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Friday, July 6, 2018

Product review: The desk that’s also a bike


At Medical News Today, we are often asked to try out new and unusual health and fitness gizmos. We tend to turn the offers down, but this device piqued my interest.
It is now common knowledge that sitting still for hours every day is bad for our health.
But many of us work in office environments, where a sedentary position is necessary.
Standing desks have become quite common over recent years, but they don’t allow you much scope for physical exertion.
Therefore, when FlexiSpot contacted me to ask if I would like to trial their Deskcise Pro, I jumped at the chance.
In short, it’s a desk with pedals, which allows you to cycle while you work.
FlexiSpot Deskcise Pro
The FlexiSpot Deskcise Pro in all its glory.
I chose to give this particular product a go because it ticked a couple of vital boxes for me: one, I am a relatively keen cyclist; and two, it seemed like it might be amusing to get everyone in the office to have a go.
After all, watching someone furiously pump the pedals while trying to type is sure to raise a few chuckles.

Was it any good?

Before the desk arrived, I had some reservations; I couldn’t really see it working that well. My main concerns were that it would be too noisy in an office environment and that I wouldn’t be able to type as I bobbed up and down with each pedal push.
In both regards, I was pleasantly surprised. The bike is silent and, actually, typing while cycling is quite easy. Because of the range of adjustments to saddle height and desk position, it is easy to find a setting that works for you.
Over the course of a few days, I spent a few minutes to an hour testing the Deskcise Pro. However, I was careful not to work up a sweat; our office is relatively small, and I didn’t think that would be fair on my colleagues. That said, I could imagine that keeping my blood pumping and muscles working might benefit my health in the long run.
Overall, I enjoyed the experience, and I will continue to use it sporadically. However, I am but one man, so I asked my colleagues to try the contraption for themselves. Here’s what they had to say.
James, our senior editor, had the following to say:
“The FlexiSpot Deskcise Pro was surprisingly easy to use, and I soon found myself working, unconscious of the fact that I was cycling away!”
“Changing the settings was simple enough, and the desk component provided welcome wrist support.”
“My desk setup is quite busy, however, and it was tricky trying to fit everything onto the surface that the device offers.”
However, he goes on, “I would also recommend wearing cool, loose-fitting clothing when using the FlexiSpot Deskcise Pro; I got quite hot wearing jeans!”
The picture above demonstrates the rather complex desk setup that James needed to make up for the lack of desk space. It also shows his inappropriate cycling attire.
Surprisingly comfortable, the cycle desk helps to keep you focused and alert. It feels good to be moving while working rather than being slumped in a chair. It was also surprisingly easy to read and type documents while maintaining a rhythmic cycle.”
Copy editor Isy
She goes on, saying, “However, the wrist support was in the wrong place for me so hindered typing somewhat. There is also not much space on the desk for anything other than a laptop, so it would probably need to be an additional desk for someone, rather than their main place of work.”

Popular all round

The desk seemed to win over some members of the team who were, initially, resolutely against the idea. For instance, despite initial hesitations, news writer Maria seems to have been wooed by the desk.
She explains, “I am not a very physically active person, and I am most definitely not into cycling. However, I decided to give the Deskcise Pro a try and see how I would fare.”
“Although, as I said, I am not the sportiest of people, I often begin to feel fidgety at work, and I have especially restless legs, so I wondered if the desk could help me deal with that and increase my focus. And it did!”
“Cycling helps me keep my restless legs occupied and my mind free to deal with the business at hand.”
“I also appreciate,” she adds, “how customizable the desk is: it’s great that I can set it to fit my (very short) height, and I also appreciate that I can customize the pedaling resistance so that I can move at the pace that I’m most comfortable with.”
“The only problem is that I fear I may soon become addicted and start fighting my colleagues for it!”
News copy editor Jasmin was similarly impressed, saying, “When I first saw the bike, I was worried that the motion of my legs while cycling would make the desk wobble around, or that the wrist support would be positioned strangely and make typing awkward.”
“How wrong I was! I knew in my first few seconds of using the bike that I would become attached to it.”
“The seat is so comfortable, the pedals move so smoothly, and the desk is the perfect size — not to mention the super useful cup holder,” Jasmin adds. “When you’re sitting at a desk all day like we in this office are, using the bike is a welcome break from shoulder ache while still being able to carry on working when we’re crunched.”
“I’ve heard that exercise can boost concentration and productivity, and this bike is proof of that! When I use it, I’m crossing things off of my to-do list faster than ever before. To summarize: an excellent addition to the MNT office.”
So, despite initial reservations in some camps, the FlexiSpot Deskcise Pro is a hit with the folks at MNT — although it might be improved with a larger desk area and an adjustable wrist support.

Your dog’s flea meds might one day protect you from Zika


Each year, thousands of people suffer from malaria, the Zika virus, and other diseases transmitted by pests such as mosquitoes. However, humans may soon be in the clear, thanks to the drugs used to protect man’s best friend from fleas and ticks. In a new study, researchers found that fluralaner and afoxolaner, sold as Bravecto and Nexgard, respectively, effectively killed infectious mosquitoes and sand fleas when they consumed human blood laced with the compounds, according to Time. Through computer modeling, these researchers also found that if enough people took the drug, 97% of infections could be prevented in Zika-prone areas, and 70% of new malaria cases could be prevented in countries that experience seasonal malaria, they reported this week in the Proceedings of the National Academy of Sciences. To test these findings, researchers are already planning clinical trials in healthy human volunteers.

‘U.S. private citizen cites mystery illness symptoms after China visit’


A U.S. private citizen who visited China has reported symptoms like those of U.S. diplomats afflicted with a mysterious illness in Havana and Guangzhou, a U.S. State Department official said on Thursday.
The person, who was not named by the department official, is the first non-official American known to have experienced the symptoms following a trip to China. Nineteen private U.S. citizens have reported similar symptoms after traveling to Cuba.
Twenty-five U.S. officials in Havana and at least one working at the U.S. consulate in Guangzhou have been sent back to the United States after exhibiting symptoms consistent with a concussion or mild traumatic brain injury.
Many of them reported the mystery illness, whose cause is unknown, following an experience of abnormal sounds or pressure.
In a March 2 travel advisory, the State Department urged U.S. citizens to reconsider travel to Cuba, saying that “numerous U.S. Embassy Havana employees appear to have been targeted in specific attacks.”
“Affected individuals have exhibited a range of physical symptoms including ear complaints and hearing loss, dizziness, headaches, fatigue, cognitive issues, visual problems, and difficulty sleeping,” it added.
News of the illness suffered by U.S. officials in Cuba first came to light last August. Reports of the illness of the American working at the U.S. consulate in Guangzhou emerged in May.
“Since the release of the first (Guangzhou-related) Health Alert on May 23, the Department of State has been contacted by one U.S. citizen who reported experiencing similar symptoms following travel to China,” said an official with the State Department’s Bureau of Consular Affairs.
Asked if the State Department had any information suggesting that the private citizens were affected by the same “attacks” as those on U.S. officials in Cuba, the official replied: “This is an evolving situation. As we state in our health alert, if you have concerns about any symptoms or medical problems, consult a medical professional as soon as possible.”
Cuban officials have denied any involvement or knowledge of what was behind the illnesses in Havana. China has said that it thoroughly investigated the initial case reported by the United States in Guangzhou and found no reasons or clues to explain it.

Smart bandages monitor and deliver treatment for chronic wounds


A team of engineers led by Tufts University has developed a prototype bandage designed to actively monitor the condition of chronic wounds and deliver appropriate drug treatments to improve the chances of healing. While the lab-tested bandages remain to be assessed in a clinical context, the research, published today in the journal Small, is aimed at transforming bandaging from a traditionally passive treatment into a more active paradigm to address a persistent and difficult medical challenge.
Chronic skin wounds from burns, diabetes, and other medical conditions can overwhelm the regenerative capabilities of the skin and often lead to persistent infections and amputations. With the idea of providing an assist to the natural healing process, the researchers designed the bandages with heating elements and thermoresponsive drug carriers that can deliver tailored treatments in response to embedded pH and temperature sensors that track infection and inflammation.
Non-healing chronic wounds are a significant medical problem – nearly 15 percent of Medicare beneficiaries require treatment for at least one type of chronic wound or infection at an annual cost of an estimated $28 billion, according to research published in Value in Health. Patients are often older, non-ambulatory, and limited in their ability to provide self-care, yet non-healing wounds are typically treated in an outpatient setting or at home. The smart bandages could provide real time monitoring and delivery of treatment with limited intervention from the patient or caregivers.
“We’ve been able to take a new approach to bandages because of the emergence of flexible electronics,” said Sameer Sonkusale, Ph.D. professor of electrical and computer engineering at Tufts University’s School of Engineering and corresponding co-author for the study. “In fact, flexible electronics have made many wearable medical devices possible, but bandages have changed little since the beginnings of medicine. We are simply applying modern technology to an ancient art in the hopes of improving outcomes for an intractable problem.”
The pH of a chronic wound is one of the key parameters for monitoring its progress. Normal healing wounds fall within the range of pH 5.5 to 6.5, whereas non-healing infected wounds can have pH well above 6.5. Temperature is also an important parameter, providing information on the level of inflammation in and around the wound. While the smart bandages in this study combine pH and temperature sensors, Sonkusale and his team of engineers have also developed flexible sensors for oxygenation – another marker of healing – which can be integrated into the bandage. Inflammation could also be tracked not just by heat, but by specific biomarkers as well.
A microprocessor reads the data from the sensors and can release drug on demand from its carriers by heating the gel. The entire construct is attached to a transparent medical tape to form a flexible bandage less than 3 mm thick. Components were selected to keep the bandage low cost and disposable, except for the microprocessor, which can be re-used.
“The smart bandage we created, with pH and temperature sensors and antibiotic drug delivery, is really a prototype for a wide range of possibilities,” said Sonkusale. “One can imagine embedding other sensing components, drugs, and growth factors that treat different conditions in response to different healing markers.”
The smart bandages have been created and tested successfully under in vitro conditions. Pre-clinical studies are now underway to determine their in vivo clinical advantages in facilitating healing compared to traditional bandages and wound care products.

Novel method of producing pluripotent stem cells


Scientists have developed a modified CRISPR tool that can stimulate the de-differentiation of somatic cells into induced pluripotent stem cells, eliminating the need for the artificial insertion of genes, which has previously been shown to cause cancer.
In 2012, Shinya Yamanaka, a Japanese scientist, made the Nobel-Prize winning discovery that it is possible to take adult skin cells through a process of reprogramming in order to convert them into induced pluripotent stem cells (iPSCs), which can develop into any cell type of the human body.
Some genes are essential for such conversion, called the Yamanaka factors. Previously, these factors had to be inserted into adult skin cells using artificial methods, creating the potential for genetic mutations and the development of cancer.
However, a recent study has reported that it is possible to activate the endogenous genes of the adult skin cells (in order to produce iPSCs) through the use of a new gene editing technology called CRISPRa.
The tool makes use of an engineered version of the Cas9 gene that usually functions to cut DNA. In CRISPRa, this genetic ‘scissor’ is blunted, making it unable to excise the section of DNA. This allows it to activate the target gene without producing gene mutations.
Professor Otonkoski, one of the lead researchers in this study, explained that the use of the CRISPR/Cas9 system to activate genes opens up great possibilities in the area of cell reprogramming by targeting multiple genes simultaneously.
Activating genes already within the cell rather than inducing overexpression of transgenes mimics human physiology more closely, and is therefore a safer way to induce cellular differentiation. This results in cells that appear and function more normally, compared to iPSCs produced using previous methods.
Another crucial discovery was that the tool could successfully activate a gene known to control the very early development of the post-fertilization embryo.
The new study also indicates the possibility of improving multiple reprogramming functions by focusing upon only those genes or related elements that are characteristic of the cell type that is targeted by the experiment.
It is also likely to help researchers better understand how genes are activated during early embryonic life. The lead researcher, PhD student Jere Weltner affirms, “The technology may find practical use in bio banking and many other tissue technology applications.”
The study was recently published in the journal Nature Communications.

HIV Vax Candidate ‘Defines Additional Path’ for Preclinical Data


The mosaic vaccine HIV-1 vaccine produced comparable immune responses in both humans and rhesus monkeys, a phase I/IIa trial found.
In humans, the vaccine was safe and produced antibody responses and T-cell responses, and in monkeys, the vaccine not only produced similar immune responses, but protected against a type of simian-human immunodeficiency virus (SHIV), reported Dan H. Barouch, MD, of Beth Israel Deaconess Medical Center in Boston, and colleagues.
Preliminary results of the APPROACH trial in humans were presented at last year’s International AIDS Conference; now they appear in peer-reviewed form for both the human and non-human studies in The Lancet.
Barouch and colleagues found that, among 393 participants in the APPROACH trial receiving at least one dose of study vaccine, the mosaic adenovirus serotype 26 (Ad26) plus high-dose gp140 boost vaccine produced the greatest immune responses in humans — with antibody responses in 100% of participants at week 52, and T-cell responses in 83% at week 50.
The vaccine was also safe and well-tolerated, with mild-to-moderate pain at the injection site as the most common adverse event. Five participants reported at least one vaccine-related grade 3 adverse event, including abdominal pain, diarrhea, postural dizziness, back pain and malaise.
Susan Buchbinder, MD, of the University of California San Francisco, one of the co-chairs of the ongoing phase IIb efficacy trial for this vaccine, explained that the results of the non-human primate study were used to help select the most appropriate candidate for the vaccine in humans.
“In the past, there were non-human primate studies and then human studies, but it was not the same kind of rigorous approach,” she told MedPage Today. “We re-ran the same assays in humans as monkeys to say ‘this is what protected monkeys, let’s see if we can generate that response in humans’ and used the APPROACH data to see whether we achieved those goals.”
Indeed, the NHP 13-19 study of 72 rhesus monkeys assigned one of five vaccine regimens or placebo found that Ad26/Ad26 plus gp140 not only induced similar types of immune responses in humans, but 67% protection against acquisition of SHIV (two-sided Fisher’s exact test P=0.007).
An accompanying editorial by George N. Pavlakis, MD, and Barbara K. Felber, PhD, both of the National Cancer Institute in Frederick, Maryland, discussed this approach, stating that it “defines an additional path for exploring the development of an effective HIV vaccine.”
“The full value of the monkey-to-human immunogenicity comparison reported in the study will be best assessed upon completion of the efficacy trial,” the editorialists wrote. “This ongoing trial might lead to further refinement of monkey models that can accelerate the preclinical evaluation of vaccine regimens.”
The HVTN 705 or the Imbokodo study, has already been launched in five African countries. Buchbinder explained that Imbokodo is from a South African proverb about the strength of women that says “you strike the women, you strike the rock,” as the trial is in the process of enrolling 2,600 non-pregnant HIV-negative women ages 18 to 35. The estimated study completion date is February 2022.
Buchbinder said that she hoped “to validate our non-human primate model to see if it works for humans and if we see the same correlates of protection.”
Asked for his opinion, Robert Gallo, MD, co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, said that there are probably seven or eight studies of HIV vaccines going on right now, and the real question is obviously will be what the efficacy trials of this vaccine will say.
“It’s a well-controlled, well done study, and it will be interesting to see where it goes,” he told MedPage Today.
This study was supported by Janssen Vaccines & Prevention BV and the NIH, the Ragon Institute of MGH, MIT and Harvard, and a cooperative agreement between the Henry M Jackson Foundation for the Advancement of Military Medicine and the US Department of Defense.
Barouch disclosed support from the NIH, the Bill & Melinda Gates Foundation, and Janssen Vaccines & Prevention BV, and is a co-inventor on HIV-1 vaccine antigen patents that have been licensed to Janssen Vaccines & Prevention BV.
Other co-authors disclosed employment with Janssen.
Buchbinder disclosed being co-chair on the HVTN 705 study.

What a U.S.-China trade war could mean for the opioid epidemic


The American struggle to curb opioid addiction could become collateral damage in President Donald Trump’s showdown on trade.
Trade tensions with allies were heightened by the White House announcement in March of tariffs on steel and aluminum imports. Now, another round specifically targeting China is set to take effect Friday.
And that China focus could interrupt other trade-related issues — specifically, those targeting the flow of dangerous drugs like fentanyl into the United States.

Though Chinese officials deny that most of the fentanyl or other opioid substances originate in their country, they have in the past cooperated with U.S. efforts to control the flow of fentanyl onto American soil.
If the tariffs become permanent, though, “it’s most likely going to have a negative effect on other areas” beyond trade, said Jeffrey Higgins, a former Drug Enforcement Administration supervisory special agent. “China could say ‘We are no longer going to cooperate with the United States on controlling these synthetic opioids,’” he continued.
Fentanyl, one of the deadliest synthetic opioids, is up to 50 times more potent than heroin and can be 100 times more potent than morphine. Of the 64,000 drug overdose deaths in 2016, more than 20,000 were related to some form of fentanyl, a Centers for Disease Control and Prevention report shows.
U.S. law enforcement and drug investigators consider China the primary source of this illicit drug and responsible for as much as 90 percent of the world’s supply.

One reason: Until recently, “illicit fentanyl [was] not widely used in China, [so] authorities [placed] little emphasis on controlling its production and export,” a U.S.-China Economic and Security Review Commission staff research reportnotes.
In a March statement before Congress, Robert Patterson, the acting administrator of the DEA, described the relationship between U.S. and Chinese drug enforcement agencies as “a significant bi-lateral mechanism to address the threat resulting from the shipment of illicit fentanyls, their precursors, and other synthetic drugs to the United States and elsewhere.”
For instance, in 2015, China added 116 new psychoactive substances, including six fentanyl products, to its list of controlled substances. Patterson called this step “a key moment,” and it led to a significant drop in U.S. seizures of the illicit drugs. In addition, Deputy Attorney General Rod Rosenstein met in 2017 with Guo Shengkun, then state councilor of the Chinese Ministry of Public Security.
But experts say this level of cooperation could wither if Trump’s China tariffs remain in place.

The tariffs have already prompted the Chinese to impose tariffs of their own, and if China continues its retaliation effort, the bilateral drug-control efforts could be the next leverage point, experts say.
At a news conference in late June, Liu Yuejin, the deputy chief of China’s drug-control agency, said that political factors will not affect China’s willingness to combat drug manufacturing and trafficking.
But China is a communist country, and the Chinese government controls major aspects of the economy and society.
“In the end, they will be pawns of whatever politics the government of China wants to enact,” said Higgins, when describing the relationship between Chinese drug enforcement agencies and central government leadership.
China might be even more inclined to take U.S.-China opioid talks hostage because the White House and Capitol Hill have prioritized action on the opioid epidemic, said Markos Kounalakis, a visiting fellow at Stanford University’s Hoover Institution.
Over the past month, the House of Representatives passed more than 70 bipartisan bills designed to combat the opioid crisis. The Department of Justice is implementing a strategy designed to “decrease the number of overdose deaths,” Attorney General Jeff Sessions announced in a speech early this year.

Although U.S. and Chinese officials tend to meet annually each fall to discuss counter-narcotic actions, agreements produced in these meetings lack the specificity necessary to secure long-term cooperation by both parties, experts say.
China’s cooperation — implementing domestic controls on illicit substances — has occurred at the behest of the United States, not as a result of binding agreements.
While the U.S. is relying on China to control the manufacture and export of illicit drugs within its own borders, there are steps Congress can take to intercept these products.
Last month, the House passed legislation that would direct the U.S. Postal Service to “require the provision of advance electronic information on international mail shipments.”
This bill has been received by the Senate Committee on Finance, where it awaits further action.
The measure would close a loophole that drug traffickers exploit: While private shippers like FedEx and UPS are required to obtain advance electronic information on most shipments, the Postal Service is not.