Search This Blog

Saturday, August 3, 2019

Resuscitation mat simplifies cardiac massage

Resuscitation mat simplifies cardiac massage
Illuminated LEDs at the upper edge of the mat indicate whether the first responder is administrating chest compressions correctly. Credit: © Fraunhofer ISC
Every year, some 10,000 people in Germany die from cardiac arrest, even though they could have been saved. In fact, only 15 percent of Germans say they would trust themselves to administer cardiac massage in an emergency situation. Now, an innovative new resuscitation mat is set to help inexperienced first responders resuscitate victims in cases of circulatory arrest. Equipped with integrated sensors, the first aid tool was developed by a team of Fraunhofer researchers in collaboration with students at the University of Applied Sciences in Munich.
On Munich’s main square, shops are about to close up for the day when suddenly a person collapses unconscious to the ground, no longer breathing. The victim has suffered an acute cardiac arrest, to which there can be only one correct response: begin with chest compressions right away. With cardiac arrests, every minute counts. And yet, according to statistics from the German Society of Anaesthesiology, only 15 percent of Germans consider themselves able to administer the basic gestures needed to save the person’s life.
“People are scared of making a mistake, and as a result either do nothing or administer the chest compressions too gently to be effective,” says Dr. Holger Böse, Scientific and Technical Manager of the Fraunhofer Institute for Silicate Research ISC’s Smart Materials Center in Würzburg. With Rescue Aid, an innovative new resuscitation mat, the physicist hopes to relieve first-aiders of their anxiety in stepping in. “If performed correctly, chest compressions significantly improve the victim’s chances of survival. Rescue Aid is a way to simplify the resuscitation process,” says Dr. Böse. The mat also eliminates direct bodily contact, reducing people’s inhibitions and easing their reluctance to intervene. The silicone mat was developed as part of Fraunhofer’s design competition, “Form follows future,” which combines elements of science and design. It was designed by students at the University of Applied Sciences in Munich with the support of the SYN foundation.
Deformation sensors to measure compression depth
Shaped to resemble the human torso, the mat is first placed over the upper body. Silicone deformation sensors integrated in the mat in a star pattern then measure the depth of compression. “Pressure from the first responder’s hand deforms the sensors, allowing them to track the progress of the compressions,” explains Böse.
The sensors are connected via cable to an electronics system in a box at the upper edge of the mat, with LEDs to show whether sufficient pressure is being applied. When the pressure is sufficient, green LEDs will light up. “The greater the pressure, the more LEDs light up. An array of red LEDs signals that the pressure was too much. The LEDs are controlled by the electronic system,” explains the researcher. This allows the first responder to continuously monitor the pressure being applied, and make adjustments as necessary. An acoustic signal serves as a metronome, dictating the pace of the compressions, with the tone generator also housed in the electronics box.
Tests carried out on a resuscitation training dummy have already proven Rescue Aid’s effectiveness. The mat is available as a demonstrator, and shall now be optimized and adapted to fit different body sizes.
Because the sensors are made of soft foil, they do not cause any injuries—a distinct advantage over the few competitor products on the market, which are rigid and cause pain in the palms of the hand during resuscitation. This is consistent with the experience of the paramedics interviewed in the course of the project.
With its technical approach and simple electronics, the  mat is cost-efficient to manufacture. “We could well imagine the Rescue Aid being a standard component of any first aid kit in the future,” says Böse.

Explore further

Another Facebook-funded step toward creating brain-reading technology

A team of researchers at the University of California’s Department of Neurological Surgery and the Center for Integrative Neuroscience in San Francisco has taken another step toward the development of a device able to read a person’s mind. In their paper published in the journal Nature Communications, the Facebook-funded group describes their work with epilepsy patients and the technology they developed that allowed them to read some human thoughts.
Technology to peer inside the to monitor thoughts has been explored in  for years. But in recent years, scientists have made important strides toward creating such devices. For example,  currently exist that allow a person to spell out words using a virtual keyboard. But it is slow going. In this new effort, the researchers report that they were able to read some complete words from the minds of .
The researchers worked with volunteer epilepsy patients who were already scheduled to have probes implanted in their brains. The volunteers listened to a sequence of questions and responded with canned answers. They then used the data from the brain probes to teach a detection and coding system to recognize words based on brainwave patterns. But instead of treating hearing and responding as separate entities, the researchers used them together. This allowed their system to use context to determine which word was being spoken. As an example, if the user was thinking the word “yes,” it would be helpful to know if they were responding to a yes/no question and that there were only two possible answers.
This video portrays the real-time decoding task using simulated data from participant 1. An MRI reconstruction of this participant’s brain surface is shown with superimposed electrode positions. High gamma magnitudes for the electrodes are plotted throughout the simulation (darker colors signify increased neural activity). The question stimuli (female speaker) and participant responses (male speaker) are included as audio. Ellipses signify speech events detected from neural activity by the speech detector.  Credit: Moses et al.
The researchers report that their system was able to discern the difference between a brain that was listening and one engaged in forming internal words. They further report that their system was able to decode brainwaves with an accuracy of 61 percent when decoding listening and 76 percent when decoding produced words. They acknowledge that their system was very simplified, but suggest it provides a proof of concept for larger studies. They also note that more work is required before a non-invasive probe could produce similar results.

Explore further

More information: David A. Moses et al. Real-time decoding of question-and-answer speech dialogue using human cortical activity, Nature Communications (2019). DOI: 10.1038/s41467-019-10994-4

Hormone therapy linked to heart fat, hard arteries

Hormone replacement therapy is a common treatment for menopause-related symptoms, and new research from the University of Pittsburgh Graduate School of Public Health reinforces the importance of tailoring hormone therapy to each patient, based on her individual risk factors for cardiovascular disease.
In a study published today in the Journal of the American Heart Association, Pitt researchers showed for the first time that hormone replacement therapy affects the accumulation of heart fat—a new risk factor for cardiovascular disease in midlife women. Importantly, they found that the formulation and delivery route of hormones—whether as a pill taken orally or a patch placed on the skin—mattered when it came to the types of fat deposits women developed and whether those fat deposits translated to hardening of the arteries.
“We cannot treat all menopause hormone therapy types the same,” said study lead author Samar El Khoudary, Ph.D., M.P.H., associate professor of epidemiology at Pitt Public Health. “We’re adding to the recognized list of cardiovascular-related effects of menopause hormone therapy by showing a novel cardiovascular risk factor that’s specific to menopausal women also is affected by hormone therapy.”
Menopause commonly comes with a host of challenges—including hot flashes, night sweats, vaginal dryness and increased risk of osteoporosis—and hormone therapy is the primary treatment.
The researchers used data from 474 healthy women ages 42 through 58 enrolled in the Kronos Early Estrogen Prevention Study (KEEPS), which was a multi-center, randomized, placebo-controlled clinical trial of the effects of oral conjugated equine estrogens and transdermal 17-beta estradiol on atherosclerosis progression. Participants enrolled between 2005 and 2008 and were followed for four years.
“The KEEPS trial is unique because it focuses on younger women close to the onset of menopause, and tested both a pill and patch formulation of menopausal hormone therapy,” said study coauthor JoAnn Manson, M.D., Dr.P.H., physician at Brigham and Women’s Hospital and Harvard Medical School. “This allowed us to see the effects of different types of hormone therapy and whether the route of delivery—oral or through the skin—affected heart health in otherwise healthy women.”
An earlier study from El Khoudary’s group showed that postmenopausal women with lower serum estrogen levels had a greater volume of paracardial fat—meaning fat that accumulates outside the pericardium—and also higher rates of coronary artery calcification, compared to premenopausal women.
El Khoudary and her team hypothesized that menopause hormone therapy would be protective against heart fat accumulation, but what they found was not so simple. The type of hormone therapy and route of administration mattered.
The transdermal estradiol patch—generally considered to be safer—compounded the harmful effects of paracardial fat deposition on   (CAC) progression. In contrast, women on the estrogen pill were less likely to see increases in heart fat in the epicardial space immediately surrounding the heart or worsening CAC.
“That was surprising,” El Khoudary said. “The patch is thought to be safer because it’s not systemic, just topical, and it doesn’t have an impact on inflammation or triglyceride levels like oral hormones.”
El Khoudary cautions against making generalizations about oral versus transdermal hormone delivery or extending these findings to other treatments or patient groups. Still, she hopes clinicians will take these findings into account when treating healthy menopausal women with the drugs used in the study.
“Many clinical guidelines recommend consideration of transdermal estradiol as a first line treatment for hormone therapy because it is associated with less risk for blood clot events compared to oral conjugated estrogen,” said study coauthor Nanette Santoro, M.D., professor of obstetrics and gynecology at the University of Colorado. “This study makes us think twice about that recommendation and reminds us that there is more complexity to the story of how or whether menopausal hormones protect women against heart disease later in life or increase their risk.”

Explore further

More information: Samar R. El Khoudary et al. Effects of Hormone Therapy on Heart Fat and Coronary Artery Calcification Progression: Secondary Analysis From the KEEPS Trial, Journal of the American Heart Association (2019). DOI: 10.1161/JAHA.119.012763

Doctors halt the menopause for 20 years

A promising new surgery could delay menopause by 20 years, according to a report in the Sunday Times of London.
The 30-minute procedure involves removing a piece of ovarian tissue from women who are under the age of 40.
The tissue is frozen, then thawed and replanted up to 20 years later.
Doing so can restart natural hormones and stop menopause, the report claims.
So far, nine women in England have undergone the procedure, it said.
The health benefits of delaying menopause including preventing hot flashes and anxiety, as well as postponing osteoporosis and other aging issues.

2019 Xtreme Eating list ranks least healthy chain restaurant meals

These foods are extreme…ly out of touch with recent studies of what people should be eating.
The 2019 “winners” of the annual Center for Science in the Public Interest (CSPI) Xtreme Eating list are in — and they may convince you to opt for a salad tonight.
CSPI, founded in 1971, is a science-based consumer advocacy group that promotes healthy eating. Each year, the organization ranks restaurant dishes with some of the highest caloric, saturated fat and/or added sugar values in the industry.
The 2019 round-up features dishes from a few old favorites, like Cheesecake Factory and Chili’s, which routinely show up on the annual reports, along with some newcomers like Maggiano’s and Topgolf.
Sonic kicks off the list with its large Oreo Peanut Butter Master Shake. The 1,720-calorie bomb, with 48 grams of saturated fat and an estimated 62 grams of added sugar, was dubbed the “Disaster Shake” by CSPI.
Next on the list is Cracker Barrel’s 1,530-calorie Country Boy Breakfast, which features three eggs, fried apples, hash browns, sirloin steak, country ham (or pork chops) and biscuits with jam and gravy — and comes loaded with around 4,730 mg of sodium. According to the Food and Drug Administration, an adult should limit their daily sodium intake to less than 2,300 milligrams a day.
The only item that bested Cracker Barrel, in terms of sodium, was the Jimmy John’s 16-inch Giant Gargantuan sandwich. The five-meat, 2,190 behemoth has 7,720 mg of sodium, or nearly three and a half times more than is recommended, daily, for an adult.
Apparently, 2019 was a big year for five-meat foods, as Chili’s also made the XTreme Eating List with its 2,020-calorie Boss Burger, stacked with smoked brisket, rib meat, sausage, bacon and a hamburger patty. The item also boasts 3,900 mg of sodium.
After you’ve had your dessert – and breakfast and lunch – the list moves on to dinner with Italian chain Maggiano’s Today & Tomorrow Pastas that all clock in at about 1,500 calories with 40-plus grams of saturated fat.
Topgolf, Dave & Busters and Cheesecake Factory also landed on the list for their sweet fare.
The Injectable Donut Holes from Topgolf, a driving range and sports bar chain, made the list for having nearly 100 grams of added sugar. However, there is a strong chance you’re sharing the 24 holes (and 1,970 total calories) with friends.
Cheesecake Factory was featured for its Cinnamon Roll Pancakes, which are offered at brunch — likely with a side serving of a midday sugar crash. The 2,040-calorie stack packs a whopping 51 grams of saturated fat and, after adding the rich icing and butter-infused syrup, about 137 grams of added sugar.
Dave & Busters completes this year’s roundup with its Chicken & Waffles Sliders, which are served with tater tots — and 2,340 calories and 3,420 mg of sodium, as well as 38 grams of saturated fat and 98 grams of added sugar.
The CPSI also noted that all eight items each boasted between 1,500 and 2,300 calories, “and at least a day’s worth of sugar, salt or saturated fat.” Along with the nutritional facts of the eight fast-casual dining options, the organization also cited statistics confirmed by the Centers for Disease Control and Prevention that show two out of three American adults are overweight or obese.

New core curriculum to educate primary care providers on substance use disorder

Dr. Michelle Lofwall, professor of behavioral science and psychiatry in the University of Kentucky College of Medicine, is one of three national addiction physician experts who led a team of healthcare professionals in developing a new core curriculum designed to educate primary care providers on the prevention, assessment and treatment of substance use disorders (SUD) throughout the continuum of care.
The new 22-module core curriculum was created by Providers Clinical Support System, a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). The modules explore such topics as screening, stigma, motivational interviewing, alcohol, tobacco, and opioid use disorder, among others. The course provides a comprehensive introduction and overview of SUDs and co-occurring mental disorders for all health professionals.
While the field of medicine is making efforts to provide more training on addiction, the large majority of healthcare professionals have received few hours of education. This curriculum is meant to provide a foundation of clinically relevant information that will help clinicians better understand, identify and treat substance use disorders and their common comorbordities in their patients.
Primary care is often the first point of contact for somebody who is struggling with a substance use disorder. With the current opioid epidemic, the specialty treatment system can’t handle the volume, nor are the majority of individuals on their own seeking services in specialty care settings. Where they’re initially seeking services is for primary care related complaints.”
Dr. Michelle Lofwall, professor of behavioral science and psychiatry in University of Kentucky College of Medicine and Bell Alcohol and Addictions Chair in the UK College of Medicine
The SUD 101 Core Curriculum is free and provides interprofessional continuing education credit. It is accessible online 24/7, can be taken over time or when it is most convenient for the learner.

Finances Affect Women’s Choice of Breast Cancer Treatment

Cost often influences breast cancer patients’ decisions about surgery, even if they have good incomes and insurance, a new study finds.
“Eligible women with early-stage breast cancer often have choices for surgical treatments that are equally effective and result in excellent cancer outcomes,” said lead study author Dr. Rachel Greenup. She is a surgeon at Duke Cancer Institute in Durham, N.C.
“Surgeons often discuss the emotional and physical side effects of treatment, yet we rarely discuss the costs,” Greenup noted in an institute news release.
For the study, the researchers surveyed more than 600 women with stage 0 to stage 3 breast cancer. Of those, 90% were white; 70% had private health insurance; 25% had Medicare; 78% were college educated; and 56% had household incomes above $74,000 a year.
Even though the women were more affluent than the U.S. average, 43% said cost was a consideration when deciding on treatment, and nearly one-third said it played into the type of surgery they chose.
Among women with annual household incomes below $45,000, treatment cost was more important than keeping their breast or its appearance, the study findings showed.
Also, 35% said their treatment caused a financial burden, and 78% never discussed costs with their cancer care team. Even among top earners, 65% said they were financially unprepared for the cost of their cancer treatment.
Of the types of breast cancer surgeries — lumpectomy with radiation; mastectomy; and double mastectomy with or without breast reconstruction — double mastectomy was associated with higher patient debt and financial hardship.
The findings were published online July 29 in the Journal of Oncology Practice.
“Women are weighing many factors when deciding what type of surgery is best for them, including their personal desire for breast preservation, options for reconstruction, recovery time, sexuality, appearance, demands for future surveillance, and their own peace of mind,” Greenup said.
“While other side effects of surgical choice are routinely discussed with their physicians, the potential for financial harm is not explicitly addressed, including both the out-of-pocket payments and lost productivity for patients and their families,” she added. “Our study suggests this should change.”