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Low-Efficacy Mu Opioid Agonists as Candidate Analgesics: Effects of Novel C-9 Substituted Phenylmorphans on Pain-Depressed Behavior in Mice [Behavioral Pharmacology]

Low-efficacy mu opioid receptor (MOR) agonists may serve as novel candidate analgesics with improved safety relative to high-efficacy opioids. This study used a recently validated assay of pain-depressed behavior in mice to evaluate a novel series of MOR-selective C9-substituted phenylmorphan opioids with graded MOR efficacies. Intraperitoneal injection of dilute lactic acid (IP acid) served as a noxious stimulus to depress locomotor activity by mice in an activity chamber composed of two compartments connected by an obstructed door. Behavioral measures included (1) crosses between compartments (vertical activity over the obstruction) and (2) movement counts quantified as photobeam breaks summed across compartments (horizontal activity). Each drug was tested alone and as a pretreatment to IP acid. A charcoal-meal test and whole-body-plethysmography assessment of breathing in 5% CO2 were also used to assess gastrointestinal (GI) inhibition and respiratory depression, respectively. IP acid produced a concentration-dependent depression in crosses and movement that was optimally alleviated by intermediate- to low-efficacy phenylmorphans with sufficient efficacy to produce analgesia with minimal locomotor disruption. Follow-up studies with two low-efficacy phenylmorphans (JL-2-39 and DC-1-76.1) indicated that both drugs produced naltrexone-reversible antinociception with a rapid onset and a duration of ~1 h. Potency of both drugs increased when behavior was depressed by a lower IP-acid concentration, and neither drug alleviated behavioral depression by a non-pain stimulus (IP lithium chloride). Both drugs produced weaker GI inhibition and respiratory depression than fentanyl and attenuated fentanyl-induced GI inhibition and respiratory depression. Results support further consideration of selective, low-efficacy MOR agonists as candidate analgesics.

SIGNIFICANCE STATEMENT

This study used a novel set of mu opioid receptor (MOR)-selective opioids with graded MOR efficacies to examine the lower boundary of MOR efficacy sufficient to relieve pain-related behavioral depression in mice. Two novel low-efficacy opioids (JL-2-39, DC-1-76.1) produced effective antinociception with improved safety relative to higher- or lower-efficacy opioids, and results support further consideration of these and other low-efficacy opioids as candidate analgesics.




oni

Is the Clinical Application of CXCR4 Imaging in the Diagnosis and Management of Primary Aldosteronism Really Happening?




oni

Ironing Out the Mechanism of gp130 Signaling [Review Article]

gp130 functions as a shared signal-transducing subunit not only for interleukin (IL)-6 but also for eight other human cytokine receptor complexes. The IL-6 signaling pathway mediated through gp130 encompasses classical, trans, or cluster signaling, intricately regulated by a diverse array of modulators affecting IL-6, its receptor, and gp130. Currently, only a limited number of small molecule antagonists and agonists for gp130 are known. This review aims to comprehensively examine the current knowledge of these modulators and provide insights into their pharmacological properties, particularly in the context of cancer and other diseases. Notably, the prominent gp130 modulators SC144, bazedoxifene, and raloxifene are discussed in detail, with a specific focus on the discovery of SC144’s iron-chelating properties. This adds a new dimension to the understanding of its pharmacological effects and therapeutic potential in conditions where iron homeostasis is significant. Our bioinformatic analysis of gp130 and genes related to iron homeostasis reveals insightful correlations, implicating the role of iron in the gp130 signaling pathway. Overall, this review contributes to the evolving understanding of gp130 modulation and its potential therapeutic applications in various disease contexts.

Significance Statement

This perspective provides a timely and comprehensive analysis of advancements in gp130 signaling research, emphasizing the therapeutic implications of the currently available modulators. Bioinformatic analysis demonstrates potential interplay between gp130 and genes that regulate iron homeostasis, suggesting new therapeutic avenues. By combining original research findings with a broader discussion of gp130's therapeutic potential, this perspective significantly contributes to the field.




oni

Agar (1.5%)-Noni Juice (50%)




oni

Cloning of Affibody Libraries for Display Methods

Affibody molecules are small (6-kDa) affinity proteins folded in a three-helical bundle and generated by directed evolution for specific binding to various target molecules. The most advanced affibody molecules are currently tested in the clinic, and data from more than 300 subjects show excellent activity and safety profiles. The generation of affibody molecules against a particular target starts with the generation of an affibody library, which can then be used for panning using multiple methods and selection systems. This protocol describes the molecular cloning of DNA-encoded affibody libraries to a display vector of choice, for either phage, Escherichia coli, or Staphylococcus carnosus display. The DNA library can come from different sources, such as error-prone polymerase chain reaction (PCR), molecular shuffling of mutations from previous selections, or, more commonly, from DNA synthesis using various methods. Restriction enzyme-based subcloning is the most common strategy for affibody libraries of higher diversity (e.g., >107 variants) and is described here.




oni

Analysis of Sleep and Circadian Rhythms from Drosophila Activity-Monitoring Data Using SCAMP

Sleep is a fundamental feature of life for virtually all multicellular animals, but many questions remain about how sleep is regulated and what biological functions it plays. Substantial headway has been made in the study of both circadian rhythms and sleep in the fruit fly Drosophila melanogaster, much of it through studies of individual fly activity using beam break counts from Drosophila activity monitors (DAMs). The number of laboratories worldwide studying sleep in Drosophila has grown from only a few 20 years ago to hundreds today. The utility of these studies is limited by the quality of the metrics that can be extracted from the data. Many software options exist to help analyze DAM data; however, these are often expensive or have significant limitations. Therefore, we describe here a method for analyzing DAM-based data using the sleep and circadian analysis MATLAB program (SCAMP). This user-friendly software has an advantage of combining several analyses of both sleep and circadian rhythms in one package and produces graphical outputs as well as spreadsheets of the outputs for further statistical analysis. The version of SCAMP described here is also the first published software package that can analyze data from multibeam DAM5Ms, enabling determination of positional preference over time.




oni

Analysis of Positional Preference in Drosophila Using Multibeam Activity Monitors

The positional preference of an animal can be very informative regarding the choices it makes about how to interact with its environment. The fruit fly Drosophila melanogaster has been used as a robust system for examining neurobiological mechanisms underlying behavior. Fruit fly positional preference can be gathered from TriKinetics Drosophila activity monitors (DAMs), which contain four infrared beams, allowing for tracking the position of individual flies along the length of a tube. Here, we describe a method for using DAM5Ms to examine food preference. Specifically, we show an example in which circadian changes in food preference are compared between different Drosophila species. More information about the evolution of behavior can be gathered by measuring feeding preference relative to time of day. Noni, fruit from Morinda citrifolia, contains octanoic acid, a chemical toxic to many species of Drosophila. D. melanogaster and D. simulans, both food generalists, show high sensitivity to octanoic acid, whereas D. sechellia, a specialist, can tolerate high concentrations. When two different food substrates are provided at each end of a tube, food preference can be inferred at various times of the day, using the sleep and circadian analysis MATLAB program (SCAMP) to extract and analyze positional data from DAM5Ms. Data gathered from these analyses can be used to compare avoidance or attraction to nutrients, tastants, or odors between species and genotypes or after specific different treatments. Additionally, such data can be examined as a function of time of day.




oni

Neural Stimulation during Drosophila Activity Monitor (DAM)-Based Studies of Sleep and Circadian Rhythms in Drosophila melanogaster

Sleep is a fundamental feature of life for virtually all multicellular animals, but many questions remain about how sleep is regulated by circadian rhythms, homeostatic sleep drive that builds up with wakefulness, and modifying factors such as hunger or social interactions, as well as about the biological functions of sleep. Substantial headway has been made in the study of both circadian rhythms and sleep in the fruit fly Drosophila melanogaster, much of it through studies of individual fly activity using Drosophila activity monitors (DAMs). Here, we describe approaches for the activation of specific neurons of interest using optogenetics (involving genetic modifications that allow for light-based neuronal activation) and thermogenetics (involving genetic modifications that allow for temperature-based neuronal activation) so that researchers can evaluate the roles of those neurons in controlling rest and activity behavior. In this protocol, we describe how to set up a rig for simultaneous optogenetic or thermogenetic stimulation and activity monitoring for analysis of sleep and circadian rhythms in Drosophila, how to raise appropriate flies, and how to perform the experiment. This protocol will allow researchers to assess the causative role in the regulation of sleep and activity rhythms of any genetically tractable subset of cells.




oni

Activity Monitoring for Analysis of Sleep in Drosophila melanogaster

Sleep is important for survival, and the need for sleep is conserved across species. In the past two decades, the fruit fly Drosophila melanogaster has emerged as a promising system in which to study the genetic, neural, and physiological bases of sleep. Through significant advances in our understanding of the regulation of sleep in flies, the field is poised to address several open questions about sleep, such as how the need for sleep is encoded, how molecular regulators of sleep are situated within brain networks, and what the functions of sleep are. Here, we describe key findings, open questions, and commonly used methods that have been used to inform existing theories and develop new ways of thinking about the function, regulation, and adaptability of sleep behavior.




oni

Weight management with orlistat in type 2 diabetes: an electronic health records study

BackgroundOrlistat is recommended as an adjunct to diet and exercise for weight loss in the treatment of type 2 diabetes mellitus (T2DM).AimTo explore associations between patient characteristics and orlistat prescribing, and to determine associations of orlistat with weight loss in T2DM and prediabetes.Design and settingCohort study using anonymised health records from a UK database of general practice.MethodThe UK Clinical Practice Research Datalink (CPRD) Aurum database was searched to compile a cohort of patients aged ≥18 years, first diagnosed with T2DM or prediabetes in 2016 or 2017. Once the data had been collated, multivariable logistic regression models were used to determine associations with starting orlistat and stopping it early (<12 weeks of prescriptions) and orlistat’s associations with weight loss in those who had not been prescribed second-line antidiabetic medications.ResultsOut of 100 552 patients with incident T2DM or prediabetes, 655 (0.8%) patients with T2DM and 128 (0.7%) patients with prediabetes were prescribed orlistat. Younger people, females, those in areas of deprivation, current smokers, those coprescribed metformin, and those recorded as having hypertension were statistically significantly more likely to be prescribed orlistat; higher baseline glycated haemoglobin levels were associated with early stopping. In comparison with patients not on orlistat, those who continued using it for ≥12 weeks were more likely to lose ≥5% weight (adjusted odds ratio [AOR] 1.69, 95% confidence interval [CI] = 1.07 to 2.67) but those who stopped orlistat early were less likely to lose ≥5% weight (AOR 0.56, 95% CI = 0.29 to 1.09).ConclusionOrlistat was significantly associated with weight loss in patients with T2DM and prediabetes when taken for at least 12 weeks; however, it was infrequently prescribed and often taken for <12 weeks. Orlistat may be a useful adjunct to lifestyle modifications for patients with T2DM and prediabetes, but barriers to continued use means it may not be effective for everyone in managing weight loss.




oni

Using the Electronic Health Record to Facilitate Patient-Physician Relationship While Establishing Care [Innovations in Primary Care]




oni

"Steroids in severe community-acquired pneumonia". S. Ananth, A.G. Mathioudakis, J. Hansel. Breathe 2024; 20: 240081.




oni

Steroids in severe community-acquired pneumonia

There is conflicting evidence regarding the use of steroids in severe community-acquired pneumonia (CAP), with previous randomised controlled trials limited by small sample sizes. ESCAPe and CAPE COD are two recently published large trials on steroids in severe CAP. ESCAPe assessed the initiation of methylprednisolone within 72–96 h of hospital admission, while CAPE COD studied the use of hydrocortisone within 24 h of the development of severe CAP. ESCAPe did not show any differences in all-cause 60-day mortality or any of its secondary outcomes. CAPE COD showed that hydrocortisone improved all-cause 28-day mortality and reduced the risk of intubation or vasopressor-dependent shock. Important differences between the trials included the steroid regimens used, timing of steroid administration and baseline characteristics, with more diabetic patients included in ESCAPe. The results of CAPE COD support the initiation of hydrocortisone within 24 h of developing severe CAP, but more research is needed to evaluate long-term outcomes and optimum dosing regimens for steroids in severe CAP.




oni

Controversies in the clinical management of chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis has a range of manifestations from indolent nodules to semi-invasive infection. Patients may be asymptomatic or have chronic symptoms such as cough and weight loss or present with life-threatening haemoptysis. The physician can choose from a range of available therapies including medical therapy with antifungals, minimally invasive therapy with intracavitary antifungal therapy and surgery involving open thoracotomy or video-assisted thoracoscopic surgery. The patients with the most severe forms of pulmonary infection may not be surgical candidates due to their underlying pulmonary condition. The management of haemoptysis can include tranexamic acid, bronchial artery embolisation, antifungals or surgery. There are few controlled studies to inform clinicians managing complex cases, so a multidisciplinary approach may be helpful.




oni

Turnbull calls for electronic voting

ROLLING UPDATES: Australia waited eight days for Malcolm Turnbull to claim election victory and now the PM and Bill Shorten have united in their push for online voting.




oni

RPG Cast – Episode 628: “Air Conditioning for Your Feet”

Josh has a decently sized angry cat burrito. Kelley butters the wolf in Rune Factory. Chris wonders if people have phones. But we all agree the new trend in game graphics should be soulshading.

The post RPG Cast – Episode 628: “Air Conditioning for Your Feet” appeared first on RPGamer.




oni

RPG Cast – Episode 710: “Xenoblade Chronicles X Doesn’t Love You Back”

Robert finds out what Godzilla sushi tastes like. Josh pimps his Segway. Phil has a pictomancer at home. The awards all Chris's fault, because he didn't vote. Also, PoE is to Chris, as CoH is to Phil.

The post RPG Cast – Episode 710: “Xenoblade Chronicles X Doesn’t Love You Back” appeared first on RPGamer.



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oni

San Antonio truck driver pleads guilty in fatal human smuggling case

Police officers work on a crime scene after 10 undocumented immigrants being smuggled into the U.S. were found dead inside a sweltering 18-wheeler trailer parked behind a Walmart store in San Antonio. Photo by Ray Whitehouse/Reuters

A 61-year-old San Antonio man pleaded guilty to two federal charges in the human smuggling incident that led to the deaths of 10 undocumented immigrants this summer.

James Matthew Bradley Jr., who appeared before a U.S. magistrate judge Monday, pleaded guilty to “one count of conspiracy to transport aliens resulting in death and one count of transporting aliens resulting in death,” according to a statement from the U.S. Attorney’s Office for the Western District of Texas.

The office added that Bradley’s “admission of guilt” meant he packed dozens of unauthorized immigrants into a tractor-trailer for financial gain, adding that the suspect confirmed that details from court documents were “factually correct.”

On July 23, San Antonio Police Department officers responded to a call from a Walmart employee shortly past midnight. Once officers arrived, they found 39 immigrants at the scene. Of those carried in the tractor-trailer, eight were found dead in the rear of the trailer, while two died later at nearby hospitals, the statement said.

Survivors of the incident said there was no air conditioning in the overheated trailer and had to take turns to breath through a hole in the back of the truck for air. Bradley also initially told investigators that he was unaware of the immigrants in the trailer until he had stopped at the Walmart in San Antonio for bathroom break.

The attorney’s office also said Bradley faces up to life in prison with the charges and that he is scheduled to be sentenced in January 2018. Immigrants said there were up to 200 people transported on the trailer and that different fees were quoted to them for the ride north from the U.S.-Mexico border, the statement added.

Jason Buch of San Antonio Express-News told the NewsHour earlier this year that Border Patrol agents in Laredo, Texas, reported an uptick of immigrants using tractor-trailers to get pass checkpoints at the border.

“People are usually going on to major metropolitan areas or regions of the country that employ a lot of immigrant laborers, so, areas with large agriculture industries or construction booms,” Buch said.

The NewsHour’s John Yang learned more about the July human smuggling case and immigration politics from Jason Buch of San Antonio Express News.

Shane M. Folden, special agent in charge of homeland security investigations in San Antonio, said in the statement that the proceeding “helps to close the door on one of the conspirators responsible for causing the tragic loss of life and wreaking havoc on those who survived this horrific incident.”

“This case is a glaring reminder that alien smugglers are driven by greed and have little regard for the health and well-being of their human cargo, which can prove to be a deadly combination,” he added.

Bradley’s co-defendant Pedro Silva Segura was also indicted last month with faces two counts of conspiracy and two counts of transporting undocumented immigrants resulting in serious bodily injury and placing lives in jeopardy.

Segura, 47, is an undocumented immigrant who resides in Laredo, Texas.

The post San Antonio truck driver pleads guilty in fatal human smuggling case appeared first on PBS NewsHour.




oni

Musical AI harmonises with your voice in a transcendent new exhibition

What happens if AI is trained to write choral music by feeding it a specially created vocal dataset? Moving new exhibition The Call tackles some thorny questions about AI and creativity – and stirs the soul with music




oni

Germany's Harsh Reckoning Is Also an Opportunity




oni

Oh my pod! Orcas moving en masse near N.L. astonish scientist

Fisheries and Oceans Canada whale researchers recently spotted one of the largest pods of orca whales ever reported off the coast of Newfoundland and Labrador.



  • News/Canada/Nfld. & Labrador

oni

English partnership Matty Lee and Noah Williams win synchronised diving gold at Commonwealth Games

  • Commonwealth Games 2022 schedule: Daily guide plus key events to watch out for
  • Geraint Thomas wins bronze but early crash costs him gold
  • Andrea Spendolini Sirieix wins diving gold with famous father Fred in crowd
  • ]]>




    oni

    BBC Sports Personality of the Year Award 2023: What time does it start tonight and who are nominees?




    oni

    Spike in earthquakes at Washington volcano prompts more monitoring from scientists

    A spike in earthquakes at Mount Adams, a volcano in Washington state, prompted scientists to install additional monitoring instruments to assess the seismic activity.



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    Orionid meteor shower to light up night sky through most of November

    The Orionids meteor shower peaks on Monday, but will continue to light up the sky through Nov. 22, as debris from Halley's Comet enters Earth's atmosphere.



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    oni

    Sweat monitor could reveal when you are exercising too hard

    A band that measures the acidity of sweat could flag if athletes or manual workers are overexerting themselves




    oni

    Chronic fatigue syndrome could be quickly diagnosed via a blood test

    Levels of certain cells, fatty molecules and proteins in the blood are different in people with chronic fatigue syndrome than in those without it, which could help doctors spot the condition sooner




    oni

    War-era sugar rationing boosted health of UK people conceived in 1940s

    People conceived during the UK's 1940s and 50s sugar rationing have a lower risk of type 2 diabetes and high blood pressure than those conceived after rationing ended




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    Trump's first Cabinet picks decidedly not isolationists: Ukraine, Israel breathe a sigh of relief

    Despite his own isolationist musings, the first picks of President-elect Donald Trump's incoming administration hail from a decidedly more traditionalist wing of the Republican Party.



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    Amazon ordered to let workers vote on unionizing -- for the 3rd time

    A federal administrative law judge says Amazon interfered in the last election on unionization at its warehouse in Bessemer, Ala.




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    ‘Mission: Impossible — The Final Reckoning’ trailer: Tom Cruise returns as Ethan Hunt for possible franchise conclusion

    This follow-up to last year’s ‘Mission: Impossible — Dead Reckoning Part One’, which earned over $571 million globally, is expected to draw blockbuster attention as one of the summer’s biggest releases




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    Avneet Kaur meets Tom Cruise on set of ‘Mission: Impossible — The Final Reckoning’

    Although Avneet hasn’t confirmed any involvement in the film, fans are hopeful this could mark her Hollywood debut, following in the footsteps of Anil Kapoor, who appeared in ‘Mission: Impossible — Ghost Protocol’ in 2011




    oni

    Muzaffar Ali interview: On reviving ‘Zooni’ with son Shaad Ali and his enduring love for horses

    The ‘Umrao Jaan’ director speaks about reviving his passion project ‘Zooni,’ which was shelved in 1989 due to the insurgency in Kashmir, and his artwork of the Kashmiri muse that evolved out of the sketches he made for the Dimple Kapadia-starrer




    oni

    ‘Victory Heat Rally’ From Skydevilpalm and Playtonic Friends Is Coming to PC and Crunchyroll for Mobile on October 3rd

    Playtonic Friends just announced that Victory Heat Rally from developer Skydevilpalm is coming to mobile through Crunchyroll and also on …




    oni

    Friends burn to death in TESLA as electronic doors wouldn't open after crash...


    Friends burn to death in TESLA as electronic doors wouldn't open after crash...


    (First column, 15th story, link)


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    oni

    Sydney’s iconic City Gym gets $1.5 million makeover

    Sydney’s iconic City Gym in Darlinghurst is open for business after a $1.5 million renovation. The gym, which opened in 1978—the same year the Sydney Gay and Lesbian Mardi Gras ...

    The post Sydney’s iconic City Gym gets $1.5 million makeover appeared first on Star Observer.




    oni

    NISAR satellite to offer precise monitoring of Earth's surface movements

    Los Angeles CA (SPX) Nov 09, 2024
    Data from NISAR will improve our understanding of such phenomena as earthquakes, volcanoes, and landslides, as well as damage to infrastructure. Earth's surface is in a state of continuous motion, although often unnoticed. Scientists have utilized satellite and ground-based technology to observe movements linked to geological events such as earthquakes, landslides, and volcanic activity. A




    oni

    Joni Mitchell's 25 greatest songs, ranked

    In honour of the icon's 81st birthday, we're celebrating the best music she's made — so far.




    oni

    Le stress chronique affaiblit le système immunitaire

    Une étude rapporte que la perturbation de l’équilibre du microbiote intestinal par le stress dérègle la fonction des cellules immunitaires.




    oni

    Vivre avec la dystonie cervicale

    Quand Chantale Boivin a ressenti les premiers symptômes d’une dystonie cervicale, elle s’est dit que ses torticolis à répétition étaient dus au stress




    oni

    SEC recommends marketing approval for Dr Reddy's SPMS drug Siponimod tablets

    The Subject Expert Committee (SEC), which advises the national drug regulator on approval of new drugs and clinical trials, has recommended grant of market authorisation for Dr Reddy's Laboratories' Siponimod




    oni

    Best Practices for Successfully Transitioning a Patient Services Hub

    Today’s guest post comes from Josh Marsh, Vice President and General Manager, Sonexus™ Access and Patient Support at Cardinal Health

    Josh discusses challenges manufacturers may face when outsourcing patient support programs. He outlines a process that smoothly transitions hubs and minimizes disruptions for patients and healthcare providers.

    To learn more, download the 3-step guide to patient hub transitions.

    Read on for Josh’s insights.
    Read more »
           




    oni

    FTC Announces Final Rule to Prohibit Deceptive Online Reviews and Testimonials

    Effective on October 21st of this year, the Federal Trade Commission (FTC) issued a new final rule that is intended to better combat ​“fake” reviews and testimonials by prohibiting the sale or purchase of “fake reviews” as well as granting the agency the opportunity to seek civil penalties against ​willful violators. The FTC made only […]




    oni

    Chronic itch is miserable. Scientists are just scratching the surface

    Journalist Annie Lowrey has a rare disease that causes a near-constant itch that doesn't respond to most treatments. She likens the itchiness to a car alarm: "You can't stop thinking about it."




    oni

    Sea Turtle Ears Inspire a New Heart Monitor Design



    This article is part of our exclusive IEEE Journal Watch series in partnership with IEEE Xplore.

    Sea turtles are remarkable creatures for a number of reasons, including the way they hear underwater—not through openings in the form of ears, but by detecting vibrations directly through the skin covering their auditory system. Inspired by this ability to detect sound through skin, researchers in China have created a heart-monitoring system, which initial tests in humans suggest may be a viable for monitoring heartbeats.

    A key way in which doctors monitor heart health involves “listening” to the heartbeat, either using a stethoscope or more sophisticated technology, like echocardiograms. However, these approaches require a visit to a specialist, and so researchers have been keen to develop alternative, lower cost solutions that people can use at home, which could also allow for more frequent testing and monitoring.

    Junbin Zang, a lecturer at the North University of China, and his colleagues specialize in creating heart-monitoring technologies. Their interest was piqued when they learned about the inner workings of the sea turtle’s auditory system, which is able to detect low-frequency signals, especially in the 300- to 400-hertz range.

    “Heart sounds are also low-frequency signals, so the low-frequency characteristics of the sea turtle’s ear have provided us with great inspiration,” explains Zang.

    At a glance, it looks like turtles don’t have ears. Their auditory system instead lies under a layer of skin and fat, through which it picks up vibrations. As with humans, a small bone in the ear vibrates as sounds hit it, and as it oscillates, those pulses are converted to electrical signals that are sent to the brain for processing and interpretation.

    iStock

    But sea turtles have a unique, slender T-shaped conduit that encapsulates their ear bones, restricting the movement of the similarly T-shaped ear bones to only vibrate in a perpendicular manner. This design provides their auditory system with high sensitivity to vibrations.

    Zang and his colleagues set out to create a heart monitoring system with similar features. They created a T-shaped heart-sound sensor that imitates the ear bones of sea turtles using a tiny MEMS cantilever beam sensor. As sound hits the sensor, the vibrations cause deformations in its beam, and the fluctuations in the voltage resistance are then translated into electrical signals.

    The researchers first tested the sensor’s ability to detect sound in lab tests, and then tested the sensor’s ability to monitor heartbeats in two human volunteers in their early 20s. The results, described in a study published 1 April in IEEE Sensors Journal, show that the sensor can effectively detect the two phases of a heartbeat.

    “The sensor exhibits excellent vibration characteristics,” Zang says, noting that it has a higher vibration sensitivity compared to other accelerometers on the market.

    However, the sensor currently picks up a significant amount of background noise, which Zang says his team plans to address in future work. Ultimately, they are interested in integrating this novel bioinspired sensor into devices they have previously created—including portable handheld and wearable versions, and a relatively larger version for use in hospitals—for the simultaneous detection of electrocardiogram and phonocardiogram signals.

    This article appears in the July 2024 print issue as “Sea Turtles Inspire Heart-Monitor Design.”




    oni

    Noninvasive Spinal Stimulation Gets a (Current) Boost



    In 2010, Melanie Reid fell off a horse and was paralyzed below the shoulders.

    “You think, ‘I am where I am; nothing’s going to change,’ ” she said, but many years after her accident, she participated in a medical trial of a new, noninvasive rehabilitative device that can deliver more electrical stimulation than similar devices without harming the user. For Reid, use of the device has led to small improvements in her ability to use her hands, and meaningful changes to her daily life.

    “Everyone thinks with spinal injury all you want to do is be able to walk again, but if you’re a tetraplegic or quadriplegic, what matters most is working hands,” said Reid, a columnist for The Times, as part of a press briefing. “There’s no miracles in spinal injury, but tiny gains can be life-changing.”

    For the study, Reid used a new noninvasive therapeutic device produced by Onward Medical. The device, ARC-EX (“EX” indicating “external”), uses electrodes placed along the spine near the site of injury—in the case of quadriplegia, the neck—to promote nerve activity and growth during physical-therapy exercises. The goal is to not only increase motor function while the device is attached and operating, but the long-term effectiveness of rehabilitation drills. A study focused on arm and hand abilities in patients with quadriplegia was published 20 May in Nature Medicine.

    Researchers have been investigating electrical stimulation as a treatment for spinal cord injury for roughly 40 years, but “one of the innovations in this system is using a very high-frequency waveform,” said coauthor Chet Moritz, a neurotechnologist at the University of Washington. The ARC-EX uses a 10-kilohertz carrier frequency overlay, which researchers think may numb the skin beneath the electrode, allowing patients to tolerate five times as much amperage as from similar exploratory devices. For Reid, this manifested as a noticeable “buzz,” which felt strange, but not painful.

    The study included 60 participants across 14 sites around the world. Each participant undertook two months of standard physical therapy, followed by two months of therapy combined with the ARC-EX. Although aspects of treatment such as electrode placement were fairly standardized, the current amplitude was personalized to each patient, and sometimes individual exercises, said Moritz.

    The ARC-EX uses a 10-kilohertz current to provider stronger stimulation for people with spinal cord injuries.

    Over 70 percent of patients showed an increase in at least one measurement of both strength and function between standard therapy and ARC-EX therapy. These changes also meant that 87 percent of study participants noted some improvement in quality of life in a followup questionnaire. No major safety concerns tied to the device or rehabilitation process were reported.

    Onward will seek approval from the U.S. Food and Drug Administration for the device by the end of 2024, said study coauthor Grégoire Courtine, a neuroscientist and cofounder of Onward Medical. Onward is also working on an implantable spinal stimulator called ARC-IM; other prosthetic approaches, such as robotic exoskeletons, are being investigated elsewhere. ARC-EX was presented as a potentially important cost-accessible, noninvasive treatment option, especially in the critical window for recovery a year or so after a spinal cord injury. However, the price to insurers or patients of a commercial version is still subject to negotiation.

    The World Health Organization says there are over 15 million people with spinal cord injuries. Moritz estimates that around 90 percent of patients, even many with no movement in their hands, could benefit from the new therapy.

    Dimitry Sayenko, who studies spinal cord injury recovery at Houston Methodist and was not involved in the study, praised the relatively large sample size and clear concern for patient safety. But he stresses that the mechanisms underlying spinal stimulation are not well understood. “So far it’s literally plug and play,” said Sayenko. “We don’t understand what’s happening under the electrodes for sure—we can only indirectly assume or speculate.”

    The new study supports the idea that noninvasive spinal cord stimulation can provide some benefit to some people but was not designed to help predict who will benefit, precisely how people will benefit, or how to optimize care. The study authors acknowledged the limited scope and need for further research, which might help turn currently “tiny gains” into what Sayenko calls “larger, more dramatic, robust effects.”




    oni

    Bionic Eye Gets a New Lease on Life



    The future of an innovative retinal implant and dozens of its users just got brighter, after Science, a bioelectronics startup run by Neuralink’s cofounder, Max Hodak, acquired Pixium’s technology at the last minute.

    Pixium Vision, whose Prima system to tackle vision loss is implanted in 47 people across Europe and the United States, was in danger of disappearing completely until Science stepped in to buy the French company’s assets in April, for an undisclosed amount.

    Pixium has been developing Prima for a decade, building on work by Daniel Palanker, a professor of ophthalmology at Stanford University. The 2-by-2-millimeter square implant is surgically implanted under the retina, where it turns infrared data from camera-equipped glasses into pulses of electricity. These replace signals generated by photoreceptor rods and cones, which are damaged in people suffering from age-related macular degeneration (AMD).

    Early feasibility studies in the E.U. and the United States suggested Prima was safe and potentially effective, but Pixium ran out of money last November before the final results of a larger, multiyear pivotal trial in Europe.

    “It’s very important to us to avoid another debacle like Argus II.”

    With the financial and legal clock ticking down, the trial data finally arrived in March this year. “And the results from that were just pretty stunning,” says Max Hodak, Science’s founder and CEO, in his first interview since the acquisition.

    Although neither Pixium nor Science has yet released the full dataset, Hodak shared with IEEE Spectrum videos of three people using Prima, each of them previously unable to read or recognize faces due to AMD. The videos show them slowly but fluently reading a hardback book, filling in a crossword puzzle, and playing cards.

    “This is legit ‘form vision’ that I don’t think any device has ever done,” says Hodak. Form vision is the ability to recognize visual elements as parts of a larger object. “It’s this type of data that convinced us. And from there we were like, this should get to patients.”

    As well as buying the Prima technology, Hodak says that Science will hire the majority of Pixium’s 35 engineering and regulatory staff, in a push to get the technology approved in Europe as quickly as possible.

    The Prima implant receives visual data and is powered by near-infrared signals beamed from special spectacles.Pixium

    Another priority is supporting existing Prima patients, says Lloyd Diamond, Pixium’s outgoing CEO. “It’s very important to us to avoid another debacle like Argus II,” he says, referring to another retinal implant whose manufacturer went out of business in 2022, leaving users literally in the dark.

    Diamond is excited to be working with Science, which is based in Silicon Valley with a chip foundry in North Carolina. “They have a very deep workforce in software development, in electronic development, and in biologic research,” he says. “And there are probably only a few foundries in the world that could manufacture an implant such as ours. Being able to internalize part of that process is a very big advantage.”

    Hodak hopes that a first-generation Prima product could quickly be upgraded with a wide-angle camera and the latest electronics. “We think that there’s one straight shrink, where we’ll move to smaller pixels and get higher visual acuity,” he says. “After that, we’ll probably move to a 3D electrode design, where we’ll be able to get closer to single-cell resolution.” That could deliver even sharper artificial vision.

    In parallel, Science will continue Pixium’s discussions with the FDA in the United States about advancing a clinical trial there.

    The success of Prima is critical, says Hodak, who started Science in 2021 after leaving Neuralink, a brain-computer interface company he cofounded with Elon Musk. “Elon can do whatever he wants for as long as he wants, but we need something that can finance future development,” he says. “Prima is big enough in terms of impact to patients and society that it is capable of helping us finance the rest of our ambitions.”

    These include a next-generation Prima device, which Hodak says he is already talking about with Palanker, and a second visual prosthesis, currently called the Science Eye. This will tackle retinitis pigmentosa, a condition affecting peripheral vision—the same condition targeted by Second Sight’s ill-fated Argus II device.

    “The Argus II just didn’t work that well,” says Hodak. “In the end, it was a pure bridge to nowhere.” Like the Argus II and Prima, the Science Eye relies on camera glasses and an implant, but with the addition of optogenetic therapy. This uses a genetically engineered virus to deliver a gene to specific optic nerve cells in the retina, making them light-sensitive at a particular wavelength. A tiny implanted display with a resolution sharper than an iPhone screen then enables fine control over the newly sensitized cells.

    That system is still undergoing animal trials, but Hodak is almost ready to pull the trigger on its first human clinical studies, likely in Australia and New Zealand.

    “In the long term, I think precision optogenetics will be more powerful than Prima’s electrical stimulation,” he says. “But we’re agnostic about which approach works to restore vision.”

    One thing he does believe vehemently, unlike Musk, is that the retina is the best place to put an implant. Neuralink and Cortigent (the successor company of Second Sight) are both working on prosthetics that target the brain’s visual cortex.

    “There’s a lot that you can do in cortex, but vision is not one of them,” says Hodak. He thinks the visual cortex is too complex, too distributed, and too difficult to access surgically to be useful.

    “As long as the optic nerve is intact, the retina is the ideal place to think about restoring vision to the brain,” he says. “This is all a question of effect size. If someone has been in darkness for a decade, with no light, no perception, and you can give them any type of visual stimulus, they’re going to be into it. The Pixium patients can intuitively read, and that was really what convinced us that this was worth picking up and pursuing.”




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    Microneedle Glucose Sensors Keep Monitoring Skin-Deep



    For people with diabetes, glucose monitors are a valuable tool to monitor their blood sugar. The current generation of these biosensors detect glucose levels with thin, metallic filaments inserted in subcutaneous tissue, the deepest layer of the skin where most body fat is stored.

    Medical technology company Biolinq is developing a new type of glucose sensor that doesn’t go deeper than the dermis, the middle layer of skin that sits above the subcutaneous tissue. The company’s “intradermal” biosensors take advantage of metabolic activity in shallower layers of skin, using an array of electrochemical microsensors to measure glucose—and other chemicals in the body—just beneath the skin’s surface.

    Biolinq just concluded a pivotal clinical trial earlier this month, according to CEO Rich Yang, and the company plans to submit the device to the U.S. Food and Drug Administration for approval at the end of the year. In April, Biolinq received US $58 million in funding to support the completion of its clinical trials and subsequent submission to the FDA.

    Biolinq’s glucose sensor is “the world’s first intradermal sensor that is completely autonomous,” Yang says. While other glucose monitors require a smartphone or other reader to collect and display the data, Biolinq’s includes an LED display to show when the user’s glucose is within a healthy range (indicated by a blue light) or above that range (yellow light). “We’re providing real-time feedback for people who otherwise could not see or feel their symptoms,” Yang says. (In addition to this real-time feedback, the user can also load long-term data onto a smartphone by placing it next to the sensor, like Abbott’s FreeStyle Libre, another glucose monitor.)

    More than 2,000 microsensor components are etched onto each 200-millimeter silicon wafer used to manufacture the biosensors.Biolinq

    Biolinq’s hope is that its approach could lead to sustainable changes in behavior on the part of the individual using the sensor. The device is intentionally placed on the upper forearm to be in plain sight, so users can receive immediate feedback without manually checking a reader. “If you drink a glass of orange juice or soda, you’ll see this go from blue to yellow,” Yang explains. That could help users better understand how their actions—such as drinking a sugary beverage—change their blood sugar and take steps to reduce that effect.

    Biolinq’s device consists of an array of microneedles etched onto a silicon wafer using semiconductor manufacturing. (Other glucose sensors’ filaments are inserted with an introducer needle.) Each chip has a small 2-millimeter by 2-millimeter footprint and contains seven independent microneedles, which are coated with membranes through a process similar to electroplating in jewelry making. One challenge the industry has faced is ensuring that microsensors do not break at this small scale. The key engineering insight Biolinq introduced, Yang says, was using semiconductor manufacturing to build the biosensors. Importantly, he says, silicon “is harder than titanium and steel at this scale.”

    Miniaturization allows for sensing closer to the surface of the skin, where there is a high level of metabolic activity. That makes the shallow depth ideal for monitoring glucose, as well as other important biomarkers, Yang says. Due to this versatility, combined with the use of a sensor array, the device in development can also monitor lactate, an important indicator of muscle fatigue. With the addition of a third data point, ketones (which are produced when the body burns fat), Biolinq aims to “essentially have a metabolic panel on one chip,” Yang says.

    Using an array of sensors also creates redundancy, improving the reliability of the device if one sensor fails or becomes less accurate. Glucose monitors tend to drift over the course of wear, but with multiple sensors, Yang says that drift can be better managed.

    One downside to the autonomous display is the drain on battery life, Yang says. The battery life limits the biosensor’s wear time to 5 days in the first-generation device. Biolinq aims to extend that to 10 days of continuous wear in its second generation, which is currently in development, by using a custom chip optimized for low-power consumption rather than off-the-shelf components.

    The company has collected nearly 1 million hours of human performance data, along with comparators including commercial glucose monitors and venous blood samples, Yang says. Biolinq aims to gain FDA approval first for use in people with type 2 diabetes not using insulin and later expand to other medical indications.

    This article appears in the August 2024 print issue as “Glucose Monitor Takes Page From Chipmaking.”




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    The Best Bionic Leg Yet



    For the first time, a small group of patients with amputations below the knee were able to control the movements of their prosthetic legs through neural signals—rather than relying on programmed cycles for all or part of a motion—and resume walking with a natural gait. The achievement required a specialized amputation surgery combined with a non-invasive surface electrode connection to a robotic prosthetic lower leg. A study describing the technologies was published today in the journal Nature Medicine.

    “What happens then is quite miraculous. The patients that have this neural interface are able to walk at normal speeds; and up and down steps and slopes; and maneuver obstacles really without thinking about it. It’s natural. It’s involuntary,” said co-author Hugh Herr, who develops bionic prosthetics at the MIT Media Lab. “Even though their limb is made of titanium and silicone—all these various electromechanical components—the limb feels natural and it moves naturally, even without conscious thought.”

    The approach relies on surgery at the amputation site to create what the researchers call an agonist-antagonist myoneural Interface, or AMI. The procedure involves connecting pairs of muscles (in the case of below-the-knee amputation, two pairs), as well as the introduction of proprietary synthetic elements.

    The interface creates a two-way connection between body and machine. Muscle-sensing electrodes send signals to a small computer in the prosthetic limb that interprets them as angles and forces for joints at the ankle and ball of the foot. It also sends information back about the position of the artificial leg, restoring a sense of where the limb is in space, also known as proprioception.

    Video 1 www.youtube.com

    “The particular mode of control is far beyond what anybody else has come up with,” said Daniel Ferris, a neuromechanical engineer at the University of Florida; Ferris was not involved in the study, but has worked on neural interfaces for controlling lower limb prostheses. “It’s a really novel idea that they’ve built on over the last eight years that’s showing really positive outcomes for better bionic lower legs.” The latest publication is notable for a larger participant pool than previous studies, with seven treatment patients and seven control patients with amputations and typical prosthetic legs.

    To test the bionic legs, patients were asked to walk on level ground at different speeds; up and down slopes and stairs; and to maneuver around obstacles. The AMI users had a more natural gait, more closely resembling movement by someone using a natural limb. More naturalistic motion can improve freedom of movement, particularly over challenging terrain, but in other studies researchers have also noted reduced energetic costs, reduced stress on the body, and even social benefits for some amputees.

    Co-author Hyungeun Song, a postdoctoral researcher at MIT, says the group was surprised by the efficiency of the bionic setup. The prosthetic interface sent just 18 percent of the typical amount of information that’s sent from a limb to the spine, yet it was enough to allow patients to walk with what was considered a normal gait.

    Next Steps for the Bionic Leg

    AMI amputations have now become the standard at Brigham and Women’s Hospital in Massachusetts, where co-author Matthew Carty works. And because of patient benefits in terms of pain and ease of using even passive (or non-robotic) prosthetics, this technique—or something similar—could spread well beyond the current research setting. To date, roughly 60 people worldwide have received AMI surgery above or below either an elbow or knee.

    In principle, Herr said, someone with a previously amputated limb, such as himself, could undergo AMI rehabilitation, and he is strongly considering the procedure. More than 2 million Americans are currently living with a lost limb, according to the Amputee Coalition, and nearly 200,000 lower legs are amputated each year in the United States.

    On the robotics side, there are already commercial leg prosthetics that could be made compatible with the neural interface. The area in greatest need of development is the connection between amputation site and prosthesis. Herr says commercialization of that interface might be around five years away.

    Herr says his long-term goal is neural integration and embodiment: the sense that a prosthetic is part of the body, rather than a tool. The new study “is a critical step forward—pun intended.”




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    This Eyewear Offers a Buckshot Method to Monitor Health



    Emteq Labs wants eyewear to be the next frontier of wearable health technology.

    The Brighton, England-based company introduced today its emotion-sensing eyewear, Sense. The glasses contain nine optical sensors distributed across the rims that detect subtle changes in facial expression with more than 93 percent accuracy when paired with Emteq’s current software. “If your face moves, we can capture it,” says Steen Strand, whose appointment as Emteq’s new CEO was also announced today. With that detailed data, “you can really start to decode all kinds of things.” The continuous data could help people uncover patterns in their behavior and mood, similar to an activity or sleep tracker.

    Emteq is now aiming to take its tech out of laboratory settings with real-world applications. The company is currently producing a small number of Sense glasses, and they’ll be available to commercial partners in December.

    The announcement comes just weeks after Meta and Snap each unveiled augmented reality glasses that remain in development. These glasses are “far from ready,” says Strand, who led the augmented reality eyewear division while working at Snap from 2018 to 2022. “In the meantime, we can serve up lightweight eyewear that we believe can deliver some really cool health benefits.”

    Fly Vision Vectors

    While current augmented reality (AR) headsets have large battery packs to power the devices, glasses require a lightweight design. “Every little bit of power, every bit of weight, becomes critically important,” says Strand. The current version of Sense weighs 62 grams, slightly heavier than the Ray-Ban Meta smart glasses, which weigh in at about 50 grams.

    Because of the weight constraints, Emteq couldn’t use the power-hungry cameras typically used in headsets. With cameras, motion is detected by looking at how pixels change between consecutive images. The method is effective, but captures a lot of redundant information and uses more power. The eyewear’s engineers instead opted for optical sensors that efficiently capture vectors when points on the face move due to the underlying muscles. These sensors were inspired by the efficiency of fly vision. “Flies are incredibly efficient at measuring motion,” says Emteq founder and CSO Charles Nduka. “That’s why you can’t swat the bloody things. They have a very high sample rate internally.”

    Sense glasses can capture data as often as 6,000 times per second. The vector-based approach also adds a third dimension to a typical camera’s 2D view of pixels in a single plane.

    These sensors look for activation of facial muscles, and the area around the eyes is an ideal spot. While it’s easy to suppress or force a smile, the upper half of our face tends to have more involuntary responses, explains Nduka, who also works as a plastic surgeon in the United Kingdom. However, the glasses can also collect information about the mouth by monitoring the cheek muscles that control jaw movements, conveniently located near the lower rim of a pair of glasses. The data collected is then transmitted from the glasses to pass through Emteq’s algorithms in order to translate the vector data into usable information.

    In addition to interpreting facial expressions, Sense can be used to track food intake, an application discovered by accident when one of Emteq’s developers was wearing the glasses while eating breakfast. By monitoring jaw movement, the glasses detect when a user chews and how quickly they eat. Meanwhile, a downward-facing camera takes a photo to log the food, and uses a large language model to determine what’s in the photo, effectively making food logging a passive activity. Currently, Emteq is using an instance of OpenAI’s GPT-4 large language model to accomplish this, but the company has plans to create their own algorithm in the future. Other applications, including monitoring physical activity and posture, are also in development.

    One Platform, Many Uses

    Nduka believes Emteq’s glasses represent a “fundamental technology,” similar to how the accelerometer is used for a host of applications in smartphones, including managing screen orientation, tracking activity, and even revealing infrastructure damage.

    Similarly, Emteq has chosen to develop the technology as a general facial data platform for a range of uses. “If we went deep on just one, it means that all the other opportunities that can be helped—especially some of those rarer use cases—they’d all be delayed,” says Nduka. For example, Nduka is passionate about developing a tool to help those with facial paralysis. But a specialized device for those patients would have high unit costs and be unaffordable for the target user. Allowing more companies to use Emteq’s intellectual property and algorithms will bring down cost.

    In this buckshot approach, the general target for Sense’s potential use cases is health applications. “If you look at the history of wearables, health has been the primary driver,” says Strand. The same may be true for eyewear, and he says there’s potential for diet and emotional data to be “the next pillar of health” after sleep and physical activity.

    How the data is delivered is still to be determined. In some applications, it could be used to provide real-time feedback—for instance, vibrating to remind the user to slow down eating. Or, it could be used by health professionals only to collect a week’s worth of at-home data for patients with mental health conditions, which Nduka notes largely lack objective measures. (As a medical device for treatment of diagnosed conditions, Sense would have to go through a more intensive regulatory process.) While some users are hungry for more data, others may require a “much more gentle, qualitative approach,” says Strand. Emteq plans to work with expert providers to appropriately package information for users.

    Interpreting the data must be done with care, says Vivian Genaro Motti, an associate professor at George Mason University who leads the Human-Centric Design Lab. What expressions mean may vary based on cultural and demographic factors, and “we need to take into account that people sometimes respond to emotions in different ways,” Motti says. With little regulation of wearable devices, she says it’s also important to ensure privacy and protect user data. But Motti raises these concerns because there is a promising potential for the device. “If this is widespread, it’s important that we think carefully about the implications.”

    Privacy is also a concern to Edward Savonov, a professor of electrical and computer engineering at the University of Alabama, who developed a similar device for dietary tracking in his lab. Having a camera mounted on Emteq’s glasses could pose issues, both for the privacy of those around a user and a user’s own personal information. Many people eat in front of their computer or cell phone, so sensitive data may be in view.

    For technology like Sense to be adopted, Sazonov says questions about usability and privacy concerns must first be answered. “Eyewear-based technology has potential for a great future—if we get it right.”