Don Bailey, Ph.D., director of the Center for Newborn Screening, Ethics, and Disability Studies at RTI International in Research Triangle Park, North Carolina, had been on a quest to collect evidence to support the inclusion of fragile X syndrome and other rare genetic diseases in standard newborn screenings. These efforts had stalled because adding a new screening test to the set of these screenings requires that an effective treatment be available for the specific disease.
It's a catch-22 situation and a translational bottleneck: Without evidence that a treatment is more effective when started earlier, a test for a genetic disease cannot be included in the standard newborn screening panel. But the evidence cannot be collected without a screening program. Rare disorders, like fragile X syndrome, pose an even greater challenge because of the tremendous difficulty identifying enough cases to conduct studies, especially before symptoms appear.
Drug overdoses are among the few causes of death on the rise, and now kill more people than guns or motor vehicles. From 2014 to 2015 alone, the number of drug deaths in North Carolina increased by 22%, over half attributed to opioids, a class of drugs that includes both illegal (such as illicit heroin) and prescription (such as morphine, hydrocodone, and prescription fentanyl) substances.
At a recent symposium, UNC epidemiologist Steve Marshall urged some 100 physicians, public health researchers, basic scientists, and pharmacists, to put their heads together to come up with solutions for what many call the worst drug crisis in American history.
"Think about how much was done to prevent motor vehicle deaths seat belts, modifications to roads and cars, driver training," said Marshall, who directs the UNC Injury Prevention Research Center. "We need to build up that kind of commitment to prevent drug overdoses, from a research standpoint. If one of us was going to solve this on our own, that would have happened a long time ago. That is why team science is so important."
Marshall made his comments at "Combating Opioid Addiction and Overdose: Advancing Science and Policy," a five-hour symposium held on Thursday, May 25 in the Blue Cross Blue Shield Auditorium at Rosenau Hall on the UNC campus.
Emerging theme of the University of North Carolina at Chapel Hill Health Informatics Symposium getting the right data to the right person at the right time
In 2015, US national health expenditures totaled $3.2 trillion, or almost $10,000 per person. The Centers for Medicare and Medicaid Services project that these expenditures will continue to increase through the year 2025. How do we stop or reverse this trajectory without compromising access to healthcare or the quality of that care?
One answer to this conundrum is getting the right data to the right person at the right time, which was a refrain heard throughout the University of North Carolina at Chapel Hill Health Informatics Symposium held in April 2017. The symposium brought together a diverse group of over 100 attendees, including faculty and staff from UNC-Chapel Hill, Duke University, NC State University, NC Central University, East Carolina University, as well as industry partners from across North Carolina, to discuss the use of data in healthcare systems.
In his keynote, Using Big Data to Improve Outcomes Under Accountable Care, Dr. David Bates reinforced the health expenditure problem that we are grappling with as a nation. "We spend a lot more per capita than any other country on health and if you look at the percentage of our total expenditures as a percent of GDP, that's really high," he explained. "We're about twice as high as the next leading competitor. This has been a real issue for us. And I would submit that this is the burning platform in healthcare in the US today and something that we've got to do something about." Dr. Bates is an internationally renowned expert in patient safety, using information technology to improve care, quality-of-care, cost-effectiveness, and outcomes assessment in medical practice. He is the Chief of the Division of General Internal Medicine and Primary Care at Brigham and Women's Hospital, a Professor of Medicine at Harvard Medical School, and a Professor of Health Policy and Management at the Harvard School of Public Health.
Raleigh, N.C. Researchers from North Carolina State University and the University of North Carolina at Chapel Hill have developed a new technique that uses modified insulin and red blood cells to create a glucose-responsive "smart" insulin delivery system. In an animal model study, the new technique effectively reduced blood sugar levels for 48 hours in a strain of mice that had Type 1 diabetes.
The researchers modified insulin by chemically binding it to a glucose derivative called glucosamine. The glucosamine could then bind to glucose transporters on the surface of a red blood cell, effectively attaching the insulin to the blood cell. The end result is a red blood cell studded with insulin molecules.
The idea is that these insulin-loaded blood cells could then be injected into a diabetic patient. In this study, the work was done in Type 1 diabetic mice.
Once in the bloodstream, the blood cells carrying insulin interact with their environment. If glucose levels are high, glucose molecules effectively displace the glucosamine in the blood cells' glucose transporters. And when the glucosamine is set free from the blood cell, so is the insulin.