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Breast Milk Could Help Prevent Heart Disease Caused by Premature Birth

Early use of breast milk could play a vital role in preventing heart disease in prematurely born infants, according to a paper led by researchers at RCSI (Royal College of Surgeons in Ireland) and the Rotunda Hospital.

The review article, published in the journal Opens in new windowPediatric Research, was written in collaboration with researchers from Harvard Medical School, University of Oxford and University of Toronto.

One of the long-term health complications that young adults born prematurely may experience is unique heart characteristics. These can include smaller heart chambers, relatively higher blood pressure and a disproportionate increase in muscle mass in the heart.

One study cited in the article looked at 30 preterm-born adults who were assigned to receive exclusive human milk and 16 preterm-born adults who were assigned to receive an exclusive formula-based diet during their hospital stay at birth. They then underwent detailed cardiovascular assessment between 23 and 28 years of age, including an MRI of their hearts. As expected, all of the hearts of those born prematurely had smaller chambers than the hearts in people who were not born prematurely.

However, the study showed that the smaller heart chambers were less profound for the exclusively human milk-fed group in comparison to those who were exclusively formula fed, suggesting a potentially protective effect of human milk for heart structure.

The researchers then identified potential reasons for why breast milk results in a lower risk of heart disease. Breast milk could help prevent heart disease by better regulating hormones and growth factors, strengthening the infant’s immune system, reducing inflammation and possibly improving the metabolism of the child.

Identifying the key components within breast milk that result in improved heart health could pave the way for a more targeted approach to improve long-term cardiovascular well being for those born prematurely.

“It is becoming increasingly clear that premature birth results in long-term adverse cardiovascular effects with important clinical consequences,” said Professor Afif EL-Khuffash, Honorary Clinical Professor of Paediatrics at RCSI and Consultant Neonatologist at The Rotunda Hospital, Dublin. “There is a distinct lack of preventative and therapeutic interventions available to alleviate those effects.”

He continued: “The current evidence comes from observational studies and highlights the strong link between early breast milk administrations and improvement in long-term heart health, but it lacks concrete mechanistic explanations. More studies on the composition of breast milk could make clear exactly what causes these health benefits, which could in turn lead to better treatment options.”

The collaborative research group is continuing to study the effects of human milk exposure on heart function in very premature infants by using novel scans to measure heart function. They hope to demonstrate that early human milk exposure in premature infants can lead to significant improvements in heart function over the first two years of age.

Autonomous Drone Delivers Diabetes Medication to a Remote Irish Island

H/O - Galway diabetes drone

Autonomous drone technology has been used to deliver diabetes medication to a location off the west coast of Ireland.

In an announcement Monday, the National University of Ireland (NUI) in Galway said the drone’s journey between Connemara Airport and Inis Mór, which is part of the Aran Islands, showed “the possibility of future deliveries of this kind within planned drone corridors.”

The contents of the delivery were insulin and glucagon, while the drone also collected a patient’s blood sample. The drone delivery was supported by the Irish Aviation Authority and maintained contact with air space regulators throughout the trip.

NUI Galway led the project and other partners included Vodafone Ireland, which used its internet of things (IOT) network to support the drone’s communications, and Novo Nordisk, which supplied the medication.

The drone used, a Wingcopter 178 Heavy Lift, is an all-electric vehicle that can travel up to 100 kilometers in under an hour. Debbie Power, Vodafone Ireland’s IOT country manager, said the length of the first leg amounted to 21.7 kilometers, while the second leg was 21.6 kilometers.

Power added that the successful internet of things connectivity had enabled the flight, “to adhere to aviation regulatory standards and provides good evidence for further investigation into drone delivery corridor planning, as long range flights, like this one, can be mapped with our radio frequency network input.”

Hyo-sang Shin, from Cranfield University’s Centre for Autonomous and Cyberphysical Systems, told CNBC via email that the “utilization of drones for delivering medical supplies to remote communities” could potentially support the wider transformation of health care.

Indeed, the use of drones for the delivery of medical supplies is becoming increasingly common. U.S. firm Zipline, for example, says it has been using drones to deliver items, including vaccines and blood, in Rwanda since 2016. In 2019 it began deliveries in Ghana.

In December 2018, Unicef announced that a baby on an island in the South Pacific country of Vanuatu had become the “world’s first child” to be administered a vaccine delivered commercially via drone.

The drone crossed nearly 40 kilometers of mountainous terrain to reach its final destination of Cook’s Bay, Unicef added. In all, 13 children and five pregnant women were given vaccines.

At the time Unicef’s executive director, Henrietta H. Fore, described the flight as “a big leap for global health.”

“With the world still struggling to immunize the hardest to reach children, drone technologies can be a game changer for bridging that last mile to reach every child,” she added.

Written by: Anmar Frangoul

Soft Robotics Breakthrough Manages Immune Response for Implanted Devices

Depiction of a soft robotic device known as a dynamic soft reservoir (DSR)

 

Discovery could enable longer-lasting and better-functioning devices — including pacemakers, breast implants, biosensors, and drug delivery devices.

Researchers from the Institute for Medical Engineering and Science (IMES) at MIT; the National University of Ireland Galway (NUI Galway); and AMBER, the SFI Research Centre for Advanced Materials and BioEngineering Research, recently announced a significant breakthrough in soft robotics that could help patients requiring in-situ (implanted) medical devices such as breast implants, pacemakers, neural probes, glucose biosensors, and drug and cell delivery devices.

The implantable medical devices market is currently estimated at approximately $100 billion, with significant growth potential into the future as new technologies for drug delivery and health monitoring are developed. These devices are not without problems, caused in part by the body’s own protection responses. These complex and unpredictable foreign-body responses impair device function and drastically limit the long-term performance and therapeutic efficacy of these devices.

One such foreign body response is fibrosis, a process whereby a dense fibrous capsule surrounds the implanted device, which can cause device failure or impede its function. Implantable medical devices have various failure rates that can be attributed to fibrosis, ranging from 30-50 percent for implantable pacemakers or 30 percent for mammoplasty prosthetics. In the case of biosensors or drug/cell delivery devices, the dense fibrous capsule which can build up around the implanted device can seriously impede its function, with consequences for the patient and costs to the health care system.

A radical new vision for medical devices to address this problem was published in the internationally respected journal, Science Robotics. The study was led by researchers from NUI Galway, IMES, and the SFI research center AMBER, among others. The research describes the use of soft robotics to modify the body’s response to implanted devices. Soft robots are flexible devices that can be implanted into the body.

The transatlantic partnership of scientists has created a tiny, mechanically actuated soft robotic device known as a dynamic soft reservoir (DSR) that has been shown to significantly reduce the build-up of the fibrous capsule by manipulating the environment at the interface between the device and the body. The device uses mechanical oscillation to modulate how cells respond around the implant. In a bio-inspired design, the DSR can change its shape at a microscope scale through an actuating membrane.

IMES core faculty member, assistant professor at the Department of Mechanical Engineering, and W.M. Keck Career Development Professor in Biomedical Engineering Ellen Roche, the senior co-author of the study, is a former researcher at NUI Galway who won international acclaim in 2017 for her work in creating a soft robotic sleeve to help patients with heart failure. Of this research, Roche says “This study demonstrates how mechanical perturbations of an implant can modulate the host foreign body response. This has vast potential for a range of clinical applications and will hopefully lead to many future collaborative studies between our teams.”

Garry Duffy, professor in anatomy at NUI Galway and AMBER principal investigator, and a senior co-author of the study, adds “We feel the ideas described in this paper could transform future medical devices and how they interact with the body. We are very excited to develop this technology further and to partner with people interested in the potential of soft robotics to better integrate devices for longer use and superior patient outcomes. It’s fantastic to build and continue the collaboration with the Dolan and Roche labs, and to develop a trans-Atlantic network of soft roboticists.”

The first author of the study, Eimear Dolan, lecturer of biomedical engineering at NUI Galway and former researcher in the Roche and Duffy labs at MIT and NUI Galway, says “We are very excited to publish this study, as it describes an innovative approach to modulate the foreign-body response using soft robotics. I recently received a Science Foundation Ireland Royal Society University Research Fellowship to bring this technology forward with a focus on Type 1 diabetes. It is a privilege to work with such a talented multi-disciplinary team, and I look forward to continuing working together.”

UL Breakthrough Turns Scourge of Plastic Waste Into Useful Raw Materials

Middle-aged male researcher in white lab coat and purple gloves holds up a plastic bottle in one hand and in the other a composite raw material that can be used to make car and tractor parts.
Dr Walter Stanley, UL. Image: IComp

Innovative UL project could help end the scourge of plastic pollution and turn waste into profit.

Researchers at University of Limerick (UL) have developed a breakthrough solution that turns waste plastic bottles into composites for many uses, including car parts.

The project by researchers at the Irish Composites Centre (IComp) has already won the backing of Enterprise Ireland and the Environmental Protection Agency, and it is currently seeking a range of industry and commercial partnerships to take it to the next level.

IComp was established in 2010 under the Enterprise Ireland-IDA Technology Centres initiative. Hosted by UL, IComp is a partnership between the university and University College Dublin, Athlone Institute of Technology and NUI Galway.

Sea borne plastic bottles on a part of Inch Strand in Kerry, November 2018.
Seaborne plastic bottles on Inch Strand in Kerry, November 2018. Image: IComp

IComp’s work involves commercialising the recycling of the plastic material polyethylene terephthalate (PET) – commonly used for water and soft-drink bottles, and other single-use products – through the development of a technology that allows these plastics to be recycled into a high-tensile fibre that can then be woven into a fabric. This fabric has the potential to be used in the production of high-performance recyclable composite parts for the automobile and agricultural vehicle industries, for example.

In recent years, there has been a growing trend towards the use of self-reinforced polymer composites (SRPs) – whereby the fibre and the matrix are the same material – for consumer goods such as high-quality luggage, sports and sailing equipment, and car parts. SRPs can make such high-performance parts without the weight of traditional materials such as steel or even aluminium.

The newly developed IComp technology – called ‘SerPET’ – will allow SRPs to be manufactured from used plastic bottles for valuable applications, reducing the volumes that go into landfill and into our oceans.

“Ireland is currently the biggest producer of plastic waste in the European Union, with an average of 61kg produced each year per person,” explained Dr Walter Stanley from IComp.

“A large proportion of this plastic is made up of single-use plastic bottles, which, apart from polluting the landscape and seascape visually, also degrade over time and leach in the environment, creating many downstream problems for nature, animals and humans.

“The technology developed by IComp aims at recycling plastic bottles (mainly PET) into a high-tensile fibre, which can then be used in a wide variety of value-added products. If successfully commercialised, this project would turn plastic bottles into a valuable raw material and stimulate greater recycling. It would lead to incentives for better plastic collection and separation, and therefore less littering, general pollution and incineration.

“The self-reinforced composites which IComp are currently developing are more energy-efficient to process and will have a lower cost than other products on the market whilst also being significantly greener, with a high level of rigidity, strength and temperature performance for many applications including car parts, which will themselves be recyclable when the cars are scrapped.”

Written by: John Kennedy of Silicon Republic

Irish Researchers Integrate Epilepsy Genomics into Electronic Patient Records

Electronic Health Record

Researchers in Ireland are one step closer to offering seamless personalized care to epilepsy patients nationwide, reporting that they have developed a genomics module within an epilepsy‐specific electronic patient record (EPR). The improved access to genomic data will allow clinical teams to understand the causes of a patient’s epilepsy and develop personalized care.

The research was published recently in the August 2019 issue of the journal Epilepsiain an article entitled “Development of a genomics module within an epilepsy‐specific electronic health record: Toward genomic medicine in epilepsy care.”

“We now know that much of previously unexplained epilepsy is due, in part, to damaging variants in a person’s genome,” said Norman Delanty, MD, first author on the paper, in a press release. “The potential to understand the reason for a particular person’s epilepsy at a molecular level, and to use this information to develop personalized therapies, will become a significant advancement in the way we practice medicine.”

Delanty is an associate professor at Royal College of Surgeons Ireland (RCSI) and consultant neurologist at Beaumont Hospital. He is also a FutureNeuro Investigator. FutureNeuro is Science Foundation Ireland’s Research Centre for Chronic and Rare Neurological Diseases, hosted by RCSI. Its researchers work with industry to develop diagnostic, therapeutic and eHealth solutions. Delanty and his colleagues worked with researchers from the Irish government’s Health Service Executive’s Epilepsy Lighthouse Project, which focuses on personalizing epilepsy care.

The authors of the new paper said their work illustrates the role of eHealth technology in embedding genomics into the clinical pathway. In the report, Delanty and colleagues outline the development and integration of an epilepsy genomics module into a preexisting epilepsy EPR system. They also describe how this EPR infrastructure is used to facilitate discussion at multidisciplinary clinical meetings around molecular diagnosis and the resulting changes in management.

Nearly 3.5 million people in the U.S. live with epilepsy, a chronic disorder that causes life-disrupting seizures. About 470,000 of those cases are children. Today, many adults and children with epilepsy of unknown cause now undergo genomic testing, shedding light on the underlying cause of their condition.

In recent years, scientists have discovered more than 20 different syndromes that have epilepsy as a main feature. These have been mapped to specific genes. In addition, many more Mendelian disorders have epilepsy as a primary symptom. Researchers have identified mutations in genes that encode sodium, potassium, and calcium channels that can cause epilepsy. These discoveries have begun to impact clinical care for epilepsy.

The new epilepsy EPR module facilitates regular multidisciplinary meetings between clinicians, geneticists, bioinformaticians, and other team members, where they review data from genomic testing to determine if there is an identifiable genetic cause for a patient’s epilepsy.

“The epilepsy EPR system is one of the largest, most detailed collections of active epilepsy eHealth records in the world,” said Mary Fitzsimons, FutureNeuro epilepsy eHealth lead and director of the Epilepsy Lighthouse Project at RCSI, in the release.

“To our knowledge, the epilepsy genomics module we have developed is the first such specific system in the world. We believe the combined power of genomics and electronic patient records has the capability of enhancing, and in some cases transforming, the practice of medicine.”

Written by: Clinical OMICS

Half of Adults Seek Health Advice Online

Half of Irish adults seek health information or advice online, while one in five has never spoken to a healthcare professional about their health concerns, a new survey has found.

According to the findings, people under the age of 25 are the age group least likely to speak to a healthcare professional about their health concerns.

The survey of 1,000 adults was carried out last month on behalf of the Royal College of Surgeons in Ireland (RCSI), to coincide with the launch of a series of public lectures it plans to give about common illnesses and health topics.

The RCSI MyHealth lecture series will run from this coming September to May 2020 and will look at topics such as cannabis, vaccinations and arthritis.

“As educators and researchers, it is our responsibility to use our expertise, knowledge and discoveries to foster improvements in health and education in our communities, our societies and around the world.

“The RCSI MyHealth lecture series aims to do just that – to de-mystify the common health concerns affecting the Irish public, drawing expertise and insight from our team of researchers and leading international health experts at the cutting edge of medical and healthcare developments,” explained Prof Hannah McGee of the RCSI.

The survey carried out on behalf of the RCSI found that cancer is women’s main health concern, followed by mental health, heart disease and stress. In those under the age of 35, almost half included stress in their top three health concerns.

Meanwhile mental health is parents’ main health concern for their children, followed by vaccinations, drugs and alcohol, and weight/obesity.

When it comes to the internet, 50% of people seek health information or advice online, yet 69% do not consider websites to be a trusted source of information.

The first talk in the RCSI MyHealth lecture series is on cannabis and youth health and it will take place at the RCSI, 26 York Street, Dublin 2, at 6.30pm on September 18.

Using AI to Improve Communication Between the Doctor and Patient

artificial intelligence

Productive communication with the physician is essential for the patient to see improvements in their condition, however, most doctors have never had their communication skills formally assessed. When the doctor does not describe conditions and treatments to their patient in a comprehensible manner, it can lead to improper medication use, worsening of the condition, and low patient satisfaction. Exploring potential digital solutions to this gap in communication, researchers from The Dartmouth Institute for Health Policy and Clinical Practice, Trinity College Dublin, and the University of Edinburgh discussed the potential of artificial intelligence (AI) in enhancing patient-provider interactions in a BMJ article.

“Many clinicians’ communications skills aren’t formally assessed–either during school or in early practice,” said senior author Glyn Elwyn, MD, PhD, MSc, Dartmouth Institute Professor. “At the same time, there is a lot of evidence that clinicians often struggle when communicating with their patients. It’s hard to improve on something when you’re not being given any feedback and don’t know how you’re doing.”

Elwyn and colleagues claim that AI is an innovative solution that could completely change the communication process in healthcare. Providing practitioners with personalized, detailed assessments of their communication skills, AI may provide the first widely used tool for evaluating physician communication. In their article, Elwyn and his associates identify three main areas where AI and recordings of patient-physician interactions could be used to improve communication between the two parties.

Analysis of Conversations

Automatic analysis of words and phrasing in dialogues between a doctor and their patient could reveal whether the two understood each other. This could also provide feedback as to whether the provider is properly recording patient histories, recommending treatments based on evidence, and using words that the patient can understand. AI also has the potential to analyze conversations in real-time and suggest diagnoses that they may not have been considering and offer a broad range of treatment suggestions.

Letting the Patient Speak Their Mind

AI could also analyze the proportion of time that the physician lets the patient speak compared to how much time they spend talking. Many patients complain that their providers do not take pauses and allow them to voice their own questions and concerns, therefore it could be very beneficial to address this issue with AI. When the patient is given space to talk, higher adherence to medications and better memory of information is typically correlated. This analysis of dialogue could eventually provide insight that helps prevent premature decisions such as the ordering of invasive procedures. This AI could, for instance, guide further questioning that leads to a diagnosis of heartburn instead of cardiac pain.

Tone and Style in Voice

Algorithms have already been used to analyze the commercial pilot’s vocal pitch and energy, and this technology could have similar benefits in the healthcare industry. Analyzing these vocal features could help detect high-risk situations in which the doctor is under stress that inhibits their communication skills. In addition, this vocal analysis could also provide insight into the patient’s mental and physical health. Conditions like depression and heart failure can be characterized by distinct vocal changes that an AI-powered speech recognition device could detect.

Challenges Accompanied by AI Use in Healthcare

Despite these benefits, there are many challenges to the application of AI in healthcare. For example, issues such as patient privacy can be brought into question when there are devices in the room recording and analyzing conversations. In addition, even the most advanced AI systems are currently not capable of fulling decoding the complicated dialogue that occurs in the medical setting.

“Five years ago, the idea of using AI to analyze medical communication wouldn’t have been on anyone’s radar,” said Elwyn. “As the technology advances, it will be interesting to see whether healthcare systems can employ it effectively and whether providers will be open to using it as a tool for improving their communication skills.”

Written by: Jack Carfagno

NUI Galway Identifies Funding Source for GPs in Northwest

It is the general practitioner (GP) who is left to decide what to do when the bemused patient asks “Should I take the aspirin?” according to one specialist’s advice, or “Should I stop the aspirin?” as instructed by another.

It harks back to the old conundrum posed by The Clash in 1981: “Should I stay or should I go now?” The problem is that one option “could be trouble”, while the other “could be double [the trouble]”.

GPs are problem-solvers. For some problems, two heads are better than one. Peer discussion of difficult cases is commonplace when GPs converge, be it in group practices, on the curbside or at CME. General practice cottoned on to the benefits of collaboration long before Chris Tarrant gave his quiz show contestants the option to phone a friend.

The increasing complexity of our patients in general practice is evident in the increasing multimorbidity we all encounter on a day-to-day basis. Multiple patients with multiple diagnoses on multiple medications!

National University of Ireland Galway (NUI Galway) are running a pilot study in collaboration with Queen’s University Belfast looking at drug prescribing in such patients.

The intervention, called MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE), was developed by Dr Carol Sinnott in conjunction with GPs.

The idea is that GPs would do a face-to-face medication review with a colleague to decide if the multimorbid patient’s prescription needs to be adjusted. Each participating intervention practice would be asked to do 20 such medication reviews.

There is support available to recompense participating GPs for their time. The research project in the Republic is led by Prof Andrew MurphyDr Lisa Hynes and Dr Scott Walkin. Research staff will be available to minimise the impact on practice time. Participating GPs will also be offered support to fulfill their clinical audit requirements for professional competence purposes. Practices in the northwest with two or more GPs are eligible to participate.

By: Dr. Scott Walkin (Mayo GP and NUI Galway lecturer at the Sligo Hospital campus

Scientists at University College Cork Discover Way to Rebuild Features of Long-Dead Animals

Maria McNamara, Senior Lecturer and Valentina Rossi, PhD student with a fossil sample at the School of Biological, Earth and Environmental Sciences in UCC (Image: Michael Mac Sweeney/Provision)

Cork-based scientists are behind a groundbreaking move to rebuild the features of long-dead animals.

In a world first, University College Cork experts have discovered a new way to put flesh on the bones of extinct creatures – 10 million years after their deaths.

They are the most accurate depictions yet of what animals such as frogs, tadpoles and bats – preserved in fossils forever – looked like when alive.

The Rebel County palaeontologists discovered the new way to reconstruct the anatomy of vertebrate animals by analysing the chemistry of fossilised melanosomes (tiny granules in their cells) from internal organs.

The study, published in a US journal, was led by UCC’s Valentina Rossi and her supervisor Dr Maria McNamara, backed by an international team of chemists from the US and Japan.

The team used cutting-edge “synchrotron techniques” to analyse the chemistry of the fossil and modern melanosomes using X-rays, allowing them to look inside the anatomy of fossils and uncover hidden features.

Until recently, most studies on fossil melanin have focused on the skin and feathers, whereas here the pigment is linked to visible colour.

Unexpectedly, the new study also showed that melanin is abundant in internal organs of modern amphibians, reptiles, birds and mammals, and their fossil counterparts.

Dr McNamara said: “This discovery is remarkable in that it opens up a new avenue for reconstructing the anatomy of ancient animals.

“In some of our fossils we can identify skin, lungs, the liver, the gut, the heart, and even connective tissue.

“What’s more, this suggests that melanin had very ancient functions in regulating metal chemistry in the body going back tens, if not hundreds, of millions of years.”

The team made the initial discovery of internal melanosomes last year on fossil frogs.

Written by: Niall Moonan of Irish Mirror Ireland

New Trinity Chancellor to Be in Place by Christmas

Trinity will have elected a new Chancellor by the end of 2020, to replace Mary Robinson, whose term finished in June.

In an email to The University Times, Aoife Crawford, the Administrative Officer in Trinity’s Secretary’s Office, said that “the process to appoint a new Chancellor (and two new Pro-Chancellors) will be conducted in Michaelmas term and a new Chancellor is expected to be in place before Christmas”.

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Mary Robinson retired as Trinity’s Chancellor in June.

An election will be held during the coming term if more than one candidate emerges.

As Chancellor, Robinson was the head of the University of Dublin. She presided over ceremonial occasions in the College such as commencement ceremonies, and officiated at honorary degree ceremonies.

The Chancellor’s other responsibilities include interpreting the College Statutes and hearing appeals against decisions of the College Board.

Robinson, a former President of Ireland, was elected to the position in 1998.The first female Chancellor since the founding of the College in 1592, she was elected a Scholar of Trinity in 1965 and graduated with a first-class honours degree in law in 1967. She served as a Senator for the University of Dublin from 1969 to 1989.

Robinson, an outspoken campaigner for action against climate change, will now take up a new role in College as an adjunct professor of climate justice in the School of Natural Sciences.

Robinson has said that the climate crisis is “a man-made problem with a feminist solution”. The Mary Robinson Foundation for Climate Justice facilitates action to achieve sustainable development, particularly for those in poor, marginalised areas that are most vulnerable to the effects of climate change.

Speaking at the Royal College of Surgeons in Ireland in February, she encouraged people to “get angry” at the government’s failure to act to resolve the crisis.

In February, Robinson launched Trinity’s Green Week. Speaking at the launch, she said: “The great thing about what’s happening in this university is students are being very active. I loved the campaign on divestment. I supported it.”

In May, a portrait of Robinson was commissioned for the Dining Hall.

Robinson also became embroiled in controversy this year after commenting on the case of Dubai Princess Sheikha Latifa.

She was criticised by human rights advocates all over the world for calling the princess, the daughter of Dubai ruler Sheikh Mohammed bin Rashid Al Maktoum, a “troubled young woman”.

Robinson said she had been invited to Dubai by Princess Haya, one of Sheikh Mohammed’s six wives, to help with what Haya called a “private family matter”.

Several weeks later, however, Haya made headlines after reportedly fleeing Dubai and seeking asylum in Europe.

Written by: Emer Moreau of University Times Ireland