Tag: 14/6/21

New Imaging Technique Picks up Earliest Stages of Neurological Disorders

A new imaging technique has the potential to detect neurological disorders such as Alzheimer’s disease at their earliest stages. 

The imaging methodology, called super-resolution, combines position emission tomography (PET) with an external motion tracking device to create highly detailed images of the brain. PET scanning, which is mostly used for oncology, where the activity of radioactive tracers introduced into the body is measured. Higher activity corresponds to greater uptake of that particular tracer.

In normal brain PET imaging, image quality is often limited by unwanted movements of the patient during scanning. In this study, researchers utilised super-resolution to make use of the normally unwanted head motion of subjects to enhance the resolution in brain PET.

Moving phantom and non-human primate experiments were performed on a PET scanner in conjunction with an external motion tracking device that continuously measured head movement with extremely high precision. Static reference PET acquisitions with no induced movement were also performed. After combining data from the imaging devices, researchers obtained PET images with higher resolution than the standard static reference scans.

Yanis Chemli, MSc, PhD candidate, Gordon Center for Medical Imaging, said: “This work shows that one can obtain PET images with a resolution that outperforms the scanner’s resolution by making use, counterintuitively perhaps, of usually undesired patient motion. Our technique not only compensates for the negative effects of head motion on PET image quality, but it also leverages the increased sampling information associated with imaging of moving targets to enhance the effective PET resolution.”

Though this super-resolution technique has only been tested in preclinical studies, researchers are preparing to try it with human subjects. Looking to the future, Chemli noted the important impact that super-resolution may have on brain disorders, specifically Alzheimer’s disease. “Alzheimer’s disease is characterized by the presence of tangles composed of tau protein. These tangles start accumulating very early on in Alzheimer’s disease–sometimes decades before symptoms–in very small regions of the brain. The better we can image these small structures in the brain, the earlier we may be able to diagnose and, perhaps in the future, treat Alzheimer’s disease,” he noted.

Source: Society of Nuclear Medicine and Molecular Imaging

Tougher Restrictions for Gauteng Being Debated

Image by Quicknews

As COVID cases continue to rise virtually unabated by the move to Level 2 lockdown, there are reportedly discussions at the National Coronavirus Command Council to tighten the lockdown restrictions.

The Gauteng government wants the province to have tighter lockdown restrictions, as it is host to about half of daily new infections of COVID in the country. Despite the high infection rate in the province, many in Gauteng are against tougher restrictions, such as the Gauteng Education Department and South African Council of Churches. Acting Health Minister Mmamoloko Kubayi-Ngubane says that she will speak to the National Coronavirus Command Council about the issue.

The province’s premier David Makhura said the province is asking for increased measures. “Level 2 as we know it currently is not having a sufficient impact,” he said. “People are going on as if we are really not in the middle of a raging pandemic.”

With Charlotte Maxeke Academic Hospital being indefinitely closed, the pressure is mounting on both public and private facilities which running out of ICU beds.

“So, we talk to the private hospitals almost on a daily basis, and they do indicate to us that they are running almost at about 80% of their capacity for ICU. In the public hospitals, we are also running at about 70%,” said Thabo Masebe, communications head of the Gauteng government.

He confirmed that the province was looking for tougher restrictions to curb new infections.

“That’s what the premier had said. He will be raising that with national government to see what added restrictions could be made to help slow down the rate of infections in the province,” Masebe said.

Source: ENCA

Vitamin D Deficiency Linked to Opioid Abuse

The human body needs adequate sunshine exposure to synthesise vitamin D, otherwise it must be supplied by supplements. Photo by Anders Jildén on Unsplash

Vitamin D deficiency enhances the craving for and effects of opioids, potentially worsening addiction risk, according to a new study.

These findings by researchers at Massachusetts General Hospital (MGH), published in Science Advances, suggest that the opioid crisis could partly be addressed by treating the common problem of vitamin D deficiency with inexpensive supplements.

In 2007, David E. Fisher, MD, PhD, director of the Mass General Cancer Center’s Melanoma Program and director of MGH’s Cutaneous Biology Research Center (CBRC) and his team found something unexpected: UVB ray exposure causes the skin to produce endorphin, which is chemically related to morphine, heroin and other opioids, which all activate the same receptors in the brain. Further research found that UV exposure raises endorphin levels in mice, which then display behaviour consistent with opioid addiction.

Endorphin induces a sense of mild euphoria. Research has suggested that some people develop urges to sunbathe and visit tanning salons that mirror the behaviours of opioid addicts. Dr Fisher and colleagues speculated that people may seek out UVB for the endorphin rush. But that suggests a major contradiction. “Why would we evolve to be behaviourally drawn towards the most common carcinogen that exists?” asked Dr Fisher.

Dr Fisher believes that the only explanation for why humans and other animals seek out the sun is that UV radiation exposure is necessary for production of vitamin D. One of vitamin D’s functions is promoting the uptake of calcium, essential for building bone. As humans migrated north during prehistoric times, they must have developed some kind of compulsion to venture outside of caves and on dark days, otherwise the vitamin D level would have debilitated them, especially the children.

This theory led Fisher and colleagues to hypothesise that sun seeking is driven by counteracting vitamin D deficiency for survival, and that vitamin D deficiency might also make the body more sensitive to the effects of opioids, potentially contributing to addiction. “Our goal in this study was to understand the relationship between vitamin D signaling in the body and UV-seeking and opioid-seeking behaviors,” says lead author Lajos V. Kemény, MD, PhD, a postdoctoral research fellow in Dermatology at MGH.

The researchers addressed the question from dual perspectives. One study arm compared normal laboratory mice with mice that were deficient in vitamin D (either through special breeding or by removing vitamin D from their diets). “We found that modulating vitamin D levels changes multiple addictive behaviours to both UV and opioids,” said Kemény. Importantly, when the mice were conditioned with modest doses of morphine, the vitamin D deficient mice continued seeking out the drug, more than the normal mice. Mice with low vitamin D levels were far more likely to develop morphine withdrawal symptoms.

The study also found that morphine relieved pain more effectively in mice with vitamin D deficiency – an exaggerated opioid response in these mice, and possibly concerning if it’s also true in humans, said Dr Fisher. For example, a surgery patient receiving morphine for pain control after the operation, and if they are deficient in vitamin D, the euphoric effects of morphine could be exaggerated, said Dr Fisher, “and that person is more likely to become addicted.”

This data suggesting vitamin D deficiency increases addictive behaviour was bolstered by analyses of human health records. One showed that, compared to those with normal levels, patients with modestly low vitamin D levels were 50 per cent more likely to use opioids, while patients who had severe vitamin D deficiency were 90 percent more likely. Another analysis found that patients with opioid use disorder (OUD) were more likely to be deficient in vitamin D.

Back in the lab, one of the study’s other critical findings could have significant implications, said Dr Fisher. “When we corrected vitamin D levels in the deficient mice, their opioid responses reversed and returned to normal,” he says. In humans, vitamin D deficiency is widespread, but is safely and easily treated with low-cost dietary supplements, notes Fisher. While more research is needed, he believes that treating vitamin D deficiency may be a new way to reduce the risk for OUD and bolster existing treatments for the disorder. “Our results suggest that we may have an opportunity in the public health arena to influence the opioid epidemic,” says Fisher.

Source: EurekAlert!

Innovative 3D Printing Makes Stronger and More Flexible Implants

Photo by Tom Claes on Unsplash

A new 3D printing process developed by University of Nottingham researchers, allows customised production of artificial body parts and other medical devices with built-in functionality offering shape and durability, while also cutting bacterial infection risk.

“Most mass-produced medical devices fail to completely meet the unique and complex needs of their users,” explained lead researcher Dr Yinfeng He, Centre for Additive Manufacturing. “Similarly, single-material 3D printing methods have design limitations that cannot produce a bespoke device with multiple biological or mechanical functions.”

“But for the first time, using a computer-aided, multi-material 3D-print technique, we demonstrate it is possible to combine complex functions within one customised healthcare device to enhance patient wellbeing.”

The team’s hope is that their new design process can be applied to 3D-print any highly customised medical device.

For example, the method could be adapted to create a single-part prosthetic limb or joint with greater comfort and functionality; or printing customised pills containing multiple drugs – known as polypills – optimised to release their contents in a planned sequence.

What it can do

For this study, the researchers applied a computer algorithm to design and manufacture 3D-printed objects made up of two polymer materials with differing stiffness that also prevent bacterial biofilm build-up. Combining these two materials, they produced an implant with the required strength and flexibility.

Artificial finger joint replacements currently use both silicone and metal parts, offering the wearer a standardised level of dexterity but must be rigid enough to implant into bone. The team 3D-printed a finger joint as a demonstration, which offered these dual requirements in one device, while also being able to customise its size and strength to meet individual patient requirements. They can even make use of intrinsically bacteria-resistant and bio-functional multi-materials, combating infection without extra antibiotics.

A new high-resolution characterisation technique (3D orbitSIMS) was used to 3D-map the chemistry of the print structures and to test the bonding between them throughout the part. This showed that the two materials were intermingling at their interfaces; a sign of good bonding and therefore a stronger device.

The study was carried out by the Centre for Additive Manufacturing (CfAM) and funded by the Engineering and Physical Sciences Research Council. The complete findings are published in Advanced Science, in a paper entitled: ‘Exploiting generative design for 3D printing of bacterial biofilm resistant composite devices’.

Prior to making the technique commercialised, the researchers plan to try out more advanced materials with extra functionalities such as controlling immune responses and promoting stem cell attachment.

Source: University of Nottingham

Journal reference: He, Y., et al. (2021) Exploiting Generative Design for 3D Printing of Bacterial Biofilm Resistant Composite Devices. Advanced Science. doi.org/10.1002/advs.202100249.

Drop in Heart Attacks Linked to COVID Pandemic

Photo by camilo jimenez on Unsplash

A sharp drop in heart attacks in Finland last year seems to be a result of the COVID pandemic, doctors believe.

Cardiologist Mika Laine noticed a roughly 30 per cent reduction in the number of patients suffering myocardial infarction at Helsinki University Central Hospital in April and May 2020. But what was even more surprising was that this was not an isolated occurrence.

“When we started to study this further, we noticed that exactly the same phenomenon happened everywhere else in Finland and also in other countries in Europe and in the United States. So it was a kind of global phenomenon that happened during the COVID pandemic,” he told Euronews.

What was behind the drop?

Dr Laine is of the opinion that the fall in heart attack patient numbers results from changes made in response to the COVID outbreak.

“We have the exact same genes that we had a year ago, two years ago. So it has to be something in the environment that has changed,” he said. One major factor could be the massive global shift to remote working for many people, as a result of the lockdowns.

“People are at home, they are less stressed because they don’t need to go through morning traffic, hurry to work and so forth,” Dr Laine added.

EU Science Hub data shows that even before the pandemic, Finns worked remotely more than almost any other EU country. Last May, EU labour research body Eurofound revealed that Finnish workers made the fastest switch to teleworking in the EU, with nearly 60 per cent switching over.

“We also see this decrease in those people who are retired, who don’t go to work, so it cannot be just because you’re commuting,” said Dr Laine.
He however cautioned that there could be other factors behind the fall in heart attack patients.

Was there a real fall in heart attacks in 2020?

“We know that many people stopped smoking because smoking was associated with severe COVID mortality,” he said.

Better air quality in urban areas as a result of the lockdown could be another cause, Laine said, since airborne particles are known to be a risk factor for heart disease.

However not all are convinced that the pandemic had a positive impact on patients with all types of heart conditions.

Research published in the Journal of the American College of Cardiology in January found that, during the early phase of the pandemic, deaths due to ischaemic heart disease and hypertensive diseases increased in some parts of the US. Some patients may have died as a result of avoiding hospital visits due to infection fears, the researchers noted. 

A temporary or permanent effect?

With Finland, however,Dr Laine believes that was not the case.

“We haven’t seen any increase in mortality in cardiac diseases and so currently we think that it’s a true decrease in the number of cases and not because patients are not seeking help,” he said. “People were not dying at home to myocardial infarction”.

According to Dr Laine, the number of heart attack patients in Finland remains about 5 per cent lower than average, despite the easing of COVID restrictions.

“I think this is a typical example that environmental factors can have profound effects on myocardial infarction. And I think it’s motivating us to change our lifestyle healthier,” Dr Laine said.

Source: EuroNews

Millions of J&J Vaccines for South Africa Unfit for Use

In yet another blow to South Africa’s flagging vaccination programme, millions of the Johnson & Johnson vaccine doses meant to be used have been declared unfit for use. This is due to contamination concerns at one of the group’s facilities in the US.

The US Food and Drug Administration said that the doses were not suitable for use. Upon reviewing this decision, the South African Health Products Regulatory Authority (SAHPRA) said in a statement that it had decided “not to release vaccine produced using the drug substance batches that were not suitable”.

J&J’s Emergent plant was ordered to pause production in April several weeks after it was determined that batches of a substance used to produce the vaccine were cross-contaminated with ingredients from another jab made by Anglo-Swedish pharma giant AstraZeneca. The FDA is yet to allow the factory to reopen.

Acknowledging the setback in South Africa’s vaccination programme, acting Health Minister Mmamoloko Kubayi-Ngubane said Saturday that the batches concerned were stored in a high-security laboratory in Port Elizabeth belonging to drugmaker Aspen. Aspen meanwhile promised that it is ramping up production elsewhere to meet the shortfall, and President Ramaphosa said that he discussed with President Biden the possibility of receiving US vaccine donations.

Along with other countries South Africa, is pushing for a patent waiver on COVID vaccines to allow low cost production of generics.

“If we are to save lives and end the pandemic, we need to expand and diversify manufacturing and get medical products to treat, combat and prevent the pandemic to as many people as quickly as possible,” President Cyril Ramaphosa told the G7 group of wealthy nations meeting in Britain on Sunday. The country needs 31 million doses of the J&J vaccine to help vaccinate its population of 59 million.

South Africa has secured 30 million doses of the highly effective Pfizer-BioNTech vaccine, but is a two-dose vaccine which has significant cold chain requirements.

Emergency shipment

SAHPRA stated that there is a new delivery of approximately 300 000 J&J doses “that have been cleared by the US FDA that meet the requirements and will subsequently be released and shipped to South Africa.” The expiry date of these doses have been extended, and will be ready for administration to South African teachers within days.

Vaccinations were already paused in April after reports of rare cases of blood clots. And in February, South Africa rejected over 1.5 million doses of AstraZeneca’s vaccine as it was deemed ineffective. The J&J vaccines were already facing expiry as they had been removed from long term storage.

South Africa has only vaccinated just over 1% of its population but as far as can be ascertained with limited testing in Africa is the hardest hit by COVID on the continent, with over 1.7 million recorded cases.
Source: Eyewitness News