Thursday, November 1, 2012

Finding triggers of birth defects in an embryo heart

ScienceDaily (Oct. 30, 2012) ? Researchers at Case Western Reserve University have found a way to create three-dimensional maps of the stress that circulating blood places on the developing heart in an animal model -- a key to understanding triggers of heart defects.

The team has begun testing the technology to uncover how alcohol, drugs and other factors set off events that result in defects found in newborn humans.

Passing blood cells drag on the endothelial cells that line the growing heart, a phenomenon called shear stress, which has been linked to changes in gene expression that results in defects, most often in the valves. But precisely how they're connected is unclear.

"Alcohol exposure may affect shear stress by modulating the heart rate, but it may also involve vigor and/or timing of the contraction," said Andrew Rollins, associate professor of biomedical engineering and senior author of the new study. "Now that we have the tool, we can start to figure that out."

"We're analyzing early and late development of the heart and trying to make the connections that result in valve dysfunction," said Lindsy M. Peterson, a PhD student in Rollins' lab and lead author. Their work is published in the current online issue of the Optical Society of America's journal Biomedical Optics Express.

The pair teamed with research assistant professor Michael W. Jenkins; senior research associate Shi Gu; Lee Barwick, an undergraduate researcher now at Brigham Young University; and Michiko Watanabe, a professor of pediatrics at Case Western Reserve School of Medicine.

To look at the structure of the developing heart and blood flow, the researchers modified a technology called Doppler optical coherence tomography. Called OCT for short, they shine an infrared laser on the heart.

The reflections measured at various depths are used to create a three-dimensional image in much the same manner submariners use sonar to picture their surroundings in the deep sea. But the researchers add the dimension of time, creating movies of blood flow through the structures, needed to map shear stress.

They take their first images at two days, during a stage of heart development called cardiac looping. This is when the simple straight tube that's an embryo heart turns clockwise into a helix, forming the beginnings of two atria and two ventricles. They take more images at three days and again at eight days, when the septum, the wall between the left and right sides of the heart, has formed.

Working with Ganga Karunamuni, a pediatrics research associate at the school of medicine, the team is now pursuing a slate of experiments testing the quail heart model's response to alcohol exposure and will also test exposure to mental health drugs called selective serotonin receptor inhibitors. Alone or together, they can alter shear stress.

They are exposing the model to alcohol at a stage called gastrulation, when the embryo changes from two sheets of cells to a multi-layered organism.

This is a critical stage for induction of birth defects, Peterson said. In humans, it's an early stage when a woman may not know that she is pregnant.

Rollins said clinical applications are a long way off but the team has begun talking about possibilities.

"If it became feasible to screen a fetus for abnormal heart function," he said, "it might be possible to intervene with drugs, with gene therapy." Or, by using non-invasive pulses of infrared light to make the heart contract on demand -- another technology the team is developing with clinical colleagues in Pediatric Cardiology- to prevent or treat defects before birth.

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The above story is reprinted from materials provided by Case Western Reserve University, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. Lindsy M. Peterson, Michael W. Jenkins, Shi Gu, Lee Barwick, Michiko Watanabe, Andrew M. Rollins. 4D shear stress maps of the developing heart using Doppler optical coherence tomography. Biomedical Optics Express, 2012; 3 (11): 3022 DOI: 10.1364/BOE.3.003022

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/health_medicine/heart_disease/~3/BCLWj3oDyh4/121030210355.htm

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Helpshift Gets $3.2M From Nexus, True Ventures To Build The ...

When it comes to companies known for providing exceptional customer service, the list is short. Zappos comes to mind, but the truth is that the consumer has low expectations for companies in this regard, and that great customer service is an exception ? not the norm. While players like Salesforce and Zendesk have helped shift the focus of CRM to the Web and social media, today, many startups and SMBs are adopting mobile-first development strategies for their businesses. Increasingly, that?s how their customers are interacting with their service ? on mobile devices.

Last year, Abinash Tripathy and Baishampayan Ghose founded Helpshift to address what they perceived to be a significantly underserved market in customer service: Mobile. After months of testing their mobile solution, the startup is getting ready to pull the curtains back on its business and, to do that, it is today announcing that it has closed a $3.2 million round of seed financing, led by True Ventures and Nexus Venture Partners, with contributions from a number of private angel investors.

The financing will support the company?s soft launch of its mobile-focused, SaaS solution, which aims to be ?the first embedded support desk for native apps,? allowing developers to capture device info from their users so that they can troubleshoot problems quicker and more effectively. Tripathy says that the startup?s goal is to enable businesses and development teams to be able to fix issues before they turn into ?tickets? by offering built-in, self-service features.

To do so, Helpshift provides a native SDK that integrates with mobile apps to offer an ?in app? customer experience that remains true to the look and feel of the app, rather than shoehorning its own design into each different mobile UX. Helpshift?s support screens can be customized to match the app?s visual style and is designed, the co-founder and CEO says, to be instantly searchable and available in offline mode, i.e. when a device isn?t connected to the network.

Today, the solution offers support for iOS and HTML5 but, according to Tripathy, is ?committed to being cross-platform? and will begin rolling out support for other mobile operating systems in the near future. Android support is slated to be added next week, he said.

In conversations with their early customers, the Helpshift founders consistently heard that the majority of their inbound customer inquiries were for common issues that already had solutions published on FAQ pages, for examples. The problem is that FAQs aren?t easily searchable or viewable given the smaller mobile form factor (in other words, smaller screens) so customers were opting to submit tickets instead of browsing through forums or FAQs to find answers on their devices.

Given this frequently occurring snag in the mobile customer experience, Helpshift wants to reduce the overall ticket volume and address the root of this problem, the CEO said, by allowing mobile developers to take advantage of proactive support. Nipping customer service problems in the bud, as it were.

In addition, the startup provides users with in-app mobile messaging functionality, enabling companies to communicate with their customers via short messages in a familiar chat-style. Device-specific diagnostics and screenshots can be sent inline within these messages, allowing customer service reps to address issues in realtime from Helpshift?s dashboard.

Noah Barr, who recently left Crittercism (a venture-backed AngelPad grad offering a performance-management solution for mobile developers) to head business development for Helpshift, tells TechCrunch that he sees a similar opportunity in mobile CRM as he does for mobile performance optimization. He said that even if big companies are thrown off by buzzwords or don?t immediately understand the use case in just asking them, ?Do you have apps? Do you have have a customer support system for those apps?? most companies get it pretty quickly.

There?s a lot of opportunity in the B2B mobile space, especially for those companies offering valuable on-demand mobile services to startups and SMBs ? like Urban Airship, for example. Businesses large and small often don?t have the resources to build or offer a mobile-centric CRM solution for their apps, and it likely will cost them less to integrate third-party services than build it themselves. You could see this kind of mobile CRM service being attractive to game companies, allowing them to easily answer questions and provide documentation for gamers using their platforms.

As for the appeal for someone actually running a mobile-first business, Astrid founder and CEO Jon Paris tells us that, any way you slice it, mobile customer support is critical to avoid long, wandering emails and negative ratings in app markets. Being able to offer an FAQ that loads asynchronously so that already frustrated users don?t have to wait for a mobile website to load or struggle with slow search over spotty WiFi connections has value for any business trying to provide a consistent mobile (customer) experience.

Astrid had tried many support forums and tools but the problem with using WordPress (WPTouch) plugins, GetSatisfaction and others, he said, was that FAQ pages were slow to navigate and impossible to reach offline, so feature requests would get confused with bug reports, which became a mess to manage. Being able to offer type-in support requests from a mobile keyboard or to attach screenshots of bugs keeps feedback brief and to the point ? and also visual (something anyone who has managed or used feedback can appreciate, he said).

?It?s allowed the Astrid team to focus on product insights and less on answering the same questions over and over again, and once they releases Android support, we?re migrating everything over to Helpshift,? Paris said.

More than a few mobile developers are justifiably worried that they?re missing a lot of feedback from customers who don?t even make it to the ?Developer Support? page in iTunes ? and many simply manage customer support for their products via labels in Gmail. By taking away some of the friction between end users and customer support teams and giving businesses and making it direct, Helpshift could help developers reduce the number of negative reviews and comments posted in app stores. And that right there is money in the bank.

More on Helpshift at home here.

Source: http://techcrunch.com/2012/10/30/helpshift-gets-3-2m-from-nexus-true-ventures-to-build-the-salesforce-of-mobile-crm/

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Study: Repeated surgeries appear to extend life of patients with deadliest of brain cancers

Study: Repeated surgeries appear to extend life of patients with deadliest of brain cancers [ Back to EurekAlert! ] Public release date: 1-Nov-2012
[ | E-mail | Share Share ]

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine

People who undergo repeated surgeries to remove glioblastomas the most aggressive and deadliest type of brain tumors may survive longer than those who have just a one-time operation, new Johns Hopkins research suggests.

Glioblastoma, the brain cancer that killed Sen. Edward Kennedy, inevitably returns after tumor-removal surgery, chemotherapy, and/or radiation. The median survival time after diagnosis is only 14 months. With recurrence a near certainty, experts say, many have questioned the value of performing second, third or even fourth operations, especially given the dangers of brain surgery, including the risk of neurological injury or death.

"We are reluctant to operate on patients with brain cancer multiple times as we are afraid to incur new neurological deficits or poor wound healing, and many times we are pessimistic about the survival chances of these patients," says Alfredo Quinones-Hinojosa, M.D., a professor of neurosurgery at the Johns Hopkins University School of Medicine and leader of the study published recently in the Journal of Neurosurgery. "But this study tells us that the more we operate, the longer they may survive. We should not give up on these patients."

For the study, Quinones-Hinojosa and his team reviewed the records of 578 patients who underwent surgery to remove a glioblastoma between 1997 and 2007 at The Johns Hopkins Hospital. At the last follow-up, 354 patients had one surgery, 168 had two resections, and 41 and 15 patients had three and four operations, respectively. The median survival for patients who underwent one, two, three and four operations was 6.8 months, 15.5 months, 22.4 months and 26.6 months, respectively.

Quinones-Hinojosa cautions that his analysis may overestimate the value of multiple surgeries based on patient selection, and that it's possible that the patients who did better had tumors with a biology that predisposed them to live longer. Further research will need to confirm his more positive conclusion.

Glioblastomas are cancerous tumors that become deeply intertwined with healthy brain tissue and, as a result, are difficult to remove. They are notoriously difficult to eradicate with surgery alone. "The only thing that has been proven to work for glioblastoma throughout history is surgery," Quinones-Hinojosa says. "Without surgery, these patients don't have much of a chance."

Along with reducing the size of tumors, repeated surgeries may also increase the efficacy of radiation and chemotherapy.

Quinones-Hinojosa says with each successive surgery, the procedure itself becomes more technically challenging as the anatomy changes, blood vessels are damaged and tissues become frail.

Patients, their families and their doctors must determine whether repeated surgery is the best course of action, weighing the potential risks against the potential benefits, Quinones-Hinojosa says. The procedure should only be done if it can be done relatively safely and patients can tolerate anesthesia and the long recovery period.

###

Other Johns Hopkins researchers involved in the study include Kaisorn L. Chaichana, M.D.; Patricia Zadnik, B.A.; Jon D. Weingart, M.D.; Alessandro Olivi, M.D.; Gary L. Gallia, M.D., Ph.D.; Jaishri Blakeley, M.D.; Michael Lim, M.D.; and Henry Brem, M.D.

For more information:

http://www.hopkinsmedicine.org/neurology_neurosurgery/experts/profiles/team_member_profile/36A35BDE9B71CB08318C8F419FD7ACB4/Alfredo_Quinones-Hinojosa

http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/brain_tumor/


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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Study: Repeated surgeries appear to extend life of patients with deadliest of brain cancers [ Back to EurekAlert! ] Public release date: 1-Nov-2012
[ | E-mail | Share Share ]

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine

People who undergo repeated surgeries to remove glioblastomas the most aggressive and deadliest type of brain tumors may survive longer than those who have just a one-time operation, new Johns Hopkins research suggests.

Glioblastoma, the brain cancer that killed Sen. Edward Kennedy, inevitably returns after tumor-removal surgery, chemotherapy, and/or radiation. The median survival time after diagnosis is only 14 months. With recurrence a near certainty, experts say, many have questioned the value of performing second, third or even fourth operations, especially given the dangers of brain surgery, including the risk of neurological injury or death.

"We are reluctant to operate on patients with brain cancer multiple times as we are afraid to incur new neurological deficits or poor wound healing, and many times we are pessimistic about the survival chances of these patients," says Alfredo Quinones-Hinojosa, M.D., a professor of neurosurgery at the Johns Hopkins University School of Medicine and leader of the study published recently in the Journal of Neurosurgery. "But this study tells us that the more we operate, the longer they may survive. We should not give up on these patients."

For the study, Quinones-Hinojosa and his team reviewed the records of 578 patients who underwent surgery to remove a glioblastoma between 1997 and 2007 at The Johns Hopkins Hospital. At the last follow-up, 354 patients had one surgery, 168 had two resections, and 41 and 15 patients had three and four operations, respectively. The median survival for patients who underwent one, two, three and four operations was 6.8 months, 15.5 months, 22.4 months and 26.6 months, respectively.

Quinones-Hinojosa cautions that his analysis may overestimate the value of multiple surgeries based on patient selection, and that it's possible that the patients who did better had tumors with a biology that predisposed them to live longer. Further research will need to confirm his more positive conclusion.

Glioblastomas are cancerous tumors that become deeply intertwined with healthy brain tissue and, as a result, are difficult to remove. They are notoriously difficult to eradicate with surgery alone. "The only thing that has been proven to work for glioblastoma throughout history is surgery," Quinones-Hinojosa says. "Without surgery, these patients don't have much of a chance."

Along with reducing the size of tumors, repeated surgeries may also increase the efficacy of radiation and chemotherapy.

Quinones-Hinojosa says with each successive surgery, the procedure itself becomes more technically challenging as the anatomy changes, blood vessels are damaged and tissues become frail.

Patients, their families and their doctors must determine whether repeated surgery is the best course of action, weighing the potential risks against the potential benefits, Quinones-Hinojosa says. The procedure should only be done if it can be done relatively safely and patients can tolerate anesthesia and the long recovery period.

###

Other Johns Hopkins researchers involved in the study include Kaisorn L. Chaichana, M.D.; Patricia Zadnik, B.A.; Jon D. Weingart, M.D.; Alessandro Olivi, M.D.; Gary L. Gallia, M.D., Ph.D.; Jaishri Blakeley, M.D.; Michael Lim, M.D.; and Henry Brem, M.D.

For more information:

http://www.hopkinsmedicine.org/neurology_neurosurgery/experts/profiles/team_member_profile/36A35BDE9B71CB08318C8F419FD7ACB4/Alfredo_Quinones-Hinojosa

http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/brain_tumor/


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2012-11/jhm-srs103112.php

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