DiversityNursing Blog

By Catharine Paddock PhD

The rise of drug-resistant bacteria - such as MRSA - is making it increasingly difficult to control even common infections like pneumonia or urinary tract infections with standard antibiotics. After repeated exposure, the bugs mutate into strains that are immune to the drugs that once killed them.

There is clearly a desperate need for new drugs to fight these superbugs. But there is also another option - to extend the useful life of a drug. Now, researchers have developed a computer algorithm that can help in this area.

Imagine the war against a superbug as a chess game, with each move that your opponent makes being a mutation in the superbug that makes it more drug-resistant. 

To stand a good chance of winning, it helps to anticipate your opponent's most likely counter-moves.

Now, a team of researchers - including members from Duke University in Durham, NC - has developed a computer algorithm that stands a good chance of beating a superbug at its own game.

The software - called OSPREY - predicts the most likely mutations that a bug develops in response to a new drug before the drug is even given to patients.

Writing in the Proceedings of the National Academy of Sciences, the team describes how they tested OSPREY with the superbug MRSA (methicillin-resistant Staphylococcus aureus). 

The researchers programmed the algorithm to identify the genetic changes that MRSA would have to undergo in order to become resistant to a promising new class of experimental drug. And when they exposed MRSA to the new drugs, they found some of the genetic changes the software had predicted actually arose.

"This gives us a window into the future to see what bacteria will do to evade drugs that we design before a drug is deployed," says author Bruce Donald, a professor of computer science and biochemistry at Duke.

The team hopes the approach they are developing will give drug designers a head start in the race against superbugs, as co-author and Duke graduate student Pablo Gainza-Cirauqui explains:

"If we can somehow predict how bacteria might respond to a particular drug ahead of time, we can change the drug, or plan for the next one, or rule out therapies that are unlikely to remain effective for long."

Resistant forms of Staphylococcus aureus now kill 11,000 people in the US every year - more than HIV. In 1975, around 2% of infections caused by the bacterium were resistant to treatment - rising to 29% in 1991 - and now the proportion is 55%.

Depending on the drug, it can take up to 20 years for resistant strains to emerge. Sometimes it only takes 1 year.

Ability to anticipate new mutations beats searching 'libraries' of known mutations

The team believes approaches like OSPREY beat the current method where scientists have to look up "libraries" of previously observed resistance mutations - an approach that is not necessarily satisfactory for predicting future mutations. Prof. Donald explains:

"With a new drug, there is always the possibility that the organism will develop different mutations that had never been seen before. This is what really worries physicians."

OSPREY - which stands for Open Source Protein REdesign for You - is based on a protein design algorithm. It identifies changes to DNA sequences in the bacteria that would enable the resulting protein to block the drug while still being able to work normally.

The team tested OSPREY with a new class of drugs called propargyl-linked antifolates that attack a bacterial enzyme called dihydrofolate reductase (DHFR), used for building DNA and other tasks. The drugs - still to be tested in humans - are showing promise as a new treatment for MRSA infections.

Using OSPREY, the team came up with a ranked list of possible mutations. They picked out four - none of which had been seen before.

One predicted mutation reduced drug effectiveness by 58%

When they treated MRSA with the new drugs, they found more than half of the bacteria that survived carried the mutation they predicted would give the organism the greatest amount of resistance: a tiny change in the bacterial DNA that reduced the effectiveness of the new drugs by 58%.

"The fact that we actually found the new predicted mutations in bacteria is very exciting," Prof. Donald says, adding that the approach could be expanded to anticipate the bug's responses more than one move ahead:

"We might even be able to coax a pathogen into developing mutations that enable it to evade one drug, but that then make it particularly susceptible to a second drug, like a one-two punch."

The team is now enhancing OSPREY to predict resistance mutations to drugs designed to treat E. coli and Enterococcus infections.

They believe OSPREY will be useful for predicting drug resistance in cancer, HIV, flu and other diseases where culturing resistant strains is harder than it is with bacteria.

Prof. Donald and colleagues are developing OSPREY in open source format so it is freely available for any researcher to use.

In September 2014, Medical News Today learned about a study that showed how an  old drug may lead to a potential new class of antibiotics . The study showed that lamotrigine - currently used as an anticonvulsant - can inhibit the assembly of ribosomes in bacteria.

Source: www.medicalnewstoday.com

By Sanjay Gupta

So, in no particular order, here's my take on the nine big health stories to watch for, and the questions they will likely raise, in 2015.

Doctor shortage. There aren't nearly enough of us to care for the U.S. population. By some estimates, the country is already short of tens of thousands of doctors, a problem that will only get worse as the demand for care increases with our aging population. That could mean longer wait times for you when you need to make an appointment. But that also means policy makers will have to consider questions like: Is there a way to increase the number of residency training slots? Are there other health care professionals who can reasonably fill in the gaps? Will the nation's quality of care go down? How can the country avoid a situation where only the wealthy will be able to afford quality care? 

Hospital errors and infections. Hospital mistakes and infections are still one of the leading causes of preventable death (indeed, some studies suggest "hospital-acquired conditions" kill more people than car accidents or diabetes). 

True, a recent study showed the rate did get better this year, saving tens of thousands of lives. But what else can hospitals do to prevent these mistakes and infections? Can technology like e-prescriptions and electronic health records prevent problems that most often occur: the mistakes caregivers make with a patient's drugs? 

Antibiotic resistance. It has been called public health's "ticking time bomb."The World Health Organization calls antibiotic resistant infections one of the biggest threats to global health today. Each year, at least 2 million peoplebecome infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year. Most of these deaths happen in health care settings and in nursing homes. How can we respond? Well, research teams around the world have already started searching for the next generation of infection-fighting drugs. But it remains to be seen if time will run out, sending us back to the beginning: a time before antibiotics, where even a cut that becomes infected could kill you. 

More do-it-yourself health care: apps and technology. Technology has made do-it-yourself patient care much easier. This goes beyond just a patient's ability to look up their symptoms online. There are apps to help with autism, apps that can simulate a check-up, apps that can monitor conditions. Wearables can motivate you to walk more or sleep more or check a diabetic's glucose level. But how does all this helping yourself make your health care better? How much is too much? And what does this mean for your privacy? After all, the health care industry accounted for 43% of all major data breaches in 2013. Meanwhile, although 93% of health care data requires protection by law, some surveys suggest only 57% of it is "somewhat protected." What could this mean for your privacy and personal information if security doesn't get better? 

Food deserts. While not everyone agrees with the term food desert, the USDA still estimates 23.5 million people live in these urban neighborhoods and rural towns with limited access to fresh, affordable, healthy food. Without grocery stores in these areas, residents often have to rely on fast food and convenience stores that don't stock fresh produce. It takes a real toll on their health. Families who live in these areas struggle more with obesity and chronic conditions, and they even die sooner than people who live in neighborhoods with easy access to healthy food. More farmers markets are now accepting food stamps and many nonprofits have stepped in to try to bring community gardens and healthy food trucks to these areas, but so far it's not enough. Will cities offer incentives to grocery store chains to relocate to these neighborhoods?  How else can this system be helped? 

Caregivers for the aging population. We are heading into a kind of caregiver crisis. The number of people 65 years and older is expected to rise 101%between 2000 and 2030, yet the number of family members who can provide care for these older adults is only expected to rise 25%. This raises a series of related questions, not least who is going to step up to fill the gaps? Will cities that don't traditionally have strong public transportation systems add to their routes? Will developers create more mixed-use buildings to make shopping and socializing easier to access? Could the government create a kind of caregiver corps that could check in on the isolated elderly? Who will pay for this expensive kind of safety net? 

The cost of Alzheimer's. Currently about 5.2 million Americans have Alzheimer's. That number is expected to double every 20 years. With a cure some way off, what can be done to ease the emotional and financial burden on families and communities affected by the disease? The Alzheimer's Association predicts that by 2050, U.S. costs for care will total $1.2 trillion, making it the most expensive condition in the nation. How will we be able to afford the costs of caring for this population? What can the country do to achieve the goal the White House set for preventing and effectively treating Alzheimer's by 2025?

Marijuana. With the growing acceptance of weed, we can expect that more laws will change to allow medical and recreational use of marijuana. How will the rest of the laws in this country adjust? For instance, Washington state is coming up with a Breathalyzer-type device to check if drivers are high. But it will be interesting to see how readily available these devices are going to be. Will legalization improve the scientific understanding of the long-term consequences of the drug? What other uses could this drug have to help those who may need pain relief most?

Missing work-life balance. Americans spend more time on the job than most other developed countries. We don't get as much vacation, we don't take what vacation we have, and we are prone to working nights and weekends. This stress has a negative impact on Americans' health. What are companies doing to help? What technology can change this phenomenon? Will millennials who say work-life balance is a bigger priority than other generations rub off on the rest of us? What can we personally do to find a better balance? 

We may not be able to answer all these questions in 2015, but we sure will try. And the health team and I look forward to exploring these issues with you in the coming New Year.

Source: www.cnn.com

By ALISON BRUZEK

The last thing on your mind while you're home from school for the holidays is avoiding a deadly disease.

But imagine catching a disease as a teenager — a disease so terrible that it takes not just months to recover, but requires sacrificing both your legs.

That's what happened to Amy Purdy at age 19, when she was diagnosed with bacterial meningitis. It affects only about 4,000 people a year in the United States, according to the Centers for Disease Control and Prevention, but more than 10 percent of those people die. Others, like Purdy, suffer devastating consequences, including hearing loss, brain damage, or the loss of limbs from bloodstream infection.

College students are especially vulnerable, because meningitis is spread by living in close quarters and sharing drinking and eating utensils, or kissing. (An outbreak at Princeton University in 2013 sped up approval a new vaccine for the meningitis B strain.)

That's why the CDC recommends meningitis vaccine for all teenagers, especially if they weren't vaccinated as preteens.

Purdy, now 35, went on to become a Paralympic snowboarding champion and contestant in Dancing with the Stars. She's got a new book, On My Own Two Feet: From Losing My Legs to Learning the Dance of Life, coming out Dec. 30. Shots spoke to her about her battle with the disease and people's misconceptions about meningitis. This is an edited version of the conversation.

Had you heard about meningitis before you became sick?

Of course I heard the name meningitis before. I recognized what it was, but I had no idea that I was at risk. And I have to say, my mom actually told me just about a year before I got sick about one of her friends' son's who battled this horrific disease that came out of nowhere. He ended up losing his legs and his kidneys. It was the exact same thing that I got a year later.

Do you know how you got meningitis?

We have no idea how I got it. I was at an age that's more at risk — I was 19 years old. However, I wasn't a college student. I didn't live in a college dorm. I really wasn't even around that environment. They do say that those who are in college dorms are slightly more at risk than the rest of the world. I don't know how I got it, I was incredibly healthy at the time, I was a massage therapist, I worked out every day, I really took care of myself. It's just this invisible killer that kind of comes out of nowhere.

How did you cope with this loss at such a young age?

For me, it was life-changing. I nearly died multiple times in the hospital. I lost my legs, I lost my spleen, I lost my kidney function. I lost the life that I knew. And going through so much in such a small amount of time and so quickly, for me it put my life into perspective. There were certain things I focused on — I focused on how grateful I was for the things I had versus things I lost. I got a second chance at life and I wanted to use it. I didn't want to waste it by dwelling on what happened or why it happened.

One of the ironies is that those losses actually led to a lot of great things, like Dancing With the Stars and the Paralympics.

Definitely. The way I look at it is, we all have disabilities. We all have things that limit us and that challenge us. But really, our real limitations are the ones we believe. And I, from the beginning, believed that I could accomplish my goals and accomplish my dreams and I set out to do that. I'm very grateful that I've had the opportunities I've had.

A new vaccine for meningitis B was approved this fall, and you're now working with the manufacturer, Pfizer, to promote it. How did that happen?

Pfizer's actually teamed up with my nonprofit organization, which is called Adaptive Action Sports. I cofounded this organization in 2005 to help people with physical disabilities get involved in action sports, go snowboarding, skateboarding. Obviously, they want to get the word out there that there's protection against this bacteria.

I'm really proud to be a part of this campaign, though. You hear about rare diseases and weird things happening to people on Oprah and Dateline and you just never think it's going to happen to you. And then come to find out you actually could've protected yourself against it. To me it seems like a no-brainer.

What do you want parents to ask their teen's doctor about meningitis?

The number one question is, "Do you carry the meningococcal meningitis vaccination?" I feel like if parents could vaccinate their kids against car accidents, they would. This is one of those things where there are ways to help protect your kid against this.

Source: www.npr.org

By LIZ NEPORENT

A 7-year-old boy is one of the first people in the country to receive a potent form of medical marijuana as part of an “extended use” clinical trial to reduce seizures.

Preston Weaver, who lives in Athens, Georgia, has Lennox-Gastaut syndrome which is a severe form of epilepsy. He experiences up to 100 seizures a day, although many are confined to his brain and aren’t noticeable to an observer. There is no known cure for the condition.

“Today’s the day, buddy. We’re not going to have any more of those,” his mom Valarie Weaver, 36, said she told her son as the headed to his first treatment Tuesday.

Her son can't see, walk or talk, Weaver said. Although he's 7, his behavior is more like that of a 2-month-old. But he lights up when he goes in the water and he seems to love the feel of the sun and the wind, Weaver said.

"Our hope is that this treatment will calm down his brain enough so that he will start communicating with us," she said.

Many of the drugs available to treat the syndrome don’t work long term, especially for children. Even with more than a dozen medications Weaver has had no relief.

The active ingredient in Epidiolex, the experimental drug that Weaver and one other child are receiving, is called cannabidiol. It’s also the main active ingredient in marijuana though it doesn’t produce a high.

Dr. Michael Diamond, the interim senior vice president of research for Georgia Regent University said the drug is not legal or approved for use by use by the Food and Drug Administration. The university’s current study, one of only a handful of trials for compassionate use being held around the country, will expand to include 50 children over the next few weeks.

“We are hopeful the drug will reduce the frequency and severity of seizures within a month, but we know it will not work for every child,” he said.

Georgia Gov. Nathan Deal approved the trials in April. It took some time to get additional clearance at the federal level, Diamond said.

“No one with a heart could hear the stories of these children and their parents and not want to exhaust every possibility to provide them with the treatment they need to combat this debilitating condition,” said Deal

Weaver told ABC News that she was grateful her son was accepted into the trial though she was disappointed the state legislature had narrowly failed to pass a bill that would have legalized the drug for use with sick children. But, she said, she’s not giving up.

"Even though Preston is on it, Preston and I are still going to fight for all the other ones too, we will be at the capital every single time, we need to be there until this becomes legal and every child in the state has the option for this treatment if they need it," Weaver said.

Source: http://abcnews.go.com

Fifty-one years ago, Arthur Lampitt of Granite City, Illinois, smashed his 1963 Thunderbird into a truck. This week during surgery in suburban St. Louis, a 7-inch turn signal lever from that T-Bird was removed from his left arm.

Dr. Timothy Lang removed the lever Wednesday during a 45-minute operation. Lampitt, now 75, is recovering at home.

The St. Louis Post-Dispatch ( http://bit.ly/1EOtGa6 ) reports that the accident broke Lampitt's hip, drawing attention away from the arm, which healed.

A decade or so ago, his arm set off a metal detector at a courthouse. An X-ray showed a slender object the length of a pencil, but since it caused no pain or hardship, Lampitt was told to let it be.

He was moving concrete blocks a few weeks ago when the arm began to hurt for the first time.

"Everything was fine until it started to get bigger," Lampitt's wife, Betty, said. "The arm started bulging."

Lampitt decided to have surgery. He initially wasn't sure what was in the arm. He wondered if perhaps a medical instrument had been left during the emergency room visit in 1963.

He unearthed a collection of old photos of the mangled Thunderbird taken by a friend at the scene. He noticed the metal blinker lever was missing from the left side of the steering column. He figured that was it, and surgery at City Place Surgery Center in Creve Coeur, Missouri, confirmed it.

"Seven inches long," Lang told Betty.

"Oh, my God," Betty said.

Lang said a protective pocket grew around the lever.

"We see all kinds of foreign objects like nails or pellets, but usually not this large, usually not a turn signal from a 1963 T-Bird," Lang said. "Something this large often gets infected."

Lampitt wasn't sure what he'd do with the lever ? maybe make a key chain out of it.

"We'll figure out something, I am sure," he said.

Source: http://abcnews.go.com

Jenna Birch

While cancer can strike anyone — young or old, unhealthy and healthy — we do have some idea of what can affect risk. Genetics often play a role, for instance, as do lifestyle habits. But according to a new study from Johns Hopkins University researchers, much of cancer risk may actually be due to mere chance.

Cancer develops when stem cells of a given tissue make random mistakes, mutating unchecked after one chemical letter of DNA is incorrectly swapped for another — the equivalent of a cell “oops.” It happens without warning, like the body’s roll of the die. 

For the new study, published in the journal Science, researchers wanted to see how much of overall cancer risk was due to these unpreventable random mutations, independent of other factors like heredity and lifestyle. 

“There is this question that is fundamental in cancer research: How much of cancer is due to environmental factors, and how much is due to inherited factors?” Cristian Tomasetti, PhD, a biomathematician and assistant professor of oncology at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, tells Yahoo Health. “To answer that question, however, the idea came that it would be important to determine first how much of cancer was simply due to ‘replicative chance.’"

To measure this, the researchers plotted the number of stem cell divisions in 31 types of tissues over the course of a lifetime against the lifetime risk of developing cancer in the given tissue. From this chart, the scientists were able to see the correlation between number of divisions and cancer risk — and from that correlation, researchers were able to determine the incidence of cancer in a given tissue due to replicative chance.

Ultimately, researchers found that roughly two-thirds of the cancer incidence was due to this replicative chance, or simply “bad luck.” (However, it’s worth noting researchers did not examine some cancers, such as breast and prostate cancers, because of lack of reliable stem-cell turnover information.)

But don’t assume you’re simply doomed to the hand fate deals you. After additional analysis, researchers found that of the 31 cancers examined, 22 could be explained by “bad luck” — but for the other nine, there was another factor aside from simple chance that likely contributed to the cancer.

This is presumably because environmental and hereditary factors play a role in development. “There are many cancers where primary prevention has huge positive effects, such as vaccines against infectious agents, quitting smoking or other altered lifestyles,” says Tomasetti. 

Incidentally, the cancers where risk could be lowered by primary preventive practices were ones you may expect — diseases like skin cancer, where limiting sun exposure can lower your risk, as well as lung cancer, where avoiding smoking is key. 

Source: www.yahoo.com

By Ronnie Cohen

Millions of people could be trying to measure their blood pressure with untested, inaccurate and potentially dangerous smartphone applications, or apps, a new study finds.

Researchers analyzed the top 107 apps for "hypertension" and "high blood pressure" that are available for download on the Google Play store and Apple iTunes and found that nearly three-quarters offered useful tools for tracking medical data.

But they also found seven Android apps that claimed users needed only to press their fingers onto phone screens or cameras to get blood-pressure readings - claims that scientists say are bogus.

"This technology is really in its nascent stages, and it's not quite ready for prime time," lead author Dr. Nilay Kumar told Reuters Health.

Kumar, an attending physician at the Cambridge Health Alliance in Cambridge, Massachusetts and a Harvard Medical School instructor, was surprised to learn that apps marketed as turning smartphones into blood pressure measuring devices had been downloaded at least 900,000 times and as many as 2.4 million times.

"That's concerning that such a small number of apps have been downloaded so many times," he said. "We were surprised by the popularity."

He wasn't sure how the technology supposedly works but said the phone camera appears to read a finger pulse.

"It's really in a research-and-development stage. It's not ready for clinical use. For now, we need to be careful that we are not using things that are inaccurate and could be potentially dangerous," he said.

Apps that inaccurately measure blood pressure could lead to false alarms and possibly fatal false assurances, Kumar said.

About one in three American adults has high blood pressure, according to the U.S. Centers for Disease Control and Prevention. Also known as hypertension, the condition has been called the silent killer because it often shows no warning symptoms but increases the risk of heart disease and stroke, two leading causes of death.

A growing number of hypertension patients use mobile-health technologies to track and manage their conditions, the authors write in the Journal of the American Society of Hypertension.

The study, conducted earlier this year, in general found good news about blood pressure apps. The majority, or 72 percent, of the most popular apps allowed consumers to keep track of their medical data. About a quarter could directly export recorded information to physicians' offices. And nearly a quarter included tools to enhance medication adherence.

But healthcare agencies, such as universities, helped develop only a tiny fraction of the apps, 2.8 percent, the study found.

The U.S. Food and Drug Administration (FDA), which regulates medical devices, has not approved any of the blood pressure apps, the authors write.

The study's findings raise "serious concerns about patient safety" and reveal an "urgent need for greater regulation and oversight in medical app development," the authors say.

Dr. Karen Margolis, an internist and director of clinical research at HealthPartners Institute for Education and Research in Minneapolis, would also like to see more oversight.

"The idea that you're going to be able to stick your finger on the camera of your smartphone and get an accurate blood pressure reading is pretty farfetched right now," she told Reuters Health.

Margolis has studied devices to measure blood pressure but was not involved in the current study.

"There is virtually no information at all about how accurate these apps are," she said. "It doesn't sound to me like it's ready for routine use in any way that medical decisions could be based on."

Regulatory authority over smartphone apps that can be turned into medical devices remains unclear, Kumar said.

Writing earlier this year in The New England Journal of Medicine, a group of three lawyers, led by Nathan G. Cortez of the Southern Methodist University Dedman School of Law in Dallas, Texas, warned that mobile health, or mHealth, poses a challenge for the FDA.

"Many members of Congress and industry believe that regulation will stifle mHealth innovation," the lawyers wrote. "The true challenge, however, is creating a regulatory framework that encourages high-value innovation while also preventing the market from being overcome with products that are ineffective or unsafe."

Source: www.huffingtonpost.com

By LIZ NEPORENT

Adopting a stray dog while in the midst of battling a disease that was deemed incurable hardly seems like the best timing, yet that’s exactly what Bill Hogencamp and his wife Kathy decided to do.

They believe that decision helped save his life.

Hogencamp, an 84-year-old semi-retired architect from Phenix, Alabama, was diagnosed with incurable cancer of the gall bladder, liver, colon and the lining of his abdomen back in May. Doctors told him he wouldn’t live to see Christmas.

“I have seven children and I’ve traveled all around the world,” Hogencamp said. “I thought if this is it, then this is it.”

Hogencamp chose to undergo treatment even though his doctor told him there was no hope, he recalled. In October, he had an operation to remove three large tumors.

Eleven days after his surgery, his wife was on her way to pick him up from a rehabilitation facility when she spotted a small white dog wandering down the middle of the road, in danger of being hit by a car. Although she was in a rush, she said something compelled her to stop and rescue the pup.

“He walked past six other cars right up to the side of my car and put his paws up on the door,” she recalled.

While his wife was hooked on the cute little dog right away, Hogencamp needed some convincing.

“I hadn’t had a dog in twenty years and I had no desire to have a dog,” he said. “I kept saying we need to find his owner.”

Despite an extensive search and nearly a dozen false leads, the Hogencamps were never able to track down the dog’s owner. They learned from a vet they visited during their search that he was a Maltese, probably around 6 years old, fixed but not chipped.

Besides, the dog very quickly won Hogencamp over. They soon became inseparable.

Whenever Hogencamp sat down, the dog -- who they named Mahjong after Kathy’s favorite card game -- would jump in his lap. Whenever Hogencamp napped, Mahjong would curl up next to him. When Hogencamp returned home after being out, Mahjong would hop onto his hind legs and dance with joy.

As he and his wife settled into life with a dog, Hogencamp underwent chemotherapy. Just before the holiday he received some miraculous news: Tests showed that he was now cancer free.

The doctors are at a loss to explain this amazing turn of events, Hogencamp’s wife said. But she said the family believes that Mahjong has played a huge part in her husband’s recovery.

“The dog seemed to know right away that Bill was sick and it was his job to take care of him -- and Bill knew it was his job to take care of the dog,” she said.

Hogencamp agreed. He said their relationship gave both him and the dog a sense of purpose. Although he knows he owes much of his cure to great medical care and a lot of luck, he said that he is convinced the little white dog was sent to him to help him get better.

As they celebrate Christmas, Hogencamp said he has two final chemotherapy treatments. He said he’s spending the day with friends, family and of course, Mahjong.

“My life has been a miracle,” Hogencamp said. “And now Mahjong is part of that miracle.”

Source: http://abcnews.go.com

A paralysed woman who controlled a robotic arm using just her thoughts has taken another step towards restoring her natural movements by controlling the arm with a range of complex hand movements.

Thanks to researchers at the University of Pittsburgh, Jan Scheuermann, who has longstanding quadriplegia and has been taking part in the study for over two years, has gone from giving "high fives" to the "thumbs-up" after increasing the manoeuvrability of the robotic arm from seven dimensions (7D) to 10 dimensions (10D).

The extra dimensions come from four hand movements--finger abduction, a scoop, thumb extension and a pinch--and have enabled Jan to pick up, grasp and move a range of objects much more precisely than with the previous 7D control.

It is hoped that these latest results, which have been published today, 17 December, in IOP Publishing's Journal of Neural Engineering, can build on previous demonstrations and eventually allow robotic arms to restore natural arm and hand movements in people with upper limb paralysis.

Jan Scheuermann, 55, from Pittsburgh, PA had been paralysed from the neck down since 2003 due to a neurodegenerative condition. After her eligibility for a research study was confirmed in 2012, Jan underwent surgery to be fitted with two quarter-inch electrode grids, each fitted with 96 tiny contact points, in the regions of Jan's brain that were responsible for right arm and hand movements.

After the electrode grids in Jan's brain were connected to a computer, creating a brain-machine interface (BMI), the 96 individual contact points picked up pulses of electricity that were fired between the neurons in Jan's brain.

Computer algorithms were used to decode these firing signals and identify the patterns associated with a particular arm movement, such as raising the arm or turning the wrist.

By simply thinking of controlling her arm movements, Jan was then able to make the robotic arm reach out to objects, as well as move it in a number of directions and flex and rotate the wrist. It also enabled Jan to "high five" the researchers and feed herself dark chocolate.

Two years on from the initial results, the researchers at the University of Pittsburgh have now shown that Jan can successfully manoeuvre the robotic arm in a further four dimensions through a number of hand movements, allowing for more detailed interaction with objects.

The researchers used a virtual reality computer program to calibrate Jan's control over the robotic arm, and discovered that it is crucial to include virtual objects in this training period in order to allow reliable, real-time interaction with objects.

Co-author of the study Dr Jennifer Collinger said: "10D control allowed Jan to interact with objects in different ways, just as people use their hands to pick up objects depending on their shapes and what they intend to do with them. We hope to repeat this level of control with additional participants and to make the system more robust, so that people who might benefit from it will one day be able to use brain-machine interfaces in daily life.

"We also plan to study whether the incorporation of sensory feedback, such as the touch and feel of an object, can improve neuroprosthetic control."

Commenting on the latest results, Jan Scheuermann said: ""This has been a fantastic, thrilling, wild ride, and I am so glad I've done this."

"This study has enriched my life, given me new friends and co-workers, helped me contribute to research and taken my breath away. For the rest of my life, I will thank God every day for getting to be part of this team."

Source: www.sciencedaily.com