Publisher Health

Widely used to monitor and map biological signals, to support and enhance physiological functions, and to treat diseases, implantable medical devices are transforming healthcare and improving the quality of life for millions of people. Researchers are increasingly interested in designing wireless, miniaturized implantable medical devices for in vivo and in situ physiological monitoring. These devices could be used to monitor physiological conditions, such as temperature, blood pressure, glucose, and respiration for both diagnostic and therapeutic procedures.
To date, conventional implanted electronics have been highly volume-inefficient — they generally require multiple chips, packaging, wires, and external transducers, and batteries are often needed for energy storage. A constant trend in electronics has been tighter integration of electronic components, often moving more and more functions onto the integrated circuit itself.
Researchers at Columbia Engineering report that they have built what they say is the world’s smallest single-chip system, consuming a total volume of less than 0.1 mm3. The system is as small as a dust mite and visible only under a microscope. In order to achieve this, the team used ultrasound to both power and communicate with the device wirelessly. The study was published online May 7 in Science Advances.
“We wanted to see how far we could push the limits on how small a functioning chip we could make,” said the study’s leader Ken Shepard, Lau Family professor of electrical engineering and professor of biomedical engineering. “This is a new idea of ‘chip as system’ — this is a chip that alone, with nothing else, is a complete functioning electronic system. This should be revolutionary for developing wireless, miniaturized implantable medical devices that can sense different things, be used in clinical applications, and eventually approved for human use.”
The team also included Elisa Konofagou, Robert and Margaret Hariri Professor of Biomedical engineering and professor of radiology, as well as Stephen A. Lee, PhD student in the Konofagou lab who assisted in the animal studies.
The design was done by doctoral student Chen Shi, who is the first author of the study. Shi’s design is unique in its volumetric efficiency, the amount of function that is contained in a given amount of volume. Traditional RF communications links are not possible for a device this small because the wavelength of the electromagnetic wave is too large relative to the size of the device. Because the wavelengths for ultrasound are much smaller at a given frequency because the speed of sound is so much less than the speed of light, the team used ultrasound to both power and communicate with the device wirelessly. They fabricated the “antenna” for communicating and powering with ultrasound directly on top of the chip.
The chip, which is the entire implantable/injectable mote with no additional packaging, was fabricated at the Taiwan Semiconductor Manufacturing Company with additional process modifications performed in the Columbia Nano Initiative cleanroom and the City University of New York Advanced Science Research Center (ASRC) Nanofabrication Facility.
Shepard commented, “This is a nice example of ‘more than Moore’ technology — we introduced new materials onto standard complementary metal-oxide-semiconductor to provide new function. In this case, we added piezoelectric materials directly onto the integrated circuit to transducer acoustic energy to electrical energy.”
Konofagou added, “Ultrasound is continuing to grow in clinical importance as new tools and techniques become available. This work continues this trend.”
The team’s goal is to develop chips that can be injected into the body with a hypodermic needle and then communicate back out of the body using ultrasound, providing information about something they measure locally. The current devices measure body temperature, but there are many more possibilities the team is working on.
Story Source:
Materials provided by Columbia University School of Engineering and Applied Science. Original written by Holly Evarts. Note: Content may be edited for style and length.

With mosquito season upon us, people are stocking up on repellents to prevent itchy bites. Bug repellents are important because they don’t just protect against the buzzing, blood-sucking little pests — they also safeguard against the diseases they carry, which kill some 700,000 people worldwide each year.
Surprisingly, despite widespread use, no one understood exactly how most mosquito repellents keep the insects away. Now researchers are starting to uncover the first pieces of the puzzle.
A new study has identified a scent receptor in mosquitoes that helps them sniff out and avoid trace amounts of pyrethrum, a plant extract used for centuries to repel biting insects.
One of the oldest insecticides known, pyrethrum comes from the dried, crushed flowers of certain chrysanthemum species. Pyrethrum breaks down quickly in sunlight and isn’t readily absorbed through the skin, so the insecticide has long been considered one of the safer options for use around children and pets.
What makes pyrethrum toxic to mosquitoes has been known for some time. It works by binding to tiny pores in the insects’ nerve cells and paralyzing them on contact. But it has another property whose mode of action is more of a mystery. At lower concentrations it protects not by killing mosquitoes but by preventing them from getting close enough to land and bite in the first place.
Led by biology professor Ke Dong, who recently joined the faculty at Duke University, the team did a variety of tests to understand how mosquitoes detect and avoid pyrethrum, and which of the extract’s chemical components help them do it.

An acute loss of smell is one of the most common symptoms of COVID-19, but for two decades it has been linked to other maladies among them Parkinson’s disease and dementia. Now, a poor sense of smell may signify a higher risk of pneumonia in older adults, says a team of Michigan State University researchers.
“About a quarter of adults 65 years or older have a poor sense of smell,” said Honglei Chen, a professor in the Department of Epidemiology and Biostatistics within MSU’s College of Human Medicine. “Unlike vision or hearing impairment, this sensory deficit has been largely neglected; more than two-thirds of people with a poor sense of smell do not know they have it.”
In a first-of-its-kind study, Chen and his team found a possible link between poor sense of smell and a higher risk of pneumonia hospitalization. They analyzed 13 years of health data from 2,494 older adults, ages 71-82, from metropolitan areas of Pittsburgh, Pennsylvania, and Memphis, Tennessee. This study aimed to examine whether a poor sense of smell in older adults is associated with a higher future risk of developing pneumonia.
Chen’s research was recently published in the journal The Lancet Healthy Longevity. The participants were given a Brief Smell Identification Test, or B-SIT, using common smells such as lemons and gasoline to determine if their sense of smell was good, moderate or poor. Then, the participants were monitored for the next 13 years using clinical exams and follow-up phone calls to identify hospitalization due to pneumonia.
The researchers found that compared with participants who had a good sense of smell, participants with a poor sense of smell were about 50% more likely to be hospitalized with pneumonia at any time point during the 13-year follow-up. Among participants (with a poor sense of smell) who never had had pneumonia before, the risk of having the first-ever pneumonia was about 40% higher.
“To our knowledge, this study provides the first epidemiological evidence that poor olfaction (sense of smell) is associated with a long-term higher risk of pneumonia in older adults,” said Yaqun Yuan, a postdoctoral fellow in Chen’s research group.
This study provides novel evidence that a poor sense of smell may have broader health implications beyond its connections to Parkinson’s disease and dementia.
“This is just an example how little we know about this common sensory deficit,” Chen said. “Either as a risk factor or as a marker, poor sense of smell in older adults may herald multiple chronic diseases beyond what we have known about. We need to think out of the box.”
Story Source:
Materials provided by Michigan State University. Original written by Emilie Lorditch. Note: Content may be edited for style and length.

Over the past year, studies have revealed that certain pre-existing conditions, such as cancer, diabetes and high blood pressure, can increase a person’s risk of dying from COVID-19. New research shows that individuals living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) — an estimated 38 million worldwide, according to the World Health Organization — have an increased risk of SARS-CoV-2 infection and fatal outcomes from COVID-19.
In a new study, published in Scientific Reports, Penn State College of Medicine researchers found that people living with HIV had a 24% higher risk of SARS-CoV-2 infection and a 78% higher risk of death from COVID-19 than people without HIV. They assessed data from 22 previous studies that included nearly 21 million participants in North America, Africa, Europe and Asia to determine to what extent people living with HIV/AIDS are susceptible to SARS-CoV-2 infection and death from COVID-19.
The majority of the participants (66%) were male and the median age was 56. The most common comorbidities among the HIV-positive population were hypertension, diabetes, chronic obstructive pulmonary disease and chronic kidney disease. The majority of patients living with HIV/AIDS (96%) were on antiretroviral therapy (ART), which helps suppress the amount of HIV detected in the body.
“Previous studies were inconclusive on whether or not HIV is a risk factor for susceptibility to SARS-CoV-2 infection and poor outcomes in populations with COVID-19,” said Dr. Paddy Ssentongo, lead researcher and assistant professor at the Penn State Center for Neural Engineering. “This is because a vast majority of people living with HIV/AIDS are on ART, some of which have been used experimentally to treat COVID-19.”
According to the researchers, certain pre-existing conditions are common among people living with HIV/AIDS, which may contribute to the severity of their COVID-19 cases. The beneficial effects of antiviral drugs, such astenofovir and protease-inhibitors, in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in people with living with HIV/AIDS remain inconclusive.
“As the pandemic has evolved, we’ve obtained sufficient information to characterize the epidemiology of HIV/SARS-CoV-2 coinfection, which could not be done at the beginning of the pandemic due to scarcity of data,” said Vernon Chinchilli, fellow researcher and chair of the Department of Public Health Sciences. “Our findings support the current Centers for Disease Control and Prevention guidance to prioritize persons living with HIV to receive a COVID-19 vaccine.”
Emily Heilbrunn, Anna Ssentongo and Jonathan Nunez of Penn State College of Medicine; Ping Du of Takeda Pharmaceuticals and Shailesh Advani of Georgetown University also contributed to this research. The researchers declare no conflicts of interest.
This research was supported by the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or FDA.
Story Source:
Materials provided by Penn State. Original written by Tracy Cox. Note: Content may be edited for style and length.

“I don’t see a lot going well for them at this point,” said one analyst.Novavax, one of the first players in the race to vaccinate the world against Covid, delivered disheartening news on Monday, saying that its highly protective vaccine would not be authorized in the United States or Britain until at least July, and that it would not reach peak production until the end of the year.The delays, announced during an earnings call with investors, are the latest setback for the little-known Maryland company, which was granted up to $1.6 billion from the U.S. federal government last year and whose product has shown robust results in clinical trials. Despite these wins, the company has struggled to demonstrate that it can deliver on its promise to supply the world with 2 billion doses this year. Novavax has never brought a vaccine to market in its 34-year history.On the call, the company’s president and chief executive, Stanley C. Erck, said that the regulatory and manufacturing hurdles causing the delay have now been resolved. “Nearly all of the major challenges have been overcome, and we can clearly see the light at the end of the tunnel,” he said.Investors did not appear to agree: By Tuesday morning, the company’s stock had fallen to $133.86, down nearly 17 percent, although it rebounded somewhat later in the day.“I don’t see a lot going well for them at this point,” said Rob Smith, the managing director of Capital Alpha Partners, an investment research firm.The company’s delay is unlikely to affect wealthy countries like the United States, which is flush with vaccines from Moderna, Pfizer-BioNTech and Johnson & Johnson.But it is likely to have significant repercussions for the rest of the world, given that just last week, Novavax finalized a deal with Gavi, a public-private global vaccine partnership, to supply 1.1 billion doses of its shot to low- and middle-income countries. Novavax has struck other deals with countries like South Korea, Japan and Australia, and has set up agreements with eight production plants around the world.In January, the company estimated that it would hit its full production capacity of 150 million doses a month by the middle of this year, a prediction it later revised after facing a shortage of supplies like filters and the giant single-use bags that are used in vaccine manufacturing. On Monday, the company delayed its estimate again, saying it expected to reach production of 100 million doses a month by the end of the third quarter, and to make 150 million a month by the fourth quarter.One of its major manufacturing partners, the Serum Institute in India, has faced its own production and geopolitical challenges. A fire at the facility earlier this year reduced its capacity, and in April, Serum’s chief executive, Adar Poonawalla, called out the United States for restricting access to raw vaccine ingredients. And though Novavax’s deal with Serum is intended to supply the rest of the world through its arrangement with Gavi, the Indian government has banned exports of vaccines from the country as it struggles with a deadly second wave of Covid-19.“Serum is the backbone of vaccine supply to the world,” said Andrea Taylor, assistant director of the Duke Global Health Innovation Center, which is tracking global vaccine deals. “I think particularly for countries in South and Southeast Asia, as well as countries in Africa, it is hard to overstate the impact that this is having.”Regulatory hurdles have also set Novavax back. On Monday, company executives said that a now-resolved issue with an “assay” — a test that was needed to confirm that their product can be consistently manufactured at commercial scale across multiple production plants — was delaying regulatory approvals around the world, and that countries like Britain and the United States would not grant authorization until at least July. Company officials once said they hoped to gain authorization for their vaccine in April.Serology test samples from the Novavax Phase 3 trial at the University of Washington Medicine Retrovirology Lab at Harborview Medical Center in Seattle in February.Karen Ducey/Getty ImagesThe delay is particularly striking in Britain, since Novavax reported positive results of its clinical trial there in January.British officials persuaded Novavax to set up a trial there last year in part by promising speed in clinical development and regulatory approval. But time is running out: About two-thirds of British adults have received a first dose of a coronavirus vaccine, most made by AstraZeneca, and every adult is expected to be offered one by the end of July.The vaccine’s role in Britain depends in part on how quickly Novavax can start distributing its shot. A British factory making the vaccines has said that it would be ready by the summer. The country has recently turned away from the AstraZeneca shot in younger people because of the risk of very rare blood clots, leaving room for Novavax to be an alternative for people under 40.The country is also studying the effects of administering a second dose of the Novavax vaccine in people who have already received a first dose from either Pfizer or AstraZeneca.In the United States, Novavax’s setback casts new light on its massive deal with the U.S. government. As recently as 2019, the company was on the verge of closing after a major trial failure for another vaccine, and it was forced to sell off its manufacturing facility to raise money.Last year, the Trump administration placed a major bet on the tiny company as part of its Operation Warp Speed project, signing a $1.6 billion contract for delivery of 110 million doses by early this year. In April, the total amount of the deal was increased to $1.75 billion, according to Novavax’s financial filings. The company’s large trial in the United States and Mexico has still not been completed, although executives said on Monday that they expected results from that study “in a few weeks.”Novavax officials said they now did not expect to deliver those doses until the end of this year or early 2022. A spokeswoman for Novavax said there was no penalty for later delivery in its contract with the U.S. government.Novavax’s spotty track record does not offer confidence that it can rise to the challenge of producing billions of doses, said Les Funtleyder, a health care portfolio manager at E Squared Capital Management who invests in domestic and emerging markets. “It seems they were really unprepared for a challenge of this magnitude,” he said.Recent news of internal turnover — such as the departure last month of Novavax’s chief financial officer, five months after taking the role, for personal reasons — does not help, Mr. Funtleyder said. “It’s a bad look,” he said.Pharmacists prepared doses of Novavax’s vaccine candidate at the Wits RHI Shandukani Research Centre in Johannesburg, in December.Joao Silva/The New York TimesBut even if it has a challenging path as a latecomer, Novavax’s vaccine could fill important gaps, some experts said. In the United States, it could be used as a booster shot to shore up waning immunity, or the Biden administration could choose to donate the vaccine to other needy countries, as it has with its unused supply of AstraZeneca doses.Novavax has said it is developing a new version of its vaccine to address the variant circulating in South Africa. And it recently announced it would begin studying the shot in children older than 12, in an effort to catch up to Moderna and Pfizer, which have already tested their products in that age group.The vaccine can also be stored at normal refrigeration temperatures, without the freezing temperatures required by Pfizer and Moderna’s vaccines.“By the end of 2021 there will still be a great need for safe and effective vaccines that can travel well,” said Ms. Taylor, of Duke University. “Novavax looks like it can fit that description.”Dr. Saad B. Omer, the director of the Yale Institute for Global Health, noted that when concerns were raised over the Johnson & Johnson and AstraZeneca vaccines because of links to blood clots, countries with multiple vaccines available were able to switch to other options.“It’s good to hedge our bets,” he said. “If we want to avoid, for example, body blow after body blow to low-income countries in many parts of the world that has an impact on everyone, we need to vaccinate a huge chunk of the world.”Benjamin Mueller and Noah Weiland contributed reporting.

According to the British Heart Foundation, heart and circulatory diseases cause more than a quarter (27 per cent) of all deaths in the UK, which equates to more than 160,000 deaths each year — or one death every three minutes.
The research, published in the top science journal Advanced Science, found that injection of the trace mineral manganese could enhanced MRI scans so that they provided more accurate details of heart function than traditional MRI methods.
These findings, if confirmed in human subjects, could have major implications for the treatment of heart attack patients. The findings could also be of great use in the preclinical evaluation of treatments for patients who suffer from cardiac ischemia — a reduction in blood supply to the heart muscle that could lead to cardiac arrest.
The study also suggests that if manganese-enhanced MRI is performed within the first few hours of a heart attack it could be used to determine the optimal treatment regime for individual patients — helping to regulate changes in the cardiac muscle and thereby further improving survival chances. Findings were evaluated by examining the infarct size and blood supply at three key intervals: one hour, one day and 14 days after a myocardial infarction was induced.
Dr Patrizia Camelliti, Principal Investigator and Senior Lecturer in Cardiovascular Science at the University of Surrey, said:
“Magnetic resonance imaging (MRI) is increasingly used to diagnose and give information on heart conditions. This research using mice allows us to measure the health status of the heart muscle rapidly after a heart attack and could provide important information for optimising treatments in patients.”
Story Source:
Materials provided by University of Surrey. Note: Content may be edited for style and length.

A new study from the University of Surrey has revealed ‘real world’ factors that influence people’s interest in adopting a dietary pattern called time-restricted feeding.
According to NHS England, 67 per cent of men and 60 per cent of women in the UK are overweight or obese — with more than 11,000 yearly hospital admissions directly attributable to obesity.
Time-restricted feeding, which is a type of intermittent fasting, is the practice of restricting the time between the first and last food intake each day — therefore prolonging the daily fasting period.
In a study published by the journal Appetite researchers from Surrey surveyed 608 people to determine the factors that would help or hinder them in adopting a time-restricted feeding routine.
The study found that the majority of respondents had a feeding window of between 10 to 14 hours on workdays and free days. More than 400 respondents believed they could reduce their feeding window by three hours if there were clear health benefits associated with the practice.
The study also revealed that the percentage of participants’ likelihood of taking up intermittent fasting declined as the duration of the time restriction increased — with 85 per cent believing they could reduce their window by up to 0.5 hours, to 20 per cent believing they could sustain a reduction of four or more hours.
The respondents also pinpointed time availability (69 per cent), ease of following (62 per cent), and work commitments (54 per cent) as key factors that might influence their decision to adopt intermittent fasting.
Jonathan Johnston, senior author of the study and Professor of Chronobiology and Integrative Physiology at the University of Surrey, said:
“Time-restricted feeding has the potential to become an extremely effective tool in the fight against the obesity epidemic facing many countries. However, the study clearly shows that the ability of people to restrict their daily feeding window is dependent on their individual lifestyles.”
Story Source:
Materials provided by University of Surrey. Note: Content may be edited for style and length.

The COVID-19 pandemic has now claimed over 2 million deaths worldwide, and this number is only increasing. In response, health agencies have rolled out tests to diagnose and understand the disease. Besides the now widely known PCR test, there is interest in serological (blood) tests that detect “antibodies” against SARS-CoV-2, the virus that causes COVID-19. These blood tests have considerable applications, from identifying blood donors with high levels of anti-SARS-CoV-2 antibodies, whose blood can be used for convalescent plasma therapy, to measuring vaccine effectiveness.
So, what are antibodies? These are proteins produced by the body’s immune system to combat foreign proteins, such as the SARS-CoV-2 virus. Antibodies function by binding to a specific part of the virus that the immune system recognizes, called “antigens.” SARS-CoV-2 is composed of four major proteins, with two being highly immunogenic (capable of producing an immune response). These immunogenic proteins are called spike (S) and nucleocapsid (N) proteins. Presence of antibodies specific to the S protein means there is a higher amount of virus-neutralizing activity while antibodies specific to N protein indicate the presence of previous SARS-CoV-2 infection.
Despite this general awareness, we actually have only a vague understanding of how different antibodies (or antibody “isotypes”) interact with the various antigens produced by SARS-CoV-2. Hence, a team of scientists led by Senior Assistant Professor Hidetsugu Fujigaki and Professor Yohei Doi from Fujita Health University, in collaboration with National Institute of Infectious Diseases, Japan, FUJIFILM Wako Pure Chemical Corporation, and FUJIFILM Corporation undertook the first detailed investigation of these interactions. “Our goal was to quantify the neutralizing activity of these different antibodies against SARS-CoV-2,” Dr. Fujigaki explains, “We looked at antibodies specific to different parts of the S protein and the N protein to determine which of them was the best predictor of stopping the virus.”
They did this through an analysis of blood samples from 41 COVID-19 patients at the Fujita Health University Hospital. The team developed assays using three common antibodies (IgG, IgM, and IgA), each of them split into isotypes that bind specifically to five antigens (three parts of the S protein, including the receptor binding domain [RBD], the full S protein, and the full N protein).
The results of their experiments showed that all antibody isotypes that bind to the S protein (full and parts) were highly specific, but antibody isotypes binding to the N protein were less so. With minor variations, all antibodies are detectable in patients at approximately 2 weeks after symptoms appear, and detection sensitivity was higher than 90% (except in the case of IgM binding to N protein). Importantly, the researchers showed that IgG specific to the RBD of S protein had the highest correlation with virus neutralizing activity and disease severity. In other words, measuring RBD-specific IgG levels could tell us a lot about the immune response of COVID-19 patients, and could be the foundation for improving COVID-19 blood tests.
“We are also very excited by our findings because of their implications for convalescent serum/plasma therapy, a type of treatment where you transfuse blood from people who recovered from COVID and have high levels of antibodies against SARS-CoV-2,” Dr. Fujigaki adds, “Being able to show that the IgG antibody against RBD is highly correlated with neutralizing activity means we can identify appropriate blood donors for this treatment.”
The world is hopefully moving into the final stages of the pandemic, and this information could be the tools needed to carve out the final few steps to a safe post-pandemic world.
Story Source:
Materials provided by Fujita Health University. Note: Content may be edited for style and length.

Researchers used AI to identify which daily changing clinical parameters best predict intervention responses in critically ill COVID-19 patients.
The investigators used machine learning to predict which patients might get worse and not respond positively to being turned onto their front in intensive care units (ICUs) — a technique known as proning that is commonly used in this setting to improve oxygenation of the lungs.
While the AI model was used on a retrospective cohort of patient data collected during the pandemic’s first wave, the study demonstrates the ability of AI methods to predict patient outcomes using routine clinical information used by ICU medics.
The researchers say the approach, where each patient’s data were analysed day-by-day instead of only on admission, could be used to improve guidelines in clinical practice going forward. It could be applied to potential future waves of the pandemic and other diseases treated in similar clinical settings.
This is the first study that examines daily COVID-19 patient data, using AI to understand the clinical response to the rapidly changing needs of patients in ICUs. Led by a team from Imperial College London and Royal Brompton and Harefield hospitals for the COVID-ICU Consortium, the research is published today in the journal Intensive Care Medicine.
First author and clinical science lead Dr Brijesh Patel, from Imperial’s Department of Surgery & Cancer and senior intensivist at Royal Brompton Hospital, said: “Most studies look at the health of a patient on admission to ICU, and whether they were discharged or sadly died. In ICU there is a huge amount of information which we use at the bedside to manage patients on a day-by-day basis, and our study focuses on how the patients’ state changed daily.

Obsessive-compulsive disorder (OCD) in children and adolescents is associated with impaired education and worse general health later in life. Access to specialist treatment is often limited. According to a study from Centre for Psychiatry Research at Karolinska Institutet in Sweden and Region Stockholm, internet-delivered cognitive behavioural therapy (CBT) can be as effective as conventional CBT. The study, published in the journal JAMA, can help make treatment for OCD more widely accessible.
Obsessive-compulsive disorder (OCD) is a potentially serious mental disorder that normally debuts in childhood.
Symptoms include intrusive thoughts that trigger anxiety (obsessions), and associated repetitive behaviours (compulsions), which are distressing and time consuming.
Early diagnosis and treatment are essential to minimise the long-term medical and socioeconomic consequences of the disorder, including suicide risk.
The psychological treatment of OCD requires highly trained therapists and access to this kind of competence is currently limited to a handful of specialist centres across Sweden.
Earlier research has shown that while CBT helps a majority of young people who receive it, several years can pass between the onset of symptoms and receipt of treatment.