A team of engineering and medical researchers has found a way to use ultrasound to monitor fluid levels in the lung, offering a non-invasive way to track progress in treating pulmonary edema – fluid in the lungs – which often occurs in patients with congestive heart failure. The approach, which has been demonstrated in rats, also holds promise for diagnosing scarring, or fibrosis, in the lung.
“Historically, it has been difficult to use ultrasound to collect quantitative information on the lung, because ultrasound waves don’t travel through air– and the lung is full of air,” says Marie Muller, an assistant professor of mechanical engineering at North Carolina State University and co-author of a paper on the work. “However, we’ve been able to use the reflective nature of air pockets in the lung to calculate the amount of fluid in the lung.”
When ultrasound waves travel through the body, most of each wave’s energy passes through the tissue. But some of that energy is reflected as an echo. By monitoring these echoes, an ultrasound scanner is able to create an image of the tissue that the waves passed through. All of this happens in microseconds.
But when ultrasound waves hit air, all of the energy is reflected – which is why ultrasound images of the lung tend to look like a big, grey blob, with little useful information for healthcare providers. And while there are some techniques that allow users to determine if a patient has pulmonary edema, those techniques still can’t tell how much fluid there is.
This is where Muller’s team comes in.
When ultrasound waves hit air pockets in the lung, or alveoli, they scatter. Those scattered waves hit other air pockets, scattering them further. This process of bouncing around means that it takes an ultrasound’s echo much longer to bounce back to the ultrasound machine – though it’s still measured in microseconds. And that is why the lung looks like a grey blob to the ultrasound scanner.
But no two ultrasound waves take the same path – they may bounce in different directions as they travel through the lung. So their echoes take different amounts of time to return to the scanner. By looking at all of the echoes, and how those echoes change over time, Muller and her collaborators were able to calculate the extent to which the space between the air pockets was filled with fluid.
To test their approach, the researchers conducted two sets of experiments using rats and rat lung tissue.
In the first set of experiments, researchers used rat lung tissue that had been injected with saline solution to mimic fluid-filled lung tissue. The new approach allowed researchers to quantify the amount of fluid in the lung to within one milliliter.
In the second set of experiments, researchers found significant differences between fluid-filled and healthy lungs in rats. Specifically, the researchers were calculating the mean distance between two “scattering events” – or how far an ultrasound wave travelled between two air pockets.
For fluid-filled lungs, the mean distance was 1,040 micrometers, whereas the mean distance in healthy lungs was only 332 micrometers.
“This is important, because one could potentially track this mean distance value as a way of determining how well pulmonary edema treatment is working,” Muller says.
The technique makes use of conventional ultrasound scanning equipment, though the algorithm used by the researchers would need to be incorporated into the ultrasound software.

North Carolina State Universityhttp://tinyurl.com/ycktwghh 

One downside to medical sensors that test human sweat: You have to sweat. Sweating from exertion or a stifling room temperature can be impractical for some patients and unsafe for others. And unless they are on the second leg of the Tour de France, it’s unlikely patients will want to sweat all day for the benefit of a sensor reading.
But researchers at the University of Cincinnati have come up with a novel way to stimulate sweat glands on a small, isolated patch of skin so subjects can stay cool and comfortable and go about their daily routine without spending hours on a treadmill.
UC professor Jason Heikenfeld and UC graduate Zachary Sonner came up with a device the size of a Band-Aid that uses a chemical stimulant to produce sweat, even when the patient is relaxed and cool. The sensors also can predict how much patients sweat, an important factor in understanding the hormones or chemicals the biosensors measure.
"Doctors would love to know if chemical concentrations are increasing or decreasing over time," Heikenfeld said. "What was your baseline before you got sick? Then by measuring the change in concentrations, we know even more about how sick you are or how quickly you are getting better."
Blood analysis is considered the gold standard for biometric analysis. But biometric testing with blood is invasive and often requires the use of a lab. It is far more difficult for doctors to perform continuous monitoring of blood over hours or days.
Sweat provides a non-invasive alternative, with chemical markers that are more useful in monitoring health than saliva or tears, Heikenfeld said.
“People for a long time ignored sweat because, although it can be a higher-quality fluid for biomarkers, you can’t rely on having access to it,” Heikenfeld said. “Our goal was to achieve methods to stimulate sweat whenever needed — or for days.”
Scientists say sweat provides much of the same useful information about patients as blood. The problem has always been getting the same consistent sample as is possible with a standard blood draw, he said.
For the study, the researchers applied sensors and a gel containing carbachol, a chemical used in eyedrops, to their subject’s forearm for 2.5 minutes.
They used three methods to obtain sensor data: the gel and sensors alone and in combination with memory foam padding (to provide better contact between the sensor and the skin) and iontophoresis, an electrical current at 0.2 milliamps that drives a tiny amount of carbachol into the upper layer of the skin and locally stimulates sweat glands but causes no physical sensation or discomfort.
Then they recorded data obtained from the subject’s sweat for 30 minutes using sensors that measured concentrations of sweat electrolytes. Carbachol was effective at inducing sweating under the sensor for as long as five hours. Heikenfeld said a subsequent study successful generated sensor results for several days using this process to stimulate sweat.
They used a pH-sensitive dye to observe the results. The orange dye turned blue when it reacted with sweat. This demonstrated that the sweat glands were stimulated evenly across the sensor area.
“This work represents a significant leap forward in sweat-sensing technology,” the study concluded.

University of Cincinnati
magazine.uc.edu/editors_picks/recent_features/Sweat.html

A multidisciplinary group that includes the University of Illinois at Urbana-Champaign and the University of Washington at Tacoma has developed a novel platform to diagnose infectious disease at the point-of-care, using a smartphone as the detection instrument in conjunction with a test kit in the format of a credit card. The group is led by Illinois Electrical and Computer Engineering  Professor Brian T. Cunningham; Illinois Bioengineering Professor Rashid Bashir; and, University of Washington at Tacoma Professor David L. Hirschberg, who is affiliated with Sciences and Mathematics, division of the School of Interdisciplinary Arts and Sciences.
Findings have demonstrated detection of four horse respiratory diseases, and in Biomedical Microdevices, where the system was used to detect and quantify the presence of Zika, Dengue, and Chikungunya virus in a droplet of whole blood. Project collaborators include Dr. David Nash, a private practice equine expert and veterinarian in Kentucky, and Dr. Ian Brooks, a computer scientist at the National Center for Supercomputing Applications.
The low-cost, portable, smartphone-integrated system provides a promising solution to address the challenges of infectious disease diagnostics, especially in resource-limited settings or in situations where a result is needed immediately. The diagnostic tool’s integration with mobile communications technology allows personalized patient care and facilitates information management for both healthcare providers and epidemiological surveillance efforts. Importantly, the system achieves detection limits comparable to those obtained by laboratory-based methods and instruments, in about 30 minutes.
A useful capability for human point-of-care (POC) diagnosis or for a mobile veterinary laboratory, is to simultaneously test for the presence of more than one pathogen with a single test protocol, which lowers cost, saves time and effort, and allows for a panel of pathogens, which may cause similar symptoms, to be identified.
Infectious diseases remain the world’s top contributors to human death and disability, and with recent outbreaks of Zika virus infections, there is a keen need for simple, sensitive, and easily translatable point-of-care tests. Zika virus appeared in the international spotlight in late 2015 as evidence emerged of a possible link between an epidemic affecting Brazil and increased rates of microcephaly in newborns. Zika has become a widespread global problem—the World Health Organization (WHO) documented last year that since June 2016, 60 nations and territories report ongoing mosquito-borne transmission. Additionally, since Zika virus infection shares symptoms with other diseases such as Dengue and Chikungunya, quick, accurate diagnosis is required to differentiate these infections and to determine the need for aggressive treatment or quarantine.
The technology is intended to enable clinicians to rapidly diagnose disease in their office or in the field, resulting in earlier, more informed patient management decisions, while markedly improving the control of disease outbreaks. An important prerequisite for the widespread adoption of point-of-care tests at the patient’s side is the availability of detection instruments that are inexpensive, portable, and able to share data wirelessly over the Internet.
The system uses a commercial smartphone to acquire and interpret real-time images of an enzymatic amplification reaction that takes place in a silicon microfluidic chip that generates green fluorescence and displays a visual read-out of the test. The system is composed of an unmodified smartphone and a portable 3D–printed cradle that supports the optical and electrical components, and interfaces with the rear-facing camera of the smartphone.
The software application operating on the smartphone gathers information about the tests conducted on the microfluidic card, patient-specific information, and the results from the assays, that are then communicated to a cloud storage database.
Dr. Nash observes that, “This project is a game changer. This is the future of medicine—empowered front-line healthcare professionals. We can’t stop viruses and bacteria, but we can diagnose more quickly. We were able to demonstrate the clear benefit to humankind, as well as to animals, during the proposal phase of the project, and our results have proved our premise.

University of Illinois
mntl.illinois.edu/news/article/23759

• Peripheral neuropathy is a very common side-effect of chemotherapy and may eventually lead to early discontinuation of treatment.
• Collaboration between research and industry led to the identification and successful testing of a new molecule capable of preventing this neurological complication.
• This molecule could potentially become the first existing treatment to prevent this frequent adverse effect and improve the quality of life of cancer patients.

IDIBELL Researchers of the Neuro-Oncology Unit of Bellvitge University Hospital – Catalan Institute of Oncology, led by Dr. Jordi Bruna, have successfully tested a new molecule capable of preventing the development of peripheral neuropathy induced by chemotherapy in cancer patients, especially in colon cancer cases, the third most common neoplasm in the world. The molecule, which has a completely novel mechanism of action, would be the first treatment against this neurological complication, for which no effective treatment has yet been approved.
One of the main adverse effects of certain chemotherapeutics used in the treatment of cancers is peripheral neuropathy, which can cause tingling, numbness, pain or alterations in the functionality of patients, among others. This complication, so far, has been regarded as a “price to pay” despite having a demonstrated negative impact on the quality of life of the patient, increasing their care expenses and often preventing the complete and effective administration of  the cytostatic treatment, with the potential decrease of survival chances that entails.
Researchers at the HUB-ICO-IDIBELL Unit identified a new molecule – developed by the Catalan laboratory Esteve – as a candidate to prevent the onset of this adverse effect. "Through a public-private partnership, we have been able to design a Phase 2b clinical trial (randomized with placebo), which has allowed us to get a great deal of scientific information – effect on pain, pathophysiology – and draw conclusions as to the potential of the drug in the prevention of neuropathies during cytostatic treatment”, explains Dr. Bruna, who led the trial.
The results of the study prove a decrease in the appearance of disorders associated with nerve dysfunction in those cancer patients who took the new drug. "When the trial was designed, safety data from the previous trials limited the duration of treatment with the new molecule and this meant that we had to work at low doses in relation to the duration of the chemotherapy treatment, but we have nevertheless obtained positive results and now we have enough information to be able to extend the duration of the treatment. Therefore, we hope to obtain even more satisfactory results" the IDIBELL researcher comments.
"Given the usual pace of clinical trials and drug agencies following fast-track approval processes in severe or orphan pathologies, this new drug could potentially reach the market soon, since it would be the first available treatment to avoid this type of neuropathy. In addition, it has other medical uses as a non-opioid analgesic”, adds Bruna. In any case, improving pain control and reducing the occurrence of severe neuropathy is undoubtedly the most prominent benefit of the development of this novel drug..
IDIBELL
www.idibell.cat/modul/news/en/1024/researchers-prove-the-effectiveness-of-a-new-drug-to-prevent-the-onset-and-the-pain-of-chemotherapy-induced-neuropathy

During operations, it can be difficult for surgeons to avoid severing crucial nerves because they look so much like other tissue. A new non-invasive approach that uses polarized light to make nerves stand out from other tissue could help surgeons avoid accidentally injuring nerves or assist them in identifying nerves in need of repair.
Although nerve injuries are a known complication for many types of surgery, surgeries involving the hand and wrist come with a higher risk because of the dense networks of nerves in this area. There are a few techniques available to help doctors identify nerves, but they have various limitations such as not providing real-time information, requiring physical contact with the nerve or requiring the addition of a fluorescent dye. 
Cousins, Kenneth and Patrick Chin, developed the idea independently from any institute to use an optical technique known as collimated polarized light imaging (CPLi) to identify nerves during surgery. Kenneth later joined a research group led by Thomas van Gulik, a surgeon at the Academic Medical Center, and brought along a working prototype which has been further developed into a practical system that can be deployed in the operating room.
In The Optical Society (OSA) journal Biomedical Optics Express, the researchers report that a surgeon using CPLi technology was able to correctly identify nerves in a human hand 100 percent of the time, compared to an accuracy rate of 77 percent for the surgeon who identified nerves using only a visual inspection.
CPLi uses a polarized beam of light to illuminate the tissue. When this light passes through a nerve, the tissue’s unique internal structure reflects the light in a way that is dependent on how the nerve fibre is oriented compared to the orientation of the polarization of the light. By rotating the light’s polarization, the reflection appears to switch on and off, making the nerve tissue stand out from other tissue. For this application, it was important to use light that was collimated, meaning all the light waves were parallel to each other, to maximize the amount of light reflected by the tissue.
“We adapted the optics used for CPLi so that they could be incorporated in a surgical microscope, which can be placed above the surgical area,” said Kenneth Chin. “The resulting system can be used in a wide range of surgical fields where superficial nerves need to be identified.”
After testing their technique on animal tissue, the researchers used it to examine 13 tissue sites from the hand of a human cadaver. A surgeon looked for nerve tissue at these sites by eye under typical surgical illumination while a different surgeon used CPLi for an independent assessment. Histological evaluation was then used to verify the presence of nerve tissue at each site. The surgeon using visual inspection correctly identified nerve tissue in 10 of the 13 cases while the surgeon using CPLi correctly identified nerve tissue in all cases.
With patient consent, the researchers also used CPLi to successfully identify nerve tissue during a procedure to relieve pain in the wrist. They plan to do additional tests of the technique during live surgery to better understand how the optical reflection of nerves might vary among patients and under various surgical conditions. 

The Optical Society
www.osa.org/en-us/about_osa/newsroom/news_releases/2017/new_tool_aims_to_make_surgery_safer_by_helping_doc/