Antibody stimulates natural repair of MS damage

From Fierce BioResearcher:

Low doses of a human antibody in mice were effective in repairing damaged myelin, a protective shield for nerves that is destroyed by multiple sclerosis. Scientists at the Mayo Clinic engineered an antibody–rHIgM22–so that it would bind to myelin and brain and spinal cord cells. That antibody triggered remyelination, restoring the protective sheath. This is the first known therapy that acts within the central nervous system. In addition, the scientists said that even at a very high dose, there were no recorded side effects from the treatment.

Top 10 Scientific Breakthroughs of 2008

Here are my favourite picks of the top scientific breakthroughs of 2008.  Taken from Wired:

(NB I have excluded some I regard as more dubious)

10. Troubleshooting stem cell therapy

In 2007, scientists learned how to reprogram skin cells into stem cells, without cloning or destroying embryos. It seemed too good to be true, and it was. The tissues grown from those cells had a nasty tendency to become cancerous, which made them useless for regenerative medicine — the science of building and fixing body parts. In 2008, several research groups figured out what was going wrong and solved the problem.

Researchers had used an an adenovirus to slip four genes into each cell, but the microbe was causing lots of collateral damage. By switching to a different kind of virus, scientists at The Whitehead Institute and Massachusetts General Hospital were able to make the procedure safe.

9. Turning water into fuel

Companies like Nanosolar and Solyndra slashed the cost of solar energy, but scientists are still looking for a clean way to store all that juice. Daniel Nocera of MIT has an elegant solution: Use electricity to break water into hydrogen and oxygen, store it in separate tanks, then recombine the gases in a fuel cell when you need power.

Anyone can do this. Just hook a 9-volt battery to electrodes and dunk them into a jar of water. The problem is that it takes a lot of energy to do this. If you want to fill tanks with those gases, and use them to run a fuel cell, you’ll need to do it very efficiently. Nocera, and his team at MIT, found a catalyst that makes the task of splitting H2O remarkably easy. It could store the energy harvested by solar cells and wind farms.

7. Building loudspeakers from carbon nanotubes

Scientists have been tinkering with carbon nanotubes for decades, and this year the work has paid off. Chinese scientists have used the nanotubes to make transparent audio speakers and sheets of paper stronger than steel. The speakers work by a thermoacoustic effect: They vibrate and make noise when heated by an electrical current. The scientists demonstrated in YouTube videos that their prototype could blast a scratchy but understandable version of the Moldovan pop song “Dragostea din tei” while it was taped to the side of a waving flag.

Another team at Florida State University made paper that is far lighter and stronger than steel by pressing sheets of carbon nanotubes together. Those composite materials, developed by Ben Wang and his team, could make aircraft parts and body armor.

In a perfect sheet of the material, all of the carbon nanotubes should be pointing in the same direction. Wang figured out how to align the tiny cylinders with magnetic fields. Thanks to that discovery, and other advances, buckypaper could be on the market within a year.

6. Sequencing entire genome of a cancer patient, including tumor

For the first time, doctors sequenced the entire genome of a cancer patient, and also read the genetic code of her diseased cells. That allowed them to pinpoint the exact mutations responsible for the illness.

In the short run, that data will give cancer researchers a much better understanding of the disease, but their real triumph is bringing the medical community a step closer to offering personalized health care.

Cancer is hard to fight because nearly every case is different, and yet doctors use a somewhat one-size-fits-all approach to treating patients. As new medications like gene therapy and RNA interference become widespread, oncologists will be able to tailor treatments for patients because of what’s wrong with their genetic code. In the meantime, some physicians are using simple genetic tests to predict which medications will work well on their patients. 

5. Breaking the petaflop barrier

The latest generation of supercomputers can perform more than a quadrillion operations per second, and that remarkable capability will revolutionize the way scientists do research. It will allow them to identify meaningful patterns in unfathomably large mounds of data, and perform simulations with unprecedented accuracy. Meteorologists could know exactly where a hurricane will strike days before it makes landfall. Neuroscientists may be able to emulate a simple brain. So far, two machines have broken the petaflop barrier, and as more follow we’ll see monumental advances in every field of science.

4. Curing HIV in Germany

Some people are remarkably resistant to HIV, and scientists have found two ways to give that immunity to others. In the first case, Berlin doctor Gero Huetter transplanted bone marrow from a virus-resistant donor to a man who had both HIV and leukemia. By doing that, he cured both diseases with one treatment. It sounds great, but Huetter had to kill off his patient’s immune system with drugs and radiation before replacing it with a better one.

Because that tactic is tremendously harsh and risky, it is unlikely that the miraculous procedure will catch on. Instead, his victory provided solid evidence that gene editing might offer a viable solution. Every virus-resistant person has two mutant copies of a gene called CCR5, and a new biotech tool called zinc finger nucleases can give anyone that mutation. Instead of transferring bone marrow from another person, doctors could take a few cells from a patient, modify them to be HIV-resistant and then put them back in.

2. Growing a new organ from a patient’s own stem cells

Thanks to stem cell research, people with failing organs may not need to wait for a donor or take harsh medications that prevent their immune systems from rejecting transplanted tissue. One of the greatest examples of regenerative medicine — the science of building or fixing body parts — took place this year, when doctors removed some cells from a 30-year-old woman with tuberculosis and used them to grow a new trachea, replacing a segment that was destroyed by the bacterium.

They took stem cells from her bone marrow, layered them onto a decellularized trachea from a deceased donor, and surgically implanted it in the woman. Four months later, Claudia Castillo could breathe well and showed no signs of the side-effects that patients have when they receive an organ from someone else.

US Study: EMR market should grow 14 percent annually through 2012

From Healthcare IT:

A new study from research firm Kalorama Information projects that the EMR market will grow 14.1 percent each year over the next few years, up from $9.5 billion in 2007. Kalorama is predicting that the growth of the personal health record niche will have a big impact on the uptake of EMRs and on healthcare in general.



The report notes that the industry is gradually beginning to expect medical records to be shared between patients and providers. 

Consumer demand for this access is beginning to force greater use of electronic medical record technology, researchers said.

According to the firm, there were 787,000 office-based physicians and 5,708 hospitals in the U.S. as of 2007. Total implementation costs for the coming EMR rollouts should be between $68 billion and $255 billion, Kalorama researchers said.



Digital Healthcare needs Incentives

This blog has often remarked that much of the healthcare system is either too distracted, poorly planned or too old-school to evaluate and implement digital solutions for practice and hospital management software.

The US government is trying to overcome this with incentives. Starting in 2011, physicians who show that they are “meaningfully” using health IT would be eligible for $40,000 to $65,000, and hospitals would be eligible for several million dollars. The incentives would be phased out over time, with penalties in place by 2016.

This news comes as another study is published showing that hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs.

The Australian government is trying to implement a Practice Incentives Program that encourages IT uptake, but is running into problems with disagreements over architecture.

Asthma, allergies and Stomach bugs

There is growing evidence that the best way to prevent asthma is to make sure your kids get nice and dirty while young – playing in the backyard, or a farm, and the like.

This Hygiene Hypothesis says that if you get early exposure to those types of things it primes your immune system in a direction away from allergy.

New evidence has come in the form of a study looking at exposure to H. Pylori, the stomach bacteria known to cause ulcers.

The study, published in PLoS ONE, shows that colonization with a certain H. pylori strain is inversely associated with asthma and is associated with an older age of asthma onset in an urban population. In other words H. pylori as one marker, amongst the many possible, for protection.

In the future one might expect that similar studies looking at serosensitivity and asthma status might lead to a type of vaccine for asthma, one of Australia’s major health concerns.

A totally non-healthcare video

I’m making a rare exception here. 

This video is one of the most amazing and insane things I have seen in a long time. If I wasn’t a man with certain responsibilities to others, and perhaps had missed the all essential self-preservation gene, I’d be doing it too…

View Wingsuit Base Jumping Video here

Recession-Resistant Medicine

From the MIT’s Technology Review:

In the third quarter of 2008, the first tremors of the financial crisis had been felt, and the number of venture deals in the U.S. fell to its lowest total since early 2005. According to Dow Jones’s VentureWire, which tracks venture investment, information technology companies fared particularly badly, with their lowest deal total in more than 10 years.

But for the quarter, total dollars invested stayed fairly steady, off only about 1 percent from each of the first two quarters. So some companies were still getting big paydays. Of the 10 companies with the biggest third-quarter deals, the plurality–four–were in the health-care sector. One of those companies, Pacific Biosciences, builds genome-sequencing machines and figures prominently in Emily Singer’s “Interpreting the Genome.” The other three are testing promising new therapies for some of the most common medical conditions.

The other three are:

CVRx

Between 25 and 33 percent of hypertension patients can’t control their condition with medication. But the body has its own mechanisms for bringing blood pressure down, which are triggered by nerve cells in the carotid artery that respond to pressure. CVRx has found a way to treat severe, drug-resistant hypertension by stimulating those nerves electrically. A device the size of an iPod Nano is implanted in the patient’s chest, with electrical leads snaking up to the carotid artery. The device is now in phase III clinical trials in the U.S. and Europe.

Proteolix

Cells clean up unneeded proteins by shipping them to a structure called the proteasome, which chops them up. If the proteasome can’t do its job, the cell eventually dies. By targeting a specific component of the structure, Proteolix has developed a proteasome inhibitor that is particularly deadly to cancer cells. In the right doses, it kills cancer with little damage to healthy tissue. A variation on the molecule targets the proteasomes in immune cells (which differ from those in normal cells), disrupting biochemical pathways that cause autoimmune disorders.

Portola

Portola’s drugs treat blood clots, which form when collagen-containing plaques on artery walls rupture. Collagen is one of the supportive tissues in blood vessels, so the body reads its sudden appearance as indication of a wound, which it sends blood-clotting agents to repair. Portola designed an imaging system that lets researchers observe blood clots forming in collagen-lined capillary tubes. The simulations led to a drug candidate that’s in clinical trials as a competitor to Plavix, the world’s second-best- selling drug.

Web 2.0 Management Tools

HR and people management would have to be the trickiest little area for any bottom line driven manager. It’s necessity has driven the creation of a variety of assessment tools and development programs.

Now the power of the web is again showing itself with the creation of a tool featured in this weeks Economist: Rypple.

Rypple is an online Performance Management solution. It uses the power of web networking to generate ‘giving and getting honest, direct, and insightful feedback to employees’. Rypple allows frequent assessment and eases the burden on supervisors. 

How does it work? Employees establish a network of trusted peers, mentors and managers whose opinions they value. They can then send out short questions, such as “What did you think of my presentation today?”, to which their network’s members can respond online. The responses are kept anonymous so that, at least in theory, employees cannot tell who has made them.

Rypple also allows users ask members of their networks to measure their performance against a scale, so they can track how they are doing over time. It also lets employers see what “tags”, or overarching themes, are being used most often in questions. If, say, creativity is key to a firm’s success but there are few requests for feedback on employees’ creativity, then bosses can tell they have not done enough to communicate their priorities.

Companies that have road-tested the product claim it puts the onus of professional development on the employees – a good thing for all – and reduces the importance of the much maligned performance reviews most groups now use.

Fascinating Facts from Freak-economists

Economics is a turn off for many of us. But there’s a new generation of young things trying to make it palatable. In this Economist article, a few of them are presented. Here’s a few facts they’ve come up with by searching troves of unwanted data:

• People are better at predicting the winner of American gubernatorial elections when they watch the candidates with the sound turned off. 
• Harsher jail conditions do nothing to deter prisoners from reoffending. If anything they encourage recidivism. 
• Preschoolers who watch television do better academically than children who don’t, especially if their parents have little education or poor English.

What really caught my eye in the Economist article was a group of ‘randomistas’. 

These economists carry out randomised trials of development projects, much like the clinical trials that prove the efficacy of new drugs. They hope to dissect the underlying physiology of economic problems. With a full anatomy of behaviour—what economists call a structural model—they can determine if a policy or project will work even before it has been attempted.

In one study, economists showed that mothers in the Indian state of Rajasthan are three times as likely to have their children vaccinated if they are rewarded with a kilogram of daal (lentils) at the immunisation camp. The result is useful to aid workers, but puzzling to economists: why should such a modest incentive (worth less than 50 cents) make such a big difference? Immunisation can save a child’s life; a bag of lentils should not sway the mother’s decision either way.

Had they arrived at this result using some other method, the economists may have assumed they had made a mistake. Randomisation removes such doubts, showing that it was indeed the lentils that made the difference.

Some other economic facts that have recently been found upon:

• The Unemployed have sufficient incentive to find work, even if they receive unemployment benefits indefinitely. 
• Bequests from one generation to the next should be subsidised by the government, with smaller inheritances receiving higher rates of subsidy. Why?Tthe biggest roll of the dice in life is the family you are born into. Their system of subsidies would take the edge off this uncertainty.

There are many more great examples of the power of economics – particularly when linked to behavioural studies in the article. Check it out sometime.