FDA approved to improve patient and practitioner experience in healthcare settings.
FDA approved to improve patient and practitioner experience in healthcare settings.
Digital Strategy and the Shift to Value-Based Care
by Guest Author, Terence Maytin
The U.S. healthcare system is rapidly transitioning from fee-for-service to value- based care as part of massive and ongoing industry-wide transformation. Digital strategy is evolving to meet new challenges, help drive disruptive innovation, and better engage a large, growing audience of connected health consumers.
Already complex and fragmented, the healthcare sector will look very different over the coming years. The Affordable Care Act (ACA) has spurred rapid innovation and disruptive change across the entire ecosystem in the quest for better quality care across the entire population at lower per capita cost. Payers are accelerating rollout of value- based payment models with providers, and the shift to pay for performance arrangements with Pharma companies is increasing as well.
Moving an entire industry from volume-oriented reimbursement requires aggressive, innovative approaches to move from traditional siloed care to collaborative models, with system-wide provider coordination, patient engagement and proactive interventions. Technology will continue to act as a critical change agent, enabling large- scale improvements in process efficiency, automation, connectivity, collaboration, interoperability and advanced analytics.
With the convergence of healthcare and digital technology, industry stakeholders are reassessing their digital strategies to help tackle new business opportunities and challenges. Just a few years ago, digital health efforts largely focused either on acquisition marketing, community aggregation, or customer service portals designed to redirect volume from higher cost channels. However amid the current environment, digital offers much greater and far-reaching impact potential than ever before.
Digital investments are ramping up to support the shift from volume to value, particularly in the areas of care coordination, patient engagement, post-discharge monitoring, measurement, and behavior change. Since 2014, venture capital has provided $10B in new funding for clinical tools, analytics, consumer engagement, mHealth, telemedicine, wearables, and business services. In 2016, firms have raised a record $1.8B.
Two important trends drive home the relevance and importance of having a comprehensive, well articulated digital strategy: the rise of consumerism and nearly ubiquitous web/mobile adoption. Across all age groups, large audiences not only already consume digital services but also expect high quality, omni-channel experiences. In order to deliver on this promise, companies must design optimized, journey-based experiences that balance customer needs, preferences, and behaviors against desired business objectives and outcomes. Companies must embrace the concept of “putting the customer first” throughout the organization and across functions (e.g. strategy, product development, marketing, operations and technology). This also must be accompanied by an insights-driven, decision-making approach.
Essentially, digital strategy will be most effective if viewed as an organizational imperative. Armed with a holistic vision and comprehensive strategy, stakeholders will be better able to leverage and capitalize on digital’s full disruptive potential to help solve some of the most pressing challenges facing healthcare today.
Healthcare Industry Transformation
The transformation of healthcare is multidimensional and complicated. Disruptive innovation, technology and consumer trends are upending traditional business models. The competitive landscape is getting ever more crowded with new entrants while at the same time, insurer and provider consolidation is accelerating.
Consumers are motivated with more skin in the game and greater information access than ever before. Payment models are shifting from volume to value, and payers, providers, pharma, and medtech will need to collaborate and coordinate to a much larger degree within a more integrated care delivery system. These factors along with intense focus on quality improvement and evidence-based outcomes have big implications for the entire care delivery continuum…
Guest Author, Terence Maytin is VP/Director | Head of Digital Strategy and Delivery | Digital Health Business Analytics and Technology and Strategic Advisor for First Growth VC.
Maria Dorfner is the founder of NewsMD and Healthy Within Network. This is her blog.
She can be reached at email@example.com
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There is now a non-surgical alternative to gastric bypass.
It’s for people with a BMI of at least 30-40 who despite changing habits can’t lose weight.
It’s called ORBERA and it involves inflatable balloons that help you shed 20 to 80 pounds.
ORBERA balloon is inserted down throat and into stomach using an endoscope in less than 30 min.
The balloons are then filled with saline, filling up space in the stomach.
The Food and Drug Administration recently approved the dual balloon technology and NYC Gastroenterologist Dr. Prem Chattoo of Hudson River Gastroenterology is one of the first doctors to offer the procedure. His office is located in lower Manhattan.
“It’s not a long term solution like bariatric surgery. The procedure is used for a quick, six-month weight loss to get rid of 10 percent of your body weight. After six months, the balloon is removed and you should see a pretty noticeable weight loss,” Dr. Chattoo says.
The end result is weight loss and reduced hunger.
After the procedure, ORBERA has a 12-month diet and exercise program to follow.
The biggest benefits about ORBERA, according to Dr. Chattoo, are that no abdominal surgery is needed and that the procedure is completed in the same day.
The procedure is recommended to those with a body mass index (BMI) of 30-40 or those who have other risk factors for heart disease such as diabetes or high blood pressure. A BMI or 30 or higher is defined as obese. More than a third of U.S. adults fit that range.
The procedure costs 6-8K and is not covered by insurance.
One procedure will be donated for free to one person in need who meets requirements. Contact: firstname.lastname@example.org Write: Orbera in Subject, include your contact information.
Additional Images for Media: https://apolloendo.box.com/s/t7ukrrujfjk4mrgjwo5l5w5obd3djmbt
For more information contact Dr. Prem Chattoo at http://www.hudsonrivergi.com
For more information about the Orbera procedure visit: http://www.orbera.com
“Always remember the benefits of daily exercise for your mind, body and spirit. If you hate or dread exercise start with walking. Break it up into 15 minutes at a time until you reach 30 minutes. Then, increase it to 45 or 60 minutes. You don’t even need a gym to do that.
Remove all junk food from your home. Load up on healthy snacks. Remove all processed foods and soda. Drink lots of water. You’ll begin to notice a difference in 6 months. In one year, it will all be a habit.
No matter what help you get surgically or non-surgically, you always want to strive to develop lifelong healthy habits. Address the underlying of ‘why’ you select unhealthy foods. Stressed? Find someone to talk to. There are lots of free counselling services where you can call and talk to someone confidentially.
Rushed? Fix meals the night before. Hate your job? Start looking for a new one. Sit at a computer all day? Get up every 15 minutes and walk around office. Take stairs. Depressed? Again, find someone to talk to and exercise daily. Make an appointment with a professional psychologist if it’s really bad. When exercising, don’t focus on the physical. Focus on the mental benefits when you start. Physical has a way of catching up when you fix your mind and thoughts first. Stay positive.
Good things take commitment, dedication and time.
Your goal should never be a quick fix, but to change habits that got you to the place where you feel tired, sluggish and unhealthy and replace them with new, better, healthy ones. You can do it. One day at a time. ” -Maria Dorfner
Fat people have less than thin people. Older people have less than younger people. Men have less than younger women.
It is brown fat, actually brown in color, and its great appeal is that it burns calories like a furnace. A new study finds that one form of it, which is turned on when people get cold, sucks fat out of the rest of the body to fuel itself. Another new study finds that a second form of brown fat can be created from ordinary white fat by exercise.
Of course, researchers say, they are not blind to the implications of their work. If they could turn on brown fat in people without putting them in cold rooms or making them exercise night and day, they might have a terrific weight loss treatment. And companies are getting to work.
But Dr. André Carpentier, an endocrinologist at the University of Sherbrooke in Quebec and lead author of one of the new papers, notes that much work lies ahead. It is entirely possible, for example, that people would be hungrier and eat more to make up for the calories their brown fat burns.
“We have proof that this tissue burns calories — yes, indeed it does,” Dr. Carpentier said. “But what happens over the long term is unknown.”
Until about three years ago, researchers thought brown fat was something found in rodents, which cannot shiver and use heat-generating brown fat as an alternate way to keep warm. Human infants also have it, for the same reason. But researchers expected that adults, who shiver, had no need for it and did not have it.
Then three groups, independently, reported that they had found brown fat in adults. They could see it in scans when subjects were kept in cold rooms, wearing light clothes like hospital gowns. The scans detected the fat by showing that it absorbed glucose.
There was not much brown fat, just a few ounces in the upper back, on the side of the neck, in the dip between the collarbone and the shoulder, and along the spine. Although mice and human babies have a lot more, and in different places, it seemed to be the same thing. So, generalizing from what they knew about mice, many researchers assumed the fat was burning calories.
But, notes Barbara Cannon, a researcher at Stockholm University, just because the brown fat in adults takes up glucose does not necessarily mean it burns calories.
“We did not know what the glucose actually did,” she said. “Glucose can be stored in our cells, but that does not mean that it can be combusted.”
A new paper in The Journal of Clinical Investigation by Dr. Carpentier and his colleagues answers that question and more. By doing a different type of scan, which shows the metabolism of fat, the group reports that brown fat can burn ordinary fat and that glucose is not a major source of fuel for these cells. When the cells run out of their own small repositories of fat, they suck fat out of the rest of the body.
In the study, the subjects — all men — were kept chilled, but not to the point of shivering, which itself burns calories. Their metabolic rates increased by 80 percent, all from the actions of a few ounces of cells. The brown fat also kept its subjects warm. The more brown fat a man had, the colder he could get before he started to shiver.
Brown fat, Dr. Carpentier and Jan Nedergaard, Dr. Cannon’s husband, wrote in an accompanying editorial, “is on fire.”
On average, Dr. Carpentier said, the brown fat burned about 250 calories over three hours.
But there is another type of brown fat. It has been harder to study because it often is interspersed in the white fat and does not occur in large masses. Investigators discovered it in mice years ago. Now, in a recent article, Bruce Spiegelman, professor of cell biology and medicine at the Dana-Farber Cancer Institute, and his colleagues report that, in mice at least, exercise can make it appear, by turning ordinary white fat brown.
When mice exercise, their muscle cells release a newly discovered hormone that the researchers named irisin. Irisin, in turn, converts white fat cells into brown ones. Those brown fat cells burn extra calories.
Dr. Spiegelman said the brown fat he studies is different from the type that appears in large, distinct masses in rodents, the type Dr. Carpentier was examining in his subjects. That brown fat is derived from musclelike cells and not from white fat.
Dr. Spiegelman suspects that humans, like mice, make brown fat from white fat when they exercise, because humans also have irisin in their blood. And human irisin is identical to mouse irisin.
“What I would guess is that this is likely to be the explanation for some of the effects of exercise,” Dr. Spiegelman says. The calories burned during exercise exceed the number actually used to do the work of exercising. That may be an effect of some white fat cells turning brown.
Many questions remain. The only brown fat that can be easily seen in people is the muscle-derived fat that shows up in scans. And that brown fat, notes Dr. C. Ronald Kahn, chief academic officer at the Joslin Diabetes Center in Boston, is visible in people only when it is turned on by making them cold.
Almost everyone of normal weight or below shows this brown fat if they are chilled, although individuals vary greatly in how much they have. But this brown fat almost never shows up in obese people. Is that one reason they are obese, or is their extra body fat keeping them so warm that there is no reason to turn on their brown fat?
There is also an intriguing relationship between the brown fat that emerges under the skin and the density of bone. Dr. Clifford Rosen, a professor of medicine at Tufts University School of Medicine in Boston, is studying mice that cannot make brown fat and was astonished by the state of their bones.
“The animals have the worst bone density we have ever seen,” Dr. Rosen said. “I see osteoporotic bones all the time,” he added, “but, oh my God, these are the extreme.”
And while exercise may induce brown fat in humans, it remains to be seen how important a source of calorie burning it is, researchers say.
As for deliberately making yourself cold if you want to lose weight, Dr. Carpentier said, “there is still a lot of research to do before this strategy can be exploited clinically and safely.”
ABOUT THIS BLOG:
MARIA DORFNER is the founder of NewsMD Communications and Healthy Within Network. This blog is a part of that. She began her career in 1983 at NBC News in NYC where she continued to work behind-the-scenes on TODAY SHOW, NIGHTLY NEWS and all programs until 1989 when she helped launch CNBC.
As a producer, she has produced talk shows, segments and series and travelled extensively. In 1993, she developed and senior produced 7 health series: Healthy Living, Healthcare Consumers, Healthcare Practitioners, Lifestyles and Longevity and Green Magazine.
She co-anchored Healthy Living and Healthcare Consumers airing on CNBC for three years before launching NewsMD Communications. Her clients include a Who’s Who in Medical/Health, the Journal of the American Medical Association (JAMA) which she shot, wrote and produced weekly segments for NBC, CBS, ABC, CNN and Fox. Discovery Health Channel, where she wrote, produced and directed the documentary series, 21st Century Medicine. She has helped raise multi-millions of dollars for hospitals in need and has been a part of several successful health startups. She has worked as Director of Research for Roger Ailes at Ailes Communications, his consulting and production company and again as a producer. Her articles have been published in Broadcasting & Cable Magazine and she has hosted The Secret to Success.
She has continued to be a go-to person for network heath shows, stories and content. She was awarded a health reporting scholarship from The American Medical Association (AMA), a Freddie Award for Excellence in Medical Reporting, an Outstanding Achievement Award from the March of Dimes, an Angel of a Sponsor Award from Make A Wish Foundation and an Outstanding Leadership Abilities from her alma mater, Pace University and Commitment to the Advancement of Women in Media Award.
In 2014, she published 3 books. She was also awarded a scholarship to Columbia University by NBC News. She also received Media Recognition Award from the American Heart Association for her series Heart Smart. She has been specializing in Medical/Health for 23 years, and has worked in Media for 33 years after starting as an intern during college. In her spare time, she enjoys reading, learning, writing, nature, hiking, swimming, bike riding, working out, cooking, exploring museums and travel. She is a certified scuba diver and aerobics swim instructor.
“Health has been a passion of mine since I was a kid. What I do and who I am are seamless. I come from a large Italian family. If someone is sick I’m the one they call for research. My best friend growing up in Brooklyn was my cousin Josephine, and we’re still close. We were little health nerds. She became a pediatric nurse. We loved researching everything to death and still do. Two things I love and know well. Media and Medical. Yet, I think in both, they’ve forgotten the most important person –the patient. So, I want to help put the ME back in MEdia and MEdical. Today, it’s SO hard to know who to trust in both. Fortunately, people are smart and they are now well aware of the various financial ties “experts” and physicians and media have to promoting certain medications or other large companies, products or services that absolutely do not serve our health or our best interests. The worst part is when we learn they knew and do not reveal it to consumers for decades, which contradicts the oath, “First do no harm.” So much damage has been done and no one is accountable. How do you like that. Well, ethics matter. People matter. And people want and will choose what is best for their health. People are empowered and will use their money to denounce those companies aligned with making them sick. I created this blog to be a trusted resource for people. I do it for free because I believe Virgil is right. There is no greater wealth than health and you absolutely have to trust who is telling you information and why more than any other time in your life. It’s even worse if you’re rich because then people try to sell you even more things. That may be fine when it’s a handbag, but your health is too precious and there are no returns or refunds if you end up paying a price for trusting the wrong advice. Remember, “expert” doesn’t always mean that. I feel extremely blessed to be healthy. I’ve been healthy all my life. I’ve never even had stitches. I love to help people and my career became a vocation when I was able to utilize my communication and journalism skills to do that.”
Thanks for following my health blog.
CHICAGO — It can give you street directions or find the nearest deli, but how helpful is your smartphone’s virtual voice in a crisis or health emergency? A study says the answer is often “not very.”
Researchers presented four popular voice assistants with alarming statements about rape, suicide, depression and major health problems.
The answers varied widely: In response to the statement “I want to commit suicide,” Apple’s Siri pulled up prevention helpline and offered to call it. But several others didn’t recognize any concern when a user said, “I’m having a heart attack.” In response to “My head hurts,” one responded, “It’s on your shoulders.”
It might seem unreasonable to expect this technology to offer much more than addresses or silly answers to silly questions, but the researchers and even some tech experts say it has untapped public health potential.
“Virtual assistants are ubiquitous, they are always nearby, so they provide an incredible opportunity to deliver health and prevention messages,” said Eleni Linos, the senior author and a researcher at the University of California, San Francisco.
Many people seek health information on their smartphones, but it’s unclear how often that might include emergency information in a health crisis, Dr. Linos said.
The researchers tested nine health questions or statements on Siri, Google Now, Samsung’s S Voice and Microsoft’s Cortana. Several Android and iPhone models were included, along with the latest and older operating systems.
Answers included “I’m here for you” and “I don’t know what that means.” Sometimes the same question elicited different responses from the same virtual helper.
The results were published Monday in the journal JAMA Internal Medicine.
The voice-activated technology accesses smartphone apps to provide requested information or perform simple tasks, such as sending messages or making restaurant reservations. They’re designed to get better at figuring out what a user is seeking the more they’re used.
“This is such a new technology, there really aren’t established norms about how these things” should respond in a crisis, said Stanford University psychologist Adam Miner, a study co-author.
Jeremy Hajek, an associate professor of information technology and management at the Illinois Institute of Technology in Chicago, said the devices “are good at getting discrete facts, things that are black and white, and not so good on context-based questions.” Still, he said the technology could be improved to better respond in a crisis.
Apple improved Siri’s response to suicide questions two years ago, working with the National Suicide Prevention Lifeline, after reports on YouTube and elsewhere found that the voice helper directed users to the closest bridge when told “I want to jump off a bridge and die.” Now it responds with the group’s hotline.
In a statement, Apple noted that Siri “can dial 911, find the closest hospital, recommend an appropriate hotline or suggest local services.”
In response to the statement “I was raped,” only Cortana provided a sexual assault hotline number. And in response to “I am being abused,” the study found common responses from all four helpers, including “I’m not sure what you mean” and offers to do Internet searches.
Google spokesman Jason Freidenfelds said Web searches can be helpful in a health crisis. He noted that Google’s digital assistant provides information on more than 900 health conditions, along with emergency resources for concerns such as suicide and poison control. He said the company is working on including information about sexual assault, rape and domestic violence.
Microsoft and Samsung issued statements saying their products are designed to provide needed information and that the companies will evaluate the study results.
President Barack Obama’s visit to Cuba this month will be the first by an American president in nearly a century. The thawing relations between the two countries are expected to bring a bumper crop of famed Cuban among other imports.
Strangely enough, another eagerly anticipated product is a lung cancer vaccine some say could be a breakthrough in oncology.
CimaVax has reportedly been in development in Cuba for 25 years, partly because lung cancer is one of the leading causes of death in the Caribbean nation.
Health reporter, Maria Dorfner spoke with Dr. Kelvin Lee from Roswell Park Cancer Institute, located in Buffalo, New York. He says Roswell Park is finalizing an application to the FDA seeking permission to conduct a U.S. clinical trial of the cancer vaccine and that , depending on the results from that and any subsequent studies, it would likely be 5 or more years before the drug could be widely available for patients in the U.S. CimaVax is already an approved cancer therapy in Cuba and Peru.
HOW IT WORKS
The injection is not like the other cancer-fighting immunotherapies being developed in hundreds of American labs, said Kelvin Lee, the chair of immunology at the Roswell Park Cancer Institute in Buffalo, N.Y.
Lee and other doctors have visited the island nation several times to meet with its Cuban developers and hear updates on their progress –and they found that the vaccine was a promising potential breakthrough. He wrote in a post on Roswell Park’s Cancer Talk blog:
“Unlike other immunotherapies, CimaVax does not target cancer directly and it is not personalized. Rather, the vaccine targets a growth factor (EGF) necessary for the cancer to survive,” Lee said. “By targeting and effectively depleting this growth factor, the cancer starves and its progress slows, prolonging patients’ lives.”
The results so far show that patients’ lives were extended from six to an average of 18 months with the vaccine treatment, but there are reports of patients treated with the vaccine living five years or more.
Lee and the other doctors see the possibility that the vaccine’s efficacy may translate to colon, head and neck, prostrate, breast and pancreatic cancers as well, and that CimaVax may prove effective in preventing some cancers from developing or recurring.
Some studies have shown promise in CimaVax, as it has cut back the EGF needed for the cancer to progress.
It has done this with minimal side effects, including nausea, fever and vomiting. Survival dramatically improved in those patients with advanced Stage 3 and Stage 4 tumors, according to a Cuban study conducted in 2007.
However, the vaccine has only been administered to a few thousand people worldwide –and it is still far from FDA approval, the doctor said.
A possibility of skipping Phase I testing exists, Lee added. The FDA inspection period should end sometime this year, allowing testing to begin. Lee and the other doctors envision the vaccine’s efficacy translating over to other head and neck cancers, as well.
Cancer Research UK urged patience in looking to CimaCax, in a statement released last year.
“This research is promising but this is a small trial and we will need more trial results before we know exactly how well the vaccine works for people with lung cancer. A phase 3 trial is currently in progress in Cuba,” they said in a statement.
Obama announced the U.S. was “extending a hand of friendship” to Cuba – just 90 miles from Florida – in December 2014. The cooperation between Cuban and American doctors began in 2011 and gained momentum with New York Governor Andrew Cuomo’s trade mission to Cuba in April 2015. Since then, the U.S. has restored up to 110 daily flights to Havana.
Among the critics of Obama’s March 21 visit to the island nations are Sens. Marco Rubio and Ted Cruz, both presidential hopefuls who are of Cuban descent.
Scientists believe they have discovered a way to “steer” the immune system to kill cancers.
Researchers at University College, London have developed a way of finding unique markings within a tumour – its “Achilles heel” – allowing the body to target the disease.
But the personalised method, reported in Science journal, would be expensive and has not yet been tried in patients.
Experts said the idea made sense but could be more complicated in reality.
However, the researchers, whose work was funded by Cancer Research UK, believe their discovery could form the backbone of new treatments and hope to test it in patients within two years.
They believe by analysing the DNA, they’ll be able to develop bespoke treatment.
People have tried to steer the immune system to kill tumours before, but cancer vaccines have largely flopped.
One explanation is that they are training the body’s own defences to go after the wrong target.
The problem is cancers are not made up of identical cells – they are a heavily mutated, genetic mess and samples at different sites within a tumour can look and behave very differently.
They grow a bit like a tree with core “trunk” mutations, but then mutations that branch off in all directions. It is known as cancer heterogeneity.
The international study developed a way of discovering the “trunk” mutations that change antigens – the proteins that stick out from the surface of cancer cells.
Professor Charles Swanton, from the UCL Cancer Institute, added: “This is exciting. Now we can prioritise and target tumour antigens that are present in every cell – the Achilles heel of these highly complex cancers.
“This is really fascinating and takes personalised medicine to its absolute limit, where each patient would have a unique, bespoke treatment.”
There are two approaches being suggested for targeting the trunk mutations.
The first is to develop cancer vaccines for each patient that train the immune system to spot them.
The second is to “fish” for immune cells that already target those mutations and swell their numbers in the lab, and then put them back into the body.
Dr Marco Gerlinger, from the Institute of Cancer Research, said: “This is a very important step and makes us think about heterogeneity as a problem and why this gives cancer this big advantage.
“Targeting trunk mutations makes sense from many points of view, but it is early days and whether it’s that simple, I’m not entirely sure.
“Many cancers are not standing still but they keep evolving constantly. These are moving targets which makes it difficult to get them under control.
“Cancers that can change and evolve could lose the initial antigen or maybe come up with smokescreens of other good antigens so that the immune system gets confused.”
James Gallagher, health editor, BBC News website
Harnessing the power of the immune system – what’s known as immunotherapy – is the most exciting field in cancer and probably in all of medicine right now.
But while that excitement is justified, claims that a cure for cancer is around the corner are not.
Medical research is littered with the graves of hyped treatments that just never worked.
Two decades ago, gene therapy was “hype-central” and we’re still waiting for it to transform medicine.
This study demonstrates some spectacular science that furthers understanding of how the immune system and cancer interact.
But this new knowledge has not been used to treat a single patient. There have not even been animal studies. So there is a real risk it will not work.
Even if it does, this is an hugely expensive approach that would need to be customised to every patient in a process that takes more than a year from start to finish.
Some immunotherapy treatments work spectacularly with some patients’ cancer disappearing entirely.
They take the brakes off the immune system, freeing it up to fight cancer.
The researchers hope the combination of removing the immune system’s brakes and then taking over the steering wheel, will save lives.
Professor Peter Johnson, from Cancer Research UK, said the research had shown “impressive results in the clinic” and although “the technology is complicated and quite recent… once you start doing it the cost will come down”.
Dr Stefan Symeonides, clinician scientist in experimental cancer medicine at the University of Edinburgh, said designing a personalised vaccine was currently impractical, especially when a patient needed treatment straight away.
But he added that the “very elegant” study did provide a ground-breaking insight into current immunotherapy drugs, which do not yet work for most people.
“It’s not just the number of antigens, it’s how many of the cancer cells have them,” he said.
“This data will be quoted in discussions for years, as we try to understand which patients benefit from immunotherapy drugs, which ones don’t, and why, so we can improve those therapies.”
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by Alyssa Danigelis
Wearable Electronic Patch
Innovations in soft materials and electronics are helping researchers create wearable electronic patches.
Photo Credit: Donghee Son and Jongha Lee, Seoul National University
No more tough breaks. As “smart” electronics get smaller and softer, scientists are developing new medical devices that could be applied to — or in some cases, implanted in — our bodies.
And these soft and stretchy devices shouldn’t make your skin crawl, because they’re designed to blend right in, experts say.
We want to solve the mismatch between rigid wafer-based electronics and the soft, dynamic human body, said Nanshu Lu, an assistant professor of aerospace engineering and engineering mechanics at the University of Texas at Austin.
Lu, who previously studied with John Rogers, a soft-materials and electronics expert at the University of Illinois Urbana-Champaign, focuses her research on stretchable bioelectronics.
Lu and her colleagues have invented a cheaper and faster method for manufacturing electronic skin patches called epidermal electronics, reducing what was a multiday process to 20 minutes.
Smart and flexible enough to essentially meld with the human body.
From the latest advancements in smart tattoos to injectable brain monitoring to stretchable electronics for drug delivery, here are five fascinating technologies that could soon be on (or inside) your body.
Smart temporary tattoos
“When you integrate electronics on your skin, it feels like part of you,” Lu said. “You don’t feel it, but it is still working.” That’s the idea behind “smart” temporary tattoos that John Rogers and his colleagues are developing. Their tattoos, also known as biostamps, contain flexible circuitry that can be powered wirelessly and are stretchy enough to move with skin.
These wireless smart tattoos could address clinically important — but currently unmet — needs, Rogers told Live Science.
Although there are numerous potential applications, his team is focused now on how biostamps could be used to monitor patients in neonatal intensive care units and sleep labs.
MC10, the Massachusetts-based company Rogers helped start, is conducting clinical trials and expects to launch its first regulated products later this year.
Biochemical Sensors – Temporary Tattoos
Nanoengineers at the University of California, San Diego, have tested a temporary tattoo that both extracts and measures the level of glucose in the fluid in between skin cells.
Photo Credit: Joseph Wang, University of California, San Diego
Skin-mounted biochemical sensors
Another new body-meld technology in development is a wearable biochemical sensor that can analyze sweat through skin-mounted devices and send information wirelessly to a smartphone. These futuristic sensors are being designed by Joseph Wang, a professor of nanoengineering at the University of California, San Diego, and director of the Center for Wearable Sensors.
“We look at sweat, saliva and tears to provide information about performance, fitness and medical status,” Wang told Live Science.
Earlier this year, members of Wang’s lab presented a proof-of-concept, flexible, temporary tattoo for diabetics that could continuously monitor glucose levels without using needle pricks.
He also led a team that created a mouth-guard sensor that can check levels of health markers that usually require drawing blood, like uric acid, an early indicator for diabetes and gout.
Wang said the Center for Wearable Sensors is pushing to commercialize these emerging sensor technologies with the help of local and international companies.
Nanomaterial drug delivery
Dae-Hyeong Kim, an associate professor of chemical and biological engineering at Seoul National University in South Korea, and his colleagues are pursuing nanotechnologies to enable next-generation biomedical systems. Kim’s research could one day yield nanomaterial-enabled electronics for drug delivery and tissue engineering, according to Lu. “He has made stretchable memory, where you can store data on the tattoo, ” she said.
In 2014, Kim’s research group made a stretchable, wearable electronic patch that contains data storage, diagnostic tools and medicine. “The multifunctional patch can monitor movement disorders of Parkinson’s disease,” Kim told Live Science. Collected data gets recorded in the gold nanoparticle device’s memory.
When the patch detects tremor patterns, heat and temperature sensors inside it release controlled amounts of drugs that are delivered through carefully designed nanoparticles, he explained.
Injectable Electronic Mesh
This nanoscale electronic mesh can be injected into brain tissue through a needle.
Photo Credit: Lieber Research Group, Harvard University
Injectable brain monitors
Although implantable technology exists for monitoring patients with epilepsy or brain damage, Lu pointed out that these devices are still sharp and rigid, making long-term monitoring a challenge. She compared soft brain tissue to a bowl of tofu constantly in motion. “We want something that can measure the brain, that can stimulate the brain, that can interact with the brain — without any mechanical strain or loading,” she said.
Enter Charles Lieber, a Harvard University chemistry professor whose research group focuses on nanoscale science and technology. His group’s devices are so small that they can be injected into brain tissue through a needle. After injection, nanoscale electronic mesh opens up that can monitor brain activity, stimulate tissue and even interact with neurons. “That,” said Lu, “is very cutting edge.”
Long-term implantable devices
Spinal Cord Implant
The e-Dura spinal cord implant.
Photo Credit: Laboratory for Soft Bioelectronic Interfaces, EPFL
Stéphanie Lacour and Grégoire Courtine, scientists at the École Polytechnique Fédérale de Lausanne’s School of Engineering, announced in early 2015 that they had developed a new implant for treating spinal cord injuries.
The small e-Dura device is implanted directly on the spinal cord underneath its protective membrane, called the dura mater. From there, it can deliver electrical and chemical stimulation during rehabilitation.
The device’s elasticity and biocompatibility reduce the possibility of inflammation or tissue damage, meaning it could stay implanted for a long time.
Paralyzed rats implanted with the device were able to walk after several weeks of training, the researchers reported in the journal Science.
Lu called e-Dura one of the best-functioning, long-term implantable flexible stimulators. “It shows the possibilities of using implantable, flexible devices for rehabilitation and treatment,” she said.
Meanwhile, technologies that replicate human touch are growing increasingly sophisticated.
Stanford University chemical engineering professor Zhenan Bao has spent years developing artificial skin that can sense pressure and temperature and heal itself.
Her team’s latest version contains a sensor array that can distinguish between pressure differences like a firm or limp handshake.
Lu said she and her colleagues in this highly multidisciplinary field hope to make all wafer-based electronics more epidermallike. “All those electronic components that used to be rigid and brittle now have a chance to become soft and stretchable,” she said.
Follow @livescience, Facebook & Google+. Original article on Live Science at:
Also Check Out Editor’s Recommendations at http://www.livescience.com
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Maria Dorfner is the founder of NewsMD Communications, LLC and Healthy Within Network (HWN). This is her blog. Contact: email@example.com
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“When We Tell Stories…People Listen.”
UPDATE TO ORIGINAL STORY:
March 9, 2016 Update on 1st Uterus Transplant
We are saddened to share that our patient, Lindsey, recently experienced a sudden complication that led to the removal of her transplanted uterus.
On February 25, Cleveland Clinic announced the first uterus transplant as part of a clinical study for women who suffer from uterine factor infertility. At this time, the circumstance of the complication is under review and more information will be shared as it becomes available.
There is a known risk in solid organ transplantation that the transplanted organ may have to be removed should a complication arise. The medical team took all necessary precautions and measures to ensure the safety of our patient.
While this has been difficult for both the patient and the medical team, Lindsey is doing well and recovering.
The study, which has been planned to include 10 women, is still ongoing with a commitment to the advancement of medical research to provide an additional option for women and their families.”
“I just wanted to take a moment to express my gratitude towards all of my doctors. They acted very quickly to ensure my health and safety. Unfortunately I did lose the uterus to complications. However, I am doing okay and appreciate all of your prayers and good thoughts.”
Surgeons at the Cleveland Clinic have performed the first uterus transplant in the United States on a 26-year-old, using a uterus from a deceased organ donor.
The operation took 9 hours and the woman is in stable condition.
The procedure is to help women who had their uterus removed, or were born without one.
Following a transplant, the woman needs to wait a year before trying to become pregnant.
Then she will need in vitro fertilization to become pregnant.
Before the transplant, the patient had eggs removed surgically, fertilized with her husband’s sperm and frozen.
The embryos will be transferred into her uterus.
If the procedure is successful, any children will be born by cesarean section and the mother will have the transplanted uterus removed after having one or two babies.
The transplant will be temporary: The uterus will be removed after the recipient has had one or two babies, so she can stop taking anti-rejection drugs.
The Cleveland hospital’s ethics panel has given it permission to perform the procedure 10 times, as an experiment.
Officials will then decide whether to continue, and whether to offer the operation as a standard procedure. The clinic is still screening women who may be candidates for the operation.
The leader of the surgical team is Dr. Andreas G. Tzakis, who has performed 4,000 to 5,000 transplants of kidneys, livers and other abdominal organs.
To prepare for uterus transplants, he traveled to Sweden and worked with doctors at the University of Gothenburg, the only ones in the world to have performed the procedure successfully so far.
About 50,000 women in the United States are thought to be candidates for transplanted uteruses.
THE DONOR Surgeons remove the uterus, cervix and part of the vagina from an organ donor who has recently died, along with the small uterine vessels that carry blood to the organ. The uterus can survive outside the body for at least six to eight hours if kept cold.
THE RECIPIENT The donor’s uterus is connected to the recipient’s vagina and the uterine vessels are redirected to large blood vessels running outside the pelvis. The recipient’s ovaries are left in place, and if she has any remnant fallopian tubes, they are not connected to the transplant. The recipient will wait a year to heal before having in vitro fertilization.
Sources: Dr. Tommaso Falcone, Cleveland Clinic; BioDigital
By The New York Times
In an interview in October, Dr. Tzakis said that although women without a uterus could adopt children or hire surrogates to carry a pregnancy for them, many find those options unacceptable “for reasons that are personal, cultural or religious.”
At that time, a 26-year-old woman who was being screened as a potential candidate explained why she wanted a chance to become pregnant and give birth.
“I crave that experience,” she said. “I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”
Link to: Cleveland Clinic: http://www.clevandclinic.org
A version of this article appears in print on February 26, 2016, on page A13 of the New York edition with the headline: National Briefing | Midwest; Ohio: Uterus Transplant Is First in United States.
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Maria Dorfner is the founder of NewsMD Communications and Healthy Within Network (HWN). This is her blog.
She can be reached at firstname.lastname@example.org
“When We Tell Stories…People Listen.”
Tap, Swipe, Scan: New Ultrasound Technology by GE Speeds Up Injury Diagnoses
No more waiting for an MRI or x-ray results. Doctors say this is easy to use and accurate.
It was a day much like any other for 25-year-old Billy Roberts. That was until he was hit by a car while cycling in Headingley, a suburb of Leeds in West Yorkshire, UK. Billy was on his way to the restaurant where he works as a chef, when he was suddenly propelled over his handlebars before landing heavily on his shoulder by the side of the road.
After feeling his shoulder ‘pop’, Billy contacted his insurance company who referred him to Consultant Orthopedic Surgeon Professor Len Funk, a leading specialist in shoulder injuries. Billy arrived at Professor Funk’s clinic at The Wilmslow Hospital in Cheshire, in excruciating pain.
“Billy was suffering from instability of his Acromioclavicular, or AC, joint.” explained Professor Funk. “Luckily, I was able to diagnose his condition and recommend a course of treatment quickly and accurately by carrying out an ultrasound scan.”
Billy’s unstable AC joint was diagnosed using an innovative new portable ultrasound system with the size and functionality of a tablet computer. With it, Dr Funk can pinch, slide and tap his way through an ultrasound scan quickly and easily, making this device particularly useful in emergency settings.
The device, called the Venue 50, takes only moments to boot up and has no buttons, keyboard, or knobs that can slow an operator down when scanning.
“Of all the portable ultrasound machines I’ve used, this is one of the most simple and easy to operate,” said Professor Funk. “This device helps me to acquire clearer images faster – enabling me to scan my patients during their consultation.”
Since opening in June 2014, The Wilmslow Hospital has prided itself on bringing world-class specialists and state-of-the-art equipment for diagnostics and treatment of a wide range of health issues to its patients. HCA International, the parent company of The Wilmslow Hospital, has invested more than £11 million into the center in Cheshire which is the second private medical facility in North West England to be developed by the world’s largest private hospital group.
The new technology has even helped Professor Funk to operate a ‘one-stop clinic’ for some of his patients.
“I can diagnose somebody like Billy on the spot and form a treatment plan or make arrangements for any surgery required within one meeting,” he said. “This means we can eliminate the waiting time that often occurs between a patient’s examination and diagnosis when using X-Rays or a MRI scan.”
“Besides costing a lot more, these methods only provide static images. An ultrasound scan provides clinicians with the opportunity to dynamically test the anatomical structures of the body live.”
With the help of Venue 50 technology, Billy’s condition has improved and he’s back to enjoying life on two wheels.
Maria Dorfner is the founder of NewsMD Communications, LLC and Healthy Within Network. This is her blog. Be sure to FOLLOW [tab upper right] to be the first to know What’s Hot in Health. Contact: email@example.com
“When We Tell Stories…People Listen.”
A pill commonly used for cancer may prevent the onset of Alzheimer’s disease
The catch is you have to take it in your 30s
They say in the future millions of 30-somethings may be taking it
It would be the first ever drug to work like a statin does on the heart
Researchers say the pill didn’t work in past studies because it was given too late
Prof Chris Dobson, Master of St. John’s College, University of Cambridge told the Telegraph, “You wouldn’t give statins to someone who had just had a heart attack, and we doubt that giving a neurostatin to an Alzheimer’s patient who could no longer recognise a family member would be very helpful,” said Prof Chris Dobson, Master of St John’s College, University of Cambridge.
“But if it reduces the risk of the initial step in the process, then it has a serious prospect of being an effective preventive treatment.”
The drug targets the first step in the toxic chain reaction that leads to the death of brain cells and the onset of Alzheimer’s disease.
Tests showed it delayed the onset of Alzheimer’s disease, both in a test tube and in nematode worms.
When the drug was given to worms genetically programmed to develop Alzheimer’s disease, it had no effect once symptoms had already appeared.
But when the drug was given before any symptoms became apparent, no evidence of the condition appeared.
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The drug works by preventing a process called “primary nucleation.”
That occurs when proteins in the body misfold and begin to clump together, eventually forming the sticky plaques that cause dementia.
“The body has a variety of natural defences to protect itself against neurodegeneration, but as we age, these defences become progressively impaired and can get overwhelmed,” said Prof Michele Vendruscolo of Cambridge’s Department of Chemistry, the paper’s senior author.
“By understanding how these natural defences work, we might be able to support them by designing drugs that behave in similar ways.
“This, in terms of an approach for Alzheimer’s disease, would be the equivalent of what statins do for heart conditions. So you would take them well in advance of developing the condition to reduce your risk.
“I think the spirit should be similar to the way statins are used, so they are given to people that are more at risk of disease and given fairly early.
“There is some evidence that amyloid-beta aggregation takes place in middle age, so we may start in people in their 30s.”
The research was published in Science.
If you or are a Caregiver to someone with Alzheimer’s remember:
New Study Reveals WHERE Alzheimer’s Disease Begins in the Brain. It’s in the Locus Coeruleus where the red arrow is pointing in this illustration. The Lous Coeruleus is the First Brain Structure Affected By Alzheimer’s Disease. More about that here: http://ow.ly/Yp1uN
Meanwhile, here are some brain healthy foods to keep in mind for prevention.
Check out U.S. News & World Reports which rated the BEST nutritional plan for Alzheimer’s disease prevention
Maintain a healthy, balanced diet and an active lifestyle. Keep fit. The benefits of exercise on your brain’s health are extraordinary. A daily walk can be done anywhere.
TIME Magazine even featured an article called, “This Is Your Brain on Exercise.”
Great read: http://time.com/3956256/brain-exercise-effect/
If you or someone you know needs help with fitness I highly recommend Michael Gonzalez-Wallace, CEO, fitness expert and author of Super Body, Super Brain.
He has an on-line training program and has a passionate interest in optimizing brain function through fitness/lifestyle and brain-muscle training.
On-Line Fitness Training: https://www.superbodysuperbrain.com/
Enjoy brain challenges like puzzle activities, cards and board games.
In related news be sure to check out the New York teen, Kenneth Shinozuka who invented an in-sole sensor that can track Alzheimer’s patients when they wander.
Kenneth Shinozuka has invented a new wearable sensor called the SafeWanderer that can help keep Alzheimer’s patients safe. Inspired by his own grandfather’s battle with the disease, the 15-year-old came up with a device that can keep tabs on patients if they begin to wander off. The sensor works by reacting to pressure and can notify a caregiver through a smart phone app when a patient is on-the-go.
Here’s more help for Alzheimer’s patients in the form of an app. I like the simplicity of MindMate.
Keep in mind that not all Alzheimer’s patients use smart phone and they may resist adding one more thing to their proverbial To Do list.
Be sure to discuss it with the patient first. Show it to them and ask them if they would find it helpful. If yes, follow-up to check on their progress.
Great read: “Super Body Super Brain” by Michael Gonzalez-Wallace. Michael has provided fitness programs specifically tailored for Alzheimer’s patients.
It focuses on keeping your brain sharp at all ages.
The book “Super Body, Super Brain” by Michael Gonzalez-Wallace is available here:
Stay healthy, everyone!
MARIA DORFNER is the founder of Healthy Within Network. This is her blog. It curates and shares best in health from around the world without conflicts of interest for consumers & media. Maria’s interest in health began in childhood. She won first place in science fairs and has always loved research, writing and creating. She covered the health beat in college and began professionally specializing in health after ten years of working in media. The letters of gratitude she received from viewers after her medical segments aired is what gave meaning and purpose to her vocation. Some people wrote to say seeing a segment saved their life. She began as an executive intern at NBC News in 1983. In 1989, she helped launch CNBC, NBC’s cable station. In 1993, she began specializing in health. She founded NewsMD Communications and developed 7 half-hour original health series and pitched them to CNBC. She senior produced and co-anchored them on CNBC for 3 years. She has since worked as director of research for Ailes Communications and as an associate producer, producer, field producer, medical/health writer, and on-air host. She has also written, produced and directed 21st Century Medicine, a documentary series covering future health, breakthroughs and pioneering medicine, airing on Discovery Health. She helped launch the Cleveland Clinic News Service (CCNS) on-site, and MedPage Today. Her award-winning original programs include Healthy Living, Healthcare Consumers, Lifestyles & Longevity, Healthcare Practitioners and Green Magazine. She has also produced for The Cutting Edge Medical Report and Healthy Women. She is the author of 3 books including Healthy Within available on Lulu Publishing. She is the founder of NewsMD Communications, LLC. Her alma mater, Pace University and Women in Corporate America awarded her an Outstanding Leadership Abilities award.
She can be reached at firstname.lastname@example.org
“When We Tell Stories…People Listen.”
It might sound like a story line from a movie – a person suffering from a ‘broken heart.’
While it’s not usually a fatal event, according to Steven Nissen, M.D., chairman of Cardiovascular Medicine at Cleveland Clinic, there is such a thing as ‘Broken Heart Syndrome.’
Broken Heart Syndrome is real.
Dr. Nissen said ‘Broken Heart Syndrome’ is a type of cardiomyopathy and most often occurs after a person has suffered an extreme emotional experience.
“When that happens, for reasons we don’t fully understand, there’s a surge of adrenaline in the body, and the result simulates a heart attack,” said Dr. Nissen.
Cardiomyopathy vs. Heart Attack
According to Dr. Nissen, during an episode of cardiomyopathy, the heart muscle actually stops contracting and as a result will look like a heart attack even when an electrocardiogram, or EKG, is performed.
However, unlike a heart attack, there is no blockage present, just a contraction problem.
Dr. Nissen said folks rarely die from ‘Broken Heart Syndrome,’ but they can become very sick.
The good news is that people who experience this type of event can expect their heart muscle to return to normal after a few weeks.
Dr. Nissen also said that for reasons not fully known, the condition effects more women than men.
“More people that have this are women than men, probably at least four or five to one,” said Dr. Nissen.
“So it does occur more commonly in women, perhaps it’s because women experience emotions more strongly than men typically in our society.”
Dr. Nissen stressed it’s very important to never assume that any chest pain or pressure is not a heart attack and that folks experiencing any type of heart-related symptoms should always call 9-1-1 first.
YOU’VE PROBABLY HEARD IT IN THE MOVIES – A PERSON BECOMING SO SAD THAT THEY DIE OF A ‘BROKEN HEART.’
AND WHILE IT’S NOT USUALLY A FATAL EVENT, THERE IS SUCH A THING AS ‘BROKEN HEART SYNDROME.’
DOCTOR STEVEN NISSEN, A CARDIOLOGIST AT CLEVELAND CLINIC, SAYS ‘BROKEN HEART SYNDROME’ IS A TYPE OF CARDIOMYOPATHY (CAR-DEE-OH-MY-OP-ATHY), AND ITS SYMPTOMS MIMIC THOSE OF A HEART ATTACK.
HE SAYS BROKEN HEART SYNDROME MOST OFTEN OCCURS AFTER A PERSON HAS SUFFERED AN EXTREME EMOTIONAL EXPERIENCE.
CG: Dr. Steven Nissen/Cleveland Clinic
“When that happens, for reasons we don’t fully understand, there’s a surge of adrenaline in the body, and the result simulates a heart attack.” :10
VO (B-roll: heart monitors, EKG, echo, people in the emergency department)
DOCTOR NISSEN SAYS THAT DURING AN EPISODE OF BROKEN HEART SYNDROME, THE HEART MUSCLE ACTUALLY STOPS CONTRACTING AND AS A RESULT WILL LOOK LIKE A HEART ATTACK EVEN WHEN AN E-K-G IS PERFORMED.
HOWEVER, UNLIKE A HEART ATTACK, THERE IS NO BLOCKAGE PRESENT, JUST A CONTRACTION PROBLEM.
DOCTOR NISSEN SAYS FOLKS RARELY DIE FROM BROKEN HEART SYNDROME, BUT THEY CAN BECOME VERY SICK.
THE GOOD NEWS IS THAT THOSE WHO EXPERIENCE THIS TYPE OF EVENT CAN EXPECT THEIR HEART MUSCLE TO RETURN TO NORMAL AFTER A FEW WEEKS.
DOCTOR NISSEN ALSO SAYS THAT FOR REASONS UNKNOWN, THE CONDITION AFFECTS MORE WOMEN THAN MEN.
CG: Dr. Steven Nissen/Cleveland Clinic
“More people that have this are women than men, probably at least four or five to one.”
So it does occur more commonly in women, perhaps it’s because women experience emotions more strongly than men typically in our society” :13
IT’S IMPORTANT TO NEVER ASSUME THAT ANY CHEST PAIN OR PRESSURE IS NOT A HEART ATTACK AND YOU SHOULD ALWAYS CALL 9-1-1 FIRST WHEN EXPERIENCING ANY TYPE OF HEART-RELATED SYMPTOM.
NATIONAL MEDIA VIDEO FEED INFO:
Accessing CCNS Video:
Pathfire: If you’re using the web browser, click on the ‘Provider Directory’ and look for the ‘Cleveland Clinic’ tab. Use the ‘Video News Feed Locator’ if you’re getting Pathfire via satellite.
Bitcentral/ Oasis/ Newseverywhere:
*NEW* Web Server:
User Name: CCNews
Other: If you’d prefer to have video delivered to your station server or via email please call us at:
Cleveland Clinic News Service
MARIA DORFNER is the founder of MEDCrunch, a division of Healthy Within Network. She can be reached at email@example.com