31 August, 2016

International trial evaluates focused ultrasound for essential tremor

A study published today in the prestigious New England Journal of Medicine offers the most in-depth assessment yet of the safety and effectiveness of a high-tech alternative to brain surgery to treat the uncontrollable shaking caused by the most common movement disorder. And the news is very good.

The paper outlines the results of an international clinical trial, led by Jeff Elias, MD, of the UVA Health System, that evaluated the scalpel-free approach called focused ultrasound for the treatment of essential tremor (ET), a condition that afflicts an estimated 10 million Americans. Not only did the researchers determine that the procedure was safe and effective, they found that it offered a lasting benefit, reducing shaking for trial participants throughout the 12-month study period.
“This study represents a major advance for neurosurgery, treatment of brain disease and specifically the treatment of ET,” Elias said. “For the first time in a randomized controlled trial, we have shown that ultrasound can be precisely delivered through the intact human skull to treat a difficult neurological disease.”
Pioneering tremor trial
The multi-site clinical trial included 76 participants with moderate to severe essential tremor, a condition that often robs people of their ability to write, feed themselves and carry out their normal daily activities. The trial participants all had tried existing medications, without success. The mean age was 71, and most had suffered with their tremor for many years.
Seventy-five percent of participants received the experimental treatment using focused ultrasound guided by magnetic resonance imaging. The remaining 25 percent underwent a sham procedure, to act as the control group. (They were later given the opportunity to undergo the real procedure.)
Participants who received the treatment showed dramatic improvement, with the beneficial effects continuing throughout the study period. The researchers employed a 32-point scale to assess tremor severity, and they found that mean tremor scores improved by 47 percent at three months and 40 percent at 12 months. Participants reported major improvements in their quality of life. People who couldn’t feed themselves soup or cereal could again do so.
Participants who received the sham procedure, on the other hand, showed no significant improvements.
“The degree of tremor control was very good overall in the study, but the most important aspects were the significant gains in disabilities and quality of life – that’s what patients really care about,” Elias said.
The most commonly reported side effects were gait disturbances and numbness in the hand or face; in most instances, these side effects were temporary but some were permanent.

Full story can be found from University of Virginia website.

18 August, 2016

No more dry mucous membranes when flying

Hovering at around 20 percent, the relative humidity in aircraft is kept very low to keep condensation from building up in the cabin. The downside for passengers and the crew is that this dries out the mucous membranes. Now a vortex ring generator will direct humidified air to passengers, increasing the humidity of the air they breathe without causing the overall relative humidity to skyrocket.



Your throat is dry, and taking a drink of water offers only brief respite: that is because the air humidity in aircraft is sometimes not even 20 percent. This has to do with the flight altitude and the low outside temperatures encountered at this height: not only does the air contain very little moisture, it also cools the aircraft fuselage. If the inside air were more humid, additional water would condense on the shell. All the same, the dry climate is unpleasant for passengers.

ReliantHeart’s aVAD Gets CE Mark

ReliantHeart’s next-generation aVAD left ventricular assist device has just earned CE Mark approval and implants are set to begin in September.



The LVAD market is going through an evolution right now as major commercial players Thoratec and HeartWare have both been acquired by large medtech companies. Thoratec was acquired by St. Jude Medical last year; St. Jude Medical has since been purchased by Abbott ($ABT). Medtronic ($MDT) announced its acquisition of HeartWare in June.

Sprinkling of neural dust opens door to electroceuticals

UC Berkeley engineers have built the first dust-sized, wireless sensors that can be implanted in the body, bringing closer the day when a Fitbit-like device could monitor internal nerves, muscles or organs in real time.



Because these batteryless sensors could also be used to stimulate nerves and muscles, the technology also opens the door to “electroceuticals” to treat disorders such as epilepsy or to stimulate the immune system or tamp down inflammation.

Edwards Transcatheter Heart Valve Receives Expanded Indication From FDA

Edwards Lifesciences announced U.S. Food and Drug Administration (FDA) approval to expand use of the Edwards SAPIEN 3 transcatheter heart valve for the treatment of patients suffering from severe, symptomatic aortic stenosis who have been determined by a Heart Team to be at intermediate risk for open-heart surgery. The SAPIEN 3 valve is the first transcatheter aortic valve replacement (TAVR) therapy to obtain this indication in the United States.

Zimmer Biomet Strengthens Musculoskeletal Diagnostic Offering with Acquisition of CD Diagnostics

Zimmer Biomet announced the acquisition of CD Diagnostics, a fully-integrated, Delaware-based diagnostics company focused on developing immunoassays and biomarker testing to inform treatment decisions that improve patient outcomes. The financial terms of the transaction were not disclosed.



Zimmer Biomet and CD Diagnostics initially partnered in 2012 to co-develop and market diagnostics in the field of musculoskeletal healthcare. As part of the original agreement, Zimmer Biomet successfully marketed the Synovasure® Periprosthetic Joint Infection (PJI) test, the first and only test specifically designed and validated for the diagnosis of PJI.

Recording analog memories in human cells

MIT biological engineers have devised a way to record complex histories in the DNA of human cells, allowing them to retrieve “memories” of past events, such as inflammation, by sequencing the DNA.



This analog memory storage system — the first that can record the duration and/or intensity of events in human cells — could also help scientists study how cells differentiate into various tissues during embryonic development, how cells experience environmental conditions, and how they undergo genetic changes that lead to disease.

Medtronic Completes $20 Million Second Tranche Investment In Mazor Robotics

Mazor Robotics Ltd. announced the completion of the second tranche of the equity investment by Medtronic pursuant to a previously executed agreement between the parties. The Company issued new securities representing 3.40% percent of Mazor’s issued and outstanding share capital, on a fully diluted basis, at a price per ADS $21.84, which is equal to the volume weighted average price of the ADS’s for the trailing 20-day period ending on and including August 9, 2016, for an aggregate purchase price of $20 million. The triggering milestone for this second tranche investment was the July 12, 2016 unveiling by the Company of Mazor X, a transformative Surgical Assurance Platform to enhance predictability of spine surgeries for the benefit of patients and those who treat them.

Aggressive cancer's aggressiveness may prove its Achilles' heel

Researchers at the School of Medicine have discovered a flaw in the armor of the most aggressive form of lung cancer, a weakness that doctors may be able to exploit to slow or even stop the disease. Remarkably, this vulnerability stems from the very aggressiveness that makes the cancer so deadly.

Using an existing drug, the scientists were able to halt the progression of small cell lung cancer tumors in genetically engineered mice. This was a notable achievement because small cell lung cancer (SCLC) is known for spreading quickly throughout the body. The finding raises the hope that the drug, which is being tested in people overseas for several types of cancers in clinical trials, might prove to be an effective way to control or prevent small cell tumor growth – possibly keeping the cancer as harmless tiny lesions.

Cook Medical Issues Global Recall of Hydrophilic Wire Guides

DSM Biomedical B.V., the Netherlands, Cook Medical’s supplier of hydrophilic coating for the Roadrunner® Uniglide® Hydrophilic Wire Guide, recalled certain lots of material due to concerns about a potential contamination by glass particles ranging in size of approximately 4 to 280 µm. Cook received one lot of the affected recalled coating. This prompted Cook Medical to initiate a recall of 8,750 units of the Roadrunner UniGlide Hydrophilic Wire Guides on June 24, 2016. Cook is taking this action as a precautionary measure, because it cannot exclude the possibility that glass particles passed through during processing and could be present in the coating of the recalled wire guide units.



Potential adverse events that may occur as a result of this contamination could include vessel damage, bleeding and embolic particulate in the circulatory system. Cook Medical has not received any reports of adverse events of these types to date.

16 August, 2016

Siemens and INSIGHTEC sign agreement to expand access to Exablate Neuro technology

INSIGHTEC announced the signing of a strategic agreement with the global leader in Magnetic Resonance Imaging, Siemens Healthineers. The strategic collaboration will involve the development of compatibility between Exablate Neuro and Siemens leading 1.5T and 3T clinical MRI systems, MAGNETOM Aera and Skyra. With this agreement, Siemens Healthineers follows its strategy of broadening and complementing its diagnostic imaging portfolio with advanced therapy solutions. Both parties will work towards providing access to Exablate Neuro for installed base, as well as new product installation customers.

Major study evaluates use of antibiotics against diarrhea

Scientists at the University of Washington and Kenya Medical Research Institute are working to discern whether antibiotics could help prevent thousands of child deaths from diarrheal disease.

A four-year, $2.5 million grant from the World Health Organization is supporting UW's role in the largest clinical trial to date examining diarrhea-management. It aims to determine potential benefits of antibiotics as well as potential harms, such as antibiotic resistance.

Diarrhea remains a leading cause of death in children, mostly affecting children under 2 years in sub-Saharan Africa and Asia. More than a half-million children under 5 died from diarrheal disease in 2013, according the UW Institute for Health Metrics and Evaluation.

“That children continue to die from diarrhea is unacceptable,” said Patty Pavlinac, UW acting assistant professor of global health and one of the lead researchers. Although interventions have greatly reduced diarrhea deaths attributed to dehydration, "young children with bacterial causes of diarrhea experience other severe consequences, including malnutrition, gastrointestinal dysfunction, and death, which are unaddressed with existing interventions," she said.

BD Cited As Infusion Pump EMR Integration Leader In KLAS Report

BD announced that its Alaris™ System infusion platform was cited as having the most customers live with bidirectional electronic medical record (EMR) integration, which health care providers said is the most important next step for improving safety to help reduce pump-programming errors in the Smart Pumps 2016: The Quest for Patient Safety report issued by KLAS.

The report from KLAS, an organization that independently monitors health care information technology performance through the active participation of thousands of health care organizations, also stated that BD has the "most comprehensive pump platform." The Alaris System from BD has the most customers live with EMR integration and is reported to be the only infusion platform to achieve EMR integration with syringe pumps.

"This recognition is important because it comes directly from the health care providers who use our products every day," said Mike Garrison, vice president and general manager of worldwide Infusion Solutions for BD. "We continue to invest in innovation to ensure our products are at the forefront of technology to help improve patient safety and care efficiency."

Mindfulness eases depressive symptoms, study shows



African-American women with lower socio-economic status have an increased risk of depressive disorders, yet they rarely seek out antidepressants or psychotherapy because of negative attitudes and stigma associated with conventional mental health treatments.

A new pilot Northwestern Medicine study showed that eight weeks of mindfulness training helped alleviate their depressive symptoms and reduce stress, providing an effective alternative to more conventional treatment.

15 August, 2016

FDA Clears SPR Therapeutics Pain Management Device

SPR Therapeutics received clearance from the United States Food and Drug Administration to commercialize the SPRINT™ Peripheral Nerve Stimulation (PNS) System. SPRINT is the first and only completely reversible and minimallyinvasive peripheral nerve stimulation system cleared to provide relief of chronic and acute pain, including postoperative and posttraumatic pain.




Simultaneous multiview capture and fusion improves spatial resolution in wide-field and light-sheet microscopy

Most fluorescence microscopes are inefficient, collecting only a small fraction of the emitted light at any instant. Besides wasting valuable signal, this inefficiency also reduces spatial resolution and causes imaging volumes to exhibit significant resolution anisotropy. We describe microscopic and computational techniques that address these problems by simultaneously capturing and subsequently fusing and deconvolving multiple specimen views. Unlike previous methods that serially capture multiple views, our approach improves spatial resolution without introducing any additional illumination dose or compromising temporal resolution relative to conventional imaging. When applying our methods to single-view wide-field or dual-view light-sheet microscopy, we achieve a twofold improvement in volumetric resolution (∼235  nm×235  nm×340  nm ) as demonstrated on a variety of samples including microtubules in Toxoplasma gondii, SpoVM in sporulating Bacillus subtilis, and multiple protein distributions and organelles in eukaryotic cells. In every case, spatial resolution is improved with no drawback by harnessing previously unused fluorescence.

Further information can be found from The Optical Society of America website.

FDA approves CyPass Micro-Stent

The CyPass® Micro-Stent is a minimally invasive device that can be implanted at the time of cataract surgery. About 20% of patients undergoing cataract surgery also have glaucoma, leading to a large number of patients who could conveniently receive combined therapy.

FDA has approved CyPass micro stent from Alcon Laboratories.


Microswimmer Robots Can Work Together And Apart

Drexel University researchers, led by MinJun Kim, PhD, a professor in the College of Engineering, have successfully pulled off a feat that both sci-fi fans and Michael Phelps could appreciate. Using a rotating magnetic field they show how multiple chains of microscopic magnetic bead-based robots can link up to reach impressive speeds swimming through a liquid. Their finding is the latest step toward using the so-called “microswimmers” to deliver medicine and perform surgery inside the body.



In a paper recently published in Nature Scientific Reports, the mechanical engineers describe their process for magnetically linking and unlinking the beads while they’re swimming, and individually controlling the smaller decoupled robots in a magnetic field. This data helps further the concept of using microrobots for targeted, intravenous drug delivery, surgery and cancer treatment.

New enzyme-mapping advance could help drug development

Scientists at MIT and the University of SĂ£o Paulo in Brazil have identified the structure of an enzyme that could be a good target for drugs combatting three diseases common in the developing world.



The enzyme, fumarate hydratase (FH) is essential for metabolic processes of parasites that are responsible for the spread of three diseases: Leishmaniases, Chagas disease, and sleeping sickness. As such, understanding the enzyme’s structure could help researchers figure out how to inhibit FH enzymes, thereby providing new medical therapies.

“This enzyme is really critical for the metabolism of organisms like Leishmania major,” says Catherine Drennan, an MIT professor whose lab hosted the research. “If you knock it out, the organism should be dead.”

Leishmaniases are a group of diseases varying from severe skin ulcers to debilitation of internal organs, and are present in Asia, Africa, the Americas, and Southern Europe. Chagas disease, located mostly in Latin America, causes cardiac and intestinal complications, and can lead to heart failure. Sleeping sickness affects humans and other animals and is an often-deadly disease concentrated in Africa.

The study of FH began at the University of SĂ£o Paulo, where researchers Patricia R. Feliciano and M. Cristina Nonato made important progress on studying Leishmania major FH. Feliciano then moved to MIT to complete the analysis of the enzyme structure with Drennan, a professor of chemistry and biology, and an investigator with the Howard Hughes Medical Institute.

“The exciting thing about this is thinking that my work could help people who have those diseases,” says Feliciano.

The paper, “Crystal structure of an Fe-S cluster-containing fumarate hydratase enzyme from Leishmania major reveals a unique protein fold,” is being published today in Proceedings of the National Academy of Sciences (PNAS). The authors are Feliciano, Drennan, and Nonato.

First in class

Fumarate hydratase enzymes fall into two types, class I and class II. The current study represents the first time that a class I fumarate hydratase enzyme has been mapped.

Significantly, the Leishmania major FH enzyme has a protein architecture — it vaguely resembles a human heart in appearance — that is distinctive from the structure of human fumurate hydratase.

“When we looked at the structure for the first time, it was like, ‘Whoa, it is completely different from the human FH enzyme,’” says Feliciano.

“The fact that it is a novel fold does add to the idea that this is a good drug target,” Drennan adds. “It has a lot of potential.”

Here’s why: The distinctive structure of class I FH makes it possible that drugs could target the parasite variant of the enzyme alone, while leaving intact the functionally equivalent enzymes that humans use.

“It’s an enzyme that does the exact same thing, but it’s a completely different enzyme,” Drennan explains. “That’s what makes this such an exciting target.”

Brazil connection

The finding stems from work Feliciano started doing nine years ago in Brazil in Nonato’s lab, but was not able to complete at the time, in part because of difficulties accessing the right equipment.

In 2012 Feliciano arrived at MIT, where the Drennan Lab has tools that let researchers form crystals of proteins under anaerobic (oxygen-free) conditions. Having formed a crystal of the Leishmania major FH enzyme, it still took Feliciano several months to completely map out the enzyme’s structure, partly because of its complexity, she notes.

Drennan emphasizes the complementary aspects of the research arrangement, with the research problem identified and important groundwork accomplished in Brazil, while MIT provided the right tools to solve the enzyme structure, and with the results hopefully having long-term application in Latin America and Africa.

“It’s a really lovely collaboration between the two groups and two countries,” Drennan says.

For that matter, Drennan says, the nature of globalization means diseases can spread worldwide in relatively short timespans these days. That means the need to find remedies for Leishmaniases, Chagas disease, and sleeping sickness is potentially global, too.

“I think it’s important to reflect on these health issues, and more people in the U.S. need to be aware of these diseases,” Drennan says. “The world is getting to be a smaller place.”

More information can be found from MIT website.

World's First Bluetooth Insulin Pen

Emperra GmbH is launching the world’s first Bluetooth® insulin pen on the market and therefore expanding its ESYSTA® product system’s function. The new ESYSTA® BT pen is equipped with a Bluetooth® interface and transfers the injected insulin doses directly to the patient’s digital blood glucose diary. The smart insulin pens automatically connected via the 868 MHz interface (similar to the ISM band) are already being successfully used in medicine in combination with a wireless transmission blood glucose meter as an integrated diabetes management system, ESYSTA®. Both the hardware components and software solutions (ESYSTA® portal, ESYSTA® app) have been certified as CE-compliant medical products. Patients and doctors can achieve a new quality of medical care for Type 1 and Type 2 diabetics using the patented ESYSTA® solution. On the basis of the available scientific data and reimbursement by statutory health insurance companies on the complex German healthcare market, Emperra is striving to use this smart insulin pen based ESYSTA® telemonitoring solution with an FDA filing process for the US market. FDA clearance is expected in 2016.



Product information is available from Emperra GmbH website.

11 August, 2016

New PET scan tracer allows first imaging of the epigenetics of the human brain

A novel PET radiotracer developed at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) is able for the first time to reveal epigenetic activity – the process that determines whether or not genes are expressed – within the human brain. In their report published in Science Translational Medicine, a team of MGH/Martinos Center investigators reports how their radiochemical – called Martinostat – shows the expression levels of important epigenetics-regulating enzymes in the brains of healthy volunteers.

“The ability to image the epigenetic machinery in the human brain can provide a way to begin understanding interactions between genes and the environment,” says Jacob Hooker, PhD, of the Martinos Center, senior author of the report. “This could allow us to investigate questions such as why some people genetically predisposed to a disease are protected from it? Why events during early life and adolescence have such a lasting impact on brain health? Is it possible to ‘reset’ gene expression in the human brain?”

A key epigenetic mechanism is the packaging of DNA into chromosomes, in which it wraps around proteins called histones forming a structure called chromatin. Modification of histones by the addition or removal of molecules called epigenetic factors can regulate whether or not an adjacent gene is expressed. One of the most important of these factors is the acetyl molecule, addition of which allows a gene to be transcribed and removal of which – called deacetylation – prevents transcription.



Enzymes called histone deacetylases (HDAC) are important regulators of gene transcription, and one group of HDACs has been linked to important brain disorders. Several established neuropsychiatric drugs are HDAC inhibitors, and others are currently being studied as potential treatment for Alzheimer’s disease and Huntington’s disease. Martinostat was developed in Hooker’s laboratory and is patterned after known HDAC inhibitors in order to tightly bind to HDAC molecules in the brain.

PET scans with Martinostat of the brains of eight healthy human volunteers revealed characteristic patterns of uptake – reflecting HDAC expression levels – that were consistent among all participants. HDAC expression was almost twice as high in gray matter as in white matter; and within gray matter structures, uptake was highest in the hippocampus and amygdala and lowest in the putamen and cerebellum. Experiments with brain tissues from humans and baboons confirmed Martinostat’s binding to HDAC, and studies with neural progenitor stem cells revealed specific genes regulated by this group of HDACs, many of which are known to be important in brain health and disease.

“HDAC dysregulation has been implicated in a growing number of brain diseases, so being able to study HDAC regulation both in the normal brain and through the progression of disease should help us better understand disease processes,” says Hooker, who is an associate professor of Radiology at Harvard Medical School. “We’ve now started studies of patients with several neurologic or psychiatric disorders, and I believe Martinostat will help us understand the different ways these conditions are manifested and provide new insights into potential therapies.”

More information can be found from Massachusetts General Hospital website.

10 August, 2016

Senseonics Reports Topline Accuracy Results from US Pivotal Study of Eversense CGM System

Senseonics Holdings announced topline results of the PRECISE II (A Prospective, Multicenter Evaluation of the Accuracy of a Novel Continuous Implanted Glucose Sensor) Clinical Investigation.

Results from the 90 adults with diabetes generated over 16,000 comparative glucose data points and demonstrated strong accuracy for the 90-day continuous wear period with a mean absolute relative difference (MARD) of 8.8% across the 40-400 mg/dL range when compared to YSI blood reference values.

According to the Principle Investigator, Dr. Mark Christiansen of Diablo Clinical Research, “The accuracy result is quite significant with the device. This was an important study and we are thankful to all the patients and clinics who participated. The early result shows that this system can be an important treatment option for our patients. Having a long lasting, 90-day CGM sensor that is safe and accurate will be a welcome addition to the diabetes community, as it will offer greater freedom of choice.”



The PRECISE II U.S. investigational device exemption trial enrolled 90 participants at eight clinical centers. The objective of the study was to determine the safety and effectiveness of the Eversense® CGM system over 90 days of continuous glucose sensor wear.

Participants in the study underwent unilateral (n=75) or bilateral sensor (n=15) insertions in the clinic and used the system’s smart transmitter and mobile app at home for the next 90 days. Sensor glucose readings were calculated prospectively. Calibration with a standard home blood glucose meter was performed twice a day but real-time glucose readings and trends were not made available to participants. Clinic visits were scheduled at approximately 30-day intervals in order to obtain lab reference glucose values for comparison with the sensor values and to evaluate hyperglycemic and hypoglycemic challenges in a controlled setting.

“The promising results and compelling accuracy data shown in the PRECISE II study represent a major milestone for the company,” said Tim Goodnow, PhD., CEO and President of Senseonics. “We are quite excited to complete the full analysis and report on other outcomes in the coming months. Pending FDA review and approval, we look forward to bringing this exciting technology to the U.S. market and to people with diabetes.”

Senseonics expects to submit its Pre-Marketing Approval (PMA) package to the U.S. Food and Drug Administration in the next few months. Subject to receiving FDA regulatory approval, Senseonics plans to initiate sales in the United States. The company currently markets the system under the brand name Eversense in select European countries.

Eversense CGM System is an Investigational Device and is limited by United States law to investigational use.

A press release can be found from Senseonics website.

Sunshine Heart Acquires Aquadex Product Line from Baxter

Sunshine Heart announced it has acquired the Aquadex product line from an indirect subsidiary of Baxter International Inc. The Aquadex system is indicated for temporary (up to eight hours) ultrafiltration treatment of patients with fluid overload who have failed diuretic therapy, and extended (longer than 8 hours) ultrafiltration treatment of patients with fluid overload who have failed diuretic therapy and require hospitalization.

“Aquadex is an important strategic investment, which allows Sunshine Heart to strengthen our presence in the heart failure market,” said John Erb, Sunshine’s Chairman and CEO. “We believe Aquadex is a valuable and highly complementary technology to our expanding heart failure product portfolio. There is a real need for fluid management in patients both before and following any kind of heart failure procedure. Aquadex is used to treat fluid overload in congestive heart failure patients and can help reduce the length of stay while in the hospital and the number of hospital visits in total.”

Under the terms of the agreement, Baxter received $4.0 million in cash and 1.0 million shares of Sunshine Heart common stock. “This is a financially attractive transaction as well,” said Mr. Erb. “We expect this product line to be accretive in the first year with a relatively quick payback period. We plan to strategically leverage our current team of clinical specialists to directly support the existing base of Aquadex customers.”

In connection with the acquisition of this product line, the Company repaid all amounts outstanding under its existing debt facility with Silicon Valley Bank and entered into a new $5.0 millionfacility to finance future working capital needs. Advances under the facility are subject to various conditions precedent, including compliance with financial covenants, which the Company does not currently meet. “This strategic acquisition will allow Sunshine Heart to further drive important advancements to heart failure treatment,” said Ben Johnson, Managing Director of Silicon Valley Bank. “We’re excited to provide the financing to support the company as it matures to the next phase of development.”

A press release can be found from Sunshine Heart website.

09 August, 2016

Medtronic Receives CE Mark for Deep Brain Stimulation Therapy

Medtronic announced it has received CE (Conformité Européenne) Mark for SureTune2(TM) software, which provides patient-specific visualization to help physicians make decisions on how to program - or tune - their patient's deep brain stimulation (DBS) therapy. SureTune2 is currently not approved in the United States.



DBS therapy applies mild electrical stimulation to precise targets in the brain in order to modulate specific symptom control. The brain targets are stimulated through lead(s) inserted into the brain and connected to an implantable neurostimulator through extensions running under the skin. A medical professional uses an external programmer to set and adjust stimulation settings.

Today DBS patient programming can be an interactive process, which can be time- consuming for the hospital and the patient. SureTune2 is designed for Medtronic DBS therapy and other DBS therapy delivery systems to help physicians more efficiently select the optimal stimulation settings on their programmer by visualizing patient-specific information in one comprehensive view including anatomy, physiology, and calculated stimulation field. Users can segment structures using a greyscale threshold within a region of interest, or by outlining shapes of interest from a patient image.

"SureTune will have an important impact on the care of patients with deep brain stimulation because it allows me for the first time to visualize activation patterns of DBS within the individual segmented patient anatomy," said Professor Jens Volkmann, MD, PhD, FEAN, chairman and professor of neurology in the University Clinic of WĂ¼rzburg. "It simplifies the trial and error process associated with DBS programming by helping me identify the best contacts, which saves me time."

"Medtronic is committed to providing advanced technology to the multidisciplinary teams who are helping DBS patients, and I'm convinced that SureTune will provide them with easy-to-use tools to aid in optimizing therapy outcomes," said Lothar Krinke, PhD, vice president and general manager of the Brain Modulation business in Medtronic's Restorative Therapies Group. "SureTune is a key aspect of Medtronic's commitment to providing integrated solutions for improving accuracy and confidence from surgery to post-operative DBS patient management."

Medtronic helped pioneer DBS, and more than 140,000 patients worldwide have received Medtronic DBS Therapy, which is approved in many locations around the world, including Europe and the United States, for the treatment of the disabling symptoms of essential tremor, Parkinson's disease and dystonia, the latter for which approval in the United States is under a Humanitarian Device Exemption (HDE). In Europe, Canada and Australia, Medtronic DBS therapy is approved for the treatment of refractory epilepsy. Medtronic DBS therapy is also approved for the treatment of severe, treatment-resistant obsessive-compulsive disorder in Europe and Australia, and in the United States under an HDE.

A press release can be found from Medtroic website.

Novel Technology May Prevent Burn Scars

A group of researchers from Tel Aviv University and Harvard University has devised a new non-invasive method to prevent burn scarring caused by the proliferation of collagen cells. They are using short, pulsed electric fields prevent the formation of burn-related hypertrophic scars — raised tissue caused by excessive amounts of collagen.



Research for the study was led by Dr. Alexander Golberg of TAU's Porter School of Environmental Studies, together with Dr. Martin Yarmush of the Center for Engineering in Medicine at Massachusetts General Hospital, Harvard Medical School and Shriners Burns Hospital in Boston. It was recently published in the Journal of Investigative Dermatology.

Ten percent of all unintentional-injury deaths are the result of fire-related burns, according to the World Health Organization. But even for those who survive the destruction of skin and tissue cells, the road to recovery is never ending. Post-burn scarring creates lifelong physical, psychological and social challenges.

Relieving lifelong suffering

"People don't die from scars, but they do suffer from them," said Dr. Golberg. "We believe that the technology we developed, called partial irreversible electroporation (pIRE), can be used to prevent debilitating burn scars from forming."

The non-invasive pIRE technique harnesses microsecond-pulsed, high-voltage, non-thermal electric fields to control the body's natural response to trauma — the proliferation of collagen cells that cause permanent scarring at the site of injury. The technique partially destroys cells in the wound with short, pulsed electric fields that cause irreversible damage to the collagen cells. But the researchers had to find a delicate balance so that the technique didn't create a new wound or "overheal" the existing wound, because scarring is the body's natural way of healing.

The researchers treated burn injuries in rats in five therapy sessions over six months, then assessed them using an imaging technique developed by Drs. Martin Villiger and Brett Bouma's group at the Wellman Center of Photomedicine at Massachusetts General. The researchers found a 57.9% reduction of the scar area in comparison with untreated scars.

Next step: Human clinical studies

"Surgical excision, laser therapy, electron-beam irradiation, mechanical compression dressing, silicone sheet application and other techniques have been tested to treat scars over the years," said Dr. Golberg, "but there have been only modest improvements in the healing outcomes among all these treatments.

"Scarring is a very complex process, involving inflammation and metabolism," said Dr. Golberg. "We have found a way to partially prevent scar formation in animal models. Next we need to raise funding to develop a device for the clinical study on humans."

More information can be found from Tel Aviv University website.

Researchers turn to policy to tackle health disparities in an age of personalized medicine

A new paper from researchers from Tufts University and colleagues addresses how increased support for minority-focused research, community-based participatory research, and studies of gene-environment interactions may improve science’s understanding of chronic diseases across races and ethnicities. The paper, published in the August issue of Health Affairs, outlines policy efforts needed to ensure the advancement of genetic applications in healthcare in ways that reduce existing disparities.



Focusing on breast cancer and chronic kidney disease, the authors show that while genetic and molecular knowledge has grown and been used to fight these diseases in the last decade, significant racial and ethnic health disparities persist and hinder universal progress. The policy recommendations they propose are:

*Increasing the enrollment of non-white participants in research on complex diseases.

*Community-based participatory research to promote genetic literacy and encourage more volunteers to become involved in research.

*Funding research on the interactions of genes and the environment.

*Educating healthcare providers as well as patients about the risks, benefits and limitations of genetic research.

“We need to collect more data from groups for whom we currently have insufficient information so that we can improve care for all individuals. If we don’t expand our efforts, the quality and effectiveness of genetic research and services will be limited in ways that can perpetuate health disparities. The Precision Medicine Initiative for one will be a big step forward in this endeavor and is to be commended for including community-based health provider organizations in its network to attract volunteers. Increasing diversity in research and testing will help maximize the possibilities of precision medicine,” said senior author JosĂ© M. OrdovĂ¡s, Ph.D., director of the Nutrition and Genomics Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

The authors identify three key areas where their recommendations would make improvements: incomplete genetic databases, inadequate treatment options, and insufficiently understood disease mechanisms.

People with non-European ancestries are underrepresented in genetic databases, limiting the ability to apply genetic knowledge to reduce disease in these groups. While researchers know that hereditary breast cancer is linked to mutations in the BRCA1 or BRCA2 genes, the “normal” genetic sequence for these genes was determined based on women of European and Ashkenazi Jewish descent. Studies show that African-American and Hispanic women are much less likely than white women to receive genetic counseling or testing for hereditary breast cancer; the absence of this data perpetuates an incomplete genetic database on which clinical decisions about treating breast cancer rely.

For many diseases, clinical advances in treatment have developed based on new knowledge of genetic markers. Studies show that non-Hispanic black women tend to be diagnosed with more advanced sporadic breast cancer (occurring without family history) compared to white women. Many potential genetic markers might explain the racial and ethnic disparity in tumor aggressiveness in sporadic cancer. However, the small number of tumor samples from non-European women offers inadequate details about patient and tumor characteristics and restricts the use of genetic knowledge in clinical treatments for all individuals.

Similarly, treatments tailored to individuals with high-risk genotypes for certain diseases have not yet been identified because the molecular mechanisms behind the diseases are unknown as well. Researchers know that African-Americans are disproportionately affected by variants in the APOL1 gene which can increase a person’s risk of kidney disease by up to seven times. Due to insufficient understanding of the molecular mechanisms by which the gene increases disease risk, effective treatments elude clinicians.

“Ultimately, we want the knowledge gained from a reduction in health disparities to lead to an increase in treatments for people who are most at risk. If we understand the aggressive breast cancer subtype that more frequently affects black women, we might be able to expand treatment options. We want to look at environmental factors as well as tumor biology to know how they contribute to the disease, and how we might then attack it,” said first author Caren E. Smith, D.V.M., a scientist in the Nutrition and Genomics Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

More information can be found from Tufts University website.

07 August, 2016

Age-Related Infertility May Be Caused By Scarred Ovaries

Women’s decreased ability to produce healthy eggs as they become older may be due to excessive scarring and inflammation in their ovaries, reports a new Northwestern Medicine study in mice.

This is the first study to show the ovarian environment ages and that aging affects the quality of eggs it produces. These findings could result in new treatments that preserve fertility by delaying ovarian aging.

Most reproductive research focuses on women’s eggs and trying to understand why their number and quality deteriorate as a woman enters her forties. Deteriorating eggs contribute to infertility, miscarriages and birth defects.



But in this study scientists examined the reproductive age-related changes that occur in the environment in which the eggs develop, known as the ovarian stroma. The environment in which cells grow and develop can greatly influence their quality and function, but surprisingly little is known about how the ovarian stroma changes with age.

“Under the microscope, eggs from reproductively young and old animals may look identical, but the environment in which they are growing is completely different,” said lead study author Francesca Duncan, executive director of the Center for Reproductive Science at Northwestern University Feinberg School of Medicine. “Ovaries from reproductively old mice are fibrotic and inflamed. There is no way this environment won’t impact the eggs growing in it, and it very likely contributes to their decrease in quality.”

The study was published August 5 in the journal Reproduction. Duncan led the study when she was at the University of Kansas Medical Center.

In this study, researchers analyzed ovarian tissue from populations of reproductively “young” (equivalent to women in their early twenties) and “old” mice (equivalent to women ages 38-45). They consistently identified fibrosis in the reproductively “old” mice. This age period is associated with a decline in reproductive function and egg quality in both humans and mice. In some reproductively “old” mice, up to 35 percent of the ovarian tissue was fibrotic.

Researchers also found a type of immune cell (multinucleated macrophage giant cells) in the ovaries of reproductively “old” mice only. When found in other tissues, these cells are associated with chronic inflammation. They also found ovaries from mice of advanced reproductive age expressed genes and produced proteins that are highly inflammatory.

“Our work establishes fibrosis and inflammation as hallmarks of the aging ovary and lays the foundation for considering the use of anti-fibrotic or anti-inflammatory treatments to delay or counteract the impact of reproductive aging,” said Duncan, also an associate research professor in obstetrics and gynecology at Feinberg.

“People tend to overlook that the egg is growing in a complex environment, and no one has taken a deep look at what is happening to that environment with age,” Duncan added. “It’s an underappreciated area.”

The findings have broader implications for women’s health because ovarian fibrosis is a key feature of polycystic ovary syndrome, a common endocrine system disorder among women of reproductive age, and is also a consequence of chemotherapy and radiation, Duncan said.

Duncan’s research team is currently investigating how to therapeutically target the ovarian environment to improve reproductive function.

Detailed information can be found from Northwestern University website.

05 August, 2016

Check-Cap Announces Agreement with GE Healthcare for X-Ray Capsule Manufacturing Collaboration

Check-Cap Ltd. announced it has entered into an agreement with GE Healthcare to develop and validate high-volume manufacturing for X-ray source production and assembly into Check-Cap's capsule. Upon successful completion, the parties may discuss collaboration on execution of a high-volume manufacturing facility and distribution of the Check-Cap system.

"We are very excited to commence this strategic relationship with GE Healthcare as we continue our efforts to optimize the supply chain for the Check-Cap system," said Bill Densel, CEO of Check-Cap. "GE Healthcare is a global leader in the development, manufacturing, and distribution of diagnostic imaging agents and radio-pharmaceutical drugs and devices. We believe that leveraging their experience and expertise provides us with a significant opportunity to meet our goal of increasing the time and cost efficiencies of production of our capsule for use in future clinical trials and commercialization."

Colorectal cancer is the second leading cause of cancer death in the U.S., with an estimated 134,000 diagnoses and 49,000 deaths in 2016. Despite compelling evidence that screening can detect colorectal cancer and precancerous polyps, nearly one-third of the recommended adult population has never been screened. The Check-Cap system was designed to improve the patient experience by eliminating the features of existing screening methods, such as bowel preparation, invasive procedure, and stool handling, that pose a barrier to test completion.

Check-Cap is currently conducting a multi-center clinical feasibility study and expects to file a CE Mark submission for the Check-Cap system in the first half of 2017.

A press release can be found from Check-Cap website.

Bioengineers grow living bone for facial reconstruction

Researchers have engineered living bone tissue to repair bone loss in the jaw, a structure that is typically difficult to restore. The team led by researchers from Columbia University, New York, grafted customized implants into pig jaws that resulted in integration and function of the engineered graft into the recipient’s own tissue.

The work, supported in part by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), and reported in the June 15, 2016 issue of Science Translational Medicine, suggests that personalized bone grafts for facial reconstruction may be possible in the future.
Birth defects and injuries can cause bone deformities in the head and face that are difficult to repair. Replacement bones must be perfectly sculpted to satisfactorily match the features of the person’s face. Bones of the jaw, in particular, must also be able to withstand a lot of force in order to chew.

Some current treatments replace missing bone with metal, bone putty derived from deceased donors, or grafted bone from elsewhere within a person’s own body. While using the patient’s own tissue is the safest strategy, sacrificing bone from elsewhere causes a secondary injury. It also can be difficult to obtain a piece large enough to carve into an exact match. Bone putty can be very useful to fill a gap, but is not structurally stable without reinforcements that doctors must remove in subsequent surgeries. Researchers have also experimented with implanting synthetic scaffolds that can enhance new bone growth, but these have not always been successful. To date, none of these options is as useful as doctors would like.

Researchers chose pigs to test the new bone reconstruction technique because their jaw anatomy and type of force and movement are similar to that of people—the ultimate beneficiaries of the potential treatment. They replaced a piece of the pigs’ jawbone with cow bone matrix—the material left after removing its resident cells. This matrix served as a scaffold for the graft. Guided by precise imaging technology, the researchers individually shaped each cow bone scaffold to fit perfectly into the missing jaw-bone region.
Next, the researchers seeded the scaffold with the pig’s own stem cells harvested from the animals’ fat, and placed the engineered tissue inside a bioreactor to grow for three weeks. They then implanted the engineered bone grafts into the pigs and monitored the growth for the next six months. Over that time, the transplanted bone seamlessly integrated into the pigs’ jaws. The grafts prompted new bone growth and strengthened the bone enough to tolerate forces needed for the pigs to chew.

The researchers found that the engineered implants remodeled like natural bone. The team found that the pig’s body reacted to the implant just like its own bone, breaking it down and rebuilding it as needed.

“This was an unexpected and also very exciting finding because it tells us that these bones will really become an integral part of the body and continue to change in the body as we change,” said Gordana Vunjak-Novakovic, Ph.D., a professor of biomedical engineering and medical sciences at Columbia University and senior author of the paper. “It’s important that the implant is responding to these changes, and acting as an integral part of the native bone of the recipient.”

Six pigs received engineered implants, while six others received the cow bone without any stem cells. Two jaw-bone deficient pigs received no implant at all. At the six-month point, all the animals had some regrowth of the missing jaw. The researchers used quantitative image analysis to determine that those pigs with the engineered implant grew the most bone. In addition, their jaws could withstand the physical forces sustained during the animals’ activities.

Although the study was in pigs, the team performed procedures just as they would be done in humans, and are hopeful that the technique will translate to the clinic. “It’s never possible to say exactly, but we are aiming to get into clinical trials within the next few years,” said Vunjak-Novakovic. “Hopefully things continue to go well.”

“This is a promising step towards creating better implants for humans,” said Rosemarie Hunziker, Ph.D., director of the NIBIB program in Tissue Engineering. “The general size and mechanics of a pig’s jaw is a reasonable test of whether such a bone graft would integrate and do the work that would be required of a jaw bone graft in our human craniofacial system.”

Several key features enhanced the clinical prospects of this research, according to Hunziker. First, the team isolated the stem cells from fat, which can be harvested with less discomfort than from bone marrow, and yields ample cells due to abundant fat supply. They also avoided using growth factors—proteins that may improve bone quality but sometimes lead to excess bone growth, and would greatly increase the cost of the procedure. She attributed the researchers’ success to their understanding and integration of key factors: a well-prepared scaffold, the right cells, optimal growth conditions, and exact timing.

04 August, 2016

Malaria, cancer drug prospects emerge from open-source test

In what is being called the first-ever test of open-source drug-discovery, researchers from around the world have successfully identified compounds to pursue in treating and preventing parasite-borne illnesses such as malaria as well as cancer.

Starting in late 2011, the Medicines for Malaria Venture, based in Geneva, Switzerland, distributed 400 diverse compounds with antimalarial activity free of charge to 200 labs in 30 countries. One-third of the labs reported their results in a paper published today in PLOS Pathogens, “Open source drug discovery with the Malaria Box compound collection for neglected diseases and beyond.”

The results have ignited more a dozen drug-development projects for a variety of diseases.



“The trial was successful not only in identifying compounds to pursue for anti-malarials, but it also identified compounds to treat other parasites and cancer,“ said lead author Wesley Van Voorhis. To help lead the project, Van Voorhis took a sabbatical from his roles as a University of Washington professor of medicine (allergy and infectious diseases) and director of the Center for Emerging and Re-emerging Infectious Diseases.

The National Cancer Institute is now working on a colon cancer drug that emerged from the testing, Van Voorhis said. Several European labs are working on anti-worm compounds, and numerous U.S. labs are investigating drugs to combat other parasites. Medicines for Malaria Venture is also working with pharmaceutical companies GSK and Novartis on related anti-malarials, he added.

In their paper, researchers cited the lack of interaction between academia and industry as a major curb to innovation in drug discovery.

“Much of the global resource in biology is present in universities, whereas the focus of medicinal chemistry is still largely within industry. Open-source drug discovery, with sharing of information, is clearly a first step towards overcoming that gap,” they wrote.

The Malaria Box distributed 400 diverse druglike molecules that were most often found in industry collections, helping to bridge the gap between industry and academia.

This open-access effort was so successful that Medicines for Malaria Venture has begun to distribute another set of compounds with broader potential applicability, called the Pathogen Box. The box is available now to scientific labs globally.

Further information can be found from University of Washington website.

Researchers Improve Computer Modeling for Designing Drug-delivery Nanocarriers

A team of University of Pennsylvania researchers has developed a computer model that will aid in the design of nanocarriers, microscopic structures used to guide drugs to their targets in the body. The model better accounts for how the surfaces of different types of cells undulate due to thermal fluctuations, informing features of the nanocarriers that will help them stick to cells long enough to deliver their payloads.

The study was led by Ravi Radhakrishnan, a professor in the departments of bioengineering and chemical and biomolecular engineering in Penn’s School of Engineering and Applied Science, and Ramakrishnan Natesan, a member of his lab.



Also contributing to the study were Richard Tourdot, a Radhakrishnan lab member; David Eckmann, the Horatio C. Wood Professor of Anesthesiology and Critical Care in Penn’s Perelman School of Medicine; Portonovo Ayyaswamy, the Asa Whitney Professor of Mechanical Engineering and Applied Mechanics in Penn Engineering; and Vladimir Muzykantov, a professor of pharmacology in Penn Medicine.

It was published in the journal Royal Society Open Science.

Nanocarriers can be designed with molecules on their exteriors that only bind to biomarkers found on a certain type of cell. This type of targeting could reduce side effects, such as when chemotherapy drugs destroy healthy cells instead of cancerous ones, but the biomechanics of this binding process are complex.

Previous work by some of the researchers uncovered a counter-intuitive relationship that suggested that adding more targeting molecules on the nanocarrier’s surface is not always better.

A nanocarrier with more of those targeting molecules might find and bind to many of the corresponding biomarkers at once. While such a configuration is stable, it can decrease the nanocarrier’s ability to distinguish between healthy and diseased tissues. Having fewer targeting molecules makes the nanocarrier more selective, as it will have a harder time binding to healthy tissue where the corresponding biomarkers are not over-expressed.

The team’s new study adds new dimensions to the model of the interplay between the cellular surface and the nanocarrier.

“The cell surface itself is like a caravan tent on a windy day on a desert,” Radhakrishnan said. “The more excess in the cloth, the more the flutter of the tent. Similarly, the more excess cell membrane area on the ‘tent poles,’ the cytoskeleton of the cell, the more the flutter of the membrane due to thermal motion.”

The Penn team found that different cell types have differing amounts of this excess membrane area and that this mechanical parameter governs how well nanocarriers can bind to the cell. Accounting for the fluttering of the membrane in their computer models, in addition to the quantity of targeting molecules on the nanocarrier and biomarkers on the cell surface, has highlighted the importance of these mechanical aspects in how efficiently nanocarriers can deliver their payloads.

“These design criteria,” Radhakrishnan said, “can be utilized in custom designing nanocarriers for a given patient or patient-cohort, hence showing an important way forward for custom nanocarrier design in the era of personalized medicine.”

Details can be found from University of Pennsylvania website.

Good Attitudes About Aging Help Seniors Handle Stress

New research from North Carolina State University finds that having a positive attitude about aging makes older adults more resilient when faced with stressful situations.

“There has been a lot of research on how older adults respond to stress, but the findings have been mixed: some studies have found that older adults are less resilient than younger adults at responding to stress; some have found that they’re more resilient; and some have found no difference,” says Jennifer Bellingtier, a Ph.D. student at NC State and lead author of a paper describing the work. “We wanted to see whether attitudes toward aging could account for this disparity in research findings. In other words, are older adults with positive attitudes about aging more resilient than older adults with negative attitudes?”

The answer is yes.

For the study, researchers had 43 adults between the ages of 60 and 96 fill out a daily questionnaire for eight consecutive days. At the beginning of the study, participants were asked about their attitudes toward aging. For example, participants were asked if they felt they were as useful now as they had been when they were younger, and whether they were as happy as when they were younger.

The daily questionnaire asked participants about any stress they’d experienced that day, as well as the extent to which they experienced negative emotions, such as fear, irritability or distress.

The researchers also accounted for the personality of study participants. Were they optimistic and upbeat about everything, or are there benefits tied specifically to an individual’s attitudes about aging?

“We found that people in the study who had more positive attitudes toward aging were more resilient in response to stress – meaning that there wasn’t a significant increase in negative emotions,” Bellingtier says. “Meanwhile, study participants with more negative attitudes toward aging showed a sharp increase in negative emotional affect on stressful days.”

“This tells us that the way we think about aging has very real consequences for how we respond to difficult situations when we’re older,” says Shevaun Neupert, an associate professor of psychology at NC State and senior author on the paper. “That affects our quality of life and may also have health ramifications. For example, more adverse emotional responses to stress have been associated with increased cardiovascular health risks.”

“Our findings are likely applicable to other Americans, but it’s not clear to what extent the findings would be relevant elsewhere,” Bellingtier says. “Attitudes toward aging vary widely across cultures, and more work would need to be done to determine the importance of aging attitudes in other settings.”

The paper, “Negative aging attitudes predict greater reactivity to daily stressors in older adults,” will be published online at 8 a.m. on Aug. 3 in the Journal of Gerontology: Psychological Sciences. The work was done with funding from NC State.

Full story can be found from NCSU website.

Portable device produces biopharmaceuticals on demand

For medics on the battlefield and doctors in remote or developing parts of the world, getting rapid access to the drugs needed to treat patients can be challenging.

Biopharmaceutical drugs, which are used in a wide range of therapies including vaccines and treatments for diabetes and cancer, are typically produced in large, centralized fermentation plants. This means they must be transported to the treatment site, which can be expensive, time-consuming, and challenging to execute in areas with poor supply chains.

Now a portable production system, designed to manufacture a range of biopharmaceuticals on demand, has been developed by researchers at MIT, with funding from the Defense Advanced Research Projects Agency (DARPA).



In a paper published today in the journal Nature Communications, the researchers demonstrate that the system can be used to produce a single dose of treatment from a compact device containing a small droplet of cells in a liquid.

In this way, the system could ultimately be carried onto the battlefield and used to produce treatments at the point of care. It could also be used to manufacture a vaccine to prevent a disease outbreak in a remote village, according to senior author Tim Lu, an associate professor of biological engineering and electrical engineering and computer science, and head of the Synthetic Biology Group at MIT’s Research Laboratory of Electronics.

“Imagine you were on Mars or in a remote desert, without access to a full formulary, you could program the yeast to produce drugs on demand locally,” Lu says.

The system is based on a programmable strain of yeast, Pichia pastoris, which can be induced to express one of two therapeutic proteins when exposed to a particular chemical trigger. The researchers chose P. pastoris because it can grow to very high densities on simple and inexpensive carbon sources, and is able to express large amounts of protein.

“We altered the yeast so it could be more easily genetically modified, and could include more than one therapeutic in its repertoire,” Lu says.

When the researchers exposed the modified yeast to estrogen β-estradiol, the cells expressed recombinant human growth hormone (rHGH). In contrast, when they exposed the cells to methanol, the yeast expressed the protein interferon.

The cells are held within a millimeter-scale table-top microbioreactor, containing a microfluidic chip, which was originally developed by Rajeev Ram, a professor of electrical engineering at MIT, and his team, and then commercialized by Kevin Lee — an MIT graduate and co-author — through a spin-off company.

A liquid containing the desired chemical trigger is first fed into the reactor, to mix with the cells.

Inside the reactor, the cell-and-chemical mixture is surrounded on three sides by polycarbonate; on the fourth side is a flexible and gas-permeable silicone rubber membrane.

By pressurizing the gas above this membrane, the researchers are able to gently massage the liquid droplet to ensure its contents are fully mixed together.

“This makes sure that the one milliliter (of liquid) is homogenous, and that is important because diffusion at these small scales, where there is no turbulence, takes a surprisingly long time,” says Ram, who was also a senior author of the paper.

Because the membrane is gas permeable, it allows oxygen to flow through to the cells, while any carbon dioxide they produce can be easily extracted.

The device continuously monitors conditions within the microfluidic chip, including oxygen levels, temperature, and pH, to ensure the optimum environment for cell growth. It also monitors cell density.

If the yeast is required to produce a different protein, the liquid is simply flushed through a filter, leaving the cells behind. Fresh liquid containing a new chemical trigger can then be added, to stimulate production of the next protein.

Although other research teams have previously attempted to build microbioreactors, these have not have not had the ability to retain the protein-producing cells while flushing out the liquid they are mixed with, Ram says. “You want to keep the cells because they are your factory,” he says. “But you also want to rapidly change their chemical environment, in order to change the trigger for protein production.”

The researchers have demonstrated a very logical and practical way to produce biologic drugs, according to Luke P. Lee, a professor of bioengineering at the University of California at Berkeley, who was not involved in the research. Their smart biologics production technique uses one of the best integrated microfluidics systems, Lee says.

“It is a pragmatic solution for biomanufacturing, and the team's flexible and portable platform shows an authentic way of producing personalized therapeutics,” he says.

The researchers are now investigating the use of the system in combinatorial treatments, in which multiple therapeutics, such as antibodies, are used together.

Combining multiple therapeutics in this way can be expensive if each requires its own production line, Lu says.

“But if you could engineer a single strain, or maybe even a consortia of strains that grow together, to manufacture combinations of biologics or antibodies, that could be a very powerful way of producing these drugs at a reasonable cost,” he says.

More information can be found from MIT website.

03 August, 2016

Flexible wearable electronic skin patch offers new way to monitor alcohol levels

Engineers at the University of California San Diego have developed a flexible wearable sensor that can accurately measure a person’s blood alcohol level from sweat and transmit the data wirelessly to a laptop, smartphone or other mobile device. The device can be worn on the skin and could be used by doctors and police officers for continuous, non-invasive and real-time monitoring of blood alcohol content.

The device consists of a temporary tattoo—which sticks to the skin, induces sweat and electrochemically detects the alcohol level—and a portable flexible electronic circuit board, which is connected to the tattoo by a magnet and can communicate the information to a mobile device via Bluetooth. The work, led by nanoengineering professor Joseph Wang and electrical engineering professor Patrick Mercier, both at UC San Diego, was published recently in the journal ACS Sensors.



“Lots of accidents on the road are caused by drunk driving. This technology provides an accurate, convenient and quick way to monitor alcohol consumption to help prevent people from driving while intoxicated,” Wang said. The device could be integrated with a car’s alcohol ignition interlocks, or friends could use it to check up on each other before handing over the car keys, he added.

“When you’re out at a party or at a bar, this sensor could send alerts to your phone to let you know how much you’ve been drinking,” said Jayoung Kim, a materials science and engineering PhD student in Wang’s group and one of the paper’s co-first authors.

Blood alcohol concentration is the most accurate indicator of a person’s alcohol level, but measuring it requires pricking a finger. Breathalyzers, which are the most commonly used devices to indirectly estimate blood alcohol concentration, are non-invasive, but they can give false readouts. For example, the alcohol level detected in a person’s breath right after taking a drink would typically appear higher than that person’s actual blood alcohol concentration. A person could also fool a breathalyzer into detecting a lower alcohol level by using mouthwash.

Recent research has shown that blood alcohol concentration can also be estimated by measuring alcohol levels in what’s called insensible sweat—perspiration that happens before it’s perceived as moisture on the skin. But this measurement can be up to two hours behind the actual blood alcohol reading. On the other hand, the alcohol level in sensible sweat—the sweat that’s typically seen—is a better real-time indicator of the blood alcohol concentration, but so far the systems that can measure this are neither portable nor fit for wearing on the body.

Now, UC San Diego researchers have developed an alcohol sensor that’s wearable, portable and could accurately monitor alcohol level in sweat within 15 minutes.

“What’s also innovative about this technology is that the wearer doesn’t need to be exercising or sweating already. The user can put on the patch and within a few minutes get a reading that’s well correlated to his or her blood alcohol concentration. Such a device hasn’t been available until now,” Mercier said.

Full story can be found from University of California San Diego website.

Imaging the brain at multiple size scales

MIT researchers have developed a new technique for imaging brain tissue at multiple scales, allowing them to peer at molecules within cells or take a wider view of the long-range connections between neurons.



This technique, known as magnified analysis of proteome (MAP), should help scientists in their ongoing efforts to chart the connectivity and functions of neurons in the human brain, says Kwanghun Chung, the Samuel A. Goldblith Assistant Professor in the Departments of Chemical Engineering and Brain and Cognitive Sciences, and a member of MIT’s Institute for Medical Engineering and Science (IMES) and Picower Institute for Learning and Memory.

“We use a chemical process to make the whole brain size-adjustable, while preserving pretty much everything. We preserve the proteome (the collection of proteins found in a biological sample), we preserve nanoscopic details, and we also preserve brain-wide connectivity,” says Chung, the senior author of a paper describing the method in the July 25 issue of Nature Biotechnology.

The researchers also showed that the technique is applicable to other organs such as the heart, lungs, liver, and kidneys.

Full story can be found from MIT website.

02 August, 2016

ClearFlow Launches FDA-Cleared PleuraFlow System for Pediatric Cardiothoracic Surgery

ClearFlow announced that its PleuraFlow® Active Clearance Technology® is now available for the treatment of pediatric cardiothoracic surgery patients. After receiving clearance from the United States Food & Drug Administration (FDA) earlier this year for expanded Indications for Use with the company’s patented technology, ClearFlow developed a new model of the PleuraFlow product for the pediatric market.

All patients undergoing heart surgery have some degree of bleeding, and thus, all patients require chest tubes to evacuate shed blood from around the heart and lungs in the early hours after surgery. The problem is that chest tubes often clog, which can limit the ability to evacuate shed blood. This can lead to complications including retained blood around the heart and lungs. The composite of drainage-related complications that are detrimental to outcomes after cardiothoracic surgery and that may require early or late intervention to remediate is known as Retained Blood Syndrome (RBS). These clinical complications have significant economic consequences, including higher costs of care for patients, hospitals, and society at large.


Inadequate drainage due to chest tube clogging is especially a problem for smaller diameter tubes required for pediatric heart surgery. When ICU care providers are concerned with chest tube clogging, they often resort to makeshift bedside techniques to strip or milk out clots, or break the sterile field and advance suction catheters or balloon catheters into the tube in an attempt to re-open them after they have clogged. These techniques are ineffective and potentially harmful.

The PleuraFlow System is a medical device that removes clots from chest tubes. A clogged chest tube can lead to retained blood around the heart and lungs. The new, smaller sized options are designed specifically for pediatric applications.

“We commonly hear from pediatric heart surgeons, pediatric intensive care specialists and ICU nurses that they encounter problems with chest tube clogging after heart surgery in children, and sometimes this results in preventable major complications or even fatal consequences. The older makeshift bedside techniques of stripping or milking conventional chest tubes has been shown ineffective to prevent these problems, and can even be harmful, and thus are banned in many hospitals. We are pleased to announce that children’s hospitals can now adopt preventative protocols to routinely clear chest tubes of clogging with a proven, FDA cleared medical device solution,” said ClearFlow CEO Paul Molloy.

In a study published in the Annals of Thoracic Surgery, smaller 20 Fr chest tubes fitted with Active Clearance Technology cleared blood significantly better than larger 32 Fr chest tubes without active clearance technology. This was the first time it was demonstrated that smaller tubes can drain better than larger tubes if the lumen is preventatively kept clear of clot. The FDA recently cleared a 20 Fr System with 4 side holes, which is ideally suited for infant, preadolescent, and adolescent patients undergoing congenital cardiac surgery. This System is also available in a 20 Fr with 6 side holes, as well as 24 Fr System when needed for larger pediatric patients.

“There has long been a need to facilitate patency of chest tubes in the smallest diameters used for pediatric heart surgery since the smaller the tube, the more prone it is to occlude,” added cardiothoracic surgeon and ClearFlow co-founder Ed Boyle, M.D. “Expanding the product offerings to facilitate prevention of chest tube clogging in children requiring complex heart operations is an important step to meet this critical unmet need.”

Product info can be found from ClearFlow website.

Smart Insulin Delivery System FDA Approved

Companion Medical announced that the U.S. Food and Drug Administration (FDA) has granted 510(k) clearance for the InPen® system, its wireless-enabled insulin pen and proprietary mobile application. 

The InPen is the first and only FDA-cleared SmartPen™ that includes technology to:
- Calculate and recommend optimal dosing;
- Track history and timing of doses;
- Monitor insulin temperature;
- Display last dose and insulin-on-board; and
- Track and report to the health care provider.

Companion Medical's InPen is cleared in the U.S. for use with Lilly Humalog® or Novo Nordisk Novolog® rapid acting insulin. The InPen app is cleared for Apple iOS with an Android version planned for late 2016. The company has also filed for CE Mark.



"FDA clearance of the InPen and mobile app represents a significant advancement in diabetes care," said Sean Saint, Chief Executive Officer. "The product combines the benefits of sophisticated insulin pumps with the simplicity and affordability of pens and syringes, providing patients, physicians, and caregivers increased confidence that diabetes is being managed optimally. We are excited to be the first to introduce this entirely new class of insulin delivery."

"Diabetes is a complex and burdensome condition requiring accurate insulin doses to stabilize blood sugar levels and prevent long-term complications," said Dr. Timothy Bailey. "Smart pens offer an improved dosing option for people living with diabetes, the majority of whom do not use insulin pumps. The InPen adds a clinician-configured bolus calculator to the ability to give multiple doses of insulin each day safely and discreetly. The insulin data can be shared with clinicians, allowing for optimized treatment planning."

Diabetes is a chronic, life-threatening disease caused by the body's failure to produce sufficient insulin or to utilize it effectively to control blood glucose levels. The majority of people worldwide that require insulin utilize syringes or insulin pens. People with diabetes are challenged to overcome the difficulties associated with delivering insulin multiple times per day. Failure to adhere to an accurate dosing regimen can lead to long term health consequences including nerve damage, blindness, heart disease, and kidney disease.

Product information can be found from Companion Medical website.

Bigfoot Biomedical Enrolls Clinical Trial of Automated Insulin Delivery System

“Life with T1D using today’s tools is unreasonable,” according to Jeffrey Brewer, founder & chief executive officer of Bigfoot Biomedical. “Therapies are too expensive, too complex, and require intense focus and attention with little support. Also, healthcare providers are overwhelmed, with too many hurdles blocking them from helping their patients. The smartloop™ automated insulin delivery system has the potential to change people’s lives. It is designed to deliver better health with greater ease of use, making life simpler for both the patient and the clinicians who treat them, ultimately lowering cost of treatment.”

Motivated by a desire to improve the lives of their children, Jeffrey Brewer, former CEO of JDRF International, and Bryan Mazlish, the mysterious “Bigfoot” in Dan Hurley’s piece for Wired Magazine, founded Bigfoot Biomedical in November 2014. Moving with unprecedented speed in medical device development, over the past 20 months they’ve assembled a team of 40 people and are driving toward commercialization of a cutting edge approach to improving the lives of people with T1D.



Bigfoot recently received approval by the FDA of its Investigational Device Exemption (IDE) submission for a first clinical study of the smartloop™ automated insulin delivery system. The trial is slated to take place at three sites, each of which is a global leader in closed-loop insulin delivery research. Bigfoot is collaborating with Stanford University School of Medicine in coordination with Lucile Packard Children's Hospital Stanford and Stanford Children's Health in Palo Alto, CA, the William Sansum Diabetes Center in Santa Barbara, CA, and the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine in Aurora, CO.

A press release can be found from Bigfoot Biomedical website.

FDA Approved Cartiva Synthetic Cartilage Implant

Cartiva Inc. announced that the first commercial U.S. patient has received the Cartiva Synthetic Cartilage Implant (SCI) following its approval by the U.S. Food and Drug Administration (FDA). The Cartiva SCI device is intended for use in the treatment of patients with painful arthritis at the base of the big toe, the most common arthritic condition in the foot. The outpatient procedure was performed by Dr. Judith F. Baumhauer at University of Rochester Medical Center’s Sawgrass Surgery Center.


The first synthetic cartilage device approved by the FDA, Cartiva provides another option for millions of patients who suffer from arthritis of the big toe joint. The current standard of care involves fusing the bones in the arthritic joint with screws and plates. While fusion is an effective procedure for eliminating pain, it permanently prevents movement of the joint. During the Cartiva procedure, the damaged cartilage is removed and replaced with Cartiva SCI, a biocompatible, biomedical polymer implant, providing a cartilage-like, compressible, low-friction and durable bearing surface. Unlike a fusion procedure, patients may begin weight bearing immediately as tolerated.

“Today, one in 40 Americans over the age of 50 experience arthritis of the toe, and with the aging population, that number is likely to grow. This condition can be particularly life-impacting - limiting a person’s ability to conduct functional activities of daily living, producing pain and discomfort and restricting shoe wear options,” said Dr. Baumhauer. “The Cartiva implant was accomplished in a quick, simple surgical procedure and we look forward to offering this innovative option to more people in need.”

More information can be found from Cartiva website.

Boston Scientific Announces Acquisition of Cosman Medical

Boston Scientific announced that it has acquired Cosman Medical, Inc., a privately held Burlington, Mass. manufacturer of radiofrequency ablation (RFA) systems. The Cosman Medical team and products will become part of the Boston Scientific Neuromodulation business, which offers a range of Spinal Cord Stimulator (SCS) systems to treat patients with chronic pain, and Deep Brain Stimulation systems for the treatment of Parkinson's disease, dystonia and essential tremor.

"This acquisition is a natural extension of our current product portfolio and will help us provide physicians and patients more options to address chronic pain with non-opioid therapeutic treatments," said Maulik Nanavaty, senior vice president and president, Neuromodulation, Boston Scientific. "The addition of the Cosman Medical product line, which is built on industry-leading technology and known for its high-quality, expands our capability to provide innovative solutions for the treatment of chronic pain."

One in three Americans suffer from chronic pain and more than 100 million people are partially or totally disabled by pain. In the United States, it is the number one cause of disability in adults.1,2 RFA is a versatile outpatient procedure with a more than 50-year track record of providing relief for patients with chronic pain. It works by applying heat to small areas of nerve tissue to interrupt pain signals. SCS works by sending electrical signals to the spinal cord, masking pain signals from reaching the brain. In the continuum of care for pain, RFA is typically used prior to SCS. While many patients with chronic pain find effective relief from RFA, others progress to SCS to manage pain.

"We are pleased to join the Boston Scientific team and help expand access to leading treatments for chronic pain," said Eric Cosman, Jr, PhD, scientific director, Cosman Medical. "This acquisition comes at a time when our society is recognizing the impact of relying extensively on opioids to treat pain and is looking for additional approaches. Our mutual commitment to innovation and quality will help us deliver solutions."

The expansion into RFA follows the recent Boston Scientific launch of the Precision Montage™ MRI Spinal Cord Stimulator (SCS) System which offers customized relief to patients with chronic pain while also enabling safe access to full body magnetic resonance imaging (MRI) in a 1.5 Tesla environment when conditions of use are met. MultiWave™ Technology enables delivery of multiple waveforms, including burst and higher rates, intended to help respond to changes in pain over time. The launch expanded the suite of Boston Scientific products that leverage the Illumina 3D™ algorithm, a three-dimensional, anatomy-driven computer model designed for simple point-and-click pain targeting to support physicians in treating chronic pain. In addition to the new Precision Montage MRI SCS System, the portfolio includes the Precision Spectra™ System, which is designed to provide broad coverage for pain with 32 contacts, and the Precision Novi™ System, the smallest high-capacity non-rechargeable device.

Boston Scientific currently expects the net impact of this transaction on adjusted earnings per share to be break-even in 2016 and accretive thereafter and more dilutive on a GAAP basis as a result of acquisition-related net charges and amortization. Specific terms of the transaction were not disclosed.

A press release can be found from Boston Scientific website.