eAsthmaTracker Helps Children and Caregivers
By Marcia C. Dibble
A new online asthma tracking tool developed by researchers at the University of Utah focuses on preventing rather than managing exacerbations and has been shown to reduce emergency-room readmissions for patients who have used it.
The tracker, which has a responsive design that adapts to any size computer screen, including phones, is currently being tested by children, their parents, and their health care providers in the Salt Lake Valley in a study exploring how better monitoring of the disease could improve quality of life.
The eAsthma Tracker (e-AT) is designed to aid medical decision-making through regular gauging of asthma control, early identification of deteriorating symptoms, and ongoing communication between parents and their child’s primary care providers. The tracker creates an “asthma control score” that illustrates if patients are doing well, or when an action is needed, such as use of an inhaler or even a visit to the doctor.
“The e-AT changes current ambulatory asthma care delivery to a new model that is continuous and proactive, focusing on prevention and control, rather than reactive and focusing on management of asthma attacks,” says Dr. Flory Nkoy, research director for the U’s Division of Pediatric Inpatient Medicine and associate research professor in the Department of Pediatrics, who is leading the research project. As of the end of 2014, Nkoy and his colleagues are closing the first year of a three-year, $1.9 million research award from the Patient- Centered Outcomes Research Institute to conduct the study.
The eAsthma Tracker helps parents monitor their child’s chronic asthma symptoms on a weekly basis and guides users to recognize warning signs of asthma attacks. The tool also provides primary care providers with real-time, objective patient information to monitor the effectiveness of asthma therapy. The e-AT offers age-specific educational resources for both parents and patients, including asthma-related games and interactive tools, and allows patients to personalize their profile in order to receive reminders and alerts.
An early version of the tracker, developed by Nkoy’s team in collaboration with Primary Children’s Medical Center, was found to result in a significant reduction in emergency-room readmissions within six months of discharge. In a study of its use from 2008 to 2010, the researchers observed that users of the tracker had readmission rates of only 2 percent, compared with 15 percent for non-users.
Asthma is a chronic lung disease that affects an estimated 18.9 million adults and 7.1 million children in the United States. In Utah, 6.9 percent of children and 9.1 percent of adults suffer from it. According to the Centers for Disease Control, the exact cause is unknown, but asthma triggers include tobacco smoke, pet dander, mold, pesticides, wood smoke, and overall poor air quality.
As of October, the eAsthma tracker was being used by about 200 pediatric patients in the Salt Lake area. Nkoy and colleagues will compare the e-AT study’s results with those in an existing care model, with the hope that the e-AT will produce better outcomes, such as a reduced number of missed school days and fewer acute care visits. “Our research enables and empowers families and their providers to take charge of a difficult to control condition and creates a model for sustainable, cost-effective patient care and smart utilization of information technology in a health care setting,” says Nkoy. “This model is replicable across the country and has the potential to shape the future of asthma care delivery in the nation.”
A Universal Tool in the Fight Against Ebola
University of Utah biochemists have discovered a potential new tool to combat the Ebola virus. The U researchers have produced a molecule related to a critical region of the virus that is found in all known strains. The molecule, known as a peptide mimic, could be used in the development of anti-Ebola agents that are effective against both current strains and likely future strains.
The U research, funded by the National Institutes of Health, was conducted by a large collaborative team led by Debra Eckert, research assistant professor of biochemistry, and Dr. Michael S. Kay, professor of biochemistry, with contributions from other laboratories and the pharmaceutical discovery and development company Navigen. The researchers have been working on the discovery for years and published their findings in October in Protein Science.
“Although the current push of clinical trials will hopefully lead to an effective treatment for the Zaire species causing the present epidemic, the same treatments are unlikely to be effective against future outbreaks of a different or new Ebola species,” Eckert says. “Development of a broadly acting therapy is an important long-term goal that would allow cost-effective stockpiling of a universal Ebola treatment.”
Christopher Basler, a scientist with the Mount Sinai Global Health and Emerging Pathogens Institute who was not involved in the U study, notes that the U researchers are taking a different approach than others looking for Ebola treatments. “It’s more likely to broadly block multiple Ebola viruses,” he told The Salt Lake Tribune.
Ebola is a lethal virus that causes severe hemorrhagic fever with a 50 percent to 90 percent mortality rate. There are five known species of the virus, and outbreaks have been occurring with increasing frequency in recent years. The development of an effective anti-Ebola agent to protect against natural outbreaks and potential bioterror exposures is an urgent global health need. No anti-Ebola agents have yet been approved by the U.S. Food and Drug Administration, but a number of promising experimental drugs are being aggressively advanced to clinical trials to address the current crisis.
The newly produced peptide mimic has shown promise in leading to new D-peptide inhibitor drug candidates. D-peptides are much simpler and less expensive to produce than the other currently most promising approach, antibodies. The Utah group has previously developed highly potent and broadly acting D-peptide inhibitors of HIV entry, currently in preclinical studies, and is adapting this approach to Ebola. The U and Navigen are now seeking additional funding to optimize these inhibitors and advance them into clinical trials in humans.
New Material Could Be Key to Superfast Computers
Quantum computers could revolutionize the electronics industry, offering processing speeds many times faster than today’s technology, but until now, no design has been able to overcome one serious drawback: overheating. University of Utah engineers have found a way to create a special material that could lead to cost-effective, superfast computers that perform lightning-fast calculations but don’t overheat.
This new “topological insulator”—a metal layer on top of a silicon semiconductor— behaves like an insulator on the inside but conducts electricity on the outside and may pave the way for quantum computers and fast spintronic devices. The research was led by Feng Liu, professor and chair of the U’s Department of Materials Science and Engineering.
Since the discovery of topological insulators almost a decade ago as a class of material designed to speed up computers, scientists have been trying to create a topological insulator that creates a large energy gap. An energy gap is the amount of energy it takes for electrons to conduct electricity in a given material. A larger gap allows electricity to be conducted on a material’s surface so a computer can operate at room temperature while remaining stable.
Liu and his team found that bismuth metal deposited on the silicon can result in a more stable large-gap topological insulator. The process also can be cost-effective and readily integrated with current widespread silicon semiconductor manufacturing techniques.