Children’s Med Center Dallas boosts ER preparedness with active shooter drills

Active shooter simulations can make emergency department staff feel more confident they’re prepared to respond to such a situation, according to a recent survey from a Texas children’s hospital.

Children’s Health Children’s Medical Center Dallas began hosting the simulations in August of 2016. In a survey of 204 staffers who underwent the voluntary training between August and December of that year, 92% said they felt more prepared and 70% said they were more knowledgeable about how to respond should a shooting occur.

Participants undergo the training in the hospital’s simulation lab, which is set up to resemble the emergency department. Actors trained in crisis simulation are brought in, while hospital staffers remain in their normal roles, said Mary Baker, the survey’s co-author and a clinical educator at the hospital.

Conducting drills has become increasingly important at hospitals around the U.S. in light of growing concerns about mass casualty incidents, such as the shooting in Las Vegas last fall. But there are also growing concerns that hospitals themselves could become targets, such as with reports that suspects recently arrested at a New Mexico compound planned to attack Atlanta’s Grady Hospital. In 2014, the Department of Health and Human Services provided guidance on active shooting preparation for healthcare facilities.

The simulation forces participants to confront one of the basics of their training—patients and their safety first—since in the event of a shooting the staff members are encouraged to run and hide if they can, she said.

“That was probably one of the biggest things that came out of this,” Baker said. “There are people who said they couldn’t leave a teammate or patient if this was a real event.  

How does it work

Ahead of the simulation itself, the participants are given an overview of the scenario and undergo some online preparation. Following the simulation, there’s a debriefing with all the simulation’s participants, including the actors.

An active shooter simulation run by Emergency Nurses Association. (ENA)

All told, the entire training typically lasts between an hour and a half and two hours, Baker said.

Then, she said, the challenge becomes sustaining that education beyond that day of practice.

Children’s Medical Center Dallas, for example, has scheduled quarterly simulations to ensure new hires have an opportunity to undergo the training and to catch any staff members that need a refresher, she said.

“You can’t just do it once and be done,” Baker said.

The Emergency Nurses Association, which Baker is a member of, backs the program at Children’s Medical Center Dallas and works with others to promote and expand such projects. Groups like that can offer a significant tool for enhancing and sharing ideas on similar programs.

Another challenge is expanding the training program to also address issues that can arise when an emergency department is called to respond to treat people injured in a shooting or other mass casualty incident outside the hospital.

The volume of patients and the magnitude of their injuries can be extremely taxing on providers, and emergency plans must address that too, Baker said.

“In that kind of critical event, what we do for their moral distress [matters],” Baker said.

The Dallas hospital isn’t the only Children’s Health facility that’s done the active shooter training. Baker said it’s been implemented at another hospital, a rehabilitation facility and several clinics.

Integrating the drills into emergency training is something other health systems or providers can easily adopt—if they go about it thoughtfully, said Virginia Young, a clinical nurse specialist at Children’s Medical Center Dallas and another of the survey’s authors.

It’s crucial to have a strong grasp on the policy and regulatory implications in an active shooter situation and bring that to the training design, Young said. And if actors are involved, they need to have experience with simulations like these, as it can become a highly emotional experience for all involved.

Baker said that buy-in from the top down is another key to success since that can ensure programs can expand like Children’s did.

“It’s well worth your effort,” Young said, “it just needs to be planned out properly.”

https://www.fiercehealthcare.com/hospitals-health-systems/children-s-health-children-s-medical-center-dallas-active-shooter-training

Hesperos gains NIH funding for Alzheimer’s ‘human-on-a-chip’ trials

It’s a devastating memory-wasting disease that has continually seen failure after failure in the clinic, but now a Florida medtech company is hoping it can seek out better Alzheimer’s treatments by creating a multi-organ “human-on-a-chip” model.

These chips are typically lined with human cells and are designed to mimic the chemical and mechanical characteristics of their target tissue.

Such intricate devices are made possible through the use of microchip fabrication processes, which are able to create tiny channels that, in the case of the lung-on-a-chip for instance, house the artificial lung and also mimic inhalation and exhalation.

Hesperos is looking to create a deeper model, incorporating more organs to better understand how treatments are working, hence the human-on-a-chip moniker, rather than just an organ.

Specifically, it’s a three-organ system that includes brain cells (cortical neurons) and functioning liver and blood-brain-barrier constructs, as well as recirculating blood and cerebral spinal fluid surrogates.

The hope is that by mimicking key parts of the human body, they can see how it reacts to new drugs being passed through it, including the how it works on the liver (to assess toxicity) and how it passes the blood-brain barrier.

Hesperos researchers will develop models using both healthy brain cells created from pluripotent stem cells, and cells with different mutations consistent with the disease.

Further down the line, the company plans to assess long-term effects in its models, as well as real patient samples, to test its “viability as a tool to inform real-time, personalized treatment decisions as part of precision medicine.”

To help kick this off, the company has now been handed a phase 1 grant from the National Institutes of Health (NIH) National Institute on Aging in the hope that it “can realistically mimic the biology of Alzheimer’s disease (AD), and the effects of potential new therapies under realistic human physiological conditions.”

Hesperos founders Michael Shuler, Ph.D., and James Hickman, Ph.D., are some of the pioneers of organ-on-a-chip technology, and their company says it is the first to create pumpless microfluidic multi-organ systems with fully integrated physiological functions, such as blood circulation and nerve connections.

“There are estimated to be 50 million people in the world with dementia—that’s more than the population of Spain, and it is projected to nearly triple by 2050. Many of the people with dementia have AD, resulting in an urgent need for new, effective treatment options for the disease,” said Hickman, Hesperos’s chief scientist and a professor at the University of Central Florida’s Hybrid Systems Laboratory.

“Development of a low-cost, easy-to-use system to assess drugs for AD would improve efficacy and toxicological evaluations for patient specific treatments, providing a significant benefit to the drug development community and patients.”

https://www.fiercebiotech.com/medtech/hesperos-gains-nih-funding-for-alzheimer-s-human-a-chip-trials

Researchers turn to deadly venoms in quest for life-saving therapies

Venomous reptiles, bugs and marine life have notorious reputations as dangerous, sometimes life-threatening creatures. But in a paper in the current issue of Science, first author Mandë Holford, an associate professor of chemistry and biochemistry at The Graduate Center of The City University of New York (GC/CUNY) and Hunter College, details how technology and a growing understanding of the evolution of venoms are pointing the way toward entirely new classes of drugs capable of treating diabetes, autoimmune diseases, chronic pain, and other conditions.

According to Holford and her colleagues, venomous species account for more than 15 percent of the Earth’s documented biodiversity, and they can be found in virtually all marine and terrestrial habitats. Still, researchers have studied very few venoms because until recently they lacked the appropriate technology for analyzing the tiny amounts of venom that can be extracted from these mostly small species. But innovations in omics (technologies that map the roles, relationships, and actions of an organism’s molecular structure) are allowing researchers to uncover evolutionary changes and diversification among specific venomous species that could prove useful in developing new drugs capable of precisely targeting and binding to molecules that are active in certain human diseases.

“Knowing more about the evolutionary history of venomous species can help us make more targeted decisions about the potential use of venom compounds in treating illnesses,” said Holford. “New environments, the development of venom resistance in its prey, and other factors can cause a species to evolve in order to survive. These changes can produce novel compounds — some of which may prove extremely useful in drug development.”

To date, only six Food and Drug Administration-approved, venom-derived drugs have been developed as a result of modern-day research, but Holford and her colleagues believe greater investment in venom research could yield therapies for currently untreatable diseases as well as improved therapeutic options.

Potential drug advances include therapeutic peptides derived from the venomous sea anemone, which researchers believe could treat autoimmune diseases; therapeutic neurotoxins derived from the Conus magus, which scientists think could provide non-addictive treatment of chronic pain; chlorotoxin from the deathstalker scorpion, which could be the basis for a surgical tumor-imaging technique; and spider toxins, which could yield ecofriendly insecticides.

Holford and her follow authors conclude that an evolution-informed perspective will help focus venom research so that it can leverage the extraordinary biochemical warfare created by nature to yield transformative therapeutics and bio-insecticides.

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Story Source:

Materials provided by Advanced Science Research Center, GC/CUNY. Note: Content may be edited for style and length.

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Journal Reference:

1. Mandë Holford, Marymegan Daly, Glenn F. King, Raymond S. Norton. Venoms to the rescue. Science, 2018; 361 (6405): 842 DOI: 10.1126/science.aau7761

https://www.sciencedaily.com/releases/2018/08/180830143146.htm

How our brain and personality provide protection against emotional distress

If you feel anxious prior to exams, take note: studies suggest that you can learn how to be resilient and manage your stress and anxiety.

Researchers at the Beckman Institute for Advanced Science and Technology at the University of Illinois recently examined a sample of 85 healthy college students to see how a number of personality traits can protect an individual’s brain against symptoms of emotional distress, namely depression and anxiety.

“In this study, we wanted to look at commonalities across brain regions and across personality traits that contribute to protective factors,” said Matt Moore, a Beckman Institute Graduate Fellow and co-author of the study. “We targeted a number of regions in the prefrontal cortex, looking specifically at the volume of those regions using structural magnetic resonance imaging. We did a confirmatory factor analysis, which is basically a statistical approach for testing whether there is a common factor underlying the observed measurements.”

The study, “Neuro-Behavioral Mechanisms of Resilience against Emotional Distress: An Integrative Brain-Personality-Symptom Approach using Structural Equation Modeling,” was recently published in Personality Neuroscience.

In order to examine resiliency in young adults, previous research has looked at the relationship between specific brain regions and certain personality traits, such as optimism, positive affect, and cognitive reappraisal, all of which factor into how an individual copes with emotional challenges.

“We knew from the clinical literature that there are relationships between brain volume and certain personality traits,” said Sanda Dolcos, a research scientist in psychology, and one of the study’s authors. “Lower brain volume in certain areas is associated with increased anxiety.”

Coupled with questionnaires that identified the personality traits, the structural information of the prefrontal cortical regions provided evidence that there are common factors in brain structure and personality that can help provide adaptive behavior in order to avoid negative emotions.

“In a statistical model, we extracted these factors, one at the brain level, one at the personality level, and we found that if you have larger volume in this set of brain regions, you had higher levels of these protective personality traits,” Moore said.

The researchers are interested in identifying these brain regions along with specific personality traits in order to create ways for individuals to learn how to combat anxiety and depression.

“We are interested in cognitive behavioral intervention,” Dolcos said. “We have identified a resilience factor, which relates to detailed components in the prefrontal cortex, so cognitive interventions would target those brain areas.”

The fact that the brain volume can change based on developing skills that might alter traits such as optimism indicates that brain training is one way to combat emotional distress.

“People are not necessarily aware of how plastic the brain is,” Dolcos said. “We can change the volume of the brain through experience and training. I teach brain and cognition, and students are so empowered at the end of the course because they realize that they are in charge.

“It means that we can work on developing new skills, for instance, new emotion regulation strategies that have a more positive approach, and can actually impact the brain.”

“This study gives us the coordinates of the brain regions that are important as well as some traits that are important,” Moore said. “As the next step, we can then try and engage this plasticity at each of these levels and then train against a negative outcome.”

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Story Source:

Materials provided by Beckman Institute for Advanced Science and Technology. Note: Content may be edited for style and length.

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Journal Reference:

1. Matthew Moore, Steven Culpepper, K. Luan Phan, Timothy J. Strauman, Florin Dolcos, Sanda Dolcos. Neurobehavioral Mechanisms of Resilience Against Emotional Distress: An Integrative Brain-Personality-Symptom Approach Using Structural Equation Modeling. Personality Neuroscience, 2018; 1 DOI: 10.1017/pen.2018.11

https://www.sciencedaily.com/releases/2018/08/180830143152.htm

Simple test detects disease-carrying mosquitoes, presence of biopesticide

The tool uses a smartphone camera, a small 3D-printed box and a simple chemical test to show whether a dead mosquito belongs to the Aedes aegypti species.

Credit: Vivian Abagiu/University of Texas at Austin

A new diagnostic tool has been developed by researchers at The University of Texas at Austin that can easily, quickly and cheaply identify whether a mosquito belongs to the species that carries dangerous diseases such as Zika virus, dengue, chikungunya or yellow fever. It can also determine whether the bug has come into contact with a mosquito-control strategy known as Wolbachia.

“Many of these diseases are spreading in areas where they weren’t common before,” said Sanchita Bhadra, a research associate in the Department of Molecular Biosciences and first author on the paper. “Having surveillance is important in conjunction with any kind of outbreak, and this method allows a rapid test in the field.”

The tool uses a smartphone camera, a small 3D-printed box and a simple chemical test to show whether a dead mosquito belongs to the Aedes aegypti species. Aedes aegypti carries Zika and other devastating viruses that afflict an estimated 100 million people worldwide each year. The species also is closely linked to the tripling of cases of mosquito-borne diseases in the United States since 2004.

The research appears in the journal PLOS Neglected Tropical Diseases.

The tool developed by scientists and students at UT Austin also detects the presence of a biopesticide called Wolbachia, a type of bacteria that keeps mosquitoes from spreading diseases. In countries around the world and in 20 U.S. states where the Aedes aegypti mosquito is found, scientists working in public health agencies have started to infect mosquitoes with Wolbachia by introducing the bacteria into a local mosquito population to help curb transmission of viruses.

Because mosquitoes show no outward signs of having the bacteria — and because existing diagnostic tests are hard to read, expensive and logistically cumbersome — the new tool represents a significant step forward for those hoping to monitor the effectiveness of Wolbachia.

“This test can happen without involving a lot of staff and equipment to make sure Wolbachia is effective and spreading as anticipated,” Bhadra said.

Public health groups trap and kill mosquitoes routinely in conjunction with monitoring efforts, but existing technology requires a complex process to extract nucleic acid from inside mosquitoes, often after they have been dead for days and have started to decay, leading to greater expense and the possibility of more errors in lab tests than the new technology.

The new diagnostic tool uses a smartphone’s camera and a simple test that can be done anywhere. It tests mosquitoes’ nucleic acid without requiring a complicated process to remove it. Officially known as a loop-mediated isothermal amplification and oligonucleotide strand displacement, or LAMP OSD, the probe delivers a simple yes-or-no readout on a cellphone, with accuracy of greater than 97 percent.

In addition to the tests to detect mosquito species and Wolbachia, the team also is exploring use of the technology to easily identify whether trapped mosquitoes are carrying Zika, dengue and other pathogens.

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Story Source:

Materials provided by University of Texas at Austin. Note: Content may be edited for style and length.

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Journal Reference:

1. Sanchita Bhadra, Timothy E. Riedel, Miguel A. Saldaña, Shivanand Hegde, Nicole Pederson, Grant L. Hughes, Andrew D. Ellington. Direct nucleic acid analysis of mosquitoes for high fidelity species identification and detection of Wolbachia using a cellphone. PLOS Neglected Tropical Diseases, 2018; 12 (8): e0006671 DOI: 10.1371/journal.pntd.0006671

https://www.sciencedaily.com/releases/2018/08/180830143213.htm

Saudi sovereign fund appoints ex-CEO of Dow Chemical as special adviser

Dow Chemical CEO Andrew Liveris

Saudi Arabia’s sovereign fund has named Andrew Liveris, the former chairman and chief executive of Dow Chemical, as a special adviser, in its highest-profile appointment of any global manufacturing executive.

Liveris will work closely with the Public Investment Fund (PIF) on matters of strategic importance, assist the fund in efforts to boost the value of its portfolio, and ensure the contribution of PIF companies to Saudi Arabia’s economic vision program 2030, the fund said in a statement on Sunday.

His appointment comes as the PIF, chaired by Crown Prince Mohammed bin Salman, is negotiating the sale of its majority stake in Saudi Basic Industries (SABIC) <2010.SE> to oil company Aramco.

Liveris joined the Aramco board on July 1.

The PIF said Liveris had extensive experience working in Saudi Arabia over the last two decades and under his leadership, Dow DuPont worked with Aramco to develop the Sadara Chemical petrochemical complex.

The PIF, which manages more than $250 billion in assets, aims to increase its asset portfolio to $400 billion by 2020.

More than half of its assets are tied up in large Saudi companies, but the PIF has also made substantial overseas commitments. This included a $45 billion agreement to invest in a giant tech fund led by Japan’s Softbank [9984.T] and another $20 billion committed to an infrastructure investment fund planned with Blackstone (NYSE: BX).

https://www.streetinsider.com/Reuters/Saudi+sovereign+fund+appoints+ex-CEO+of+Dow+Chemical+as+special+adviser/14569924.html

What Every Woman Needs to Know About Ovarian Cancer

Women need to know the symptoms of ovarian cancer and see a doctor if they have them, an ob-gyn expert says.

Ovarian cancer is the fifth-leading cause of death in American women, claiming more lives than any other cancer of the female reproductive system, according to the American Cancer Society.

About 22,240 women in the United States will be diagnosed with the disease in 2018, and over 14,000 will die from it, according to the U.S. National Cancer Institute.

September is Ovarian Cancer Awareness Month.

“Any woman who experiences unexplained bloating, an upset stomach, an urgency to urinate or abdominal pain for a few weeks, should go see a doctor, and if her doctor does not take these symptoms seriously, she should see another doctor,” said Dr. Stephanie Blank. She is director of gynecologic oncology for the Mount Sinai Health System in New York City.

Other symptoms include pelvic pain, fatigue, unexplained weight change, and abnormal bleeding or any bleeding after menopause.

“Too often, women are sent to the wrong doctor, or [are] told they’re just aging or gaining weight when experiencing these kinds of symptoms, and by then they have lost valuable time,” Blank said in a Mount Sinai news release.

Women who are diagnosed with ovarian cancer before it has spread have a five-year survival of 93 percent, researchers have found. But detection of ovarian cancer is difficult and often delayed.

Women with BRCA1 and BRCA2 gene mutations are at increased risk for ovarian cancer, and the risk for all women increases with age. Half of all ovarian cancers are diagnosed in women who are 63 and older.

Long-term use of birth control pills reduces the risk of ovarian cancer by about 50 percent, according to the news release. Removing fallopian tubes and ovaries is the best means of ovarian cancer prevention, but is not appropriate for all women.

More information

The American Cancer Society has more on ovarian cancer.

SOURCE: Mount Sinai Health System, news release, Aug. 28, 2018

https://consumer.healthday.com/cancer-information-5/ovarian-cancer-news-104/what-every-woman-needs-to-know-about-ovarian-cancer-737276.html