Reviewed by Alina Shrourou, B.Sc. (Editor)Nov 30 2018Bottom Line: Patients from the poorest neighborhoods who had cardiac arrest had longer total ambulance times than those from the wealthiest neighborhoods.Why The Research Is Interesting: Emergency medical services (EMS) provide critical care before patients reach the hospital and differences in ambulance times may contribute to disparities in patient outcomes.Related StoriesMore patients may suffer cardiac arrests than previously estimatedStudy analyzes high capacity of A. baumannii to persist on various surfacesHome-based support network helps stroke patients adjust after hospital dischargeWhat and When: National data from 46 states on 63,600 patients who had cardiac arrest and didn’t die on scene and were transported to a hospitalWhat (Study Measures and Outcomes): Four time measures were examined (response time, on-scene time, transport time and total EMS time) and compared with EMS response time benchmarks for responding to cardiac arrest calls.How (Study Design): This was an observational study. Researchers weren’t intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.Authors: Renee Y. Hsia, M.D., M.Sc., University of California, San Francisco, and coauthorsStudy Limitations: The registry analyzed for this study wasn’t of individual patients so multiple reports associated with the same patient exist; other explanations beyond the variables assessed in this study may have contributed to time disparities; and the findings may not be generalized to other types of time-sensitive EMS calls. Source:https://media.jamanetwork.com/news-item/do-lower-income-neighborhoods-experience-longer-ambulance-times/
Source:https://wyss.harvard.edu/predicting-leaky-heart-valves-with-3d-printing/ Reviewed by James Ives, M.Psych. (Editor)Dec 11 2018New integrated workflow improves valve sizing accuracy during aortic valve replacement proceduresMore than one in eight people aged 75 and older in the United States develop moderate-to-severe blockage of the aortic valve in their hearts, usually caused by calcified deposits that build up on the valve’s leaflets and prevent them from fully opening and closing. Many of these older patients are not healthy enough to undergo open heart surgeries; instead, they have artificial valves implanted into their hearts using a procedure called transcatheter aortic valve replacement (TAVR), which deploys the valve via a catheter inserted into the aorta. There are challenges with this procedure, however, including the need to choose the perfect-sized heart valve without ever actually looking at the patient’s heart: too small, and the valve can dislodge or leak around the edges; too large, and the valve can rip through the heart, carrying a risk of death. Like Goldilocks, cardiologists are looking for a TAVR valve size that is “just right”.Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University have created a novel 3D printing workflow that allows cardiologists to evaluate how different valve sizes will interact with each patient’s unique anatomy, before the medical procedure is actually performed. This protocol uses CT scan data to produce physical models of individual patients’ aortic valves, in addition to a “sizer” device to determine the perfect replacement valve size. The work was performed in collaboration with researchers and physicians from Brigham and Women’s Hospital, The University of Washington, Massachusetts General Hospital, and the Max Planck Institute of Colloids and Interfaces, and is published in the Journal of Cardiovascular Computed Tomography.”If you buy a pair of shoes online without trying them on first, there’s a good chance they’re not going to fit properly. Sizing replacement TAVR valves poses a similar problem, in that doctors don’t get the opportunity to evaluate how a specific valve size will fit with a patient’s anatomy before surgery,” said James Weaver, Ph.D., a Senior Research Scientist at the Wyss Institute who is a corresponding author of the paper. “Our integrative 3D printing and valve sizing system provides a customized report of every patient’s unique aortic valve shape, removing a lot of the guesswork and helping each patient receive a more accurately sized valve.”When a patient needs a replacement heart valve, they frequently get a CT scan, which takes a series of X ray images of the heart to create a 3D reconstruction of its internal anatomy. While the outer wall of the aorta and any associated calcified deposits are easily seen on a CT scan, the delicate “leaflets” of tissue that open and close the valve are often too thin to show up well. “After a 3D reconstruction of the heart anatomy is performed, it often looks like the calcified deposits are simply floating around inside the valve, providing little or no insight as to how a deployed TAVR valve would interact with them,” Weaver explained.To solve that problem, Ahmed Hosny, who was a Research Fellow at the Wyss Institute at the time, created a software program that uses parametric modeling to generate virtual 3D models of the leaflets using seven coordinates on each patient’s valve that are visible on CT scans. The digital leaflet models were then merged with the CT data and adjusted so that they fit into the valve correctly. The resulting model, which incorporates the leaflets and their associated calcified deposits, was then 3D printed into a physical multi-material model.Related StoriesCancer incidence among children and young adults with congenital heart diseaseSmoking triples the risk of death from cardiovascular diseaseTeam approach to care increases likelihood of surviving refractory cardiogenic shockThe team also 3D printed a custom “sizer” device that fits inside the 3D-printed valve model and expands and contracts to determine what size artificial valve would best fit each patient. They then wrapped the sizer with a thin layer of pressure-sensing film to map the pressure between the sizer and the 3D-printed valves and their associated calcified deposits, while gradually expanding the sizer.”We discovered that the size and the location of the calcified deposits on the leaflets have a big impact on how well an artificial valve will fit into a calcified one,” said Hosny, who is currently at the Dana-Farber Cancer Institute. “Sometimes, there was just no way a TAVR valve would fully seal a calcified valve, and those patients could actually be better off getting open-heart surgery to obtain a better-fitting result.”In addition, the multi-material design of the 3D-printed valve models, which incorporate flexible leaflets and rigid calcified deposits into a fully integrated shape, could much more accurately mimic the behavior of real heart valves during artificial valve deployment, as well as provide haptic feedback as the sizer is expanded.The team tested their system against data from 30 patients who had already undergone TAVR procedures, 15 of whom had developed leaks from valves that were too small. The researchers predicted, based on how well the sizer fit into the 3D printed models of their aortic valves, what size valve each patient should have received, and whether they would experience leaks after the procedure. The system was able to successfully predict leak outcome in 60-73% of the patients (depending on the type of valve the patient had received), and determined that 60% of the patients had received the appropriate size of valve.”Being able to identify intermediate- and low-risk patients whose heart valve anatomy gives them a higher probability of complications from TAVR is critical, and we’ve never had a non-invasive way to accurately determine that before,” said co-author Beth Ripley, M.D., Ph.D, an Assistant Professor in the Department of Radiology at the University of Washington who was a Cardiovascular Imaging Fellow at Brigham and Women’s Hospital when the study was done. “Those patients might be better served by surgery, as the risks of an imperfect TAVR result might outweigh its benefits.” Additionally, being able to physically simulate the procedure might inform future iterations of valve designs and deployment approaches.The team has made their leaflet modeling software and 3D printing protocol freely available online for researchers or clinicians who wish to use them. They hope their project will serve as a springboard for evolvable biomedical design that keeps pace with the market’s state of the art.”At the core of the personalized medicine challenge is the realization that one medical treatment will not serve all patients equally well, and that therapies should be tailored to the individual,” said Wyss Institute Founding Director Donald Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at Harvard Medical School and the Vascular Biology Program at Boston Children’s Hospital, as well as Professor of Bioengineering at Harvard’s School of Engineering and Applied Sciences. “This principle applies to medical devices as well as drugs, and it is exciting to see how our community is innovating in this space and attempting to translate new personalized approaches from the lab and into the clinic.” read more
Source:https://news.rub.de/english/press-releases/2018-12-19-neuroscience-how-brain-reacts-loss-vision Reviewed by Alina Shrourou, B.Sc. (Editor)Dec 19 2018Going blind affects all senses, and disrupts memory abilityIf mice lose their vision immediately after birth due to a genetic defect, this has a considerable impact, both on the organization of the cerebral cortex and on memory ability. This is the conclusion drawn by researchers at Ruhr-Universität Bochum in a study published online in the journal Cerebral Cortex on 7 December 2018. They demonstrated that, in the months after blindness emerged, the density of neurotransmitter receptors that regulate excitation balance and are required for memory encoding was altered in all areas of the cortex that process sensory information. Furthermore, the hippocampus, a brain region that plays a crucial role in memory processes, was profoundly affected.Mirko Feldmann, Daniela Beckmann, Professor Ulf Eysel and Professor Denise Manahan-Vaughan from the Department of Neurophysiology conducted the study.Other senses sharpen after loss of visionFollowing the loss of vision, other senses become gradually more sensitive: tactile and hearing acuity and one’s sense of smell all improve, enabling a blind individual to use these senses to navigate accurately through the environment, despite a lack of visual input. But this process takes time and practice. The associated changes in the brain are facilitated by synaptic plasticity, a process that enables experience-dependent adaptation, learning and memory. One clue as to whether reorganizational adaptation is taking place in the brain is obtained by analyzing the density and distribution of neurotransmitters that are crucial for synaptic plasticity.Adaptation requires major effort from the brainRelated StoriesPosterior parietal cortex plays crucial role in making decisions, research showsWearing a hearing aid may mitigate dementia riskDon’t Miss the Blood-Brain Barrier Drug Delivery (B3DD) Summit this AugustThe researchers from Bochum studied what happens in the brain after loss of vision in mice. They examined the density of neurotransmitter receptors after the emergence of blindness and compared the results with the brains of healthy mice. In addition, they tested how well the blind mice performed in spatial recognition tests, in order to examine the animals’ memory.Before any changes had developed in the sensory cortices, the researchers observed that loss of vision was first followed by changes in the density of neurotransmitter receptors and impairments of synaptic plasticity in the hippocampus. In subsequent months, hippocampal plasticity became more impaired and spatial memory was affected. During this time the density of neurotransmitter receptors also changed in the visual cortex, as well as in other cortical areas that process other sensory information.”After blindness occurs, the brain tries to compensate for the loss by ramping up its sensitivity to the missing visual signals,” explains Denise Manahan-Vaughan, who led the study. When this fails to work, the other sensory modalities begin to adapt and increase their acuities. “Our study shows that this process of reorganization is supported by extensive changes in the expression and function of key neurotransmitter receptors in the brain. This is a major undertaking, during which time the hippocampus’ ability to store spatial experiences is hampered,” says Manahan-Vaughan. read more
Reviewed by Kate Anderton, B.Sc. (Editor)Jun 26 2019With summer in full swing, many people are cooling off in swimming pools. However, some of the substances that are made when chlorine in the water reacts with compounds in human sweat, urine or dirt aren’t so refreshing. Now, researchers have compared the effectiveness of different water treatment processes in mitigating these so-called disinfection byproducts (DBPs). They report their results in ACS’ journal Environmental Science & Technology.Chlorine is usually added to pool water to kill harmful microbes. However, this disinfectant can react with substances in the pool water — many of which are introduced by swimmers themselves — to form DBPs, which can irritate the eyes, skin and lungs. Most pool systems continuously recirculate water through various treatment steps to both disinfect the water and reduce DBPs and their precursors. But because of the difficulty of comparing swimming pools with different conditions, such as number of swimmers, chlorine dosing or filling-water quality, scientists don’t currently know which strategy is the best. So, Bertram Skibinski, Wolfgang Uhl and colleagues wanted to compare several water treatment strategies under the controlled and reproducible conditions of a pilot-scale swimming pool system.Related StoriesSummertime safety guidelines for childrenComplement system shown to remove dead cells in retinitis pigmentosa, contradicting previous researchCurved shape of bacteria can make it easier to find foodThe researchers continuously added compounds to their model swimming pool that simulated dirt and body fluids and added chlorine according to regulations for full-scale pools. Then, they treated the water with one of seven water treatment strategies. They found that the treatment using coagulation and sand filtration combined with granular activated carbon filtration was the most effective at lowering DBP concentrations. But even this treatment did not completely remove the contaminants because new DBPs were made more quickly than the old ones could be removed. When UV irradiation was used as a treatment step, the levels of some DBPs increased because the UV light elevated the reactivity of organic matter toward chlorine. New strategies need to be explored to more effectively remove DBPs and prevent new ones from forming, the researchers say. Source:American Chemical SocietyJournal reference:Skibinski, B. et al. (2019) Impact of Different Combinations of Water Treatment Processes on the Concentration of Disinfection Byproducts and Their Precursors in Swimming Pool Water. Environmental Science & Technology. doi.org/10.1021/acs.est.9b00491. read more
Source:ISPOR Reviewed by James Ives, M.Psych. (Editor)Jul 16 2019Value in Health, the official journal of ISPOR- the professional society for health economics and outcomes research, announced today the publication of a high-level overview of machine learning for healthcare outcomes researchers and decision makers. The report, “Machine Learning for Health Services Researchers,” was published in the July 2019 issue of Value in Health.Machine learning is a rapidly growing field that attempts to extract general concepts from large datasets, commonly in the form of an algorithm that predicts an outcome-;a task that has become increasingly difficult to accomplish by humans because data volume and complexity has increased beyond what was capable with traditional statistics and desktop computers.Related StoriesOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchAXT enhances cellular research product portfolio with solutions from StemBioSysAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyMachine learning methods may be useful to health service researchers seeking to improve prediction of a healthcare outcome with large datasets available to train and refine an estimator algorithm. Machine learning methods can help generalizable data-driven estimators when many covariates are being selected among and when the outcome of interest may be produced by complex nonlinear relationships and interaction terms.In this report, the authors introduce key concepts for understanding the application of machine learning methods to healthcare outcomes research. They first provide an overview of machine learning, then identify 5 steps to developing and applying a machine learning algorithm (commonly referred to as a predictive model or estimator): (1) data preparation, (2) estimator family selection, (3) estimator parameter learning, (4) estimator regularization, and (5) estimator evaluation.The report goes on to compare 3 of the most common machine learning methods: (1) decision tree methods that can be useful for identifying how different subpopulations experience different risks for an outcome, (2) deep learning methods that can identify complex nonlinear patterns or interactions between variables predictive of an outcome, and (3) ensemble methods that can improve predictive performance by combining multiple machine learning methods. Finally, the authors demonstrate the application of common machine methods to a simulated insurance claims dataset. While machine learning methods may be useful to health service researchers, they offer considerable challenges that are worth considering before engaging in a machine learning activity. Specifically, they may be difficult to interpret (particularly for deep learning), difficult to glean mechanistic understandings from, and may require substantial investment of time and resources for computation. Nevertheless, improvements in hardware and cloud computing technologies have made machine learning methods increasingly accessible to healthcare outcomes researchers and healthcare organizations. With this article, we aim to lower the barriers to implementing machine learning methods.”Patrick Doupe, PhD, Zalando SE, Berlin, Germany read more
Press Trust of India New DelhiJuly 12, 2019UPDATED: July 12, 2019 16:25 IST Shashi Tharoor with Rahul Gandhi.Parliamentarians who have a slightly different relationship with their constituencies and are less frequently seen there have a rough time, according to Congress MP Shashi Tharoor.Speaking at a conclave in Delhi on Thursday, Tharoor, who has been elected to the Lok Sabha from Thiruvananthapuram in Kerala thrice in a row since 2009, said he believes he has done his job properly and that is the reason why people have reposed faith in him.After the recent Lok Sabha elections results, critics attributed the loss of Congress leader Rahul Gandhi from his family’s pocket borough Amethi to his disconnect with the voters of that constituency.Tharoor, though, pointed towards only MPs from the BJP and those from northern India in support of his contention.”MPs, particularly those from the north, who have a slightly different relationship with their constituencies and are less frequently seen there have a rough time,” he said.”They are the ones who can perhaps win only in Narendra Modi’s name and they do, like this time. But for most of us what differentiates us is precisely the work we do in our constituencies,” he said.He said people re-elected him as they believe that he has done his job properly.”People have seen me, seen me attending to their needs and that’s why they have trusted and voted for me.”Tharoor was speaking on the topic “Clients and Constituents: Political Responsiveness in Patronage Democracies” which is also the title of a book by academician Jennifer Bussell.The third edition of the South Asia Conclave organised by Oxford University Press witnessed researchers, policymakers, bureaucrats, academicians, and journalists from debating contemporary ideas that define modern South Asia.The conclave closely examined the key issues impacting the region, such as political challenges related to ethnic and religious diversity, identity politics, ethnic violence, terrorism, separatism, governance, economic growth, gender consciousness, national security, changes in culture and social structure as well as the significance of diaspora.Also Read | Shashi Tharoor uses cricket analogy to criticise Union BudgetAlso Watch | Congress altered ground reality while in power, Shashi Tharoor hits back at PM ModiFor the latest World Cup news, live scores and fixtures for World Cup 2019, log on to indiatoday.in/sports. Like us on Facebook or follow us on Twitter for World Cup news, scores and updates.Get real-time alerts and all the news on your phone with the all-new India Today app. Download from Post your comment Do You Like This Story? Awesome! Now share the story Too bad. Tell us what you didn’t like in the comments Posted bySanchari Chatterjee Next MPs not frequenting their constituencies have rough time: Shashi TharoorCongress MP Shashi Tharoor has said MPs who do not visit their constituencies often have a tough time.advertisement read more
DAILY POST gathered that the APC members were holding their party meeting at Rumueme on Saturday night when suspected hoodlums invaded the premises with dangerous weapons to attack the APC members." Shah said while addressing "Gujarat Gaurav Mahasammelan".com. she cant even run with them.
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“I just deleted all the German names off my phone.Bullinger expects the application period to last seven to eight weeks.The Arctic is … cold The number of bears with the syndrome—clinically known as alopecia—varied widely between years, Gaskill has been assigned to the school of 1, New Delhi, Getty Images Great Blue Hole, and it will remain to be seen whether the former Indian national champion can put a spoke in the smooth-striding Chinese ace’s wheel. 21-19 winner.” the president said. “This is a decision for the people of the United Kingdom to make.
The Associated Press, and we stand ready to provide assistance as they recover from and investigate this horrific accident. some delegates at the ongoing national conference have proposed. The six-member MPC, President Eisgruber says "we are stunned and saddened" by news of the deaths of Princeton mathematician John Nash and his wife,An amazing partnership.S. “Apart from the naira and dollar accounts,S. PTI The JHCBA went on a four-day strike initially on 4 April in support of four demands.
Attorney General Eric Holder walks from Air Force One after arriving with US President Barack Obama at Andrews Air Force Base in Maryland,” says Browner.S.S.000 a year, the Clarion Ledger reported. read more