New biosensor that warns when athletes are about to 'hit the wall' undergoes first human tests

Main Category: Medical Devices / Diagnostics
Also Included In: Sports Medicine / Fitness
Article Date: 26 Jul 2013 - 1:00 PDT Current ratings for:
New biosensor that warns when athletes are about to 'hit the wall' undergoes first human tests

A new biosensor, applied to the human skin like a temporary tattoo, can alert marathoners, competitive bikers and other "extreme" athletes that they're about to "bonk," or "hit the wall," scientists are reporting. The study, in ACS' journal Analytical Chemistry, describes the first human tests of the sensor, which also could help soldiers and others who engage in intense exercise - and their trainers - monitor stamina and fitness.

Joseph Wang and colleagues explain that the sensor monitors lactate, a form of lactic acid released in sweat. Lactate forms when the muscles need more energy than the body can supply from the "aerobic" respiration that suffices during mild exercise. The body shifts to "anaerobic" metabolism, producing lactic acid and lactate. That helps for a while, but lactate builds up in the body, causing extreme fatigue and the infamous "bonking out," where an athlete just cannot continue. Current methods of measuring lactate are cumbersome, require blood samples or do not give instant results. Wang's team sought to develop a better approach.

They describe the first human tests of a lactate sensor applied to the skin like a temporary tattoo that stays on and flexes with body movements. Tests on 10 human volunteers showed that the sensor accurately measured lactate levels in sweat during exercise. "Such skin-worn metabolite biosensors could lead to useful insights into physical performance and overall physiological status, hence offering considerable promise for diverse sport, military, and biomedical applications," say the scientists. Future research will further correlate sweat lactate levels with fitness, performance and blood lactate levels, Wang added.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The authors acknowledge funding from the National Science Foundation, the National Institutes of Health IMSD program, the UCSD von Liebig Entrepreneurism Center under the U.S. Department of Energy-sponsored Southern California Clean Energy Technology Acceleration Program and the National Natural Science Foundation of China.

American Chemical Society

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Treating people who use drugs is the first step towards eliminating hepatitis C - international guidelines for treatment released today

Main Category: Liver Disease / Hepatitis
Also Included In: Alcohol / Addiction / Illegal Drugs
Article Date: 25 Jul 2013 - 1:00 PDT Current ratings for:
Treating people who use drugs is the first step towards eliminating hepatitis C - international guidelines for treatment released today

The burden of liver disease could be dramatically reduced by increasing treatment for hepatitis C infection among people who inject drugs, suggest new recommendations developed by researchers from the Kirby Institute at UNSW, in collaboration with colleagues from the International Network on Hepatitis Care in Substance Users (INHSU).

In Australia, 226,000 people are living with chronic hepatitis C and over 10,000 new cases are reported every year. Hepatitis C can lead to serious liver complications such as liver failure or cancer, which are associated with considerable costs to the health care system. Although almost 80 per cent of all infections occur among people who inject drugs, only one per cent of these people currently receive treatment.

"Treatment for hepatitis C infection among people who inject drugs remains unacceptably low," said Dr Jason Grebely, Senior Lecturer at the Kirby Institute, UNSW, and co-lead author of the recommendations. "Clinicians have been hesitant to recommend treatment in this population because of a lack of understanding about how lifestyle factors may impede successful treatment."

But research supporting the first set of international recommendations ever released for treating hepatitis C in people who inject drugs has shown that treatment can be very successful when barriers are addressed within a supportive environment.

"Reducing the significant burden of liver disease related to hepatitis C in Australia and internationally will require improved assessment and treatment of the population most affected: people who currently inject drugs and those who have injected drugs in the past," says Philip Bruggmann, President of INHSU. "By providing appropriate care to this group, we can reduce the burden of hepatitis C-related liver disease in this vulnerable population and slow the spread of this world-wide epidemic. These new recommendations serve as a first step towards elimination of hepatitis C."

The global recommendations are published online today in the journal Clinical Infectious Diseases ahead of World Hepatitis Day on July 28. They are part of a supplement entitled "Prevention and Management of Hepatitis C Virus Infection Among People Who Inject Drugs: Moving the Agenda Forward", developed in collaboration with INHSU.

Additional Stakeholder Comments:

"These are exceptionally positive and welcome findings. Following the listing of new hep C treatments for subsidy by the Australian Government in April, almost all people in Australia living with hepatitis C in Australia can enjoy cure rates of around 75 to 80 per cent. This new evidence shows us that people who have been least able to access treatment in the past, can and should be able to benefit from these new treatment advances."

Stuart Loveday
CEO of Hepatitis NSW

"This report is most welcomed. It finally provides the much needed endorsement that peer support requires to validate it as an efficacious treatment modality. That combined with the recognition that people who continue to inject or use drugs can access treatment will mean that more people will be able to access treatment. For too long those most affected by hepatitis C have been on the periphery, this report puts them where they belong - front and centre."

Nicky Bath
CEO of the NSW Users and AIDS Association

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'Treating people who use drugs is the first step towards eliminating hepatitis C - international guidelines for treatment released today'

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First patient receives innovative new treatment to tackle combined diabetes and obesity in NHS approved trial initiated by the ABCD, UK

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 26 Jul 2013 - 2:00 PDT Current ratings for:
First patient receives innovative new treatment to tackle combined diabetes and obesity in NHS approved trial initiated by the ABCD, UK

Combined diabetes and obesity, 'diabesity', is a serious health problem with considerably increased risks of premature heart attack, stroke and death. If not controlled, it can also affect the eyes leading to blindness, the kidneys leading to kidney failure and the feet leading to ulcers and amputation.

The number of patients with diabesity is increasing rapidly, both in the UK and world-wide. Despite all the available expertise and best use of the most modern treatments there are many patients who remain considerably overweight and with poor diabetes control, rendering them vulnerable to these complications.

For such patients a possible new treatment has become available. It is called endobarrier and consists of a 60cm tube-like liner made from a thin, flexible and durable impermeable polymer. It is inserted by the simple procedure of endoscopy and is anchored in place, just beyond the stomach, by a basket of very thin wire made of Nitinol-an alloy of nickel and titanium. The endobarrier prevents food from contacting the first two feet of small intestine and this leads to considerable weight loss (18% reduction) and improvement in diabetes control (87% of patients reach the target control level).

Because this treatment could well be just what is needed for the patients who remain in trouble from their diabetes despite the best treatments available, ABCD have initiated a national trial of the new device funded by a grant from their Diabetes Care Trust (ABCD ) Registered Charity Number 1139057. The study is supported by the NHS and is centred at Birmingham's City Hospital with supporting centres in London (King's College Hospital and Guy's and St Thomas' Hospitals) and Glasgow (Glasgow Royal Infirmary).

Dr Piya Sen Gupta, ABCD Research Fellow, who is conducting the study for ABCD, said: "This trial presents an exciting opportunity for patients with combined diabetes and weight problems, who currently have limited treatment options, to kick start their way back to health.

"It is a novel idea to use a device to treat diabesity when the usual medications have failed and it may offer a valuable treatment option, avoiding in some, the need for invasive bariatric surgery. By opening this study up to NHS patients in Birmingham, London and Glasgow, the results will be relevant throughout the UK. This study has been so named, as we do hope that it goes some way to REVISE-Diabesity"

The first patient to receive the new treatment in the trial is due to have her device inserted on the morning of Thursday 25th July, 2013, at Birmingham's City Hospital.

ABCD Chairman, Dr Chris Walton, said :"The twin epidemics of obesity and diabetes may bankrupt our healthcare systems. The projected spend on diabetes rises from the current 10% of NHS expenditure to 17% of NHS expenditure by 2035 and it is estimated that, for type 2 diabetes, the cost of complications of the disease is more than threefold the cost of treatment. ABCD is keen to research new technologies that confront obesity in diabetes and which may prevent the relentless progress to complications, so the placement of the first endobarrier device in this study is a landmark date''

Dr Bob Ryder, Principal Investigator for the ABCD study, said: "At the moment we have many patients who remain overweight and with poor diabetes control, despite all the available diabetes treatments. Because the endobarrier reduces weight and improves the diabetes control, it is a treatment that could break the cycle of problems for these patients who have otherwise come to the end of the line.

"The best thing about the endobarrier is that it is not permanent and after insertion at endoscopy, it is removed up to a year later, and we then have to hope that the improvement is sustained. This treatment is not currently an NHS treatment, but this is an NHS approved study, and if the trial proves successful and cost effective, we expect that the device will be considered by NICE for approval as part of mainstream NHS diabetes treatment in the future".

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The Association of British Clinical Diabetologists (ABCD) is the national organisation of Consultant Physicians in Britain who specialise in Diabetes Mellitus. Most are also Acute General Physicians, and many are also Specialists in Endocrinology and Lipid Metabolism.

The Association of British Clinical Diabetologists (ABCD)

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posted by Dr.K.Ramakrishnan on 26 Jul 2013 at 10:12 am

Of course, the procedure is fantastic. Here some more clarifications needed. 1. Since the endobarrier is kept for one year ,is there a possibility of vital nutrient dificiency. 2. Can the procedure recommend for obesity and overwieght? 3. After one year is there any weightgain?

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'First patient receives innovative new treatment to tackle combined diabetes and obesity in NHS approved trial initiated by the ABCD, UK'

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World's first IVF baby born after preimplantation genome sequencing is now 11 months old

Main Category: Fertility
Also Included In: Genetics
Article Date: 24 Jul 2013 - 1:00 PDT Current ratings for:
World's first IVF baby born after preimplantation genome sequencing is now 11 months old

The largest genomic institute of the world, BGI Shenzhen, China (hereinafter BGI), together with Reproductive & Genetic Hospital CITIC-XIANGYA (hereinafter CITIC-XIANGYA) have announced that they have successfully applied Next Generation Sequencing (NGS) to detect in vitro fertilized (IVF) embryos with genetic abnormalities. The successful application of preimplantation sequencing (the most advanced form of preimplantation genetic screening, PGS) opens a new chapter in the field of human assisted reproduction, providing new hopes for IVF couples.

In preimplantation sequencing, 7 to 12 cells are removed from morphologically normal human embryos 5 days after fertilization in vitro. Embryos are subsequently cryopreserved by vitrification, and samples are analyzed by using the latest DNA technologies to detect abnormalities. Only genetically intact embryos are transferred to the uterus during the subsequent cycle, with minimal or no hormonal stimulation.

Since 2010, as a result of collaboration between BGI and CITIC-XIANGYA, sequenced embryos from 33 couples were transferred, and 22 pregnancies were achieved. The success rate was 66.7%. Up to now, 17 healthy babies were born.

On August 24, 2012, the world's first IVF baby sequenced before implantation was born in Hunan Province, China. Five days after fertilization in vitro, 7 embryos were biopsied and all samples were shipped to BGI for preimplantation sequencing. Based on a combination of NGS and bioinformatics analysis, 3 embryos were found to have normal chromosomal content and two of them were selected for transfer resulting in pregnancy. The baby is now 11 months old, healthy and developing normally.

At the 29th Annual Meeting of the European Society for Human Reproduction and Embryology (ESHRE) London, research findings of BGI and CITIC- XIANGYA were presented in the lecture of Dr. Jian Li and colleagues from BGI, creating considerable acknowledgement among experts worldwide. In the next talk, Dr. Dagan Wells and colleagues from Oxford University announced the birth of the first IVF baby of the Western Hemisphere after genomic sequencing in England.

Professor Guangxiu Lu, President of CITIC XIANGYA and one of the founders and pioneers in human assisted reproduction in China called the birth as a landmark event in human IVF. As sequencing is the most accurate method for detection of genetic anomalies, doctors can transfer the best embryos of the cohort, this way pregnancy rates may be increased and the chance of abnormalities of genetic origin decreased.

Dr. Yutao Du, Vice-President of BGI Health Group said that with the introduction of new procedures, the cost of sequencing has decreased dramatically. Accordingly, preimplantation sequencing will become a choice for more and more IVF couples. The accuracy is increasing continuously, and new bioinformatic analysis approaches enable scientists to detect specific genetic disorders, even from single cells. Accordingly, preimplantation sequencing may have a crucial role in improving the efficiency and safety of human assisted reproduction.

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NFC Forum issues first health care technical specification and two candidate technical specifications

Main Category: Medical Devices / Diagnostics
Article Date: 19 Jul 2013 - 2:00 PDT Current ratings for:
NFC Forum issues first health care technical specification and two candidate technical specifications

The NFC Forum, a non-profit industry association that advances the use of Near Field Communication (NFC) technology, has published three specifications, all of which are available now to the public for download at no charge. The three specifications are the Personal Health Device Communication (PHDC) Technical Specification, and the Connection Handover 1.3 and Signature Record Type Definition (RTD) 2.0 Candidate Technical Specifications.

The PHDC Technical Specification enables devices such as wireless blood pressure monitors, weighing scales, and glucose meters to transmit health data easily via NFC technology to external computer systems for monitoring by physicians. Wireless health monitoring devices are being increasingly advocated by health care providers as a means of better managing chronic health conditions, such as heart disease and diabetes, and reducing health care costs. NFC technology supports these use cases by making communication between health devices, computers, and NFC-enabled phones fast, easy, and intuitive.

Formerly a candidate specification, the PHDC Technical Specification provides an interoperable data transport for personal health devices conforming to the ISO/IEEE-11073-20601 Optimized Exchange Protocol and NFC Forum specifications.

Health Care and Consumer Electronics are two of five areas of growth targeted by the NFC Forum as part of its Special Interest Group (SIG) initiative. The NFC Forum also supports SIGs for Retail, Payment, and Transport.

The two other specifications published are candidate technical specifications:

The Connection Handover 1.3 Candidate Technical Specification defines the structure and sequence of interactions that allow two NFC-enabled devices to establish a connection using other wireless communication technologies, such as Wi-Fi or Bluetooth. This makes it possible for solutions providers to deploy applications that combine the simple, one-touch set-up of NFC with the high-speed communication of Bluetooth or Wi-Fi. Connection Handover also supports static handover, in which the connection handover information is stored on an NFC tag. Version 1.3 of Connection Handover includes updates to the Connection Handover 1.2 Technical Specification, as well as support for mediated handover, whereby an NFC-enabled device acts as a handover mediator to facilitate connection handover between two other NFC-enabled devices. This capability is useful if those two devices are difficult to place in proximity to each other due to weight, size, or having a fixed location. The Signature RTD 2.0 Candidate Technical Specification provides developers with a means of enabling users to verify the authenticity and integrity of data within NFC Data Exchange Format (NDEF) messages. It specifies the format used when signing NDEF records and provides a list of suitable signature algorithms and certificate types that can be used to create signatures. Signature RTD 2.0 adds to the features of Signature RTD Technical Specification 1.0 (published in 2010) by supporting compact certificate formats to accommodate most tag types, and increasing security strength by supporting National Institute of Standards and Technology (NIST) and Federal Office of Information Security (BSI) recommended algorithms. Signature RTD 2.0 is designed to be open to all Certificate Authorities (CA), such as those issuing certificates for Transport Layer Security (TLS). "Together, the Personal Health Device Communication specification and updates to the Connection Handover and Signature RTD specifications enable solutions providers to both broaden and focus the power of NFC in a growing variety of use cases and industries, from Health Care to Consumer Electronics," said Koichi Tagawa, NFC Forum Chairman. "We are especially grateful to our members who helped to bring these specifications to fruition, and to our liaison partner Continua Health Alliance for its collaboration and adoption of PHDC into the latest Continua Guidelines."

Candidate specifications remain candidates for final release pending feedback from NFC Forum members and other standards organizations. By releasing candidate specifications, the NFC Forum enables organizations in the NFC ecosystem to begin integrating them into their own work. This gives both NFC Forum members and other standards organizations an opportunity to accelerate their development and provide valuable feedback that can be incorporated into the final specifications. Once the feedback has been evaluated and integrated, the specification will be officially adopted and released by the NFC Forum.

NFC technology makes life easier and more convenient for consumers around the world by making it simpler to make transactions, exchange digital content, and connect electronic devices with a touch. A standards-based connectivity technology, NFC harmonizes today's diverse contactless technologies, enabling current and future solutions in areas such as access control, consumer electronics, health care, information collection and exchange, loyalty and coupons, payments, and transport. NFC technology is supported by the world's leading communication device manufacturers, semiconductor producers, network operators, IT and services companies, and financial services organizations. NFC is compatible with hundreds of millions of contactless cards and readers already deployed worldwide.

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App In Development To Monitor Blood Pressure At Home Scoops Top Prize At First BMJ Hack Day

Main Category: Hypertension
Also Included In: IT / Internet / E-mail
Article Date: 11 Jul 2013 - 2:00 PDT Current ratings for:
App In Development To Monitor Blood Pressure At Home Scoops Top Prize At First BMJ Hack Day

A simple smartphone app that makes it easier for GPs to help patients with long terms conditions that require regular monitoring, such as high blood pressure, won "Best in Show" at the first ever BMJ hack day in London which took place on 6/7 July 2013.

As Andy Murray clinched the Wimbledon singles title, hackers Andrea Weir and Alok Matta teamed up with Anne Marie Cunningham, a GP and clinical lecturer at the University of Cardiff, to develop a simple yet effective way for patients manage their high blood pressure based on national guidelines.

The judges were impressed by its "simplicity and cheapness" and the team will now work with BMJ to take their idea forward. For example, how the data would be sent to the GP and how the app could be adapted to other conditions such as diabetes and asthma that also rely on patient self management.

The two-day hack, organised for BMJ by Rewired State, began on Saturday morning with an outline of the four challenges by BMJ staff and 13 "hack teams" were given access to the underlying datasets that drive products such as Best Practice, BMJ learning and Onexamination, as well as collections of journal articles.

The hackers were asked to develop ideas aimed at:

Creating a "zero harm" NHSInnovative applications to create better doctors for future healthcare needsHow to "localise" BMJ's published materials to make them more relevant in different countries How to revolutionise the scholarly publishing process

On Sunday afternoon, each of the teams took part in a "show and tell" to present their solutions to the judges.

The winning team outlined key features of their app, including a video on how and when to take blood pressure readings at home - and "push notifications" to remind patients that they need to take a reading.

The app also prevents patients from adding wrong values or adding more readings too quickly. It would work offline and across different platforms and results could be emailed or exported.

In second place was a reward-based game aimed at making revision for medical students more collaborative and less solitary. It was developed by Jon Hilton, Daniel Inniss, Giuseppe Sollazzo, Kaelan Fouwels, and Kush Depala using BMJ'sOnexamination obstetrics and gynaecology questions.

Hilton, a medical student sitting his exams this week, who describes himself as a "self confessed geek" said the technology could also accommodate a doctor who can join in to advise on answers - and could also address BMJ's localisation challenge by testing the translation skills of UK doctors working overseas.

In third place was an idea to address the challenge set by BMJ on the scholarly publishing process, with an open access button that allows researchers to find an open access version of the paper they are trying to read.

The judges felt that, as well as championing open access publishing models, the tool could also function as a "pester power" resource to persuade librarians to subscribe to a particular journal.

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