Medicine

Doctors Tried To Lower $148K Cancer Drug Cost; Makers Tripled Its Price (arstechnica.com) 381

Slashdot reader Applehu Akbar writes: Imbruvica, a compound that treats white blood cell cancers, has until now been a bargain at $148,000 per year. Until now, doctors have been able to optimize dosage for each patient by prescribing up to four small-dose pills of it per day.

But after results from a recent small pilot trial indicated that smaller doses would for most patients work as well as the large ones, its manufacturer, Janssen and Pharmacyclics, has decided on the basis of the doctors' interest in smaller dosages to reprice all sizes of the drug to the price of the largest size. This has the effect of tripling the price for patients, and doctors have now put off any plans for further testing of lower dosages.

The researchers are retaliating by urging clinical investigators to test whether the expensive pill could be safely given every other day -- and by calling on America's public health regulators to investigate the drug's pricing.
Medicine

Researchers Find Genetic Cause For Alzheimer's, Possible Method To Reverse It (upi.com) 113

schwit1 quotes UPI: Scientists at an independent biomedical research institution have reported a monumental breakthrough: The cause of the primary genetic risk factor for Alzheimer's disease, and a possible cure for the disease. Researchers at Gladstone Institutes in San Francisco identified the primary genetic risk factor for the disease, a gene called apoE4... Their findings were published this week in the journal Nature Medicine... By treating human apoE4 neurons with a structure corrector, it eliminated the signs of Alzheimer's disease, restored normal function to the cells and improved cell survival.
The study's senior investigator says he's already working with a San Francisco pharmaceutical startup to develop the approach and move towards clinical trials, adding that "we are working to accelerate the timeline as much as possible."
Medicine

'Is Curing Patients a Sustainable Business Model?' Goldman Sachs Analysts Ask (arstechnica.com) 368

In an April 10 report for biotech clients, Goldman Sachs analysts noted that one-shot cures for diseases are not great for business as they're bad for longterm profits. The investment banks' report, titled "The Genome Revolution," asks clients: "Is curing patients a sustainable business model?" The answer may be "no," according to follow-up information provided. Slashdot reader tomhath shares the report from Ars Technica: Analyst Salveen Richter and colleagues laid it out: "The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically engineered cell therapy, and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies... While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."

For a real-world example, they pointed to Gilead Sciences, which markets treatments for hepatitis C that have cure rates exceeding 90 percent. In 2015, the company's hepatitis C treatment sales peaked at $12.5 billion. But as more people were cured and there were fewer infected individuals to spread the disease, sales began to languish. Goldman Sachs analysts estimate that the treatments will bring in less than $4 billion this year. [Gilead]'s rapid rise and fall of its hepatitis C franchise highlights one of the dynamics of an effective drug that permanently cures a disease, resulting in a gradual exhaustion of the prevalent pool of patients," the analysts wrote. The report noted that diseases such as common cancers -- where the "incident pool remains stable" -- are less risky for business.

Science

Late To Bed, Early To Die? Night Owls May Die Sooner (livescience.com) 217

An anonymous reader shares a report: Bad news for "night owls": Those who tend to stay up late and sleep in well past sunrise are at increased risk of early death, a new study from the United Kingdom suggests. The research, which involved nearly half a million people, found that self-described "evening people" were 10 percent more likely to die over a 6.5-year period, compared with self-described morning people. The findings add to a growing body of research that suggests that being a night owl could have negative effects on health. Many of these effects may be attributable to a misalignment between a person's internal clock, or circadian rhythm, and the socially imposed timing of work and other activities, the researchers said. "'Night owls' trying to live in a 'morning lark' world may have health consequences for their bodies," study co-author Kristen Knutson, an associate professor of neurology at Northwestern University Feinberg School of Medicine, said in a statement.
Medicine

FDA Worried Drug Was Risky; Now Reports of Deaths Spark Concern (cnn.com) 183

Blake Ellis and Melanie Hicken, writing for CNN: Two years ago, Brendan Tyne pleaded with the Food and Drug Administration to approve a drug that he was hopeful could finally bring his mother some peace. She could no longer move without assistance and had fallen victim to the debilitating and frightening psychosis that haunts many people with Parkinson's disease. "She thinks there are people in the house and animals are trying to get her," he told an FDA advisory committee. He believed that a new medication called Nuplazid, made by San Diego-based Acadia Pharmaceuticals, was the answer.

Nuplazid's review was being expedited because it had been designated a "breakthrough therapy" -- meaning that it demonstrated "substantial improvement" in patients with serious or life-threatening diseases compared to treatments already on the market. Congress created this designation in 2012 in an effort to speed up the FDA's approval process, which has long been criticized for being too slow. Around 200 drugs have been granted this designation since its creation. [...] The committee voted 12-2 and recommended that the FDA approve Nuplazid for the treatment of Parkinson's disease psychosis based on a six-week study of about 200 patients. It hit the market in June 2016. As caregivers and family members rushed to get their loved ones on it, sales climbed to roughly $125 million in 2017

[...] In November, an analysis released by a nonprofit health care organization, the Institute for Safe Medication Practices, warned that 244 deaths had been reported to the FDA between the drug's launch and March 2017. [...] Since the institute released its analysis, FDA data shows that the number of reported deaths has risen to more than 700. As of last June, Nuplazid was the only medication listed as "suspect" in at least 500 of the death reports.

Medicine

Hot-Air Dryers Suck In Nasty Bathroom Bacteria, Shoot Them At Your Hands (arstechnica.com) 133

An anonymous reader quotes a report from Ars Technica: Hot-air dryers suck in bacteria and hardy bacterial spores loitering in the bathroom -- perhaps launched into the air by whooshing toilet flushes -- and fire them directly at your freshly cleaned hands, according to a study published in the April issue of Applied and Environmental Microbiology. The authors of the study, led by researchers at the University of Connecticut, found that adding HEPA filters to the dryers can reduce germ-spewing four-fold. However, the data hints that places like infectious disease research facilities and healthcare settings may just want to ditch the dryers and turn to trusty towels. Indeed, in the wake of the blustery study -- which took place in research facility bathrooms around UConn -- "paper towel dispensers have recently been added to all 36 bathrooms in basic science research areas in the UConn School of Medicine surveyed in the current study," the authors note. The researchers speculated that "one reason hand dryers may disperse so many bacteria is the large amount of air that passes through hand dryers, 19,000 linear feet/min at the nozzle. The convection generated by high airflow below the hand dryer nozzles could also draw in room air."
Medicine

Drug-Resistant 'Nightmare Bacteria' Pose Growing Threat (statnews.com) 87

"Nightmare bacteria" with unusual resistance to antibiotics of last resort were found more than 200 times in the United States last year in a first-of-a-kind hunt to see how much of a threat these rare cases are becoming, health officials said this week. From a report: That's more than they had expected to find, and the true number is probably higher because the effort involved only certain labs in each state, officials say. The problem mostly strikes people in hospitals and nursing homes who need IVs and other tubes that can get infected. In many cases, others in close contact with these patients also harbored the superbugs even though they weren't sick -- a risk for further spread. Some of the sick patients had traveled for surgery or other health care to another country where drug-resistant germs are more common, and the superbug infections were discovered after they returned to the U.S.
Science

X-ray 'Ghost Images' Could Cut Radiation Doses (sciencemag.org) 21

Sophia Chen, writing for Science magazine: On its own, a single-pixel camera captures pictures that are pretty dull: squares that are completely black, completely white, or some shade of gray in between. All it does, after all, is detect brightness. Yet by connecting a single-pixel camera to a patterned light source, a team of physicists in China has made detailed x-ray images using a statistical technique called ghost imaging, first pioneered 20 years ago in infrared and visible light. Researchers in the field say future versions of this system could take clear x-ray photographs with cheap cameras -- no need for lenses and multipixel detectors -- and less cancer-causing radiation than conventional techniques.

"Our system is much smaller and cheaper, and it could even be portable if you needed to take it into the field," says Wu Ling-An, a physicist at the Chinese Academy of Sciences in Beijing whose work with her colleagues was published on 28 March in Optica. The researchers' system still isn't ready to be used in medicine. But they have lowered the x-ray dose by about a million times compared with earlier attempts, says Daniele Pelliccia, who in 2015 made some of the first x-ray ghost images.

Science

Consumer Genetic Tests May Have a Lot of False Positives (theverge.com) 99

A new study, published in the journal Genetics in Medicine, found that consumer genetic tests bring up a lot of false positives. "In this case, 40 percent of the results from the consumer tests were false positives," reports The Verge, noting that the findings "cover a very small sample size and don't show that consumer tests always have a 40 percent false positive rate." From the report: The research was done by scientists at Ambry Genetics, a medical laboratory in California. By looking through their own database, they found that 49 people had been referred to them because of some worrying results from their consumer genetic tests. Still, scientists at Ambry were able to confirm only 60 percent of the results when they compared the raw data from consumer tests with more thorough genetic tests done by themselves and other clinical laboratories. So, 40 percent of variants in a variety of genes reported in DTC raw data were false positives, meaning that they said a genetic variant was there when it wasn't. (Most of these turned out to be variants linked to cancer.) Additionally, the authors write, some variants classified as "increased risk" were not only classified as "benign" by clinical laboratories, but they were actually common variants.
AI

New Deep-Learning Software Knows How To Make Desired Organic Molecules (nature.com) 46

dryriver shares a report from Nature about a neural network-based, deep-learning software that is as good as trained chemists in figuring out what reagents and reactions may lead to the successful creation of a desired organic molecule: Chemists have a new lab assistant: artificial intelligence. Researchers have developed a "deep learning" computer program that produces blueprints for the sequences of reactions needed to create small organic molecules, such as drug compounds. The pathways that the tool suggests look just as good on paper as those devised by human chemists. The tool, described in Nature on March 28, is not the first software to wield artificial intelligence (AI) instead of human skill and intuition. Yet chemists hail the development as a milestone, saying that it could speed up the process of drug discovery and make organic chemistry more efficient. Chemists have conventionally scoured lists of reactions recorded by others, and drawn on their own intuition to work out a step-by-step pathway to make a particular compound. They usually work backwards, starting with the molecule they want to create and then analyzing which readily available reagents and sequences of reactions could be used to synthesize it -- a process known as retrosynthesis, which can take hours or even days of planning. The new AI tool, developed by Marwin Segler, an organic chemist and artificial-intelligence researcher at the University of Munster in Germany, and his colleagues, uses deep-learning neural networks to imbibe essentially all known single-step organic-chemistry reactions -- about 12.4 million of them. This enables it to predict the chemical reactions that can be used in any single step. The tool repeatedly applies these neural networks in planning a multi-step synthesis, deconstructing the desired molecule until it ends up with the available starting reagents.
Medicine

Meet the Interstitium, the Largest Organ We Never Knew We Had (thedailybeast.com) 208

An anonymous reader quotes a report from The Daily Beast: A study published in Scientific Reports on Tuesday suggests that a previously unknown organ has been found in the human body. More astonishingly, the paper puts forth the idea that this new organ is the largest by volume among all 80 organs -- if what the researchers found is, in fact, an organ. The new organ, [pathologist Neil Theise] explained, was a thin layer of dense connective tissue throughout the body, sandwiched just under our skin and within the middle layer of every visceral organ. The organ also made up all the fascia, or the thin mesh of tissue separating every muscle and all the tissue around every vein and artery, from largest to smallest. What initially seemed to be a solid, dense, connective tissue layer was actually a complex network of fluid-filled cavities that are strong and flexible, yet so tiny and undiscerning that they escaped the attention of the brightest scientific minds for generations. In fact, Theise expanded, this "interstitium" could explain many of modern medicine's mysteries, often dismissed by the establishment as either silly or explainable by other phenomena. Take acupuncture, Theise said -- that energetic healing jolt may be traced to the interstitium. Or perhaps the interstitium acted as a "shock absorber," something that protected other organs and muscles in daily function. Also, the space is in direct communication with the lymphatic system as the origin of lymph fluid -- which means the interstitium's system of fluid-filled backroads could explain the metastasis of cancer cells and their quick spread beyond the limits of the organ in which the cancer started.
Biotech

Can We Fight Drug-Resistant Bacteria With Non-Antibiotic Drugs? (economist.com) 62

Slashdot reader Bruce66423 shares what researchers learned by studying the effect of drugs on bacteria in the gut: The research reveals that it's not just antibiotics that have the effect of causing resistance to antibiotics. "Of the drugs in the study, 156 were antibacterials (144 antibiotics and 12 antiseptics). But a further 835, such as painkillers and blood-pressure pills, were not intended to harm bacteria. Yet almost a quarter (203) did....

"However, Dr Maier's study also brings some good news for the fight against antimicrobial resistance. Some strains she looked at which were resistant to antibiotics nevertheless succumbed to one or more of the non-antibiotic drugs thrown at them. This could be a starting point for the development of new antimicrobial agents which would eliminate bacteria that have proved intractable to other means."

Every drug the researchers tested has already been approved for human use -- which means they could all eventually be used as a second wave of antibiotics.
Medicine

British Scientists Develop Wearable MRI Scanner (wcax.com) 29

British scientists have invented a new type of brain scanner that patients can wear on their head allowing them to move while being tested. "Neuroscientists will be able to envisage a whole new world of experiments where we try to work out what a brain is doing but whilst a person is behaving naturally," said Matt Brookes, a physicist at the University of Nottinham. CBS reports: The device, which looks like a prop from a budget sci-fi movie or phantom of the opera, is in fact the latest thing in brain scanning. "I think in terms of mapping brain activity, brain function, this represents a step change," said Brookes. Because you can do this while wearing it -- play bat and ball, or even drink a cup of tea. It was at Nottingham University in the early 70s that the MRI was first developed. Now the wearable 'MEG' system has the potential to open a whole new field of brain scanning. The scanner records the magnetic field produced by brain activity and can show precisely where in the brain these movements are being controlled. The area of the brain shown in blue is where wrist and arm movements are controlled while playing bat and ball.
Medicine

One Startup is Using Phone Calls and Other Inexpensive Means To Save TB Patients (microsoft.com) 30

Tuberculosis (TB) is one of most common causes of death globally. In 2016 alone, more than 10.4 million people fell sick to TB and 1.7 million TB-related deaths were reported. The WHO says India, in particular, and developing markets, in general, lead the count for the occurrence of TB in the world even as the local authorities provide free and effective medications to anyone who is ill. From a report: "One of the biggest barriers to recovery from TB is medication adherence," explains Microsoft Researcher Bill Thies, who is also the Chairman and Co-founder of Everwell Health Solutions, a Bangalore-based healthcare start-up. "Patients have to take daily drugs for a full six months, or else they do not fully recover, and are at risk of developing drug resistance. While medication adherence might sound like a simple problem, it turns out to be an enormously complex and heavily studied multi-disciplinary problem. If patients start feeling better after a few weeks, how can we convince them to take toxic drugs for another five months -- especially if patients have little or no understanding of germs and antibiotic resistance?"

The popular recommended practice to ensure medication adherence is Directly Observed Treatment or DOTS, which involves the patients going to a healthcare centre where they ingest the medication in front of a health worker. As it was implemented at the start of their work, patients needed to visit the centre three times per week for the first two months and once a week for the remaining four months. The system involves an unnecessary burden on the patients, who are typically from low-income groups -- every visit means travel expense and loss of work.
There are ways to ensure that a patient has taken medication on time -- we have things like smart pills, and you can send texts to people to remind them about the pills -- but in places like India, these solutions are beyond the reach of people. So in 2013, Thies and his colleagues, along with Microsoft Research Program Manager and TEM collaborator, started a project called 99DOTS to explore if any low-cost tech solution could be employed. They did find one, and it involves making a "missed call" to people. Here's the fascinating story of what happened next.
Medicine

Patients Regain Sight After Groundbreaking Trial (bbc.com) 73

An anonymous reader quotes a report from the BBC: Doctors have taken a major step towards curing the most common form of blindness in the UK -- age-related macular degeneration. Douglas Waters, 86, could not see out of his right eye, but "I can now read the newspaper" with it, he says. He was one of two patients given pioneering stem cell therapy at Moorfields Eye Hospital in London. Cells from a human embryo were grown into a patch that was delicately inserted into the back of the eye.

The macula is the part of the eye that allows you to see straight ahead -- whether to recognize faces, watch TV or read a book. The macula is made up of rods and cones that sense light and behind those are a layer of nourishing cells called the retinal pigment epithelium. When this support layer fails, it causes macular degeneration and blindness. Doctors have devised a way of building a new retinal pigment epithelium and surgically implanting it into the eye. The technique, published in Nature Biotechnology, starts with embryonic stem cells. These are a special type of cell that can become any other in the human body. They are converted into the type of cell that makes up the retinal pigment epithelium and embedded into a scaffold to hold them in place. The living patch is only one layer of cells thick -- about 40 microns -- and 6mm long and 4mm wide. It is then placed underneath the rods and cones in the back of the eye. The operation takes up to two hours.

Medicine

How a Virus Spreads Through an Airplane Cabin (gizmodo.com) 76

An anonymous reader shares a report: Traveling by plane greatly increases our chances of getting sick, or so many of us are wont to believe. To be fair, it's not uncommon to come down with a nasty illness after we return from a vacation or business trip. But is flying the culprit? The latest research suggests the answer is no -- but much of it depends on where we sit. New research published today in Proceedings of the National Academy of Sciences suggests that airline passengers infected with influenza -- a disease that spreads through the air -- aren't likely to infect other passengers who sit more than two seats to the left or right, or more than two seats in front or back. In other words, your chances of contracting the flu from an infected passenger are slim -- unless you're sitting within about three feet (one meter) of them. Given that three billion of us fly annually, combined with the popular conception that we often contract diseases inflight, it's surprising to learn that very few studies have looked into this issue in detail.
Medicine

Lead Exposure Kills Hundreds of Thousands of Adults Every Year in the US, Study Finds (theguardian.com) 220

Bruce66423 shares a report from The Guardian: Last week, a massive new study concluded that lead is 10 times more dangerous than thought, and that past exposure now hastens one in every five U.S. deaths. Researchers at four North American universities, led by Bruce Lanphear, of Simon Fraser University in Vancouver, studied the fate of 14,289 people whose blood had been tested in an official U.S. survey between 1988 and 1994. Four fifths of them had harbored levels of the toxic metal below what has, hitherto, been thought safe. The study found that deaths, especially from cardiovascular disease, increased markedly with exposure, even at the lowest levels. It concluded that lead kills 412,000 people a year -- accounting for 18% of all U.S. mortality, not much less than the 483,000 who perish as a result of smoking. The study has been published in the Lancet Public Health journal.
Earth

Microplastics Found In 93 Percent of Bottled Water Tested In Global Study (www.cbc.ca) 177

An anonymous reader quotes a report from CBC.ca: The bottled water industry is estimated to be worth nearly $200 billion a year, surpassing sugary sodas as the most popular beverage in many countries. But its perceived image of cleanliness and purity is being challenged by a global investigation that found the water tested is often contaminated with tiny particles of plastic. The research was conducted on behalf of Orb Media, a U.S-based non-profit journalism organization with which CBC News has partnered. Professor Sherri Mason, a microplastics researcher who carried out the laboratory work at the State University of New York, and his team tested 259 bottles of water purchased in nine countries (none were bought in Canada). Though many brands are sold internationally, the water source, manufacturing and bottling process for the same brand can differ by country. The 11 brands tested include the world's dominant players -- Nestle Pure Life, Aquafina, Dasani, Evian, San Pellegrino and Gerolsteiner -- as well as major national brands across Asia, Africa, Europe and the Americas. Researchers found 93 per cent of all bottles tested contained some sort of microplastic, including polypropylene, polystyrene, nylon and polyethylene terephthalate (PET).

Orb found on average there were 10.4 particles of plastic per liter that were 100 microns (0.10 mm) or bigger. This is double the level of microplastics in the tap water tested from more than a dozen countries across five continents, examined in a 2017 study by Orb that looked at similar-sized plastics. Other, smaller particles were also discovered -- 314 of them per liter, on average -- which some of the experts consulted about the Orb study believe are plastics but cannot definitively identify. The amount of particles varied from bottle to bottle: while some contained one, others contained thousands.

Medicine

Scientists Create a Way For People With Amputations To Feel Their Prosthetics (gizmodo.com) 42

An anonymous reader quotes a report from Gizmodo: Prosthetic hands have gotten increasingly sophisticated. Many can recreate the complex shape and detail of joints and fingers, while powered prostheses allow for independent, willful movement. But a new study published Wednesday in Science Translational Medicine offers a potential glimpse into the future of the technology: Artificial hands that actually feel like a living limb as they move. The researchers recruited people with amputations who had been given surgery that reconfigured certain muscle and sensory nerves surrounding the amputated limb, allowing them to control their prosthesis through intuitive brain signals (thoughts) sent to the repurposed nerves. Across a series of experiments involving three of these patients, the researchers attached devices that generated vibrations along specific muscles near the amputation site. When the device was turned on, these vibrations created an illusionary sense of kinesthesia -- an awareness of conscious self-movement -- in the prosthetic hand as the person performed tasks with it, both in a virtual stimulation and in the real world. The volunteers had amputations that extended just past their elbow as well as their whole arm. Not only did the experiment let them "feel" their hand as they opened and closed it, but the restored intuition allowed them to perform tasks without needing to constantly look at their hand. And coupled with vision, it gave them overall better motor control over their prosthesis.
Businesses

How Amazon Became Corporate America's Nightmare (bloomberg.com) 243

Zorro shares a report from Bloomberg that details Amazon's rapid growth in the last three years: Amazon makes no sense. It's the most befuddling, illogically sprawling, and -- to a growing sea of competitors -- flat-out terrifying company in the world. It sells soap and produces televised soap operas. It sells complex computing horsepower to the U.S. government and will dispatch a courier to deliver cold medicine on Christmas Eve. It's the third-most-valuable company on Earth, with smaller annual profits than Southwest Airlines Co., which as of this writing ranks 426th. Chief Executive Officer Jeff Bezos is the world's richest person, his fortune built on labor conditions that critics say resemble a Dickens novel with robots, yet he has enough mainstream appeal to play himself in a Super Bowl commercial. Amazon was born in cyberspace, but it occupies warehouses, grocery stores, and other physical real estate equivalent to 90 Empire State Buildings, with a little left over. The company has grown so large and difficult to comprehend that it's worth taking stock of why and how it's left corporate America so thoroughly freaked out. Executives at the biggest U.S. companies mentioned Amazon thousands of times during investor calls last year, according to transcripts -- more than President Trump and almost as often as taxes. Other companies become verbs because of their products: to Google or to Xerox. Amazon became a verb because of the damage it can inflict on other companies. To be Amazoned means to have your business crushed because the company got into your industry. And fear of being Amazoned has become such a defining feature of commerce, it's easy to forget the phenomenon has arisen mostly in about three years.

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