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New 'swallowable needles' could deliver insulin as a pill

Diabetics have to endure constant injections on a daily basis, but this new device could make staying alive easier.

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  • Insulin breaks down in the stomach, so diabetics haven't had the option of taking insulin in a pill.
  • A new device whose design is inspired by tortoises can be swallowed and inject diabetics with insulin from the inside.
  • Though it's still a prototype, the device is an exciting development for delivering insulin and other drugs.

No matter the delivery mechanism, consistently getting a dose of insulin is inconvenient, complicated, and non-negotiable. The unfortunate nature of insulin is that it must enter the bloodstream—if one were to swallow insulin as a pill, for instance, the stomach's enzymes would break the compound down, rendering it useless. So, diabetics must resort to constant injections. However, every new advancement in insulin administration technology has the potential to vastly improve the onerous task of staying alive for a diabetic. This is why a new paper published in Science is so exciting.

A team of researchers has developed a prototype for what amounts to insulin in a pill. But, since insulin can't persist in the stomach, the new device is more accurately described as a swallowable needle. That may sound terrifying, but their research thus far suggests that it's safe, effective, and painless. SOMA—or the self-orienting millimeter-scale applicator—is a tiny device about 1.7 mm tall. When swallowed, it flips and turns around in the stomach, landing in such a way that a biodegradable needle can be deployed into the stomach lining. Because there aren't that many sharp pain receptors in the stomach, this needle causes no pain. And SOMA is small enough that once it's done its job, it easily passes through the rest of the digestive tract.

How does it work?

Like many well-designed products, SOMA took its inspiration from nature; specifically, the leopard tortoise. Tortoises in general have a big problem: Once they flip onto their backs, they have a lot of trouble getting back upright. Stuck upside down, they're liable to be eaten by predators or cooked in the hot sun. Some tortoises, like the leopard tortoise, have evolved a unique shape that makes orienting themselves easier. Their bottom half is fairly flat, but the top of their shells arches up in a sharp, dome-like shape. This is the same design that SOMA uses—it's shaped like a leopard tortoise's shell or an acorn so that it lands on its bottom, where the needle emerges. Furthermore, the top half of the device is made out of a lightweight, biodegradable polyester, while the bottom half is made of heavier stainless steel, encouraging it to flip in the necessary direction.

A leopard tortoise, whose shell shape inspired the design, and a cross section of the device.

Abramson et al., 2019

To test the device, the researchers fed SOMA to pigs, whose physiology resembles that of humans in many respects. In these trials, the researchers made a needle of biodegradable polymer, with a tip made from insulin. Once injected, the insulin performed as expected, encouraging the cellular uptake of glucose. Since these pigs weren't diabetic, though, this wasn't exactly a pleasant experience for them—they became hypoglycemic, where their blood sugar levels dropped too low. Before you worry too much, the researchers did rescue them with a quick dose of dextrose, bringing their blood sugar back to normal.

What's next?

While insulin was used for testing purposes and is clearly an exciting use case for this technology, it's not the only drug SOMA could be used for. In theory, any drug that can be cast into a needle tip and administered safely and stably through stomach lining could be used.

While its certainly an innovative technology, it's important to remember that this is just a prototype. How it might work in humans, especially diabetics who must consistently take insulin, is unclear. The repeated internal injections could be unsafe. In addition, the size of the device and the thickness of the stomach lining limit the maximum dosage SOMA can deliver, potentially rendering it ineffective for certain medications. But despite these possible limitations, SOMA's promising prototype trials suggest that a drug-delivery system like it could be put into use in the future.

Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Lee Jae-Sung of Korea Republic lies on the pitch holding his knee during the 2018 FIFA World Cup Russia group F match between Korea Republic and Germany at Kazan Arena on June 27, 2018 in Kazan, Russia.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

Surprising Science

How often do vaccine trials hit paydirt?

Vaccines find more success in development than any other kind of drug, but have been relatively neglected in recent decades.

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