develop a method that could provide both molecular information and an image of where these molecules were located. We know from decades of research in cancer that this is a molecular disease, so providing molecular information to the physician will help improve detection and diagnosis. Breast cancer screening provides an excellent opportunity to apply this approach to improve detection. Currently, estimates indicate that we are overspending $4 billion per year on the overdiagnosis and overtreatment of breast cancer because we cannot accurately determine which patients need treatment and which can be safely monitored with no intervention. Despite this problem with overdiagnosis, however, screening saves lives…we simply need a better way.

Molecular imaging has the capability of providing both molecular information and the location within the body. However, most of these techniques are expensive and use ionizing radiation, meaning there is a small risk of actually causing cancer. This is not acceptable for screening large numbers of otherwise healthy patients. To avoid this risk and provide a safe, inexpensive, and relatively easy method for patients to undergo screening, we decided to develop near-infrared fluorescent imaging agents that can be taken as a pill. The goal is for the patient to simply take a pill a day or two before their visit, and then the physician shines near-infrared light on the breast tissue to detect tumors where they ‘light up’ by giving off a different color of light.

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Solar Powered Oxygen Could Fill Critical Gap in Underserved Areas

MedicalResearch.com Interview with:

Michael Hawkes MD PhD Adjunct Professor Assistant Professor  Pediatrics, Faculty of Medicine School of Public Health University of Alberta

Dr. Hawkes

Michael Hawkes MD PhD
Adjunct Professor
Assistant Professor
Pediatrics, Faculty of Medicine
School of Public Health
University of Alberta

MedicalResearch.com: What is the background for this study? What are the main findings?

  • Pneumonia is the leading cause of mortality in children globally.
  • Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
  • Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
  • We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
  • Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.

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Artificial Pancreas Reduces Hypoglycemia in Type 1 Diabetes

MedicalResearch.com Interview with:

Dr-Apostolos Tsapas

Dr. Tsapas

Apostolos Tsapas, MD PhD MSc(Oxon)
Associate Professor of Medicine
Director of the Second Medical Department | Aristotle University Thessalonik
Cruddas Link Fellow
Harris Manchester College
University of Oxford  

MedicalResearch.com: What is the background for this study?

Response: Artificial pancreas treatment, also referred to as closed loop glucose control, is an emerging treatment option combining a pump and continuous glucose monitoring with a control algorithm to deliver insulin (and potentially glucagon) in a glucose responsive manner. Compared with insulin pumps or sensor augmented pumps, artificial pancreas use can reduce the burden for patients by automatically adjusting the amount of insulin entering the body on the basis of sensor glucose levels. The US Food and Drug Administration has recently approved the first artificial pancreas system for use by people with type 1 diabetes over 14 years of age, based on a safety outpatient study.

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Smartphone App Bests Clinical Assessment of Blood Flow

MedicalResearch.com Interview with:

Benjamin Hibbert MD PhD FRCPCz Interventional Cardiologist Clinician Scientist and Assistant Professor CAPITAL Research Group Vascular Biology and Experimental Medicine Laboratory University of Ottawa Heart Institute

Dr. Benjamin Hibbert

Benjamin Hibbert MD PhD FRCPCz
Interventional Cardiologist
Clinician Scientist and Assistant Professor
CAPITAL Research Group
Vascular Biology and Experimental Medicine Laboratory
University of Ottawa Heart Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: When we designed the study in 2014 we were routinely using the modified allen’s test (MAT) to screen patients for transradial access for coronary angiography and PCI. We all had iPhones and we started using the HeartRate monitoring application as a photoplethysmograph. Quite quickly we found that using the application was simple, worked well and because we always had our iPhone with us we tended to use it more often. That being said – we wanted to test it in a scientifically rigorous method and thus we elected to perform an RCT to evaluate it’s diagnostic accuracy.

smart app measures blood flowThe current study is the first to use the photoplethysmographic capabilities of smartphones to assess blood flow – in this case in the hand to assess for blockages in arteries before accessing them for a procedure. The hand is supplied by two arteries – the radial artery and the ulnar artery. In many cases in medicine we use the radial artery, whether it be placing a catheter to monitor blood pressure, as a method of getting to the heart for angioplasty and in coronary artery bypass grafting it is removed and used as a bypass to restore blood flow to the heart. In many instances doctors assess the patency of the ulnar artery to decided if they are going to use the radial artery for a procedure – the concept being that if the ulnar is compromised and we use the radial then the hand can develop complications from not enough blood flow. To determine if a patient is eligible doctors would use a bedside physical exam test called the modified Allen’s test in which they occlude both arteries to cause the hand to turn white. They then release pressure on the ulnar letting blood only pass through this vessel to see if the hand turns pink. However, there is a lot of variability in what doctors consider to be abnormal and determining if the test is positive can depend on numerous factors including skin tone, the amount of pressure applied and the size of the vessels. Continue reading

Neural Prosthetic Improved Short Term Memory Coding and Recall

MedicalResearch.com Interview with:

Robert E. Hampson, PhD Professor, Physiology & Pharmacology School of Medicine Wake Forest

Dr. Hampson

Robert E. Hampson, PhD
Professor, Physiology & Pharmacology
School of Medicine
Wake Forest

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are many diseases and injuries that affect human memory, and many types of memory deficits, from inability to recall stored memories to the inability to make new memories.  We focused on problems with making new memories, and identifying the brain activity associated with those memories.  We found that we could identify when the brain formed “codes” for new memory, and when those codes were incorrect or faulty.  By identifying what both “strong” and “weak” naturally occurring codes should be, we influence the process to strengthen the weak codes, resulting in better memory.

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Single-Dose LipiFlow® Treatment Relieves Dry Eye Symptoms

MedicalResearch.com Interview with:

Dr. Caroline A. Blackie, OD PhD FAAO Medical Director, Dry Eye Johnson & Johnson Vision

Dr. Caroline Blackie

Dr. Caroline A. Blackie, OD PhD FAAO
Medical Director, Dry Eye
Johnson & Johnson Vision

MedicalResearch.com: What is the background for these studies? Would you briefly explain the problem of dry eye, how common it is and why it is difficult to treat? 

Response: Dry eye disease is a condition where the eyelids and/or the tear film are unable to protect the ocular surface from the negative effects of desiccating stress. If left untreated, a vicious cycle ensues resulting in a broad spectrum of sequelae, including ocular discomfort and compromised vision. The result is partial or pervasive reduced quality of life for the individual along with a significant economic burden on our society. Conversely, when the ocular surface is healthy, patients feel better, see better and live better.

Meibomian gland health is essential for ocular surface health. Meibomian glands secrete the oils necessary to protect the ocular surface from the negative effects of desiccating stress. Predictably, meibomian gland dysfunction (MGD) is a leading cause of dry eye disease. MGD is almost always the result of thickened and stagnated gland secretions. These stagnated secretions obstruct and/or limit the flow of functional oil into the tear film. MGD is the most common form of dry eye disease and is also known as evaporative dry eye. While management of dry eye in general can be complex, the management of MGD affords a relatively straightforward approach, which is to improve meibomian gland function by treating obstruction.

Dry eye disease is pretty common – more than 340 million people suffer from it globally. Short-term management of dry eye involves improving signs and symptoms of the condition, including the use of tear supplementation and reducing ocular surface inflammation.

Long-term dry eye management requires that the cause (or causes) of the condition is also diagnosed and treated. That cause is often MGD, and MGD can be successfully managed with LipiFlow®.  Continue reading

Machine Learning Enhances Ability To Predict Survival From Brain Tumors

MedicalResearch.com Interview with:

Lee Cooper, Ph.D. Assistant Professor of Biomedical Informatics Assistant Professor of Biomedical Engineering Emory University School of Medicine - Georgia Institute of Technology

Dr. Cooper

Lee Cooper, Ph.D.
Assistant Professor of Biomedical Informatics
Assistant Professor of Biomedical Engineering
Emory University School of Medicine – Georgia Institute of Technology

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Gliomas are a form of brain tumor that are often ultimately fatal, but patients diagnosed with glioma may survive as few as 6 months to 10 or more years. Prognosis is an important determinant in selecting treatment, that can range from simply monitoring the disease to surgical removal followed by radiation treatment and chemotherapy. Recent genomic studies have significantly improved our ability to predict how rapidly a patient’s disease will progress, however a significant part of this determination still relies on the visual microscopic evaluation of the tissues by a neuropathologist. The neuropathologist assigns a grade that is used to further refine the prognosis determined by genomic testing.

We developed a predictive algorithm to perform accurate and repeatable microscopic evaluation of glioma brain tumors. This algorithm learns the relationships between visual patterns presented in the brain tumor tissue removed from a patient brain and the duration of that patient’s survival beyond diagnosis. The algorithm was demonstrated to accurately predict survival, and when combining images of histology with genomics into a single predictive framework, the algorithm was slightly more accurate than models based on the predictions of human pathologists. We were also able to identify that the algorithm learns to recognize some of the same tissue features used by pathologists in evaluating brain tumors, and to appreciate their prognostic relevance. Continue reading

AI Trained Computer Program Can Monitor Health Forums To Detect Adverse Drug Reactions

MedicalResearch.com Interview with:

Kavita Sarin, M.D., Ph.D.

Dr. Sarin

Kavita Sarin, M.D., Ph.D.
Assistant Professor of Dermatology
Stanford University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Drug reactions occur in the majority of patients undergoing cancer therapies. Half of serious drug reactions are detected after market approval which can result in painful complications and interruption in therapy. Post-market drug surveillance platforms such as FDA monitoring rely on medical publications and physician reporting and take time to identify trends. We sought to determine if we could identify trends in patient discussions in internet health forums to more rapidly identify chemotherapeutic drug reactions. We chose skin reactions as a proof-of-principle because patients can more easily describe what they see on their skin.

Julia Ransohoff, a medical student, and Azadeh Nikfarham, an informatics postdoctoral fellow trained a computer to recognize when a patient undergoing anti-cancer treatment with PD-1 antagonists or EGFR-inhibitors described a drug reaction in their internet forum posts.

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Social Media Does Not Displace Face-to-Face Communication With Family and Friends

MedicalResearch.com Interview with:

Jeffrey A. Hall, Ph.D. Associate Professor The University of Kansas

Dr. Hall

Jeffrey A. Hall, Ph.D.
Associate Professor
The University of Kansas
Relationships and Technology Lab

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The idea that new forms of media displace our face-to-face relationships with close friends and family is an old idea.  Two decades ago, when the internet experienced a period of rapid growth, the most recent form of the social displacement hypothesis emerged. Studies from that time ended up finding little to no evidence of displacement by the internet.

The main findings of this study focus on displacement by social media.  The first study was conducted with a longitudinal, nationally representative sample of Americans from 2009-2011.  This study found that during a period of rapid social media adoption, there was little to no association between adopting and using social media and direct social contact over the three years of the study.  Furthermore, using more social media did not result in lowered well-being.

The second study in this paper looked at data from 2015, and found that using social media in a day had little bearing on who people communicated with and how they communicated. That is, passive social media use did not seem to displaced face-to-face communication with close friends and family.  Continue reading

Decision Aids Can Help Heart Failure Patients Determine If They Want an LVAD

MedicalResearch.com Interview with:

A left ventricular assist device (LVAD) pumping blood from the left ventricle to the aorta, connected to an externally worn control unit and battery pack. Wikipedia image

A left ventricular assist device (LVAD) pumping blood from the left ventricle to the aorta, connected to an externally worn control unit and battery pack.
Wikipedia image

Larry A. Allen, MD, MHS
Associate Professor, Medicine
Associate Head for Clinical Affairs, Cardiology
Medical Director, Advanced Heart Failure
Aurora, CO 80045

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Deciding whether or not to get a left ventricular assist device (LVAD) is one of the most challenging medical decisions created by modern medicine.

LVADs improve overall survival but also come with serious risks and lifestyle changes. Particularly for older patients with multiple medical problems, this is a complex choice.

Our research group at the University of Colorado spent years systematically developing unbiased pamphlet and video decision aids for patients and caregivers. We also developed a clinician-directed decision support training for LVAD program staff. The DECIDE-LVAD trial studied the implementation and effectiveness of this decision support intervention with patients and their caregivers in 6 hospitals in the U.S. When compared to previously used education materials, the decision aids appeared to improve patients’ decision quality and lowered the total number of patients getting LVADs.

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Machines Can Be Taught Natural Language Processing To Read Radiology Reports

MedicalResearch.com Interview with:

Eric Karl Oermann, MD Instructor Department of Neurosurgery Mount Sinai Health System New York, New York 10029 

Dr. Oermann

Eric Karl Oermann, MD
Instructor
Department of Neurosurgery
Mount Sinai Health System
New York, New York 10029 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Supervised machine learning requires data consisting of features and labels. In order to do machine learning with medical imaging, we need ways of obtaining labels, and one promising means of doing so is by utilizing natural language processing (NLP) to extract labels from physician’s descriptions of the images (typically contained in reports).

Our main finding was that (1) the language employed in Radiology reports is simpler than normal day-to-day language, and (2) that we can build NLP models that obtain excellent results at extracting labels when compared to manually extracted labels from physicians.  Continue reading

Arm Cycling Can Improve Walking After Stroke

MedicalResearch.com Interview with

Paul Zehr PhD Professor & Director Centre for Biomedical Research, Rehabilitation Neuroscience Laboratory, McKinnon Division of Medical Sciences Exercise Science, Physical & Health Education International Collaboration on Repair Discoveries (ICORD)| Affiliate, Division of Neurology, Department of Medicine, UBC

Dr. Zehr

E. Paul Zehr PhD
Professor & Director
Centre for Biomedical Research,
Rehabilitation Neuroscience Laboratory, McKinnon
Division of Medical Sciences
Exercise Science, Physical & Health Education
International Collaboration on Repair Discoveries (ICORD)|
Affiliate, Division of Neurology, Department of Medicine, UBC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many years we explored the role of the spinal cord in regulating rhythmic arm and leg movements like we do during walking, running and swimming.  Although we humans tend to move and locomote around on our two legs as bipeds, we are basically quadrupeds in terms of how our nervous system controls our limbs during walking. We have an extensive network of brain and spinal cord connections that help coordinate our limbs while we move. A lot of our work showed that using the arms rhythmically, like during arm cycling, strongly affected the activity of the spinal cord controlling leg muscles. Getting the spinal cord for leg muscles more coordinated and activated is a major goal of rehabilitation  of walking after neurotrauma so we wanted to see if training the arms could help with this. This is particularly important because a lot of the time, the arms are not engaged at all in rehabilitation training for the legs.

We found that after only 5 weeks of arm cycling (3 x 30 minutes each week), neural excitability, strength, and leg function were increased along with enhanced clinical tests of balance and walking ability.

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