Category: Fall 2019

  • The Heart of an Industry: The Long Term Impacts of Historical Gold Mining

    by: Katherine Stenger

    In 1849, California was considered to be the land of gold; today, it is a region filled with more toxins than shiny metals, a direct consequence of mining activity from the California Gold Rush nearly 200 years ago. Community members in the Sierra Nevada foothills had been particularly concerned for decades, worried that gold-extracting heavy metals that persistently remain in the environment of the region lead to the region’s higher than average instances of breast cancer. However, no biomonitoring of the residents had ever been conducted, and cancer risks, particularly for women, had never been assessed. In 2019, a group of researchers sought to evaluate the health of this population by quantifying traces of mining-era toxins in urine. In partnership with Nevada County, the team uncovered connections between lifestyle, heavy metal exposure, and potential health risks, and worked to create an inclusive dialogue regarding the potential health consequences of living in a mining affected region.

    Gold mining is directly associated with the industrial use of various metals and toxins, which were a vital part of separating gold from surrounding sediment regardless of the extraction method being used. One such method was panning, which involved collecting river silt in a shallow metal pan before adding mercury and other heavy metals to separate gold from the surrounding debris. Additionally, these gold extracting compounds included mercury, arsenic, and cadmium, which are known carcinogens, or cancer-causing compounds that can also lead to poisoning if ingested or exposed to in high amounts. While these elements are known to directly lead to the development of cancer cells in a research setting, it is unclear whether cancer and other observable health effects are directly caused by these Gold Rush-era contaminants. Although these practices occurred nearly 200 years ago, it is known that these elements are still likely to create health hazards due to the significant amount of time it takes for them to decay completely and no longer pose a threat to human health..

    To begin what is planned to be an ongoing study in the years to come, researchers focused solely on women, a demographic thought to be particularly at risk for health problems associated with heavy metals introduced to the region. Sixty women from arguably the most affected region, Nevada County, were recruited to participate through the production of extensive radio and internet advertising. Participants then filled out a questionnaire regarding their lifestyle habits and choices, such as smoking and diet, and then asked to provide a urine sample. The research institute’s lab subsequently analyzed the urine samples for traces of heavy metals related to gold extraction methods, including arsenic, cadmium, mercury, cobalt, manganese, and uranium. The study utilized octopole collision cell technology, which involves the collision of helium with interfering ions, thus isolating the elements of interest. Chemical levels in the sample group were then compared to national averages before being directly analyzed in conjunction with the aforementioned lifestyle questionnaires. 

    The results of this study shed light on the situation of women living in gold mining impacted regions of Northern California. While the test subjects were found, on average, to have lower levels of uranium, mercury, and manganese than the national average, total arsenic and cadmium levels were found to be significantly higher. Twelve women had what are considered to be dangerously high arsenic levels above the national level of concern, which is 20 μg/L. When cross referenced with the lifestyle questionnaire, some dietary correlation was found, including higher levels of arsenic in those who consumed local fish, meat, and produce. Women who lived in the area for more than ten years or were smokers were also found to have higher arsenic levels. Cadmium levels were also found to be elevated in regular smokers, residents living along dirt roads, and women with active and outdoor lifestyles within the local region. However, cadmium levels on average were lower than the national average in the test region. That being said, women who had lived in the area for more than ten years had cadmium levels higher than the national average, presumably due to the ability of the element to accumulate over time. The study ultimately concluded that women who lived in Nevada County for a prolonged period of time, were likely to have relatively low levels of uranium, mercury, and manganese in their bodies, but more likely to have abnormally high  levels of cadmium and arsenic.

    The results raise serious concerns for the health of women living in the region. Many women are genetically predisposed to have a high chance of developing breast cancer, and exposure to both cadmium and arsenic are thought to lead exponentially increase this risk. Breast cancer cells can grow when they are exposed to estrogen, but only when estrogen receptors are activated. Interestingly, both cadmium and arsenic bind to and activate these estrogen receptors, thus increasing the risk of those exposed to either element to the development of breast cancer. Additionally, when compared with local and national data, rates of breast cancer in the Nevada County region have been noticeably higher than the national average since data was first collected in 1988. 

    Although this first test group was limited to women within a small geographical area, the findings also raise concerns for other demographics within the greater Northern California region. For example, men are at risk for certain cancers, and the same heavy metals associated with increased cancer risk in women could raise the same risk for men. Additionally, as this region is physically near the “top” of the watershed and thereby supplies water through tributaries for the Sacramento Valley and the San Joaquin Valley, these accumulated heavy metals associated with gold mining could travel and affect those not living in the originally affected zone. California provides agricultural goods for much of the country and world as well, and if water originating in the Sierra Nevadas is used for irrigation, heavy metals could also build up in the produce and in turn also affect people in both the domestic and international zones. 

    The researchers hope to soon expand their study to include a larger portion of the population, including adult men, older women, and children. The impact of gold mining reaches far beyond both the region and time period in which it occurred. The study found that heavy metals used in the 1849 California Gold Rush still impact the women of today, and their ability to remain toxic for long periods of time and accumulated relate to increased risk for certain cancers. Due to the location of gold mining impacted regions in California, this situation runs the risk of affecting so many more individuals beyond the studied zone.

    Photo by Curioso Photography on Unsplash

  • Hacked – When Life-Saving Technology becomes a Life-Threatening Risk

    by: Katherine Stenger

    The withholding of a pacemaker shock after cardiac arrest. The delivery of an extremely high dose of insulin. The prevention of access to medical files in an emergency room. All three of these potentially fatal situations can be created with simple hacks to extremely vulnerable medical devices. 

    For a growing number of hospital patients, the chance of having a life-saving medical device hacked has increased in conjunction with the rise of software based medical technology. While this is truly a chilling new reality, it is not a surprising one. According to health care security researcher Dr. Nina Alli, hospitals are among the fastest facilities to adopt new technology, but are also some of the slowest environments to also bring in proper malware defense measures. Thankfully, due to the recent legalization of hacking-based research on devices within hospitals, Alli and her company, BioHacking Village, have used unconventional methods to make their own headway in the field. Through public engagement, BioHacking Village hopes to help expose system weaknesses within medical devices that have the potential to affect millions of patients each and every year. 

    As hospitals have become increasingly digitized, code-based, and internet connected, their vulnerability to hacking is thought to have increased as well. Reports of hackers holding digital medical files hostage until a ransom is paid have surfaced within the last year. Similarly, incidences of pacemaker hacks that withhold shocks after cardiac arrest have grown in number. Beyond very dramatic and high profile situations such as these, the full scope of what devices have the potential to be hacked is relatively unknown. Until 2016, it was actually illegal for researchers to test security features of medical technology through lab based “cracking” (intentional hacking by tech companies themselves to test system durability), making understanding the precise vulnerabilities of the devices, and their solutions, extremely difficult.

     As an advocate for medical device security, health care researcher Dr. Nina Alli has stationed herself with information on the epidemic at a small booth housed at the annual Las Vegas hacking convention, DEF CON. The popular event has over 30,000 annual participants and draws those who are considered to be the best professional hackers from around the world. At events like this, many industries allow, and even incentivise, the hacking of their devices and web systems. Participants are observed, their hacks noted, and updates made to further secure the software. Unfortunately, companies tied to production of systems or devices directly related to hospitals have not been able to participate in this same research method due to legal issues, as well as lack of financial support. However, with the recent legalization of medical device hacking, as well as full support and financial backing from ten major medical device manufacturers, Alli hopes that BioHacking Village will be able achieve the same research other industries have had access to for years. 

    With its new funds, BioHacking Village has physically expanded at DEF CON. Participants now have the opportunity to become immersed in a simulation hospital filled with hundreds of medical devices, and can work together to disable as many medical devices as they can. Alli hopes that the full scope of hospital vulnerability will be exposed and further understood through this research project. 

    Alli also mentions hacking based research is not the only way for the medical world to protect its patients. According to research conducted by BioHacking Village, those installing and using devices regularly are not often aware of how to activate device security features, therefore medical professionals themselves should also be trained in device security. In this sense, doctors, nurses, and others working in hospitals are a “first line of defense” of medical device security.

    While BioHacking Village has helped the medical world make strides in device security, patients who already rely on much older devices are still at risk for hacks. Current research can only help medical device developers make improvements in devices for future patients, and those who have older implants are not always in a position to receive a new one. The group hopes to also address this quandary in future research projects. 

    New medical devices have the opportunity to help save millions of patient lives. That being said, device security must also match the rapid evolution of medical technology in order to protect the lives of the most vulnerable. Through the bolstering of device security itself, and through the proper technology training of medical professionals, an untold number of lives have the chance to be saved in the years to come. 

    Photo by Ilya Pavlov on Unsplash

  • Sleep Patterns: The Key to Predicting Alzheimer’s

    by: Doris Ma

    Sleep patterns could be the key to predicting one’s likelihood of developing Alzheimer’s disease (AD). A recent study published in JNeurosci shows that the accumulation of β-amyloid and tau proteins are associated with the disease which could be an early indicator of AD.

    Two proteins are thought to be the culprits of cognitive deterioration leading to AD: Tau proteins and β-amyloids. Tau proteins are markers of brain injury that spill into cerebrospinal fluid (CSF) through the breakdown of cellular membranes leading to cell degeneration and cell loss, while β-amyloid (Aβ) are amino acids that are found to be the main deposits in amyloid plaques found in AD patients. 

    Sleep spindles and slow oscillations are characteristic of electroencephalographic (EEG) rhythms during slow-wave sleep (SWS), the deepest phase of non-rapid eye movement (NREM) sleep, which is considered crucial to memory formation and synaptic plasticity. Sleep spindles are bursts of brain activity that occur to inhibit mental processing and promote a tranquil state where the person can progress to the next stage of deep sleep. On the other hand, slow oscillations are slow frequencies (≤ 1 Hz) in the corticothalamocortical network, which represents neurons activating and deactivating in synchrony during slow-wave sleep and deep anesthesia, otherwise considered as the default rhythm of neural activity. 

    The coupling of slow oscillations and sleep spindles in SWS reactions promote memory consolidation in adults. Hence, the disruption of these coupled reactions eventually leads to the disruption of the brain’s ability to communicate with other cells, causing the most apparent symptoms of AD: memory loss. Recent studies on rats and mice suggest that there may be associations between sleep waves, tau, and Aβ proteins.

    The decrease in sleep spindles is a good indicator of Tau pathology because they are affected by sleep/wake regulating centers that usually decline with age. They are also associated with sleep-dependent motor learning and memory. Thus, a decrease in these neuroplasticity-promoting processes could cause an individual to be more vulnerable to the buildup of Tau pathology. Using these indicators, scientists can have a better idea of a time-sensitive window to measure biomarkers which could predict one’s susceptibility to AD.

    Researchers from UC Berkeley and UC Irvine used three methods to predict the AD pathology in male and female older adults: PET measures of Aβ and tau, EEG sleep recordings, and retrospective sleep evaluations. 

    PET Imaging Analysis

    Researchers recruited 101 cognitively normal older adults from the Berkeley Aging Cohort Study to conduct a longitudinal study of cognitive aging. The participants were enrolled in positron-emission tomography (PET) and magnetic resonance imaging (MRI) data collection. PET imaging is a medical technology that measures metabolism in the body, in which researchers use to measure tau and Aβ pathology in older adults. On the other hand, MRI uses strong magnetic resonance to create detailed images of the brain. All participants were free of depressive symptoms and were not on antidepressants or hypnotic medications that may affect brain activity, and all displayed normal performance on neuropsychological testing. 

    Sleep EEG Analysis

    Thirty-one subjects then completed sleep EEG assessment using a test called polysomnography by Grass Technologies systems. A sleep score was then developed using standard criteria by a single trained scorer blind to PET data. Sleep quality measures including total sleep time, wake after sleep onset, sleep efficiency, arousals and respiratory events were scored following American Academy of Sleep Medicine guidelines. The EEG data was also decomposed using the researchers’ published DETOKS method, classifying spindles as fast (13-16 Hz) or slow (11-13 Hz). 

    Sleep Questionnaire Analysis

    Ninety-five subjects wore a wrist-based actigraph on their less dominant hand for seven days. The actigraph collects information about gross motor activity in order to monitor human rest/activity cycles. The subjects also completed a questionnaire about lifespan sleep duration and sleep quality change to confirm actigraphy data. A percent sleep duration change by decade and sleep duration slope graph was generated.

    Statistical Analysis

    Lastly, researchers used t-tests to assess differences in sleep EEG measures and PET-defined groups. SO-spindle coupling differentiated 2 tau groups, so individuals with categorically high medial temporal lobe (MTL) tau had significantly lower SO-spindle coupling than individuals with categorically low MTL tau burden.

    Results

    The growing interest in the preclinical stage of AD has sparked research in the field, allowing researchers to realize the shifting role of sleep in relation to AD. Researchers found that individuals with higher MTL Tau were associated with significantly weaker SO-spindle coupling, and those with lower MTL Tau had stronger SO-spindle coupling, confirming that disruptions to non-REM SO-coupling is associated with high MTL tau burden. SWA disruption was also confirmed to have a more significant effect on cortical Aβ than on MTL Tau. The results from the sleep questionnaires also show that a decrease in sleep quantity throughout aging, from the 50s through 70s, was associated with higher levels of β-amyloid and tau later in life. 

    This research proposes that changes in brain activity during sleep and sleep quantity during specific time frames could serve as a warning sign for AD, allowing for early preventive care. Lead researcher Joseph R. Winer from UC Berkeley shared that the next steps of this project is to investigate people’s sleep/wake cycles in their own homes rather than in a lab setting, in order to more intricately understand the applications of this knowledge. The ultimate goal of this project, he says, is to be able to “intervene at some point in people’s lives and improve people’s sleep to hopefully slow the progression of disease.”

    Image Credit: Unsplash