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Deathbed Visions at End of Life

May 24, 2017

(Medscape) – The field of palliative care encompasses the broad trajectory from diagnosis of a serious illness until the time of death. There has been extensive interest in the final hours or days before death as a specific period in which patients may experience new symptoms or concerns that affect both patients and their families.

How to End a Life

May 24, 2017

(Toronto Life) – For some doctors, the aftermath is difficult. Just because doctors are regularly exposed to death doesn’t mean they’re comfortable performing euthanasia. A 2006 study on the emotional effects of physician-assisted death in the Netherlands and Oregon found that doctors often felt isolated and powerless after performing the procedure. At UHN, Li has seen physicians who deal with death on a daily basis break down after conducting a medically assisted death. Since MAID became legal, the number of willing providers in Ontario has shrunk, as nearly 30 doctors have pulled their names from the ministry’s list.

When Artificial Intelligence Botches Your Medical Diagnosis, Who’s to Blame?

May 23, 2017

(Quartz) – This inability arises from the opacity of AI systems, which—as a side effect of how machine-learning algorithms work—operate as black boxes. It’s impossible to understand why an AI has made the decision it has, merely that it has done so based upon the information it’s been fed. Even if it were possible for a technically literate doctor to inspect the process, many AI algorithms are unavailable for review, as they are treated as protected proprietary information. Further still, the data used to train the algorithms is often similarly protected or otherwise publicly unavailable for privacy reasons. This will likely be complicated further as doctors come to rely on AI more and more and it becomes less common to challenge an algorithm’s result.

Unprecedented Cholera Outbreak Tears through War-Torn Yemen

May 23, 2017

(New Scientist) – A cholera outbreak in Yemen has killed 332 people, and left more than 32,000 ill in the last four weeks, the World Health Organization reports. The disease, which is caused by ingesting food or water contaminated with Vibrio cholerae bacteria, has spread faster than any previous known outbreak in Yemen. It could affect as many as 300,000 people over the next 6 months, the WHO says.

We Need to Fix a Patient Data Gap to Cope with the Rise of “Rich” Diseases in Africa

May 23, 2017

(Quartz) – When it comes to killer diseases in Africa many people think of infectious diseases like tuberculosis, malaria, or even Ebola. But the reality is that diseases like cancer, diabetes and heart disease – known as non-communicable diseases (NCDs)—are a major threat. It’s estimated that there will be about 3.9 million deaths from these diseases in Africa by 2020. The rising burden will have an impact not only on people’s health. It will also affect economic productivity and the social fabric of societies. This is why there’s been an increasing focus on NCDs – they’re been included in the Sustainable Development Goals and will be the focus of the upcoming World Health Assembly.

The Silk Road Creator’s Life Sentence Actually Boosted Dark Web Drug Sales

May 23, 2017

(Wired) – Two years ago this week, Ross Ulbricht was sentenced to life in prison without parole for running the Silk Road, an unprecedented dark web bazaar for drugs and other contraband. The judge intended the sentence to serve as a warning to other would-be internet narcotraffickers. But new research suggests more clearly than ever before that the strategy of making an example of Ulbricht didn’t deter Silk Road users. In fact, it may have had the opposite effect. In a study published in a forthcoming issue of the British Journal of Criminology, Boston College sociologist Isak Ladegaard provides some of the strongest quantitative evidence yet that the dark web drug trade actually received a sales bump following the news of Ulbricht’s surprisingly harsh sentence.

Major Teaching Hospitals Have Lower Rates of Death, Study Says

May 23, 2017

(UPI) – Major U.S. teaching hospitals are often considered more expensive than the competition, but a new study suggests they may have an important quality advantage. Older adults treated at major teaching facilities are less likely to die in the weeks and months following their discharge than patients admitted to “non-teaching” or community hospitals, the study found. The study involved more than 21 million hospitalizations of Medicare beneficiaries from 2012 through 2014.

World Health Organization Gets First Leader from Africa

May 23, 2017

(Nature) – The World Health Organization (WHO) has its first head to hail from Africa. Ethiopia’s Tedros Adhanom Ghebreyesus will take up the post of the agency’s director-general from 1 July – succeeding Margaret Chan – after winning a 23 May vote by WHO member states at the World Health Assembly, their annual gathering in Geneva, Switzerland. Tedros, 52, is a public health expert who has formerly been both a health minister and a foreign minister in Ethiopia’s government, and will lead the WHO for a 5-year term.

Medicine Is Going Digital. The FDA Is Racing to Catch Up

May 23, 2017

(Wired) – When Bakul Patel started as a policy advisor in the US Food and Drug Administration in 2008, he could pretty much pinpoint when a product was going to land in front of the reviewers in his division. Back when medical devices were heavy on the hardware—your pacemakers and your IUDs—it would take manufacturers years to get them ready for regulatory approval. FDA reviewers could keep up pretty well. But as computer code took on more complex tasks, like spotting specious moles and quantifying blood flow, their duties began to accelerate. Software developers needed months, not years, to make it to the market. And there were a lot of them. It got harder to match pace. And then came artificial intelligence.

Reproductive Medicine Puts Physicians in Ethical Quandaries

May 23, 2017

(Medscape) – Ethics is not something one should avoid or defer to a philosopher for. “As physicians, we can be ethicists as well, and we should not shy away from using our voice,” said Dr King. In reproductive medicine, you often have two patients in front of you, she explained. For example, when you have a woman with diabetes not using her medications appropriately, the risk for stillbirth and other adverse outcomes is high. “How do you maintain a relationship with the patient while protecting the child? How do you go about addressing that in a meaningful way? How far should you go?” she asked.

Revealed: Facebook’s Internal Rulebook on Sex, Terrorism and Violence

May 23, 2017

(The Guardian) – Facebook’s secret rules and guidelines for deciding what its 2 billion users can post on the site are revealed for the first time in a Guardian investigation that will fuel the global debate about the role and ethics of the social media giant. The Guardian has seen more than 100 internal training manuals, spreadsheets and flowcharts that give unprecedented insight into the blueprints Facebook has used to moderate issues such as violence, hate speech, terrorism, pornography, racism and self-harm.

Speeding Up Quality Control for Biologics

May 23, 2017

(PhysOrg) – Monitoring the quality of these drugs has proven challenging, however, because protein production by living cells is much more difficult to control than the synthesis of traditional drugs. Typically these drugs consist of small organic molecules produced by a series of chemical reactions. MIT engineers have devised a new way to analyze biologics as they are being produced, which could lead to faster and more efficient safety tests for such drugs. The system, based on a series of nanoscale filters, could also be deployed to test drugs immediately before administering them, to ensure they haven’t degraded before reaching the patient.

New Service to Predict Genetic Disorders in Children

May 22, 2017

(The Japan Times) – A major genetic testing company in Japan plans to provide a service from as early as next year to check the probability that future children will have genetic disorders, The Yomiuri Shimbun has learned. By examining the genetic codes of a couple, the testing can ascertain the incidence rate of about 1,050 conditions, including certain types of muscular dystrophy and Parkinson’s disease, according to the company. However, related academic societies are considering whether to issue a statement expressing their concerns, as they believe that while there is a need for such testing, there are also concerns that it will promote new forms of discrimination.

Instagram Worst Social Media App for Young People’s Mental Health

May 22, 2017

(CNN) – Instagram is the most detrimental social networking app for young people’s mental health, followed closely by Snapchat, according to a new report by the Royal Society for Public Health in the UK. Their study, #StatusofMind, surveyed almost 1,500 young people aged 14 to 24 on how certain social media platforms impact health and well-being issues such as anxiety, depression, self-identity and body image. YouTube was found to have the most positive impact, while Instagram, Snapchat, Facebook and Twitter all demonstrated negative affects overall on young people’s mental health.

CRISPR Creator Jennifer Doudna of the Promises–and Pitfalls–of Easy Genetic Modification

May 22, 2017

(Wired) – For $150, you can buy a Crispr kit online and use it to engineer heartier gut bacteria in your kitchen. That’s thrilling, but the technology is giving Jennifer Doudna, an inventor of the gene-­editing method, nightmares. Easy genetic modification could mean cures for cancer (yay!), kitty-sized pigs (squee!), and, yes, designer babies (ack). In her new book, A Crack in Creation, Doudna urges innovators to slow their roll. Here she considers the daunting prospects and promises of the monster-maker she created.

Study Confirms ‘Flushing’ Blocked Fallopian Tubes Can Improve Fertility and Reduce Need for IVF

May 22, 2017

(The Conversation) – A technique that effectively “unblocks” a woman’s fallopian tubes by flushing them with liquid to help her conceive has been used for decades, with varying levels of success. Now a study has confirmed that the method significantly improves fertility, and that a certain type of fluid – one that is oil-based rather than water-based – shows strong results. Published in The New England Journal of Medicine, our H2Oil study involved 1,119 women in 27 medical centres in The Netherlands. All women were younger than 38 and had been trying to conceive for 18 months on average.

Team Discovers Neural Stem Cells Can Become Blood Vessels

May 22, 2017

(Medical Xpress) – Mother cells from the adult carotid body can transform into blood vessels as well as neurons. This discovery could have important repercussions on the treatment of such diseases as pediatric tumors and Parkinson’s. Researchers from the University of Seville and the Seville Institute of Biomedicine (IBiS) have just published a scientific article in the journal Cell Reports, in which they show that mother cells from the adult carotid body can transform into blood vessels, as well as into neurons. The work was led by the post-doctoral researcher Valentina Annese.

A New Edition of The New England Journal of Medicine Is Now Available

May 22, 2017

The New England Journal of Medicine (vol. 376, no. 20, 2017) is available online by subscription only.

Articles include:

  • “The Committed Perspective — Policy Principles for Regional Health Plans” by C. Connolly and T.H. Lee
  • “A 21st-Century Health IT System — Creating a Real-World Information Economy” by K.D. Mandl and I.S. Kohane
  • “Letter to a Young Female Physician” by S. Koven

 

Yemen Cholera Cases Could Hit 300,000 within Six Months: WHO

May 19, 2017

(Reuters) – Yemen could have as many as 300,000 cases of cholera within six months and an “extremely high” number of deaths, the World Health Organization said on Friday. “We need to expect something that could go up to 200,000-250,000 cases over the next six months, in addition to the 50,000 cases that have already occurred,” Nevio Zagaria. WHO Yemen representative, told reporters in Geneva by phone. The cost in lives from this will be will be “extremely, extremely high”, he said.

‘Adopted’ Embryo Program Produces New Style Extended Families

May 19, 2017

(Science Daily) – Experts at the University of Huddersfield are researching the emergence of a new style of family creation that sees couples “adopt” embryos and, after the child is born, remain in contact with the donors and in many cases develop a special relationship with them. Some of the couples who have experienced the system — so far available only in the USA and New Zealand — have given highly positive responses to the UK-based research team.

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