Categories : General InterestTags :

Gift of the Givers is on the Ground in Gaza

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Imtiaz Sooliman calls for negotiations and compromise. “The only way to solve the problem is to do what is just.”

Haitham Najjar (left) of The Gift of the Givers Foundation helping to distribute water in Gaza. Photo supplied

By Matthew Hirsch for GroundUp

Dr Imtiaz Sooliman, founder of The Gift of the Givers Foundation, has appealed for negotiations, compromise and peace in the Middle East. The respected South African aid organisation has had a presence in Gaza for nine years.

Gift of the Givers doesn’t have an office in Gaza. Instead, the team of three people moves around distributing medical supplies, food and water. They are also involved in a women and child care centre, a health facility, and schools.

Sooliman says the organisation wants to send more people. “We are preparing to send medical teams but only if it’s not any risk to them.” He says a ceasefire or safe corridor is needed before the teams can enter Gaza. The organisation has 40 medical personnel ready to go in, Sooliman told GroundUp.

On Sunday Gift of the Givers reported that the team has been under severe physical and mental stress.

In 2014 Israel attacked Gaza for seven weeks. Sooliman said his team is reporting that this time it’s completely different. “They said it’s so difficult to move around. There’s so much anxiety and so much fear. The amount of bombs being dropped has never happened before.”

On Tuesday the UN High Commissioner for Human Rights said that 4200 people have been killed, and over one million people displaced, in just ten days, while large areas of the Gaza strip have been reduced to rubble.

The death toll includes a large number of women and children, as well as at least 11 Palestinian journalists, 28 medical staff and 14 UN workers. It also includes over 1300 Israelis, mostly civilians, killed by Hamas on 7 October.

Sooliman said that Gaza’s people face challenges with access to food and water. “Because there’s no electricity, the sewage plants don’t work. Because they can’t do burials, the decomposed bodies are going to cause infections. Because hospitals don’t have antibiotics, there’s a threat of infection there.

“They managed to do some mass funerals yesterday. As the bodies are coming in they are doing it straight away. There are thousands of bodies lying under the rubble that they can’t reach. They don’t have the equipment, they don’t have the personnel, but above all, it’s bloody dangerous to get there,” said Sooliman.

Sooliman said that he had a meeting with the Egyptian ambassador and South Africa’s Foreign Affairs Department on Monday in an attempt to get a humanitarian aid corridor open. “We are also looking at flying supplies on a cargo plane from South Africa and sending trucks to the border in Cairo.”

Asked how this situation compared to other humanitarian relief efforts the organisation had been involved in, Sooliman responded: “This is the worst situation in the world because there is no exit route. You can’t get out. The area is so small. It’s so easy to bomb it … Nobody can have a safety plan. Where are you going to hide? There’s no such thing as safety in Gaza.”

Gaza is only 350km2. It could fit into Cape Town nearly seven times, yet it has half Cape Town’s population.

Sooliman described Israel’s call to evacuate more than one million people from the north to the south of Gaza as “quite ludicrous”. “How can you move 1 million people in 24 hours when there’s no fuel and no cars? Where are you going to go to? Everything is bombed. How do you move an intensive care unit patient?”

He also called for restraint from both sides. “Civilians cannot be attacked in a war and that applies to both sides … At the end of the day, both sides must remember that there is no winner in war. Everybody loses out. The only way to solve this problem in the Middle East is to make peace, act rationally and make compromises.”

“This is not a thing about Jews against Muslims; it’s human against human. It’s not a religious thing, it’s a human thing … it’s about humanity. It’s in the interests of all parties to make compromises. The only way to solve the problem is to do what is just,” he stressed.

“When you act justly you will have peace, prosperity and peace in the entire region. Nobody loses out. Actually everybody gains more. They should go to the negotiating table, make compromises and give a just solution. If you do that then we never have to send any more supplies to the Middle East again,“ Sooliman added.

He said Gift of the Givers were accepting donations for their work in Gaza.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Cancer Cardiovascular DiseaseTags :

Addition of a Statin Reduces Treatments Needed to Shrink Breast Cancer Tumour

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Colourised scanning electron micrograph of a breast cancer cell. Credit: NIH

A novel therapeutic approach that combines human epidermal growth receptor factor 2 (HER2)-targeted therapies with the cholesterol-lowering drug lovastatin can reduce the number of cancer treatments required to prevent tumour growth. Monitored by immuno-PET scans, this combination therapy has the potential to personalise treatment for cancer patients and spare them from harmful side effects. This research was published in The Journal of Nuclear Medicine.

Antibody-drug conjugates (ADCs) have become an eminent cancer treatment because of their ability to precisely target tumours with potent efficacy. HER2-ADC therapies have been effective in treating breast, lung, bladder, and stomach cancers. Although usually well-tolerated, multiple doses of the drugs can result in severe side effects, including low blood counts, liver damage, and lung damage. Strategies that reduce toxic side effects caused by ADCs and predictive biomarkers of ADC toxicity are currently an unmet clinical need.

“In this study, we sought to determine whether a single dose of HER2-ADCs could be administered in combination with lovastatin (which temporarily elevates cell-surface HER2) to achieve therapeutic efficacy similar to that of a multiple dose regime,” said Patricia Pereira, PhD, assistant professor at the Washington University School of Medicine. “We also used HER2-targeted immuno-PET to monitor changes in HER2 expression after ADC therapy.”

Researchers injected mice with cultured gastric cancer cells and patient-derived gastric cancer cells. When tumours grew sufficiently, the mice were divided into groups and received various treatment schedules (no treatment, multiple doses of ADC, multiple doses of ADC with lovastatin, single dose of ADC, or single dose of ADC with lovastatin). Immuno-PET was used to investigate the dosing regimen and the efficacy of the treatment schedules.

A single dose of ADC therapy combined with lovastatin was found to reduce tumour volume at rates similar to those resulting from multiple doses of ADC in a preclinical setting. The study results showed that immuno-PET can noninvasively monitor HER2 tumour levels after treatment with HER2-targeted ADC therapies.

“This preclinical work is significant because it has the potential to improve therapy for patients with HER2-positive cancers,” noted Pereira. “It not only simplifies treatment by exploring single-dose schedules of antibody-drug conjugates but can also reduce side effects by minimizing the number of doses required. Additionally, it personalises therapy using molecular imaging, enhancing treatment efficacy.”

She continued, “The findings suggest a future where molecular imaging techniques play a critical role in guiding drug development and cancer treatment decisions, particularly as various ADCs are being tested and approved for cancer treatment. Currently, there is no perfect way to select tumours or monitor their response to ADCs. This research indicates that molecular imaging can bridge this gap by providing real-time insights into therapy response.”

Source: Society of Nuclear Medicine and Molecular Imaging

Categories : NeurologyTags :

The Vascular System also Plays a Role in Forming Memories

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Diagram of a capillary. Source: Wikimedia Commons

Research on long-term memories has largely focused on the role of neurons but in recent years, research is revealing that other cell types are also vital in memory formation and storage. A new study reveals the crucial role of vascular system cells (pericytes) in the formation of long-term memories of life events – memories that are lost in diseases such as Alzheimer’s. The research, published in the journal Neuron, shows that pericytes, which wrap around the capillaries work in concert with neurons to help ensure that long-term memories are formed.

Pericytes help maintain the structural integrity of the capillaries. Specifically, they control the amount of blood flowing in the brain and play a key role in maintaining the barrier that stops pathogens and toxic substances from leaking out of the capillaries and into brain tissue.

“We now have a firmer understanding of the cellular mechanisms that allow memories to be both formed and stored,” says Cristina Alberini, a professor in New York University’s Center for Neural Science and the paper’s senior author. “It’s important because understanding the cooperation among different cell types will help us advance therapeutics aimed at addressing memory-related afflictions.”

“This work connects important dots between the newly discovered function of pericytes in memory and previous studies showing that pericytes are either lost or malfunction in several neurodegenerative diseases, including Alzheimer’s disease and other dementia,” explains author Benjamin Bessières, a postdoctoral researcher in NYU’s Center for Neural Science.

The discovery, reported in the new Neuron article, of the pericytes’ significance in long-term memory emerged because Alberini, Bessières, Kiran Pandey, and their colleagues examined the role of insulin-like growth factor 2 (IGF2) – a protein that was known to increase following learning in brain regions, such as the hippocampus, and to play a critical role in the formation and storage of memories.

They found that IGF2’s highest levels in the brain cells of the hippocampus do not come from neurons or glial cells, or other vascular cells, but, rather, from pericytes.

Source: New York University

Categories : GastrointestinalTags :

A Common Tricyclic Drug can Improve IBS Symptoms

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Source: CC0

A cheap and widely available prescription drug can improve symptoms of irritable bowel syndrome in patients seen in GP surgeries, according to research findings published in The Lancet and presented today at UEG Week 2023. 

Amitriptyline, a tricyclic which is commonly used at low doses for a range of health concerns, has been found to improve irritable bowel syndrome (IBS) symptoms too, according to the results of the ATLANTIS trial. 

The study was conducted in primary care, with GPs prescribing the drug and patients managing their own dose based on the severity of their symptoms, using an adjustment document designed for the trial. Most people with IBS are seen and managed in primary care by their GP, which means that the results of this trial are likely to be applicable to many people with the condition. 

Led by researchers at the Universities of Leeds, Southampton, and Bristol and funded by the National Institute for Health and Care Research (NIHR), the study showed that patients taking amitriptyline were almost twice as likely to report an overall improvement in symptoms as those taking a placebo. 

Now the trial team is recommending that GPs support their patients with IBS to use amitriptyline to manage their symptoms – and has made the dose adjustment document available for clinicians and patients. 

Co-chief Investigator Alexander Ford, Professor of Gastroenterology in the University of Leeds’s School of Medicine, said: “Amitriptyline is an effective treatment for IBS and is safe and well tolerated. This new rigorously conducted research indicates that general practitioners should support patients in primary care to try low-dose amitriptyline if their IBS symptoms haven’t improved with recommended first-line treatments.” 

Most treatments for IBS, which affects around 1 in 20 people, only have a modest effect and people often have ongoing troublesome symptoms. 

Amitriptyline was originally used at high doses to treat depression, but is now superseded by newer and better antidepressants.  

Previous small trials of low-dose tricyclic antidepressants for IBS suggested a possible benefit in patients seen in hospital clinics, who often have more difficult to treat symptoms, but this new study is the first randomised controlled trial of low-dose amitriptyline versus a placebo tablet for IBS in primary care. It is also the largest trial of amitriptyline for IBS undertaken worldwide. 

GPs already prescribe low-dose amitriptyline to treat chronic nerve and back pain, and to help prevent migraine attacks. NICE guidelines currently state that GPs could consider using a low dose tricyclic, like amitriptyline, for IBS but, until now, the evidence for a benefit has been uncertain. 

Based on the results of the trial, which showed a clear benefit of amitriptyline, GPs can offer low-dose amitriptyline to people with IBS as part of shared decision making if symptoms don’t improve with first-line treatments.   

Co-chief Investigator Hazel Everitt, Professor of Primary Care Research at the Primary Care Research Centre, University of Southampton, said: “Prior to ATLANTIS, GPs haven’t often prescribed amitriptyline for IBS as the research evidence was uncertain, but our new research provides good evidence of benefit. 

 “GPs already prescribe low-dose amitriptyline for other conditions, such as chronic pain and poor sleep, and when we interviewed GPs as part of this research, they were willing to prescribe it for IBS if the research evidence supported this. Participants were also keen to have another option to try to help their IBS symptoms and most were happy to self-adjust their dose depending on symptoms and side effects.’’ 

Some 463 people with IBS took part, recruited from 55 general practices across the UK.  

Participants were put at random into two groups – those receiving amitriptyline and those receiving a placebo. Participants controlled how many tablets of the trial medication they took, receiving support via the patient dose adjustment document that was developed with patient representatives especially for this trial. This enabled participants to increase or decrease the number of tablets based on their IBS symptoms and any side effects experienced.  

IBS scores were measured using the IBS-SSS scale. Amitriptyline participants scored a 99-point improvement compared with a 69-point improvement among placebo participants. 

Participants taking amitriptyline reported a bigger improvement in their symptom scores after six months compared with those taking a placebo. Those taking amitriptyline were almost twice as likely as those taking a placebo to report an overall improvement in IBS symptoms, with amitriptyline performing better across a wide range of IBS symptom measures. 

Researchers monitored participants’ anxiety or depression scores and found that they were not altered – suggesting that the beneficial effects of the medication were via the gut, not because of any effect as an antidepressant. 

No safety concerns were identified and side effects in people on amitriptyline were mostly mild, such as a dry mouth in the morning. 

Matthew Ridd, GP and Professor of Primary Health Care at the Centre for Academic Primary Care, University of Bristol, said: “Pragmatic trials like this are always challenging to do in primary care and the team worked hard to overcome the additional challenges of the Covid-19 pandemic.  It’s fantastic that we’ve found that amitriptyline is an effective and safe option for patients with IBS to try.” 

Amanda Farrin, Professor of Clinical Trials and Evaluation of Complex Interventions, who leads the Complex Intervention Division of the Leeds Clinical Trials Research Unit, said: “The participants in the ATLANTIS trial had moderate to severe symptoms and an average duration of IBS of 10 years. The fact that amitriptyline had such a big effect over a placebo is significant because it can help improve the quality of life of patients with this condition.” 

Professor Andrew Farmer, Director NIHR’s Health Technology Assessment (HTA) Programme, said: “The results of this study are hugely encouraging. It shows that a drug already widely available to treat a number of other conditions appears to be safe and effective for people with IBS. The findings the research team have shared around the adjustment of dosages can be tremendously helpful to GPs in guiding them when treating patients. 

“IBS affects a significant number of people in the UK and can have a debilitating effect on their day-to-day lives. This is another excellent example of how high-quality research can lead to positive changes in health and social care practice and treatments for the benefit of patients and healthcare professionals.” 

Source: EurekAlert!

Categories : Allergies PaediatricsTags :

Sublingual Immunotherapy for Peanut-Allergic Toddlers is Safer and More Effective

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Photo by Corleto on Unsplash

A three-year clinical trial has shown that the sublingual immunotherapy (SLIT) is safe in peanut-allergic children ages one to four, with a greater likelihood of desensitisation and remission the earlier the treatment began. SLIT approach where the treatment is given as a small amount of liquid under the tongue, instead of peanut flour that is mixed with other food and then eaten like it is during oral immunotherapy, or OIT.

Published in the Journal of Allergy and Clinical Immunology, this is the first randomised, controlled trial to investigate – in this young age group – the efficacy and feasibility of SLIT.

The study included 50 peanut-allergic children between the ages of one and four, randomised to receive 4mg peanut SLIT versus placebo. Participants were randomised 1:1 to receive either peanut SLIT or placebo. Desensitization to peanut was assessed by double-blind, placebo-controlled food challenge (DBPCFC) after three years of treatment.

Findings showed that peanut SLIT can be highly effective in treating peanut-allergic toddlers with almost 80% tolerating 15 peanuts without allergic symptoms after completing the treatment. With most typical peanut-allergic reactions being caused by one peanut or less, these results would translate into strong protection against exposures to peanut. In addition, researchers showed that remission of the peanut allergy may be possible after peanut SLIT with 63% of the toddlers maintaining their protection three months after stopping the treatment. These new findings show that early intervention with peanut SLIT is promising and warrants further development.

Led by Edwin Kim, MD, associate professor of paediatrics at the UNC School of Medicine, said: “From our prior studies in older children, we were optimistic that peanut SLIT could have a similar treatment effect in toddlers.

“However, what we found was even better. The desensitisation levels we saw were higher than expected and on par with levels we normally would only expect with oral immunotherapy. Just as important, rather than wearing off quickly, we were excited to see that over 60% stayed protected three months after stopping the treatment.”

One of the presumed strengths of the SLIT approach when compared to OIT has been its overall safety and simple administration. While most treatment side effects with OIT are mild to moderate, severe reactions requiring emergency treatment do occur and there remains a critical need to develop treatments with more manageable side effects.

“Peanut OIT is currently available and being offered by increasing numbers of allergists, however we are quickly learning that in addition to its known risk of allergic reactions, the actual doing of OIT can be very difficult for many families,” said Kim. “Peanut SLIT could be a good option to consider as it may be able to provide comparable levels of protection while being safe and easier to administer.”

Compared to OIT, the SLIT approach is likely to be a safer option, Kim said, with the most common side effect consisting of oral itching. Treatments that can protect children from allergic reactions while still being safe and practical for busy families can be life-changing, and researchers are hopeful that peanut SLIT can be one of those options.

“Even with the push to introduce peanut in early childhood in order to prevent the allergy, peanut allergy remains one of the most common food allergies,” said Kim. “A result of early peanut introduction is that we are diagnosing peanut allergy at younger and younger ages making it vitally important to develop treatments that can be safe and effective at preventing allergic reactions in these young children.”

Source: UNC School of Medicine

Categories : Medical IndustryTags :

Uniting in a Shared Vision for Improved Patient Safety

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Talk to your patients about safe, effective use of medicines

Photo by Cottonbro on Pexels

Approximately one in ten patients experience an adverse drug reaction during their care1. This can lead to serious harm or even death. Sanofi is committed to reducing these numbers by working with healthcare practitioners to create a culture of patient safety.

“Patient safety is a top priority for Sanofi,” says Yusuf Dawood, Multi-Country Safety Head for Sanofi Southern Africa. “We believe that patients should be essential partners in their healthcare journeys, and we are committed to working with healthcare professionals alongside their patients to ensure optimal therapeutic outcomes. We call on all healthcare practitioners to join us in raising awareness of patient safety. By working together, we can advocate for improved communication and reduce patient harm.”

Here are some key tips for healthcare practitioners on how to improve patient safety:

  • Ask patients about their concerns and listen to their feedback. They can provide valuable insights into their own health and well-being and by engaging them, healthcare practitioners can ensure that potential issues are detected as soon as possible and handled appropriately.
  • Provide patients with clear and concise information about their care. Patients need to understand what their diagnosis is, what treatment options are available, and what the benefits and risks of each option are. They also need to know what to expect during and after their treatment, and how to manage any side effects or complications. By giving patients accurate and easy-to-understand information, healthcare practitioners can empower them to make informed choices about their care.
  • Communicate with patients and other members of the healthcare team. Use simple and unambiguous language, avoid jargon and acronyms, and confirm that the patient has understood the information they have been given. Use tools such as checklists, handovers, and feedback loops to ensure that the information they share is complete and accurate.
  • Follow safety protocols and procedures. Healthcare practitioners need to adhere to guidelines, policies, protocols, best practices and standards of care established by professional bodies and regulatory authorities, which have been designed to prevent or minimise harm to patients.
  • Report issues immediately. Report any patient safety issues to the appropriate authorities in the interest of public safety. Report any medication-related patient safety issues to the relevant pharmaceutical companies. This enables companies to continuously monitor the benefit-risk profile of their products and ensure the safe use of medicines.

“Patient safety should be a top priority for healthcare professionals and pharmaceutical companies because the goal of both sectors is to improve and protect the well-being of individuals,” says Dawood. “When safety is compromised, it not only jeopardises the health and trust of patients but also undermines the credibility and integrity of the entire healthcare system. By working with pharmaceutical companies like Sanofi, healthcare professionals can provide real-world feedback on drug efficacy and side effects. This collaborative approach ensures that treatments are both safe and effective.

Join Sanofi in championing patient care. Let’s collaborate, communicate, and make every patient’s journey safer.

Reference
1. Ribeiro, M. et al. (2018) ‘Increase of 10% in the rate of adverse drug reactions for each drug administered in hospitalized patients’, Clinics, 73, pp. 1–6. doi:10.6061/clinics/2018/e185.

Categories : Diseases, Syndromes and ConditionsTags :

A Common Drug may be an Effective Treatment for Hand Osteoarthritis

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Source: Pixabay

Relief could be on the way for people with painful hand osteoarthritis after a new study found an affordable existing drug can help. Until now there has been no effective treatment.

Published in The Lancet, the paper investigated methotrexate, a low-cost, effective treatment for inflammatory joint conditions such as rheumatoid arthritis and psoriatic arthritis. It has been widely used in Australia and globally since the early 1980s.

Researchers led by Monash University and Alfred Health found that methotrexate reduced symptoms in those with hand osteoarthritis (OA). A 20mg weekly oral dose over six months had a moderate effect in reducing pain and stiffness in patients with symptomatic hand OA.

Hand OA is a disabling condition that causes pain and affects function, impeding daily activities such as dressing and eating. It can significantly reduce quality of life. About one in two women and one in four men will experience symptoms from hand OA by the time they turn 85.

About half will have inflamed joints, which cause pain and are associated with significant joint damage. Despite the high prevalence and disease burden, there are no effective medications.

Senior author Professor Flavia Cicuttini said that the study identified the role of inflammation in hand OA and the potential benefit of targeting patients who experience painful hand OA.

“In our study, as with most studies of osteoarthritis, both the placebo group and methotrexate groups’ pain improved in the first month or so,” Professor Cicuttini said.

“However, pain levels stayed the same in the placebo group but continued to decrease in the methotrexate group at three and six months, when they were still decreasing. The pain improvement in the methotrexate group was twice as much as in the placebo group.

“Based on these results, use of methotrexate can be considered in the management of hand osteoarthritis with an inflammatory pattern. This provides clinicians with a treatment option for this group, which tends to get more joint damage.”

Professor Cicuttini said in patients with hand OA and inflammation, the effects of methotrexate were present at about three months and by six months it was very clear if it worked.

“At that time patients and their doctors can decide whether to continue or stop it,” she said. “This is very similar to what we currently do with other forms of inflammatory arthritis.”

The randomised, double-blind, placebo-controlled trial of 97 people with hand OA and MRI-detected inflammation assessed whether 20mg of methotrexate weekly reduced pain and improved function compared to placebo in patients with symptomatic hand OA and synovitis (inflammation) over six months.

Professor Cicuttini said the results could provide relief for people with hand OA inflammation, which was particularly common in women as they experienced menopause.

“Further trials are needed to establish whether the effect of methotrexate extends beyond six months, for how long we need to treat patients, and whether methotrexate reduces joint damage in patients with hand osteoarthritis and associated inflammation,” she said.

Professor Cicuttini now plans to conduct an extension trial to address these questions, in particular whether women who develop hand OA around menopause and often have severe pain and joint damage may benefit.

Source: Monash University

Categories : Ageing Diet and NutritionTags :

In Humans, Reducing Calorie Intake Rejuvenates Muscles and Stimulates Anti-ageing Effects

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Photo by Thought Catalog on Unsplash

Reducing overall calorie intake may rejuvenate muscles and activate biological pathways important for good health, according new study, published in the journal Aging Cell. Calorie restriction, which cuts intake of calories but not essential nutrients, has long been known to delay the progression of age-related diseases in animal models. This finding, by researchers at the National Institutes of Health and their colleagues, suggests the same biological mechanisms may also apply to humans.

Researchers analysed data from participants in the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE), a study supported by the National Institute on Aging (NIA) that examined whether moderate calorie restriction conveys the same health benefits seen in animal studies. They found that during a two-year span, the goal for participants was to reduce their daily caloric intake by 25%, but the highest the group was able to reach was a 12% reduction. Even so, this slight reduction in calories was enough to activate most of the biological pathways that are important in healthy aging.

“A 12% reduction in calorie intake is very modest,” said corresponding author and NIA Scientific Director Luigi Ferrucci, MD, PhD. “This kind of small reduction in calorie intake is doable and may make a big difference in your health.”

The research team next sought to understand the molecular underpinnings of the benefits seen in limited, previous research of calorie restriction in humans. One study showed that individuals on calorie restriction lost muscle mass and an average of 20 pounds of weight over the first year and maintained their weight for the second year. However, despite losing muscle mass, calorie restriction participants did not lose muscle strength, indicating calorie restriction improved the amount of force generated by each unit of muscle mass, called muscle specific force.

For the current study, scientists used thigh muscle biopsies from CALERIE participants that were collected when individuals joined the study and at one-year and two-year follow ups.

To figure out which human genes were impacted during calorie restriction, the scientists isolated messenger RNA (mRNA), a molecule that contains the code for proteins, from muscle samples. The team determined the protein sequence of each mRNA and used the information to identify which genes originated specific mRNAs. Further analysis helped the scientists establish which genes during calorie restriction were upregulated, meaning the cells made more mRNA; and which were downregulated, meaning the cells produced less mRNA. The researchers confirmed calorie restriction affected the same gene pathways in humans as in mice and non-human primates. For example, a lower caloric intake upregulated genes responsible for energy generation and metabolism, and downregulated inflammatory genes leading to lower inflammation.

“Since inflammation and aging are strongly coupled, calorie restriction represents a powerful approach to preventing the pro-inflammatory state that is developed by many older people,” said Ferrucci.

Source: NIH/National Institute on Aging

Categories : Implants and ProsthesesTags :

‘Cyberpunk’ Inspired Finger Prostheses will be Available to All via 3D Printing

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A groundbreaking, easy-to-use 3D printable finger prosthesis created by a recent University of Houston graduate could offer amputees a low-cost solution to restore finger functionality. David Edquilang first designed Lunet, which doesn’t need metal fasteners, adhesives or special tools to assemble, as an undergraduate student at the Gerald D. Hines College of Architecture and Design. While standard prostheses can cost thousands of dollars, Edquilang aims to make his design open access on the internet, instead of selling it.

Edquilang explains: “Lunet began when I decided to design and 3D print prototype finger mechanisms for a prosthetic hand for fun in my free time. 2 weeks and 18 prototypes later, I created a mechanism and finger structure that closely replicated the range of motion of real fingers.”

Edquilang’s mentor at UH was Associate Professor Jeff Feng, co-director of UH’s Industrial Design program. Through a partnership with Harris Health System, Feng learned of a patient who had her fingers amputated due to frostbite. Inspired by working on an upper limb prosthesis Edquilang previously developed with student Niell Gorman, working closely with Professor Feng, Edquilang created prosthetic fingers that returned mobility to the patient, allowing her to pick up objects again.

Edquilang continues: “My professor and I were then referred to a finger amputee who lost 3 of her fingers. I applied the mechanism I created to design a finger prosthesis for her. Nearly 40 design iterations and multiple rounds of patient testing were performed to ultimately create a functional prosthesis that fit her.

His “breakthrough” came from a literal break in his design.

“After we finished working with this amputee patient, I continued to tinker with my finger designs. I intentionally broke one of my finger prototypes to see where its structural weakpoint is. It broke at the distal knuckle. This led to me having a breakthrough in the design. I added a linkage that replaces the previously rigid distal knuckle, and I stumbled upon inventing a novel finger mechanism that was more flexible and nearly unbreakable. I then set on refining the design to be more functional, easily 3D printable, and more visually appealing. Inspiration from cyberpunk art and fighter jets influenced the design. 28 design iterations and a myriad of prototypes later resulted in Lunet.”

“It feels great knowing you have the capability to positively impact people’s lives and give them help they otherwise wouldn’t be able to get,” said Edquilang.

“Not every good idea needs to be turned into a business. Sometimes, the best ideas just need to be put out there ,” said Edquilang, who graduated with a Bachelor of Science in Industrial Design last year. “Medical insurance will often not cover the cost of a finger prosthesis, since it is not considered vital enough compared to an arm or leg. Making Lunet available online for free will allow it to help the greatest number of people.”

Lunet wins awards

The prosthetic design garnered Edquilang a 2023 Red Dot: Luminary award, the highest level of recognition accorded at the Red Dot Award: Design Concept. He and Feng took home the coveted accolade at Red Dot’s ceremony last month in Singapore.

“Good results come from dedication. Extraordinary results come from experimentation. Incredible results come from a combination of both,” he said upon winning the award. He has also received a number of other accolades, including iFDesign, and national runner up for the James Dyson Award.

“David’s recent success in winning the most prestigious design awards across the world is the best manifestation of the unparalleled education and training students experience in our Industrial Design program,” Feng said. “Built upon a belief that every student is a creative individual, the program pedagogy focuses on methods of cultivating innovative minds, which is enforced with rigorous professional training.”

Lunet’s geometry inspired its name

Lunet is made up of two common types of 3D printed plastics: polylactic acid and thermoplastic polyurethane. Each finger is made up of four parts held together by plastic pins. Edquilang describes arcs and circular orbits as the foundation for the motion of the finger mechanism. The geometric basis of the design evoked the idea that the prosthesis orbits around the user’s joints like a moon, or lunet, hence the name.

Another element of Lunet’s uniqueness is that it is nearly impossible to break; other finger prosthetics can be complicated and require many parts.

“The problem with higher mechanical complexity is that these designs are less durable,” Edquilang said. “The more parts you have, the more points of failure. You need to make prosthetic fingers robust and as strong as possible, so it doesn’t break under normal use, yet you want the design to be simple. This was one of the greatest challenges in making Lunet.”

He encourages other design students not to be afraid to experiment and fail because that is often how one can learn to improve the most.

“Where the world has an abundance of problems, designers have an abundance of talent, and we should not be selfish with it,” Edquilang said.

Source: University of Houston

Categories : Neurology Regenerative MedicineTags :

3D-Printed Structures Hold Promise for Repair of Traumatic Brain Injuries

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Researchers at the University of Oxford have produced an engineered tissue representing a simplified cerebral cortex by 3D printing human stem cells. The results, published in the journal Nature Communications, showed that, when implanted into mouse brain slices, the structures became integrated with the host tissue.

The breakthrough technique could lead to tailored repairs for brain injuries. The researchers demonstrated for the first time that neural cells can be 3D-printed to mimic the architecture of the cerebral cortex.

Brain injuries, including those caused by trauma, stroke and surgery for brain tumours, typically result in significant damage to the cerebral cortex. For example, each year, around 70 million people globally suffer from traumatic brain injury (TBI), with 5 million of these cases being severe or fatal. Currently, there are no effective treatments for severe brain injuries, leading to serious impacts on quality of life.

Tissue regenerative therapies, especially those in which patients are given implants derived from their own stem cells, could be a promising route to treat brain injuries in the future. Up to now, however, there has been no method to ensure that implanted stem cells mimic the architecture of the brain.

In this new study, the University of Oxford researchers fabricated a two-layered brain tissue by 3D printing human neural stem cells. When implanted into mouse brain slices, the cells showed convincing structural and functional integration with the host tissue.

Lead author Dr Yongcheng Jin (Department of Chemistry, University of Oxford) said: ‘This advance marks a significant step towards the fabrication of materials with the full structure and function of natural brain tissues. The work will provide a unique opportunity to explore the workings of the human cortex and, in the long term, it will offer hope to individuals who sustain brain injuries.’

The cortical structure was made from human induced pluripotent stem cells (hiPSCs), which have the potential to produce the cell types found in most human tissues. A key advantage of using hiPSCs for tissue repair is that they can be easily derived from cells harvested from patients themselves, and therefore would not trigger an immune response.

The hiPSCs were differentiated into neural progenitor cells for two different layers of the cerebral cortex, by using specific combinations of growth factors and chemicals. The cells were then suspended in solution to generate two ‘bioinks’, which were then printed to produce a two-layered structure. In culture, the printed tissues maintained their layered cellular architecture for weeks, as indicated by the expression of layer-specific biomarkers.

When the printed tissues were implanted into mouse brain slices, they showed strong integration, as demonstrated by the projection of neural processes and the migration of neurons across the implant-host boundary. The implanted cells also showed signalling activity, which correlated with that of the host cells. This indicates that the human and mouse cells were communicating with each other, demonstrating functional as well as structural integration.

The researchers now intend to further refine the droplet printing technique to create complex multi-layered cerebral cortex tissues that more realistically mimic the human brain’s architecture. Besides their potential for repairing brain injuries, these engineered tissues might be used in drug evaluation, studies of brain development, and to improve our understanding of the basis of cognition.

The new advance builds on the team’s decade-long track record in inventing and patenting 3D printing technologies for synthetic tissues and cultured cells.

Senior author Dr Linna Zhou (Department of Chemistry, University of Oxford) said: “Our droplet printing technique provides a means to engineer living 3D tissues with desired architectures, which brings us closer to the creation of personalised implantation treatments for brain injury.”

Senior author Associate Professor Francis Szele (Department of Physiology, Anatomy and Genetics, University of Oxford) added: “The use of living brain slices creates a powerful platform for interrogating the utility of 3D printing in brain repair. It is a natural bridge between studying 3D printed cortical column development in vitro and their integration into brains in animal models of injury.”

Senior author Professor Zoltán Molnár (Department of Physiology, Anatomy and Genetics, University of Oxford) said: “Human brain development is a delicate and elaborate process with a complex choreography. It would be naïve to think that we can recreate the entire cellular progression in the laboratory. Nonetheless, our 3D printing project demonstrates substantial progress in controlling the fates and arrangements of human iPSCs to form the basic functional units of the cerebral cortex.”

Source: University of Oxford