henry copeland @hc

having fun with people and pixels, via racery, pullquote, twiangulate, improv, running

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On the keto diet? Ditch the cheat day: Just one dose of carbohydrates can damage blood vessels -- ScienceDaily

For their test, the researchers recruited nine healthy young males and had them consume a 75-gram glucose drink before and after a seven-day high fat, low carbohydrate diet. The diet consisted of 70 per cent fat, 10 per cent carbohydrates and 20 per cent protein, similar to that of a modern ketogenic diet. "We were originally looking for things like an inflammatory response or reduced tolerance to blood glucose," says Durrer. "What we found instead were biomarkers in the blood suggesting that vessel walls were being damaged by the sudden spike in glucose." Little says the most likely culprit for the damage is the body's own metabolic response to excess blood sugar, which causes blood vessel cells to shed and possibly die. "Even though these were otherwise healthy young males, when we looked at their blood vessel health after consuming the glucose drink, the results looked like they might have come from someone with poor cardiovascular health," adds Little. "It was somewhat alarming."

Your healthcare provider's expectations on whether a treatment works may impact its effectiveness -- ScienceDaily

"These findings demonstrate how subtle social interactions can impact clinical outcomes. Even though the study participants were role playing and weren't actual health professionals or patients, you can imagine that in a real clinical context, if the healthcare providers seemed competent, empathetic and confident that a treatment may work, the impact on patient outcomes could be even stronger. Additional research however, is needed to see how this plays out in the real world," explained senior author Luke J. Chang, an assistant professor of psychological and brain sciences and director of the Computational Social Affective Neuroscience Laboratory (Cosan Lab) at Dartmouth.

Transient and long-term disruption of gut microbes after antibiotics - ScienceBlog.com

In contrast, the triple-antibiotics individuals showed a significant increase of new strains that persisted as long as six months after treatment, as compared to the single antibiotic and the control individuals. Furthermore, the fraction of transient strains was also significantly higher in the multiple antibiotics individuals. This suggested a long-term change to an alternative stable microbiome state, Morrow says. These changes were not due to a difference in growth rates. “Given the importance of the microbiome in human health, we think our results with these data sets can be used to help evaluate microbiome stability under different conditions,” Morrow said. “For example, we can now provide guidance to clinical investigators to judge the impact of certain treatments for diseases, such as cancer or diabetes, on the gut microbial community that could be significant for evaluation of outcomes. Furthermore, this approach could be applied to a patient’s pre- and post-hospitalization to identify individuals who may need further management of their microbiomes.”

Statins, pain, glutamate (relates to leg pain post caffeine?)

The McMaster research team found muscle cells treated with statins released the amino acid called glutamate at much higher levels than muscle cells that were untreated. As glutamate is a potent activator of muscle pain receptors, this release was proposed to trigger the sensation of muscle pain. Thomas Hawke, senior author of the study and a professor in pathology and molecular medicine at McMaster University said: "We found that statins were able to enter the muscle cells and cause oxidative stress. This resulted in the muscle trying to increase its production of antioxidants to combat this stress. The side-effect of this antioxidant production was the release of glutamate out of the muscle cells."

Light works, Prozac ties placebo

A total of 122 patients were randomized (light monotherapy, 32; fluoxetine monotherapy, 31; combination therapy, 29; placebo, 30). The mean (SD) changes in MADRS score for the light, fluoxetine, combination, and placebo groups were 13.4 (7.5), 8.8 (9.9), 16.9 (9.2), and 6.5 (9.6), respectively. The combination (effect size [d] = 1.11; 95% CI, 0.54 to 1.64) and light monotherapy (d = 0.80; 95% CI, 0.28 to 1.31) were significantly superior to placebo in the MADRS change score, but fluoxetine monotherapy (d = 0.24; 95% CI, −0.27 to 0.74) was not superior to placebo.

Scientists discover skin keeps time independent of the brain -- ScienceDaily

But, he said, this study found that the skin actually expresses its own photoreceptors using a previously mysterious member of the opsin gene family, neuroposin. This means that skin can sense whether it is day or night even when it's cultured by itself in a dish. "If you simulate taking the cultured skin from Seattle to Japan (by simulating the light changes across time zones), the skin figures out that the time zone has changed and adapts to the new time zone within days because of neuropsin," said co-author Russ Van Gelder, professor and chair of ophthalmology at the UW School of Medicine. .

Fake doctor saved thousands of infants and changed medical history

But for all his showbiz, Couney was in the lifesaving business, and he took it seriously. The exhibit was immaculate. When new children arrived, dropped off by panicked parents who knew Couney could help them where hospitals could not, they were immediately bathed, rubbed with alcohol and swaddled tight, then “placed in an incubator kept at 96 or so degrees, depending on the patient. Every two hours, those who could suckle were carried upstairs on a tiny elevator and fed by breast by wet nurses who lived in the building. The rest [were fed by] a funneled spoon.”

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

Rivaroxaban (Xarelto) and apixaban (Eliquis) are the most commonly prescribed direct-acting oral anticoagulants (DOACs) in the U.S., but no head-to-head comparisons are available to guide physicians' choices between these drugs. In this study, researchers used a large U.S. claims database to compare the effectiveness and safety of rivaroxaban and apixaban in patients with newly diagnosed venous thromboembolism (VTE). About 3000 apixaban users were compared with about 12,000 propensity-score-matched rivaroxaban users. During average follow-up of about 3 months, recurrent VTE occurred significantly less often in apixaban users than in rivaroxaban users (3 vs. 7 events per 100 person-years). Major bleeding also occurred significantly less often with apixaban (3 vs. 6 events per 100 person-years). These findings were consistent across various subgroups.

An AI startup tries to take better pictures of the heart

Caption Health provided me with unpublished data from a study in which 8 nurses with no previous experience in cardiac ultrasound performed four different types of scans on 240 patients. For assessing patients’ left ventricular size and function, as well as assessment of pericardial effusion, or fluid around the heart, the AI took the same number of usable images. For each, 240 scans were performed, and 237, or 98.8%, were of sufficient quality, according to a panel of five cardiologists. For images of the right ventricle, which is harder to see, the results were a bit worse: 222 images, or 92.5% of them, were of adequate quality. Eric Topol, the director and founder of the Scripps Research Translational Institute, commented that this was still a small number of samples for AI work; Caption Health said it “respectfully disagrees” because the study was prospective. The goal of the study was to show the test was 80% accurate.

Data standards may be wonky, but they will transform health care - STAT

The proposed rule creates a highly promising road map toward the easy exchange of electronic health information that exemplifies a minimalist regulatory approach for creating the standardization and uniformity needed to spark an apps marketplace. It would also create economic and commercial guardrails to promote a level playing field between electronic health record vendors and app developers. These regulations are an essential ingredient for a burgeoning apps market. All six individuals who previously served as the national coordinator of health information technology have endorsed the rule. It has sparked robust conversation: During the public comment period on the proposed rule, nearly 2,000 comments were submitted about interoperability and information blocking. As might be expected, there is pushback from the electronic health record industry on timelines and price controls. The proposed timeline — two years of development— has proven highly realistic, given the successful implementation of SMART on FHIR among the major brands of electronic health records by the Argonaut working group in just one year, and the work of the CARIN alliance to help connect patient apps to the SMART API.

Solve surprise medical bills with benchmarking, not arbitration - STAT

I know many doctors who are waiting to see if mandatory arbitration becomes law before deciding to leave their insurance networks. Doctors like me who practice orthopedic surgery, for example, along with general surgeons, cardiologists who treat heart attack victims, and neurologists who treat stroke patients will all have financial incentives to promptly leave insurance networks and bill patients directly at rates significantly above those allowed by insurers, safe in the knowledge that insurance companies are now legally required to pay all out-of-network bills.

App could help diagnose ear infections more accurately (developing countries)

The funnel is placed on the outside of the ear, at which point the app sends a bird chirp-like sound into the ear. Depending on the sounds that the app picks up in return, a machine learning algorithm built into the app is able to tell whether or not there is liquid in the ear. “It’s like tapping on a wine glass,” Chan said. “Depending on whether it’s empty or not, it’s going to sound different.”

Central sleep apnoea—a clinical review

Central sleep apnoea—a clinical review

Effect of added dead space on sleep disordered breathing at high altitude. - PubMed - NCBI

Baseline data revealed two clearly distinct groups: one with severe sleep disordered breathing (n=5, AHI>30) and the other with moderate to no disordered breathing (n=7, AHI<30). DS markedly improved breathing in the first group (baseline vs DS): apnea hypopnea index (AHI) 70.3 ± 25.8 vs 29.4 ± 6.9 (p=0.013), oxygen desaturation index (ODI): 72.9 ± 24.1/h vs 42.5 ± 14.4 (p=0.031), whereas it had no significant effect in the second group or in the total population. Respiratory events were almost exclusively central apnea or hypopnea. Microarousal index, sleep efficiency, and sleep architecture remained unchanged with DS. A minor increase in mean PtcCO(2) (n=3) was observed with DS.

First smart speaker system that uses white noise to monitor infants' breathing - ScienceBlog.com

Detecting breathing in babies has an extra wrinkle: the movement of their chests is so tiny that the smart speaker needs to know exactly where the babies are to be able to “see” them breathing. “The breathing signal is so weak that we can’t just look for a change in the overall signal we get back,” Wang said. “We needed a way to scan the room and pinpoint where the baby is to maximize changes in the white noise signal. Our algorithm takes advantage of the fact that smart speakers have an array of microphones that can be used to focus in the direction of the infant’s chest. It starts listening for changes in a bunch of potential directions, and then continues the search toward the direction that gives the clearest signal.”

Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea | Journal of Applied Physiology

In summary, we have demonstrated that an abrupt reduction inFET CO 2 FETCO2 immediately precedes the onset of the central apneas in patients with ICSAS. Furthermore, we have shown for the first time that inhalation of a CO2-enriched gas or addition of dead space eliminates central apneas and hypopneas in these patients in association with an increase inFET CO 2 FETCO2 and Ptc CO 2 tcCO2 and a dampening of breath-to-breath oscillations ofFET CO 2 FETCO2 . These findings provide compelling evidence that the mechanism for initiation of central hypopneas and apneas in ICSAS is a reduction inPa CO 2 PaCO2 toward or below the apneic threshold, respectively. Our data further indicate that the mechanism for abolition of these events by CO2 inhalation and addition of dead space is by increasing and stabilizingPa CO 2 PaCO2 above the apneic threshold. Taken together, these findings indicate that ICSAS is a disorder of respiratory control system instability that isPa CO 2 PaCO2 dependent. Although the purpose of this study was not to test the clinical effects of increasingPa CO 2 PaCO2 , our findings that CO2 inhalation and addition of dead space eliminate central apneas and hypopneas point to their potential as treatments for this disorder. More studies over longer time periods will be required to test the therapeutic potential of these approaches.

Hope is a key factor in recovering from anxiety disorders: Hope increases in therapy -- ScienceDaily

His study examined the role of hope in predicting recovery in a clinical trial of 223 adults in cognitive behavior therapy (CBT) for one of four common anxiety disorders: social anxiety disorder, panic disorder, generalized anxiety disorder and obsessive-compulsive disorder. "In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery," said Gallagher who reports that moderate-to-large increases in hope and changes in hope were consistent across the five separate CBT treatment protocols.

Can Anticoagulants Prevent Alzheimer's?

After receiving dabigatran for 1 year, the mice had no memory loss, and there was no reduction in cerebral circulation. Dabigatran also reduced typical AD symptoms, including cerebral inflammation, blood vessel injury, and amyloid protein plaques.

Influence of Cerebral Blood Flow on Central Sleep Apnea at High Altitude | Sleep | Oxford Academic

Carbon dioxide (CO2) therapy has been shown to reduce the severity of CSA when administered constantly in a normal volunteer model6 and more potently in a mathematical model when administered dynamically.7 However, neither approach has been adopted into clinical practice. The pathogenesis of CSA remains incompletely understood, thus a better understanding of the underlying mechanisms/ pathogenesis of CSA may provide improved treatment options.

A reliable clock for your microbiome: Genetic oscillator records changes in microbiome growth patterns in vivo -- ScienceDaily

The system uses an oscillating gene circuit, called a repressilator, as a kind of genetic clock to measure bacterial growth. The repressilator consists of three bacterial genes that code for three proteins (tetR, cl, and lacI), each of which blocks the expression of one of the other proteins. The genes are linked into a negative feedback loop, so that when the concentration of one of the repressor proteins falls below a certain level, the protein it had been repressing is expressed, which blocks the expression of the third protein, and the process repeats in a cyclical fashion. When all three genes are inserted into a plasmid and introduced into bacteria, the number of negative feedback loop cycles completed can serve as a record of how many cell divisions the bacteria have undergone. Every time the bacteria divide, any repressor proteins present in their cytoplasm are diluted, so their concentration gradually falls and triggers the expression of the next protein in the repressilator cycle. Crucially, the repressilator cycle repeats after 15.5 bacterial generations regardless of how quickly or slowly the bacteria are growing. This allows it to act as an objective measurement of time, much like a clock or a watch.

Chronobiology: Sleep and synaptic rhythms -- ScienceDaily

In the second study published in the same issue of Science the same group, in collaboration with a group from the University of Zürich (Steve Brown), has showed that synaptic protein abundance is also rhythmically shaped by sleep-wake cycles. In particular, they demonstrated that synaptic activity triggers the cycling production of proteins from messenger molecules that rhythmically accumulate at the synapses across the day. While protein production completely depends on wake-sleep cycles, messenger molecules travel and accumulate in the synapses predominantly in response to circadian mechanisms.

Habitual tea drinking modulates brain efficiency: Evidence from brain connectivity evaluation -- ScienceDaily

Although individual constituents of tea have been related to the roles of maintaining cognitive abilities and preventing cognitive decline, a study with behavioural and neurophysiological measures showed that there was a degraded effect or no effect when a constituent was administered alone and a significant effect was observed only when constituents were combined. The superior effect of the constituent combination was also demonstrated in a comparative experiment that suggested that tea itself should be administered instead of tea extracts; a review of tea effects on the prevention of Alzheimers disease, found that the neuroprotective role of herbal tea was apparent in eight out of nine studies.

Under time pressure, people tell us what we want to hear -- ScienceDaily

To test this assumption, Protzko, Zedelius and their UCSB colleague Jonathan Schooler devised a test of 10 simple yes-or-no questions, such as "I sometimes feel resentful when I don't get my way," and "No matter who I'm talking to, I'm always a good listener." Through a survey, respondents were asked to take fewer than 11 seconds, or alternatively, more than 11 seconds to answer each question.They found that the fast-answering group was more likely to give socially-desireable answers, while the slow answerers and the ones who were not given any time constraints (fast or slow) were less likely to do so, Protzko said.

N-of-1 Trials: FDA Plots Path to Regulation | RAPS

“At the very least, during the time needed to discover and develop an intervention, quantifiable, objective measures of the patient’s disease status should be identified and tracked, since, in an N-of-one experiment, evaluation of disease trends before and after treatment will usually be the primary method of assessing effectiveness,” Woodcock and Marks explained.

Can Anticoagulants Prevent Alzheimer's?

In the new study, long-term anticoagulation therapy with dabigatran (Pradaxa, Boehringer Ingelheim) inhibited thrombin and abnormal deposition of fibrin in a mouse model of AD. After receiving dabigatran for 1 year, the mice had no memory loss, and there was no reduction in cerebral circulation. Dabigatran also reduced typical AD symptoms, including cerebral inflammation, blood vessel injury, and amyloid protein plaques.

Time in range: a new blood sugar metric for people with diabetes - STAT

With nearly 300 blood sugar measurements a day, CGMs offer a new way to evaluate how well an individual is controlling his or her diabetes: time in range. This is expressed as a percentage of the time an individual’s blood sugar is within the target values. This metric, recently endorsed by the American Diabetes Association and by an international consensus committee, correlates nicely with control of diabetes and the implied development of complications such as vision loss, kidney problems, and low blood sugar excursions. Greater time in range has been linked to more stable glucose control, which should lead to fewer complications.