What Is The Most Useful Characteristic Of A Tortoise?

Source: Pets 4 Homes

Anyone with Type 1 diabetes will tell you that delivering insulin via syringe gets old very quickly.  Although, most patients get used to the process very quickly and as time passes do not even realize that the process might seem unusual throughout the day to a person who knows nothing about type 1 diabetes.  New technologies of insulin delivery have been arriving in different forms such as inhalers, insulin pens, jet injectors, insulin pumps, etc.  Each have their positive and negative aspects to the delivery of insulin.



Now, the next generation solution to delivering insulin via the oral pathway is being researched and reported in the "Director's Blog" on the National Institutes for Health website.  The answer seems to be inspired by the tortoise.  Yes, the tortoise shown in the picture above:

In a study published in the journal Science, a team, led by Robert Langer at Massachusetts Institute of Technology, Cambridge, and Giovanni Traverso, Brigham and Women’s Hospital, Harvard Medical School, Boston, took a new approach to the problem by developing a tiny, ingestible injection system [1]. They call their pea-sized device SOMA, short for “self-orienting millimeter-scale applicator.”

In designing SOMA, the researchers knew they had to come up with a design that would orient the injection apparatus correctly. So they looked to the African leopard tortoise. They knew that, much like a child’s “weeble-wobble” toy, this tortoise can easily right its body if tipped over due to its low center of gravity and highly curved shell. With the shape of the tortoise shell as a starting point, the researchers used computer modeling to perfect their design. The final result features a partially hollowed-out, polymer-and-steel capsule that houses a tiny, spring-loaded needle tipped with compressed, freeze-dried insulin. There is also a dissolvable sugar disk to hold the needle in place until the time is right.

Here’s how it works: once a SOMA is swallowed and reaches the stomach, it quickly orients itself in a way that its needle-side rests against the stomach wall. After the protective sugar disk dissolves in stomach acid, the spring-loaded needle tipped with insulin is released, injecting its load of insulin into the stomach wall, from which it enters the bloodstream. Meanwhile, the spent SOMA device passes on through the digestive system.

The researchers were challenged to deliver a medication consistently to the side wall of the stomach.  If this method is to be used in the future, then not only insulin should be able to be delivered via injection but also other biological therapeutics -- proteins, peptides, and nucleic acids.  Plus the challenge is to overcome the extremely acidic (low pH) environment along with digestive enzymes in the stomach wall through to the bloodstream - unaffected.



First though, the drug needs to be consistently delivered via injection into the stomach wall.  How do you position a vial of medication inside the stomach to have the correct orientation such that the injection into the side wall of the stomach is easily accomplished?  The answer lies in taking the unwavering ability of nature to have animals keep their orientation intact.  By that I mean, the tortoise is able to reorient itself by turning itself over in a variety of situations.  The solution is the 'self-orienting millimeter-scale applicator".  A picture of the device is shown below:

Source: NIH Director's Blog

Last but not least, the researchers were able to show the ability to deliver a payload (a dose) which is equivalent to that of a normal dose currently.  The dose was 3 milligrams which is equivalent to the current dose given through injection to a human.   One of the many novel aspects of this design is that the delivery of medication without excess chemicals which serve little or no purpose.  By this I mean that normally medication is composed of the active ingredient plus a 'matrix' of chemicals which assist in the delivery of that active ingredient into the blood stream.  This includes through the acidic environment along with moving that medication past the digestive enzymes in the stomach wall.  Additionally, the ability to reduce unwanted side effects due to the 'matrix' chemicals is greatly appreciated.



To gain more insight into the study, feel free to read the original research which was published in the Journal 'Science' titled "An ingestible self-orienting system for oral delivery of macromolecules."  The research highlighted above represents exciting solutions which make our lives easier.  Innovative designs and concepts will ultimately make life better in the future.  Anytime there are additional (new) avenues by which to deliver drugs which are non-invasive and easy along with being effective represent true innovative steps in research and discovery.



The pathway toward realization hopefully will be mainstreamed to deliver an alternative solution to the existing solutions thus far.  Moreover, the importance of this project is proven by the efficacy along with our ability to come up novel designs which overcome interesting challenges presented to us with the biological (human) system with which we work with.



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How Many People Can 254 Pounds Of Fentanyl Kill?

Source: Fortune

The largest amount of Fentanyl seized in a drug bust to cross the Mexico border into the United States occurred a little over a week ago as reported on 'Voice Of America' recently:

PHOENIX — 

U.S. Customs and Border Protection officials announced Thursday their biggest fentanyl bust ever, saying they captured nearly 254 pounds (114 kilograms) of the synthetic drug that is helping fueling a national epidemic of fatal opioid overdoses from a secret compartment inside a load of Mexican produce heading into Arizona.

And shown (the picture taken from the article) below:

Source: VOA

Readers who are familiar with my writing will remember that I wrote a similar post on this very topic a half a year ago.  In that post, I developed the methodology for determining the amount of Fentanyl needed to kill a person.  The result was a range of 2-3 milligrams needed to kill an adult.  WOW.  The photograph at the beginning of the blog post illustrates the differences of quantities needed between heroine and Fentanyl to kill a person.  As you can see the vial located on the right has barely any powder inside of it.  Hence, the range of 2-3 milligrams is spot on.



Of course, as I also mentioned in the previous blog post, the exact amount needed to kill a person has never been determined.  That amount would be officially reported as the 'LD50' -- the amount needed to kill 50% of the population (testing population) off.

254 Pounds Of Fentanyl = "x" Deaths?

First, the amount of milligrams contained in a single pound are needed.  Why?  The Fentanyl was reported in units of measurement -- pounds -- in the article.  Whereas the range of quantities needed to kill a person is expressed in units of 'milligrams'.  Therefore, consulting Google with the following question: How many milligrams are in a pound?  The following answer appears as shown below:

There are 453,592 milligrams in a pound.  The only unit conversion for this analysis is ready to be accomplished given the conversion factor obtained above.  Since there are 453,592 milligrams in a pound, the number of milligrams in 254 pounds can be determined as shown below:

The calculation above reveals that in 254 pounds of Fentanyl, there are 115,212,368 milligrams.  Now the amount of people which could be killed with 254 pounds of Fentanyl can be determined.  This is because all of the numbers are expressed in the same units of measurement -- milligrams.



Since the number cited in my previous blog post was a range of values 2-3 milligrams, the answer which is expected will also be a range.  Shown below are the two values which make up the range of the amount of Fentanyl needed to kill a single person:

And the upper limit of the range is 3 milligrams as shown below:

Our analysis shows that the total number of people which could be killed with 254 pounds of Fentanyl (which was seized at the border) is between 38.4 million and 58 million people.  Oh my goodness. These statistics need to be stated in news articles too.  The problem with stating the statistics is that there are no hard numbers which represent the LD50 of Fentanyl.



Regardless, the amount of Fentanyl needed is super small compared to the amount of heroin needed to kill a person.  Which really drives up the danger posed with seizing the drug.  If border agents or other law enforcement agencies do not have adequate training on handling the seizure of such an enormous amount, death could be a strong possibility.  Therefore, handling the Fentanyl coming across the border should be carried out with the utmost (and urgent) care to avoid any large catastrophe (or death).



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The future: Making Medicines in your kitchen?

Source: New York Times

Synthesizing drugs in a cooking kitchen is usually reserved for dangerous drug dealers or characters in the popular crime/drama show 'Breaking Bad.'  Although, in China, last November, the New York Times reported on the shortage of drugs which has driven those desperate for medications to resort to drug synthesis in kitchen's (as shown above) and described below:

Zhang Zhejun used a fat plastic straw to gently tap the pale yellow pharmaceutical powder onto a piece of silver foil that lay on an electronic scale. He made sure the amount was just right before he poured it into a clear capsule.

When you’re making cancer drugs at home, the measurements must be precise.

Mr. Zhang has no medical experience and no background in making drugs professionally. He did this out of desperation. His mother suffered from lung cancer and required expensive drugs that China’s ambitious but troubled health care system couldn’t provide.

He was aware of the risks. The drug he was making hadn’t been approved by regulators in China or the United States. Mr. Zhang had bought the raw ingredients online, but he wasn’t sure from whom, or whether they were even real.

As described in the article cited above, the prices of medications are driven by a crisis in health insurance coverage in China.  Since drugs have been synthesized in the kitchen by many around the world over decades (illegally I might add), one is left to wonder with the advances in technology, how far off are we from synthesizing drugs in a kitchen?  Why would I ask such a question?



As technology increases in the pharmaceutical sector along with advancing nanotechnology, the prospect of making pharmaceutical (drugs) might soon be possible from within your kitchen. What?  Yes, you heard me correctly.  Until a few days ago, I was unaware of the fact of the possibility also.  I was catching up on old blog posts on the National Institutes of Health website.  Specifically, the Director of the National Institutes of Health personal blog site -- which is awesome I might add.



After reading the blog post discussed below, I remembered the article cited above from the New York Times.  I just had to connect the two for a blog post.  And here we are.  According to the Director's blog page for the National Institutes of Health, new research and emerging technology called Integrated Scalable Cyto-Technology (InSCyT) as described below:

Today, vaccines and other protein-based biologic drugs are typically made in large, dedicated manufacturing facilities. But that doesn’t always fit the need, and it could one day change. A team of researchers has engineered a miniaturized biopharmaceutical “factory” that could fit on a dining room table and produce hundreds to thousands of doses of a needed treatment in about three days.

As published recently in the journal Nature Biotechnology, this on-demand manufacturing system is called Integrated Scalable Cyto-Technology (InSCyT). It is fully automated and can be readily reconfigured to produce virtually any approved or experimental vaccine, hormone, replacement enzyme, antibody, or other biopharmaceutical. With further improvements and testing, InSCyT promises to give researchers and health care providers easy access to specialty biologics needed to treat rare diseases, as well as treatments for combating infectious disease outbreaks in remote towns or villages around the globe.

In today’s commercial manufacturing facilities, biologic therapies used to treat cancer, cardiovascular disease, and many other disorders are made in huge vats, in which harmless bacteria, yeast, or mammalian cells churn out large quantities of a single product. But researchers, led by NIH grantee J. Christopher Love, Massachusetts Institute of Technology (MIT), Cambridge, have recognized a growing need to design a new kind of manufacturing system, capable of producing a wide variety of clinical-grade products on an as-needed basis.

Dr. Collins continues on in the blog post to describe the simple 3-step modular process: Production, Purification, and Formulation.  The three module system is interconnected and as described in the introduction could potentially fit onto a kitchen or dining room table.  Currently, the researchers were able to produce (synthesize) Human Growth Hormone (HGH).  Of course, this was due to the extensive knowledge surrounding HGH by the scientific community.



Other synthetic compounds were listed.  Typical process development times are at around 12 weeks to fully develop a process for medication.  The amount of doses possible to synthesize in a given week are an astounding 100.  Yes, with this modular set up, the prospect of synthesizing 100 doses in a single week is supposedly being reported.



Currently, the process is composed of plastic bottles, vials, and instruments linked with plastic tubing.  In the future, researchers hope to make the system more user-friendly for the non-chemist in the house.  Does this research line up with where we are as a society?



Shows like 'Breaking Bad' tells us that synthesis is dangerous but a potentially profitable business if you are willing to take the risk.  On the flip side, if the residents in the United States were confronting the crisis in resourcing their medications like those in China are, where are we left to be?  Add to that, the changing academic landscape which is moving more courses from a traditional lecture based room to an online platform - such as "MOOC" - Massive Open Online Courses.



A cursory search for home ready lab class kits reveal a couple of contenders.  First up is a company called "Hands On Labs."  Shown below is an overview video of the product/platform:

The company has been successfully providing lab experiments to universities and people from 1994.  Of course, that is not to say that 'Hands On Labs" has been shipping chemistry labs to individual houses for instruction since 1994.  Individual shipping has kept pace with the development of the 'Massive Open Online Course' platform.  More and more universities are leaning or being nudged to adopt a version of this curricula as technology improves and education changes.  Visit 'Hands On Labs' website for greater detail.



Next up is a competitor company is 'Carolina Biological Supply Company' with a website filled with kits ready for purchase and soon to be shipped immediately after.  Here is an introductory video shown below:

The company was founded by professors as indicated on their 'Wikipedia' page.  For those interested in looking into greater detail into Carolina Biological Supply Company, access their website by clicking here or their YouTube Channel by clicking here.  The range of experiments and samples offered by these companies really gives a person a sense that the university is rapidly disappearing. Not so...at least for the moment.



There still exists a large array of common experiments which cannot be 'outsourced' to an individual's home for self application.  Hazardous chemicals which work extremely well in certain synthetic routes still need to be professionally handled by trained staff members at the university.  Although, one could argue that the production of such kits is great for one reason alone.  Production of laboratory kits with experiments which illustrate principles taught in first and second year chemistry course will improve science overall.  What do I mean by this?



As the world changes toward more sustainable living conditions, corporations will eventually have to find 'greener' substitutes for harsher (corrosive) chemicals.  Products from companies listed above give us hope that the transition is already being considered.  Any shipped chemistry experiment has the potential to turn a kitchen or workspace inside a house into a disaster zone if improperly handled.  Therefore, the researchers/producers of such kits need to consider every possible misuse of their products by the average user.



In turn, this discovery/consideration forms the impetus for a transition inside of corporations to change toward more environmentally friendly chemicals in their commercial synthesis.  Lab kits like those above are exciting and show the range of possibilities when good scientists put their thinking caps on and think critically toward alternatives which are safe for the consumer and safe for the environment.  Hopefully, no American resident finds himself/herself in a position as described in the New York Times article above -- synthesizing medication in their kitchen out of necessity.  Although, if they do, at least commercial products which have been introduced above will provide a platform for success.



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NIDA Director Nora Volkow: How Health Communicators and Journalists Can Help Replace Stigma with Science

Source: Clay Behavioral Health Center

Drug addiction affects us either indirectly or directly in some way.  To say that it does not, is not really looking at the whole picture.  Statistics of death and addiction from drugs are all over the news along with stories which stigmatize people who suffer from drug addiction.  These actions are not only not helpful, but actually can result in greater drug use and distortion of the problem at large.  Director Nora Volkow is very familiar with these distortions on behalf of the news.  She wrote a letter as director of the National Institute of Drug Abuse (NIDA) to spell out the issue at large:

Director, NIH's National Institute on Drug Abuse (NIDA)

No matter how much progress we make in understanding addiction and how to treat it, my colleagues and I in the field of addiction science keep running into the same obstacle: There are still people who believe addiction is a moral failing that could be solved if the person had more willpower. In fact, the science is clear: Addiction is a chronic, relapsing neurobiological disorder caused by changes in the brain that make controlling drug use extremely difficult, even when an individual knows it has terrible consequences for his or her life and health and wants to stop. It goes well beyond willpower.

Sadly, the drug seeking and related behaviors that typify this disease—which can include lying and failing to meet work and family responsibilities—can make it challenging for loved ones or care providers to have compassion or empathy, and this reinforces the misconceptions. The resulting social stigma can make it difficult for those suffering with addiction to ask for help and can make them less likely to get the help they need when they do summon the courage to ask.

Indeed, only a fraction of people with substance use disorders seek out or receive treatment. For example, in 2015, an estimated 21.7 million people aged 12 or older needed substance use disorder treatment, but only 2.3 million received treatment at a specialty facility. Even those who can access affordable treatment often find themselves in a rehab facility that does not use evidence-supported treatments, such as buprenorphine or methadone for opioid addiction.

I have imaged the brain of addicted individuals for decades, and through these studies I have seen how drug use and addiction changes activity in the brain. Though drugs act by activation of brain reward circuits, which generates the high and the euphoria, their repeated use leads to adaptations that makes them increasingly less sensitive to both natural and drug rewards. The result is that the person no longer experiences pleasure in response to natural rewards—such as food, sex, or positive social interactions—and loses the motivation for achieving these rewards. In parallel, drug use renders brain circuits that control stress responses more reactive, making the person more vulnerable to stress and negative moods while also impairing frontal cortical areas of the brain that enable self-control and decision-making. These changes make it harder for someone with an addiction to manage stress, control impulses, and make the healthy choice to stop drug use.

How Communicators Can Help

Many science journalists go to great lengths to report the science behind addiction, but others do not, perhaps because they believe they have a commonsense understanding of substance use and addiction. But we are often misguided when we assume that our own experiences translate to someone else’s. Most people who use alcohol or drugs never become addicted, and there are many individual biological, social, and psychological factors that influence one’s risk.

Journalists can help reduce the stigma toward addiction by providing information that helps the reader understand the person suffering from addiction rather than writing stories that generate anger and disgust. Increasing the public understanding of the underlying pathology and cultural reinforcers of addiction is a critical first step for improving the way our society addresses addiction. Journalists can now dig deeper and ask how we can facilitate a more compassionate public health-based approach to those suffering from addiction.

There is no immediate solution to solve the ongoing problem of drug abuse and addiction.  As I said in a previous post, I am a member of Alcoholics Anonymous (AA).  I say this because there are routes which are not highly publicized which lead to viable solutions.   One of the best solutions is one drug/alcohol addict talking to another.  Just like one person casually asks a network of friends what are the best solutions to issues at hand, an addict can get help from another addict in AA.



The power behind the AA program is that there will always be an 'ear' available to listen and help you when in need.  There are a whole host of AA meetings throughout the United States (and world for that matter) to give a person an ample change to get help.  What AA will not do for you is provide a solution which is 'effort free'.  Sobriety is great but work too.  Living life on the straight and narrow as is said takes work and dedication.  The framework behind AA gives a person the opportunity to live a wonderful life.  I highly recommend trying the program if in need.



With that being said about treatment, there is a lot of room for improvement on the Journalism front.  What is reported in the news is highly stigmatized -- which upon entry is counter to what you learn about the program.  Further, alcohol addiction is not very much different from any other addiction.  As indicated by Director Nora above in the letter -- activating the brain 'rewarding circuits' can be achieved by a number of 'vices' - which can lead easily to addiction.  Traditionally, drug/alcohol addiction is stigmatized the greatest in the news and society.



In closing, I will provide an example.  Think of a person riding their bicycle around town -- an adult.  At first sight, if the cyclist is not wearing lycra (spandex pants), a common perception is that person got a DUI - driving under the influence of alcohol.  That designation stigmatizes the person into a negative category.  Instead, maybe the person just wants to incorporate a little exercise into his/her commute by riding a bicycle around town.  Instead, a potentially good situation has now been perceived (and quite possibly reported) as a negative situation.



Further, reporting on the negative stigma might persuade a person (separate person from the cyclist) not to pursue riding a bicycle -- making a better change for their health.  That is one example which serves as evidence of a need to change how reporting on society could link drug/alcohol addiction to a problem which does not exist.   That is one example - perception.  What about science?



The science behind addiction treatment has been changing over the last couple of decades.  Medicines do exist to curb addiction to alcohol along with other drugs.  The efficacy of these treatments by themselves is severely under reported.  Treatments only can take an addict so far.  Common treatments (drugs, short term treatment) are usually coupled with other treatment methods from the medical community -- psychiatry and psychology.  More could be reported on this front to provide solutions to people.



Other medications are being developed to treat people with addiction on a long term basis.  These medications are still being developed or are in clinical trials.  Why not report on these medications?  Society needs to understand where each field is at presently.  Otherwise, why should anyone expect viable treatments to be funded in the future.  Journalists could change how they portray situations and drug/alcohol abuse in general.  Maybe then, more people might find the help that they are in great need of.



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