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Category: Health/Medicine News

The Technologies Driving Tomorrow’s Healthcare Solutions

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Robots performing surgeries? New hip joints “printed” on command? “House calls” made from hundreds, even thousands of miles away? What seemed like science fiction just a few years ago has become an everyday reality as technology is revolutionizing the way healthcare is delivered.

Innovation changes health care for the better

Back in 2010, a video of a surgical robot sewing a split grape back together seemed so improbable, it went viral, garnering more than 5 million views [“Suturing a Grape,” YouTube clips (various uploads).] Fast forward to today, and robot-assisted surgery is firmly in the mainstream, used for gallbladder, prostate, gynecologic and kidney surgeries. The benefits of this minimally invasive technique are significant, including faster recovery times, shorter hospital stays, and less patient down time.

3D printing, still in its relative infancy, is already making massive contributions in healthcare. 3D-printed joint components have been used in more than 100,000 hip replacement surgeries over the past decade, according to a GE Report from March of 2018. The next evolution for 3D printing will be even more spectacular, promising the ability to print artificial organs, blood vessels, and even synthetic ovaries.

At a time when there is a shortage of doctors, especially in rural areas, telehealth is becoming a viable alternative to an in-office visit.

Virtual medical providers enable doctors to treat millions of Americans each year through internet and telephone consultations. That’s based on estimates from a recent J.D. Power study from July 2019, which found 9.6% of the adult population has used telemedicine in the past year. More than 75 percent of hospitals use telehealth services, too, as noted by the American Hospital Association Fact Sheet dated February 2019. Patients can consult with a doctor via phone or video, and receive diagnoses and prescriptions. Some employers use telehealth to provide virtual health clinics for employees.

Managing the cost

While such health innovations are exciting, they come at a cost. That’s where supplemental insurance can play a key role, enabling employers to offer a benefits option that provides added financial security over and above traditional health insurance. Beyond financial security, supplemental insurance also offers employees peace of mind.

“Employees are increasingly shouldering the high cost of medical care, especially when it comes to new medical solutions,” says Teresa White, president of Aflac U.S. In fact, 85 percent of employees see the need for supplemental insurance benefits to cover such costs, according to the Aflac WorkForces Report.

Adding to the challenge is the complexity of what’s covered and what isn’t under traditional health insurance.

“Health care today isn’t simple,” says Virgil Miller, Aflac EVP and chief operating officer. “Some consumers are confused by their benefit options and what their health care plans cost and cover. Our annual Aflac WorkForces Report found that just 39 percent of employees have a full understanding of their health insurance policies.

“And with medical debt being the most common reason people fall behind on bills, supplemental benefits such as Aflac’s should be a priority on every smart preparation checklist. Aflac helps cover the expenses health insurance doesn’t.”

Innovations improve insurance, too

Customer concerns like these led Aflac to create online tools like its easy-to-use critical illness calculator. “The calculator makes it easier for consumers to understand typical out-of-pocket heath care expenses and how Aflac’s critical illness coverage can help cover the costs health insurance doesn’t cover,” Miller says.

Aflac sees technological innovation as essential in serving its policyholders. To provide good customer service, Aflac worked with several industry experts on a technique called journey mapping to understand the various touch points and pain points customers have. “Through journey mapping, our customer experience teams created reliable road maps of where we needed to take our technology in the future,” adds Keith Farley, vice president of innovation for Aflac.

One byproduct of this research is an advanced mobile app called MyAflac. With the MyAflac mobile app, policyholders can handle myriad healthcare-related tasks, ranging from filing a claim to signing up for direct deposit of their insurance payments, right from their phones. Combined with Aflac’s One Day PaySM initiative, it helps get payments into the hands of policyholders faster than ever. “Our goal is to help policyholders worry less about finances and focus more on recovery, which can lead to better health outcomes,” adds Miller.

Innovation is woven into every level of Aflac’s culture. Farley points to My Special Aflac Duck as a perfect example of this. “This isn’t just a toy, it is a high-tech robot that interacts with children, helping provide them with comfort as they move through their cancer treatment. As a company, we have been blown away by the response,” Farley says.

The company has invested millions of dollars into this program including donating to cancer research, developing the duck and giving away more than 5,000 of them to pediatric cancer patients at more than 220 hospitals in 47 states.

Innovation is also at the heart of how Aflac designs its benefits policies. Aflac’s cancer policy, for example, helps policyholders take greater advantage of cutting-edge medical techniques. “Genetic testing helps identify potential health risks and help people understand and prepare for potential risks. Screenings can also save lives. Aflac’s cancer policy is designed to reflect the evolution of patient needs and challenges, and it helps cover modern approaches to prevention, early detection and diagnosis, treatment, and ongoing care,” White says.

At Aflac, innovation is more than saving money and improving efficiencies. It is part of its mission to help employers support their employees to lead healthier and happier lives. At the end of the day, it’s about growing consumer trust and satisfaction, Miller says.

One Day PaySM is available for certain individual claims submitted online through the Aflac SmartClaim process. Claims may be eligible for One Day Pay processing if submitted online through Aflac SmartClaim, including all required documentation, by 3 p.m. ET. Documentation requirements vary by type of claim; please review requirements for your claim(s) carefully. Aflac SmartClaim is available for claims on most individual Accident, Cancer, Hospital, Specified Health, and Intensive Care policies. Processing time is based on business days after all required documentation needed to render a decision is received and no further validation and/or research is required. Individual Company Statistic, 2019.

Aflac herein means American Family Life Assurance Company of Columbus and American Family Life Assurance Company of New York. WWHQ | 1932 Wynnton Road | Columbus, GA 31999

By Anita CampbellCEO, Small Business Trends

@smallbiztrends

Source: The Technologies Driving Tomorrow’s Healthcare Solutions

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https://www.job-applications.com/afla… An Aflac benefits consultant talks about the interview process, interview questions, how to get a job and what its like to work for Aflac.

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Howto & Style

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This Inexpensive Action Lowers Hospital Infections And Protects Against Flu Season

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Harvard Medical School graduate and lecturer, Stephanie Taylor, is something of an Indiana Jones of medicine. She’s a determined scientist who can’t seem to sit still. Along with a resume full of accolades and publications, she’s a skydiver with 1,200 jumps. She solves haunting medical mysteries. “Anything that seems scary, I say I need to learn more about that,” she explained in a recent interview

While practicing pediatric oncology at a major teaching hospital, Taylor wondered why so many of her young patients came down with infections and the flu, despite the hospital’s herculean efforts at prevention. Her hunch: the design and infrastructure of the building contributed somehow.

Dr. Taylor embarked on a quest to find out if she was right. First, the skydiving doctor made a career jump: She went back to school for a master’s in architecture, and then began research on the impact of the built environment on human health and infection. Ultimately, she found a lost ark.

She and colleagues studied 370 patients in one unit of a hospital to try to isolate the factors associated with patient infections. They tested and retested 8 million data points controlling for every variable they could think of to explain the likelihood of infection. Was it hand hygiene, fragility of the patients, or room cleaning procedures? Taylor thought it might have something to do with the number of visitors to the patient’s room.

While all those factors had modest influence, one factor stood out above them all, and it shocked the research team. The one factor most associated with infection was (drum roll): dry air. At low relative humidity, indoor air was strongly associated with higher infection rates. “When we dry the air out, droplets and skin flakes carrying viruses and bacteria are launched into the air, traveling far and over long periods of time. The microbes that survive this launching tend to be the ones that cause healthcare-associated infections,” said Taylor. “Even worse, in addition to this increased exposure to infectious particles, the dry air also harms our natural immune barriers which protect us from infections.”

Since that study was published, there is now more research in peer-reviewed literature observing a link between dry air and viral infections, such as the flu, colds and measles, as well as many bacterial infections, and the National Institutes of Health (NIH) is funding more research. Taylor finds one of the most interesting studies from a team at the Mayo Clinic, which humidified half of the classrooms in a preschool and left the other half alone over three months during the winter. Influenza-related absenteeism in the humidified classrooms was two-thirds lower than in the standard classrooms—a dramatic difference. Taylor says this study is important because its design included a control group: the half of classrooms without humidity-related intervention.

Scientists attribute the influence of dry air to a new understanding about the behavior of airborne particles, or “infectious aerosol transmissions.” They used to assume the microbes in desiccated droplets were dead, but advances in the past several years changed that thinking. “With new genetic analysis tools, we are finding out that most of the microbes are not dead at all. They are simply dormant while waiting for a source of rehydration,” Taylor explained. “Humans are an ideal source of hydration, since we are basically 60% water. When a tiny infectious particle lands on or in a patient, the pathogen rehydrates and begins the infectious cycle all over again.”

These findings are especially important for hospitals and other health settings, because dry air is also associated with antibiotic resistance, which can devastate whole patient populations. Scientists now believe resistant organisms do not develop only along the Darwinian trajectory, where mutated bacteria produce a new generation of similarly mutated offspring that can survive existing antibiotics. Resistant pathogens in infectious aerosols do not need to wait for the next generation, they can instantly share their resistant genes directly through a process called horizontal gene transfer.

According to her research, and subsequent studies in the medical literature, the “sweet spot” for indoor air is between 40% and 60% relative humidity. An instrument called a hygrometer, available for about $10, will measure it. Every hospital, school, and home should have them, according to Taylor, along with a humidifier to adjust room hydration to the sweet spot.

Operating rooms, Taylor notes, are often kept cooler than other rooms to keep gown-wearing surgical staff comfortable. Cool air holds less water vapor than warm air, so condensation can more easily occur on cold, uninsulated surfaces. Consequently, building managers often turn humidifiers off instead of insulating cold surfaces. This quick fix can result in dry air, and Taylor urges hospitals to bring the operating room’s relative humidity up, even when it is necessary, to maintain a lower temperature. Taylor’s research suggests this reduces surgical site infections.

Taylor travels the country speaking with health care and business groups to urge adoption of the 40%–60% relative humidity standard. And she practices what she preaches. “My husband has ongoing respiratory problems and had at least one serious illness each winter. Ever since we started monitoring our indoor relative humidity and keeping it around 40%, even when using our wood stove, he has not been sick. Our dogs also love it because they do not get static electricity shocks when being petted in the wintertime!”

The bad news is that it takes on average of 17 years for scientific evidence to be put into medical practice, according to a classic study. The good news is that Taylor is on the case, and she’s on a crusade against the destruction of bacteria and viruses. She’s not waiting 17 years. Jock, start the engine.

Follow me on Twitter. Check out my website.

Leah Binder

I run an organization called The Leapfrog Group with a membership of highly impatient business leaders fed up with problems with injuries, accidents, and errors in hospitals. I can’t stand the sight of blood but I’ve worked in healthcare over 20 years, including a rural hospital system, Mayor Rudolph Giuliani’s health policy office, and the National League for Nursing. Follow me on twitter: @leahbinder.

Source: This Inexpensive Action Lowers Hospital Infections And Protects Against Flu Season

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The flu season in the U.S. has already claimed a number of lives in what the Centers for Diseases Control and Prevention (CDC) has called one of most severe flu seasons in nearly a decade. “People often forget that tens of thousands of Americans will die each year from influenza infection; the vast majority of those who die are those who have underlying medical comorbidities,” says Dr. Pritish Tosh, an infectious diseases specialist at Mayo Clinic. “They have heart disease or lung disease, and influenza tips them over and they end up dying from their underlying medical comorbidity, or chronic illness.” More health and medical news on the Mayo Clinic News Network http://newsnetwork.mayoclinic.org/

4 Wellness Trends You Have To Try

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Wellness is seeping into every aspect of our lives, from exercise and diet to sleep and work. According to the Global Wellness Summit, complete health also has become a big business, raking in $4.2 trillion a year worldwide.

As GWS prepares for its annual conference of industry professionals at Grand Hyatt Singapore October 15 to 17, we asked organizers to share their insights on the latest trends in approaches to wellness.

Nature Immersion Getaways

GWS reports that there’s a wave of global urbanization, with 55 percent of the world population living in cities. That number is projected to jump to 68 percent by 2050. A consequence of this surge in urban living is that people are seeking ways to immerse themselves deeper into nature. Hotels are accommodating by moving workouts and spa treatments into the great outdoors. But nothing captures this trend more than the rise in forest bathing.

Today In: Lifestyle

Shinrin-yoku, or forest bathing, began in Japan in the 1980s. Despite the translation, the practice doesn’t literally mean to take a bath among the trees. Instead, it focuses on soaking up the essence of the forest. The practice is supposed to aid immune systems, reduce blood pressure, ease stress, boost energy and improve sleep.

Forbes Travel Guide Four-Star L’Apothecary Spa at L’Auberge de Sedona in Arizona steeps you in its pristine Oak Creek surroundings with its Connecting with Nature offerings. Led by a certified forest bathing facilitator, the personalized sensory sessions encourage you to absorb the gushing waters, towering trees, red rocks, blue skies and local wildlife. You’ll receive a journal to record your experience. Another option is a nighttime forest immersion. Star bathing helps you find peace under the serene starlit sky amid the wooded backdrop. When the darkness of night envelops your sight, your other senses are heightened.

Tough and Transformative Wellness

Travelers want to visit wellness destinations that push them harder to conquer challenges, engage in extreme experiences and, ultimately, transform them, GWS reports.

Four-Star Four Seasons Hotel Hampshire in England has devised The Escape, an antidote to boring old fitness routines. Amid the property’s 500 countryside acres, the two-day bootcamp includes an outdoor meditation session, two “extreme” exercise classes, a nutrition masterclass, tailored treatments in the spa, yoga, tai chi and a highwire adventure.

Chatham Bars Inn hosts an ongoing Wellness Weekend series that features interactive itineraries hosted by wellness experts in stunning Cape Cod. The activities consist of mindfulness workshops, motivational lectures, personal coaching and plenty of exercise at the Four-Star hotel.

In Mexico, Four-Star Grand Velas Los Cabos targets women with its five-night Alpha Female Adventure Getaway. The rigorous schedule includes a power hike through the Sierra de la Laguna biosphere reserve, swimming in a hot spring, snorkeling and paddleboarding. The getaway also comes with a four-handed tequila massage, an 80-minute treatment that releases muscle tension. A therapist rubs the liquor into the skin to reduce inflammation.

Sleep Performance

Alongside exercise and diet, sleep is essential for optimal health. And the focus on rest across the travel industry has been one of the biggest wellness trends.

Hotels are rethinking the sleep experience. Four-Star The Ritz-Carlton, Tysons Corner is attacking stress-induced insomnia with a holistic approach. Partnering with sleep experts at Longeva, the D.C. hotel created a spa treatment that fosters a good night’s rest, a special snooze-inducing room service menu with dishes like almond butter banana dark chocolate toast (the treat’s high magnesium relaxes muscles, and bananas have tryptophan, the same amino acid in turkey that makes you drowsy after Thanksgiving dinner), a TV station that serves as a sleep machine and a take-home kit so that you can continue deep slumbers in your own bed.

The newly opened Equinox Hotel Hudson Yards in New York City was built with sleep in mind. The wellness hotel’s rooms have total soundproofing, blackout blinds and mattresses made with temperature-regulating natural fibers to prevent night sweats. If that’s not enough send you to dream land, you can employ the assistance of an Equinox sleep coach.

Digital Detox

For all the good they provide, smartphones also have sparked a slew of problems: they cause an “always on” work mentality, the overconsumption of negative news and a social media addiction that has led to an anxiety and depression crisis, GWS says.

More travelers want to go to a place to unplug, clear their minds and recover. Mandarin Oriental launched a digital wellness initiative at all of its spas in 2018. In collaboration with the Mayo Clinic, the program teaches ways to manage your relationship with technology and the stress that can accompany a constantly connected digital lifestyle. Experience it at Mandarin Oriental, Guangzhou’s luxurious Five-Star spa. The 100-minute Digital Wellness Escape homes in on the head, eyes, neck, shoulders, hands and feet.

Mandarin Oriental Wangfujing, Beijing turned its offerings into a two-night package that includes a 90-minute treatment, a class pass to nearby Pure Yoga in WF Central as well as breakfast and a healthy lunch at Café Zi.

Jennifer Kester
Jennifer Kester

 

 

Source: 4 Wellness Trends You Have To Try

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Last year some of the big wellness trends were collagen, intermittent fasting and CBD oil. But 2019 brings a new set of ways to be our best selves.

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Entertainment

More Blood Pressure Medication Recalls Due To Cancer Concerns

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You may want an MBA. But you want to avoid NMBA.

NMBA stands for N-Methylnitrosobutyric acid, something that you don’t want in your blood pressure medications. But alas, this probable carcinogen continues to appear in various medications at higher than acceptable levels.

The latest news is that Torrent Pharmaceuticals Limited is further expanding its recall of Losartan Potassium Tablets USP and Losartan Potassium/hydrochlorothiazide tablets, USP, according to the U.S. Food and Drug Administration (FDA). The FDA announcement includes five more lots of these medications. The additional lots add to the lots of blood pressure medications that have been recalled in the past 14 months or so.

In 2018 and 2019, it seems like news about potential cancer-causing contaminants in medications has become as repetitive as the lyrics “My Name Is” in Eminem’s song “My Name Is.” I’ve written about such news for blood pressure medications in November of last year, January of this year, and again March of this year. Then, just last week I covered impurities found in a common heartburn medication, ranitidine. Then, on Thursday, I added an update that Novartis was halting its distribution of ranitidine, the generic form of Zantac, until further testing could be done.

Today In: Innovation

As they say when you soil your pants, one time may be an accident but more than three times is a trend. It is time to take a closer look at how drugs are being manufactured, stored, and distributed and how such processes are being monitored. As I have mentioned before, making medications is not the same as making handbags. You don’t, at least you shouldn’t, eat your handbags. While a poorly-made handbag could lead to social embarrassment, a poorly-made medication can have much greater and even life-threatening implications.

The FDA is the main agency to protect you against fraudulent and contaminated medications. But the FDA currently may not have the funding and the resources to carefully check everything that every drug manufacturer and distributor is doing, especially when some of these operations are rapidly changing or occurring overseas.

For now, if you are taking blood pressure medications, or any medications for that matter, pay attention to FDA warnings and recall news. The FDA maintains a searchable listing of active product warnings and recalls. As a precautionary measure, you may want to search for a medication before starting it. You can also check with your pharmacist to make sure that your medication is not on a recall or warning list. Of course, if you do find that your medication has a warning or is being recalled, don’t just stop taking it. That can be like trying to return a parachute while you are using it. Check with your doctor first to determine your course of action.

Follow me on Twitter or LinkedIn. Check out my website.

Bruce Y. Lee

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), and Associate Professor at the Johns Hopkins Carey Business School. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.

Source: More Blood Pressure Medication Recalls Due To Cancer Concerns

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Dr. Luke Laffin, staff cardiologist in Preventive Cardiology and Clinical Specialist in Hypertension at Cleveland Clinic answers questions that patients often ask about taking high blood pressure medicines: types of medications, side effects, when to call the doctor, role of self-blood pressure monitoring (including how often), the best time to take blood pressure medications, and if there is a chance that patients can come off medications. He ends the program with three important points for patients with high blood pressure.

A Low-Fat Diet May Lower the Risk of Dying from Breast Cancer

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Breast cancer treatments have come a long way in recent decades, but understanding how to prevent tumors from forming in the first place has been a major challenge.

In a new study being presented at the annual American Society of Clinical Oncology meeting in Chicago next month, researchers report intriguing evidence that a low-fat diet, similar to the kind doctors recommend for heart health, is also linked to a lower risk of dying from breast cancer.

The study analyzed data from the Women’s Health Initiative, a large trial sponsored by the National Institutes of Health that studies the health effects of hormone therapy, diet and certain supplements on the health of more than 160,000 postmenopausal women. In this trial, researchers led by Dr. Rowan Chlebowski, an investigator at LA Biomedical Research Institute at Harbor-UCLA Medical Center, focused on a group of nearly 49,000 women who were randomly assigned to follow either a low-fat diet or a control diet for 8.5 years. The low-fat diet group aimed to reduce their fat intake to 20% of their total daily calories and to increase the consumption of fruit, vegetables and grains. None of the women had breast cancer at the start of the study.

After the study ended, the rates of new breast cancers were about the same in the two groups, but women who were diagnosed with breast cancer in the interim had a 35% lower risk of dying from any cause compared to those on the control diet. Even 20 years after the study ended, the women who ate the low-fat diet continued to have a 15% lower mortality risk. And in the longer follow-up data, their risk of dying specifically from breast cancer was 21% lower than that of the women who didn’t change their diet.

“This is a very exciting result for us,” says Chlebowski. “Now we have randomized clinical trial evidence that dietary moderation, which is achievable by many, can have health benefits including reducing risk of death from breast cancer. That’s pretty good; it’s hard not to be happy about that.”

The study is the first to rigorously test a potential factor that could influence deaths from breast cancer. Earlier observational studies did not assign volunteers to specific diets but looked at cancer outcomes depending on what people, on their own, chose to eat. In this study, volunteers were provided with dietary guidelines to follow about what to eat. “Until this study, we lacked any data from a prospective randomized control trial, which is the gold standard, for showing that a dietary approach really does reduce the risk of dying from breast cancer,” says Dr. Neil Iyengar, a medical oncologist at Memorial Sloan Kettering Cancer Center, who was not involved in the study. “Many of us who are proponents of considering diet and exercise in the cancer treatment plan are excited by this trial data because it is the first to show in a very robust way that we can improve outcomes and prevent cancer-related deaths just by changing the diet.”

In a separate sub-study, the research team also showed that the longer women were on the modified diet, the lower their risk of death during the study period. The results should give doctors more confidence in considering diet when discussing treatment options with women who are diagnosed with breast cancer. While the study did not find a significant connection between dietary changes and the incidence of new breast cancer, the results do suggest that modifying the diet can lower a woman’s risk of dying from any cause, or from breast cancer, if she is diagnosed with the disease.

The reason for that, says Iyengar, may have to do with the diet’s “dose.” It’s possible, for example, that the effect of the dietary change is greater on tiny tumors in the breast tissue that are already established, although they aren’t robust enough yet to lead to a diagnosis of breast cancer. “The effect of this diet may be stronger in preventing the growth of already established tumors rather than preventing the development of tumors,” he says. “What this trial does is position us to take a deeper dive, now that we know we can effectively change the tumor or cancer behavior with diet.”

Chlebowski plans to dig deeper into the data to find out more about how diet is working to lower deaths from breast cancer. During the trial, women provided blood samples both at the start of the study and one year later, so he and his team may find factors that changed among the women on the diet compared to those on the control plan.

In the meantime, he hopes cancer doctors will talk about diet with their patients who might be at higher risk of developing breast cancer. Though not all women in the study were able to lower their fat intake to 20% of their daily calories,“these dietary changes are achievable by many,” he says. Even though not all of the women on the low-fat diet met the target, the study showed that the modifications still reduced risk of dying from any cause and from breast cancer. “It’s about taking smaller pieces of meat, and adding vegetables to the plate to balance things out,” he says.

By Alice Park

Source: https://time.com/

 

Promising Blood Test Could Help to Predict Breast Cancer Recurrence

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Doctors have gotten much better at detecting and treating breast cancer early. Drug and chemotherapy regimens to control tumors have gotten so effective, in fact, that in some cases, surgery is no longer necessary. In up to 30% of cases of early-stage breast cancer treated before surgery, doctors can’t find evidence of cancer cells in postoperative biopsies. The problem, however, is that there is currently no reliable way to tell which cancers have been pushed into remission and which ones have not.

That’s where an easy identifier, like a blood test, could transform the way early stage breast cancer is treated. In a paper published in Science Translational Medicine, researchers led by a team at the Translational Genomics Institute (TGen), an Arizona-based nonprofit, report encouraging results on just such a liquid biopsy. Its test, called Targeted Digital Sequencing (or TARDIS), was up to 100 times more sensitive than other similar liquid-biopsy tests in picking up DNA shed by breast cancer cells into the blood.

Currently available ways of tracking breast cancer cells in the blood are most useful in people with advanced cancer. In those conditions, cancer cells litter the blood with fragments of their DNA as they circulate throughout the body to seed new tumors in other tissues like the bone, liver and brain. But in early-stage breast cancer, these cells are, by definition, scarcer.

To address the problem, the research team, which included scientists at Arizona State University, the City of Hope, Mayo Clinic, and the Cancer Research UK Cambridge Institute, developed a new way to pick up elusive cancer DNA. They genetically sequenced tumor biopsy tissue from 33 women with stage 1, 2, or 3 breast cancer, most of whom received drug or chemotherapy treatment prior to getting surgery to remove their tumors. By comparing the tumor sequence to the sequence from the patients’ normal cells, the scientists isolated potential mutations that distinguished the cancer cells and identified those that were most likely to be so-called “founder mutations”—genetic aberrations present in the original cancer cells and carried into the resulting tumor.

On average, each patient harbored about 66 such founder mutations. For each patient, the scientists combined the founder mutations to form a personalized assay, which could then be used to pick up signs of breast cancer DNA in blood samples. Combining a number of mutations together turned out to be a more sensitive way to detect tumor DNA than trying to pick up a single or a small number of mutations in an already small number of tumor DNA fragments present in the blood.

They combined this approach with a new strategy for amplifying the scarce tumor DNA found in a blood sample by preserving the size of these snippets and attaching unique molecular identifiers to them to make them more easily detectable.

At the start of the study, TARDIS was able to find tumor DNA in the blood samples of all the patients; other liquid biopsies for breast cancer currently in development have reported picking up 50% to 75% of the cancer cases.

After the pre-surgery treatment TARDIS detected circulating tumor DNA in the blood in concentrations as low as 0.003%, or 100-fold more sensitive than other tests being developed.

“This is an important advance,” says Dr. Debu Tripathy, professor and chair of the breast medical oncology department at the University of Texas MD Anderson Cancer Center, who was not involved in the study. “This test can help identify those with early stage breast cancer who may still have residual cancer in their body that may not be detectable with standard scans.”

That could help guide treatment, by, for example, determining which patients require closer monitoring for recurrent growths. Because the sequencing identifies the genetic mutations contributing to the tumor, the test could also help doctors to decide which targeted drug therapies, which are designed to address specific cancer mutations, to prescribe for their patients.

Most importantly, the test could help women whose tumors are effectively eliminated by their pre-surgery treatment to avoid an operation altogether since the blood test would reassure her and her doctor that no residual tumor DNA remained.

“If we could really know with a more accurate degree of certainty that you don’t have residual disease, it would be help in saying that you don’t need any more therapy [including surgery],” says Dorraya El-Ashry, chief scientific officer of the Breast Cancer Research Foundation. ”Conversely, if you still had residual disease, if there is information from the test that can pinpoint the next therapy, that would also be better.”

Muhammed Murtaza, co-director of the center for non-invasive diagnostics at TGen, says TARDIS needs to be tested in a larger group of breast cancer patients before it can be rolled out to doctors’ offices. His team is planning to study the test’s efficacy in about 200 breast cancer patients, in order to clarify exactly what levels of tumor DNA found in the blood are most likely to lead to recurrence. They are also exploring how modified versions of TARDIS could be applied to other cancers, like esophageal, colorectal, pancreatic and prostate.

There’s even encouraging precedent for this sort of a liquid biopsy. Doctors routinely rely on a blood test for chronic myeloid leukemia, for example, to track patients’ response to targeted drugs that treat specific mutations driving the cancer. “Applying this same technology to more common solid cancers like breast cancer is the new frontier,” says Tripathy.

By Alice Park

Source: https://time.com

 

Here’s How Much Caffeine May Trigger a Migraine, According to a New Study

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Caffeine can be both a treatment and a trigger for migraine headaches, which makes it difficult for sufferers to know how much to sip. Experts believe caffeine helps block adenosine, a molecule involved in migraine attacks, from binding to receptors in the brain, so many people use it as an at-home remedy; it’s also an ingredient in many over-the-counter migraine drugs. But, counter intuitively, some migraine sufferers also say consuming caffeine can bring on their debilitating headaches.

“The complex thing with caffeine is sometimes it’s harmful and sometime it’s beneficial,” says Elizabeth Mostofsky, a cardiovascular epidemiology researcher at Beth Israel Deaconess Medical Center in Boston. “It really amounts to the dose and the frequency of having it.”

Mostofsky is a co-author on a new study published in the American Journal of Medicine that helps define that risk-benefit balance. The findings suggest that having three servings of caffeinated beverages such as coffee, tea and soda in a day seems to be the tipping point at which caffeine becomes a possible migraine trigger. (A serving is typically defined as eight ounces of coffee, six ounces of tea, 12 ounces of soda or two ounces of an energy drink. While caffeine content can vary from drink to drink, the study did not distinguish between types of caffeinated beverages.)

For the study, researchers asked 98 adults who suffered two to 15 migraines per month to log their caffeine consumption twice a day for six weeks, along with information about other possible migraine triggers including exercise, alcohol consumption, mood, sleep, menstrual status and weather changes. They also provided information about the symptoms of migraines they suffered during the study period, and how they treated them. Participants also provided their demographic and medical histories. Most of them, like most U.S. migraine sufferers, were female.

After adjusting for other potential triggers, the researchers noticed an inflection point around three servings of caffeine per day. One or two caffeinated beverages per day wasn’t statistically associated with a higher chance of migraine, but downing three or more was linked to a higher risk of headaches both on that day and the one following, the researchers found.

The fact that the correlation applied to the day after high-caffeine consumption is especially telling: Many migraine sufferers use caffeine as a treatment for existing headaches, but the fact that people were more likely to have headaches the day after heavy caffeine consumption suggests that the drinks were causing, not treating, migraines, Mostofsky says.

Mostofsky notes that an individual’s tolerance to caffeine, which can build over time, likely matters too. For example, in this study, people who said they typically had less than one serving of caffeine per day saw a higher risk of migraine on days that they drank even one or two caffeinated beverages. The reverse may be true, too. Plenty of evidence shows that people who are heavy caffeine users can experience headaches, migraine or otherwise, if they miss their daily dose.

The study did not look at which types of caffeinated beverages were most strongly associated with headaches. And since the study was observational, meaning it looked only at patterns reflected in the data, Mostofsky says she can’t prescribe the perfect amount of caffeine. Nonetheless, she says migraine sufferers should keep these findings in mind the next time they’re at the coffee-shop counter.

By Jamie Ducharme

Source: https://time.com

Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

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If you were walking down the street and a man fell to the pavement clutching his chest, would you know what to do? According to a recent study, of 19,331 out-of-hospital cardiac arrests, there’s a 45 percent chance that someone would rush forward to give the man the CPR he needs.

Important follow-up question: if you were walking down the street and a woman fell to the pavement clutching her chest, would you know what to do? The same study showed that a woman is 27 percent less likely than a man to get CPR from a bystander in public. While there isn’t enough research on the intersecting factors of gender and race, studies looking at race and gender separately suggest that women of color are even less likely to receive bystander CPR.

As half a million Americans will die from cardiac arrest annually, timely CPR is an incredibly important matter. Even as major health organizations train tens of millions of people in resuscitation techniques each year, women still lack equal access to the lifesaving compressions of CPR.

It’s important to look at why bystanders are so much less likely to intervene to save a woman in cardiac arrest. The first barrier is a wildly inaccurate myth that women don’t even experience cardiac arrest. Though many people think heart issues are a “men’s problem,” heart disease actually affects more women than men, killing roughly one woman every minute. Even when bystanders accurately identify that a woman needs CPR, they may be afraid to touch her breasts, confused about where to put their hands, or apprehensive about pushing down hard and fast on a woman’s body.

So, how do we address this laundry list of misconceptions that are literally killing women? The same way we popularized the resuscitation techniques that remarkably double or triple cardiac arrest victims’ chances of survival: through education.

Imagine a CPR manikin (the medical term for the dummies used in training courses), that expressionless, universal human form meant to represent everybody and anybody who could suffer cardiac arrest. See something missing from the manikin’s body? Or rather, two things?

Noticing this shocking oversight, an equal parts pissed-off and inspired team at JOAN Creative had an idea—the WoManikin. The WoManikin is a universal attachment that can easily be slipped over the common flat-chested manikin to add breasts. The WoManikin teaches people how to perform CPR on a torso with breasts during training, so they’ll know what to do when they see a woman or person with breasts in cardiac arrest.

By putting the sleeve design on WoManikin.org as an open source pattern and starting a fund to create more attachments, JOAN hopes to get a WoManikin in every CPR training program in the country by 2020. JOAN developed the WoManikin in collaboration with CPR experts, cardiologists, and organizations that care about closing the gender gap in CPR. So, in that way, the WoManikin doesn’t just provide a way to challenge biased CPR training—it shows what happens when women collaborate and apply creativity to tackle the inequities around them.

To learn more and join the fight to end gender disparities in CPR, visit WoManikin.org.

Hannah Lewman Hannah Lewman Brand Contributor

Hannah Lewman is a Strategist for JOAN Creative.

Source: Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

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Photographer: Scott Eisen/Bloomberg

© 2016 Bloomberg Finance LP

The landscape of experimental Alzheimer’s disease (AD) drugs is strewn with failures, so much so that it has been referred to as “an unrelenting disaster zone”. Recognizing the greatly increasing number of patients with this disease, many biopharma companies have invested a lot of resources in attacking this problem, only to be turned away in late stage studies as happened to Merck with its BACE inhibitor, verubecestat, and Lilly with its beta-amyloid antibody, solanezumab.

Now add Biogen to the list of companies that have failed in this arena. Its drug, aducanumab, partnered with Eisai, was believed to be better in removing beta-amyloid from the brain than any agent previously tested. Many have hypothesized that beta-amyloid causes the formation of damaging clumps of debris in the brain leading to AD. Unfortunately, Biogen halted a major clinical trial with aducanumab due to a futility analysis showing that the drug doesn’t work.

This is a terrible result for Alzheimer’s patients who had hoped that this was the drug that would finally succeed in treating AD. But the demise of aducanumab is also disastrous for Biogen which had expended an enormous amount of resources into this program, likely at the expense of other opportunities. It was a risky bet and one for which Wall Street has delivered a punishing blow. Biogen’s stock dropped by nearly 30% shortly after announcing the disappointing aducanumab results.

How is Biogen going to respond? As John Carroll has reported, many industry analysts believe that there aren’t many gems in the Biogen pipeline that can make up for the loss of this potential blockbuster. In predicting Biogen’s next steps, perhaps there are some learnings from another such pipeline failure – that of Pfizer’s torcetrapib.

Torcetrapib was the first of a class of compounds known as CETP inhibitors, drugs that both raised HDL-cholesterol and lowered LDL-cholesterol. A CETP inhibitor had the potential to remodel a heart patient’s lipid profile thereby greatly reducing his risk of a heart attack or stroke. There was tremendous excitement generated in this potential breakthrough treatment, not just in Pfizer but also among cardiologists and heart patients. In fact, internal commercial analyses predicted annual sales in excess of $15 billion. However, as happened with aducanumab, on December 4th, 2006, Pfizer announced that torcetrapib failed its long-term clinical study. The drug was dead. The Wall Street reaction was swift, albeit not as dramatic as Biogen’s experience. Pfizer stock dropped 10% as a result of this news.

Internally, the Pfizer reaction was intense. Torcetrapib was supposed to be the blockbuster that would drive growth into the next decade. Its loss created an enormous hole. Pfizer CEO Jeff Kindler responded in a couple of ways. First, he decided to “right size” R&D in relation to lower expected future revenues. In effect, hundreds of millions of dollars needed to be cut from R&D. Pfizer’s R&D budget had already undergone major portfolio adjustments and reorganizations over the previous five years due to the acquisition of Warner-Lambert Parke-Davis in 2000 followed by the acquisition of Pharmacia in 2004. Meeting the new R&D budget targets weren’t going to be achieved by simple cuts; rather, major research sites had to be closed and jobs had to be eliminated. Gone were R&D sites around the world including those in France, Japan and, most significantly, the iconic laboratory in Ann Arbor, Michigan.

But budget cuts weren’t going to be enough for Pfizer to meet its desired goals. The company began assessing major M&A opportunities and in 2009 it acquired Wyeth for $68 billion leading to yet another round of reorganizations and portfolio reshuffling. The ripple effect of the torcetrapib demise was felt by the entire company and lasted for a number of years.

So, how will Biogen respond? Undoubtedly, there will be budget cuts. In addition, perhaps Biogen will look at its R&D portfolio and give a higher priority to those programs that have the potential to deliver revenues in the short term. There might also be a push to drop programs deemed to be very risky or where the proof-of-concept requires long, expensive clinical trials. Finally, it wouldn’t be surprising to see Biogen become aggressive in their M&A activities. But make no mistake. The death of an important drug like aducanumab will have both a short and a long term effect on Biogen as a company and especially on R&D.

John LaMattina

Contributor

I was the president of Pfizer Global Research and Development in 2007 where I managed more than 13,000 scientists and professionals in the United States, Europe, and Asi…

Source: How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

Open Innovation In Japan Breaks New Ground In The Operating Room

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Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women's University's Institute of Advanced Biomedical Engineering and Science

Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science pose in a version of the Smart Cyber Operating Theater (SCOT).JAPAN BRANDVOICE

Imagine undergoing surgery on a robotic bed that can automatically help perform a magnetic resonance imaging (MRI) scan while an artificial intelligence (AI) system actively supports surgeons by suggesting various procedures. It sounds like a scenario from a Hollywood movie, but it’s reality in Japan.

Doctors at the Tokyo Women’s Medical University – Waseda University Joint Institution for Advanced Biomedical Sciences (TWIns) recently performed a groundbreaking brain surgery to treat essential tremor, a neurological disorder. It was the first clinical use of the latest version of the institution’s Smart Cyber Operating Theater (SCOT). Hyper SCOT, as it’s known, brings robotics and AI into the operating theater so that patients can have better post-surgical outcomes. It’s an impressive example of the many forms of open collaboration driving innovation in Japan.

A new frontier in surgery

Walking into the Hyper SCOT operating room at Tokyo Women’s Medical University, one gets the feeling of entering Sick Bay aboard the starship Enterprise from Star Trek. Silver doors slide open to reveal a sleek white room illuminated by variable-color lights. In the center are a pair of robots: an operating bed that swivels to position a patient under a large MRI scanner nearby, and a dual-armed industrial-style robot that can support a surgeon’s arms while operating. On the wall are high-resolution images of a patient’s brain. Surgeons can gesture to zoom in or change the images’ orientation, a feature inspired by the Tom Cruise film Minority Report.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.JAPAN BRANDVOICE

Hyper SCOT is designed to transform surgery from an analog process, where standalone equipment is not connected, into a digital process where data are shared. It can support surgical teams by providing them with a rich stream of data from networked medical tools as well as AI-powered advice on surgical options. SCOT also aims to improve precision by helping brain surgeons accurately navigate to a tumor site. Although MRI had only been available to surgeons before an operation, Hyper SCOT would enable them to get scans during the procedure, which could dramatically improve outcomes.

“If we have many kinds of information, we need some kind of strategy desk, like Mission Control at NASA,” says SCOT project leader Yoshihiro Muragaki, a professor in Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science. “Our moonshot is to make new eyes, brains and hands for surgeons. With SCOT, we can perform precision-guided therapy.”

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women's Medical University.

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women’s Medical University. JAPAN BRANDVOICE

A neurosurgeon himself, Muragaki conceived of the SCOT project and has spearheaded it since its inception in 2000. Back then it was known as the Intelligent Operating Theater, a version now known as Classic SCOT. Supported by a grant from the Japan Agency for Medical Research and Development (AMED), the system began as an initiative to enhance interoperability among devices used in the medical theater, but the development team later added features such as multiple surgery cameras that can send imagery to remote consultants, usually senior surgeons. These advisors have a bird’s-eye view of the action as well as near-real time data streams of patients’ vital statistics. Since 2000, the technology has been used in some 1,900 cases, mostly brain surgeries. MRI has been key in detecting residual tumor tissue that escaped surgeons’ notice during operations.

“Even under a microscope, it’s very difficult to detect where brain tumor tissue ends and healthy tissue begins,” says Muragaki. “That’s why we need MRI during surgery. It’s a very powerful tool for removing tumors. But that also means we can only use MRI-compatible devices in the operating room and we must choose them carefully.”

Fruits of teamwork

With over 100 researchers, SCOT is the result of a complex collaboration between academia and the private and public sectors. Aside from the two universities in TWIns, Muragaki and colleagues are working with Hiroshima University and Shinshu University, where versions of SCOT are being evaluated in clinical settings. High-tech companies are also helping to develop SCOT, including Hitachi, Canon Medical, and Air Water. Another participant is Denso. It developed a medical-equipment middleware called OpeLiNK that is based on factory automation technology as well as ORiN, a platform created with the support of the New Energy and Industrial Technology Development Organization (NEDO), a leading Japanese state-backed research center. Orchestrating all these players was essential in creating SCOT.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery. JAPAN BRANDVOICE

“If one company tried to do this alone, it would want to use its own technology and keep rivals out,” says Muragaki. “That company wouldn’t succeed in integrating all the various technologies. That’s why public institutions are vital for this kind of open innovation project. They act like the frame in a traditional sensu Japanese folding fan, keeping everything together as the project unfolds.”

The collaborations that gave birth to SCOT were recently recognized when it picked up the Minister of Health, Labour and Welfare Award as part of the first Japan Open Innovation Prize. Sponsored by the Japanese government, the accolade was set up to promote initiatives that can serve as future role models for open innovation. In Japan, companies traditionally kept R&D in-house, even in recent years. But the public and private sectors have been pushing open innovation as a vehicle for enhancing competitiveness. Collaborations between government labs, corporations and universities are now flourishing. Major telecom carrier KDDI, for instance, launched the first of a series of Open Innovation Funds in 2012, aimed at investing in IT startups in Japan and overseas.

“There’s a growing recognition that if a company categorizes itself as a camera company, for instance, it is limiting itself,” Keiichiro Koumura, an official with major real estate company Mitsui Fudosan, recently told attendees at an open innovation seminar at Mitsui Fudosan’s Base Q in Tokyo. “Because as technology changes, cameras have become smartphones. One way to address this is open innovation.”

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.japan brandvoice

Looking to the future

As for SCOT, Muragaki hopes to spread the technology to other hospital facilities such as intensive care units, and apply it to other forms of surgery such as vascular operations. He also hopes to take the technology overseas.

“Most doctors are resistant to change. Before they try SCOT, surgeons don’t regard it as something that’s necessary but once they give it a go, their view changes,” says Muragaki. “After brain surgeries, we want to try the technology on bone tumors, and keep going. If you could do all surgeries with SCOT, it would decrease risks and increase benefits. That’s something we can work toward.”

To find out more about SCOT, visit the university’s website here.

For more on the Japanese Government’s innovations and technologies, please click here.

Japan

Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as

Source: Open Innovation In Japan Breaks New Ground In The Operating Room

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