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Infectious diseases ‘clear and present danger’ everywhere

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COVID-19 continues to demonstrate how quickly “an infectious disease can sweep across the world”, pushing health systems to the brink and upending daily life for all of humanity, the UN chief said on Monday, marking the International Day of Epidemic Preparedness.

“It also revealed our failure to learn the lessons of recent health emergencies like SARS, avian influenza, Zika, Ebola and others”, Secretary-General António Guterres said in his message.

“And it reminded us that the world remains woefully unprepared to stop localized outbreaks from spilling across borders, and spiraling into a global pandemic”.

Halting infectious diseases

Noting that infectious diseases remain “a clear and present danger to every country”, Mr. Guterres maintained COVID-19 would not be the last pandemic for humanity.

Even as the world responds to this health crisis, he spelled out the need to prepare for the next one.

“This means scaling-up investments in better monitoring, early detection and rapid response plans in every country — especially the most vulnerable”, he said.

“It means strengthening primary health care at the local level to prevent collapse… ensuring equitable access to lifesaving interventions, like vaccines for all people and…achieving Universal Health Coverage.”

The Secretary-General upheld that by building global solidarity, every country would have a fighting chance “to stop infectious diseases in their tracks”.

Battling as one

Earlier in the month, the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, welcomed the decision of a special session of the World Health Assembly (WHA) – the UN agency’s top decision-making body – to develop a new global accord on pandemic prevention and response. 

While acknowledging a long road ahead, he described the decision as “cause for celebration, and cause for hope”.

“There are still differences of opinion about what a new accord could or should contain”, he said, but the consensus has proven that “differences can be overcome, and common ground can be found”, the WHO chief said

Spreading like wildfire

Meanwhile, as cases of the new Omicron variant continue to spread like wildfire, 70 per cent of COVID vaccines have been distributed to the world’s ten largest economies, and the poorest countries have received just 0.8 per cent, according to the UN, calling it “not only unjust” but also a threat to the entire planet.

To end this cycle, the Organization underscored that at least 70 per cent of the population in every country must be inoculated, which the UN vaccine strategy aims to achieve by mid-2022.

Although this will require at least 11 billion vaccine doses, it is doable so long as sufficient resources are put into distribution.

“An outbreak anywhere is a potential pandemic everywhere”, said the Secretary-General”.

“On this International Day of Epidemic Preparedness, let’s give this issue the focus, attention and investment it deserves”.

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New generation of artificial hearts promises lifeline to patients

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Scandinavian Real Heart’s Total Artificial Heart in front of the surgeons during animal studies. © Scandinavian Real Heart, 2022

The human heart beats 100 000 times a day, every beat circulating blood, oxygen and nutrients to all parts of the body. Heart failure happens when the fist-sized organ is unable to perform this vital function properly.

Most people with the condition are forced to seek long-term mechanical support for blood circulation. While pumps and artificial hearts have been available for more than 40 years, the options currently on offer are tricky for their users.

New normal

The devices are often noisy and require patients to carry heavy battery packs and have wires going through their skin to power the device. Some even use pumps outside the body to circulate the blood.

But researchers are hopeful that a new generation of artificial hearts will improve things.

‘Our vision is that one should be able to live a completely normal life with an artificial heart,’ said Ina Laura Perkins, co-ordinator of the EU-funded ArtOfHeart project.

Heart failure dramatically affects quality of life. Normal activities such as taking the stairs, engaging in domestic chores or even putting on clothes become difficult.

It also makes participating in social activities and keeping a job challenging. Once patients have reached the point of severe heart failure, they are often bedridden.

Cardiovascular disease kills 3.9 million people in Europe every year, accounting for 45% of all deaths. The European Heart Network estimates that more than 10 million people in the EU are likely to be affected by heart failure.

While transplants can offer a solution, only a select few patients are added to waiting lists for such an operation as a result of a severe worldwide shortage of donor hearts. Consequently, the prospect of an effective artificial alternative offers a lifeline for many.

As well as being difficult to live with, today’s artificial hearts can also damage the blood.

‘What I think is preventing artificial hearts from really realising their full potential is the blood-related complications that patients suffer,’ said Perkins.

Swedish tests

ArtOfHeart, partly funded by the European Innovation Council (EIC), is investing €38 million to conduct clinical and pre-clinical testing of an artificial heart developed by Swedish company Scandinavian Real Heart AB.

The problem with current devices, according to Perkins, is that the mechanical flow they generate can create a lot of stress on the blood, damaging and deforming cells. This in turn can lead to clotting, thrombosis and strokes.

For instance, some artificial hearts circulate the blood using a propeller-like device rather than a pump. This creates a continuous blood flow instead of a pulse and causes a lot of force at the blade edges.

The artificial heart being tested claims to be the first designed to closely mimic the structure of the human heart. It consists of two pumps that each have an atrium, a ventricle and a pair of mechanical valves. The idea is that the more natural blood flow produced in this way will reduce the complications that can arise with existing devices.

To gain regulatory approval, Real Heart is exploring its device’s reliability and impact on blood in a series of laboratory tests. The company is also conducting a series of animal studies in sheep. The team aims to begin clinical trials in around 10 patients in 2024 and have the artificial heart on the market in 2026.

The first version will be connected by a cable through the skin to a battery belt. The hope, however, is that in the future this cable connection will not be needed.

‘Our device is very energy-efficient, so it opens up the possibility of doing wireless charging through the skin,’ said Perkins.

With such a setup, patients would wear a vest or a belt around their chest to provide the wireless charge. In the meantime, the device’s energy efficiency means that the battery packs patients have to carry should be relatively small and light compared with other artificial hearts.

Inflatable balloons

Another EU project is developing an artificial heart using soft robotics. Funded by the EICs Pathfinder programmeHybridHeart is seeking to create artificial muscles that mimic the contraction of the heart’s natural muscles.

The resulting artificial heart can be thought of as a set of complex balloons, according to Bas Overvelde, an expert in soft robotics at Eindhoven University of Technology in the Netherlands and a member of the multidisciplinary HybridHeart team.

The device has an internal chamber that holds the blood. When the balloons are inflated, the internal chamber contracts and pumps the blood around the body.

‘Instead of having a heart muscle, like in our natural heart, we have these soft actuators that cause contraction of the heart,’ Overvelde said.

Pumping the blood in this way spreads the force and the stresses across the whole chamber, just like in a human heart, he said. This enables a gentler motion and should reduce localised stresses that can damage blood cells.

More freedom

While the basic workings of the device may seem simple, getting it to work well is complex, according to Overvelde.

For instance, as a result of their structure, the stiffness of a heart’s tissues changes in response to alterations in blood pressure. This leads to an automatic adjustment in the heart’s pumping force and rate.

The hope is that the soft robotics can provide the HybridHeart device with a similar feedback mechanism to regulate its beating.

To provide patients with more freedom and a better quality of life, Overvelde said that energy efficiency is key.

‘At the moment, we are aiming for the device to be wirelessly charged, and for a half hour to an hour untethered, so that you can take a shower,’ Overvelde said. ‘It is essential that you can be untethered for a little while, so that you can temporarily be disconnected from any external battery.’

The HybridHeart project is testing the artificial heart in goats and sheep. The hope is to progress to clinical trials in around seven years, a step that will require additional funding.

While the device probably won’t be better than a natural-heart transplant, Overvelde says there are too limited a number of those available for all the patients in need of such an operation.

Perkins echoes this view, stressing that patients are dying because of a lack of transplants and good alternatives. This is the void artificial hearts need to fill.

Research in this article was funded by the EU. If you liked this article, please consider sharing it on social media.

Research in this article was funded by the EU. This article was originally published in Horizon, the EU Research and Innovation Magazine.

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Mushrooms emerge from the shadows in pesticide-free production push

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By Ali Jones

Mention La Rioja in northern Spain and most people will picture majestic sun-drenched vineyards nestled in the hillsides. But, hidden from the sunlight, the region is also home to a very different crop that happens to be at the heart of efforts to make European food production more sustainable.

Three small villages in La Rioja house the vast, dark, humid growing sheds that produce its 77 000 tonnes of mushrooms each year. Almost half of Spain’s cultivated mushroom crop is grown in the region, making Spain the third-largest producer in Europe, behind Poland and the Netherlands.

New world

‘Mushrooms are a whole different world than we are used to, from growing plants or rearing animals,’ said Pablo Martínez, an agronomist who worked in wineries before being drawn to the specialist mushroom sector after a chance conversation with a former colleague.

Based at the Mushroom Technological Research Centre of La Rioja (CTICH), Martínez manages a Europe-wide project to tackle the environmental challenges faced by the industry.

Many people know very little about how mushrooms are grown. While it’s easy to buy a starter kit online to have a go at home, growing on a commercial scale is very different – managing humidity, temperature and light to produce a regular, quality crop while contending with pest control.

Cultivated mushrooms can double in size in a day and consumer demand for them is mushrooming too.

The global market is projected to grow from around 15 million tonnes in 2021 to more than 24 million tonnes over the next five years. Packed with nutrients, they deliver a protein-rich umami kick that is well suited to the soaring trend for plant-based foods.

To meet demand, growers need to fail-safe their crop from pests and, for now, they rely on pesticides. Tighter regulations are limiting available products and concerns over the impact on the environment and human health mean growers are looking to researchers to come up with answers.

CTICH is coordinating the BIOSCHAMP project, which works with researchers, commercial partners and mushroom growers in six European countries. In addition to Spain, they are Belgium, the Netherlands, Poland, Serbia and the UK.

Peatland protection

Mushrooms are grown on a substrate, or base layer, made of straw and animal manure, then covered with a thick blanket of peat known as the casing. Made up of partially decayed vegetation, peat perfectly mimics nature’s forest floors that so readily yield mushrooms.

The depletion of precious finite peatlands is a global concern. These wetlands store more carbon than all other vegetation types in the world combined and their conservation is ever more important for countering climate change.

‘Mounting restrictions on peat extraction in European countries threaten the long-term continuity of peat supplies,’ said Martínez. ‘We’re looking to develop a new product for growing mushrooms that could cut pesticide use by 90% while reducing the industry’s reliance on peat.’ 

Most of Europe’s peat comes from the Baltic countries, traveling first by boat to the Netherlands, where it is treated ready for commercial use, before being distributed to growers across Europe, amassing transport costs and a heavy carbon footprint.

BIOSCHAMP aims to create a low-peat sustainable casing for cultivated mushrooms made from renewable materials sourced close to existing mushroom production.

While the exact details are under wraps, it will combine with a substance known as a biostimulant to enhance the natural growing processes and strengthen the mushroom mycelium in their early phase, protecting them against disease without the need for chemical pesticides.

Fertile waste 

In Norway, two mushroom enthusiasts have pioneered a project to explore whether the crop could be cultivated in food waste. The EU-funded initiative is called VegWaMus CirCrop.

Dr Agnieszka Jasinska, who completed her postgraduate research on mushroom substrates, has led the research in partnership with Dr Ketil Stoknes, senior project leader of research and development at waste-management company Lindum and himself once a specialist mushroom grower.

The project has demonstrated that organic residue from food waste – usually used to feed anaerobic digestors, devised to capture methane and divert it from problematic greenhouse gas to useful fuel – can be a successful starter for mushrooms.

The European Food Information Council (EUFIC) estimates that a whopping one third of all food produced for human consumption is wasted. Anaerobic digestion, also known as biogas, allows the nutrients from waste to be reused for growing plants in greenhouses.

‘It enables a climate-efficient, resilient, urban food production system based entirely on waste,’ said Stoknes.

Tomatoes, lettuce and herbs had been chosen as the initial candidates. But Stoknes said that mushrooms are degraders, breaking down fibres and so on, and are a necessary part of an integrated biosystem. Inspired by the natural cycle in the forest, the project set out to combine mushrooms and plants in one circular system.

The biogas system is explained as ‘food to waste to food’ and it’s a movement that is growing in popularity.

While mushroom cultivation ceased on a commercial scale in Norway in the early 2000s, unable to compete with other countries, VegWaMus CirCrop has proved there could be a sustainable future for Norwegian mushroom production after all.

Side hustle

The project has hatched a start-up company called SOPPAS with ambitions to scale up the process commercially. In the meantime, it’s embarking on a raft of new ideas, including expanding production at the food waste biogas facility from button mushrooms to oyster mushrooms.

‘The new company will produce starter blocks for growing mushrooms for farmers, plant producers and greenhouse owners who might want to diversify to mushrooms in their low season,’ said Jasinska. ‘They can put their existing pickers, packing line and cold-storage facilities to good use in idle times and sell the produce locally.’

Against the backdrop of growing momentum for producing food from waste and an interest in keeping production local, both EU-funded projects look set to give mushrooms their moment in the sun.

Research in this article was funded via the EU’s Marie Skłodowska-Curie Actions (MSCA). ). This article was originally published in Horizon, the EU Research and Innovation Magazine.

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High blood pressure? A heart app prescribes musical therapy

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By ANTHONY KING

The opening of a Beethoven symphony thrills the heart – but not just figuratively. While music touches us emotionally, it stimulates the heart physically and can lower blood pressure.

More than one in five people aged 15 years and over in the EU have reported having high blood pressure, which can lead to failure in the heart, kidneys or brain. Lowering blood pressure even slightly can reduce the risks of cardiovascular disease.

Heartfelt tunes

From the Science and Technology of Music and Sound Laboratory in Paris to King’s College London, Professor Elaine Chew is developing an app for smartphones to boost heart health as part of an EU-funded project called HEART.FM.

‘We’re creating an app that will monitor people’s response as they listen to music and then tailor that music to benefit them,’ said Chew, a professor of engineering at King’s who collaborates with St Bartholomew’s Hospital in London.

The app uses measurements of the person’s heart and artificial intelligence algorithms to create a listening regimen that regulates blood pressure.

While HEART.FM stands to help people today, another EU-funded project called GOING VIRAL looks back at how public perceptions and uses of music in Europe have evolved through the course of disease outbreaks over the past four centuries.

In the 17th century, music was believed by many people in Europe to have the power to stop or even prevent an outbreak of the plague, according to Professor Marie Louise Herzfeld-Schild, who leads GOING VIRAL and is a musicologist at the University of Music and Performing Arts Vienna.

The two projects show how popular views of music have changed since the days of Handel, and the heightened power of music when combined with modern technology.

Personal perspective

Chew has a personal connection to the project. She had suffered from an irregular heartbeat, which was successfully treated. The experience made Chew conscious of her own and others’ heart health.

‘Medicine made it possible for me to have a much better quality of life and it led me to rethink the purpose of what it is I do,’ she said.

A professional-level piano player herself, Chew has since 2018 studied how people’s hearts respond to music, starting with patients who have pacemakers.

A pacemaker is used to treat some abnormal rhythms – called arrhythmias – that can cause the heart to beat too slowly, too fast or irregularly. The pacemaker enables a patient’s heart to beat regularly by sending electrical pulses to it.

Chew and colleagues at St Bartholomew’s Hospital discovered some good news: the recovery time between beats of the hearts of people with pacemakers could be modulated by music. In general, quicker recovery times signal stress, while longer ones indicate relaxation or calm.

Chew is drawing on the findings of her work involving pacemaker patients to develop the HEART.FM app for a much broader group of people.

‘People enjoy music as a pleasurable pastime – the difference here is that we are monitoring how the body responds,’ she said.

HEART.FM’s goal is to fingerprint the cardiovascular responses of people listening to music. Chew often hooks up students to the testing device and then sends them data from the app so they can see their own physiological response to music.

The app in development would be downloaded onto a smartphone by users to track their heart’s rhythmical responses to music and to guide them on a therapeutic path to lower blood pressure. The plan is to make the app globally available for download from app stores.

Shifting views

Under GOING VIRAL, funded by the European Research Council, Herzfeld-Schild is interested in how Europeans of bygone eras felt about music.

Her project is investigating and comparing the emotional experiences that people had from music during three epochs of disease outbreaks in Vienna: plague in 1679 and 1713, cholera in 1831 and flu in 1918-19.

Herzfeld-Schild believes that emotional experiences differ through the periods of history.

‘The way we navigate the world emotionally is bound to our upbringing and what we learned about the world,’ she said. ‘That changes how we feel about music.’

During the plague outbreaks, people in western Europe often blamed the planets and believed music could influence them and, as a result, end or ward off the pestilence.

At the same time, there was also a belief that contaminated items could make you sick. Records exist of people burning instruments or sheet music. 

‘Music in that context was dangerous,’ said Herzfeld-Schild. ‘Religion was quite important, so people understand the plague to be a punishment from God.’

Alternatively, they would blame Jews or foreigners from the East, she said.

Musical escapes

During the 1700s, perceptions in Europe evolved again to embrace the idea of music as a source of listening bliss.

‘The idea of a universal kind of “true” music and that music is good for everyone begins in the 18th century,’ said Herzfeld-Schild. ‘Also, in the late 18th century, there arises this idea of music as a kind of religious experience, like a revelation, or escape from this bleak life.’

By the time of the cholera outbreak in the 19th century, medical practices and popular attitudes to music had shifted. Once people realised that this disease had its origins in dirty water, charity balls were run in Vienna for cholera victims and even featured new music from the composer Johann Strauss. 

The final outbreak that Herzfeld-Schild will investigate is the so-called Spanish flu, which started in 1918. It came when some people could buy early versions of gramophones and listen to music in their own homes.

This was a tumultuous time for Austria because the first flu outbreak coincided with the end of the First World War, collapse of the monarchy and disappearance of the Habsburg Empire.

‘There’s really a lack of knowledge about how music was perceived emotionally during these times of diseases,’ said Herzfeld-Schild.

During the Covid-19 pandemic that started in 2020, she noticed that people seemed to assume a shared experience with those who faced disease outbreaks in earlier eras. But this supposition seemed wrong to Herzfeld-Schild based on her study of the history of music, medicine and emotions for more than a decade.

‘From everything I know, right now, the emotional experiences of music during pandemics have been different throughout times and throughout places,’ she said. ‘I’m sure it was very different for people in the past.’

Research in this article was funded via the EU’s European Research Council (ERC). This article was originally published in Horizon, the EU Research and Innovation Magazine.

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