In World First, University of Hong Kong Scientists Develop Flu Drug Using Genes from the Virus Itself

Mary Ann Benitez wrote . . . . . . . .

A team of Hong Kong scientists on Friday claimed a “vital breakthrough” in the fight against flu by developing a treatment using genes from the virus itself to boost resistance in infected mice.

The discovery could lead to more effective drugs for human patients as new strains of the flu rapidly emerge across the globe, raising the risk of a pandemic.

Researchers from the department of microbiology at the University of Hong Kong’s Li Ka Shing Faculty of Medicine said their “virus against the virus” approach was a world first, and worked through what they termed a double-knockout effect.

It involved isolating the virus’ defective interfering genes and dual-functional proteins, and using them to develop an antiviral drug.

Professor Yuen Kwok-yung, chair of infectious diseases at the department, said the team tested whether a fusion of proteins TAT-P1 and three genes called DIG3 could help laboratory mice with swine flu strain H1N1 2009 or bird flu fight off the illness. H1N1 became a pandemic that year.

The scientists designed the DIG3 genes to inhibit the growth of the flu virus and induce broad anti-flu activity.

They then had to formulate a gene delivery system to introduce DIG3 to the virus cells. This was done using proteins from HIV by fusing TAT and P1 peptides.

The DIG3 genes then exerted their antiviral activity by inhibiting acid production inside the target cells’ endosomes and attacking infected cells.

Laboratory tests showed delivery of the genes to the airway of mice either one to two days before or six hours after infection with a bird flu virus or 2009 H1N1 strain could “reduce body weight loss, improve survival and decrease the amount of flu virus in the lung”.

“It shows that DIG3/TAT-P1 is effective for both prophylaxis and treatment,” the team said.

This method of “cheating” the virus was effective almost 100 per cent of the time in fighting off bird flu in mice, and in 50 per cent of cases against the 2009 H1N1 strain.

A provisional patent has been filed in the United States and the team’s findings published in the prestigious Nature Communications science journal.

The antiviral treatment could in the future be delivered by a nasal spray like zanamivir, known under the trade name Relenza.

However, the HKU team, which also includes postdoctoral fellow Dr Zhao Hanjun and clinical associate professor Dr Kelvin To Kai-wang, would need about HK$100 million (US$12.74 million) to develop the drug and market it.

Zhao said their technique had “important implications for the future treatment of flu” as well as other viral infections such as Middle East respiratory syndrome and severe acute respiratory syndrome.

“This is the first time defective interfering genes have been shown to protect flu-virus-infected mice,” he said, and the “first gene delivery system with antiviral activity against the flu virus”.

Yuen told the Post he was confident investors in mainland China would be interested in the treatment as there was a great deal of money being spent on drug development across the border.

“The important thing is to get things done,” he said. “Another pandemic could come so easily … because the population is growing, the number of pigs and chickens is growing … It might not be longer than 30 years.”

With large swathes of the world population potentially lacking immunity to any new flu strain, an outbreak could spark a pandemic similar to the Spanish flu (H1N1) of 1918, Asian flu (H2N2) in 1957, Hong Kong flu (H3N2) of 1968 or Mexican flu (H1N1) seen in 2009.

Source : SCMP

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Researchers Develop Automated Robotic Device For Faster Blood Testing

Rutgers researchers have created an automated blood drawing and testing device that provides rapid results, potentially improving the workflow in hospitals and other health-related institutions to allow health care practitioners to spend more time treating patients.

A study describing the fully automated device is published online in the journal TECHNOLOGY.

“This device represents the holy grail in blood testing technology,” said Martin L. Yarmush, senior author of the study and Paul & Mary Monroe Endowed Chair & Distinguished Professor in the Department of Biomedical Engineering at Rutgers University–New Brunswick. “Integrating miniaturized robotic and microfluidic (lab-on-a-chip) systems, this technology combines the breadth and accuracy of traditional blood drawing and laboratory testing with the speed and convenience of point-of-care testing.”

Diagnostic blood testing is the most commonly performed clinical procedure in the world, and it influences most of the medical decisions made in hospitals and laboratories. But the success rate of manually drawing blood samples depends on clinicians’ skill and patient physiology, and nearly all test results come from centralized labs that handle large numbers of samples and use labor-intensive analytical techniques.

So, a Rutgers biomedical engineering research team created a device that includes an image-guided robot for drawing blood from veins, a sample-handling module and a centrifuge-based blood analyzer. Their device provides highly accurate results from a white blood cell test, using a blood-like fluid spiked with fluorescent microbeads. The testing used artificial arms with plastic tubes that served as blood vessels. The device could provide rapid test results at bedsides or in ambulances, emergency rooms, clinics and doctors’ offices.

“When designing the system, our focus was on creating a modular and expandable device,” said Max Balter, who led the study and holds a doctorate in biomedical engineering from Rutgers. “With our relatively simple chip design and analysis techniques, the device can be extended to incorporate a broader panel of tests in the future.”

Source: Rutgers, The State University of New Jersey

Drones a Lifesaver for Cardiac Arrest Patients

Drones, the unmanned aircraft that got its start as part of the U.S. military’s arsenal and is today being used by everyone from photographers to farmers, are now heralded as a solution to a problem that’s bedeviled emergency medical personnel for years: How to deliver lifesaving defibrillators to people suffering cardiac arrest in areas not quickly reached by ambulances.

Experiencing a cardiac arrest — when the heart stops due to an electrical malfunction in the heart — is almost always a death sentence when suffered outside a hospital. Of the more than 356,000 out-of-hospital cardiac arrests each year in the United States, nearly 90 percent of them are fatal, according to statistics from the American Heart Association.

The survival rate could be dramatically improved, experts said, if bystanders would perform CPR and use portable devices called automated external defibrillators, or AEDs. Research shows brain cell death starts three minutes after the heart stops beating and every minute that elapses without defibrillation means a 10 percent decrease in the odds of survival.

Drones are being tested to see if they can swiftly and safely bring defibrillators to those in distress. Some drones use a cord to lower the AED to the ground, while others land and a bystander removes the AED.

A Canadian study published in Circulation last year found that when compared to ambulances, using drones in the Toronto area cut AED delivery times in urban areas by 6 minutes, 43 seconds and slashed it in rural neighborhoods by 10 minutes, 34 seconds in most cases. Likewise, a Swedish study published in JAMA last year showed that drones deployed in Stockholm took an average of 5 minutes, 21 seconds to reach their destination — more than 16 minutes faster than ambulances.

“Faster response time should lead to higher survival,” said Timothy Chan, director of the Centre for Healthcare Engineering at the University of Toronto and an author of the Toronto study. “Getting a defibrillator is time-sensitive and literally every second counts. If we can do it and keep people safe, this is a no-brainer.”

It’s unclear if drones have ever successfully delivered AEDs in real-life situations. The Toronto study applied mathematical models to out-of-hospital cardiac arrests that occurred in the city from 2006 to 2014. The Swedish study dispatched drones and ambulances to the same location as an experiment though no patients were involved.

However, the opportunity for real-life experience is growing.

The city of Reno, Nevada, was selected last month to participate in the Federal Aviation Administration’s drone pilot program that will help determine how to regulate and safely integrate drones into the U.S. airspace. The city will partner with drone delivery startup Flirtey to deliver AEDs.

The Canadian County of Renfrew began using drones last year and has deployed one roughly every two weeks to provide services such as conducting reconnaissance and delivering medicine, said Michael Nolan, chief paramedic and director of emergency services for the county of 100,000 people located just outside of Ottawa. They recently deployed a drone with an AED, but the ambulance arrived first.

However, the county is awaiting approval from Canadian regulators to fly drones a distance of 4 nautical miles (4.6 miles), an increase from the currently approved 2 nautical miles (2.3 miles), increasing the chances the aircraft could be used to deliver a defibrillator.

Nolan said he worked with Canadian regulators for two and a half years to pave the way for the first approval — a time span he called “a blink of an eye in the public policy world,” especially given that drones are still a relatively new technology.

“The biggest concern that we and the regulators shared was making sure we were integrated with the aviation community to make sure that people in the air and on the ground were safe,” said Nolan.

Together they set limits on how high and far the drones could fly. Test runs proved to regulators the drones could fly safely even though the operators couldn’t see the aircraft. The drones also needed some modifications such as being formatted to fly at night. Meanwhile, 911 operators had to learn how to instruct bystanders to approach the drone and use the defibrillator.

“It is a lifesaving device that provides a benefit,” said Nolan. “When you do the safety-risk assessment, it is clear that the risk associated with doing something outweighed the risk of doing nothing.”

Source: HealthDay

Scientists Create First 3D-Printed Corneas

These days, medical advances seem to be happening in the blink of an eye. Now, British scientists report they have created human corneas using 3D-printing technology.

The researchers said they hope this breakthrough will one day ensure an unlimited supply of corneas. Human corneas are now in short supply. Yet, there are 10 million people around the world who need them to prevent blindness.

These millions need surgery to prevent corneal blindness caused by diseases such as trachoma, an infectious eye disorder.

Another 5 million people already suffer total blindness from corneal scarring caused by burns, lacerations, abrasion or disease, the researchers added.

The cornea, the outermost layer of the eye, plays a vital role in focusing, the study authors explained.

The new process uses a simple, low-cost 3D bio-printer to form the shape of a human cornea. It takes less than 10 minutes to print. The researchers then showed that stem cells on the printed cornea grew, creating a human cornea.

“Many teams across the world have been chasing the ideal bio-ink to make this process feasible,” said lead researcher Che Connon, a professor of tissue engineering at Newcastle University in England.

“Our unique gel — a combination of alginate and collagen — keeps the stem cells alive whilst producing a material which is stiff enough to hold its shape, but soft enough to be squeezed out the nozzle of a 3D printer,” he explained in a university news release.

The researchers are now ready to use bio-ink containing stem cells, which will allow printing tissues without having to worry about growing the cells separately, Connon said.

Connon’s team also showed it could create a cornea that matches a patient’s unique specifications.

The dimensions of the printed cornea were taken from an actual cornea. Scanning a patient’s eye, the researchers were able to use the data to print a cornea that matched it in size and shape.

“Our 3D-printed corneas will now have to undergo further testing, and it will be several years before we could be in the position where we are using them for transplants,” Connon added.

The report was published in the journal Experimental Eye Research.

Source: HealthDay

Artificial Intelligence Better Than Dermatologists at Catching Skin Cancers

Amy Norton wrote . . . . . . . . .

A computer can beat even highly experienced dermatologists in spotting deadly melanomas, researchers report.

The study is the latest to test the idea that “artificial intelligence” can improve medical diagnoses.

Typically, it works like this: Researchers develop an algorithm using “deep learning” — where the computer system essentially mimics the brain’s neural networks. It’s exposed to a large number of images — of breast tumors, for example — and it teaches itself to recognize key features.

The new study pitted a well-honed computer algorithm against 58 dermatologists, to see whether machine or humans were better at differentiating melanomas from moles.

It turned out the algorithm was usually more accurate. It missed fewer melanomas, and was less likely to misdiagnose a benign mole as cancer.

That does not mean computers will someday be diagnosing skin cancer, said lead researcher Dr. Holger Haenssle, of the University of Heidelberg in Germany.

“I don’t think physicians will be replaced,” Haenssle said.

Instead, he explained, doctors could use artificial intelligence (AI) as a tool.

“In the future, AI may help physicians focus on the most suspicious skin lesions,” Haenssle said.

A patient might, for instance, undergo whole-body photography (a technology that’s already available), then have those images “interpreted” by a computer algorithm.

“In the next step,” Haenssle explained, “the physician may examine only those lesions labeled as ‘suspicious’ by the computer.”

Doctors already do skin exams with the help of a technology called dermoscopy — where a hand-held device is used to light and magnify the skin. Haenssle said AI could again be used to help analyze those images.

Dr. Mary Stevenson is an assistant professor of dermatology at NYU Langone Medical Center in New York City.

She agreed that the technology is not going to replace doctors, but could serve as an “aid.”

There are still questions to be answered, according to Stevenson, who was not involved in the research. For one, she said, this study focused only on differentiating melanoma from benign moles — and there is more to skin cancer diagnosis than that.

For the study, Haenssle’s team recruited 58 dermatologists from 17 countries. Over half had more than five years of experience and were considered “expert” level.

First, the doctors examined 100 dermoscopic images of either melanomas or harmless moles.

Four weeks later, they viewed those images and were given more information about the patients — such as their age and position of the lesion on the body. That more closely reflected what doctors work with in the “real world.”

In the first phase, the doctors accurately caught melanomas nearly 87 percent of the time, on average; they correctly identified moles about 71 percent of the time.

The computer, however, did better: When it was tuned to have the same level of accuracy as doctors in detecting benign moles, the computer caught 95 percent of melanomas.

The doctors boosted their accuracy when they also had information about the patients. They caught 89 percent of melanomas, and accurately identified benign moles about 76 percent of the time.

The computer still outperformed them, though: At that same level of accuracy for catching melanoma, the computer correctly diagnosed about 83 percent of moles.

Haenssle said that in some parts of Germany, doctors are already using the algorithm tested in this study — in software sold by the company FotoFinder Systems GmbH. He has received fees from the company and others that market devices for skin cancer screening.

For now, traditional skin exams remain the standard of care.

Stevenson said she suggests people get one head-to-toe exam to inspect the skin for suspicious growths — and then talk to their doctor about how to follow up.

“I also recommend getting in front of a mirror once a month to do a self-exam,” Stevenson said.

The point is to spot any changes in the size, shape or color of a mole or other dark spot on the skin. According to Stevenson, some warning signs of melanoma include asymmetry in a growth, as well as irregular borders, uneven coloring and a large diameter (larger than a pencil eraser).

“When melanoma is caught early,” Stevenson said, “it is highly curable.”

Source: HealthDay