Sunday, November 25, 2012
Nano-patch: Vaccine delivery device (Rolex Award)
Nano-patch: Vaccine delivery device
Paradigm shift in vaccine delivery.
http://www.rolexawards.com/profiles/laureates/mark_kendall
Paradigm shift in vaccine delivery.
http://www.rolexawards.com/profiles/laureates/mark_kendall
Monday, November 19, 2012
Wednesday, November 14, 2012
Xerox Designs System to Reduce Busywork for Nurses (and doctors)
Xerox Designs System to Reduce Busywork for Nurses
The system automatically pulls up patient files and lets nurses use mobile devices to document work.
Nurses spend lots of time doing what seems like busywork—logging into computers, pulling up patient files, entering details of what they did, and coordinating their duties with others. Researchers at Xerox are developing what they call the Digital Nurse Assistant to automate and simplify some of this work. The project is part of a broader trend to adapt information technology to the health-care system to make it more efficient and cost-effective.
“Its craziness, because the technology solutions are out there. We just haven’t integrated them into our systems. We are running on old technology,” says Carol Bickford, a health IT expert and senior policy fellow at the American Nurses Association.
Patients do better in and out of hospitals when they receive more hours of care from nurses (see, for example, this New England Journal of Medicinestudy). And yet the United States and many other countries face nursing shortages. One solution could be to give nurses tools that make their workdays more efficient. A study published in The Permanente Journal in 2008 found that more than half of their time was spent documenting and coördinating their work with other team members. Documentation took the majority of their time—more than a third.
“It becomes burdensome for the nurse to walk to the computer, push buttons or mouse, log in, choose the right patient, then sort through the material that might be there to find what’s needed,” says Bickford.
Xerox’s PARC division, a research unit of the company, worked with ethnographers to see exactly what nurses do each day to better understand how to help them. The PARC ethnographers helped uncover some of the details of the Permanente study, such as why it took so long to document things and how difficult electronic medical records are to use. Every time a nurse logged into a workstation, he or she might have to go down six menus before arriving at the necessary information. The challenge of coördination also became clear—a nurse may repeatedly order medication that never seems to arrive. The reality may be that another nurse did deliver the medicine, but did not document the task immediately, perhaps waiting until the end of his shift to go through all of his documentation tasks at once.
“Imagine you are a nurse going into a patient’s room,” says Markus Fromherz, chief innovation officer of health care at Xerox. Instead of going straight to a computer workstation to log in, a badge you are wearing detects your presence and automatically logs you into a system that knows which patient is in the room and which tasks need immediate attention and the information required to complete those tasks. You can then quickly document your work with the patient into a handheld device or mobile computer.
Fromherz says that nurses were involved in the design process to shape the system and ask for additional features. A pilot system has been tested at an undisclosed location.
Monday, November 12, 2012
Thursday, November 8, 2012
Interesting: Pregnancy Test Used to Detect Testicular Cancer
Home pregnancy tests may detect men's cancer
If you've been near social media or on the Internet, you may be aware of the buzz over posts claiming a teenage boy took a home pregnancy test as a joke, received a positive result, and wound up being diagnosed with testicular cancer.
CNN interviewed a girl who identified herself as a friend of the 17-year-old, but was not able to independently confirm the posts.
However, it's true home pregnancy tests can detect some types of testicular cancer in men, experts say - but the tests would not be useful as a screening tool.
According to the American Cancer Society, pregnancy tests work by detecting a hormone called Beta-HCG (human chorionic gonadotropin). Beta-HCG is produced by the cells of a woman's placenta during pregnancy, but is also excreted by some tumors "including some, but not all, testicular cancers," the cancer society says.
"At the time of diagnosis, only a small minority of men with testicular cancer have HCG levels high enough to be detected by a home urine pregnancy test," says Dr. Ted Gansler, director of medical content for the American Cancer Society, in a statement. "More sensitive blood tests for HCG with a lower cutoff level could detect a somewhat higher percentage, but several non-cancerous conditions can cause false positive results.
"Current evidence does not indicate that screening the general population of men with a urine test for HCG (or with urine or blood tests for any other tumor marker) can find testicular cancer early enough to reduce testicular cancer death rates," Gansler says.
Gansler told CNN in an e-mail that "much less often, some other cancers might cause a positive pregnancy test." Medical journals have documented that both men and women patients with pancreas, lung, stomach or other cancers may have HCG levels high enough to cause a positive pregnancy test result, he says.
A lump on the testicle is the first sign of cancer, according to the cancer society, and men should see a doctor right away if one is found.
But even regular self-exams aren't recommended by the ACS because they have not been studied enough to show they reduce the death rate from testicular cancer. "Without that evidence, the American Cancer Society cannot make a recommendation on regular testicular self-exams for all men," the organization said. "But we do think men should decide for themselves whether or not to do regular exams."
Tuesday, November 6, 2012
Memory Loss Linked to High Blood Pressure as Early as 30's
Memory Alert: Even Slightly High Blood Pressure May Age Your Brain - And Even If You're Under 40
+ Comment now
The white and gray matter of the brain are important in memory and thought (image from University of Maryland)
Researchers at the University of California at Davis released a studytoday that should give anyone with even mildly elevated blood pressure pause. It seems that having blood pressure higher than the optimal 120/80 may be aging your brain, putting you at risk for memory problems and eventually for dementia and Alzheimer’s. And this appears to be true even for people in their thirties and even for people with pre-hypertension.
(This might include cutting back on salt today, says the American Heart Association (AHA) in a new advisorydescribing recent studies linking salt and heart disease risk.)
Using data from the highly regarded Framingham Heart Study, the UC Davis team led by professor of neurology Charles DeCarli compared detailed brain scans of 575 people who joined the study in 2009, most in their thirties. DeCarli and his team divided the participants into three groups: hypertensive, pre-hypertensive, and normal blood pressure. They then analyzed the gray and white matter of their brains using high-tech MRIs.
Previous studies have linked high blood pressure with memory loss, Alzheimer’s, and dementia but this study, published online today in the November online version of The Lancet Neurology, appears to be the first one showing that the decline may begin as early as the 30s and 40s. Experts believe that stiffening or hardening of the arteries caused by high blood pressure gradually limits blood flow to the brain, depriving the brain of oxygen over time.
The scans used were both MRIs and diffusion tensor imaging, which obtains a micro view of the brain’s white matter and the axons within it that carry electrical signals between different parts of the brain. According to the researchers, the brains of 30-year-olds with high blood pressure looked similar to the brains of people in their 40s who had normal blood pressure.
DeCarli wants the public to get the message that high blood pressure should be controlled to prevent brain aging, and this is true no matter what age you are. What this would mean is that people in their thirties should regularly get their blood pressure tested, something that most people don’t do until they’re older.
If your blood pressure is elevated, make lifestyle changes (lose weight, exercise, lower your salt intake) or take medication or both to lower it to below 120/80.
Back to Salt: Yes, you should cut out salt if you’re pre-hypertensive or hypertensive. But actually, this applies to you no matter how healthy your numbers, the AHA announced this week. In fact, cutting out salt might be one of the fastest and easiest fixes all of us can make to save our brains.
According to the AHA, eating more than the recommended 1500 milligrams a day puts you at direct risk of high blood pressure. Yet in America we consume an average of 3400 milligrams a day; more than twice what we should. While people with hypertension and heart disease are always advised by doctors to eat less salt, the AHA wants all of us to do this, whether or not our blood pressure is currently in the normal range. “The entire U.S. population, not just at risk groups” should restrict salt to 1500 milligrams, says Nancy Brown, chief executive officer of the AHA.
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New Breakthrough Offers a Better Way to make Drugs - up to 10x Faster
This manufacturing breakthrough is a major deal to the cost and availability of future medicine around the world.
Breakthrough Offers a Better Way to Make Drugs
An MIT-Novartis collaboration could be a boost for so-called “continuous flow” manufacturing.
Better chemistry: To produce drugs in a continuous-manufacturing method, MIT engineers had to develop several new pieces of equipment, including this reactor, which enabled a faster reaction and eliminated the need for a toxic solvent.
Despite the huge amounts of money that the pharmaceutical industry spends on drug discovery, it is notoriously old-fashioned in how it actually makes its products. Most drugs are made in batch processes, in which the ingredients, often powders, are added in successive and often disconnected steps. The process resembles a bakery more than it does a modern chemistry lab. That could be about to change.
This summer, a team of researchers from MIT and Swiss pharmaceutical company Novartis proved that a continuous production line that integrated several new chemical processes and equipment specially designed for the project could make a higher quality drug faster, and in a less wasteful manner. This more nimble method may even create more opportunities in early drug discovery. In their continuous-manufacturing process, raw ingredients are fed into a parade of heaters, spinners, extractors, and sensors that relay the intermediates through chemical reactions. At the end, round, coated pills fall out.
Earlier this year, Novartis CEO Joseph Jimenez said that his company plans to build a commercial-scale continuous-manufacturing facility by 2015 (see “The Future of Pharma is Incredibly Fast”). Other pharmaceutical companies, including Pfizer, the world’s largest, have invested in research to develop their own continuous-manufacturing technologies. But the success of the MIT collaboration suggests that Novartis may be the first to use it for production.
Moving from the batch method to the continuous method requires new kinds of reactions and equipment. While some segments of a batch process may themselves be called continuous because they are constantly running, the breakthrough in the MIT Novartis collaboration is that each step of the process is fully integrated. The products of one reaction flow into the next, typically through small-volume tubes. This enables drug makers to use certain kinds of chemical reactions that aren’t feasible in the large vats used in batch processing, such as those that require higher temperatures or that happen very rapidly. The method could bring new types of molecules into drug discovery.
Making the switch from batch to a fully integrated, continuous production meant that even the way a pill was formed had to be tweaked. The experimental system built at MIT was a jumble of wires, heaters, filters, mixers, and tubes, all enclosed in a 24-foot-long and eight-foot-wide clear plastic case. It could produce a drug that would typically have to be made in multiple facilities. At a few spots, technicians could reach in and adjust equipment or add material, but for the most part, the system was controlled by software that was fed details on temperature, pressure, and other reaction parameters by the many sensors that keep a close eye on the chemistry inside. The MIT system was made to produce one specific drug, but the researchers say the system is adaptable—different pieces of equipment could be swapped in to create a different final product.
The experimental plant at MIT has been dismantled, and the technology is now being further studied at the Novartis headquarters in Basel, Switzerland. The hope is that the continuous-manufacturing method would be more cost-effective. One benefit could be a significantly reduced time between issuing a manufacturing order for a product and having the finished drug in hand. This would be especially helpful during clinical trials, in which companies have to balance the need for sufficient drugs for upcoming trial stages with the risk that most of those drugs will end up failing. The faster production times promised by the continuous method—at least 10 times speedier in the MIT experimental facility—and the smaller scale of production would be much better suited to the uncertain nature of drug development.
The speedier manufacturing could also reduce the risk that pharmaceutical companies face when bringing a new drug to market. “When you launch a new drug, there’s often a lot of uncertainty in demand. Forecasting is very tough in the business,” says Gary Pisano, a Harvard Business School professor who specializes in life science manufacturing. “If you have a small amount of production and the [drug’s sales] takes off, then you are short, and ramping up will be slow. But if you’ve got a big plant for that drug and if it is not successful, then you are stranded,” he says.
The method could also reduce costs, because continuous facilities can be much smaller and require less energy and fewer raw materials. The smaller amounts of material used in continuous also demand more control over reactions, which, in the end, may ensure a higher quality final product. If you are running a batch process over time and end up with hundreds or thousands of gallons of a chemical at a certain step, you can in some sense “mix away your mistakes,” says MIT chemical engineer Richard Braatz. But the small volumes and fast reactions that typically occur in continuous pharmaceutical manufacturing require that higher product quality requirements be built into the design of the control system.
Yet despite all its benefits, it may be a struggle to bring this new method of drug manufacturing into widespread use. “People have talked a lot about the idea of continuous-flow manufacturing in pharmaceuticals but there’s not been much progress,” says Pisano. “A lot of companies were very conservative about trying anything radically new with their manufacturing,” he says. The batch method, while it has its shortcomings, was tried and true. “Finding a more efficient and effective way to do manufacturing was not high on the priority list,” says Pisano.
This resistance to change is also due to a lack of financial pressure. “For decades, these inefficiencies of batch processing have been masked by large margins earned by blockbuster drug sales, but now the pharmaceutical business model is changing,” says Salvatore Mascia, project manager for the Novartis-MIT Center for Continuous Manufacturing. “The combination of our new technologies with an end-to end integration strategy will allow production of pharmaceuticals on-demand, with benefits in term of speed, quality, and cost,” he says. As revenues continue to decline for many companies and they move toward more targeted therapies with smaller markets, producers are showing interest in continuous manufacturing.
Allan Myerson, an MIT chemical engineering professor, says the drug industry’s engineers have long understood the potential efficiencies of continuous manufacturing, but never took it seriously because of the relatively small scale at which drugs are produced. “The difference in pharma is that they make so many different products,” says Myerson. “But there is much more economic pressure on pharma now to reduce manufacturing costs.” The MIT-Novartis collaboration demonstrated that companies could use the techniques of continuous manufacturing with only a small facility. “There’s a lot of potential financial as well as environmental benefits,” he says.
In addition to cost savings, continuous manufacturing could also provide benefits in manipulating the chemistry. Take, for example, the ability to use light-dependent reactions, which could give medicinal chemists more options of molecular structures to use when creating new candidate drugs. In batch processing, light cannot efficiently shine through the large volumes of material used, says Tim Jamison, an MIT chemist. The volumes of chemicals used in the team’s continuous system, however, are smaller and flow through tubes that enable a more even light exposure. Other kinds of reactions—those that produce dangerous chemical intermediates or that run very quickly, are more amenable to continuous. “One of the most exciting aspects is that this could open up new families of chemical structures that really aren’t viable currently and therefore expand treatments we have available for various diseases,” says Jamison.
The pilot facility was built to produce one particular compound. Now, the 11 MIT groups involved in the collaboration continue to find new reactions and tools so that other drug compounds can be produced in the automated, continuous-flow manner. “Traditionally, the industry has not been focused on manufacturing, but there’s a lot of momentum now,” says project director and MIT chemical engineer Bernhardt Trout. “We understand we have to make a long-term commitment to get this started.”
Monday, November 5, 2012
Great use of tracking technology for natural disaster management
State of New Jersey Awards Radiant RFID 5-Year Emergency Management Solution Contract. - SFGate.com
Radiant RFID will provide the New Jersey Office of Homeland Security and Preparedness (OHSP) with an RFID-based managed evacuation solution that tracks evacuees, pets, emergency transport vehicles and commodities deployed at state shelters in preparation for and in the event of a hurricane, natural disaster or other incident to assist in reunification of families.
Radiant RFID (“Radiant”) announced today that the State of New Jersey has awarded the company a five-year contract to assist evacuation and emergency tracking during catastrophic events.
Radiant will provide the Office of Homeland Security and Preparedness (OHSP) with a managed evacuation solution that tracks evacuees, pets, emergency transport vehicles and commodities deployed at state shelters in preparation for and in the event of a hurricane, natural disaster or other man-made incident to assist in reunification of families. In addition, Radiant will manage hardware components, deployment processes and training as well as all maintenance and management functions in support of the State of New Jersey.
Continue Reading: http://www.sfgate.com/
Radiant RFID will provide the New Jersey Office of Homeland Security and Preparedness (OHSP) with an RFID-based managed evacuation solution that tracks evacuees, pets, emergency transport vehicles and commodities deployed at state shelters in preparation for and in the event of a hurricane, natural disaster or other incident to assist in reunification of families.
Radiant RFID (“Radiant”) announced today that the State of New Jersey has awarded the company a five-year contract to assist evacuation and emergency tracking during catastrophic events.
Radiant will provide the Office of Homeland Security and Preparedness (OHSP) with a managed evacuation solution that tracks evacuees, pets, emergency transport vehicles and commodities deployed at state shelters in preparation for and in the event of a hurricane, natural disaster or other man-made incident to assist in reunification of families. In addition, Radiant will manage hardware components, deployment processes and training as well as all maintenance and management functions in support of the State of New Jersey.
Continue Reading: http://www.sfgate.com/
Sunday, November 4, 2012
PA Programs - big tip
Important Announcement:
If you are seriously considering a PA program, I got a big tip from a PA yesterday. The PAEA (Physician Assistant Education Association) has a great school locating service. After creating an account you can type in all the classes that you have taken in school so far, your volunteer hours, work experience and it will find all of the schools in the country that you can apply to and are eligible for. It really helps to know all the ones you are eligible for. The PA I was talking to was a new graduate and said it was totally worth it for the small subscription fee they charged. There are many PA programs that require enormous hours of work experience or volunteer hours even to apply, so this locator service really helps find programs you are eligible for and not waste your time.
http://www.paeaonline.org/index.php?ht=d/sp/i/25515/pid/25515
Breadcrumb:
Home > Admissions > Applicants > PA Program Directory
If you are seriously considering a PA program, I got a big tip from a PA yesterday. The PAEA (Physician Assistant Education Association) has a great school locating service. After creating an account you can type in all the classes that you have taken in school so far, your volunteer hours, work experience and it will find all of the schools in the country that you can apply to and are eligible for. It really helps to know all the ones you are eligible for. The PA I was talking to was a new graduate and said it was totally worth it for the small subscription fee they charged. There are many PA programs that require enormous hours of work experience or volunteer hours even to apply, so this locator service really helps find programs you are eligible for and not waste your time.
http://www.paeaonline.org/index.php?ht=d/sp/i/25515/pid/25515
Breadcrumb:
Home > Admissions > Applicants > PA Program Directory
Genetics: Born No Collarbones
No Collarbones? No Problem!
November 4, 2012Updated Nov 2, 2012 at 6:53 PM PST
Joshua Carter of Leesburg, Georgia is an ordinary guy with an ordinary job, but as he was growing up he noticed that he was different than his classmates.
"It was probably elementary school to middle school. I realized that I could touch my shoulders and nobody else could," he says.
After going to the doctor, he discovered that he had a condition known as cleidocranial dysostosis.
"It's a condition in where you can have defects in certain parts of the connective tissue in the body. In this circumstance, you're looking at bone, in where the clavicle may not form or may be shorter than it would be," explains Dr. Troy Skidmore of the Phoebe Orthopaedic Specialty Group said,
With no collarbone, Carter can squeeze into places that few other people can, like an 11 inch wide opening.
It's a genetic condition, so he's not the only one in his family who has it.
"My sister, my mom and my mom's granddad," Carter says.
Many genetic defects can have serious health consequences, but fortunately this one is not generally harmful.
"These people end up living normal lives, meaning in longevity," Dr. Skidmore says.
The other potential problem would be social.
It's great to be able to squeeze into your car when someone has parked close to you at the mall, but people with any condition that makes them different can be ostracized by their peers.
Not so for Carter's co-workers.
Their reaction has been overwhelmingly positive.
"They love it, they think it's really cool," he says.
If others with the condition suffer abuse from their peers, Carter has some advice.
"You've just got to roll with it and move on. Because at the end of the day you're really a little cooler than they are," Carter says.
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