Prototype vascular surgical device wins clinical innovation award

L-R, Mr. Gary Fingerhut; Dr. Cliona Murphy; Dr. Keith O’Neill.

Winning idealooks to make it safer to introduce devices into arteries through needlepuncture

A prototype device to enable “less traumatic introduction of large diameter therapeutic vascular devices” into the body has won this year’s ClevelandClinic and EnterpriseIreland clinical innovationaward.

The winning idea looks to make it safer to introduce devices into arteries through needle puncture during procedures such as aortic aneurysm repair and aortic valve replacement, said Dr Cliona Murphy, who accepted the award last week at the Medical Technology Industry Excellence Awards in Limerick.

A GP, Dr Murphy is taking part in the BioInnovateprogramme at NUIGalway, where she spent time observing surgical procedures and spotted a clinical need where an innovation could help.

“There has been a shift in the treatment of certain heart procedures from open surgery to the vascular approach, and one of these procedures is transcatheter aortic valve implantation,” she said.

“For this they require a large-diameter device to be inserted into the vessel to go to the heart, and the difficulty is that you need a large ‘introducer sheath’ that can result in complications. We have designed [a sheath] that reduces the axial force on the blood vessel, hopefully preventing complications.”

The team behind the idea will receive a grant of €15,000 and the opportunity to work with Cleveland Clinic and Enterprise Ireland to develop the device further.

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Medical Council National Trainee Experience Survey:

BULLYING and undermining of trainee doctors in Ireland is endemic - and more than twice as bad as in the UK, a major report reveals.

Senior consultants are the biggest culprits, but the junior doctors also complain of bullying by patients and the public, the first nationwide survey of trainees by the Medical Council revealed.
It is worst in hospitals and is less of a problem in mental health services, while it happens least among junior medics training to be GPs.

Three-out-of-10 trainees reported being bullied and undermined. Interns who are fresh out of medical school suffer most, and the problem reduces among older trainees. View report here.

The findings come as Health Minister Leo Varadkar has pledged to improve the teaching and work environment for junior doctors in a bid to persuade more of them to stay in Irish hospitals.

Asked to comment on why so many senior specialists are accused of bullying, Freddie Wood, the president of the Medical Council said the environment in the health service is now "much more hostile than it was" for doctors.

He cited overcrowding, waiting lists as well as pressure to meet targets, litigation and patient expectations as adding to the stress."With the downturn in the economy many doctors are in negative equity and that all adds up to poor well-being. If you are a busy consultant surgeon and you have 40 patients to see, you will have only got to where you are through diligence and perfectionism. The people who get to that level are perfectionists and they demand the same as everybody else," said Mr Wood, a retired heart surgeon.

"Like a lot of things it needs to be talked about. This report gives us a definite basis to say to consultants that they need to be aware of it and do something about it."

Key weaknesses revealed by the report included:
* 30pc of trainees said they received no explanation of their role and responsibilities;
* Three-in-10 interns felt medical school did not prepare them for hospital training. This is two to three times higher than in the UK;
* Basics such as educational supervision and matching responsibility with the young doctor's competence were also found wanting. Concerns also emerged about the safety practices when one team of doctor hands over a patient to another;
* Interns and doctors on basic specialist training also reported the worst experiences of indication and orientation.

The report said the impact on patient safety cannot be overlooked and the training setting must be a better place to learn, work and care for patients.

Mr. Varadkar, who launched the report, talked about when he graduated as a doctor in 2003.
"My general impression as a trainee was very good, particularly in the GP training scheme I felt well supported by trainers."

However he said the same was not the case during his time as a hospital doctor.
View more here

Tackling Data Irreproducibility

Drug discoverers chart path, to tackling data irreproducibility:

Researchers from across the biomedical research community met in October to discuss solutions to the 'irreproducibility epidemic', which has been re-emphasized by new data from Novartis and Sigma-Aldrich.

One result that the scientific community has consistently reproduced in recent years is the finding that a vast body of biomedical research is irreproducible. Yet, while scientists at Bayer, Amgen, the ALS Therapy Development Institute and elsewhere have documented the 'irreproducibility epidemic', few organizations have come up with demonstrated solution.

So, in October, leading experts from universities, industry, the US government and journals gathered in Cambridge, Massachusetts, USA, for the first major, multi-stakeholder symposium dedicated to tackling biomedical irreproducibility.

“For the first time people are coming together to talk about it,” says Sitta Sittampalam, a senior advisor at the US National Institutes of Health (NIH)'s National Center for Advancing Translational Sciences (NCATS) in Bethesda, Maryland, USA. “On the one hand, it's depressing to hear about all of this. But on the other, solutions are starting to crop up.”

Various nascent initiatives were discussed — and broadly welcomed — at the symposium. But these efforts aren't enough on their own to mitigate the problem, says Barbara Slusher, Director of the Brain Science Institute Drug Discovery Program at Johns Hopkins University in Baltimore, Maryland, USA. “Right now there are no negative consequences to publishing something that's irreproducible,” she says. “The incentive programme in academia really needs to have some shifts.” A pharma veteran of 18 years, Slusher also directs the Academic Drug Discovery Consortium (ADDC), a non-profit network of more than 100 research centres worldwide (Nature Rev. Drug Discov. 12, 811–812; 2013).

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Scopus adds Impact per Publication to its growing portfolio of journal metrics.

Elsevier are excited to announce a new journal metric in Scopus: Impact per Publication (IPP). IPP measures the ratio of citations per article published. It provides you with an additional metric for comparing and evaluating journals to help you confidently know where to publish. Access the IPP metric from the "Compare journals" tool and elsewhere in Scopus.

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Obesity can shorten life by eight years

Being obese can shorten life by eight years and condemn a person to almost two decades of ill-health, new research has shown.

Scientists used a computer model to predict that diabetes and heart disease were likely to deprive an obese person of up to 19 years of healthy living.

For the very obese, with a Body Mass Index (BMI) of 35 or more, between one and eight years of life were likely to be lost.

Overweight individuals with BMIs of 25 to 30 were predicted to have their lives shortened by up to three years.

BMI is calculated by dividing a person’s weight in kilograms by height in metres squared and is the standard tool used to define levels of obesity.  Someone who is obese is said to have a BMI of 30 or more.

Lead researcher Professor Steven Grover, from McGill University in Montreal, Canada, said: “Our computer modelling study shows that obesity is associated with an increased risk of developing cardiovascular disease (including heart disease and stroke) and diabetes that will, on average, dramatically reduce an individual’s life expectancy and the healthy life-years free from living with these chronic illnesses compared with people of normal weight.

“The pattern is clear.The more an individual weighs and the younger their age, the greater the effect on their health, as they have many years ahead of them during which the increased health risks associated with obesity can negatively impact their lives.”

The study, published in The Lancet Diabetes & Endocrinology journal, drew on data from the US National Health and Nutrition Examination Survey (NHANES).

View more here

New DNA mapping project to discover causes of MND launched

Today sees the formal launch in Ireland of Project Mine, an ambitious international effort to find the genetic causes of motor neurone disease. It will involve scientists in 14 countries, including Ireland, who will collect patients’ DNA, sequence it and then do comparative studies that will help provide answers about this terrible disease.

Ireland sees 110 new cases of motor neurone disease every year, says Prof Orla Hardiman, who will lead Project Mine activity in Ireland. Scientists are still learning about the disease, but there is undoubtedly a genetic component, hence the need for an initiative such as this.

“The project is based on looking at the population genetics of motor neurone disease; whole genome association studies, ” says Hardiman, a professor of neurology at Trinity College Dublin and a consultant neurologist at Beaumont Hospital. “It is based on looking at genes, but being able to do this is all about computers, maths and statistics.”

“Ireland is a really good place to do this work; it is good for gene research. It can be easier to do these studies in Ireland because we have larger families and can compare family genes against the wider population.”

The complexity of the genetic background here is also lower than in a country such as the US or mainland Europe.

Only an international effort could tackle such a huge job, says Dr Russell McLaughlin, a postdoctoral research fellow in Trinity’s academic unit of neurology.The genetic resource created by the project will be important not just for motor neurone disease but for research into other conditions. McLaughlin is also involved in a study of irritable bowel syndrome, and the genetic information could be used to study multiple sclerosis, diabetes or Parkinson’s, says Hardiman.

Members of the consortium will share data freely, and so, although we will only pay for a part of the project, we will benefit from having access to all of the resultant data. “We get the data back,” says Vajda. “It is not giving genetic information away, it is bringing it back to us. It represents a new era in gene research. We need to be be involved. We need to be a partner in this to avoid missing out.”

View more here

Early Deaths Through Alcohol Related Illnesses

PEOPLE as young as 20 have died from alcohol-related illnesses, one of the countries leading consultants has revealed.  Dr. Stephen Stewart, a consultant hepatologist in the Mater Hospital, Dublin said there has been a stark increase in the number of young people who are presenting themselves in hospitals with alcohol related illnesses in recent years.

 Dr. Stewart revealed that he seen one young man suffering from the ill-effects of alcohol who was just 18-years-old.  "It used to be 60-year-old men, and now it is very commonly 30- and 40-year-old women, as well as those men," Dr. Stewart explained.

"There is only one guy who I saw that was 18, there was one guy who was 20-years-old who died from an alcohol related liver disease. We are seeing progressively more young to middle-aged people with end-stage liver disease.

"They are coming in jaundiced, with cirrhosis and with bad addiction. Some of those are starting drinking very young in their life, in the mid to late teens," Dr. Stewart said.  Cirrhosis is a potentially life threatening serious liver disease which occurs after large amounts of regular tissue is replaced by scar tissue in the liver.

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"Alcohol is the World Health Organisation's class one carcinogen. It's one of the few really well-known cancer causing agents", said Dr. Stewart.

"The real problems come from repeated, even moderate to heavy use . . . It increases risk of cancer, it increases risk of liver disease. It massively increases risk of breast cancer and suicide. Those are the issues long-term," he added.

View article here