New research has estimated that each year five babies in every 1,000 born in England suffer a condition or sign linked to brain injury.
The study, conducted by researchers at the Neonatal Data Analysis Unit at Imperial College London and Chelsea and Westminster Hospital NHS Foundation Trust, analysed data on babies born between 2010 and 2015 to assess the number that may have sustained brain injury at or soon after birth.
The researchers used routinely recorded NHS data and so were able to measure the incidence rate of brain injury in newborns without any additional workload for doctors or nurses. Ultimately, this research could lead to a better understanding of how to prevent brain injury in preterm and full term babies.
Dr Chris Gale, lead author and Clinical Senior Lecturer in Neonatal Medicine at Imperial College London and Consultant Neonatologist at Chelsea and Westminster Hospital NHS Foundation Trust, said: “Brain injury at or soon after birth is a serious problem, as it can lead to long-term conditions later in life such as cerebral palsy, blindness, deafness and learning deficits. A proportion of these cases could be avoided.”
Neena Modi, Professor of Neonatal Medicine at Imperial College London and Head of the Neonatal Data Analysis Unit, said: “Before now UK health services did not have a standard definition of brain injury in babies and there has been no systematic collection of data for this purpose.
Professor Modi added: “With colleagues, and in collaboration with the Department of Health, we have devised a practical way to measure the incidence rate of brain injury in babies.”
Published in the journal Archives of Disease in Childhood, the research estimated that 3,418 babies suffered conditions linked to brain injury at or soon after birth in 2015, which equates to an overall incidence rate of 5.14 per 1,000 live births. For preterm births (babies born at or less than 37 weeks) the rate was 25.88 per 1,000 live births in 2015, more than seven times greater than the rate for full term births, which was 3.47 per 1,000 live births.
It is often not known whether a baby has suffered brain injury until later in life. Therefore, the new standardized definition of brain injuries in newborn babies, developed by a group of experts convened by the Department of Health, consists of a range of conditions and signs that are known to be related to brain injury. These include seizures or fits, bleeding within the brain, stroke just before or at birth, infections like meningitis, and damage caused by oxygen deprivation.
The research, commissioned by the Department of Health, is the first to present estimates for the number of babies with brain injuries based on a definition that includes multiple conditions in one measure.
It is also the first time this estimate has been made using data gathered routinely during day-to-day clinical care on neonatal units. The use of routine data required no additional work for clinical staff and provides a valuable way to measure the effectiveness of interventions to reduce brain injury.
As part of a drive to make England a safer place to give birth, the Department of Health has set a target of reducing the number of babies that incur brain injury during or soon after birth by 20% by 2020 and to halve them by 2030. Using these new estimates this equates to lowering the incidence of babies with brain injury to four per 1,000 live births by 2020 and to 2.5 babies per 1,000 live births by 2030.
Overall, the research found that the most common type of condition that contributed to brain injuries was damage caused by lack of oxygen to the brain, called hypoxic ischemic encephalopathy; this is seen mainly in full term babies. For preterm babies, the largest contributor to brain injuries is from bleeding into and around the ventricles of the brain, a condition called periventricular hemorrhage.
Dr Gale added: “Being able to measure how common brain injuries are allows health professionals and researchers to focus on reducing these devastating conditions. This includes the consistent use of treatments that reduce the risk of brain injuries in preterm infants, such as steroids and magnesium sulphate given to the mother before birth.
“This measure will also help us to evaluate other interventions, for example, making sure that as many preterm babies as possible are born at hospitals with advanced neonatal services on site, which we know reduces the risk of brain injury.
“The next step is to use routine data to understand the long-term effects of these conditions on the children and their families.”

Imperial College Londonhttps://tinyurl.com/ycnbqzlo

Biomedical engineers at the University of California, Davis, have developed a new technique for measuring blood flow in the human brain, which could be used in patients with stroke or traumatic brain injury, for example. The new technique, based on conventional digital camera technology, could be significantly cheaper and more robust than prior methods.
“Our setup is very promising, and the cost should be lower,” said Wenjun Zhou, a postdoctoral researcher working with Vivek Srinivasan, associate professor at the UC Davis Department of Biomedical Engineering.
If you shine a light into a cloudy solution, light particles, or photons, will be scattered in different directions. An experimental technique called diffuse correlation spectroscopy, or DCS, uses essentially this approach to look inside someone’s skull. Laser light is shined on the head; as photons from the laser pass through the skull and brain, they are scattered by blood and tissue. A detector placed elsewhere on the head, where the photons make their way out again, picks up the light fluctuations due to blood motion. These fluctuations provide information about blood flow.
The light signal is very weak, and the further it passes through the skull and brain tissue, the weaker it gets. So DCS requires a number of very sensitive, expensive single photon counting detectors. Boosting the light going in risks burning the patient’s skin.
Zhou and Srinivasan took a different approach, based on the fact that overlapping light waves will reinforce or cancel each other out, like overlapping ripples on a pond.
They first split the light beam into “sample” and “reference” paths. The sample beam goes into the patient’s head and another, stronger, reference beam is routed so that it reconnects with the sample beam before going to the detector. This boosts the signal, meaning that instead of needing about 20 photon-counting detectors that cost a few thousand dollars each, the researchers could use a single CMOS-based digital camera chip for a fraction of the price.
“The strong reference light enhances the weaker signal from the sample,” Zhou said.
They call the method interferometric diffusing wave spectroscopy, or iDWS. An added advantage is that they do not need to turn off the room lights while making measurements with iDWS, Zhou said. Eventually, they may even be able to monitor brain blood flow outdoors, under bright sunlight.
So far, the team has tested their device by making brain recordings from volunteers in the laboratory. They are working with Dr. Bruce Lyeth and Dr. Lara Zimmermann in the UC Davis Department of Neurological Surgery to validate and adapt the technology for eventual use in neurocritical care. UC Davis has applied for a provisional patent on the technology.
Other authors on the paper are graduate student Oybek Kholiqov and postdoctoral researcher Shau Poh Chong. Srinivasan also holds an appointment at the Department of Ophthalmology and Vision Science, UC Davis School of Medicine. The work was funded by grants from the National Institutes of Health.

University of California – Daviswww.ucdavis.edu/news/new-technology-measuring-brain-blood-flow-light

Massive banks of genetic information are being harnessed to shed new light on modifiable health risks that underlie common diseases.
University of Queensland researchers have pioneered a method to integrate data from multiple large-scale studies to assess risk factors such as body mass index (BMI) and cholesterol levels, and their association with diseases including type two diabetes and heart disease.
Professor Jian Yang, from UQ’s Institute for Molecular Bioscience and Queensland Brain Institute, said the new method was more powerful than earlier techniques and enabled scientists to identify risk associations that were difficult to detect in smaller samples.
“Identifying new risk factors provides an avenue to look at diseases from a different angle,” Professor Yang said.
“For example, LDL-cholesterol is known to be a risk factor for cardiovascular disease, but we were surprised to see that it actually lowers your risk of type two diabetes.
“Discoveries like this could have significant implications for medical research, the pharmaceutical industry and public health policy.”
The study looked at seven known health risk factors and more than 30 common diseases, in genetic data from more than 400,000 people.
Professor Yang said the method identified 45 potentially causal associations between health risk factors and diseases.
“Some of these associations – such as the link between BMI and type 2 diabetes and cardiovascular disease – have already been confirmed in randomized controlled trials, which validates our methods,” Professor Yang said.
“Others identified in this study provide candidates for prioritization in future trials, and fundamental knowledge to understand the biology of the diseases.
“For example, we identified a highly significant risk effect of HDL-cholesterol on age-related macular degeneration.”
Professor Yang said the method was particularly valuable where clinical trials to investigate associations would be impractical or even unethical.
“Years of education is one trait we looked at in the study, and it had a protective effect against most diseases, particularly for Alzheimer’s and coronary artery disease – but it is something that needs to be carefully investigated in the future,” Professor Yang said.
University of Queenslandhttps://tinyurl.com/y9lfo963

The heart is capable of terminating arrhythmias itself after local gene therapy, potentially avoiding the need for patients to undergo painful electric shocks, according to a proof-of-concept study.
Atrial fibrillation is the most common heart rhythm disorder (arrhythmia). Treatment aims to restore the heart’s normal rhythm and includes drugs, which are not effective in all patients, ablation, for which efficiency remains suboptimal in the long-term, and electric shocks, which are effective but painful and require hospitalization. This leaves a large and growing group of patients without optimal treatment options.
That is why study author Dr Emile Nyns, a physician and PhD candidate in the laboratory of Daniël Pijnappels at the Leiden University Medical Centre, Leiden, the Netherlands, took a completely different approach. He said: “As the heart itself is already electrically active, we tested whether and how it could generate the electrical current needed for arrhythmia termination.”
The researchers used a technique called optogenetics, which uses light to control functioning of cells that have been genetically modified to express light-sensitive ion channels.
First they genetically modified the right atrium in eight adult rats using a process called gene painting, which involves a small thoracic incision and actually painting the atrium with vectors coding for these ion channels.
The researchers waited four to six weeks for the light-sensitive ion channels to be expressed, then made a small incision in the thorax of each rat and induced atrial fibrillation. Next they shone a light on the atrium for one second. This terminated 94% of atrial fibrillation.
Dr Nyns said: “Shining light on the atrium opened the light-sensitive ion channels. This led to depolarization of the atrium, which terminated atrial fibrillation and restored the heart’s normal rhythm. We only needed a single light pulse of one second to terminate nearly all arrhythmias.
“The heart itself generated the electrical current needed to stop the arrhythmias,” he continued. “It is completely pain free, unlike electric shocks.”
He said: “Our study provides proof-of-concept that the heart can be enabled to terminate atrial fibrillation by itself after optogenetic gene therapy.”
In future Dr Nyns envisages that the technique could be used in atrial fibrillation patients together with an implantable light-emitting diode (LED) device. “The result would be continuous, ambulatory and pain-free maintenance of the heart’s normal rhythm, something that cannot be achieved today,” he said. “The quality of life and prognosis of AF patients could be significantly increased, especially for patients with frequent episodes of drug refractory, symptomatic atrial fibrillation, despite ablation therapy.”
The researchers did not observe adverse effects from the method, but Dr Nyns said: “Further research is certainly needed before this technique can be used in patients. However, the results are promising and we believe that the time has come to develop the next generation of therapy for cardiac arrhythmias, which do not rely on pills or electronics, but on biology instead.”

ScienceDailyhttps://tinyurl.com/yc4atkg8