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A smartphone’s camera and flash could help people measure blood oxygen levels at home

When we breathe in, our lungs fill with oxygen, which is distributed to our red blood cells for transportation throughout our bodies. Our bodies need a lot of oxygen to function, and healthy people have at least 95% oxygen saturation all the time.

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Newswise — First, pause and take a deep breath. 

When we breathe in, our lungs fill with oxygen, which is distributed to our red blood cells for transportation throughout our bodies. Our bodies need a lot of oxygen to function, and healthy people have at least 95% oxygen saturation all the time.

Conditions like asthma or COVID-19 make it harder for bodies to absorb oxygen from the lungs. This leads to oxygen saturation percentages that drop to 90% or below, an indication that medical attention is needed. 

In a clinic, doctors monitor oxygen saturation using pulse oximeters — those clips you put over your fingertip or ear. But monitoring oxygen saturation at home multiple times a day could help patients keep an eye on COVID symptoms, for example.

In a proof-of-principle study, University of Washington and University of California San Diego researchers have shown that smartphones are capable of detecting blood oxygen saturation levels down to 70%. This is the lowest value that pulse oximeters should be able to measure, as recommended by the U.S. Food and Drug Administration.

The technique involves participants placing their finger over the camera and flash of a smartphone, which uses a deep-learning algorithm to decipher the blood oxygen levels. When the team delivered a controlled mixture of nitrogen and oxygen to six subjects to artificially bring their blood oxygen levels down, the smartphone correctly predicted whether the subject had low blood oxygen levels 80% of the time.

The team published these results Sept. 19 in npj Digital Medicine.

“Other smartphone apps that do this were developed by asking people to hold their breath. But people get very uncomfortable and have to breathe after a minute or so, and that’s before their blood-oxygen levels have gone down far enough to represent the full range of clinically relevant data,” said co-lead author Jason Hoffman, a UW doctoral student in the Paul G. Allen School of Computer Science & Engineering. “With our test, we’re able to gather 15 minutes of data from each subject. Our data shows that smartphones could work well right in the critical threshold range.”

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Another benefit of measuring blood oxygen levels on a smartphone is that almost everyone has one.

“This way you could have multiple measurements with your own device at either no cost or low cost,” said co-author Dr. Matthew Thompson, professor of family medicine in the UW School of Medicine. “In an ideal world, this information could be seamlessly transmitted to a doctor’s office. This would be really beneficial for telemedicine appointments or for triage nurses to be able to quickly determine whether patients need to go to the emergency department or if they can continue to rest at home and make an appointment with their primary care provider later.”

The team recruited six participants ranging in age from 20 to 34. Three identified as female, three identified as male. One participant identified as being African American, while the rest identified as being Caucasian.

To gather data to train and test the algorithm, the researchers had each participant wear a standard pulse oximeter on one finger and then place another finger on the same hand over a smartphone’s camera and flash. Each participant had this same set up on both hands simultaneously.

“The camera is recording a video: Every time your heart beats, fresh blood flows through the part illuminated by the flash,” said senior author Edward Wang, who started this project as a UW doctoral student studying electrical and computer engineering and is now an assistant professor at UC San Diego’s Design Lab and the Department of Electrical and Computer Engineering.

“The camera records how much that blood absorbs the light from the flash in each of the three color channels it measures: red, green and blue,” said Wang, who also directs the UC San Diego DigiHealth Lab. “Then we can feed those intensity measurements into our deep-learning model.” 

Each participant breathed in a controlled mixture of oxygen and nitrogen to slowly reduce oxygen levels. The process took about 15 minutes. For all six participants, the team acquired more than 10,000 blood oxygen level readings between 61% and 100%.

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The researchers used data from four of the participants to train a deep learning algorithm to pull out the blood oxygen levels. The remainder of the data was used to validate the method and then test it to see how well it performed on new subjects.

“Smartphone light can get scattered by all these other components in your finger, which means there’s a lot of noise in the data that we’re looking at,” said co-lead author Varun Viswanath, a UW alumnus who is now a doctoral student advised by Wang at UC San Diego. “Deep learning is a really helpful technique here because it can see these really complex and nuanced features and helps you find patterns that you wouldn’t otherwise be able to see.”

The team hopes to continue this research by testing the algorithm on more people.

“One of our subjects had thick calluses on their fingers, which made it harder for our algorithm to accurately determine their blood oxygen levels,” Hoffman said. “If we were to expand this study to more subjects, we would likely see more people with calluses and more people with different skin tones. Then we could potentially have an algorithm with enough complexity to be able to better model all these differences.”

But, the researchers said, this is a good first step toward developing biomedical devices that are aided by machine learning. 

“It’s so important to do a study like this,” Wang said. “Traditional medical devices go through rigorous testing. But computer science research is still just starting to dig its teeth into using machine learning for biomedical device development and we’re all still learning. By forcing ourselves to be rigorous, we’re forcing ourselves to learn how to do things right.” 

Additional co-authors are Xinyi Ding, a doctoral student at Southern Methodist University; Eric Larson, associate professor of computer science at Southern Methodist University; Caiwei Tian, who completed this research as a UW undergraduate student; and Shwetak Patel, UW professor in both the Allen School and the electrical and computer engineering department. This research was funded by the University of Washington. The researchers have applied for a patent that covers systems and methods for SpO2 classification using smartphones (application number: 17/164,745).

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Source: University of Washington

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Rural Americans don’t live as long as those in cities − new research

Rural Americans, especially men, face shorter life expectancies compared to urban dwellers due to higher rates of chronic conditions and limited healthcare access. Education disparities significantly contribute to these health inequities, influencing lifestyle choices and economic stability.

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Rural Am,ericans
Part of the problem is that people living in rural areas don’t always have easy access to health care. cstar55/iStock via Getty Images

Elizabeth Currid-Halkett, University of Southern California; Bryan Tysinger, University of Southern California, and Jack Chapel, University of Southern California

Rural Americans – particularly men – are expected to live significantly shorter, less healthy lives than their urban counterparts, according to our research, recently published in the Journal of Rural Health.

We found that a 60-year-old man living in a rural area is expected on average to live two fewer years than an urban man. For women, the rural-urban gap is six months.

A key reason is worse rates among rural people for smoking, obesity and chronic conditions such as high blood pressure and heart disease. These conditions are condemning millions to disability and shortened lives.

What’s more, these same people live in areas where medical care is evaporating. Living in rural areas, with their relatively sparse populations, often means a shortage of doctors, longer travel distances for medical care and inadequate investments in public health, driven partly by declines in economic opportunities.

Our team arrived at these findings by using a simulation called the Future Elderly Model. With that, we were able to simulate the future life course of Americans currently age 60 living in either an urban or rural area.

The model is based on relationships observed in 20 years of data from the Health and Retirement Study, an ongoing survey that follows people from age 51 through the rest of their lives. Specifically, the model showed how long these Americans might live, the expected quality of their future years, and how certain changes in lifestyle would affect the results.

We describe the conditions that drive our results as “diseases of despair,” building off the landmark work of pioneering researchers who coined the now widely used term “deaths of despair.” They documented rising mortality among Americans without a college degree and related these deaths to declines in social and economic prospects.

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The main causes of deaths of despair – drug overdoses, liver disease and suicide – have also been called “diseases of despair.” But the conditions we study, such as heart disease, could similarly be influenced by social and economic prospects. And they can profoundly reduce quality of life.

We also found that if rural education levels were as high as in urban areas, this would eliminate almost half of the rural-urban life-expectancy gap. Our data shows 65% of urban 60-year-olds were educated beyond high school, compared with 53% of rural residents the same age.

One possible reason for the difference is that getting a bachelor’s degree may make a person more able or willing to follow scientific recommendations – and more likely to work out for 150 minutes a week or eat their veggies as their doctor advises them to. https://www.youtube.com/embed/_WzwHJbAGVc?wmode=transparent&start=0 Rural communities are increasingly hampered by their lack of access to health care.

Why it matters

The gap between urban and rural health outcomes has widened over recent decades. Yet the problem goes beyond disparities between urban and rural health: It also splits down some of the party lines and social divides that separate U.S. citizens, such as education and lifestyle.

Scholarship on the decline of rural America suggests that people living outside larger cities are resentful of the economic forces that may have eroded their economic power. The interplay between these forces and the health conditions we study are less appreciated.

Economic circumstances can contribute to health outcomes. For example, increased stress and sedentary lifestyle due to joblessness can contribute to chronic health issues such as cardiovascular disease. Declines in economic prospects due to automation and trade liberalization are linked to increases in mortality.

But health can also have a strong influence on economic outcomes. Hospitalizations cause high medical costs, loss of work and earnings, and increases in bankruptcy. The onset of chronic disease and disability can lead to long-lasting declines in income. Even health events experienced early in childhood can have economic consequences decades later.

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In tandem, these health and economic trends might reinforce each other and help fuel inequality between rural and urban areas that produces a profoundly different quality of life.

What still isn’t known

It should be noted that our results, like many studies, are describing outcomes on average; the rural population is not a monolith. In fact, some of the most physically active and healthy people we know live in rural areas.

Just how much your location affects your health is an ongoing area of research. But as researchers begin to understand more, we can come up with strategies to promote health among all Americans, regardless of where they live.

The Research Brief is a short take on interesting academic work.

Elizabeth Currid-Halkett, James Irvine Chair in Urban and Regional Planning and Professor of Public Policy, University of Southern California; Bryan Tysinger, Assistant Professor of Health Policy and Management, University of Southern California, and Jack Chapel, Postdoctoral Scholar in Economics, University of Southern California

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Food and Beverage

Seed oils are toxic, says Robert F. Kennedy Jr. – but it’s not so simple

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Seed oils have become a mainstay of the American diet. d3sign/Moment via Getty Images

Mary J. Scourboutakos, University of Toronto

Robert F. Kennedy Jr., who is expected to clear the final hurdles in his confirmation as President Donald Trump’s health secretary, and a host of health influencers have proclaimed that widely used cooking oils such as canola oil and soybean oil are toxic.

T-shirts sold by his “Make America Healthy Again” campaign now include the slogan, “make frying oil tallow again” – a reference to the traditional use of rendered beef fat for cooking.

Seed oils have become a mainstay of the American diet because unlike beef tallow, which is comprised of saturated fats that increase cholesterol levels, seed oils contain unsaturated fats that can decrease cholesterol levels. In theory, that means they should reduce the risk of heart disease.

But research shows that different seed oils have varying effects on risk for heart disease. Furthermore, seed oils have also been shown to increase risk for migraines. This is likely due to their high levels of omega-6 fatty acids. These fats can increase inflammation, a heightened and potentially harmful state of immune system activation.

As a family physician with a Ph.D. in nutrition, I translate the latest nutrition science into dietary recommendations for my patients. When it comes to seed oils, the research shows that their health effects are more nuanced than headlines and social media posts suggest.

How seed oils infiltrated the American diet

Seed oils — often confusingly referred to as “vegetable oils” — are, as the name implies, oils extracted from the seeds of plants. This is unlike olive oil and coconut oil, which are derived from fruits. People decrying their widespread use often refer to the “hateful eight” top seed oil offenders: canola, corn, soybean, cottonseed, grapeseed, sunflower, safflower and rice bran oil.

These oils entered the human diet at unprecedented levels after the invention of the mechanical screw press in 1888 enabled the extraction of oil from seeds in quantities that were never before possible.

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Between 1909 and 1999, U.S. consumption of soybean oil increased 1,000 times. This shift fundamentally changed our biological makeup. Due to increased seed oil intake, in the past 50 years the concentration of omega-6 fatty acids that Americans carry around in their fatty tissue has increased by 136%

https://datawrapper.dwcdn.net/rFwW9/1

Evaluating the omega-6 to omega-3 fatty acid ratio

Omega-6 and omega-3 fatty acids are essential nutrients that control inflammation. While omega-6s tend to produce molecules that boost it, omega-3s tend to produce molecules that tone it down. Until recently, people generally ate equal amounts of omega-6 and omega-3 fatty acids. However, over the past century, this ratio has changed. Today, people consume 15 times more omega-6s than omega-3s, partly due to increased consumption of seed oils.

In theory, seed oils can cause health problems because they contain a high absolute amount of omega-6 fatty acids, as well as a high omega-6 to omega-3 ratio. Studies have linked an increased omega-6 to omega-3 ratio to a wide range of conditions, including mood disorders, knee pain, back pain, menstrual pain and even preterm birth. Omega-6 fatty acids have also been implicated in the processes that drive colon cancer.

However, the absolute omega-6 level and the omega-6 to omega-3 ratio in different seed oils vary tremendously. For example, safflower oil and sunflower oil have ratios of 125:1 and 91:1. Corn oil’s ratio is 50:1. Meanwhile, soybean oil and canola oil have lower ratios, at 8:1 and 2:1, respectively.

Scientists have used genetic modification to create seed oils like high oleic acid canola oil that have a lower omega-6 to 3 ratio. However, the health benefit of these bioengineered oils is still being studied.

The upshot on inflammation and health risks

Part of the controversy surrounding seed oils is that studies investigating their inflammatory effect have yielded mixed results. One meta-analysis synthesizing the effects of seed oils on 11 inflammatory markers largely showed no effects – with the exception of one inflammatory signal, which was significantly elevated in people with the highest omega-6 intakes.

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To complicate things further, genetics also plays a role in seed oils’ inflammatory potential. People of African, Indigenous and Latino descent tend to metabolize omega-6 fatty acids faster, which can increase the inflammatory effect of consuming seed oils. Scientists still don’t fully understand how genetics and other factors may influence the health effects of these oils.

A small bottle of soybean oil beside a bowl of soybeans, on a wooden table
Soybean oil is the most highly purchased oil in the United States. fcafotodigital via Getty Images

The effect of different seed oils on cardiovascular risk

A review of seven randomized controlled trials showed that the effect of seed oils on risk of heart attacks varies depending on the type of seed oil.

This was corroborated by data resurrected from tapes dug up in the basement of a researcher who in the 1970s conducted the largest and most rigorously executed dietary trial to date investigating the replacement of saturated fat with seed oils. In that work, replacing saturated fats such as beef tallow with seed oils always lowers cholesterol, but it does not always lower risk of death from heart disease.

Taken together, these studies show that when saturated fats such as beef tallow are replaced with seed oils that have lower omega-6 to omega-3 ratios, such as soybean oil, the risk of heart attacks and death from heart disease falls. However, when saturated fats are replaced with seed oils with a higher omega-6 to omega-3 ratio, such as corn oil, risk of death from heart disease rises.

Interestingly, the most highly purchased seed oil in the United States is soybean oil, which has a more favorable omega-6 to 3 ratio of 8:1 – and studies show that it does lower the risk of heart disease.

However, seed oils with less favorable ratios, such as corn oil and safflower oil, can be found in countless processed foods, including potato chips, frozen dinners and packaged desserts. Nevertheless, other aspects of these foods, in addition to their seed oil content, also make them unhealthy.

The case for migraines – and beyond

A rigorous randomized controlled trial – the gold standard for clinical evidence – showed that diets high in omega-3 fatty acids and low in omega-6 fatty acids, hence low in seed oils, significantly reduced the risk of migraines

In the study, people who stepped up their consumption of omega-3 fatty acids by eating fatty fish such as salmon experienced an average of two fewer migraines per month than usual, even if they did not change their omega-6 consumption. However, if they reduced their omega-6 intake by switching out corn oil for olive oil, while simultaneously increasing their omega-3 intake, they experienced four fewer migraines per month.

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That’s a noteworthy difference, considering that the latest migraine medications reduce migraine frequency by approximately two days per month, compared to a placebo. Thus, for migraine sufferers — 1 in 6 Americans — decreasing seed oils, along with increasing omega-3 intake, may be even more effective than currently available medications.

Overall, the drastic way in which omega-6 fatty acids have entered the food supply and fundamentally changed our biological composition makes this an important area of study. But the question of whether seed oils are good or bad is not black and white. There is no basis to conclude that Americans would be healthier if we started frying everything in beef tallow again, but there is an argument for a more careful consideration of the nuance surrounding these oils and their potential effects.

Mary J. Scourboutakos, Adjunct Lecturer in Family and Community Medicine, University of Toronto

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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Lifestyle

Is it COVID-19? Flu? At-home rapid tests could help you and your doctor decide on a treatment plan

At-home rapid tests for COVID-19 and influenza are becoming available, allowing simultaneous diagnosis, which aids timely and effective treatment and improves patient outcomes.

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Over-the-counter multiplex tests for more than one illness may soon come to a pharmacy near you. Paco Burgada/iStock via Getty Images

Julie Sullivan, Emory University and Wilbur Lam, Georgia Institute of Technology

A scratchy, sore throat, a relentless fever, a pounding head and a nasty cough – these symptoms all scream upper respiratory illness. But which one?

Many of the viruses that cause upper respiratory infections such as influenza A or B and the virus that causes COVID-19 all employ similar tactics. They target the same areas in your body – primarily the upper and lower airways – and this shared battleground triggers a similar response from your immune system. Overlapping symptoms – fever, cough, fatigue, aches and pains – make it difficult to determine what may be the underlying cause.

Now, at-home rapid tests can simultaneously determine whether someone has COVID-19 or the flu. Thanks in part to the National Institutes of Health’s Rapid Acceleration of Diagnostics, or RADx, program, the Food and Drug Administration has provided emergency use authorization for seven at-home rapid tests that can distinguish between COVID-19, influenza A and influenza B.

Our team in Atlanta – composed of biomedical engineers, clinicians and researchers at Emory University, Children’s Healthcare of Atlanta and Georgia Institute of Technology – is part of the RADx Test Verification Core. We closely collaborate with other institutions and agencies to determine whether and how well COVID-19 and influenza diagnostics work, effectively testing the tests. Our center has worked with almost every COVID and flu diagnostic on the market, and our data helped inform the instructions you might see in many of the home test kits on the market.

While no test is perfect, to now be able to test for certain viruses at home when symptoms begin can help patients and their doctors come up with appropriate care plans sooner.

A new era of at-home tests

Traditionally, identifying the virus causing upper respiratory illness symptoms required going to a clinic or hospital for a trained medical professional to collect a nasopharyngeal sample. This involves inserting a long, fiber-tipped swab that looks like a skinny Q-tip into one of your nostrils and all the way to the back of your nose and throat to collect virus-containing secretions. The sample is then typically sent to a lab for analysis, which could take hours to days for results.

Person inserting cotton swab into test tube for a rapid test
The COVID-19 pandemic made over-the-counter tests for respiratory illnesses commonplace. DuKai/Moment via Getty Images

Thanks to the COVID-19 pandemic, the possibility of using over-the-counter tests to diagnose respiratory illnesses at home became a reality. These tests used a much gentler and less invasive nasal swab and could also be done by anyone, anytime and in their own home. However, these tests were designed to diagnose only COVID-19 and could not distinguish between other types of illnesses.

Since then, researchers have developed over-the-counter multiplex tests that can screen for more than one respiratory infection at once. In 2023, Pfizer’s Lucira test became the first at-home diagnostic test for both COVID-19 and influenza to gain emergency use authorization.

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What are multiplex rapid tests?

There are two primary forms of at-home COVID-19 and COVID-19/flu combination tests: molecular tests such as PCR that detect genetic material from the virus, and antigen tests – commonly referred to as rapid tests – that detect proteins called antigens from the virus.

The majority of over-the-counter COVID-19 and COVID-19/flu tests on the market are antigen tests. They detect the presence of antigens in your nasal secretions that act as a biological signature for a specific virus. If viral antigens are present, that means you’re likely infected. https://www.youtube.com/embed/s45GMoZaHFE?wmode=transparent&start=0 Respiratory illnesses such as flu, COVID-19 and RSV can be hard to tell apart.

To detect these antigens, rapid tests have paper-like strips coated with specially engineered antibodies that function like a molecular Velcro, sticking only to a specific antigen. Scientists design and manufacture specialized strips to recognize specific viral antigens, like those belonging to influenza A, influenza B or the virus that causes COVID-19.

The antibodies for these viral targets are placed on the strip, and when someone’s nasal sample has viral proteins that are applied to the test strip, a line will appear for that virus in particular.

Advancing rapid antigen tests

Like all technologies, rapid antigen tests have limitations.

Compared with lab-based PCR tests that can detect the presence of small amounts of pathogen by amplifying them, antigen tests are typically less sensitive than PCR and could miss an infection in some cases.

All at-home COVID-19 and COVID-19/flu antigen tests are authorized for repeat use. This means if someone is experiencing symptoms – or has been exposed to someone with COVID-19 but is not experiencing symptoms – and has a negative result for their first test, they should retest 48 hours later.

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Another limitation to rapid antigen tests is that currently they are designed to test only for COVID-19, influenza A and influenza B. Currently available over-the-counter tests aren’t able to detect illnesses from pathogens that look like these viruses and cause similar symptoms, such as adenovirus or strep.

Because multiplex texts can detect several different viruses, they can also produce findings that are more complex to interpret than tests for single viruses. This may increase the risk of a patient incorrectly interpreting their results, misreading one infection for another.

Researchers are actively developing even more sophisticated tests that are more sensitive and can simultaneously screen for a wider range of viruses or even bacterial infections. Scientists are also examining the potential of using saliva samples in tests for bacterial or viral infections.

Additionally, scientists are exploring integrating multiplex tests with smartphones for rapid at-home diagnosis and reporting to health care providers. This may increase the accessibility of these tests for people with vision impairment, low dexterity or other challenges with conducting and interpreting at-home tests.

Faster and more accurate diagnoses lead to more targeted and effective treatment plans, potentially reducing unnecessary antibiotic use and improving patient outcomes. The ability to rapidly identify and track outbreaks can also empower public health officials to better mitigate the spread of infectious diseases.

Julie Sullivan, Chief Operating Officer of RADx Tech, Emory University and Wilbur Lam, Chief Innovation Officer, Children’s Healthcare of Atlanta Pediatric Technology Center; Professor of Biomedical Engineering, Georgia Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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