Stem Cells Converted Into Lung Tissue.


Lung transplant recipients have a relatively low 10 year survival rate of about 28%. Cellular rejection of the donor organ occurs about 90% of the time, which brings additional obstacles for the patient and doctors. This might be about to change, as functional lung tissue has been created from human stem cells. The research comes from Hans-Willem Snoeck from the Columbia Center for Translational Immunology and was published in the current edition of Nature Biotechnology.

A couple of years ago, Dr. Snoeck was able to convert stem cells into the precursor endoderm cells that can eventually differentiate into lung cells. This was done with human embryonic stem cells as well as human induced pluripotent stem cells, which involve a bit more work but are easier to come by. Those precursor cells were shown to actually differentiate into six different respiratory tissues, including the coveted type II alveolar cells. which facilitate gas exchange and produce surfactant.

Type 2 alveolar cells, also called pneumocytes, are responsible for producing surfactant, the compound that allows the lungs to remain inflated with air. These type II cells also aid in gas exchange and lung repair.

The lung tissue produced by stem cells could give researchers a unique perspective to study the tissue and learn more about how lung diseases originate. This could lead to better treatment options for lung diseases.

If treatments do not work and transplant becomes inevitable, physicians can use the patient’s own cells to provide a new disease-free organ. This eliminates both the potential for cellular rejection as well as the stress of waiting on the transplant list. To make a replacement lung, researchers would first remove the patient’s lung and decellularize it, leaving only a cartilaginous scaffold. The stem cells would then be used to coat the scaffold and regrow functional tissue to be put back into the patient.

Though it is a long way from getting implanted into a human body, these results are exciting. A patent has been filed by Columbia University for their technique of converting induced pluripotent stem cells into the functional tissue.

Nanomechanical FM transmitter is smallest yet.


Researchers at Columbia University in the US have built the smallest frequency-modulated (FM) radio transmitter ever. Based on a graphene nanomechanical system (NEMS), the device oscillates at a frequency of 100 MHz. It could find use in a variety of applications, including sensing tiny masses and on-chip signal processing. It also represents an important first step towards the development of advanced wireless technology and the design of ultrathin mobile phones, says team co-leader James Hone.

“Our device is much smaller than any other radio-signal source ever made and, importantly, can be put on the same chip that is used for data processing,” he explains.

Graphene is a sheet of carbon atoms arranged in a honeycomb-like lattice that is just one atom thick. Since its discovery in 2004, this “wonder material” has continued to amaze scientists with its growing list of unique electronic and mechanical properties, which include high electrical conductivity and exceptional strength. Indeed, some researchers believe that graphene might even replace silicon as the electronic industry’s material of choice in the future.

Ideal for making NEMS

Graphene is ideal for making NEMS – which are scaled-down versions of the microelectromechanical systems (MEMS) that are routinely employed in vibration-sensing applications. The new device made by Hone and colleagues is a NEMS version of a common electronic component known as a voltage-controlled oscillator (VCO) and generates a frequency-modulated (FM) signal of about 100 MHz. This frequency lies exactly in the middle of the FM radio band (87.7–108 MHz) and the researchers say that they have already succeeded in using low-frequency music signals to modulate the 100 MHz carrier signal from their graphene NEMS and recover the signals again using an ordinary FM receiver.

While graphene NEMS might not replace conventional radio transmitters yet, they will certainly be used in many other wireless signal-processing applications. Although electrical circuits have been continuously shrinking over the last few decades (as described by Moore’s law), there are still some types of devices – especially those involved in creating and processing radio-frequency (RF) signals – that are notoriously difficult to miniaturize, explains team co-leader Kenneth Shepard. Called off-chip components because they cannot be integrated with miniaturized devices, they require a lot of space and electrical power, and their frequency cannot be easily tuned.

Graphene NEMS offer a solution to this problem because they are very small – the active area is only a few microns across – and they can potentially be integrated directly onto conventional CMOS chips. Most importantly, it is easy to tune their frequency thanks to graphene’s exceptional strength.

Adjusting the tension

The Columbia researchers made their devices by contacting graphene sheets to source and drain electrodes and freely suspending the sheets over metal gates. In this configuration, the graphene functions like the skin of a drum. A DC gate voltage pulls the graphene down towards the gate and this adjusts the tension and, therefore, the mechanical resonance frequency, explains Hone. A radio-frequency signal on the gate drives sheet vibrations. “Finally, we apply a DC bias across the graphene and when the graphene vibrates it acts as a transistor whose gate capacitance is constantly changing – and it is this that creates an RF source–drain current,” he says.

The team studied the vibrational properties of the device at room temperature in a vacuum chamber. “To make an oscillator, we first adjust the signal gain to just above unity (using a variable amplifier) and the phase to zero (using a phase shifter) at the resonance frequency,” says Hone. “We then connect the output to the gate. This creates a closed loop that amplifies random thermal vibrations and makes the device oscillate.”

The researchers say they are now busy looking at how to put their devices directly onto integrated circuits that already contain all the necessary drive and readout circuitry. They also hope to improve the performance of their oscillators and reduce device noise.

Google Glass: the definitive road-test.


Google Glass may or may not transform the future.
But one thing is beyond question: it elicits mighty strong reactions in the
present.

AFP/Getty

The first week I got my tiny new face computer, I wore it to a barbecue and sat down at a table to eat pasta salad. “That is the most annoying thing in the world,” snapped a mother of twins, pointing at my new gadget from across the table.

“I disagree,” I responded.

“No, really. It is.”

“One second,” I said. I tapped the black frames with my finger to turn the device on. “OK, Glass, ‘What is the most annoying thing in the world?’.”

In the mini-screen perched above my right eye, an article popped up. I clicked on it. I scrolled. She waited.“All right, I have a list from The Daily Telegraph with the top 100 most annoying things. There’s people who drive too close to you. Noisy eaters. Rude clerks. No Google Glass.”

She was unconvinced and yammered on about privacy invasion, the failure to embrace real life, the evils of distraction, the usual.

Yet, earlier that same day, several strangers had approached me as if I were a minor celebrity. “Are they as awesome as people say?” “Where can I get the Google Goggles?”  “Mind if I try them on?” (For all the fears of privacy advocates, it was mostly my privacy that was invaded.)

As with coriander and Hillary Clinton, there’s not a lot of middle ground. Google Glass – which will be released for sale some time in 2014 – has become the flashpoint in the war between tech-fearing, Jonathan-Franzen-admiring, our-kids-should-play-with-wooden-blocks types and the self-quantifying, singularity-loving, Cloud-computing-will-save-the-world evangelists.

After much cajoling, Google sold me an early prototype for $1,500. I would be one of 8,000 “Explorers” – a group of engineers, scientists, artists, and journalists allowed to test it out. At the Glass office in New York, I got a crash course on how to connect my Glass to the internet, take video, snap a photo, get directions, search for nearby fast-food restaurants, return emails, make calls, and watch CNN – all without the effort of reaching into my pocket for my smartphone. I was also advised about what I should definitely not do.

So that’s what I would do. My mission: I would push Glass to its limits to give me a glimpse of the real-life utopia and/or dystopia that awaits.

OPERATION: LITERATURE

The first few days are a mix of exhilaration and frustration. One minute I’m marvelling, “Holy crap, this street map moves when I turn my head!” The next I’m having heated arguments with Glass’s voice-recognition feature: “CNN. Not Rihanna. CNN! CNN!” That’s not to mention the added challenge of friends who sneak up behind me and shout inappropriate Google searches to clog my browser’s history.

The tiny screen (roughly three-quarters of an inch by half an inch) takes some getting used to. For a while, I was squinting half the day, but I’ve now learned to adjust. You have to point your eyeballs up and to the right, so you spend a lot of time looking as if you’re trying to do long division in your head.

Glass is designed to display short snippets of text: quick emails such as “See you at Sbarro at 10:00.” Or CNN headline updates, such as LIZARD SUSPECTED OF EATING NEIGHBOUR’S CAT (which I was helpfully informed of at the doctor’s office).

As the Google PR told me, Glass is not meant for poring over 2,000-word articles. Yet what’s the harm in trying? In fact, why not use my Glass to read something even more substantial, like Moby-Dick? Imagine the joy of having a tiny great work of literature in front of your face at all times.

As my wife drives the family to our friend’s house, I ride shotgun, tilt my head back, and dive into some 19th-century fiction. “OK, Glass, Google ‘Moby-Dick full text’,” I say. I find a free file from Princeton University. The problem? The sentences don’t fit on the screen. If I want to finish a line, I have to turn my head to the right, then shift it back to the left. I look like a spectator at Wimbledon or a five-year-old throwing a tantrum. I’m also carsick.

“Can you stop?” my wife asks. “It’s very distracting.”

After a half-hour break, I try again. I find another version of Moby-Dick that fits on the screen. I start to read. It’s both strange and wonderful. The words float against the sky. The text is so close to my eyes, the book feels like it’s inside my brain. I’m in my own secret world, like the kid with the flashlight under the blanket, but without the flashlight or blanket.

I’ve never read Moby-Dick, and the details seem so visceral up close: Queequeg harpooning the breakfast beefsteaks from across the table, or draping his tattooed arm over Ishmael during a forced spooning. And who knew Melville was such a cranky bastard, an early Louis C.K., with his urge to step into the street and start “methodically knocking people’s hats off”?

After 45 minutes, I get an ice-pick headache and have to stop. I later tell some tech-loathing book-world friends, who react with horror – as if reading on an iPad weren’t bad enough. In their honour, I read a long article on my Glass called “35 Arguments Against Google Glass”, which gives me an ironic thrill.

Literature verdict: Briefly fantastic.  Use caution.

OPERATION: TEXAS HOLDEM

One of Glass’s most impressive features is that it can live-stream video from your point of view. Anyone can see the world through your eyes. If you’re at the supermarket facing a baffling array of tomato sauces, just video-call your wife. On her laptop, she can scan the shelf and tell you to get the organic passata. Very useful.

Also useful? Invite some friends over for poker and have your cousin who’s a professional poker player in Vegas secretly observe your cards from his laptop and signal to you how to bet. I have such a cousin. He agreed to the plan.

We spend the day practicing our scheme. On his computer, he can see my cards. On my walnut-sized screen, I can see a teensy version of him holding up handwritten signs, such as FOLD. Or RAISE TEN DOLLARS. Or CALL. I keep my cousin on mute for two reasons: First, I don’t want my fellow cardplayers to hear him. And second, he’s kind of a cocky bastard.

At 8pm on a Thursday, my three unsuspecting friends come to my place. They know I’m testing Glass, but I tell them it’s only for email. I deal. I lift my hand to show my cousin my jack and six. And… the video goes black. I tap the side of my frames furiously to reconnect. We finally do, but 10 seconds later, his image freezes mid-scribble. Dammit!

After losing a bunch of hands, I excuse myself to go to the bathroom and call my cousin on my cell. We whisper-argue over who is to blame for the technical snafu.

Back at the table, we get the live stream running again. And he holds up the FOLD sign three hands in a row. Ugh. And then, on an ace-ten, he has me bet $10, then raise $15. It’s much more aggressive than my usual strategy. We win! I get a head-rush. Another hand, he writes, LET’S BLUFF. BET $20.

It’s thrilling, this freedom from choice, the comfort of knowing that I’m playing like a master. Granted, it’s far from a flawless plan. At times, my cousin can’t see my hand, even though I shove my nose right up to the cards. The video is spotty and slow (it’s a prototype, after all), so I spend a lot of time stalling. “Hmm. Let me think.” And, as I mentioned, my cousin has an attitude. CLEAN UP YOUR STACK!! he writes on his whiteboard.

At one point, my nine-year-old son joins the game. He gets a good hand, but my cousin senses mine is better and tells me to raise my son $40, the kid’s life savings. I can’t do it. My cousin writes, PUSSY.

But overall, the plan works surprisingly well. After two hours, I’ve tripled my money to $200, at which point I confess my sin to my friends and give them back their money. They seem more baffled than angry. “So what are you seeing? He’s in that little thing?” The next day, one friend emails to thank me for the night, adding, “despite the fact that I woke up with a somewhat violated feeling that I can’t seem to shake.”

Poker verdict: Delightful. Dangerous.

OPERATION: DICTATION

Three weeks in, class [correction: Glass] and I are getting along better. There are still plenty of annoyances, like accidentally tweeting a photo of a café counter. But I love taking video of my sons without them getting me and I’m rolling “Oh, Dad.” [Correction: without them giving me an eye-rolling “Oh, Dad.”] I’ve successfully Googled the “XYZ affair”, “flank steak against the grain”, and “burrata cheese”.

I’m also getting the hang of the voice-recognition feature. I find Glass prefers in order to perform [correction: Glass prefers a more chipper voice], like I’m a tour guide at a theme park. Not my favourite own [correction: tone], but I adjust.

In fact, I have dictated this entire section of the article. Perhaps most impressive: Glass is no prude. It understands and spells out every naughty word I can think of. And that includes blumpkin. See? Please do not Google that.

Dictation verdict: Lawless [correction: flawless].

OPERATION: MOVIES AND TV

More than 25 years ago, a heavyweight boxer named Mitch Green was arrested for allegedly driving with a working TV mounted on the hood of his car. Prescient.

I don’t plan to drive while watching my Glass, but what if I tried to watch video every moment of the day that I’m not operating heavy machinery? My first plan was to stream a series of back-to-back epic movies on my Glass as I ran my errands and made my calls. Unfortunately, Glass isn’t yet compatible with Netflix.

Instead, I had to settle for 16 hours of YouTube. I watch Ali G while at the shops. I watch a TED talk about bipolar disorder while scrubbing the dishes. While taking my kids to the Museum of Natural History, I creep myself out by watching the “Blurred Lines” video, squinting to make out the world’s tiniest nipples.

Things start to spin out of control. How could they not? It’s my childhood dream come true, this ever-present TV. My wife approaches me in the kitchen. I can see her mouth moving. I tell her: “I’m watching a Richard Pryor clip about the first black president. If it’s important, let me know, and I’ll pause.” She walks away.

I begin trying to improve life. When I’m out for a hike, I see a waterfall. It’s fine. But why not spice things up with a video of Angel Falls in Venezuela? Now, that’s spectacular. I have lunch at a local restaurant, but why not search for video of the inside of Le Bernardin? Sadly, I couldn’t find it. But I’m sure I will soon.

I’m worried for reality.

Movies-and-TV verdict: Incomplete. But promising.

OPERATION: OUTSOURCED CONSCIENCE 

This brings up the distraction issue. Many say Glass is taking our ADHD culture to its logical, horrible conclusion. Google argues that Glass will make you less distracted. Its position is that you don’t have to look down to see your emails. And no more fishing in your pocket to get your iPhone to snap your kid’s violin recital. Just click a button. Technology becomes seamless.

I agree with both sides. If used judiciously, Glass can make you more in the moment, less likely to steal glances at your smartphone. You are relaxed, free from what the kids call FOMO (fear of missing out). But the opposite can be true, especially if you over-eagerly subscribe to updates from email, Twitter, , The New York Times, and a location-based service that tells me I just passed the site of the 1981 movie My Dinner With André.

The constant dings have turned me into Mr Magoo. I’ve bumped into a parking sign and stumbled on the sidewalk. My friend Paul says that I’ll soon be saying, “OK, Glass. Google ‘Help me, I broke eight ribs.’ ”

Maybe I can put these interruptions to good use. I once read that in ancient Rome, when a general came home victorious, they’d throw him a triumphal parade. But there was always a slave who walked behind the general, whispering in his ear to keep him humble. “You are mortal,” the slave would say.

I’ve always wanted a modern non-slave version of this – a way to remind myself to keep perspective. And Glass seemed the first gadget that would allow me to do that. In the morning, I schedule a series of messages to email myself throughout the day. “You are mortal.” “You are going to die someday.” “Stop being a selfish bastard and think about others.”

I’m waiting in line at the pharmacy when I get a message from myself: “Think about what you are thinking.” I’m stewing about how this woman can’t figure out which way to swipe her debit card. Glass is right: This is not how I want to be using my brain power.

Outsourced conscience verdict: Could be a great business. Whose profits I would donate, of course.

CONCLUSION

Will I wear Glass in real life? That depends a lot on whether everyone else wears it. I’m impressed, but I don’t want to be one of those in the small cadre of Glassholes. I need social acceptance.

It’s hard to predict whether Glass will become a mass phenomenon. But if it doesn’t, something like it will. Perhaps a gadget that looks no more noticeable than a pair of wire-rimmed glasses. Technology won’t stop. We are all on a long, slow march toward becoming half-android. Will the good outweigh the bad? Who the hell knows? Well, that’s not entirely true. “OK, Glass, Google ‘Will Glass be good or bad for society?’”

Salt in medicines ‘a health risk’


Effervescent tablet

Soluble painkillers used by millions of people in Britain could pose a health risk because they are high in salt, UK researchers are warning.

Some formulations taken at maximum dose tip users over the recommended daily sodium intake for an adult, with potentially dangerous consequences, the study authors say.

Their work in the BMJ looks at the outcomes for 1.2 million UK patients.

It found a link between effervescent tablets and heart attacks and stroke.

“Start Quote

Without clear labelling on these products, it is impossible to know how much additional sodium you would be eating”

Prof Gareth Beevers Blood Pressure UK

All medicines that contain at least 1mmol (or 23mg) of sodium – a component of salt – in each dose are required to declare on their labelling that the product contains sodium.

The accompanying patient information leaflet provides information on the quantity of sodium and includes a warning to patients on a low-sodium diet to take the amount of sodium in the medicine into account.

Compared with patients taking the same drugs without salt, those who regularly took effervescent or soluble medications increased their risk of having a heart attack, stroke or dying from a vascular cause by a fifth

They were also seven times more likely to develop high blood pressure or hypertension, which the researchers say is at the root of the problem.

Lead researcher Dr Jacob George, from Dundee University, said: “We know that high salt causes hypertension and that hypertension leads to stroke.”

The British Heart Foundation said it was important to remember that the research applied to people who were taking these medicines every day – it did not mean that occasional use could damage your heart health.

Hidden salt

Effervescent medicines contain a substance called bicarbonate, which helps them fizz and dissolve, and this is often combined with sodium.

The study looked at 24 different prescribed effervescent medicines, including common painkillers such as paracetamol and aspirin, as well as supplements.

But Dr George said many more people bought these types of treatment from chemists, without a prescription.

He said that people needed to be aware of the risks and drug manufacturers should look at cutting the salt content of their products.

In the study, sodium levels in tablets ranged from as low as 3mmol to as high as 18mmol – approximately a fifth of a teaspoon.

The recommended sodium intake for an adult in the UK is 104mmol per day.

A person who takes the maximum daily dose of eight tablets of soluble paracetamol, for example, would ingest 148.8mmol of sodium, which exceeds their daily salt allowance.

If you then took in to account the dietary salt a person was likely to get from the food that they ate, their overall salt intake could be dangerously high, said Dr George.

The Medicines and Healthcare products Regulatory Agency (MHRA) said it kept a close check on the safety of all licensed medicines.

“We will carefully review the findings of this new research,” said a spokeswoman.

“We recommend that people with questions about their salt intake should read the patient information leaflet and speak to their GP,” the MHRA said.

But Prof Gareth Beevers, of Blood Pressure UK, said many consumers would be unaware of the risks.

“It is extraordinary to think that sodium has been hiding in our medicines all this time.

“Without clear labelling on these products, it is impossible to know how much additional sodium you would be eating, so it is shocking to find you could be having more than your daily maximum from medicines alone.

“Eating too much sodium – in any form – puts up our blood pressure, which puts you at increased risk of strokes and heart attacks, the biggest killers in the world.”

Energy drinks ‘change heartbeat’


Caffeine energy drinks ‘intensify heart contractions’

Energy drinks

Energy drinks packed with caffeine can change the way the heart beats, researchers warn.

The team from the University of Bonn in Germany imaged the hearts of 17 people an hour after they had an energy drink.

The study showed contractions were more forceful after the drink.

The team told the annual meeting of the Radiological Society of North America that children and people with some health conditions should avoid the drinks.

Researcher Dr Jonas Dorner said: “Until now, we haven’t known exactly what effect these energy drinks have on the function of the heart.

“The amount of caffeine is up to three times higher than in other caffeinated beverages like coffee or cola.

“There are many side effects known to be associated with a high intake of caffeine, including rapid heart rate, palpitations, rise in blood pressure and, in the most severe cases, seizures or sudden death.”

The researchers gave the participants a drink containing 32mg per 100ml of caffeine and 400mg per 100ml of another chemical, taurine.

Short-term impact

They showed the chamber of the heart that pumps blood around the body, the left ventricle, was contracting harder an hour after the energy drink was taken than at the start of the study.

Dr Dorner added: “We’ve shown that energy drink consumption has a short-term impact on cardiac contractility.

“We don’t know exactly how or if this greater contractility of the heart impacts daily activities or athletic performance.”

The impact on people with heart disease is also unknown.

However, the research team advises that children and people with an irregular heartbeat should avoid the drinks.

The British Soft Drinks Association already says the drinks are not for children.

Plastic ‘a threat’ to biodiversity


Microplastics ‘pose toxic threat to marine biodiversity’

Micro plastic
An estimated 150 million tonnes of plastic is “lost” each year

Tiny particles of waste plastic that are ingested by shoreline “eco-engineer” worms may be negatively affecting biodiversity, a study says.

So-called microplastics may be able to transfer toxic pollutants and chemicals into the guts of lugworms, reducing the animals’ functions.

An estimated 150 million tonnes vanishes from the global waste-stream each year.

The findings have been published in the academic journal Current Biology.

“We are losing a large volume of plastic and we know it is going into the environment and the assumption being made by policymakers is that this material is non-hazardous, it has got the same ranking as scraps of food,” explained co-author Mark Browne, an ecologist from the US-based National Center for Ecological Analysis and Synthesis.

“The research we have done really challenges that,” Dr Browne added, referring to the findings of lab work carried out by colleagues at Plymouth University, UK, led by co-author Prof Richard Thompson.

“Our findings show that the plastic itself can be a problem and can affect organisms.

“Also, when particles of plastic go into the environment what you find is that they accumulate large quantities of pollutants that are banned. So you have these particles themselves but also a load of nasty chemicals.”

Important role

The team found that the tiny bits of plastic, which measure 1mm or smaller, transferred pollutants and additive chemicals – such as flame-retardants – into the guts of lugworms (Arenicola marina).

This process results in the chemical reaching the creatures’ tissue, causing a range of biological effects such as thermal stress and the inability to consume as much sediment.

Dr Browne explained that this had consequences for the surrounding ecosystem.

“If the animals are not able to eat as much then there is a change in the function of the organisms and there is an impact on the semblance of the species found in an area,” he said.

He added that the worms had earned the nickname “eco-engineers” as a result of their ability to eat organic matter from the sediment and prevent the build-up of silt.

“Through that process, it produces burrows and changes the whole assemblage of animals that live around it,” Dr Browne observed.

“This is quite considerable because if you look at the total biomass of a shoreline, about 32% can be made up from these organisms.”

He told BBC News that it was the first study of its kind to highlight the toxic risk posed by microplastics to marine organisms.

“For about 40 or 50 years, we have been finding very large concentrations of chemicals in animals. Then they started to find animals with larger concentrations of pollutants and plastics, so researchers began to establish this correlation.

“But no-one had actually shown whether chemicals could transfer from plastic when they are eaten by animals and accumulate in their bodies and reduce important functions that maintain their health.”

Instead of the ER: Paramedics making house calls to chronic patients.


Emergency rooms — which can cost patients thousands of dollars each visit — have become the primary source of medical care for the uninsured and people with chronic illnesses.

A Minnesota health care provider is testing a new program in the hopes of reducing ER admissions and keeping people healthier: they’re sending paramedics on house calls to some of the area’s sickest patients who might otherwise end up in the ER.

The need for such out-of-the-box solutions is clear. In the last year, one in five Americans went to the ER at least once for an estimated 130 million visits. The cost of all those ER visits is staggering, considering that the price for treating some of the most common conditions can range from an average of $750 all the way up to $73,000.

“We don’t screen for insurance at the door,” said Dr. Joey Duren, an emergency physician with North Memorial Healthcare System in Minnesota. “So in our country now, a big thing is that the emergency department is a safety net for people who don’t have insurance.”

Patients with chronic conditions like asthma and diabetes can spiral out of control without regular monitoring and land in the ER multiple times in a single year. The number of repeat patients is often staggering; some of whom visit dozens of times each month, according to North Memorial’s chief medical officer, Dr. Kevin Croston.

“What’s really the biggest cost in health care are the chronic conditions where there are readmissions to the emergency department,” Duren said. “We realized we needed to create care that stopped that.”

That’s where house calls from the community paramedics came in. Since the program began last October paramedics have made more than 1,000 home visits, at a fraction of the cost for a trip to the ER. Although North Memorial doesn’t have data yet on the savings, officials believe the program will help reduce admissions.

“The role of this community paramedic is helping people get on top of their chronic disease processes so they aren’t getting so sick that they need to come to us in the emergency department,” Duren explained. “We’re controlling their diseases so they can be handled in an outpatient setting versus having to come here or be admitted to the hospital for multiple days because they’ve gotten so far behind in their insulin for their diabetes or their COPD has gotten out of control.”

Chris Anderson is among the first group of paramedics who were specially trained to make house calls. He quickly recognized the value of those home visits.

“It’s when you get to spend more time with [patients], you get to find out what’s going on, what’s truly bothering them, what they need the most help with,” Anderson said.

The house calls have been a life-saver for folks like 65-year-old Victoria Denbleyker, who suffers from multiple, hard-to-manage chronic conditions, like diabetes, congestive heart failure, and rheumatoid arthritis—problems that used to routinely send her to the ER.

With doctors, Denbleyker said, “you don’t have that much time to really talk to them, even if you get the maximum amount of time, which is half an hour. Sometimes there are too many things going on. “

Without consistent monitoring, Denbleyker’s condition can rapidly descend into the danger zone.

“My system can change in a heartbeat,” she said. “I never know what is coming next. So the fact that they know what is going on with me means a lot.”

The Minnesota project started last October. To figure out which patients might benefit from the program, the hospital searched for anyone who had used the ER nine or more times in a year.

Nine was “the number we had to land on for our own survival mode,” said North Memorial’s Croston.

Think that’s a lot?

“We’ve had some patients that were here 23 times in a month,” he said.

Croston said, “readmission rates are down for us as a health system, and that’s largely due to the fact that we’re intervening once they leave the hospital or once they leave the emergency department.”

Barb Andrews, who runs the program, says it’s a new way of thinking about health care.

“It gives us, as paramedics, an opportunity to be proactive rather than reactive,” she said. “The community paramedics empower [patients] to be able to manage their own health better in the home.”

And ultimately, she said, that can “keep them out of the hospital, keep them out of the nursing home.”

What is the second law of thermodynamics?


What is the second law of thermodynamics?

http://gu.com/p/3kt6q

Top 20 things politicians need to know about science.


Top 20 things politicians need to know about science

http://www.theguardian.com/science/2013/nov/20/top-20-things-politicians-need-to-know-about-science

Stem cell transplant repairs damaged gut in mouse model of inflammatory bowel disease.


A source of gut stem cells that can repair a type of inflammatory bowel disease when transplanted into mice has been identified by researchers at the Wellcome TrustMedical Research Council Cambridge Stem Cell Institute at the University of Cambridge and at BRIC, the University of Copenhagen, Denmark.

The findings pave the way for patient-specific regenerative therapies for inflammatory bowel diseases such as ulcerative colitis.

All tissues in our body contain specialised stem cells, which are responsible for the lifelong maintenance of the individual tissue and organ. Stem cells found in adults are restricted to their tissue of origin, for example, stem cells found in the  will be able to contribute to the replenishment of the gut whereas stem cells in the skin will only contribute to maintenance of the skin.

The team first looked at developing intestinal tissue in a mouse embryo and found a population of stem cells that were quite different to the  that have been described in the gut. The cells were very actively dividing and could be grown in the laboratory over a long period without becoming specialised into the adult counterpart. Under the correct growth conditions, however, the team could induce the cells to form mature intestinal tissue.

When the team transplanted these cells into mice with a form of , within three hours the stem cells had attached to the damaged areas of the mouse intestine and integrated with the gut cells, contributing to the repair of the damaged tissue.

Dr Kim Jensen, a Wellcome Trust researcher and Lundbeckfoundation fellow, who led the study, said: “We found that the cells formed a living plaster over the damaged gut. They seemed to respond to the environment they had been placed in and matured accordingly to repair the damage.

“One of the risks of  like this is that the cells will continue to expand and form a tumour, but we didn’t see any evidence of that with this immature stem cell population from the gut.”

Cells with similar characteristics were isolated from both mice and humans and the team were also able to generate similar cells by reprogramming adult human cells, so called induced Pluripotent Stem Cells (iPSCs), and growing them in the appropriate conditions.

“We’ve identified a source of gut  that can be easily expanded in the laboratory, which could have huge implications for treating human inflammatory bowel diseases. The next step will be to see whether the human cells behave in the same way in the mouse transplant system and then we can consider investigating their use in patients,” added Dr Jensen.