Hearing Aids Are Finally Entering the 21st Century

Most people probably associate three things with hearing aids: an elderly demographic, beige plastic construction and high-pitched feedback in public places. As it turns out, all those notions are now obsolete—or will be soon.

The most popular hearing-aid style is still the one that rests over your ear—a design that debuted in the 1950s. You know what else is decades old? Our country’s system for getting and paying for hearing aids.

Basic Medicare and most other insurance providers have never paid for adult hearing aids. At an average cost of $4,700 a pair, that makes hearing aids the third-largest purchase in most people’s lives after a house and a car.

The channel for buying hearing aids hasn’t changed in 60 years, either: You must buy them from an audiologist or doctor. They’re not available over the counter or by mail order.

Only six companies make most of the world’s hearing aids, and they sell them directly through hearing specialists. (You can buy “personal sound amplification products” in stores, but they can’t be marketed as hearing aids. In any case, most are fairly crude and ineffective for severe hearing loss.)

That’s one reason the price of hearing aids hasn’t dropped over time, the way most electronics do: the medical professionals you have to go through account for a significant fraction of the cost. Bottom line: many people who need them don’t get them.

“This is the sad part,” says Frank Lin, director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. “About 20 percent of adults who have a hearing loss actually use a hearing aid. I mean, 20 percent. And this figure hasn’t changed in decades.”

The other 80 percent may wind up missing out on a lot more than conversation in a noisy restaurant. Lin’s studies, which followed older adults for many years, revealed that hearing loss is “incredibly strongly” linked to serious outcomes, including impaired thinking, greater risk of hospitalization, even dementia.

Appalled at these findings, Lin teamed up with the President’s Council of Advisors on Science and Technology, under Barack Obama, and other groups to pursue a radical agenda: deregulating hearing aids. The result passed last year with bipartisan support. It requires that the FDA develop a new category of over-the-counter hearing aids, including safety and reliability standards.

The new law, Lin says, will lower the price and remove obstacles to innovation—and so help more patients. “People widely expect that companies like Bose, Samsung and Apple could all enter the market now,” he observes. Obviously the concept of over-the-counter aids isn’t popular with today’s manufacturers, who will lose their exclusivity.

“The concern is people trying to self-diagnose, people trying to self-program,” says Chris McCormick, chief marketing officer at Starkey Hearing Technologies, the only U.S.-based company among the big six hearing-aid makers. “The products will have to be standardized, and the problem is that everybody’s hearing is different.” Even so, Starkey and others are preparing for the new marketplace. Part of that is taking the hearing aid well beyond the realm of sound processing.

Later this year Starkey will release a new model that incorporates Fitbit-like health and heart rate monitoring and another that will automatically notify a loved one if you fall and can’t get up. Bose already sells something called Hearphones—with noise cancellation, directional microphones and various sound-processing options—that are moderate-strength hearing aids in all but name.

As for those popular misconceptions: Many hearing aids today aren’tbeige (turns out that matching them to your hair color is better camouflage). Most have antifeedback circuitry.

And now, thanks partly to the new law, older people may not be the primary customer demographic. Your ear turns out to be a great, inconspicuous place for a computer to hide, as the movie Her brilliantly depicted. Hearing aids may mostly aid your hearing—but soon they’ll help with directions, read our messages, play our music and track our health, all without the distraction of a smartphone screen. This could be the dawn of a new ear era.

https://www.scientificamerican.com/article/hearing-aids-are-finally-entering-the-21st-century/

Brookdale Senior Living: Hurricane Watch, Tropical Storm Florence Warning

Updated 5 PM EST – 9/8/18

Tropical Storm Florence is becoming better organized over the Atlantic Ocean and is increasingly likely to either make landfall or strike a part of the U.S. East Coast as a formidably strong hurricane mid- to late next week.

We are monitoring the storm and have storm preparedness plans in place. Our coastal communities are equipped with water, food, permanent or temporary generators and supplies to care for residents.

We are taking appropriate actions to keep them safe throughout the storm, watching the storm closely and we will follow the directions of authorities.

We will update this website and community Facebook pages with updated information as we receive it.

https://www.marketscreener.com/BROOKDALE-SENIOR-LIVING-11849/news/Brookdale-Senior-Living-Hurricane-Watch-and-Tropical-Storm-Florence-Warning-27233173/

Osteoarthritis research effort works to understand cartilage development

USC scientists are exploring the processes of growing stem-cell derived cartilage cells.

Credit: Ben Van Handel/Denis Evseenko Lab/USC Stem Cell

There are more than 3 million cases of arthritis in the U.S. each year, and osteoarthritis is the most common type. In patients, cartilage — the slick surface on the ends of bones — wears away, bone rubs against bone, causing swelling and stiffness.

Now Keck School of Medicine of USC scientists in the USC Stem Cell laboratory of Denis Evseenko have collaborated with colleagues to offer new insights on how gene activity drives the development of cartilage. Their findings appear Friday in Nature Communications.

Based on their studies, the scientists identified and characterized, for the first time, unique cell populations that form the superficial zone of human joint cartilage. The zone has the most critical role in cushioning the joint and is often partially or completely lost in arthritis.

“Our results not only offer a unique molecular atlas of human skeletal development, but also define a strategy for joint cartilage repair,” said Evseenko, the study’s corresponding author and an associate professor of orthopedic surgery, and stem cell biology and regenerative medicine at the Keck School of Medicine.

Osteoarthritis research: gene activity of human cartilage cells

In a series of experiments, postdoctoral scholar-research associate Gabriel Ferguson and postdoctoral scholar-research associate Ben Van Handel and colleagues compared the gene activity of developing human cartilage cells with several other cell types.

First they compared the cartilage cells to four other types of developing human cells: the precursors to bone, muscle, tendon and ligament. As the cartilage matured, the genes specific to cartilage became increasingly active, while genes related to the other cell types became repressed.

The scientists then compared these developing human cartilage cells to equivalent cells from mice. The team found many broad similarities in gene activity.

The researchers also carried out a detailed comparison of ordinary human cartilage cells and stem cell-derived human cartilage cells, taking into account genetics, genetic regulation and function. They demonstrated that stem cell-derived cartilage does not fully develop in the Petri dish but rather retains the genetic hallmarks typical of fetal cartilage. However, if the scientists transplanted stem cell-derived human cartilage at a particular stage of development into an arthritic rat, the cartilage would lose its fetal hallmarks and fully mature — regenerating the critical superficial zone.

Other authors were Maxwell Bay, Siyoung Lee, Ruzanna Shkhyan, Nicholas Banks, Mila Scheinberg, Biagio Saitta, Joseph Elphingstone and Michael Bonaguidi from USC; Petko Fiziev, April Pyle, Nicholas Bernthal, Hanna KA Mikkola and Jason Ernst from UCLA; Tonis Org from UCLA and the University of Tartu in Estonia; Ling Wu from InVitro Cell Research; and A. Noelle Larson, Scott Riester and Andre van Wijnen from the Mayo Clinic.

The study was supported by the National Institutes of Health (award number R01AR071734), the U.S. Department of Defense (award number W81XWH-13-1-0465) and the California Institute for Regenerative Medicine (award numbers RB5-07230-B and TRAN1-09288).

---

Story Source:

Materials provided by University of Southern California. Original written by Cristy Lytal. Note: Content may be edited for style and length.

---

Journal Reference:

1. Gabriel B. Ferguson, Ben Van Handel, Maxwell Bay, Petko Fiziev, Tonis Org, Siyoung Lee, Ruzanna Shkhyan, Nicholas W. Banks, Mila Scheinberg, Ling Wu, Biagio Saitta, Joseph Elphingstone, A. Noelle Larson, Scott M. Riester, April D. Pyle, Nicholas M. Bernthal, Hanna KA Mikkola, Jason Ernst, Andre J. van Wijnen, Michael Bonaguidi, Denis Evseenko. Mapping molecular landmarks of human skeletal ontogeny and pluripotent stem cell-derived articular chondrocytes. Nature Communications, 2018; 9 (1) DOI: 10.1038/s41467-018-05573-y

https://www.sciencedaily.com/releases/2018/09/180907091514.htm

A new generation of pain medications

Researchers from Charité — Universitätsmedizin Berlin and the Zuse Institute Berlin have developed a new generation of pain medications. The researchers used computer simulations to develop new opioids that will only work at sites affected by injury or inflammation. These drugs can prevent the occurrence of brain- and gut-related side effects typically associated with conventional opioids and have been shown to be successful in preclinical studies. Results from this research have been published in Pain and Scientific Reports.

Opioids are a class of drugs with powerful pain-relieving properties. They are mainly used to treat the pain associated with tissue damage and inflammation, such as that caused by surgery or cancer. Common side effects associated with their use include drowsiness, nausea, constipation, dependency and, in some cases, respiratory arrest. The research team, which is led by Prof. Dr. Christoph Stein of the Department of Anesthesiology and Surgical Intensive Care Medicine on Campus Benjamin Franklin, are hoping to develop new types of pain medications which will work without producing dangerous side effects. Collaborating with PD Dr. Marcus Weber of the Zuse Institute Berlin, the researchers used computer simulations to develop two new opioids. In both cases, the researchers used fentanyl as the starting molecule.

The researchers hypothesized that tissues which are damaged or inflamed show stronger interaction between ‘opioid agonists’ — the substances that elicit the pain-relieving effect — and the opioid receptors they bind to. Their computer simulations suggested that this is due to an increased concentration of protons in inflamed tissues, which leads to lower pH values than in healthy tissues, resulting in acidic conditions. Opioid molecules need to undergo protonation before they can bind to and activate opioid receptors. The researchers used this knowledge to design two drugs that would only exist in their protonated state in the presence of inflammation. This restricts opioid receptor activation to sites of tissue damage or inflammation, rather than receptors in the brain or gut.

“Our innovative design method provides a robust basis for a new generation of pain medications,” reports Prof. Stein. He adds: “These drugs could help us both to avoid the dangerous side effects of conventional opioids and to reduce complications. They would also help us stem the opioid crisis, a problem that is particularly evident in the United States.”

The researchers hope to further develop these newly-designed drugs in order to make them available to patients. They also plan to enhance their understanding of the molecular processes underlying the complex interactions seen in inflamed tissues, in the hope that they may be able to support opioid optimization through the insights they gain. Ideally, their insights will also be beneficial for other drugs, such as those used to treat high blood pressure.

---

Story Source:

Materials provided by Charité – Universitätsmedizin Berlin. Note: Content may be edited for style and length.

---

Journal References:

1. Antonio Rodriguez-Gaztelumendi, Viola Spahn, Dominika Labuz, Halina Machelska, Christoph Stein. Analgesic effects of a novel pH-dependent μ-opioid receptor agonist in models of neuropathic and abdominal pain. PAIN, 2018; 1 DOI: 10.1097/j.pain.0000000000001328
2. Viola Spahn, Giovanna Del Vecchio, Antonio Rodriguez-Gaztelumendi, Julia Temp, Dominika Labuz, Michael Kloner, Marco Reidelbach, Halina Machelska, Marcus Weber, Christoph Stein. Opioid receptor signaling, analgesic and side effects induced by a computationally designed pH-dependent agonist. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-27313-4

https://www.sciencedaily.com/releases/2018/09/180907110431.htm

A New, Healthy Way To Tap Emerging Markets

A pair of exchange-traded funds dedicated to China’s booming health care investment opportunity debuted earlier this year.

KraneShares, the issuer behind one of those China healthcare funds, took the emerging markets health care investment opportunity further with the debut of the KraneShares Emerging Markets Healthcare Index ETF NYSEKMED.

What Happened

New York-based KraneShares is known for its lineup of China-focused ETFs, but the firm also offers ETFs with more expansive reaches across the emerging markets space. KMED is the latest addition to firm’s broader emerging markets offerings.

The new ETF, which debuted Wednesday, tracks the Solactive Emerging Markets Healthcare Index. That benchmark “seeks to track the equity market performance of companies engaged in the health care sector in various emerging markets,” according to KraneShares. “The issuers include small-cap, mid-cap, and large-cap companies involved in hospital management, healthcare management, pharmaceutical manufacturing, and biotechnology, among other sub-industries.”

Why It’s Important

Data suggest the emerging markets health care investment opportunity is potentially massive.

“By 2040, emerging market countries on average are projected to increase healthcare spending as percent of GDP by 24.4% compared to just 9.8% in developed markets over the same time period,” according to KraneShares. “Healthcare expenses now comprise the largest segment of household consumption in China, which has the second largest healthcare market globally. At the same time, healthcare expenditure as a percent of GDP lags developed markets in both China and broad emerging markets, indicating there is significant room for growth in the sector.”

While KMED features exposure to multiple developing economies, it’s top-heavy at the geographic level as China, South Korea and combine for about 81 percent of the new ETF’s country exposures. Those are three of Asia’s four largest economies.

What’s Next

KMED isn’t the first health care ETF from KraneShares. The firm In January introduced the KraneShares MSCI All China Health Care Index ETF KURE 0.86%, which now has $34.13 million in assets under management.

KMED charges 0.79 percent per year, or $79 on a $10,000 investment.

https://www.benzinga.com/trading-ideas/long-ideas/18/09/12311423/a-new-healthy-way-to-tap-emerging-markets

Youth soccer injury prevention program saves healthcare costs

An injury prevention program tailored to children’s soccer is not only more effective than typical warmups and stretches at keeping players safe, it’s also associated with lower healthcare costs, a Swiss study suggests.

Researchers studied soccer teams for kids under age 9 and under age 13 over a season in Switzerland. The teams were randomly chosen to do their usual warm-ups or to warm up with the “11+ Kids” injury prevention program, which includes 15 minutes of exercises focused on dynamic stability, power, core strength, and falling techniques.

Previously, the study team found the 11+ Kids program reduced the overall injury risk in children’s soccer by 48 percent and cut the risk of severe injuries by 74 percent, researchers report in the British Journal of Sports Medicine.

The new analysis focused on the costs of the 11+ Kids program – including printed manuals and instructions for coaches – and the cost of treating injuries sustained by young soccer players during the season they tested the program.

Healthcare costs for every 1,000 hours of soccer exposure totaled 228.34 Swiss francs (US$235.74 at current exchange rates) for players who participated in the 11+ Kids program all season, compared with 469.00 francs ($484.20) for children who did only traditional warmups.

This translates into a savings of 240.66 francs ($248.46) for every 1,000 hours of soccer participation with the 11+ Kids program. Implementing the program nationwide would save 1.48 million francs ($1.53 million) a year, the researchers calculated.

“It is especially important to keep children injury free, as certain types of injuries clearly increase the risk for subsequent injury, potentially lead to drop out from sport, or even lead to long-term disability,” said lead study author Roland Rössler of the University of Basel in Switzerland.

“As such, the implementation of injury prevention from early age is highly (recommended),” Rössler said by email. “It is a win-win situation: The player (by reducing the risk of injury) as well as the society (by reducing health-care costs) could profit.”

A separate study in the same journal offers fresh evidence of the need for injury prevention in youth soccer. This study, done in Finland, examined overuse injuries in 733 soccer players ages 9 to 14.

During the 20-week study, researchers texted athletes’ parents weekly to find out about any injuries, then followed up by phone with players to determine whether these injuries might be due to overuse.

A total of 343 players, or 47 percent, had overuse injuries during the study.

Each week, about 13 percent of players had an overuse injury, and 6 percent had serious overuse injuries.

Knee injuries were the most common, and girls were almost three times more likely to report these injuries than boys, the study found.

For boys, the likelihood of heel injuries was almost triple the odds for girls.

Older players were also more apt to get overuse injuries than younger athletes.

While it’s no surprised that kids can get hurt on the field, the type of injuries might surprise some players and parents, said lead study author Dr. Mari Leppänen of the Tampere Research Center of Sports Medicine at the UKK Institute in Finland.

“There has been a belief that most of the injuries in youth soccer are acute injuries such as ankle sprains,” Leppänen said by email.

“This study showed that overuse problems in children’s soccer are more common than previously expected,” Leppänen added. “Although these conditions often require no medical treatment, these problems cause a long absence from sports, cause significant pain and discomfort, and may discourage child from participating in physical activity.”

More information about the 11+ Kids program is available here: bit.ly/2MZzZlS.

SOURCE: bit.ly/2MZAfBm and bit.ly/2MUG5nm British Journal of Sports Medicine, online August 14 and 21, 2018.

https://www.reuters.com/article/us-health-kids-soccer/youth-soccer-injury-prevention-program-saves-healthcare-costs-idUSKCN1LN2OB

2 health scares at U.S. airports tied to Mecca pilgrims: CDC

Two major health scares at U.S. airports involving inbound flights are related to pilgrims returning from the Hajj, the Muslim pilgrimage to the holy city of Mecca, Saudi Arabia, which ended in late August, U.S. health officials said on Friday.

On Wednesday, U.S. health officials sent an emergency response team with mobile diagnostic equipment to John F. Kennedy International Airport in New York after they were told that more than 100 passengers aboard an Emirates airlines flight from Dubai were experiencing flu-like symptoms.

Dr. Martin Cetron, director for the division of Global Migration and Quarantine at the U.S. Centers for Disease Control and Prevention, told Reuters in a telephone interview that health officials evaluated nearly 549 passengers at the airport, and sent a total of 11 people to a local hospital for more testing.

Ten people were tested for a battery of respiratory viruses and bacteria in hopes of ruling out serious pathogens that could present a public health threat.

Two of them tested positive for an especially virulent type of influenza A virus, and one of the two, who was gravely ill with pneumonia, was co-infected with another respiratory virus, Cetron said. A third person tested positive for a cold virus.

All three had taken part in the Hajj, which this year drew some 2 million people to Mecca, Cetron said.

Seven crew members, who boarded the flight in Dubai and were not at the pilgrimage, tested negative for a number of respiratory infections of public health concern, Cetron said.

The next day, two flights arriving in Philadelphia from Europe were screened by medical teams after 12 passengers reported flu-like symptoms. One of them had visited Mecca for the Hajj.

Cetron said health officials in New York had been prepared to quarantine a large group of sick passengers in an area at the airport. From a total of 11 passengers taken to hospital for evaluation, 10 were tested for respiratory symptoms; one showed signs of food poisoning.

“It was a much smaller incident. That’s not uncommon,” Cetron said. “Often the incoming information from multiple sources can be exaggerated beyond what we really find.”

All 10 patients with respiratory symptoms tested negative for the Middle East Respiratory Syndrome or MERS, a highly infectious and deadly respiratory infection that was first identified in the Middle East in 2012.

The CDC was not alerted in advance about the two flights that landed in Philadelphia from Paris and Munich, but several travelers had complained of illness, triggering a “medical review” of 250 passengers from those flights, a spokesman said.

Twelve passengers were found to have sore throats and coughs, and one also tested positive for the flu, a CDC spokesman confirmed.

The responses were part of a well-rehearsed network of public health officials trained to identify and contain pathogens as U.S. airports and ports of entry, Cetron said.

“Our most critical issue was to rule several respiratory illnesses of urgent public health significance,” Cetron said.

Cetron said the CDC monitors databases to track outbreaks of infectious disease that could post a treat in the United States. Although unlikely, MERS was definitely a concern that the team needed to rule out, he said.

“That was a low-probability, high consequence event that we wanted to rule out,” he said.

The CDC said in a statement that the cases were a reminder that flu season is coming, and urged all U.S. citizens six months or older to get a flu shot by the end of October.

https://www.reuters.com/article/us-airlines-illness/two-health-scares-at-u-s-airports-tied-to-mecca-pilgrims-u-s-officials-idUSKCN1LN2RB