Researchers Produce First Map of Microbes in NYC Subway

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(Relative amount of DNA found in the New York subway system form bacteria associated with the human body. Courtesy: Weill Cornell Newsroom)

The first-ever city-wide map of microbial diversity shows that half of all DNA on the New York City subway system’s surfaces match no known organism, and that about 10 percent of all sequenced DNA matched those related to the respiratory tract.

Results of the massive undertaking, published in Cell Systems, are part of an ongoing PathoMAP project to create a molecular portrait of New York City.

The majority of the identified bacterial, viral, fungal and animal species were harmless species that were commonly found on human skins or in the gastrointestinal tract. There were, however, DNA fragments of Bacillus anthracis (anthrax), Yersinia pestis (Bubonic plague), Staphylococcus aureus, and live methicillin-resistant S. aureus (MRSA) at some of subway stations.

S. aureus is commonly found on human skins as well as in the airways and doesn’t always cause diseases. Some strains, such as the antibiotic-resistant ones, may lead to complications.

“Despite finding traces of pathogenic microbes, their presence isn’t substantial enough to pose a threat to human health,” Dr. Christopher Mason, the study’s senior investigator was quoted as saying. “The presence of these microbes and the lack of reported medical cases is truly a testament to our body’s immune system, and our innate ability to continuously adapt to our environment.

The researchers also analyzed human DNA samples left on the surfaces of the subway system and were able to successfully predict the U.S. Census demographics of a neighborhood.

The study found mostly African American and Yoruban alleles at Canarsie station in Brooklyn, while they found Mexican, Colombian and Puerto Rican alleles in a primarily Hispanic and Amerindian area of Bronx. In Midtown Manhattan, they noted an increase in British, Tuscan and other European alleles with some potentially Chinese alleles.

“This provides a forensic ability to learn about the ancestry of the people who transit a station,” Dr. Mason was quoted as saying. “[A]nd it means the DNA people leave behind can reveal a clue as to the area’s demographics.”

Weill Cornell’s news release is available here. And the full study in Cell Systems can be downloaded here.

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1.2 M Britons May Have Been Wrongly Diagnosed with Asthma

(Courtesy U.S. NIH,: National Heart, Lung, Blood Institute [Public domain], via Wikimedia Commons)

(Courtesy U.S. NIH,: National Heart, Lung, Blood Institute [Public domain], via Wikimedia Commons)

More than 1.2 million people in the U.K. may have been wrongly diagnosed with asthma and may be taking unnecessary medications, according to a new draft clinical guideline for asthma diagnosis.

The National Institute for Health and Care Excellence (NICE) said up to 30 percent of 4.1 million adults who are treated for asthma in the United Kingdom do not have clear evidence of the chronic condition, although some might have had it once.

About 235 million people worldwide suffer from asthma, according an estimate by the World Health Organization (WHO). Yet asthma remains under-studied, under-diagnosed and under-treated, and creates a significant burden on patients, their families and the health care systems.

TRIGGERS OF ASTHMA

  • Indoor allergens (dust mites, pollution, pet dander)
  • Outdoor allergens (pollens, molds)
  • Cockroach allergens
  • Tobacco smoke
  • Workplace chemical irritants
  • Air pollution
  • Respiratory infections
  • Cold air
  • Physical activity
  • Stress and strong emotions
  • Sulfites and preservatives

(Sources: WHO, CDC, Mayo Clinic)

Prof. Mark Baker, director of clinical practice at NICE, acknowledged that under-diagnosis is a concern along with misdiagnosis:

 Accurate diagnosis of asthma has been a significant problem which means that people may be wrongly diagnosed or cases might be missed in others. Our aim with this guideline is to give clarity and set out the most clinical and cost effective ways to diagnose and monitor asthma based on the best available evidence.

The 315-page draft guideline stresses that signs and symptoms alone are insufficient for an accurate diagnosis and recommends spirometry as the go-to clinical tool to check for obstructive airway disease.

The clinical guideline summarizes differential diagnosis in four flow charts that refers suspected occupational asthma to a specialist and recommends spirometry for those who are five and older.

Use spirometry as the first-line investigation for asthma in adults and young people older than 16 and children aged 5-16 years. Regard a forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio of less than 70% as a positive test for obstructive airway disease (obstructive spirometry).

For those with obstructive spirometry, the watchdog recommends a bronchodilator reversibility (BDR) test to see if FEV1 improves by 12% or more and if the volume increases by 200 mL or more.

In the United States, 18.7 million adults and 6.8 million children live with asthma, according to the Centers for Disease Control and Prevention. Asthma kills an estimated 3,345 people in the U.S. each year.

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New VBMax S-Series Features Smaller Mouthpiece for Children and Adults

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VBMax™ S-Series spirometry filters were designed for pediatric use as well as for situations where patients feel more comfortable with a smaller mouthpiece during spirometry maneuvers.

vbmax-s-series-ridgesWe designed the oval-shaped mouthpiece of the VBMax S-Series PFT filters to be approximately 35% smaller than that of VBMax Standard PFT filters. With some updates to the overall design, we achieved our goals without sacrificing the low resistance to flow that has helped VBMax family of pulmonary function test filters become popular worldwide.

A smaller mouthpiece may also be helpful to patients with temporomandibular joint dysfunction (TMD) or anyone with a limited maximum oral aperture. The S-Series VBMax also features three, equally spaced, superior and inferior ridges for a tighter and easier grip.

If you’d like a sample or have any question about the VBMax S-Series PFT Filters, please let us know.

 

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How to Choose the Right Nebulizer

Nebulizers, Compressors, Portable and Desktop

A modern nebulizer system turns liquid medications for respiratory diseases into a fine mist that can be inhaled. Your doctor may determine that a powered nebulizer, instead of a metered-dose inhaler alone, may help you maximize the use of the inhaled medication to treat and manage asthma, COPD, cystic fibrosis and other respiratory conditions.

Desktop nebulizer systems are designed for home use and tend to be larger but cheaper.

Mabis MiniComp

Your doctor and respiratory therapist are the best resource for helping you choose the right nebulizer type or system that works with your prescribed medications. Still their recommendation might be broad and generic. They also might not take your lifestyle into consideration. Most consumer nebulizers on the market today fall into two categories:

Desktop Nebulizer Systems

  • Often require a firm, flat surface and AC power for indoor use
  • May have built-in compartments, therefore can be bulkier, to store oxygen tubing, medication cups and electrical cords
  • Likely based on proven piston-pump technology (see below) to generate mist
  • May be weighted at the bottom to increase stability for pediatric use
Portable nebulizers are handheld and have multiple power sources.

Portable nebulizers are handheld and have multiple power sources.

Portable and/or Handheld Systems

  • Are designed for handheld operation at home or on the go
  • May use piston-pump or ultrasonic technology to generate mist (see below)
  • Offer multiple ways to power your nebulizer: with AC power, a car charger, or rechargeable battery

Advances in technologies have helped similar nebulizer systems consistently produce finer mists without the bulky housing of the past. If you use a nebulizer only at home, a bulky housing may not matter much. And they tend to be more cost effective. Nebulizer technologies fall largely into three categories:

Piston-Pump Compressor Nebulizers (Jet Nebulizers)

  • High-velocity air created by a piston-powered compressor helps aerosolize liquid medication in the nebulizer cup so you can inhale the medication as a mist
  • Tends to be heavier and noisier, but cheaper, than ultrasonic nebulizers

Ultrasonic Wave Nebulizer

  • Vibrating a metal plate at ultrasonic frequencies creates a mist in the medication cup, which is then mixed with air for easy inhalation
  • Creates slightly smaller and more uniform aerosols than compressor nebulizers
  • Operates almost silently, comes in compact, portable forms, and costs more than jet nebulizers

Ultrasonic Vibrating Mesh Technology Nebulizer (“Mesh” Nebulizer)

  • A membrane, or mesh, with thousands of tiny holes vibrates at ultrasonic frequency to pump out a mist which is then mixed with air for inhalation
  • Operates nearly silently, comes in compact, portable forms, creates uniform particles with little waste
  • The most expensive of all types of nebulizers

Disposable parts are also important to keep in mind when choosing a nebulizer system.

Air filters: Nebulizer compressors usually require an air filter that should be replaced every 30 days or whenever it becomes dirty.

Nebulizers: Manufacturers recommend that disposable nebulizers be replaced every two weeks, while reusable nebulizers be replaced every six months. They should still be cleaned regularly according to manufacturer instructions.

Cleaning and Maintenance: Cleaning instructions vary according to manufacturer and the technology used in a nebulizer system. Regular cleaning and maintenance go a long way in helping you get the most use of your nebulizer system.

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Karl Deisseroth Earns Keio Medical Science Prize for Optogenetics

Keio Prize Awarded to Karl DeisserothKarl Deisseroth was chosen as one of two recipients of this year’s prestigious Keio Medical Science Prize for his “enormous contributions towards the fundamental understanding of brain function in health and disease,” Keio University announced yesterday.

Keio University lauded his efforts in inventing optogenetics, which has been adopted rapidly as a tool to precisely target and demonstrate “causal relationship between neuronal circuits and behavior.”

Thus, Dr. Deisseroth first provided “a method by which all neurons of just one type could be activated or inactivated, leaving the others more or less unaltered” (Francis Crick, 1979), which had been a long-required task in the field of neuroscience.

Optogenetics has further permitted us to control intracellular signals such as calcium and cAMP signals, and thus it can be widely applied to biomedical and life science research. By making optogenetics a reality and leading this new field, Dr. Deisseroth has made enormous contributions towards the fundamental understanding of brain function in health and disease.

“It is a tremendous honor to receive the 2014 Keio Medical Science Prize, in recognition of our efforts to develop optogenetics,” Deisseroth told Keio University. “Prize is particularly meaningful because optogenetics originated as a tool to study the basic science of biology, not medical illness.”

But optogenetic investigations into forms of Parkinson’s in rodent models have already helped neurosurgeons better target implanted stimulating electrodes. Some Parkinson’s patients receive implanted electrodes as part of their treatment to reduce symptoms. However, the precise neuronal connections to target had been up for debate–until optogenetics helped pinpoint the wiring.

“Now neurosurgeons are finding that placing their electrical contacts to target connections gives better results in treating symptoms in people with Parkinson’s and many other conditions,” Deisseroth told Standord News Service in an interview.

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Spirometry Data Coming to Your iPhone

Apple's decision to add spirometry data types could herald a new era of portable spirometers.

Apple’s decision to add spirometry data types could herald a new era of portable spirometers.

The addition of three spirometry data types to Apple’s iOS 8 HealthKit, announced ahead of Apple’s iPhone 6 launch event next Tuesday, may herald a new era of personal medical devices designed for monitoring asthma, emphysema, chronic bronchitis and other respiratory conditions.

By offering recognition of data types that can be gathered from sleep monitors and portable spirometers, Apple’s HealthKit goes beyond common apps that track, calculate and store fitness- and nutrition-related data.

Spirometry, which measures your lung capacity as well as various functions, remains the gold standard in diagnosing and monitoring asthma, chronic bronchitis, emphysema and pulmonary fibrosis.

In the release notes of iOS 8 Beta 5, Apple announced that “Spirometry data types are now available in HealthKit.” An iPhone alone cannot measure your lung functions or diagnose COPD, for example. But the availability of spirometry data types allows software and medical device developers to design apps and portable spirometers that pass the data to an iPhone for recognition.

So far three basic spirometry data types have been added to HealthKit:

  • HKQuantityTypeIdentifierForcedExpiratoryVolume1
  • HKQuantityTypeIdentifierForcedVitalCapacity
  • HKQuantityTypeIdentifierPeakExpiratoryFlowRate
MySpiroo, a portable spirometer developed in Poland by Piotr Bajtala and Dr. Lukasz Koltowski, plugs into an iPhone. (Image courtesy MySpiroo)

MySpiroo, a portable spirometer developed in Poland by Piotr Bajtala and Dr. Lukasz Koltowski, plugs into an iPhone. (Image courtesy MySpiroo)

In a move seen as a push to develop a platform for health-related software and hardware, Apple has recently hired a team of medical device experts, including Roy Raymann, a sleep researcher and founder of the Philips Sleep Experience Lab, and Divya Nag, dubbed “a rising star in the medical device community” and an expert in regulatory affairs.

Even before Apple’s recognition of spirometry as an important diagnostic and monitoring tool, developers around the world have been looking for ways to turn an iPhone into a pocket-sized spirometer.

The Respi Project, a graduate of the DreamIt Health accelerator at Johns Hopkins University, wants to help patients monitor lung conditions constantly from anywhere.

The Respi Project, a graduate of the DreamIt Health accelerator at Johns Hopkins University, wants to help patients monitor lung conditions constantly from anywhere.

As mentioned here previously, researchers at University of Washington’s Ubiquitous Computing Lab created SpiroSmart, a software that measures FEV1, FVC and PEF using only a user’s lip reverberation.

In Poland, Piotr Bajtala and Dr. Lukasz Koltowski are wrapping up their development of MySpiroo, a portable spirometer designed to relay its spirometry data to an iPhone through the earphone jack. MySpiroo so far can measure FEV, FVC, PEF, MVV, SVC, TLC, FRC, RV, ERV and more.

The Respi Project, a graduate of the DreamIt Health accelerator at Johns Hopkins University, has also designed a portable spirometer for iPhones with the goal of allowing patients to monitor their lungs from anywhere at any time.

These personal, portable spirometers do not replace consultations with and diagnoses by a physician. However, Apple’s recognition of spirometry as an important tool in managing and monitoring chronic lung conditions is likely to help empower patients living with asthma and COPD.

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ACP Releases New Sleep Apnea Diagnosis Guidelines

Illustration of Obstructive Sleep Apnea (Courtesy Habib M’henni / Wikimedia Commons)

Sleep studies for the assessment of obstructive sleep apnea should be limited to patients with unexplained daytime sleepiness after other potential causes have been ruled out, according to new guidelines from the American College of Physicians.

The Clinical Guidelines Committee of the College also recommended that patients suspected of having obstructive sleep apnea (OSA) should undergo polysomnography (PSG). But those without serious comorbidities may use portable sleep monitors when a sleep study lab is not available to them.

The recommendations, however, were rated as weak and based on low- to medium-quality evidence, the Committee wrote in the paper published in the latest edition of the Annals of Internal Medicine.

Polysomnography performed at a sleep lab has been the gold standard in diagnosing obstructive sleep apnea, but it’s expensive, resource-intensive and requires patients to spend a night away from home.

Some portable sleep monitors, those designed for use at home, may help identify suspected OSA cases through the apnea-hypopnea indiex (AHI), the number of apnea or hypopnea events per sleeping hour. But their results vary widely across different types of portable monitors. And no study to date has directly compared different portable monitors.

There was insufficient evidence to determine if sleep questionnaires, like the Epworth Sleepiness Scale, phased testing and preoperative screening for OSA were useful, the authors noted.

OSA is caused by an obstruction of the upper respiratory tract which can partially (hypopnea) or completely (apnea) block the airflow. The most common risk factor for obstructive sleep apnea is obesity. And OSA may lead to daytime sleepiness, hypertension, heart attack, stroke, cognitive impairment and other serious conditions.

Learn more about OSA at the National Heart, Lung, and Blood Institute.

 

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Back-to-School Pollution Could Trigger Respiratory Problems

No Idle Zones are popping up across the United States. (Courtesy Mike Licht / flickr)

No Idle Zones are popping up across the United States. (Courtesy Mike Licht / flickr)

Returning to classes after a relaxing summer vacation could pose multiple challenges to school children with asthma and other respiratory conditions. A myriad triggers and factors may contribute to the challenges. But one factor has gained the attention of parents and health professional: health consequences of exhaust from excessive idling.

Many previous studies, including those done in Taiwan, the U.K. and the U.S., have linked traffic-related air pollution to the risk of developing or triggering asthma in children, but ‘No Idling Campaigns’ urge concrete steps to minimize the health impact of excessive idling on school grounds.

It is easier said than done especially when extreme temperatures can either melt or freeze you without an A.C. or a heater. Still some California air pollution control districts, including the one in San Joaquin Valley, are urging parents to turn off their engine while waiting for their children. In Seattle, CoolMom has partnered with the Puget Sound Clean Air Agency to promote “Idle-Free Elementary” schools and protect children’s health.

For its part, the U.S. Environmental Protection Agency has a “Turn Off Your Engine, Kids Breathe Here” campaign designed to educate school bus drivers. While air pollution, fuel, money and wear on the engine factor into their campaign, the impacts on human health is cited as a key reason for their push.

EPA has determined that diesel exhaust is a likely human carcinogen and can contribute to other acute and chronic health concerns (see EPA’s Health Assessment Document for Diesel Exhaust). People with existing heart or lung disease, asthma, bronchitis or other respiratory problems are most sensitive to the health effects of fine particles. The elderly and children are also at risk. Children are more susceptible to air pollution than healthy adults because their respiratory systems are still developing and they have a faster breathing rate.

What has been your experience with no-idling campaigns and state laws?

 

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ActualTrack Recognizes and Analyzes Common Animal Behavioral Tasks

ActualTrack automatically tracks, recognizes and analyzes the behaviors of experimental animal models from video you collect. Analyze all your trials with just a couple of clicks. Validated by behavioral neuroscientists, ActualTrack is designed to save you time, and priced to save you money.

The animal behavior analysis software was designed to support single- and multi-subject tracking in rodent, zebrafish and Drosophila models with simple graphical user interfaces. The software doesn’t require any hardware key or dongles and lets you work from the lab, your office, or even at home.

3 Steps to analyzing your video:: Capture, Analyse, Discover

  1. Capture
    • Record experiments using standard webcams or Firewire cameras
    • Upload your video using an easy import tool that accepts all common video file formats
  2. Analyze
    • Designed for all common experimental paradigms
    • Define any areas of interest with simple drawing tools
    • Single and Multi-subject tracking
    • Multi-point tracking
    • Three-point tracking (nose, center and tail-base): Rodent, Zebrafish and Drosophila larvae
    • Two-point tracking (nose and center): adult Drosophila
    • Manual coding solution to easily score non- automated behaviors
  3. Discover
    • Results in CSV and Microsoft Excel format
    • Export results to Excel, R, SPSS and other leading statistical packages to support further analysis
    • Includes basic locomotor and zonal statistics including: distances; times; zone entries and exits; velocities and latencies in SI units
    • Easily change configurations and re-analyze data
    • Statistical analysis of the data collected

Learn more about ActualTrack animal behavior tracking and analysis software. Check out the following tutorials to get a better idea of what ActualTrack can do for you:

 

 

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Study: Direct Medical Cost of COPD Set to Reach $49 Billion

Between 12 million and 15 million adults in the United States say they have been diagnosed with chronic obstructive pulmonary disease. But the actual number may be higher due to under-reporting. (Courtesy National Heart, Lung and Blood Institute)

Between 12 million and 15 million adults in the United States say they have been diagnosed with chronic obstructive pulmonary disease. But the actual number may be higher due to under-reporting. (Courtesy National Heart, Lung and Blood Institute)

Direct costs associated with chronic obstructive pulmonary disease in the United States totaled $32.1 billion in 2010 and is set to reach $49 billion by 2020, the CDC reported in a study published in journal Chest.

The study attributed another $3.9 billion to COPD-related absenteeism, bringing the total burden of the chronic disease to $36 billion in 2010. The latest estimate counts 16.4 million days of lost work annually due to COPD and related illnesses.

Private insurance paid 18% of the medical costs, Medicare 51%, and Medicaid 25%, according to the study, which was published online early.

About 15 million people in the United States say they have been diagnosed with COPD, often under-reported and under-diagnosed, though the actual number may be higher, according to the CDC.

In the developing world, poor indoor air quality is thought to play a key cause of COPD, but tobacco smoke remains the leading factor in the development of the chronic disease.

Dr. Earl Ford and his colleagues at the Centers for Disease Control and Prevention (CDC) used national surveys, medicare and medicaid data, and the 2010 census to compile their findings and project costs through 2020.

“Evidence-based interventions that prevent tobacco use and reduce clinical complications of COPD may result in potential decreased COPD-attributable costs,” the study concluded.

COPD Resources:

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