Tech

Charlottesville, VA (March 13, 2018). Smartphones have changed the ways in which we live. They connect us with friends and families by phone, texts, and pictures. They warn us about what weather to expect and what traffic patterns we'll face on our way to work. They keep us abreast of all the news of the day and in touch with colleagues and clients.

Here's another item we can add to the list: smartphones can assist neurosurgeons in performing intricate surgeries. In a paper published today in the Journal of Neurosurgery, "Smartphone-assisted minimally invasive neurosurgery," Mauricio Mandel, MD, and colleagues from São Paulo, Brazil, describe a smartphone-endoscope device for use in minimally invasive neurosurgery. These authors found the device easy to use, efficient, cost effective, and a great learning tool for less experienced neurosurgeons.

Background

Neuroendoscopy is a minimally invasive neurosurgical procedure performed in select cases to correct hydrocephalus, remove tumors, treat vascular disease, and manage other disorders. Neuroendoscopic procedures generally result in less pain, shorter recovery times, and less scarring than craniotomy (open surgery).

During the neuroendoscopic procedure, a rigid or flexible neuroendoscope is inserted through a small incision in the skull, nose, or roof of the mouth and moved on to the planned surgical site in the brain, ventricles, or subdural or subarachnoid spaces. The neuroendoscope contains a light source to illuminate the surgical field, a lens for magnification, and a camera, which sends images to a nearby video monitor so that surgeons can see where they are operating. The neuroendoscope also contains channels and ports through which surgeons can insert and maneuver endoscopic instruments and irrigate the surgical site.

Present Study

In this paper, the authors describe their experiences in performing a variety of neurosurgical procedures with the aid of smartphone-endoscope integration: intraventricular procedures, such as treatment for hydrocephalus; vascular neurosurgery, such as aneurysm clipping or cavernoma resection; and emergency neurosurgery, such as evacuation of a subdural or intracranial hematoma. The authors demonstrate how a smartphone takes the place of the video camera usually used in neuroendoscopy and makes the presence of a separate video monitor optional.

During minimally invasive surgeries performed in 42 patients, a fully charged smartphone (iPhone models 4, 5, and 6) was attached to the front of the neuroendoscope by means of an adapter. The primary surgeon focused directly on the iPhone screen in front of him or her, rather than off to one side where the video monitor normally stands. The smartphone relayed images from the screen via Wi-Fi to a video monitor placed elsewhere in the operating room.

The video monitor remained in the operating room so that other members of the surgical team could view the procedure or in case the primary surgeon wished to revert to more conventional neuroendoscopy. The surgeons who tested the smartphone-endoscope device found images provided by the smartphone to be sufficient and did not switch to the conventional method.

In each case the device worked well. All surgeries were successful, and no complications related to use of the smartphone occurred.

Based on their experience, the authors list several advantages of using smartphone-assisted neuroendoscopy:

The smartphone is light-weight and small. It attaches easily to the endoscope by means of an adapter.

Despite the small size of the smartphone screen, its high-definition image provides an excellent view of the surgical site.

The smartphone camera supports real-time video acquisition, storage, and transmission via a variety of wireless technologies (Wi-Fi, 4G, Bluetooth, etc.). Images viewed by the primary surgeon can be simultaneously shared with the rest of the operative team on a video monitor, streamed directly to other colleagues or websites, and recorded for review and teaching purposes.

Images can be manipulated in real time using camera functions on the smartphone.

Compared with standard video equipment, smartphones are cheaper, more portable, and do not require an external power source. Should the battery become depleted during a prolonged surgery, the smartphone can be recharged without an interruption in the procedure.

Having the smartphone screen directly in front of the primary surgeon allows "a more dynamic and intuitive approach to resection" than can be experienced when a surgeon has to look away from the endoscope being manipulated to view the surgical field on a separate video monitor.

The learning curve for neurosurgical residents less experienced in neuroendoscopy is reduced when the smartphone is used.

The authors recognize that their study is preliminary and the number of cases is low. Nevertheless, they suggest that the smartphone-endoscope device may provide an alternative method of performing neuroendoscopy. The relatively inexpensive costs of a smartphone and adapter could prove beneficial in underserved areas and in countries whose medical infrastructure cannot support expensive equipment.

When asked about the study, Dr. Mandel said, "The most interesting aspect of this project was that our initial goal was to reduce the cost of the neuroendoscopic video set, but, in the end, we came across a new, more intuitive and fluid method of performing these procedures."

The stress of open-heart surgery significantly reduces patients' vitamin D levels, but aggressive supplementation with vitamin D3, just before and after surgery, can completely eliminate the observed drop in vitamin D, researchers have found.

Researchers at the Intermountain Medical Center Heart Institute in Salt Lake City conducted a study called ASSESS-D, in which they discovered two key findings related to vitamin D levels and open-heart surgery: first, that open-heart surgery patients generally have low levels of vitamin D to begin with, and secondly, that stress associated with the surgery further reduced their vitamin D levels by the time they were discharged from the hospital.

The Intermountain Medical Center Heart Institute study showed that giving heart patients vitamin D3 supplements before and after surgery reduced those deficiencies. Patients who were given the supplement had normal levels of vitamin D shortly after the surgery.

This connection is important since a deficiency of vitamin D is associated with an increased risk of heart attacks, strokes, congestive heart failure, and other cardiovascular conditions, including high blood pressure and diabetes, according to J. Brent Muhlestein, MD, lead author of the study, and cardiovascular researcher at the Intermountain Medical Center Heart Institute.

"We're gathering more evidence that vitamin D deficiency is strongly associated with heart disease and death," said Dr. Muhlestein. "Our study was a mechanistic approach to try and figure out what exactly is happening with vitamin D, and perhaps give us some information as we press forward with a randomized trial to find out the real answer to the question of the impact of vitamin D on heart disease and related problems."

Results from the study will be presented at the American College of Cardiology Scientific Session in Orlando on March 12, at 9:30 a.m., ET.

In the ASSESS-D study, Dr. Muhlestein and his team studied 150 randomized elective open-heart surgery patients. Half of the patients received three daily 50,000-unit doses of vitamin D3 starting before their procedures. The other half were given a placebo. Patients were monitored for vitamin D levels and major adverse cardiovascular events throughout their hospitalization, and then again six months after their surgery.

Among the patients who received a placebo, vitamin D levels dropped significantly after open-heart surgery. Among those who received vitamin D supplementation, their vitamin D levels actually rose into the normal range.

"Now that we know that the stress from surgery causes vitamin D levels to drop, we want to continue our research and see if supplementing vitamin D levels will help prevent heart problems in the future, given our understanding that low levels of vitamin D can cause an increased risk for heart problems," said Dr. Muhlestein.

The researchers from the Intermountain Medical Center Heart Institute's next step is to evaluate the effect of vitamin D supplementation on future cardiovascular risk among patients who present with a heart attack.

In an ongoing study, called the Target-D Trial, patients who come in with a heart attack are randomized to receive long-term vitamin D supplementation or not. They are then followed to see if the supplements reduce their risk of a second heart attack or other complications.

"We need hard evidence, and we hope the Target-D trial will give us real randomized controlled outcomes data to figure out if it's good to take vitamin D supplements if you're a heart patient who has low vitamin D levels," said Dr. Muhlestein.

Vitamin D, commonly known as the sunshine vitamin, is a hormone produced by the skin. It helps regulate more than 200 genes throughout the body. Vitamin D keeps abnormal cells from multiplying in breast and colon tissues, helps regulate blood pressure in the kidney, and helps regulate blood sugar levels in the pancreas.

The human body produces vitamin D on its own, particularly when you're out in the sun. Because people today are spending less time outdoors, and using more sunscreen when they are outdoors, the entire American population has general deficiency of the vitamin. Other factors can lead to lower vitamin D levels, including a person's weight, skin, pigmentation, sex, age, and where they live.

People generally like to feel happy, but achieving a state of happiness takes time and effort. Researchers have now found that people who pursue happiness often feel like they do not have enough time in the day, and this paradoxically makes them feel unhappy. Aekyoung Kim of Rutgers University in the US and Sam Maglio of the University of Toronto Scarborough in Canada have investigated this effect in a study in the journal Psychonomic Bulletin & Review, which is published by Springer and is an official journal of the Psychonomic Society.

Kim and Maglio conducted four studies in which they investigated how the pursuit of happiness as well as the state of being happy influenced people's perception of time. Pursuing happiness caused the participants to think of time as scarce.

In the studies, some participants were either instructed to list things that would make them happier or asked to try to make themselves feel happy while watching a dull movie about building bridges, thus demonstrating happiness as goal pursuit. The other participants came to think of happiness as a goal that they had already accomplished, achieved by watching a slapstick comedy (rather than the bridge movie) or listing items showing that they are already happy. Afterwards, all participants reported how much free time they felt they had.

The researchers' main findings showed that a person's perception of time scarcity is influenced by their pursuit of (often unattainable) happiness. The feeling that time was scarce lessened for participants who maintained that they had attained their goal of being happy to some degree.

"Time seems to vanish amid the pursuit of happiness, but only when seen as a goal requiring continued pursuit," explain the researchers. "This finding adds depth to the growing body of work suggesting that the pursuit of happiness can ironically undermine well-being." According to the researchers, the findings imply that while happiness can impair positive emotions, it need not necessarily do so. Instead, if someone believes they have achieved happiness, they are left with the time to appreciate this, for instance by keeping a gratitude journal. The research further underscores that people have different concepts about happiness, which in turn may well influence how they perceive the time they have to achieve happiness.

"Because engaging in experiences and savoring the associated feelings requires more time compared with merely, for instance, buying material goods, feeling a lack of time also leads people to prefer material possessions rather than enjoying leisure experiences," the researchers continue, who say that feeling pressed for time often also makes people less willing to spend time helping others or volunteering. "By encouraging people to worry less about pursuing happiness as a never-ending goal, successful interventions might just end up giving them more time and, in turn, more happiness."

The two researchers believe that given the influence that time availability has on people's decision-making and well-being, it remains essential to understand when, why, and how they perceive and use their time differently in their pursuit of happiness and other goals.

When you were a kid, you might have used a magnifying glass to focus the sun's light onto a spot on the sidewalk. The lens of the magnifying glass allowed you to concentrate the sun's energy by converging the light rays on a point.

Say instead of focusing the sun's light on the ground, you wanted to focus the light on a piece of paper. Then imagine that piece of paper was moving. If you wanted to keep the focus on the paper, you could move the lens (the magnifying glass) or you could make the focus (the concentration of light) move. Allowing the focus to move creates a concept known as the flying focus.

For the first time, researchers at the University of Rochester's Laboratory for Laser Energetics (LLE) have found a way to use the flying focus to better control the intensity of lasers over longer distances. Their technique includes capturing some of the fastest movies ever recorded and has the potential to help researchers design the next generation of high-power lasers or produce light sources with novel wavelengths. The next generation of high-power lasers could be powerful enough to generate particles from a vacuum, while the light sources could produce new terahertz beams for studying complex materials and molecules.

The researchers published their findings in a paper in Nature Photonics.

"People may have unintentionally produced flying focus in the past, but this is the first time the flying focus has been recognized as a useful way to manipulate the focal velocity," says Dustin Froula, a senior scientist at the LLE and an assistant professor of physics at Rochester.

If you direct the sun’s light—made up of varying wavelengths of light, or colors—using a magnifying glass, you direct all the wavelengths to the same focal spot on the ground. The colors focus on the point and come to a stop. Froula and his colleagues developed a technique using a laser beam that, like the sun’s light, is made up of different wavelengths of colors. They direct this beam at a novel flying focus lens created at the LLE. Directing the laser beam at the flying focus lens produces a focus of light, but within that focus, each of the wavelengths of color comes to a different focal point.

"This turns out to be super powerful," Froula says. "The flying focus allows us to have that high intensity over hundreds of times the distance than we could before. Right now we're trying to make the next generation of high-powered lasers and flying focus could be that enabling technology."

The technique LLE researchers developed allows them to conduct measurements by capturing movies of the moving focal spot at a rate of one-trillionth of a frame per second--one of the fastest movies ever recorded.

Froula and his colleagues accomplished this using a short pulse laser and a diffractive lens, made by Terry Kessler, an optical and imaging sciences group leader at the LLE.

"There are only a few of these lenses in the world and three of them were built at the LLE by Terry and his team more than 10 years ago as part of the OMEGA EP project," Froula says. "Our plasma physics group set out to design an experiment that would measure the propagation of a focal spot at any velocity, including 50 times the speed of light. This required a diagnostic that could make a movie with frames at a trillionth of a second."

Froula says the cooperative support of the LLE's Laser Science Team helped to achieve this feat: "The collaborative cross-disciplinary groups at LLE enabled this novel concept to become reality and are leading breakthroughs in many laser-plasma applications."

CHAMPAIGN, Ill. -- A new lightweight, low-cost agricultural robot could transform data collection and field scouting for agronomists, seed companies and farmers.

The TerraSentia crop phenotyping robot, developed by a team of scientists at the University of Illinois, will be featured at the 2018 Energy Innovation Summit Technology Showcase in National Harbor, Maryland, on March 14.

Traveling autonomously between crop rows, the robot measures the traits of individual plants using a variety of sensors, including cameras, transmitting the data in real time to the operator's phone or laptop computer. A custom app and tablet computer that come with the robot enable the operator to steer the robot using virtual reality and GPS.

TerraSentia is customizable and teachable, according to the researchers, who currently are developing machine-learning algorithms to "teach" the robot to detect and identify common diseases, and to measure a growing variety of traits, such as plant and corn ear height, leaf area index and biomass.

"These robots will fundamentally change the way people are collecting and utilizing data from their fields," said U. of I. agricultural and biological engineering professor Girish Chowdhary. He is leading a team of students, engineers and postdoctoral researchers in development of the robot.

At 24 pounds, TerraSentia is so lightweight that it can roll over young plants without damaging them. The 13-inch-wide robot is also compact and portable: An agronomist could easily toss it on a truck seat or in a car trunk to transport it to the field, Chowdhary said.

Automating data collection and analytics has the potential to improve the breeding pipeline by unlocking the mysteries of why plant varieties respond in very different ways to environmental conditions, said U. of I. plant biology professor Carl Bernacchi, one of the scientists collaborating on the project.

Data collected by the crop-scouting robot could help plant breeders identify the genetic lineages likely to produce the best quality and highest yields in specific locations, Bernacchi said.

He and Stephen P. Long, a Stanley O. Ikenberry Endowed Chair and the Gutgsell Endowed University Professor of Crop Sciences and Plant Biology at Illinois, helped determine which plant characteristics were important for the robot to measure.

"It will be transformative for growers to be able to measure every single plant in the field in a short period of time," Bernacchi said. "Crop breeders may want to grow thousands of different genotypes, all slightly different from one another, and measure each plant quickly. That's not possible right now unless you have an army of people - and that costs a lot of time and money and is a very subjective process.

"A robot or swarm of robots could go into a field and do the same types of things that people are doing manually right now, but in a much more objective, faster and less expensive way," Bernacchi said.

TerraSentia fills "a big gap in the current agricultural equipment market" between massive machinery that cultivates or sprays many acres quickly and human workers who can perform tasks requiring precision but move much more slowly, Chowdhary said.

"There's a big market for these robots not only in the U.S., where agriculture is a profitable business, but also in developing countries such as Brazil and India, where subsistence farmers struggle with extreme weather conditions such as monsoons and harsh sunlight, along with weeds and pests," Chowdhary said.

As part of a phased introduction process, several major seed companies, large U.S. universities and overseas partners are field testing 20 of the TerraSentia robots this spring through an early adopter program. Chowdhary said the robot is expected to become available to farmers in about three years, with some models costing less than $5,000.

"We're getting this technology into the hands of the users so they can tell us what's working for them and what we need to improve," Chowdhary said. "We're trying to de-risk the technology and create a product that's immediately beneficial to growers and breeders in the state of Illinois and beyond."

Tasks often feel easier to perform as we gain experience with them, which can have unintended consequences when the task involves rating a series of items, according to findings published in Psychological Science, a journal of the Association for Psychological Science. The findings show that people tend to attribute the increasing ease of making ratings to the items themselves rather than to the ratings process, resulting in rating inflation over time.

"We find that increased experience makes the evaluation process easier which, in many instances, leads to an upward trend in judges' evaluations," says study author Kieran O'Connor of the McIntire School of Commerce at the University of Virginia. "This effect emerged with judges on a dance show, with teachers who give higher grades the longer they teach a course, and in the lab where we have people evaluate photos or short stories over successive days."

Given that sequential ratings are a part of many everyday activities, this research has potentially wide-reaching implications.

"These findings suggest that people new to an evaluation task may be more critical than those who have been doing the evaluation task for longer," O'Connor notes. "This can bias decisions about hiring, employee evaluations, grading, and scoring - simply based on the experience of the evaluator."

In one study, O'Connor and coauthor Amar Cheema examined judges' ratings from the TV show Dancing With the Stars. The researchers specifically looked at 5,511 scores made by the three core judges over 20 seasons of the show. They found that the judges' average scores increased season by season over the 20-season run. Additional analyses indicate that the rise in ratings was not due to professional dance partners' increasing experience with the show, or increased dance ability, over successive seasons.

Ratings inflation also emerged in a domain with broad relevance: Student grades. The researchers analyzed data from 991 course sections offered at a large US university over successive spring and fall semesters from 2000 to 2009. They found that successive sections offered by the same instructor had higher grades over time, a phenomenon that couldn't be explained by instructor ability or student performance improving over time, or even by calendar year (i.e., general grade inflation over time).

Studying the phenomenon in a controlled experimental setting, O'Connor and Cheema also found the rating inflation effect in students' ratings of short stories. Students evaluated 1 story per day over a 2-week period, evaluating a total of 10 stories presented in random order. Analyses of 1,572 observations from 168 participants showed that participants tended to rate each successive story more positively than the previous one. Participants also reported that the rating process became easier, quicker, and more enjoyable over time, but did not believe that their ratings became more favorable.

Another online study produced a similar result, showing that participants perceived the ratings process as more fluent -- that is, easier and quicker -- as they evaluated more stories, which boosted their ratings over time. Despite this, participants remained unaware of the study aims.

The inflation effect may be small, the researchers note, but it is consistent across different contexts and can influence outcomes in meaningful ways. In the college grades study, for example, course GPA increased on average from a B+ to an A- over approximately 20 successive offerings.

Typical approaches to ensuring objectivity, such as randomizing the order of items, will not address the inflation effect. As such, it is important to understand the factors that could actually mitigate this bias:

"Making people aware of this pattern, and perhaps providing them an explicit standard that they should stick to when evaluating, may be the way to go," O'Connor says.

People with schizophrenia may now benefit from more effective, tailored treatments and greater self-empowerment, thanks to research establishing a link between childhood trauma and some of schizophrenia's most common symptoms.

Researchers from Orygen, the National Centre of Excellence for Youth Mental Health; the University of Melbourne; Port Phillip Prison and University Hospital of Gran Canaria Dr Negrin, Spain, have shown that childhood sexual, physical and emotional abuse are associated with severe hallucinations in schizophrenia and other psychotic disorders.

The study's strongest finding was that hallucinations in those with psychotic disorders were associated with all types of childhood trauma, said Dr Sarah Bendall, the study's lead author and head of trauma research at Orygen. "This means there's something about childhood trauma that leads some people to develop hallucinations," Dr Bendall said.

The meta-analysis, which analysed 29 studies on childhood trauma and psychotic symptoms, also found that childhood sexual abuse was associated with delusions.

The study was published last month in the journal Schizophrenia Bulletin, and provides the missing link for clinicians who have long theorised about the association between childhood trauma and hallucinations and delusions.

Dr Bendall said providing this evidence was a crucial first step in developing tailored, sensitive and effective treatments for trauma-based psychotic symptoms.

Around one in every 100 people will experience a psychotic disorder in their lives, with the majority developing symptoms at 18-25 years old. Psychotic symptoms can include detachment from reality, hallucinations, delusions, disorganised thinking, and lack of motivation or emotion.

Until now, treatments for trauma in psychosis have focused on post-traumatic stress disorder rather than specific symptoms such as hallucinations and delusions.

Dr Bendall said the new research would not only help refine treatments for patients with psychotic disorders but may also help to empower young patients.

"When young people come to youth mental health services, we should be assessing for trauma and for emerging psychotic symptoms, and treating them as soon as they emerge," Dr Bendall said.

"We can also arm young people with some of this research knowledge and then they can make decisions about the factors that may have caused their psychosis to develop or continue. It's a very empowering thing to be able to give people that information."

A team of researchers from the College of Engineering at Texas A&M University have developed a mechanically robust conductive coating that can maintain performance under heavy stretching and bending.

Stretchable, bendable and foldable electronics are crucial for the development of emerging technologies like adaptive displays, artificial skin, and biometric and wearable devices. This presents a unique challenge of balancing electronic performance and mechanical flexibility. The difficulty lies in finding a material that can withstand a wide array of deformations, like stretching, bending and twisting, all while maintaining electrical conductivity. Adding to the challenge is the need for this conductivity to be engineered into a variety of different surfaces, such as cloth, fiber, glass or plastic.

A collaborative team from the Artie McFerrin Department of Chemical Engineering and the Department of Materials Science and Engineering led by Dr. Jodie Lutkenhaus , associate professor and holder of the William and Ruth Neely Faculty Fellowship, has solved this problem through the development of a new surface-agnostic stretchable, bendable and foldable conductive coating, opening the door for a wide variety of flexible electronics.

Two-dimensional metal carbides (MXenes) were chosen as the main focus of the research as previous research has shown them to have a metallic-like conductivity. The previous research on MXenes has focused primarily on the materials in the form of sheets. Although these sheets have the desired conductivity, they are not stretchable and their integration into different surfaces has not been shown.

Rather than using MXene sheets, the Texas A&M research team created MXene coatings through the sequential adsorption of negatively charged MXene sheets and positively charged polyelectrolytes using an aqueous assembly process known as layer-by-layer (LbL) assembly (See image 1-A). The results of this process, described in depth in the latest issue of Science Advances, demonstrate that MXene multilayer coatings that can undergo large-scale mechanical deformation while maintaining a high level of conductivity (see video). The team has also successfully deposited the MXene multilayer coatings onto flexible polymer sheet, stretchable silicones, nylon fiber, glass and silicon.

Being on the cutting edge of science and technology excites Hollings Cancer Center (HCC) researcher Carsten Krieg, Ph.D. Each day, he walks into his lab that houses a mass cytometry machine aptly labeled Helios. Krieg explains how it can heat plasma up to 6,000 degrees Celsius, levels comparable to temperatures found on the sun.

This allows the German native, who recently joined the faculty of the Medical University of South Carolina's departments of immunology and dermatology, to accomplish an interesting feat. He creates a sort of 'Instagram' of a person's immune system. For cancer patients on experimental immunotherapy treatments, the practical application is obvious and exciting, he said.

"What I use here is a very new and nerdy technology, which is called mass cytometry, that allows you with a very high sensitivity to make pictures of your immune system. And this is possible because there's artificial intelligence, machine learning combined with algorithms that can make a very complex system easy to visualize." ??Basically, how it works is that researchers stain cells using rare metal-conjugated antibodies that target surface and intracellular proteins. "Normally in biological tissues, there are no rare metals, so this technique offers greater sensitivity in detecting targets."

Inside the Helios, the cells are ionized using an inductively-coupled plasma. The ions derived from each stained cell are maintained in discrete clouds that can be detected in a mass spectrometer. The technique can potentially detect up to 100 markers per cell, although, due to practical restrictions, about 40 are more realistic, he said. Then researchers use artificial intelligence and bioinformatics to create a two-dimensional mapping that can read the results, creating an Instagram of millions of blood cells.

"It's an easy way to look at a complex response such as one you would find during immunotherapy."

This is critical as Krieg and other cancer researchers hope to advance the field of immunotherapy. Though immunotherapy has shown great promise, the vast majority of patients either don't respond, have adverse side effects or relapse. Krieg, who comes to HCC from the University Research Priority Program (URPP) in Zurich, Switzerland, wanted to know if the technology could be used to predict which patients might respond to certain treatments.

While in Zurich, he and his colleagues decided to use the technique to study melanoma. Research featured on the cover and in the February issue of Nature Medicine, titled "High-dimensional single-cell analysis predicts response to anti-PD-1 immunotherapy" identified biomarkers in the blood that can predict whether metastatic melanoma cancer patients will respond positively to immunotherapy. The goal was to see if a blood test for these biomarkers could identity those who are likelier to benefit, while allowing "non-responders" to begin other treatments without losing time, he said. "It's a decision instrument for physicians and for the health care system."

It's also a powerful research tool as it gets to the mechanisms behind what makes immunotherapy work. The recent study found an immune cell type known as classical monocytes in the peripheral blood may be a potential biomarker for patients who will respond to anti-PD-1 immune checkpoint therapy in metastatic melanoma. "Surprisingly, what we clearly found is that it's the frequency of monocytes that is enhanced in responders over non-responders before immunotherapy."

Krieg said he was eager to join HCC to work with immunotherapy researchers here and to take advantage of the synergy he feels across departments. He wants to continue his work in melanoma as well as look at using this technique for other cancers, including head and neck, gastrointestinal and lung cancer.

Zihai Li, M.D., Ph.D., chair of the Department of Microbiology and Immunology and co-leader of the Cancer Immunology Program at HCC, said MUSC is fortunate to have recruited Krieg.

"He brings not only his wealth of knowledge in immunology but also his expertise in mass cytometry technology and its applications. This technique offers a powerful platform for high dimensional analysis of patients' blood on the single cell level."

Krieg's recent study in Nature Medicine demonstrates that the technique can be used in the clinics to profile patients' immune systems to better guide decisions about immunotherapy treatment. "Importantly, MUSC has already invested in this technology by obtaining a second-generation instrument," Li said. "Dr. Krieg's arrival will catalyze the rapid development and application of this technology to benefit the patients in the state of South Carolina."

Beyond looking for predictive biomarkers, Krieg said scientists can use this technique to closely examine how cells interact in the microenvironment of the tissue and the tumor. "We now have Instagram pictures, a picture before therapy and a picture during therapy. But you can make many more of these pictures, so you're looking after three months, after half a year, a year," he said. "This allows more of a Facebook approach, so every time you get a picture of the immune system, you're getting context."

Krieg sees the technology as ushering in a new era in cancer research. Looking back only a couple of decades, chemotherapy was the main course of treatment, he said. Then science advanced to sequence genomes and find mutations in the DNA for which specific inhibitors were developed.

"After DNA and the transcriptome, the exciting thing about this technology is the next step in evolution: we're now looking at the proteome."

The proteome is the complete set of proteins being expressed by a genome or cell at a certain time under certain conditions. "I am so excited about the work because it's the next step in science. This actually is what makes the interactions happen, where the immune cell interacts with an immune cell or a tumor cell. We're studying this whole networking of cells in your body and how they react toward your environment and in immunotherapy.

Doing real-time monitoring in patients based on their specific genetic make-up and the immunotherapy treatment they are receiving opens all kinds of research possibilities. This allows physicians to apply precision medicine to help patients and researchers to use systems biology to discover the mechanisms of disease, he said.

"I hope to make a difference in the clinic so that patients are on the right therapy from the start. Then on the research side, we want to understand how this works. Which elements do you need, when? Which element of the immune system needs to be kicked in?"

Tropical Cyclone Hola was dropping heavy rainfall on Vanuatu and New Caledonia when the Global Precipitation Measurement mission or GPM core satellite passed overhead.

There are regional warnings for Vanuatu and New Caledonia. In Vanuatu a gale warning is in force for Tafea and Shefa provinces. In New Caledonia, the territory is on pre-alert, with the exception of Ouvéa, Maré and Lifou, which are on tropical cyclone alert #2.

The GPM core observatory satellite had a fairly good look at powerful Tropical Cyclone Hola on March 8, 2018 at 3:12 a.m. EST (0812 UTC). Hola was located northeast of New Caledonia with maximum sustained winds of about 95 knots (~ 105 mph). The rainfall rate was derived from GPM's Microwave Imager (GMI) and Dual Frequency Precipitation Radar (DPR) instruments. GPM's GMI provided the best coverage of the tropical cyclone. GMI data indicated that storms within Hola were dropping rain at a rate of greater than 49 mm (1.9 inches) per hour in the southeast quadrant of the tropical cyclone. GPM's DPR swath scanned an area west of the heaviest concentration of rainfall around the center of tropical cyclone Hola. GPM's radar (DPR Ku band) found that some convective storms in feeder bands north of the tropical cyclone's eye were producing rain at a rate of over 127 mm (5 inches) per hour.

GPM is a joint mission between NASA and the Japan Aerospace Exploration Agency, JAXA.

On March 9 at 10 a.m. EST (1500 UTC) Tropical Cyclone Hola was centered near 19.6 degrees south latitude and 167.4 degrees east longitude, about 120 nautical miles northwest of Port Vila, Vanuatu. Hola was moving to the southeast at 10 knots (11.5 mph/18.5 kph). Maximum sustained winds dropped to 75 knots (86.3 mph/139 kph) making it a Category 1 hurricane on the Saffir-Simpson Wind Scale.

The Joint Typhoon Warning Center (JTWC) expects the subtropical ridge to cause Tropical Cyclone Hola to recurve toward the southeast avoiding a direct impact with New Caledonia.

JWTC noted that as Hola "continues to track southeastward it will encounter unfavorable vertical wind shear (up to 90 knots) and cooler sea surface temperatures which will lead to a decrease in intensity." By March 11, Hola will begin extratropical transition while moving toward northeastern New Zealand.

BIRMINGHAM, Ala. - Human blood from donors can be stored for use up to 42 days, and it is a mainstay therapy in transfusion medicine. However, recent studies looking back at patient records have shown that transfusion with older, stored blood is associated with adverse effects.

For severely injured patients who have massive bleeding and receive many transfusion units, older blood was associated with dysfunction in blood flow, increased injury and inflammation in critical end organs, and lung infection.

In a collaborative study using a mouse model, University of Alabama at Birmingham researchers from the departments of Anesthesiology and Perioperative Medicine, Biostatistics, Emergency Medicine, Pathology, and Surgery have found mechanistic links between older stored red blood cell transfusions and subsequent bacterial pneumonia.

This may reveal new approaches to improve safety of stored red blood cell transfusions.

The key player is free heme, a breakdown product from degraded red blood cells. Heme is part of the oxygen-binding hemoglobin pigment that gives blood cells their red color and carries oxygen through the body from the lungs. While in the red blood cell, heme is relatively safe; but once outside the confines of the red cells, free heme is toxic and can cause tissue injury. During storage and upon transfusion, stored red blood cells lyse open, releasing free heme.

An adverse role for heme suggests that finding ways to limit heme exposure or prevent heme toxicity may improve safety of stored red blood cell transfusions, say UAB researchers Rakesh Patel, Ph.D., and Jean-Francois Pittet, M.D.

Patel is a professor of pathology and director of the Center for Free Radical Biology, and Pittet is a professor of anesthesiology and perioperative medicine at the UAB School of Medicine.

In a study led by Patel and Pittet and published in the journal PLOS Medicine, mice were resuscitated after trauma and hemorrhage, using either fresh or two-week-old stored blood. Two days later, they were challenged by instilling the lungs with the bacteria Pseudomonas aeruginosa. A two-week storage of mouse blood approximates storage of human red blood cells for 42 days.

Compared to fresh blood, resuscitation with the stored blood significantly increased bacterial lung injury, as shown by higher mortality, and increases in fluid accumulation and bacterial numbers in the lungs.

A connection between free heme and infection susceptibility and severity was shown two ways. First, Pseudomonas aeruginosa-induced mortality was completely prevented by the addition of hemopexin, a scavenging protein in humans that removes free heme from the blood.

Second, adding an inhibitor of a cell surface receptor called toll-like receptor 4, or genetically removing that receptor from mice, also prevented the bacteria-induced mortality. Free heme -- which is known to induce inflammatory injury to major organs in diseases like sickle cell or sepsis -- acts, in part, by activating the toll-like receptor 4.

The researchers also found that transfusion with stored blood induced release of the inflammation mediator HMGB1, part of the body's immune response.

In tissue culture experiments, Patel, Pittet and colleagues found that addition of free heme increased permeability in a sheet of endothelial cells, and free heme inhibited macrophages from ingesting Pseudomonas aeruginosa. Macrophages are immune cells that remove infection by ingesting and destroying bacteria.

Finally, in a 16-month study, the researchers found that human trauma-hemorrhage patients who received large amounts of transfused blood were also receiving amounts of free heme sufficient to overwhelm the normal amounts of hemopexin found in a person's blood.

"We recognize that many challenges and questions remain and view our data as hypothesis-generating," Patel, Pittet and colleagues said. "Clinically, our findings underscore the need to establish whether the storage age of transfused red blood cells correlates with increasing levels of free heme after transfusion, and whether low ratios of hemopexin to free heme will identify patients at greater risk for adverse outcomes after massive transfusions."

People who use moist snuff 'snus' have significantly higher levels of the protein cornulin in their blood than non-snusers. This previously unknown relationship was found in a new study from Umeå University, Sweden. Whether higher levels per se increase the risk of disease has, however, not yet been clarified.

"It's important to know about this type of association if you want to use blood-based markers for disease. For some markers, acceptable limits might have to be individualized, since lifestyle factors can influence background levels," says Robin Myte, doctoral student at Umeå University and one of the researchers behind the study.

Scientists at Umeå University investigated whether a person's lifestyle can be reflected in the blood levels of 160 different proteins. The study is based on blood samples and lifestyle data collected during health examinations in the Västerbotten Intervention Programme in northern Sweden.

It is now possible to measure the levels of hundreds of proteins in less than a drop of blood. The scientists hope that one or more of the proteins included in the study may someday be used to detect and predict diseases such as diabetes, cardiovascular disease or cancer. Previous studies have shown that tobacco habits, physical activity and alcohol consumption affect health, and probably also the protein composition in the blood. But the relationships among them are largely unknown.

For each of the 138 participants in the study, two blood samples, collected ten years apart, were analysed. Several proteins were linked to different lifestyle behaviours. The strongest finding was that snusers had significantly higher levels of the protein cornulin compared to non-snusers.

Swedish snus, also called moist snuff, is a finely ground, moistened smokeless tobacco product, placed in a lump or tea-bag-like portion between the lip and the gum.

Cornulin is a protein that is produced mainly in the mouth and throat by cells exposed to external stress. The newly discovered relationship between snus and cornulin levels was completely independent of whether or not the participants were smokers. The association was also confirmed in another study, through collaboration with researchers from Uppsala University. The consistent results increase the reliability of the finding. On the other hand, it is still unclear whether the higher cornulin levels in snusers are linked to an increased risk of disease.

"Protein markers are an exciting tool for diagnosis and early detection of diseases, but protein levels may vary due to many different factors. That is why we aimed to map some of the 'normal' variation in protein levels in our study," says Robin Myte.

HOUSTON - (March 9, 2017) - Scientists at Rice University and the Indian Institute of Science, Bangalore, have discovered a method to make atomically flat gallium that shows promise for nanoscale electronics.

The Rice lab of materials scientist Pulickel Ajayan and colleagues in India created two-dimensional gallenene, a thin film of conductive material that is to gallium what graphene is to carbon.

Extracted into a two-dimensional form, the novel material appears to have an affinity for binding with semiconductors like silicon and could make an efficient metal contact in two-dimensional electronic devices, the researchers said.

The new material was introduced in Science Advances.

Gallium is a metal with a low melting point; unlike graphene and many other 2-D structures, it cannot yet be grown with vapor phase deposition methods. Moreover, gallium also has a tendency to oxidize quickly. And while early samples of graphene were removed from graphite with adhesive tape, the bonds between gallium layers are too strong for such a simple approach.

So the Rice team led by co-authors Vidya Kochat, a former postdoctoral researcher at Rice, and Atanu Samanta, a student at the Indian Institute of Science, used heat instead of force.

Rather than a bottom-up approach, the researchers worked their way down from bulk gallium by heating it to 29.7 degrees Celsius (about 85 degrees Fahrenheit), just below the element's melting point. That was enough to drip gallium onto a glass slide. As a drop cooled just a bit, the researchers pressed a flat piece of silicon dioxide on top to lift just a few flat layers of gallenene.

They successfully exfoliated gallenene onto other substrates, including gallium nitride, gallium arsenide, silicone and nickel. That allowed them to confirm that particular gallenene-substrate combinations have different electronic properties and to suggest that these properties can be tuned for applications.

"The current work utilizes the weak interfaces of solids and liquids to separate thin 2-D sheets of gallium," said Chandra Sekhar Tiwary, principal investigator on the project he completed at Rice before becoming an assistant professor at the Indian Institute of Technology in Gandhinagar, India. "The same method can be explored for other metals and compounds with low melting points."

Gallenene's plasmonic and other properties are being investigated, according to Ajayan. "Near 2-D metals are difficult to extract, since these are mostly high-strength, nonlayered structures, so gallenene is an exception that could bridge the need for metals in the 2-D world," he said.

WASHINGTON -- A new report from the National Academies of Sciences, Engineering, and Medicine identifies strategies for improving the reliability of bolts used in offshore oil and gas drilling rigs, thereby reducing the risk that a bolt failure could cause a spill of oil, drilling fluids, or natural gas into the environment. Although the oil and gas industry has made important advances in improving the reliability of bolts, there are multiple opportunities for the industry and the U.S. Department of the Interior's Bureau of Safety and Environmental Enforcement (BSEE) to work together to further improve reliability and safety culture, the report says.

Bolts and other fasteners are an integral part of undersea equipment in offshore oil rigs, including for critical pieces of safety equipment such as blow-out preventers (BOP). No major oil spills have resulted from the failure of a bolt or fastener, but there have been minor oil releases and near misses caused by unexpected bolt failures. Such incidents illustrate a compelling need for augmenting the regular inspection with an industrywide continuous monitoring program of bolts that have shown issues, the report says; currently there is no standard industrywide program to inspect bolts that have failed or are being replaced, such as after the five-year inspection required for BOPs.

BSEE could proactively work with the oil and gas industry to construct a comprehensive road map of key objectives and priorities to be implemented by the industry, the report says. Industry should have a large role in determining the priority for addressing potential improvements.

The road map could include sections on:

investigating bolting cluster failures using a large-scale, fully instrumented test rig that simulates undersea conditions on fasteners;

researching and developing innovations that could significantly advance the reliability of offshore fasteners in critical service;

identifying gaps in current standards and obtaining the necessary data to guide updates to the standards; and

promoting a strategic vision for the safety culture throughout the oil and gas industry. This would include collecting and disseminating information about fastener performance, failures, and near misses, and using this information to guide roadmap priorities.

The report also recommends several other actions the oil and gas industry should take to improve the reliability of undersea bolts. For example, industry should establish a standard laboratory test method to assess how susceptible bolting materials are to cracking and embrittlement from exposure to hydrogen. It should review the standards, such as those related to bolt tensioning, in order to minimize the likelihood of excessive stress being placed on bolts in subsea environments. And it should promote an enhanced safety culture across organizations and disciplines - one that is reflected in work rules and encourages all levels of the organization to improve the reliability of undersea bolts.

The study was sponsored by the Bureau of Safety and Environmental Enforcement of the U.S. Department of the Interior. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visit http://national-academies.org. A committee roster follows.

Dupilumab (trade name: Dupixent) has been approved since September 2017 for the treatment of adult patients with moderate to severe neurodermatitis (atopic dermatitis) who are candidates for systemic treatment. Typical symptoms of this chronic, non-contagious skin disease include rash and severe itching, which occur in flare-ups and might entail massive impairment of the quality of life.

In an early benefit assessment, the German Institute for Quality and Efficiency in Health Care (IQWiG) examined whether the new drug offers these patients an advantage over conventional treatments. According to the findings, the dossier contains informative data on the treatment goals that are essential for the patients, the so-called outcomes. They demonstrate clear advantages in symptom alleviation and particularly regarding the quality of life.

First neurodermatitis drug undergoing the AMNOG procedure

In most cases, neurodermatitis is treated topically with anti-inflammatory, cortisone-containing ointments. Patients with severe diseases might also undergo treatment with UV light or a so-called systemic therapy. The drug dupilumab is supposed to reduce the inflammation of the skin by inhibiting a proinflammatory mediator. Dupilumab is injected under the skin and is the first neurodermatitis drug undergoing the benefit assessment according to the Act on the Reform of the Market for Medicinal Products (AMNOG).

In accordance with the specifications of the Federal Joint Committee (G-BA), dupilumab was to be compared with the therapy that has been standard to date (appropriate comparator therapy).

Drug manufacturer presented one relevant study

The manufacturer presented one usable randomized controlled trial in which patients were observed over a sufficiently long period (52 weeks). All participants received glucocorticoid ointments as so-called background therapy. In two study arms they were additionally administered two different dosages of dupilumab, the patients in the third study arm (control group) received a placebo.

Quality of life well documented

As the CHRONOS data show, the treatment results are in favour of dupilumab for numerous aspects of treatment (patient-relevant outcomes). This applies to itching and sleep loss on the one hand, and to health-related quality of life on the other. For the latter, the improvement is shown for the symptom-related outcomes. And this is also where the difference compared with the control group turns out to be most clear (indication of a major added benefit).

Dupilumab also has a disadvantage regarding side effects: Eye disorders occurred more often than in the control group in the study. According to the scientists, however, this issue does not challenge the advantages of the other outcomes.

Accurate assessment of the extent of the advantage is impossible

However, an accurate assessment of the total extent of this advantage, i.e. across all outcomes, is impossible. For the design of the CHRONOS study has one shortcoming: To prevent further occurrence of the symptoms, patients also received drugs when they were free of symptoms (proactive therapeutic strategy).

While dupilumab was continuously injected within the CHRONOS study, the background therapy was stopped in the placebo arm. Consequently, these patients might have been "undertreated". As it is unclear how this might have influenced the differences in the treatment results, IQWiG rates the - basically undisputed - added benefit as "non-quantifiable". It can therefore be minor, considerable or major.

G-BA decides on the extent of added benefit

The dossier assessment is part of the early benefit assessment according to AMNOG supervised by the G-BA. After publication of the dossier assessment, the G-BA conducts a commenting procedure and makes a final decision on the extent of the added benefit.