Day: 12/22/2022

Emerging Research Identifies Powerful Food for Remedying Type 1 Diabetes

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We’ve known for a while that diet can help improve type 2 diabetes, but it’s rare to find an intervention for type 1 diabetes

Emerging Research Identifies Powerful Food for Remedying Type 1 Diabetes

In recent years, more and more studies have found that there is a vegetable that contains hundreds of active substances with unique effects that can alleviate the symptoms of both type I and II diabetic patients and also benefit the glucose metabolism of healthy people: This food is bitter melon.

According to the International Diabetes Federation, there were 537 million people with diabetes and 6.7 million diabetes-related deaths worldwide in 2021. This is equivalent to one person dying every five seconds due to diabetes.

In addition, 541 million adults worldwide have impaired glucose tolerance (IGT) and are at high risk of developing type II diabetes. The number of people with diabetes is expected to rise to 643 million by 2030 and to 783 million by 2045.

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Diabetes is a chronic disease that can gradually damage the heart, blood vessels, eyes, nerves, and musculoskeletal system, and it is a major cause of kidney failure and blindness.

Diabetes is generally divided into four categories: type I diabetes, type II diabetes, gestational diabetes, and other specific types of diabetes.

Under normal circumstances, cells can absorb sugar and convert it into energy under the “command” of insulin.

In type I diabetes, the insulin-producing beta cells in the pancreas are damaged for various reasons, resulting in a reduced ability to secrete insulin. Since the body lacks insulin, people with type I diabetes have symptoms of high blood sugar and need to inject insulin into their bodies.

Type II diabetic patients mainly have insulin resistance. Their pancreas can produce insulin normally, but the body is insensitive to insulin. Even if the insulin level is sufficient, or even very high, the cells do not receive sufficient instructions to absorb sugar, so the blood sugar does not drop properly. These patients usually need oral hypoglycemic drugs to lower their blood sugar.

Bitter Melon Has a Wide Range of Therapeutic Effects, and Its Anti-Diabetic Effect Has Attracted Attention

In addition to medication, diet and lifestyle management are also important aspects for diabetes treatment. People have also been looking for natural plants that have curative effects on diabetes.

Bitter melon is one of the most prominent of these plants.

Although bitter melon has a peculiar bitter taste, it is still a popular vegetable around the world, often found in farmers’ markets and supermarkets. This is in part because people love the many benefits of this bitter-tasting vegetable and that it has some properties that other vegetables may not have.

The entire plant, especially its seeds and fruits, have been used for thousands of years for healing purposes. As a folk medicine, bitter melon is widely used—it is used to treat toothache, diarrhea, boils, and worms. It’s also antimalarial, and a laxative. It is also used to treat dysmenorrhea, eczema, gout, jaundice, leprosy, hemorrhoids, pneumonia, psoriasis, rheumatism, and scabies. Some people also use it for contraception purposes.

Bitter melon has more than 225 medicinal ingredients and contains many beneficial components.

Besides polysaccharides, proteins, peptides, and lipids, bitter melon also contains triterpenoids, saponins, flavonoids, alkaloids, and sterols. These substances have anticancer, antioxidant, anti-inflammatory, antiviral, antibacterial, immune-enhancing, and/or antidiabetic effects.

The anti-diabetic effect of bitter melon is gaining attention and further research worldwide. A search on PubMed, a biomedical literature engine, by using “bitter melon and diabetes” as the keyword showed that the research results published had been increasing in recent years.

These studies show that bitter melon can alleviate and treat type I and type II diabetes to a certain extent. The anti-diabetic effect of bitter melon is achieved by regulating the function of the pancreas and by modulating mechanisms outside of the pancreas.

Bitter Melon Helps Relieve Type I Diabetes by Stimulating Insulin Secretion

1. Components in bitter melon stimulate insulin secretion

Some components in bitter melon, such as bitter melon saponins and bitter melon polysaccharide-chromium complex, can promote insulin secretion from the pancreas.

Bitter melon extract can also stimulate the secretion of an enzyme in the intestine, which can contribute to the proliferation of islet cells and the secretion of insulin. Islet cells are cells in the pancreas that produce hormones like insulin and glucagon.

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2. Bitter melon components can protect islet cells from damage

Triterpenoids and polysaccharides in bitter melon can protect the activity of pancreatic cells from damage, especially oxidative damage.

Researchers have treated pancreatic cells with sugar and then added aqueous extract of bitter melon and found that the aqueous extract of bitter melon was effective in ensuring the survival of pancreatic cells within a certain time frame, compared to the control group without the addition of this substance.

The components in bitter melon can protect the β-cells in the pancreas by down-regulating the activity of some enzymes. Excessive glucocorticoids can damage the β-cells in the pancreas, but bitter melon extract can regulate this hormone, thereby protecting the pancreas and ensuring the secretion of insulin.

3. Bitter melon components promote the repair of pancreatic cells

Bitter melon extract can promote the regeneration of damaged pancreatic cells and restore their number; and oral intake of bitter melon juice can improve the condition and function of the pancreas.

Bitter melon extract can also increase the number and volume of β-cells in the pancreas, thus making the amount of insulin secreted comparable to that of the non-diabetic group.

Bitter melon powder can significantly increase the expression of a gene that regulates the development of the pancreas and stimulates the growth of β-cells in the pancreas.

In addition, animal experiments (pdf) have shown that feeding bitter melon juice to rats with type I diabetes has a good effect on their blood glucose and lipid control.

Bitter Melon Can Alleviate Type II Diabetes by Improving Insulin Resistance

Bitter melon can improve insulin resistance by reducing glucose production by the liver, promoting glucose uptake by muscle cells and fat cells, and promoting insulin secretion to lower excessive insulin levels in the blood.

First, several glycosides, polypeptides, and polysaccharides in bitter melon can lower blood glucose.

Second, triterpenoids in bitter melon, such as bitter melon glycosides, and some proteins and peptides can increase the uptake, consumption, and utilization of glucose by cells. Some can be achieved by cooperating with insulin, and some can act independently of insulin.

Third, the bitter melon glucoside and charantin can inhibit the action of some enzymes and delay the absorption of sugar. In addition, the rich fiber of bitter melon can also slow down the absorption of glucose.

Fourth, bitter melon can inhibit the production of glucose by liver cells, as well as inhibit gluconeogenesis (creating glucose from non-carbs) in the liver.

Fifth, bitter melon can inhibit enzymes related to islet resistance, thus regulating insulin resistance.

Sixth, bitter melon contains antioxidant and anti-inflammatory agents that reduce insulin resistance and control the onset and development of diabetes.

Bitter Melon Has a Glucose-Lowering Effect and Cardiovascular Protection Function

There have been some small clinical trials on the consumption of bitter melon, which showed similar effects to those of hypoglycemic drugs.

In India, a group of patients with type II diabetes who had their oral hypoglycemic medication reduced by half and took bitter melon extract had a greater hypoglycemic effect after secen days than a control group taking a full dose of hypoglycemic medication.

In 100 patients with moderate non-insulin-dependent diabetes (NIDDM) who consumed bitter melon juice, 86 percent of them showed significant reductions in both fasting and postprandial serum glucose levels, and another 5 percent showed reductions in fasting serum glucose.

Another randomized controlled trial in non-insulin-dependent diabetics showed that the effects of taking bitter melon extract were similar to those achieved with the antidiabetic drug rosiglitazone.

Another common glucose-lowering drug is metformin. In a four-week double-blind randomized controlled trial, researchers evaluated the efficacy of bitter melon and metformin in patients with newly diagnosed type II diabetes and concluded that bitter melon had a modest hypoglycemic effect compared to the drug, a conclusion similar to that of another controlled trial using bitter melon and glibenclamide in 2015.

Moreover, a 2015 experiment published in Nutrition Journal further found that triglyceride and total cholesterol levels were significantly lower in those using bitter melon, while blood lipids increased in those taking the drug.

Epoch Times Photo
Epoch Times Photo

This indicates that bitter melon has a comprehensive effect on diabetics in terms of lipid regulation and metabolism, in addition to lowering sugar. Moreover, bitter melon is a natural food, which can avoid some side effects and harm of drugs to the body.

2 Types of People Need to Take Extra Caution

The bitter melon is a valuable vegetable, but some people need to take extra care when eating it.

Given the hypoglycemic effect of bitter melon, it is best not to ingest bitter melons on an empty stomach.

Moreover, bitter melon has been used in some traditional medicine for abortion and contraception.

Studies have shown that bitter melon may have a risk of miscarriage and congenital malformation (pdf). Bitter melon also causes a significant decrease in estrogen and progesterone levels, showing anti-fertility and anti-sperm effects. Therefore, bitter melon should be used with caution in diabetic patients who are planning to get or are already pregnant.

It has also been suggested by researchers that removing the seeds when consuming the fresh fruit of bitter melon may reduce the risk of some adverse events.

Aqueous extracts of bitter melon have been found to be more effective in treating diabetes than dried powder. This may be due to the loss and or inactivation of some active ingredients as a result of drying and further processing of the powder. Freeze-dried extracts of bitter melon juice have been used in some human studies because of the relatively good preservation of their biological activity and the ease of handling.

When choosing to acquire the beneficial components of bitter melon through supplements, a daily intake of 3 mg cucurbitane-type triterpenoids may be a reasonable amount, which is the average intake amount of many bitter melon supplementation products.

The Pandemic, Alcohol, and Your Liver

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More than half of the 2020 deaths caused by alcohol were from alcoholic liver disease.(Explode/Shutterstock)

More than half of the 2020 deaths caused by alcohol were from alcoholic liver disease.(Explode/Shutterstock)

Data released by the Centers for Disease Control and Prevention (CDC) suggests that deaths caused by alcohol took off between 2019 and 2020 as the first wave of the pandemic rocked the country.

Stress, boredom, and other factors likely played a role as people around the nation sought to grapple with the unknowns of COVID-19, lockdowns, and social isolation.

The report showed that the alcohol-induced death rate skyrocketed by 26 percent during that period, killing more than 49,000, according to the CDC. That number works out to 13 deaths for every 100,000 people; the 2019 death rate was 10.4 per 100,000.

History has shown that people typically drink more during large-scale traumatic effects. Small studies have shown that roughly a quarter of the population increased their drinking to help cope with stress. Many who drink to cope with stress develop an alcohol disorder.

More than half of the 2020 deaths caused by alcohol were from alcoholic liver disease, while other causes included mental health disorders related to alcohol use.

The CDC also suggested that the numbers would have tripled if the analysis had also included deaths that could be attributed to excessive drinking rather than directly causing it.

Heart disease, genetic mutations, and accidents—like car crashes—can all be attributed to excessive alcohol use.

Alcohol adds wear and tear to your body over time, and consistently high consumption levels can expedite the effects. It can easily become problematic because of its acceptance and accessibility in society.

Unlike other drugs, alcohol is legally available everywhere. There are commercials for it on television, and it’s a major sponsor of community events.

Because it’s so prevalent, misuse or abuse can easily be missed.

If you’re drinking in excess of moderation, meaning more than one standard-size drink per day for women and two for men, you may want to find ways to curb consumption.

You can try non-alcoholic options of beer, wine, and spirits. Drinking soda water with a lime in between drinks may slow consumption, as well. Taking yourself out of situations where there is pressure to drink can also help.

Of course, going it alone can be difficult. If you’re struggling to drink less, talk to a professional about how to help.

mRNA Behind the Reoccurrence of COVID-19 Symptoms in Fully Vaccinated Individuals?

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Unintended consequences potentially explain vaccine failure from the outset

(MattLphotography/Shutterstock)

One of the curious findings from the original randomized trials of mRNA vaccines was an explosive rate of early infection after the first injection as compared with placebo.

In a recent paper from Sfera et al, the description of pathological syncytia or fusion between immune cells is described: “The LNP technology, to put it simply, mimics viral envelopes with externalized phosphatidylserine (ePS), a universal “eat me” signal, that directs immune cells to engulf the particle.

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Sfera A, Thomas KG, Sfera DO, Anton JJ, Andronescu CV, et al. (2022) Do Messenger RNA Vaccines Induce Pathological Syncytia?. Int J Pathol Clin Res 8:137. doi.org/10.23937/2469-5807/1510137

However, as ePS is also a potential “fuse me” signal, LNP may inadvertently facilitate the formation of pathological syncytia. Moreover, ePS may activate a disintegrin and metalloprotease 10 and 17 (ADAM10) (ADAM 17), master regulators of syncytia formation, contributing further to the unintended consequence of cell-cell fusion…

As mRNA vaccines are based on pre-fusion epitopes, the fusion pathology may be undeterred, allowing viral infection by syncytia formation to continue unabated. This is significant, as it could account for the reoccurrence of COVID-19 symptoms in fully vaccinated individuals.”

The authors point out that SARS-CoV-2 utilizes more than just the ACE2 receptor to gain entry into the fused cells and by overlooking this possibility, vaccine developers have made a blunder. This is further complicated by the choice of lipid nanoparticles and polyethylene glycol which facilitate entry into organs were syncytia as well as Spike protein will incite inflammation and immune system regulation.

Sfera also considers pregnancy: “Several studies demonstrated that SARS-CoV-2 can activate HERV-W, an ancestral gene that encodes for the physiological placental fusogen syncytin-1 responsible for the merger of trophoblasts during the early pregnancy. This suggests that the reproductive post-vaccine events may be triggered by the furin cleavage site pathology.” Such processes could occur in the gravid uterus and compound the bleeding and clotting risks of ill-advised vaccination is this special population.

In summary Sfera et al point out the following blind spots of well-funded DARPA consultants, BARDA funded academic researchers, and later by Pfizer and Moderna in mRNA vaccine development:

1) pathologic syncytia formation,

2) use of lipid nanoparticles with PEG,

3) failure to consider SARS-CoV-2 could use alternative points of cell entry other than ACE2 (metalloprotease pathway, antibody dependent enhancement, cell penetrating peptides, viroporins).

With billions of people rushed into indiscriminate mRNA vaccination, virologists and immunologists will be picking up the pieces of a failed vaccine campaign that has left so many at risk for more SARS-CoV-2 infections and progressive complications over the months and years to come.

FDA approves Fresenius Kabi’s Idacio as eighth adalimumab biosimilar

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The FDA has approved Idacio as the eighth biosimilar to adalimumab, for all eligible indications of the reference product, clearing the way for its U.S. release in 2023 alongside a deluge of other Humira biosimilars.

Idacio (adalimumab-aacf, Fresenius Kabi) is a citrate-free biosimilar to the world’s top-selling Humira (adalimumab, AbbVie), a TNF inhibitor approved to treat patients with rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis and plaque psoriasis.

U.S. Food and Drug Administration
The FDA has approved Idacio as the eighth biosimilar to adalimumab, for all eligible indications of the reference product, clearing the way for its U.S. release in 2023 alongside a deluge of other Humira biosimilars. Source: Adobe Stock.

“This is another important milestone for Fresenius Kabi in fulfilling our strategic priority of introducing biosimilars for patients worldwide,” Michael Schönhofen, PhD, chief operating officer and management board member at Fresenius Kabi, said in a company press release. “In the United States, we are a leading manufacturer of small-molecule injectable medicines. This second U.S. biopharmaceutical approval serves to broaden and diversify our U.S. portfolio to bring even more value to patients, payers and health care providers, and to reduce the financial pressure on health care systems globally.”

Idacio is now the eighth Humira biosimilar to earn FDA approval in the United States, following the FDA approval of Yusmiry (adalimumab-aqvh, Coherus) in December 2021. To date, none of the approved adalimumab biosimilars have reached the U.S. marketplace due to AbbVie patent protections that will remain in place until 2023.

According to Fresenius Kabi, Idacio will be available in the United States in two forms, as a self-administered prefilled syringe and a self-administered pre-filled autoinjector, starting in July 2023.

The FDA based its approval on a review of a comprehensive data package as well as the totality of evidence, which demonstrated similar analytical profile, pharmacokinetic, efficacy, safety and immunogenicity to the reference product, the company noted.

Fresenius Kabi first launched Idacio in 2019. The biosimilar has been approved and marketed in more than 37 countries, according to the company.

AI ‘Simulants’ Could Save Time and Money on New Medications

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Artificial intelligence is poised to make clinical trials and drug development faster, cheaper, and more efficient. Part of this strategy is creating “synthetic control arms” that use data to create “simulants,” or computer-generated “patients” in a trial. 

This way, researchers can enroll fewer real people and recruit enough participants in half the time. 

Both patients and drug companies stand to gain, experts say. An advantage for people, for example, is simulants get the standard-of-care or placebo treatment, meaning all people in the study end up getting the experimental treatment. For drug companies unsure of which of their drug candidates hold the most promise, AI and machine learning can narrow down the prospects. 

“So far, machine learning has primarily been effective at optimizing efficiency – not getting a better drug but rather optimizing the efficiency of screening. AI uses the learnings from the past to make drug discovery more effective and more efficient,” says Angeli Moeller, PhD, head of data and integrations generating insights at drugmaker Roche in Berlin, and vice chair of the Alliance for Artificial Intelligence in Healthcare board. 

“I’ll give you an example. You might have a thousand small molecules and you want to see which one of them is going to bind to a receptor that’s involved in a disease. With AI, you don’t have to screen thousands of candidates. Maybe you can screen just one hundred,” she says.

‘Synthetic’ Trial Participants

The first clinical trials to use data-created matches for patients – instead of control patients matched for age, sex or other traits – have already started. For example, Imunon Inc., a biotechnology company that develops next-generation chemotherapy and immunotherapy, used a synthetic control arm in its phase 1B trial of an agent added to pre-surgical chemotherapy for ovarian cancer.

This early study showed researchers it would be worthwhile to continue evaluating the new agent in a phase 2 trial. 

Using a synthetic control arm is “extremely cool,” says Sastry Chilukuri, co-CEO of Medidata, the company that supplied the data for the Phase 1B trial, and founder and president of Acorn AI.

“What we have is the first FDA and EMA approval of a synthetic control arm where you’re replacing the entire control arm by using synthetic control patients, and these are patients that you pull out of historic clinical trial data,” he says.

A Wave of AI-Boosted Research?

The role of AI in research is expected to grow. To date, most AI-driven drug discovery research has focused on neurology and oncology. The start in these specialties is “probably due to the high unmet medical need and many well-characterized targets,” notes a March 2022 news and analysis piece in the journal Nature. 

It speculated that this use of AI is just the start of “a coming wave.”

 “There is an increasing interest in the utilization of synthetic control methods [that is, using external data to create controls],” according to a review article in Nature Medicine in September.  

It said the FDA already approved a medication in 2017 for a form of a rare pediatric neurologic disorder, Batten disease, based on a study with historical control “participants.”

One example in oncology where a synthetic control arm could make a difference is glioblastoma research, Chilukuri says. This brain cancer is extremely difficult to treat, and patients typically drop out of trials because they want the experimental treatment and don’t want to remain in the standard-of-care control group, he says. Also, “just given the life expectancy, it’s very difficult to complete a trial.” 

Using a synthetic control arm could speed up research and improve the chances of completing a glioblastoma study, Chilukuri says. “And the patients actually get the experimental treatment.”

Still Early Days

AI also could help limit “non-responders” in research.

Clinical trials “are really difficult, they’re time-consuming, and they’re extremely expensive,” says Naheed Kurji, chair of the Alliance for Artificial Intelligence in Healthcare board, and president and CEO of Cyclica Inc, a data-driven drug discovery company based in Toronto. 

“Companies are working very hard at finding more efficient ways to bring AI to clinical trials so they get outcomes faster at a lower cost but also higher quality.”

There are a lot of clinical trials that fail, not because the molecule is not effective … but because the patients that were enrolled in a trial include a lot of non-responders. They just cancel out the responder data,” says Kurji. 

“You’ve heard a lot of people talk about how we are going to make more progress in the next decade than we did in the last century,” Chilukuri says. “And that’s simply because of this availability of high-resolution data that allows you to understand what’s happening at an individual level.”

“That is going to create this explosion in precision medicine,” he predicts.

In some ways, it’s still early days for AI in clinical research. Kurji says, “There’s a lot of work to be done, but I think you can point to many examples and many companies that have made some really big strides.”

Can AI Drive More Diversity in Drug Development?

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Artificial intelligence could help improve diversity, equity, and inclusion in clinical trials and drug development by overcoming some traditional human bias in these areas, but we’re not there yet, experts say. The technology could also assist doctors with data insights to make diagnosis and treatment more precise. 

News Special: AI in Healthcare

  • It starts with quality. Artificial intelligence (AI) relies on large amounts of data to create algorithms – or computer instructions – to develop best practices and predictions. But the instructions are only as good as the data used to create them. And people are the ones creating the data.

“Underpinning the development of AI technologies are people, and those people have their own biases,” says Naheed Kurji, the chair of the board for the Alliance for Artificial Intelligence in Healthcare. “As a result, the algorithms will have their own biases.”

Technology that uses speech to diagnose disease is an example. 

“There are many cases, examples where companies have failed to recognize the differences in speech across different cultures,” says Kurji. When technology is based on speech patterns of a limited demographic, “then when that model is applied in the real world to a different demographic with a different accent, that model fails.”

“As a result, it’s not representative.”

Another example is genetic and genomic data. 

“Give or take, 90-plus percent of genetic and genomic data has originated from people of European descent. It’s not from people from the continent of Africa, Southeast Asia, Asia, or South America,” says Kurji, who is also president and CEO of Cyclica Inc., a data-driven drug discovery company based in Toronto. 

Therefore, “a lot of research that has been done on that level of data is inherently biased,” he says. 

To Be Fair 

Creating data that takes diversity, equity, and inclusion of people and cultures around the world into account is not a hopeless challenge. But it will take time, experts say. Once that is achieved, AI should be closer to being free of human and systemic biases.

Greater awareness is essential. 

“The solution to the problem comes from people inherently understanding that the bias exists,” Kurji says, and then only including fair and balanced data that passes a diversity test.

Choosing More Wisely?

Another promising avenue for AI is streamlining the drug development process, narrowing down potential drug candidates, and making clinical trials more cost-effective. 

“If the source data has challenges and limitations, then that the AI is going to just keep propagating those limitations,” agrees Sastry Chilukuri, co-CEO of the data-driven clinical trial company Medidata and founder and president of Acorn AI. “The source data has to get more representative and has to get more equitable for the AI to reflect what’s happening.”

When it comes to human or systemic bias in drug development, “it would be too much of a simplification to say AI or machine learning can fix it,” says Angeli Moeller, PhD, head of data and integrations generating insights at Roche in Berlin. “But responsible use of AI and machine learning can help us identify biases and find ways to mitigate any negative effects it might cause.”

Silent Partners?

At the same time AI aims to streamline drug development, the technology also can help make all doctors better at their jobs, experts say. AI would, for instance, help by spreading knowledge and expertise far and wide, sharing best practices from doctors with a lot of experience in more complex patients. This would help guide those who treat only a few such patients each year. 

The surgical volumes in New York City or in Delhi could be as high as hundreds of patients a year, Chilukuri says. “But if you go to interiors of the U.S. like Nebraska, the surgeon just doesn’t see that much volume.” 

AI could help doctors “by providing the kind of tools that allow them to be able to deliver the same top-notch care to all of their populations at lot faster,” he says.

Boosting Efficiency 

AI could help target therapy by using data to identify patients at highest risk. The technology also could improve some bottleneck areas in medicine, such as the time it takes to interpret radiology images, Kurji says. 

There is an AI company “whose entire business model is not to replace your radiologist but to make radiologists better,” he notes. One of company’s aims is “to prevent death or severe ailment from radiology scans that get missed or that get stacked on the pile and just don’t get acted on fast enough for that patient.” 

Radiologists are so busy, they may have only 30 seconds or less to interpret each scan, says Chilukuri. AI can flag a lesion of potential concern, but it can also compare an image to past scans on the same patient. This view afforded by AI does not just apply to radiology but across data-driven areas of medicine. 

Advancing Personalized Medicine

AI could also guide a personal approach to surgery, “because it’s not like humans come in small, medium and large,” Chilukuri says. The technology could help surgeons determine exactly where to operate on an individual patient.

Moeller agrees that AI holds potential for boosting personalized medicine.  Slideshow

Emerging Trends in Health Technology

“AI can help with diagnosis and risk prediction, which can mean earlier interventions,” says Moeller, who’s also vice chair of the Alliance for Artificial Intelligence in Healthcare board.  “If you look, for instance, at a diabetic patient, what is the likelihood that he or she might develop eye problems from diabetic macular edema?”

The technology could also help with getting a look at the big picture. 

“Machine learning can look for patterns in a population that might not be in your medical textbook,” Moeller says. 

Beyond diagnosis and treatment, AI also could help with recovery by customizing rehabilitation for each patient, Chilukuri predicts. 

“It’s not like every person is going to rehab the exact same way. So, you have highly individualized AI plans that allow you to actually stay on track and predict where you’re going.”

AI in Health Care: No, the Robots Are Not Taking Over

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It’s common for many people to fear the unknown, and exactly how artificial intelligence might transform the health care and medical experience is no exception. 
News Special: AI in Healthcare

Can AI Drive More Diversity in Drug Development?

AI 'Simulants' Could Save Time, Money on New Meds

No, Robots Are Not Taking Over

People might be afraid, for example, that AI will remove all human interaction from health care in the future. Not true, say the experts. Doctors and other health care workers might fear the technology will replace their clinical judgment and experience. Also not true, experts say. 

The AI robots are not taking over. 

AI and machine learning remain technologies that add to human know-how. For example, AI can help track a patient over time better than a health care professional relying on memory alone, can speed up image analysis, and is very good at prediction.

But AI will never replace human intuition in medicine, experts say.

“AI is unemotional. It’s fast and very, very smart, but it does not have intuition,” says Naheed Kurji, board chair of the Alliance for Artificial Intelligence in Healthcare and CEO of Cyclica Inc. 

Machine learning, a form of artificial intelligence where a computer learns over time as it gets more and more data, could sound threatening to a person who might not fully understand the technology. That’s why education and greater awareness are essential to ease any concerns about this growing technology. 

“You need to have an understanding of human behavior and how to help people overcome their inherent fears of something new,” Kurji says. 

All this new science needs to be explained to the public, and machine learning is certainly one that deserves explanation,” says Angeli Moeller, PhD, head of data and integrations generating insights at Roche in Berlin, and board vice chair for the Alliance for Artificial Intelligence in Healthcare. 

“It’s useful to ground it in examples that the general population is familiar with and with technology that has grown,” she says. “On our smartphones, we benefit from a significant amount of machine learning – even if you just look at your Google search or your satellite navigation system.”

Moeller says it’s helpful to think of AI as an assistant to a doctor, nurse, a caregiver, or even a patient trying to understand more about a medical diagnosis, treatment plan, or prognosis. 

Also, with big data comes big responsibility. “Health care industry accountability is important,” she says. 

With than in mind, the Alliance for Artificial Intelligence in Healthcare was created in 2019 as a forum for industry players – drug companies, biotechnology firms, and database entities – to convene and address important AI questions. The group seeks to answer some fundamental questions, including: How do we ensure that we have ethical and appropriate use of artificial intelligence in health care? How do we make sure that that innovation gets to the patient as quickly as possible? 

“If you think about your personal life, a decade ago, your car didn’t have autopilot modes where it drove itself,” says Sastry Chilukuri, co-CEO of Medidata and founder and president of Acorn AI. “You didn’t really have an iPhone – which is like a computer in your hand – much less like have an Apple Watch – which is like another minicomputer on your wrist pumping out all kinds of data.”

“Our world has dramatically changed over just like the last 15 years,” he says. “It’s very interesting, I think. It’s a good time to be alive.”

Lifestyle Changes That Can Lower Your Blood Pressure

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Make Small Changes

Make Small Changes

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If you have high blood pressure, there’s plenty you can do every day to control it. Eating healthier, exercising more, and tweaking other day-to-day habits can help keep your readings in check. That might keep you from needing medication to keep your numbers where they should be. Need some ideas to get started? Read on.

Eat a Healthy Diet

Eat a Healthy Diet

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You can lower your blood pressure by eating lots of whole grains, fruits, vegetables, and low-fat dairy. Look for foods that don’t have much fat or cholesterol. This approach has a name: the Dietary Approaches to Stop Hypertension (DASH) diet. It includes lean meats, poultry, fish, and nuts. It’s also high in protein and fiber and avoids sugary drinks, red meats, and sweets.

Lose Extra Weight

Lose Extra Weight

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Shedding even a few extra pounds can lower your blood pressure. It’s also important to watch your waist. Too much bulk around your midsection can affect your BP. For women, a waist of more than 35 inches is high. For men, it’s more than 40 inches.

Be Active

Be Active

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Exercise can help you lower your blood pressure and lose weight. Aim to get at least 150 minutes of physical activity each week. Look for aerobic workouts that make your lungs and heart work a little harder. Try things like brisk walking, biking, swimming, or dancing. Even chores like raking leaves or washing windows count.

Watch Your Salt

Watch Your Salt

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Too much sodium can raise your blood pressure. You should aim for no more than 1,500 milligrams a day. You don’t get sodium just from the salt you sprinkle in foods. It can also hide in packaged foods. Read labels before you buy. Salt can lurk in things like soups, sandwiches, and pizza.

Get More Potassium

Get More Potassium

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Your blood pressure is likely to be higher if you don’t get enough of this nutrient. Shoot for between 3,000 and 3,500 milligrams each day. How much is that? A medium banana has about 420 milligrams. A baked potato with the skin gives you more than 900 milligrams. Spinach, beans, tomatoes, oranges, yogurt, and sweet potatoes are also high in potassium. Some people with medical issues like kidney disease or who take certain medicines may have to be careful with potassium. So check with your doctor before changing what you eat.

Ease Stress

Ease Stress

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It might have an impact on your blood pressure, especially if you deal with it by eating a lot of unhealthy foods, or by smoking or drinking. Find ways to cope with stress, like meditation, yoga, or deep breathing. Take time to relax and do things you enjoy, whether it’s listening to music, gardening, or spending time with friends.

Limit Alcohol

Limit Alcohol

8/13

Drinking too much of it can raise your blood pressure. If you’re on medicine for your blood pressure, alcohol may affect how well it works. Women should try to have no more than one drink a day. For men, it’s two. One drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.

Quit Smoking

Quit Smoking

9/13

It raises your blood pressure and makes a heart attack or stroke more likely. When you smoke, you hurt the linings of your blood vessels. That makes it harder for them to relax. What’s more, smoking can make some medicines you take for your blood pressure less effective. Your doctor can give you tips on how to quit.

Pay Attention to Caffeine

Pay Attention to Caffeine

10/13

If you regularly drink coffee, soda, and other drinks with caffeine, it may not affect your BP much. But if you rarely have it, caffeine can cause a short spike in your blood pressure when you drink it. Talk to your doctor about what your limit should be.

Get Enough Sleep

Get Enough Sleep

11/13

Your blood pressure goes down when you get some ZZZs. Getting enough is an important way to keep your heart and blood vessels healthy. How much is enough? Most folks need at least 7 hours of high-quality sleep each night. That means you fall asleep within 30 minutes, don’t wake up more than once, and fall back to sleep quickly when you do.

Keep Tabs on Your Blood Pressure

Keep Tabs on Your Blood Pressure

12/13

Check yours regularly to make sure it doesn’t get too high. High blood pressure often doesn’t have symptoms. So measuring your BP is the best way to tell if diet, exercise, and other lifestyle changes are working. You can check it with a home monitor, or you can visit your doctor.

Control Other Conditions

Control Other Conditions

13/13

Work with your doctor to make sure any other health issues you have are under control. Many people with diabetes also have high blood pressure. Other conditions like high cholesterol, sleep apnea, and thyroid disorders are also often linked with it. When you manage your overall health, you’ll help keep your blood pressure in check.

New colonoscopy tech has potential to revolutionize industry

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Innovations in colonoscopy technology are progressing rapidly and have the potential to revolutionize colonoscopy effectiveness. Here are some newer techniques to consider, per industry experts at MDLix:

1. Endoscopy 2.0

Linked color imaging is a technique that enhances endoscopy still images by rendering red areas redder and white areas whiter. This decreases the likelihood of subtle lesions being missed and can help clinicians with less experience better identify lesions. 

Results from a randomized controlled trial published in Endoscopy International Open found that linked color imaging is better than rival image-enhancing technology, such as blue laser imaging, blue laser imaging-bright and conventional white-light images. 

“While both groups of endoscopists received significant benefit from linked color imaging, the benefit was even greater for non-expert endoscopists,” researchers said in the study.

2. MRI colonography

A noninvasive method of detecting colorectal polyps and cancer can assess cancer metastasis. Compared to computed tomography colonography, it doesn’t use ionizing radiation, though it does require similar bowel prep as that of colonoscopy. 

The colorectal cancer detection rate was 98.2 percent, and the pooled sensitivity was 82 percent for detection of large polyps and 38 percent for any polyp, data published in Nature Reviews showed.

3. CT capsule

No bowel preparation is needed for this X-ray technology that takes the form of an imaging capsule called Check-Cap, which is swallowed. The capsule emits low-dose X-ray beams as it travels through the colon.

The radiation exposure is about equal to that of a chest X-ray. 

The goal of these new technologies is to make the experience more bearable and more effective at polyp detection.

Repurposed Cardiovascular Drugs May Aid Acute Kidney Injury

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Repurposing existing, approved medications is always a great plan to get therapeutics to patients in need much more rapidly. And for disorders of the kidneys, speed is of the essence. Now, a new study from investigators at the University of Edinburgh has found evidence that existing medicines could help treat a serious condition that can cause the kidneys to stop working suddenly.

Findings from a new study performed in mice and published recently in Science Translational Medicine, through an article titled, “Endothelin blockade prevents the long-term cardiovascular and renal sequelae of acute kidney injury in mice,” found that medicines usually used to treat angina and high blood pressure, prevented much of the long-term damage to the kidney and cardiovascular system caused by acute kidney injury (AKI).

Experts hope the findings will pave the way for improved treatment of AKI—a common illness that occurs in approximately 20% of emergency hospital admissions in the U.K. and up to 35 million hospitalizations in the U.S., according to data collected by the CDC from 2000–2014.

“AKI is a harmful condition, particularly in older people, and even with recovery, it can have a long-term impact on a person’s health,” noted senior study investigator Neeraj Dhuan, MD, PhD, a senior clinical lecturer and honorary consultant nephrologist at the University of Edinburgh’s Centre for Cardiovascular Science. “Our study shows that blocking the endothelin system prevents the long-term damage of AKI in mice. As these medicines are already available for use in humans, I hope that we can move quickly to see if the same beneficial effects are seen in our patients.”

The condition is usually caused by other illnesses that reduce blood flow to the kidney or due to toxicity arising from some medicines. AKI must be treated quickly to prevent death. AKI can cause long-lasting damage to the kidneys and the cardiovascular system even if the kidneys recover. Of those who survive an episode of AKI, 30% are left with chronic kidney disease (CKD). The remaining 70% that recover full kidney function are at an almost 30-fold increased risk of developing CKD.

A team from the University of Edinburgh found that patients with AKI had increased blood levels of endothelin—a protein that activates inflammation and causes blood vessels to constrict. Moreover, endothelin levels remained high long after kidney function had recovered.

“An activated endothelin system promotes cardiovascular and kidney disease progression. We hypothesized a causal role for this in the transition of AKI to chronic disease,” the authors wrote. “Plasma endothelin-1 was threefold higher; urine endothelin-1 was twofold higher; and kidney preproendothelin-1, endothelin-A, and endothelin-B receptor message up-regulated in patients with AKI. To show causality, AKI was induced in mice by prolonged ischemia with a four-week follow-up. Ischemic injury resulted in hypertension, endothelium-dependent, and endothelium-independent macrovascular and microvascular dysfunction, and increased circulating inflammatory Ly6Chigh monocytes. In the kidney, we observed fibrosis, microvascular rarefaction, and inflammation.”

After finding the same increase in endothelin in mice with AKI, experts treated the animals with medicines that block the endothelin system. The medications—commonly used to treat angina and high blood pressure—work by stopping the production of endothelin or shutting off endothelin receptors in cells.

The mice were monitored over four weeks after AKI. Those treated with the endothelin-blocking medicines had lower blood pressure, less inflammation, and reduced scarring in the kidney. In addition, their blood vessels were more relaxed, and kidney function was also improved, compared with untreated mice.

“Administration of endothelin-A antagonist, but not dual endothelin-A/B antagonist, normalized blood pressure, improved macrovascular and microvascular function, and prevented the transition of AKI to CKD,” the authors stated in their published work. “Endothelin-A blockade reduced circulating and renal proinflammatory Ly6Chigh monocytes and B cells and promoted the recruitment of anti-inflammatory Ly6Clow monocytes to the kidney. However, blood pressure reduction alone provided no benefits; blood pressure reduction alongside blockade of the endothelin system was as effective as endothelin-A antagonism in mitigating the long-term sequelae of AKI in mice.”

The investigators were encouraged by their findings and are looking forward to moving their studies into humans to see if the effects continue to hold up.

“Impaired kidney function that results from acute kidney injury can also increase a person’s chance of developing and dying from heart and circulatory diseases, so it’s vital we find ways to reduce this risk, concluded James Leiper, PhD, associate medical director at the British Heart Foundation, who is not associated with the currently published study. “This promising research suggests that widely available medicines could help tackle acute kidney injury’s impact before it can cause damage and further complications. While further studies will be needed to demonstrate whether this treatment is safe and effective for patients, this early research is an encouraging first step.”