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A new risk calculator that can better predict people at high risk of heart and circulatory diseases years before they strike, is ready for use across the UK and Europe researchers say. The risk calculator, SCORE2, enables doctors to predict who is at risk of having a heart attack or stroke in the next 10 years with greater accuracy.
Researchers say the tool will help to save people from having a potentially deadly heart attack or stroke, ultimately saving lives. People who are flagged as having an increased risk can be put on personalised preventative treatment, such as statins, or will receive lifestyle advice to lower their risk.
Around 200 investigators and researchers across Europe analysed data from nearly 700,000 participants – mostly middle-aged – from 45 different studies. When recruited to the studies, participants had no prior history of heart and circulatory disease, and in the 10 years they were followed up, 30,000 had a cardiovascular event – including fatal or non-fatal heart attack or stroke.
The risk tool was statistically recalibrated, by using regional-specific cardiovascular and risk factor data from 10.8 million people, to more accurately estimate cardiovascular risk for populations split into four European risk regions. It uses known risk factors for heart and circulatory diseases such as age, sex, cholesterol levels, blood pressure and smoking. The calculator accounts for current trends in heart and circulatory diseases, can predict both fatal and non-fatal conditions and is adaptable to countries with different levels of risk. Researchers say it can better estimate the cardiovascular risk amongst younger people, and will improve how treatment is tailored for older people and those in high-risk regions across Europe.
Professor Emanuele Di Angelantonio, BHF-funded researcher at the University of Cambridge BHF Centre of Research Excellence, said: “This risk tool is much more powerful and superior than what doctors have used for decades. “It will fit seamlessly into current prevention programmes with substantial real-world impact by improving the prevention of cardiovascular diseases across Europe before they strike.”
Professor Sir Nilesh Samani, medical director at the British Heart Foundation and cardiologist, said: “This new risk tool is a major advance and will save many more people from developing heart attacks, stroke and heart disease, all of which develop silently over many years and strike without warning. “It will be the new gold standard for doctors to determine which patients are at the highest risk of these conditions, and enable tailored treatment and lifestyle advice to be given much earlier.”
MIT engineers have discovered a new way of generating electricity using tiny carbon particles that can create a current simply by interacting with liquid surrounding them. The liquid, an organic solvent, draws electrons out of the particles, generating a current that could be used to drive chemical reactions or to power micro– or nanoscale robots, the researchers say.
“This mechanism is new, and this way of generating energy is completely new,” says Michael Strano, the Carbon P. Dubbs Professor of Chemical Engineering at MIT. “This technology is intriguing because all you have to do is flow a solvent through a bed of these particles. This allows you to do electrochemistry, but with no wires.”
In a new study describing this phenomenon, the researchers showed that they could use this electric current to drive a reaction known as alcohol oxidation — an organic chemical reaction that is important in the chemical industry. Strano is the senior author of the paper, which appears today in Nature Communications.
The new discovery grew out of Strano’s research on carbon nanotubes — hollow tubes made of a lattice of carbon atoms, which have unique electrical properties. In 2010, Strano demonstrated, for the first time, that carbon nanotubes can generate “thermopower waves.” When a carbon nanotube is coated with layer of fuel, moving pulses of heat, or thermopower waves, travel along the tube, creating an electrical current.
That work led Strano and his students to uncover a related feature of carbon nanotubes. They found that when part of a nanotube is coated with a Teflon-like polymer, it creates an asymmetry that makes it possible for electrons to flow from the coated to the uncoated part of the tube, generating an electrical current. Those electrons can be drawn out by submerging the particles in a solvent that is hungry for electrons.
To harness this special capability, the researchers created electricity-generating particles by grinding up carbon nanotubes and forming them into a sheet of paper-like material. One side of each sheet was coated with a Teflon-like polymer, and the researchers then cut out small particles, which can be any shape or size. For this study, they made particles that were 250 microns by 250 microns.
When these particles are submerged in an organic solvent such as acetonitrile, the solvent adheres to the uncoated surface of the particles and begins pulling electrons out of them. “The solvent takes electrons away, and the system tries to equilibrate by moving electrons,” Strano says. “There’s no sophisticated battery chemistry inside. It’s just a particle and you put it into solvent and it starts generating an electric field.”
The current version of the particles can generate about 0.7 volts of electricity per particle. In this study, the researchers also showed that they can form arrays of hundreds of particles in a small test tube. This “packed bed” reactor generates enough energy to power a chemical reaction called an alcohol oxidation, in which an alcohol is converted to an aldehyde or a ketone. Usually, this reaction is not performed using electrochemistry because it would require too much external current.
Mayo Clinic today recognized the debut of a groundbreaking multi-cancer early detection (MCED) test called Galleri™ that can detect more than 50 types of cancers through a simple blood draw. The Galleri test is intended to complement U.S. guideline-recommended cancer screenings.
Mayo Clinic Oncologist Minetta Liu, M.D. was involved in the development of the new test. “Today, many cancers are found too late, leading to poor outcomes,” says Dr. Liu. “The ability to detect cancer early is critical to successful treatment.”
Cancer is expected to become the leading cause of death in the U.S. this year. Currently recommended cancer screening tests only cover five cancer types and screen for a single cancer at a time. In fact, there are no recommended early detection screening tests for other cancers, which account for 71% of cancer deaths.
Researchers used the Galleri test in the Circulating Cell-free Genome Atlas (CCGA) Study, a prospective, observational, longitudinal study designed to characterize the landscape of genomic cancer signals in the blood of people with and without cancer. In the study, the Galleri test demonstrated the ability to detect more than 50 types of cancers — over 45 of which have no recommended screening tests today — with a low false-positive rate of less than 1%.
According to Dr. Liu, when a cancer signal is detected, the Galleri test can identify where in the body the cancer is located with high accuracy — a critical component to help enable health care providers to direct diagnostic next steps and care.
“We are grateful to Mayo Clinic for its dedication to advancing new technologies for early cancer detection and for playing a pivotal role in the development of Galleri,” says Dr. Josh Ofman, chief medical officer and head of external affairs at GRAIL.“A simple blood test capable of detecting more than 50 cancers is a ground-breaking advancement and could have a tremendous human and economic benefit.”
Initial results from the interventional PATHFINDER Study, which involved the return of Galleri test results to providers to communicate to participants, were presented today at the 2021 American Society of Clinical Oncology Annual Meeting. They demonstrate Galleri’s performance in the clinical setting was consistent with findings from previous observational studies, underscoring the potential real-world ability of Galleri to find deadly cancers earlier.
A weight-loss drug described as a ‘game-changer‘ by obesity researchers has just been approved by the US Food and Drug Administration (FDA), representing the first time the agency has endorsed such a treatment in several years. Wegovy, a weight-management therapy to be manufactured by Danish pharmaceutical company Novo Nordisk, is the the first FDA-approved weight-loss drug since 2014, but it’s not entirely a new medication.
The same drug, called semaglutide, has been used in the US and other countries as an anti-diabetic medication for years. More recently, however, evidence has shown that semaglutide at a different dosage also functions as a powerful and effective appetite-suppressant. In a study published earlier in the year involving almost 2,000 obese adults from 16 different countries, researchers reported that long-term treatment with the medicine led to almost 15 percent weight loss on average across the cohort.
Some lost even more, with over 30 percent of the group dropping in excess of 20 percent of their body weight – results that the scientists singled out as remarkable.
“No other drug has come close to producing this level of weight loss – this really is a game-changer,” obesity researcher Rachel Batterham from University College London said at the time.
“For the first time, people can achieve through drugs what was only possible through weight-loss surgery.”
Aducanumab, or Aduhelm, is the first new Alzheimer’s treatment in 18 years and the first to attack the disease process. But some experts say there’s not enough evidence it can address cognitive symptoms. The Food and Drug Administration approved the first new medication for Alzheimer’s disease in nearly two decades, a contentious decision made despite opposition from the agency’s independent advisory committee and some Alzheimer’s experts who said there was not enough evidence that the drug can help patients.
The drug, aducanumab, which will go by the brand name Aduhelm, is a monthly intravenous infusion intended to slow cognitive decline in people with mild memory and thinking problems. It is the first approved treatment to attack the disease process of Alzheimer’s instead of just addressing dementia symptoms. Biogen, its manufacturer, announced that the list price would be $56,000 a year. In addition, there will most likely be tens of thousands of dollars in costs for diagnostic testing and brain imaging. Recognizing that clinical trials of the drug had provided incomplete evidence to demonstrate effectiveness, the F.D.A. granted approval for the drug to be used but required Biogen to conduct a new clinical trial. If the new trial, called a Phase 4 trial, fails to show the drug is effective, the F.D.A. can — but is not required to — rescind its approval.
About six million people in the United States and roughly 30 million globally have Alzheimer’s, a number expected to double by 2050. Currently, five medications approved in the United States can delay cognitive decline for several months in various Alzheimer’s stages. Patient advocacy groups had lobbied vigorously for approval because there are so few treatments available for the debilitating condition. Some other drugs in clinical trials are more promising, but they are most likely three or four years away from potential approval.
The F.D.A. advisory committee, along with an independent think tank and several prominent experts — including some Alzheimer’s doctors who worked on the aducanumab clinical trials — said the evidence raised significant doubts about whether the drug is effective. They also said that even if it could slow cognitive decline in some patients, the benefit suggested by the evidence would be so slight that it would not outweigh the risk of swelling or bleeding in the brain that the drug caused in the trials.
“The data included in the applicant’s submission were highly complex and left residual uncertainties regarding clinical benefit,” the F.D.A.’s director of the Center for Drug Evaluation and Research, Dr. Patrizia Cavazzoni, wrote on the agency’s website. But, she said, the agency had decided to approve the drug through a program called accelerated approval, which is designed “to provide earlier access to potentially valuable therapies for patients with serious diseases where there is an unmet need, and where there is an expectation of clinical benefit despite some residual uncertainty regarding that benefit.” Michel Vounatsos, Biogen’s chief executive, hailed the approval and said in a statement, “We are committed to sharing our future insights about Aduhelm with the scientific community as we collect more data from the real-world use of this treatment.”
Several major websites, including those of the British government, The New York Times, CNN, The Financial Times and The Guardian, were inaccessible for many users on Tuesday morning. According to Downdetector.com, which tracks internet disruptions, sites including Etsy, Hulu, PayPal, Reddit, Twitch and Twitter also reported problems. Many of the affected sites appeared to have been restored after a little less than an hour.
The outage was connected to Fastly, a provider of cloud computing services used by scores of companies to improve the speed and reliability of their websites. Fastly later said on its website that the issue had been identified and that a fix was being made.
Fastly works on technology known as a content delivery network, which is a highly distributed network of servers used to reduce the distance between a server and user, and increase the speed at which a website loads.
The body is always interesting. For decades some physical therapists have treated knee pain by having their patients perform knee exercises. However, more recently physical therapists have figured out that most kneecap pain is actually coming from a hip problem. Let’s dig in.
The knee cap has to track evenly in the groove or it can become painful and wear away the cartilage on one side or the other. Since the most common way the knee cap is shifted is toward the outside (lateral) and there is a muscle that can pull it toward the inside (the VMO or vastus medialis obliqus), for decades physical therapists would give patients exercises for that muscle. However, there’s another reason the knee cap can track toward the outside. That has to do with the leg bone itself moving inward. That moves the groove for the knee cap, which is controlled at the hip. So which is it? Do you need to exercise the knee muscles? The hip muscles? Or both?
The hip muscles do all sorts of things and one of them is to hold your hips externally rotated. When these muscles get weak, the body caves inward, much like we see in our modern computer and phone-centric worlds (see above). When that happens, the knee cap groove at the end of the femur moves inward. Hence, much of hip physical therapy for patellofemoral problems is working on the hip external rotators. Meaning exercises where you rotate the feet or hip outward, for example, clamshell exercises.
This new research is a meta-analysis of 13 studies on exercises to help patellofemoral pain. The authors broke the studies how into hip+knee, hip-only, and knee-only exercises. They found that hip+knee and hip-only exercises worked about as well as each other to get rid of PF pain, but that knee-only exercises were inferior. This fits with what we know about how this problem develops.
The upshot? If you want to get rid of knee cap pain, the answer lies in strengthening your weak hip muscles! So make sure you get your clamshells and glute bridges in today.
The cerebral cortex is the thin surface layer of the brain found in vertebrate animals that has evolved most recently, showing the greatest variation in size among different mammals (it is especially large in humans). Each part of the cerebral cortex is six layered (e.g., L2), with different kinds of nerve cells (e.g., spiny stellate) in each layer. The cerebral cortex plays a crucial role in most higher level cognitive functions, such as thinking, memory, planning, perception, language, and attention. Although there has been some progress in understanding the macroscopic organization of this very complicated tissue, its organization at the level of individual nerve cells and their interconnecting synapses is largely unknown.
Petabyte connectomic reconstruction of a volume of human neocortex. Left: Small subvolume of the dataset. Right: A subgraph of 5000 neurons and excitatory (green) and inhibitory (red) connections in the dataset. The full graph (connectome) would be far too dense to visualize.
Mapping the structure of the brain at the resolution of individual synapses requires high-resolution microscopy techniques that can image biochemically stabilized (fixed) tissue. We collaborated with brain surgeons at Massachusetts General Hospital in Boston (MGH) who sometimes remove pieces of normal human cerebral cortex when performing a surgery to cure epilepsy in order to gain access to a site in the deeper brain where an epileptic seizure is being initiated. Patients anonymously donated this tissue, which is normally discarded, to our colleagues in the Lichtman lab. The Harvard researchers cut the tissue into ~5300 individual 30 nanometer sections using an automated tape collecting ultra-microtome, mounted those sections onto silicon wafers, and then imaged the brain tissue at 4 nm resolution in a customized 61-beam parallelized scanning electron microscope for rapid image acquisition.
Imaging the ~5300 physical sections produced 225 million individual 2D images. The team then computationally stitched and aligned this data to produce a single 3D volume. While the quality of the data was generally excellent, these alignment pipelines had to robustly handle a number of challenges, including imaging artifacts, missing sections, variation in microscope parameters, and physical stretching and compression of the tissue. Once aligned, a multiscale flood-filling network pipeline was applied (using thousands of Google Cloud TPUs) to produce a 3D segmentation of each individual cell in the tissue. Additional machine learning pipelines were applied to identify and characterize 130 million synapses, classify each 3D fragment into various “subcompartments” (e.g., axon, dendrite, or cell body), and identify other structures of interest such as myelin and cilia. Automated reconstruction results were imperfect, so manual efforts were used to “proofread” roughly one hundred cells in the data. Over time, the scientists expect to add additional cells to this verified set through additional manual efforts and further advances in automation.
Hydrogen will play an indispensable role in a future carbon-free energy system, according to nearly everyone concerned with the matter. But scenarios showing its share in final energy in the year 2050 vary considerably. The International Renewable Energy Agency (IRENA) says 12%, the Brussels-based Hydrogen Council says 18%, while the EU’s announced target is 24%.
Whatever the final outcome may be, industry watchers now largely agree that there are two realms where costs must come down for carbon-free hydrogen to advance. The cost of renewable energy, already the object of remarkable reductions in the past decade, must continue to fall. And the cost of water electrolysis for hydrogen production, encompassing the basic hardware of green hydrogen, the electrolyser, must follow a similar path downward.
Many see both poised to happen. In fact, the two are integrally related, with operating expense and capital cost factoring into the total cost of electrolyser operation. The decline of renewable power prices is expected to continue, with accelerated deployment of renewables into grids. But capital costs must come down as well, with electrolysis equipment being manufactured more quickly and less expensively.
While the price of solar PV power has fallen approximately 90% in the past 10 years, it needs to fall still further and governments appear determined to help. For example, in March, the US Department of Energy (DOE) announced its objective that the cost of utility-scale solar power fall by more than half in 10 years, from a current cost of 4.6 cents per kilowatt-hour (kWh) to 3 cents/kWh by 2025 and 2 cents/kWh by 2030. DOE announced a host of R&D projects and seed capital for improved photovoltaics (perovskites, thin films) and Concentrated Solar Power (CSP) to achieve higher efficiencies and lower costs.
The cost of electrolysis technology has been declining as well, with design improvements for higher efficiency. Improved alkaline units are being deployed even while buyers are turning increasingly to higher efficiency proton exchange membrane (PEM) electrolysers. Meanwhile the technology is advancing for solid oxide electrolyser cells (SOEC), which promise to achieve very high efficiency from high heat input, from industrial heat sources, and potentially from nuclear reactors.