Source:http://www.chestnet.org/News/Press-Releases/2018/10/Triple Reviewed by James Ives, M.Psych. (Editor)Oct 5 2018The InforMing the PAthway of COPD Treatment (IMPACT) study was conducted to assess the benefits of triple versus dual therapy in patients with COPD. In a study at CHEST, researchers found that regardless of baseline reversibility, the usage of triple dual therapies significantly reduced the annual rate and moderate-to-severe and severe exacerbations, improved lung function and overall quality of life in patients.Related StoriesSmarter, more educated people get a cognitive ‘head start’, but aren’t protected from Alzheimer’sResearch sheds light on sun-induced DNA damage and repairAXT enhances cellular research product portfolio with solutions from StemBioSysThe randomized, double-blind, parallel-group, global study was conducted in 10,355 symptomatic patients with COPD with a history of moderate-to-severe exacerbations over a 52-week period. During the screening, patient was defined as reversible through differences shown between their pre- and post-albuterol assessments of forced expiratory volume in 1 second (FEV1) of ≥12 percent and ≥200 mL. Researchers also assessed the effect of baseline reversibility on treatment response with fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) and with FF/VI and UMEC/VI. The lung function and quality of life (QoL) of patients were measured by St George Respiratory Questionnaire (SGRQ) and observed for FF/UMEC/VI over UMEC/VI independent of reversibility status at screening.During screening, 18 percent of patients demonstrated reversibility. In both reversible and nonreversible patients, there was a statistically significant reduction in the rate of moderate and severe exacerbations with FF/UMEC/VI as compared to UMEC/VI. They also found a reduction in the risk of having a moderate/severe exacerbation and the risk of having a severe exacerbation in both groups of patients. Quality of life was also improved in both reversible and non-reversible patients. read more

Reviewed by James Ives, M.Psych. (Editor)Oct 10 2018New research from the University at Buffalo has, for the first time, identified differences between men and women in their preferences for maintaining comfort both while exercising and in recovery. The results could one day inform the development of new athletic apparel.The human body has a variety of automatic mechanisms in place to respond to being too warm, including sweating and increased skin blood flow. But people also have voluntary ways of cooling themselves down. If you’re in a stuffy room, for example, you can remove your jacket.Scientists refer to these voluntary actions as “thermal behavior.””This study is the first to highlight sex differences in thermal behavior,” said Nicole Vargas, a postdoctoral fellow in exercise and nutrition sciences in UB’s School of Public Health and Health Professions.Vargas is the lead author on the study, published online in August ahead of a scheduled December print date in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.The study took place in UB’s Center for Research and Education in Special Environments. Researchers had 10 men and 10 women in their early 20s exercise at low intensity — about 65 revolutions per minute — on a stationary bicycle for one hour while watching a nature documentary. Each participant was equipped with a custom-made device: a dual tubing system that was in direct contact with the back of their neck.The basic model for this study harkened back to similar studies in thermal behavior done in the 1970s. Those, however, used the hand for cooling purposes. “The neck makes more sense, however, because it’s more sensitive perceptually, so it gave us a more sensitive measure of thermal behavior,” explained Zachary Schlader, the study’s senior author and an assistant professor of exercise and nutrition sciences at UB.One set of tubing was perfused with 93.2 degrees Fahrenheit water. The other series of tubes contained -4 degree liquid, but the flow of this liquid was controlled by a valve. Participants were instructed to “thermally behave” — or open the valve, thereby releasing the flow of extremely cold liquid — any time they felt that their neck was uncomfortably warm while exercising.”As soon as they felt thermally comfortable again, they would turn the valve off and the 93 degree water would come through again, which effectively warmed their neck to thermoneutral range. If they felt they were getting too warm again, they could turn that valve back on,” Vargas said.Related StoriesSupervised fun, exercise both improve psychosocial health of children with obesityLiver fat biomarker levels linked with metabolic health benefits of exercise, study findsIt’s never too late to take up exercise, advise researchersParticipants were monitored for one hour after exercising and were instructed during the recovery phase to maintain their neck temperature at a comfortable level.Researchers found that the female participants wanted more cooling than the males — despite similar overall changes in body temperature — as evidenced by the females’ more frequent use of the antifreeze liquid while exercising. Vargas says there are several potential explanations: Women have more subcutaneous fat than men, and women tend to have greater perceptual responses to temperature changes.”The really interesting thing we found was during recovery,” Vargas said. “The dynamic of how skin temperature recovers versus core temperature in females compared to males was a lot different.”Whereas skin temperature in males gradually fell following exercise, returning to normal levels within 60 minutes, skin temperature fell more rapidly in females, returning to normal levels within 10 minutes following exercise.This rapid fall in skin temperature should theoretically decrease the desire for neck cooling in females. However, the women in the study continued to thermally behave by releasing the flow of the extremely cold liquid, likely because their core temperature remained elevated. This highlighted the importance of core temperature as a major contributor to thermal behavior following exercise, which was more apparent in females.While the research team isn’t involved on the product side, the results of this study may help inform the development of new athletic apparel in the years to come.Since this study was completed, researchers have begun applying the basic study model and technique to more clinical applications. For example, Vargas received a grant through the American College of Sports Medicine to examine thermal behavior in people with multiple sclerosis. The symptoms of MS can be exacerbated during exercise.”We’re interested in determining whether people with MS use thermal behavior appropriately and if that can help mitigate some of the symptoms they feel while exercising,” Vargas explains. “This whole line of thermal behavior research has opened up a lot of doors for us.” Source:http://www.buffalo.edu/news/releases/2018/10/018.html read more

Reviewed by Kate Anderton, B.Sc. (Editor)Oct 26 2018Researchers developed a new digital stethoscope that combines precision sensors, electrocardiogram technology and machine learning applications into one piece of equipment to better detect heart ailments and problems that might occur with an implanted heart pump.Jason Kolodziej and Steven Day, engineering professors at Rochester Institute of Technology, worked with Dr. Karl Schwarz, cardiologist and professor of medicine at the University of Rochester Medical Center, to develop an Advanced Digital Stethoscope prototype. The researchers expanded capabilities and functions of a traditional stethoscope to detect off-rhythms of the heart, primarily one with an embedded left ventricular assist device, or heart pump.Left ventricular assist devices (LVAD) are used to help manage end-stage heart failure, pumping blood from the left ventricle to the aorta to provide needed blood flow for patients with severely reduced heart function. The research team determined that natural heart sounds and the sounds of the implanted LVAD may hold the key to diagnosing patients with suspected device dysfunction.”This stethoscope that we designed integrates multiple sensors into one. It is not necessarily a new sensor that measures something never measured before; it is something that in a hospital setting would be done by multiple machines. Most cardiologists aren’t wheeling around this data collection hardware,” said Kolodziej, associate professor of mechanical engineering in RIT’s Kate Gleason College of Engineering.Cardiovascular disease is one of the leading causes of death in the U.S. with more than 600,000 dying of heart disease annually, according to the Center for Disease Control. Diagnosis of the disease entails performing several important tests and assessments including ECG, echocardiograms, x-rays and cardiac magnetic resonance imaging, for example. Acoustic information through a stethoscope is also one means to attain information about heart function.Stethoscope design has changed little since its invention in 1816 by Rene Laennec. Schwarz, director of the URMC’s Echocardiography Laboratory, performs routine imaging and advanced imaging studies on patients with complex cardiac disease and of patients with mechanical assist devices. The RIT and URMC researchers proposed modernizing a stethoscope design and worked to develop a prototype using innovative digital signal processing techniques, including digital signal filtering, advanced beat-based rejection algorithms and ensemble averaging.Related StoriesNew research links “broken heart syndrome” to cancerTeam approach to care increases likelihood of surviving refractory cardiogenic shockCutting around 300 calories a day protects the heart even in svelte adultsThe new design includes a microphone for recording data collected through the stethoscope, combined with ECG leads–stainless steel contact pads that would normally be affixed to a patient’s chest, arms and legs. Usually the ECG leads are part of a separate piece of equipment standard in acquiring digital audio of heart sounds. Instead, researchers attached them to the new stethoscope head. The new leads were 3D-printed at The Construct, an RIT laboratory.Apart from hardware for the project, computer algorithms–also referred to as machine learning techniques–are incorporated into the larger system to take in signals, and to learn and recognize defects. Techniques to improve acoustic diagnostics include spectral analysis, advanced automated neural networks and a combination of smartphone-based, interactive software that will allow the clinician to make a diagnosis when integrating the advanced acoustic analyses with other routine clinical information.Improvements to digital stethoscopes provide more information in the acoustic signature than is normally being used, and having been trained to listen for different things, physicians hear signals such as heart murmurs, valve regurgitation and other signals that indicate different defects, Day explained further.”It is almost unconscious, like people listening to engines, and hear something off that could mean a problem. But if you ask what sounds different, they may not be able to explain it or articulate it, but they just know. This is about getting the device to do that, to hear sounds and then to make that determination of what the problem could be,” said Day, a professor and head of RIT’s biomedical engineering program. He also has vast experience in the development of LVADs, building a state-of-the-art implantable blood pump with peers from the University of Virginia, the Utah Artificial Heart Institute and MedQuest Inc. Source:https://www.rit.edu/news/story.php?id=68280 read more

Such a procedure requires a massive amount of new bone cells. If we could direct bone cell creation at the site of the fusion, we could help patients recover more quickly and reduce the risk of complications.”Aaron James The regenerative group of cells, known collectively as stem cells, all have the potential to develop into a variety of cell types including those that make up living tissues, such as bones. Scientists have long sought ways to manipulate the growth and developmental path of these cells, in either a living animal or the laboratory, to repair or replace tissue lost to disease or injury.Previous studies by others, James points out, showed that a particular type of stem cell — perivascular stem cells — had the ability to become either bone or fat and numerous studies since then have focused on advancing the understanding of what signaling proteins drive this developmental change.From past studies of his own, James also knew that the protein WISP-1 plays a key role in directing the stem cells.In his new experiments, James and his team genetically engineered stem cells collected from patients to block the production of the WISP-1 protein. Looking at gene activity in the cells without WISP-1, they found that four genes that cause fat formation were turned on 50-200 percent higher than control cells that contained normal levels of the WISP-1 protein.Related StoriesStudy: Megakaryocytes play an important role in cell migrationSingle-cell encapsulation technology can protect transplanted MSCs from immune attackComprehensive cell atlas of the human liverThe team then engineered human fat tissue stem cells to make more WISP-1 protein than normal, and found that three genes controlling bone formation became twice as active as in the control cells, and fat driving genes such as peroxisome proliferator-activated receptor gamma (PPARγ) decreased in activity in favor of “bone genes” by 42 percent.With this information in hand, the researchers next designed an experiment to test whether the WISP-1 protein could be used to improve bone healing in rats that underwent a type of spinal fusion — an operation frequently performed on people to alleviate pain or restore stability by connecting two of the vertebrae with a metal rod so that they grow into a single bone. An estimated 391,000 spinal fusions are performed in the U.S. each year, according to the U.S. Agency for Healthcare Research and Quality. A report on the experiments was published online Oct. 23 in the journal Scientific Reports. According to the Office of the Surgeon General,The researchers also plan to explore whether reducing the level of WISP-1 protein in stem cells could preferentially favor the development of fat cells for soft tissue wound healing as well. Reviewed by Alina Shrourou, B.Sc. (Editor)Jan 7 2019If harnessed in people, it could speed recovery for bone breaks, spinal fusions, osteoporosisIn experiments in rats and human cells, Johns Hopkins Medicine researchers say they have added to evidence that a cellular protein signal that drives both bone and fat formation in selected stem cells can be manipulated to favor bone building. If harnessed in humans, they say, the protein — known as WISP-1 — could help fractures heal faster, speed surgical recovery and possibly prevent bone loss due to aging, injury and disorders. Source:https://www.hopkinsmedicine.org/news/newsroom/news-releases/stem-cell-signal-drives-new-bone-building In their experiments, the researchers mimicked the human surgical procedure in rats, but in addition, they injected — between the fused spinal bones — human stem cells with WISP-1 turned on.After four weeks, the researchers studied the rats’ spinal tissue and observed continued high levels of the WISP-1 protein. They also observed new bone forming, successfully fusing the vertebrae together, whereas the rats not treated with stem cells making WISP-1 did not show any successful bone fusion during the time the researchers were observing. Our bones have a limited pool of stem cells to draw from to create new bone. If we could coax these cells toward a bone cell fate and away from fat, it would be a great advancement in our ability to promote bone health and healing.”Aaron James, M.D., Ph.D., associate professor of pathology at the Johns Hopkins University School of Medicine, and the study’s senior author We hope our findings will advance the development of cellular therapies to promote bone formation after surgeries like this one and for other skeletal injuries and diseases, such as broken bones and osteoporosis.” Aaron James Bone formation in the rat spine. Credit: Aaron James, Johns Hopkins Medicine read more