Wall & Main


My perspectives as an investor and consumer

A glimpse into the future VI

RobertTurner_LightBulbThis week’s look into the world of cutting edge research:

  1. Herbal extract inhibits the development of pancreatic cancer. An herb appears to inhibit development of pancreatic cancer as a result of its anti-inflammatory properties, according to researchers from the Kimmel Cancer Center at Jefferson who presented their work at the 100th meeting of the American Association of Cancer Research.  Thymoquinone, the major constituent of the oil extract from a Middle Eastern herbal seed called Nigella sativa, exhibited anti-inflammatory properties that reduced the release of inflammatory mediators in pancreatic cancer cells, according to Hwyda Arafat, M.D., Ph.D.  “Not only patients with chronic pancreatitis could benefit from this, but also several other groups with risk of development or recurrence of pancreatic cancer, such as high-risk family members and post-surgical patients. These potent effects show promise for the herb as a potential preventive and therapeutic strategy for pancreatic cancer,” Dr. Arafat said.
  2. Reversible generation of high capacity hydrogen storage material demonstrated. Researchers at the U.S. Department of Energy’s Savannah River National Laboratory have created a reversible route to generate aluminum hydride (alane), a high capacity hydrogen storage material. This achievement is not only expected to accelerate the development of a whole class of storage materials, but also has far reaching applications in areas spanning energy technology and synthetic chemistry.  For years, one of the major obstacles to the realization of the hydrogen economy has been hydrogen storage. Solid-state storage, using solid materials such as metals that absorb hydrogen and release it as needed, has many safety and practicality advantages over storing hydrogen as a liquid or gas.  Alane possesses the desired qualities but until now, had been considered impractical because of the high pressures required to combine hydrogen and aluminum to reform the hydride material.
  3. ‘Designer’ immune cells created with the help of microscopic ‘beads’ ignore transplanted organs. The future of organ transplantation could include microscopic beads that create “designer” immune cells to help patients tolerate their new organ, Medical College of Georgia researchers say. The degradable microparticles deliver the most powerful known form of HLA-G, a natural suppressor of the immune response, straight to dendritic cells, which typically show the immune system what to attack. The microparticles are given right after a transplant, just as dendritic cells are giving the immune system a heads up to get busy attacking the new organ. Unlike current anti-rejection drugs that generally suppress the immune system – leaving patients vulnerable to infections, cancer and more – HLA-G offers specific “tolerance.” Marked microparticles also have treatment potential in diseases where the immune system attacks normal tissue, such as arthritis, multiple sclerosis and inflammatory bowel disease.
  4. New approach to scrambling light may lead to sharper images, wider views. When photographers zoom in on an object to see it better, they lose the wide-angle perspective — they are forced to trade off “big picture” context for detail. But now an imaging method developed by Princeton researchers could lead to lenses that show all parts of the scene at once in the same high detail.  The new method could help build more powerful microscopes and other optical devices.  This method addresses the shortcomings of small apertures by taking advantage of the unusual properties of substances called nonlinear optical materials. In conventional lens materials such as glass or plastic, rays of light pass through without interacting with one another. In nonlinear materials, light rays mix with each other in complex ways.  The image from a nonlinear lens would therefore be rich in detail once the information is unscrambled, which is what the researchers have been able to accomplish.
  5. Physical reality of string theory demonstrated. String theory has come under fire in recent years. Promises have been made that have not been lived up to. Leiden theoretical physicists have now for the first time used string theory to describe a physical phenomenon. Their discovery has been reported in Science Express.  Electrons can form a special kind of state, a so-called quantum critical state, that plays a role in high-temperature super-conductivity.  Super-conductivity only seemed possible at very low temperatures close to absolute zero, but more and more examples are coming up where it also occurs at higher temperatures.  However, no one had managed to explain this phenomenon.  The quantum-critical state occurs in a material just before it becomes super-conductive at high temperature, where the electrons exhibit the same behavior at small quantum mechanical scale or at macroscopic human scale.  An aspect of string theory has been used by the Leiden physicists to shed light on this phenomenon.

Filed under: Health, Science, Technology, ,

A glimpse into the future V

Webster_Messenger1.  A new target may help maintain healthy blood pressure. In trying to understand the role of prostaglandins – a family of fatty compounds key to the cardiovascular system – in blood pressure maintenance, researchers at the University of Pennsylvania School of Medicine discovered that mice that lack the receptor for one type of prostaglandin – PG F2-alpha – have lower blood pressure and less atherosclerosis than their non-mutant brethren. The normal role for PG F2-alpha is to increase blood pressure and accelerate atherosclerosis, at least in rodents.  Targeting this pathway could represent a novel therapeutic approach to cardiovascular disease.  Results were published in the Proceedings of the National Academy of Sciences.  The delicate balance the body maintains to keep blood pressure stable involves not only the prostaglandin system, but another biological pathway, the renin-angiotensin-aldosterone system, or RAAS.  Mice lacking the PG F2-alpha receptor also showed reduction in levels of renin, angiotensin I, and aldosterone, a biological situation leading to lower blood pressure.

2.  A smartphone can now serve as an ultrasound imager. William D. Richard and David Zar, researchers at Washington University in St. Louis, are bringing the minimalist approach to medical care and computing by coupling USB-based ultrasound probe technology with a smartphone, enabling a compact, mobile computational platform and a medical imaging device that fits in the palm of a hand.  It is now possible to build smartphone-compatible USB ultrasound probes for imaging the kidney, liver, bladder, and eyes, endocavity probes for prostate and uterine screenings and biopsies, and vascular probes for imaging veins and arteries for starting IVs and central lines.  The vision of the new system is to train people in remote areas of the developing world on the basics of gathering data with the phones and sending it to a centralized unit many miles, or half a world, away where specialists can analyze the image and make a diagnosis.  A typical, portable ultrasound device may cost as much as $30,000. Some of these USB-based probes sell for less than $2,000 with the goal of a price tag as low as $500.

3.  Blood cells can be reprogrammed to act as embryonic stem cells. In a recent study, U.S. researchers have reprogrammed cells found in circulating blood into cells that are molecularly and functionally indistinguishable from embryonic stem cells which provide a readily accessible source of stem cells and an alternative to harvesting embryonic stem cells. Embryonic stem cells have long been coveted for their potential to treat a multitude of diseases as a result of their unique properties of self-renewal and pluripotency (the ability to develop into any type of cell in the body), but their use has been the subject of political controversy.  To generate induced pluripotent stem cells (dubbed iPS cells), scientists isolated CD34+ cells – a type of stem cell that produces only blood cells – from blood samples.  The CD34+ cells were infected with viruses carrying reprogramming factors that can reset the blood cells to an embryonic state. The colonies of cells exhibited physical characteristics similar to embryonic stem (ES) cells and expressed the same markers as ES cells.

4.  A super-fast 167-processor chip is ultra energy-efficient. A new, extremely energy-efficient chip, containing an array of 167 processors, that provides breakthrough speeds for a variety of computing tasks has been designed by a group at the University of California, Davis. The chip, dubbed AsAP, is ultra-small, fully reprogrammable and highly configurable, so it can be widely adapted to a number of applications. The chip is designed for digital signal processing. While not the principal kind of processor chip used in desktop computers, digital signal processing chips are found in a myriad of everyday and specialized devices such as cell phones, MP3 music players, video equipment, anti-lock brakes and ultrasound and MRI medical imaging machines.  Twelve chips working together could perform more than half-a-trillion operations per second (.52 Tera-ops/sec) while using less power than a 7-watt light bulb – up to 10 times the speed of currently available chips while decreasing power consumption up to 75 times.  Details of the chip design have been published in IEEE Journal of Solid State Circuits.

5.  The future of infrastructure could be in self-healing concrete. A concrete material developed at the University of Michigan can heal itself when it cracks. No human intervention is necessary, just water and carbon dioxide.  Self-healing is possible because the material is designed to bend and crack in narrow hairlines rather than break and split in wide gaps, as traditional concrete behaves.  Self-healed specimens recovered most, if not all, of their original strength after researchers subjected them to a 3 percent tensile strain.  It’s the equivalent of stretching a 100-foot piece an extra three feet – enough strain to severely deform metal or catastrophically fracture traditional concrete.  Traditional concrete will fracture and cannot carry a load at .01 percent tensile strain.  Today, builders reinforce concrete structures with steel bars to keep cracks as small as possible. But they’re not small enough to heal, so water and deicing salts can penetrate to the steel, causing corrosion that further weakens the structure.  The self-healing concrete needs no steel reinforcement to keep crack width tight, so it eliminates corrosion.

Filed under: Health, Science, Technology, ,

Scientifically exploring solutions to health care

BrianDettmer_WheelAs America considers major health care reforms, can its crafting of policy benefit from scientific guidance?    Ryan Moore, co-author of a study published in The Lancet, a leading international medical journal, thinks so.  Seguro Popular is Mexico’s ambitious plan to improve healthcare for its estimated 50 million uninsured citizens.  The publication was the culmination of a collaborative study of Seguro Popular between Mexican health officials and researchers from leading American universities.  As a result of this study, U.S. policymakers are encouraged to scientifically explore solutions to America’s own looming healthcare crisis – an experimental approach with the potential for providing objective answers to even the most controversial and politically charged questions.

“If the administration has done arms-length science and has involved third parties, like the researchers who were involved in this study, then the case that the administration can make for continuing these programs is much stronger,” said Moore, an assistant professor of political science at Washington University in St. Louis. “They’re more likely to get at the truth – it’s good politics and it’s good science.”

The article, “Public Policy for the Poor? A Randomized Assessment of the Mexican Universal Health Insurance Program,” details a massive, two-year field experiment designed to evaluate Mexico’s push to bring better healthcare to communities ranging from remote villages to crowded urban areas. The study turned dozens of Mexican communities into real-world laboratories where causal effects of the insurance program could be empirically measured and evaluated at the household level as new services rolled out in phases across seven Mexican states: Guerrero, Jalisco, Estado de Mexico, Morelos, Oaxaca, San Luis Potosi and Sonora.

Moore and colleagues developed the experimental design, wrote public-use software to implement it and then “tied their own hands” by publishing a preliminary study detailing exactly how the experiment and analysis would be carried out – a process designed to insulate findings from after-the-fact political meddling.

Researchers identified 74 matched pairs of communities that shared similar demographic and health conditions, and worked with Mexican officials to conduct household surveys capturing a baseline snapshot of each community’s health status. Then, working independent of the Mexicans, researchers randomly selected one from each matched pair of communities for early introduction of Seguro Popular, establishing a controlled framework in which individual changes in health experiences in one community could be empirically compared to control conditions in the matching community.

“This was the largest randomized health policy evaluation ever undertaken,” Moore said. “We the researchers were involved in experimental design, and in charge of data collection and analysis at the other end. Mexican officials had no control over the results and we had full freedom to publish what we found.”

Residents in test areas were encouraged to enroll in Seguro Popular, and participating Mexican states received funds to upgrade medical facilities and improve access to health services, preventive care and medications. Follow-up surveys show the program is making a difference on its primary objective, documenting a 23 percent reduction in families experiencing catastrophic health expenditures.

According to Moore, “If money is put into a program targeting the poor to receive health insurance, and if that program is well structured, then the poor can actually see reductions in the amount they pay out of pocket for health care. That may seem obvious, but it’s not. Designing a program that’s targeted in a certain way may not mean that resources actually reach the people it’s intended to reach.”

In fact, the Lancet study identified areas where Seguro Popular needs improvement, showing it’s been slow in reaching some residents. Surprisingly, researchers found no measurable, first-year effect on medication spending, health outcomes or utilization of health services. The bottom line, Moore said, is that without objective empirical evaluations of new programs, it’s difficult to say whether funds are being spent effectively.

“This example of arms-length field experimentation and policy evaluation demonstrates how social science can contribute to bettering individuals’ lives,” said Moore. “A great deal can be gained when policymakers are willing to let science steer the evaluation process, when they’re willing to subject themselves to the possibility of being wrong. When they do that, not only is better public policy made in the long run, but we have a stronger case to make for successful policies in the short run.”

Moore is confident the Seguro Popular evaluation template could be used to guide healthcare reforms now contemplated by the Obama Administration. He points to the State Children’s Health Insurance Program, known as SCHIP, as an example of legislation that already incorporates incentives for states to experiment with funding and services. Some Medicare reform plans encourage experimentation as a way to answer questions about what works best, both on cost and quality of care.

If America wants to be ready to make large-scale changes in its health system, now is the time for small-scale testing. “If researchers are allowed to select these test areas — using scientifically and statistically valid methods -– we’ll be able to use experimental methods to do good science, to cut through the politics and get the answers we need,” Moore said. “We can get at truth using these randomized experiments.”

Filed under: Government, Health, Politics, , , , , , ,

A glimpse into the future IV – Cancer Research

uramchoe_collageSince May is recognized by the United States Congress as National Cancer Research Month, I’m dedicating this edition of “A glimpse into the future” to the men and women working tirelessly to address cancer prevention, diagnostics, treatment, and survivorship.  This post is also dedicated to my mom who is a cancer survivor and has been in remission for over eight years.  She is a woman of immense faith, courage, and inner strength and a great inspiration to me.

  1. Cancer rates have been predicted to grow dramatically over the next 20 years. The number of new cancer cases diagnosed annually in the United States will increase by 45 percent, from 1.6 million in 2010 to 2.3 million in 2030, with a dramatic spike in incidence predicted in the elderly and minority populations.  The overall population is expected to grow by 19 percent during the same period (from 305 million to 365 million).  These statistics were presented by researchers from The University of Texas M. D. Anderson Cancer Center in the Journal of Clinical Oncology.  Regarding disease-specific findings, the leading cancer sites are expected to remain constant – breast, prostate, colon and lung. However, cancer sites with the greatest increase in incidence expected are: stomach (67 percent); liver (59 percent); myeloma (57 percent); pancreas (55 percent); and bladder (54 percent).  These findings also highlight that the cost of cancer care is growing at a rate that may not be sustainable and a dire need of new medical oncologists entering the health care system.
  2. The “longevity” protein takes on tumors. Scientists at the Mayo Clinic’s Department of Oncology have identified another anti-cancer effect of the “longevity” protein SIRT1. By speeding the destruction of the tumor promoter c-Myc, SIRT1 curbs cell division. The study was published in the Journal of Cell Biology. The yeast and nematode equivalents of SIRT1 are fountains of youth that stretch lifespan. Whether SIRT1 slows aging in mammals isn’t certain, but it’s beneficial in other ways. The protein tunes up metabolism, reducing blood levels of glucose and insulin, and might forestall neurodegenerative illnesses such as Alzheimer’s disease and ALS.  Yuan et al. determined SIRT1’s effect on the transcription factor c-Myc, whose expression surges in many breast, colon, and liver cancers. The two proteins are tangled in a regulatory loop, the team found. c-Myc latched onto SIRT1’s promoter, spurring cells to manufacture more SIRT1. In turn, SIRT1 detached acetyl groups from c-Myc, hastening its breakdown.
  3. Brain tumor growth may be fought by reversing the effects of an altered enzyme. An international team of scientists from the Moores Cancer Center at the University of California, San Diego, the University of North Carolina and several institutions in China have explained how a gene alteration can lead to the development of certain types of brain tumors – low grade gliomas and secondary glioblastomas, and they have identified a compound – alpha-KG – that could staunch the cancer’s growth. The researchers have shown that when a mutated enzyme fails to do its job, the development of tumor-feeding blood vessels increases, allowing more nutrients and oxygen to fuel cancer growth. They have also shown in the laboratory that they could reverse the mutant enzyme’s effects, effectively blocking this process, called angiogenesis, and provide a potential future treatment strategy against some types of brain tumors. They reported their findings in the journal Science.
  4. The inhibitor of an insulin-like growth factor receptor may reduce the growth of pancreatic cancer. Researchers at Amgen are testing a fully human monoclonal antibody that inhibits the activity of insulin-like growth factors (IGF-1 and IGF-2) and appears to reduce pancreatic cancer cells in early testing, according to a report in Molecular Cancer Therapeutics, a journal of the American Association for Cancer Research. Pancreatic cancer is one of the deadliest cancers, and less than 4 percent of the 200,000 patients diagnosed annually live more than five years. The only available clinical treatment is gemcitabine, but this has yet to show a survival benefit. It is known that insulin-like growth factors play a role in cancer development, particularly in mediating cell survival. According to Amgen, AMG 479, a fully human anti-IGF-1 monoclonal antibody, is the first drug that specifically targets the receptor for these growth factors without cross-reacting with the closely related insulin receptor.
  5. Some promise seen in treating previously drug-resistant prostate cancer. A new therapy for metastatic prostate cancer has shown considerable promise in early clinical trials involving patients whose disease has become resistant to current drugs.  According to research presented in Science Express, the drugs are second-generation antiandrogen therapies that prevent male hormones from stimulating growth of prostate cancer cells. The new compounds – manufactured by the pharmaceutical company Medivation and known as MDV3100 and RD162 – appear to work well even in prostate cells that have a heightened sensitivity to hormones. That heightened sensitivity makes prostate cancer cells resistant to existing antiandrogen therapies.  Of 30 men enrolled in a multisite phase I/II trial designed to evaluate safety, 22 showed a sustained decline in the level of prostate specific antigen (PSA) in their blood. Phase III clinical trials are planned to evaluate the drug’s effect on survival in a large group of patients with metastatic prostate cancer.

Filed under: Health, Science, , ,

A glimpse into the future III

lyndi-0-lHere is this week’s look into the world of cutting edge research:

  1. A therapeutic target in Alzheimer’s disease identified. Work led by Professor Mark Pepys FRS over more than 20 years has identified a protein known as serum amyloid P component (SAP) as a possible therapeutic target in Alzheimer’s disease.  In collaboration with Roche he developed a new small molecule drug, CPHPC, which specifically targets SAP and removes it from the blood. In the exciting new work reported in the Proceedings of the National Academy of Sciences, the Pepys team has shown that the drug also removes SAP from the brains of patients with Alzheimer’s disease. In this first study of the drug in patients with Alzheimer’s disease, CPHPC was given to 5 individuals for 3 months.  There was the usual depletion of SAP from the blood, seen in all subjects receiving this treatment, but also remarkable disappearance of SAP from the brain. Laboratory tests revealed for the first time the way in which SAP accumulates in the brain in Alzheimer’s disease.
  2. Nanosensors could lead to development of highly sensitive security and medical devices. Scientists have designed tiny new sensor structures that could be used in novel security devices to detect poisons and explosives, or in highly sensitive medical sensors, according to research published in Nano Letters. The new ‘nanosensors’, made of gold or silver, are about 500 times smaller than the width of a human hair. One is shaped like a flat circular disk while the other looks like a doughnut with a hole in the middle. When brought together they interact with light very differently than they do on their own.  This difference in the interaction with light is affected by the composition of molecules in close proximity to the structures.  The device could be tailored to detect different chemicals by decorating the nanostructure surface with specific ‘molecular traps’ that bind the chosen target molecules. Once bound, the target molecules would change the colors that the device absorbs and scatters, alerting the sensor to their presence.
  3. Understanding and preventing the movement of tumor cells. Tumor cells that lack a certain protein can become extremely mobile and “adept” at penetrating healthy tissue to form metastases. Scientists at the Pharmacology Institute of the University of Heidelberg have identified this protein as the previously unknown cell signal factor SCAI (suppressor of cancer cell invasion).  When the factor’s functioning was disrupted, the cancer cells moved much more effectively. They adapted to the consistency of the respective tissue by changing their shapes constantly and attaching flexibly to surrounding tissues during movement with the help of special surface structures (receptors).   One of these receptors is known as b1-integrin. Suppression of SCAI causes b1-integrin to be overactive and the tumor cell to take on an aggressive form.  The discovery of SCAI, presented in the prestigious journal Nature Cell Biology, could be an interesting starting point for research into new mechanisms for fighting cancer.
  4. Advances in organic LED’s may provide cheap and efficient natural light. Roughly 20 percent of the electricity consumed worldwide is used to light homes, businesses, and other private and public spaces. Though this consumption represents a large drain on resources, it also presents a tremendous opportunity for savings. Improving the efficiency of commercially available light bulbs — even a little — could translate into dramatically lower energy usage if implemented widely. In the Journal of Applied Physics, a group of scientists at the Chinese Academy of Sciences is reporting an important step towards that goal with their development of a new type of light emitting diode (LED) made from inexpensive, plastic like organic materials. Designed with a simplified “tandem” structure, it can produce twice as much light as a normal LED — including the “natural” white light desired for home and office lighting.  Progress in this area promises further reduction in the price of organic LEDs.
  5. Doctors look to an inexpensive drug to relieve fibromyalgia pain. Fibromyalgia is a disorder classified by chronic widespread pain, debilitating fatigue, sleep disturbance and joint disorder. Advocates and doctors who treat the disorder, estimate it affects as much as 4 percent of the population.  In a small 14-week pilot study at Stanford, patients were given a low dose of a drug called naltrexone for the treatment of chronic pain.  The drug, which has been used clinically for more than 30 years to treat opioid addiction, was found to reduce symptoms of pain and fatigue an average of 30 percent over placebo, according to the results of the study published in the journal Pain Medicine.  “Patients’ reactions were really quite profound,” said senior author Sean Mackey, MD, PhD, associate professor at Stanford University Medical Center. Still, Mackey and his colleagues remain cautious about recommending the drug this early on in the research process.  The researchers are moving ahead with a second, longer-term trial of 30 patients who will be tested during a 16-week period.

Filed under: Health, Science, Technology, ,

A glimpse into the future II

ashbee_work02In this second issue of what I intend as a weekly tradition, I present five recent research findings from diverse areas:

  1. Stem cell therapy grows new blood vessels. Research led by David Hess at The University of Western Ontario has identified how to use selected stem cells from bone marrow to grow new blood vessels to treat diseases such as peripheral artery disease.  It’s one of the severe complications often faced by people who’ve had diabetes for a long time.  Reduced blood flow (ischemia) in their limbs can lead to resting pain, trouble with wound healing and in severe cases, amputation. The research is published in Blood.  These stem cells have a natural ability to hone in on the area of ischemia to induce blood vessel repair and improve blood flow.  The preclinical data from Hess’ research was used by a biopharmaceutical company, Aldagen (www.aldagen.com ) to receive FDA approval for a multi-center clinical trial now underway in Houston, Texas, involving 21 patients with end-stage peripheral artery disease.  “These principles could be applied not only to ischemic limbs, but to aid in the formation of new blood vessels in ischemic tissue anywhere in the body, for example after a stroke or heart attack.” says Hess.
  2. Algae could help in manufacture of solar panels that are simpler and more efficient. Engineers at Oregon State University have discovered a way to use an ancient life form to create one of the newest technologies for solar energy.  The secret: diatoms.  These tiny, single-celled algae have dye-containing rigid shells that can be used to generate electricity in a natural way at a nanoscale.  Researchers have created a new way to make “dye-sensitized” solar cells, in which photons bounce around inside the shells like they were in a pinball machine, striking these dyes and producing electricity.  This technology may be slightly more expensive than existing approaches to make dye-sensitized solar cells, but can potentially triple the electrical output.  These solar cells work well in lower light conditions and offer manufacturing simplicity and efficiency.  The process involves letting the diatoms settle on a transparent conductive glass surface.  The living organic material is removed, leaving behind the tiny skeletons of the diatoms to form a template.  Titanium dioxide is then precipitated creating a thin film semiconductor for the dye-sensitized solar cell device.  This process was presented in ACS Nano.
  3. If you think current microprocessor fabrication is impressive, think again. The ability to create tiny patterns is essential to the fabrication of computer chips and many other current and potential applications of nanotechnology. Yet, creating ever smaller features, through a widely-used process called photolithography, has required the use of ultraviolet light, which is difficult and expensive to work with.  John Fourkas, Professor of Chemistry and Biochemistry at the University of Maryland, and his research group have developed a new, table-top technique called RAPID (Resolution Augmentation through Photo-Induced Deactivation) lithography that makes it possible to create small features without the use of ultraviolet light. This research was published in Science magazine.  Nanofabrication has depended on short wavelength ultraviolet light to generate ever smaller features.  RAPID lithography allows the creation of patterns twenty times smaller than the wavelength of light employed and structures that are 2500 times smaller than the width of a human hair.  RAPID is expected to find applications in areas such as electronics, optics, and biomedical devices.
  4. What if you could repair the damaged cells following a heart attack? A protein that the heart produces during its early development reactivates the embryonic coronary developmental program and initiates migration of heart cells and blood vessel growth after a heart attack, researchers at UT Southwestern Medical Center have found. The molecule, Thymosin beta-4 (TB4), is expressed by embryos during the heart’s development and encourages migration of heart cells. The new findings in mice suggest that introducing TB4 systemically after a heart attack encourages new growth and repair of heart cells. The study appears in the Journal of Molecular and Cellular Cardiology.  “This molecule has the potential to reprogram cells in the body to get them to do what you want them to do,” said Dr. J. Michael DiMaio, associate professor of cardiothoracic surgery at UT Southwestern and senior author of the study. Obviously, the clinical implications of this are enormous because of the potential to reverse damage inflicted on heart cells after a heart attack.”
  5. The dream of a Hydrogen Economy moves one step closer to reality. The design of efficient systems for splitting water into hydrogen and oxygen underpins the long term potential of hydrogen as a clean, sustainable fuel. But man-made systems that exist today are very inefficient and often require additional use of sacrificial chemical agents.  Prof. David Milstein and colleagues of the Weizmann Institute’s Organic Chemistry Department demonstrated a new mode of bond generation between oxygen atoms and even defined the mechanism by which it takes place.  Their results were recently presented in Science magazine.  The new approach is divided into a sequence of reactions, which leads to the liberation of hydrogen and oxygen in consecutive thermal- and light-driven steps, mediated by a “smart” complex consisting of a metal core – ruthenium – and an outer organic part.  They were able to demonstrate the production of hydrogen gas, oxygen gas, and reversion of the metal complex to its original state.  For their next study, they plan to combine these stages to create an efficient catalytic system, bringing those in the field of alternative energy an important step closer to realizing this goal.

Filed under: Health, Science, Technology, ,

A glimpse into the future

dettmer3_1This is the debut of a weekly post, “A glimpse into the future” where I present five research findings as published in various scientific journals.  These projects represent the cutting edge of scientific research.

Advancements in science and technology form the foundation for future economic growth.  Many of these projects are a decade or two from producing applications or products for consumer use.  The ones that make it could significantly improve our quality of life.  As an investor, some of these may serve as candidates for sizeable returns.

  1. Fluorescent cancer cells could guide brain surgeons. Gliomas are malignant brain tumors that arise from glial (supporting) cells of the brain. Gliomas are often resistant to chemotherapy. These tumors grow fine extensions that infiltrate normal brain tissue and, in addition, individual tumor cells can form satellites in surrounding tissue. Therefore, it is almost impossible to remove the tumor tissue completely by surgery. Yet, radical surgical removal of the tumor would substantially improve the prognosis of patients.  The scientists took advantage of the fact that tumors cover their increased energy needs, among other things, by taking up large amounts of the blood protein albumin. The researchers attached a fluorescent substance (5-aminofluorescein) to albumin, which is distributed throughout the body via the bloodstream and eventually accumulates in the brain tumor. Laser light causes the substance to glow and makes the fine extensions of the tumor visible.  The scientists tested the albumin method in thirteen patients with malignant gliomas. In nine cases it was possible to remove the fluorescent tumor tissue completely thanks to the intensive yellow-green light signal.  The researchers calculated that the probability of the glowing tissue being tumor cells is 97 percent.  Tolerability and effectiveness of the staining method will be validated next year in a larger study involving several hospitals.
  2. Worrying about hard drive failures may be a thing of the past. Physicists at the University of Leeds and scientists at IBM Research’s Zurich lab have made new advances in researching a new kind of memory, called  ‘racetrack’ memory, which could become the standard method of storing information on home computers. Racetrack memory, a concept invented by Stuart Parkin at IBM Research’s Almaden Lab, has no moving parts – instead it is the information which moves. Using a kind of physics called spin transfer, scientists use electrons (in the form of electrical current) to switch the magnetism of the domains, pushing them to a different location along a nanowire.  Racetrack memory looks to combine the benefits of flash – no moving parts, with that of a hard drive – low cost.  It is significantly faster than hard disks as there are no ‘seek’ times when the head has to search the disk for information.  Racetrack memory in a computer is estimated to be 100 times cheaper per bit than flash.
  3. A battery powered by viruses could help run your car or electronic devices. MIT researchers have shown they can genetically engineer viruses to build both the positively and negatively charged ends of a lithium-ion battery. The new virus-produced batteries have the same energy capacity and power performance as state-of-the-art rechargeable batteries being considered to power plug-in hybrid cars, and they could also be used to power a range of personal electronic devices, said Angela Belcher, the MIT materials scientist who led the research team.  The new batteries could be manufactured with a cheap and environmentally benign process: The synthesis takes place at and below room temperature and requires no harmful organic solvents, and the materials that go into the battery are non-toxic.Now that the researchers have demonstrated they can wire virus batteries at the nanoscale, they intend to pursue even better batteries using materials with higher voltage and capacitance, such as manganese phosphate and nickel phosphate, said Belcher. Once that next generation is ready, the technology could go into commercial production, she said.
  4. An important piece in clean coal technology – carbon sequestration – may have a sparkling future. New research shows that for thousands of years carbon dioxide has been stored safely and naturally in underground water in gas fields saturated with the greenhouse gas. The findings – published in Nature – bring carbon capture and storage a step closer. Politicians are committed to cutting levels of atmospheric carbon dioxide to slow climate change. Carbon capture and storage is one approach to cut levels of the gas until cleaner energy sources are developed.  Naturally-occurring carbon dioxide can be trapped in two ways. The gas can dissolve in underground water – like bottled sparkling water. It can also react with minerals in rock to form new carbonate minerals, essentially locking away the carbon dioxide underground.  Real studies to support either of these predictions had, until now, been missing.  This study showed that carbon dioxide has been stored naturally and safely in underground water in natural gas fields.  This new approach will be essential for monitoring and tracing where carbon dioxide captured from coal-fired power stations goes when we inject it underground – this is critical for future safety verification.
  5. World’s first nanofluidic device with complex 3-D surfaces. Researchers at the Commerce Department’s National Institute of Standards and Technology (NIST) and Cornell University have capitalized on a process for manufacturing integrated circuits at the nanometer (billionth of a meter) level and used it to develop a method for engineering the first-ever nanoscale fluidic (nanofluidic) device with complex three-dimensional surfaces. As described in a paper published in the journal Nanotechnology, the Lilliputian chamber is a prototype for future tools with custom-designed surfaces to manipulate and measure different types of nanoparticles in solution.  Among the potential applications for this technology: the processing of nanomaterials for manufacturing; the separation and measuring of complex nanoparticle mixtures for drug delivery, gene therapy and nanoparticle toxicology; and the isolation and confinement of individual DNA strands for scientific study as they are forced to unwind and elongate (DNA typically coils into a ball-like shape in solution) within the shallowest passages of the device.

Filed under: Health, Science, Technology, ,

Use leverage to transform health care in the US

ailing_healthcare_by_frantzwahWe all understand to some extent that our health care system is in dire need of reform.  Do we know what its condition really is?  Allow me to paint a picture.

What is the current and projected state of health care in the US?

National Health Expenditure (NHE) is defined as the total health care spending in the United States.  According to Centers for Medicare & Medicaid Services (CMMS), which quantifies health spending on an annual basis, the NHE grew 6.1% to $2.2 trillion in 2007, or $7,421 per person.  In comparison, this cost was $75 billion or $356 per person in 1970.  Health care spending currently accounts for 16% of our Gross Domestic Product (GDP) and is projected to grow by an average of 6.2% per year between 2008 and 2018.  At that rate the NHE will have reached $4.5 trillion in ten years and account for 20% of our GDP.  Healthcare spending has exceeded overall economic growth (GDP) annually by an average of 2.5 percentage points since 1970.

80% of health care spending goes to hospital care (37%), physician and other professional services (29%), and drugs (14%).  Many doctors complain that the system is now turned on its head where more and more of each healthcare dollar goes to cover administrative costs associated with the first two categories than to pay professional fees.  The facilitator of the doctor-patient relationship has become the principal entity.  Meanwhile, the doctor-patient relationship is now there to support the facilitator.

Private health insurance and out-of-pocket payments accounted for the largest part of health spending (55%) in 2007.  Public programs like Medicare, Medicaid, etc., comprised 45% of NHE.  While worker’s earnings and overall inflation has increased ~30% since 1999, health insurance premiums have grown 119% during the same period.  This usually means that workers have to spend more of their income each year on health care to maintain coverage.  These effects may either be direct – through increased worker contributions for premiums or reduced benefits, or indirect – such as when employers forgo wage increases to offset increases in premiums.  I gather you’ll agree with me that neither of these options is ideal.

Due to the influence of the recession and the leading edge of the Baby Boom generation becoming eligible for Medicare, average annual spending growth by public payers is expected to outpace that of private payers.  As a result, CMMS projects that public programs will overtake private insurance and reach 51% of NHE by 2018.  Not only will it be necessary for us to allocate greater portions of our income to employer-covered insurance premiums and Medicare, there is no guarantee that it will be sufficient to bear the imminent burden on our health care system.

How can this problem be addressed?

Victor Fuchs, Professor of Economics and of Health Research and Policy at Stanford University, proposes tackling health care reform around four essential principles: coverage for the uninsured, cost control, coordinated care, and choice1.  According to him, any reform which does not cover these essentials is doomed to fail.  In addition, any reform plan that is not controversial is certain to be inconsequential.

Dr. Benjamin Carson has one such controversial and ambitious plan.  Dr. Carson, who has served in a medical advisory role for both President Clinton and President Bush, suggests the idea of a medical endowment where ten percent of the cost of health care be set aside annually in an endowment fund2.  The interest from the endowment would be used initially to cover health care expenses for the uninsured and underinsured, the first C of Prof. Fuchs principles.  He envisions growing the fund to such a size in 15-20 years that it can cover most of the country.  He has initiated a pilot program at Johns Hopkins Medicine.  The fund, called the Benevolent Endowment Network fund, will be started off in pediatric neurosurgery, expanded to all of neurosurgery with the hope of eventually covering the entire hospital.

On the corporate side, Wal-Mart is slowly positioning itself to be a force in health care through a controversial plan for tackling the second C – cost control.  I call it controversial because Wal-Mart tends to elicit a visceral reaction from many people, who view the company as “pure evil.”  I merely present the company as one of the potential forces necessary for true health care reform to be accomplished.  In September 2006, the company introduced $4 30-day prescription pricing for 291 generics in the Tampa Bay, FL area, which was available to the uninsured.  It has since expanded the program to 49 states covering 350 generics and 1000 over-the-counter medications.  Pricing now includes an option for a 90-day prescription for $10.  Several pharmacy chains, including Target and K-Mart, were forced to follow suit.  Anecdotal evidence from my pharmacist friends, who work for other chains, suggests anger at this move.  Meanwhile, many consumers applauded the move.

The company is now looking to shake up Pharmacy Benefits Management (PBM).  It announced a pilot with Caterpillar to provide 2500 prescription drugs to 70,000 of its employees, spouses, and retirees.  If successful, it is sure to try expanding the deal with other employers.  This, in turn, could help employers cut their costs related to prescription drug coverage.

The third leg in Wal-Mart’s stool is electronic medical records (EMR).  According to an article in the New York Times, Wal-Mart has decided to team its Sam’s Club division with Dell and eClinicalWorks to market hardware, software, installation,maintenance, and training to physicians’ offices.  They will be mainly targeting small physician groups where 75% of the nation’s physicians practice.  Another initiative in the works for Wal-Mart is telemedicine in collaboration with NuPhysicia, LLC.

Michael Porter, University Professor at Harvard Business School and Director of the Institute for Strategy and Competitiveness, has a plan for tackling the third and fourth C’s – coordinated care and choice.  He proposes a value-based health care delivery system where players strive to create value for patients rather than capturing more revenue, shifting costs, and restricting services.  The centerpiece of this strategy involves bundled reimbursement for an entire care cycle instead of individual services like doctor visits, MRI scan, radiologist consultation, biopsies, etc.  He provides examples of institutions such as The Cleveland Clinic and MD Anderson Cancer Center where disease-based integrated practice is bearing fruit.

Despite the various forces working to address the four C’s, one important issue that I see missing is that of preventive medicine.  I proffer this as the most important piece for the long term viability of any health care reform that’s implemented.  Most reform ideas center around the reduction of current health care burden which are all remedial in nature.  In fact, our entire nation’s health care focus seems to be on treating the disease.  Even the preventive measures mainly target regular screenings.  The assumption here is that some type of disease is inevitable; so let’s try to nip it in the bud through screenings.  What about the notion that many diseases may be prevented if we actively engage in a lifestyle that’s healthier this year than it was the last?  A friend of mine (hat tip CJC) made a statement recently which I believe to be true:

No health care reform or plan in the world can bear the burden of overweight and obesity and the complications that arise from it.”

According to the National Institutes of Health, two-thirds of us are overweight and one-third are obese.  Overweight and obesity are known risk factors for several diseases.  Certain diseases can trigger other complications and multiply the cost associated with treating them all.  For example, people with diabetes spent $190 billion for health care in 2004, nearly seven times the $28 billion they spent specifically to treat diabetes.  A sizeable portion of the total spending for these people went to the treatment of conditions that are common complications of diabetes3.  So leverage, in this case, works against us and multiplies the burden on the health care system.

However, leverage may be employed to our advantage, as well.  What if we take personal responsibility for our long term health through healthier eating and more physical activity?  We may be able to reduce conditions of overweight, and obesity and diseases like diabetes, heart attack, stroke and other related disorders.  As a result, we will find ourselves making fewer doctor visits outside our regular check-ups.  Fewer complimentary services are ordered by our primary physician.  All of this reduces the burden on our health care system.  Health care providers can, in turn, focus on patients with diseases that are out of their control and provide better value.  Meanwhile, consumers may be willing to apply some of the savings from their reduced insurance premiums to cover the uninsured and underinsured.  The four C’s have a better chance of success in providing coverage for all of us because less strain is put on by each of us.  And the best part: this leverage monetarily costs us next to nothing.

All it requires is one question and small steps to answer it: How can I live healthier this year than I did last year?


1 Health Reform: Getting the Essentials Right by Victor R. Fuchs

2 The vision of the Benevolent Endowment Network fund by Dr. Ben Carson

3 Roehrig C., et al. National Health Spending by Medical Condition, 1995-2005.  Health Affairs.  Volume 28, Number 2 (2009): pp 358-367.

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