Hologram technology may help doctors deliver targeted liver cancer treatments

Data from one of the first clinical uses of augmented reality guidance with electromagnetically tracked tools shows that the technology may help doctors quickly, safely, and accurately deliver targeted liver cancer treatments, according to a research abstract presented during a virtual session of the Society of Interventional Radiology's 2020 Annual Scientific Meeting on June 14.

The technology provides a three-dimensional holographic view inside a patient's body, allowing interventional radiologists to accurately burn away tumors while navigating to avoid organs and other critical structures.

Converting traditional two-dimensional imaging into three-dimensional holograms which we can then utilize for guidance using augmented reality helps us to better view a patient's internal structures as we navigate our way to the point of treatment."

Gaurav Gadodia, MD, Study Lead Author and Radiology Resident, Cleveland Clinic

"While conventional imaging like ultrasound and CT is safe, effective, and remains the gold-standard of care, augmented reality potentially improves the visualization of the tumor and surrounding structures, increasing the speed of localization and improving the treating physicians' confidence."
In this initial in-human pilot study, the technology was used to deliver a treatment known as percutaneous thermal ablation of solid liver tumors.

To apply this technology, the physicians use multi-phase CT to record coordinate markers placed on a patient's body. This imaging data is added to a software application that allows for the segmentation of the tumor and nearby structures within the marked coordinate space.

This information is fed into a proprietary augmented reality application, which utilizes Microsoft's HoloLens technology, a virtual reality headset with transparent lenses, to project a segmented hologram of the patient's imaged anatomy directly onto the patient. The hologram is registered to the coordinate markers to ensure the accurate location of the relevant anatomy.

Utilizing electromagnetic tracking, instruments including the ablation probe can also be visualized in the augmented reality space during the procedure, thus allowing for true holographic intraprocedural guidance.

Interventional radiologists can then use the combination of the holographic images of the patient's anatomy and tracking tools to find the tumor in the patient's liver quickly, check for optimal targeting of the tumor by the ablation probe, and avoid key structures.

The study included five patients who were selected for microwave ablation of their liver tumors. For safety during this IRB-approved study, the gold standard of ultrasound was used for primary clinical decision making and probe guidance, with direct comparison to holographic guidance.

Following ablation, images and video from post-procedural sonography, cone beam and multi-detector row CT, and HoloLens recordings were evaluated. In all five cases, intra-procedural holographic guidance was in agreement with the standard ultrasound-based guidance.

Post-procedural imaging showed adequate tumor ablation, and no patients experienced tumor recurrence at the three-month follow-up.

In this early phase pilot study, the authors anecdotally observed that the speed of tumor localization was faster with holographic guidance and that their confidence in optimal ablation and critical structure avoidance was improved over standard imaging guidance.

They are further attempting to quantify these findings as they continue to enroll patients in the study.
Beyond its use during treatments, interventional radiologists also see value in using this tool for clinicians' planning purposes and for improving patient engagement and understanding of the condition and treatment.

"This technique can be used intra-procedurally to check the accuracy and quality of the treatment, as well as pre-procedurally to engage with the patient in their own care," said Charles Martin, III, MD, FSIR, an interventional radiologist at Cleveland Clinic who is the principal investigator of the IRB and the senior author of the study.

"We can change 2D images into holograms of a patient's distinct anatomy so that both the physician and the patient get a better understanding of the tumor and treatment."

Researchers continue to test this technology for ablations in the abdominal area with plans to expand to other types of procedures and in other areas of the body.

The technology has only been tested for feasibility and therefore cannot yet be used as a standalone method for delivering treatment.

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Adverse health effect on infants born to mothers breathing polluted air

Mothers-to-be who are exposed to particulate air pollution during pregnancy are likely to deliver infants who show reduced cardiac response to stress, according to a study published recently.

Variability in how the heart rate responds to stressful experiences is essential for maintaining optimal functioning of the cardiovascular, respiratory, and digestive systems and also is central to emotional well-being and resilience to stress over one’s lifetime.

Decreased heart rate variability, as observed in this study, is a known risk factor for mental and physical health problems in later life. Air pollution’s negative effect on heart rate variability has previously been found to lead to medical and psychological conditions such as heart disease, asthma, allergies, and mood or behavioral disorders in studies of older children, adolescents, and adults.

Researchers in this study took into account 237 Boston-based mothers and their infants and used satellite data and air pollution monitors to determine the level of particulate air pollution the mothers were exposed to during pregnancy.

By studying the babies’ heart rate and respiration at age six months, researchers found that the higher the level of the mother’s exposure to air pollution in pregnancy, the less variability in the infant’s heart rate in response to a stress challenge.

“These findings, in combination with increasing worldwide exposure to particulate air pollution, highlight the importance of examining early-life exposure to air pollution in relation to negative medical, developmental, and psychological outcomes,” said senior author of the study.

“Identifying exposures that disrupt key processes such as heart rate response will lead to prevention strategies early in life when they can have the greatest impact,” said first author of the study. 

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Researchers develop robotic thread that may slip through brain's blood vessels

Researchers have developed a magnetically steerable, thread-like robot that may actively glide through narrow, winding pathways like the brain's tiny blood vessels. The study, revealed that the magnetically controlled device could one day deliver clot-reducing therapies in response to strokes or other brain blockages.

If acute stroke can be treated within the 1st 90 minutes or so, patients' survival rates could increase significantly, the researcher said.

If we could design a device to reverse blood vessel blockage within this ' golden hour', we could potentially avoid permanent brain damage. That's our hope. To clear blood clots in the brain, surgeons currently need to insert a thin wire through a patient's main artery, usually in the leg or groin, and manually rotate the wire up into the damaged brain vessel, guided  by a fluroscope that images the blood vessels using x-rays.

However, the procedure is physically taxing, requiring surgeons who must be specifically trained in the task, to endure repeated radiation exposure.

The researchers created a robotic thread core made from bendy, springy nickel-titanium alloy, and they coated the wire core in a rubbery paste filled with magnetic particles.

They then bonded the magnetic covering with a kind of hydrogel that gives the thread a slippery, friction-free surface, but does not affect the responsiveness or the magnetic particles, according to the study.

The researchers tested the thread in a life-size silicone replica of the brain's major blood vessels modeled after scanning an actual patient's brain. Those silicone vessels also have clots and abnormal sacs.

They filled the vessels with a liquid simulating the viscosity of blood, then successfully manipulated a large magnet around the model to steer the robot through the vessels' winding, narrow paths.

The team demonstrated that the thread's wire core can also be replaced with an optical fibre that can activate the laser once the robot reached a target region to clear blockages.

They are preparing to test the robotic thread in vivo, according to the researchers.

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Women With Big Butts Produce Smarter Children

The good news just keeps on coming for my fellow ladies who are well-endowed in the butt area.
Big behinds are having a moment, thanks to celebrities  but this is not just limited to pop culture. The scientific community are interested too. 

There have been a number recent studies with focus on larger than average behinds and the results are really interesting. 

Recent research  revealed that women with bigger glutes are smarter and healthier than their counterparts with smaller butts. The study also linked larger bums to the ability to resist chronic illnesses as well as having lower cholesterol and lower levels of glucose. 

Now, another part of the study  has resurfaced, revealing even more benefits to having a lot of junk in the trunk. 

This time, the researchers were able to find a correlation between big butts and your child's IQ, and concluded that women with big butts give birth to smarter children. 

This is possible because of the higher levels of "good" fatty acids, specifically Omega-3, in the bodies of women with above average derrières. 

Babies need these fatty acids for their brains to develop properly, and since the fats in the mother's breast milk comes from the lower part of the body, babies whose moms are blessed with big behinds get a lot more of Omega-3. 

A similar research from 2007 also proved that gluteofemoral fat plays a huge role in producing smart babies, so this more recent study only strengthens those findings. 

However, the researchers do also highlight that while having a fatter bottom can be key to having genius offspring, your genetics and lifestyle also play a role. 

So if you're hoping to improve your chances of creating the next Albert Einstein, it's important that you eat healthy and stay active. It probably wouldn't hurt to add a couple of extra squats to your routine. 

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Novel therapy promises prostate cancer treatment

A new gene therapy could have the potential to treat prostate cancer that causes 300,000 deaths worldwide each year, a new study said after it halted the majority of tumours in laboratory models. 

The 'seek-and-destroy' gene therapeutic system was used against two types of a prostate tumour and more than half of them vanished over a period of one month.

However, the therapy is currently in limited use due to lack of delivery systems that can selectively deliver the genes to the tumours without adverse side effects to healthy tissues.

The 'seek-and-destroy' nanomedicine linked to an iron-carrying protein called lactoferrin was developed and the study focused on two prostate cancer cell lines -- PC-3 and DU145.

The intravenous administration of the nanomedicine treatment resulted in the complete disappearance of 70 per cent of the PC-3 tumours and half of the DU145 prostate tumours over one month, revealed the findings published in the journal.

"Although some treatments, including chemotherapy and radiotherapy, can be effective against localised tumours, there is still no effective treatment for patients whose cancer recurs or spreads.

"This means that new therapeutic approaches are urgently needed for these patients," said a Senior Lecturer and researcher. Prostate cancer is the fourth most widespread cancer in the world.

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Caffeine in tea, coffee may be risky to foetus

Pregnant women who consume caffeine - whether it’s from coffee or tea - have smaller babies than those who abstain from the stimulant during pregnancy, new research suggests.

Even women who took in less than 200 milligrams of caffeine, the safe cutoff during pregnancy according to the doctors, had a significantly increased risk of delivering prematurely or having a low-birth weight baby.

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“Based on the consistent associations we observed, and because many pregnancies are unplanned, we would recommend women who are pregnant or seeking to become pregnant to at least limit their intakes of caffeinated coffee and tea,” lead study author said.

The study cannot prove cause and effect, he cautioned. But several previous studies have linked caffeine exposure in the womb to negative effects, the researchers said.

In most of those studies, coffee was the main caffeinated beverage consumed.

For the current study, the team looked at 941 mother-child pairs born in Ireland, where people drink more tea than coffee. Nearly half of the mothers in the study drank tea, while about 40 percent drank coffee.

Every additional 100 milligrams of caffeine consumed daily during the first trimester of pregnancy was associated with a 72-gram (2.5 ounce) lower birth weight, as well as significantly lower gestational age, birth length and head circumference.

Women who took in the most caffeine had babies weighing about 170 grams (6 ounces) less than those who consumed the least, the researchers found. Whether the caffeine came from coffee or tea made no difference to the results.

 “High caffeine intake can result in restricted blood flow in the placenta which may subsequently affect fetal growth,” the Dr. explained. “Caffeine can also cross the placenta readily, and because caffeine clearance slows as pregnancy progresses, caffeine accumulation may occur in fetal tissues.”

One 12-ounce cup (355 ml) of brewed coffee contains about 200 mg of caffeine, but tea generally contains less caffeine and the amount can vary by type of tea and how long it was brewed. The Lipton Tea company, for example, says its black tea contains about 83 mg caffeine in a 12-ounce cup.
The public doesn’t seem to recognize tea’s caffeine content, said the study’s senior author. “Thus, maternal intake of both tea and coffee need to be taken into account when trying to minimise overall caffeine intake during pregnancy. This is especially important where tea is the predominant caffeine source,” she told.

Doctor states that consuming less than 200 milligrams of caffeine per day in pregnancy “does not appear to be a major contributing factor in miscarriage or preterm birth.” The World Health Organization recommends that women consume less than 300 mg of caffeine daily in pregnancy.
 “This paper and other papers show that this is likely too high,” said a senior scientist. 

“Epidemiological findings based on self-reported caffeine consumption are usually not very precise. Thus, any cutoffs chosen by experts and WHO can only be considered as rough reference points. Biologically, it is unlikely that 300 mg is risky while 299 mg is safe,” the Dr. said .

“The message to women I would prefer would be ‘the less the better,’” the Dr. said. “Then the women can choose for themselves.”

Reports touting the health benefits of caffeine also need to include a caveat stating that it may be harmful in pregnancy, added the Dr., whose own research has linked caffeine consumption in pregnancy to miscarriage and childhood obesity. “My advice would be try to reduce as much as you can, if you can totally quit that would be even better.”

Researchers told  that it reviews all of its recommendations every 18 to 24 months, includes all new research in its reviews, and makes adjustments to recommendations as needed. “Until that time, ACOG’s current guidance still stands.”

Tiny carrier can help treat brain tumour

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 A nanocarrier engineered to be small enough to get past the blood-brain barrier could be targeted to deliver a chemotherapeutic drug more efficiently to tumour cells in the brain, a new study reveals.

The blood-brain barrier is a protective barrier designed to keep a stable environment within and surrounding the brain. In experiments, the researchers found that the new method resulted in increased killing in the targeted cells.

"I was very surprised by how efficiently and well it worked once we got the nanocarrier to those cells," said Ann-Marie Broome from Medical University of South Carolina in the US.

The findings potentially point the way to a new treatment option for patients with certain conditions, such as glioblastoma multiforme (GBM), the focus of this study. 

 Glioblastoma multiforme is a devastating disease with no curative options due to several challenges, Broome said.
The brain tumour has a significant overall mortality, in part due to its location, difficulty of surgical treatment and the inability to get drugs through the blood-brain barrier.
In 40 percent of cases, standard treatments will extend life expectancy four to seven months. 

 That led the researchers engineer a micelle that is a phospholipid nanocarrier, "a bit of fat globule," to deliver a concentrated dose of the chemotherapy drug temozolomide (TMZ) to the deadly tumour cells.


"Micelles of a certain size will cross the blood-brain barrier carrying a concentrated amount of TMZ," Broome explained about how the nanotechnology works.

The study was published online in the international journal Nanomedicine - Future Medicine.

In medicine, Broome said, researchers construct nanocarriers that are stable and stealthy. "Your immune cells can't attack them. They remain hidden.

"When the package gets to where it's going, nanotechnologists have various methods to get the micelles to release their payloads -- one way is to use the acidic nature of a rapidly growing tumour," she said.