Sunday, July 12, 2020

A lab takes a frugal-science approach to COVID-19


In origami microscope, a 20-cent centrifuge, and an app for tracking and identifying mosquitoes.
These are just a few of the many imaginative inventions that have resulted from the curiosity-driven — and often frugal — work of Manu Prakash, associate professor of bioengineering at Stanford University, and his lab. With their penchant for turning whimsical ideas into scientific realities, it’s perhaps unsurprising that these researchers are leading several COVID-19 projects.
 
But this time, the work is far from business-as-usual.

“The process right now is very strange. The lab was shut down,” said Prakash, referring to Stanford’s restrictions against all but the most essential lab operations during the pandemic. “We got approvals to do some essential work but there are still very stringent rules.”

Prakash and his team have evolved to become an all-hours virtual hive of activity, teleconferencing and sharing documents with collaborators around the world.



It has been an interesting time,” said Prakash during a Zoom interview sandwiched between two others that would take him to 11 p.m. “But I’m focused.”

The team is developing six COVID-19 projects so far — a number that will likely continue to grow. In brief, they are: a converter that makes full-face snorkel masks into reusable personal protective equipment, or PPE; guidelines for decontaminating N95 masks; a universal remote for controlling ventilators from outside a patient’s room; a ventilator built with abundantly available parts; a simple filtration test setup for face masks; and a technique, inspired by cotton candy machines, for spinning filter fibers from Styrofoam.

That trademark splash of Prakash lab quirkiness remains, but every creative solution conceived amidst this pandemic is built on deadly serious intentions and painstaking analysis. The group continues to follow their frugal science approach but with an increased emphasis on being able to scale up their innovations quickly and responsibly.

A scientific checkpoint
In the very early stages of each project, the lab is sharing their ideas and aims publicly on their website and Twitter.

“If any of our work inspires and energizes others, it already moves the needle in the right direction,” said Prakash. “This crisis is not just in our own backyard but is global, and making all the information — our current experiments, data, thoughts and ideas — accessible and live to everyone is the only way I could think of working in this time of crisis.”

Once the team feels their work has reached a stage where it could be a feasible solution in the clinical world, they move onto some formal work behind the scenes, such as final data analysis and, in at least one case so far, application for FDA approval. The last step, for now, is publishing a preprint and creating a formal website for each final product.

Of course, “finality” is a shifting concept in the fast-paced world of the novel coronavirus. Before this pandemic, health projects like these would have required months, maybe years of testing, fundraising and approvals. Now, with so many people looking to apply whatever skills or resources they have to the quick creation of vital solutions, barriers have been lowered and actions are swift, but this also raises the likelihood of overpromising and under-delivering.

“What started bothering me early on was that everybody was waking up to the crisis but not appreciating that these are clinical problems that require a really rigorous mindset,” said Prakash. “For these solutions, there are strict expectations and you have to follow those no matter how much you love an idea.”

More so than ever before, the Prakash lab understands that the greatest value they can offer in the current situation is taking responsibility for the most scientifically-demanding portions of their projects in a process that unites expert and non-expert contributors.

“There are lots of DIY [do-it-yourself] solutions out there, but the DIY community is not used to clinical validation. Many people are working on the first 90 percent of every problem,” said Prakash.
“If people want to help, they can replicate our efforts and they can share their replicated data. Then we can cover that last 10 percent. The role we are really playing is being a scientific checkpoint. People’s lives are on the line.”

A new way

Like many of us, Prakash and his team are exhausted. They’re encouraged by their achievements so far — including going from idea generation to FDA submission in seven days for their snorkel-based “Pneumask” — and the need for creative solutions keeps them determined. Thinking beyond COVID-19 can feel like a luxury, but Prakash wonders, in the brief snatches of free time available to him, what he and others will do with the hard-won lessons of this pandemic once it’s over.

“It’s almost teaching us a new way of doing science,” said Prakash. “It’s something I’ll reflect more on later, when I can. But what if we did something like this for malaria? What if we did this for climate change? Could we finally crack those problems?”

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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Thursday, April 23, 2020

Proning' Is a Promising Treatment for Coronavirus—Here's How It Works

Some doctors on the frontlines of the coronavirus pandemic are having success treating COVID-19 patients with a simple technique called 'proning.' The term basically means putting a patient in the prone position, or "flat on their belly with their chest and face down, rather than on their back,” Jack Stewart, MD, a pulmonologist with St. Joseph Hospital in Orange County, California, tells Health.

Proning requires little or no equipment, and the technique may prove to help patients who are critically ill avoid being put on ventilators for breathing assistance.

Why does proning work? Flipping a patient on their stomach helps respiration because “oxygenation (getting more oxygen into the blood) is easier in the prone position," says Dr. Stewart. It's a function of anatomy, as the human body has more lung tissue in the back of the body than in the front. The coronavirus causes abnormal fluids and secretions to pool toward the back, where there's more lung tissue, and leads to greater interference with lung function.

“When a patient is in the prone position, gravity helps the secretions move downward, so more of the ‘good’ lung is on top and therefore less affected,” Harry Peled, MD, a medical director in critical care at St. Jude Medical Center in Fullerton, California, tells Health. 

Proning is also an effective treatment for a condition called acute respiratory distress syndrome (ARDS), a life-threatening complication of coronavirus infection that manifests as shortness of breath and quickly progresses. A study published last month in JAMA Internal Medicine suggests that more than 40% of individuals in the study hospitalized for severe and critical COVID-19 developed ARDS—and over 50% of those diagnosed died from the disease.

ARDS poses a risk to patients who have influenza, pneumonia, and pulmonary edema (fluid in the lungs from heart disease) as well. “Proning has been used to treat ARDS for a number of years,” says Dr. Stewart. A 2013 study by French doctors published in the New England Journal of Medicine found that patients suffering from ARDS had a lower risk of death if prone positioning was used in the hospital early on. 


Further research on how proning affects coronavirus patients is needed, but anecdotal evidence shows the effectiveness of the treatment since the global pandemic began.

In the US, a coronavirus patient at Long Island Jewish Hospital managed to avoid needing life support after being put in the prone position, CNN reported. In the UK, a 50-year-old woman with COVID-19 pneumonia who doctors were convinced only had a “couple of hours” to live made a remarkable recovery after medics turned her onto her belly, according to an article written by the patient’s husband for The Times. 

Proning isn’t just being used for patients in critical condition. In fact, new guidance from the UK’s Intensive Care Society, written by doctors and nurses who specialize in intensive care and respiratory medicine, says the technique can reduce the need for invasive ventilation and the chance of death for conscious COVID-19 patients before they reach intensive care.

“Prone positioning is a simple intervention that can be done in most circumstances, is compatible with all forms of basic respiratory support, and requires little or no equipment in the conscious patient,” states the new guidance. However, the technique is not suitable for all patients, such as morbidly obese people, pregnant women or those with facial injuries.

A team at Rush University Medical Center in Chicago is currently conducting a clinical trial to establish whether the prone position is helpful for COVID-19 patients who are not so sick that they need a ventilator to breathe for them, but sick enough to require supplemental oxygen delivered through a tube in their nose.

Proning does come with some risks, such as pressure sores and dislodging of an endotracheal tube (a flexible plastic tube placed through the mouth and inserted into the windpipe to help a patient breathe), says Dr. Peled. The greatest risk is difficulty performing CPR if a patient goes into cardiac arrest. “It’s crucial to have a highly trained team and organized approach to ensure the procedure is performed safely and efficiently,” he adds.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

 
This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

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