A new, non-invasive way to track the progression of Parkinson’s disease could help evaluate experimental treatments to slow or stop the disease’s progression.
University of Florida researchers used functional magnetic resonance imaging to reveal areas where Parkinson’s disease and related conditions cause progressive decline in brain activity.
The study, funded by the National Institutes of Health, was published in the journal Neurology.
While current treatments focus on controlling symptoms, biomarkers provide a quantifiable way to measure how medications address not just symptoms, but the neurological changes behind them.
Previous studies have used imaging techniques that require the injection of a drug that crosses the blood-brain barrier.
“Our technique does not rely upon the injection of a drug. Not only is it non-invasive, it’s much less expensive,” said David Vaillancourt, Ph.D., a professor in UF’s Department of Applied Physiology and Kinesiology and the study’s senior author.
The study’s authors – which included researchers from UF’s College of Health and Human Performance and College of Medicine as well as the Medical University of South Carolina – used functional magnetic resonance imaging to evaluate five areas of the brain that are key to movement and balance. A year after the baseline study, the 46 Parkinson’s patients in the study showed declining function in two areas: the primary motor cortex and putamen. Parkinson’s-related disorders evaluated in the study also showed declines: The 13 subjects with multiple system atrophy had reduced activity in three of the five areas, while the 19 with progressive supranuclear palsy showed declines in all five areas. The brain activity of the 34 healthy control subjects did not change.
“For decades, the field has been searching for an effective biomarker for Parkinson’s disease,” said Debra Babcock, M.D., Ph.D., program director at the NIH’s National Institute of Neurological Disorders and Stroke. “This study is an example of how brain imaging biomarkers can be used to monitor the progression of Parkinson’s disease and other neurological disorders.”
The finding builds on a 2015 UF study that was the first to document progressive deterioration from Parkinson’s via MRI, showing an increase in unconstrained fluid in an area of the brain called the substania nigra. An NIH-funded study beginning in November will use both biomarkers to test if a drug approved for symptom relief can slow or stop progressive degeneration.
Katrina Gwinn, M.D., also a program director at the NIH’s National Institute of Neurological Disorders and Stroke, described the effort to identify biomarkers as “an essential part of moving towards the development of treatments that impact the causes, and not just the symptoms, of Parkinson’s disease.”
Grace Everitt is helping University of Florida engineering students participate in SpaceX’s Hyperloop competition. She isn’t doing it for course credit or because it will look good on her résumé.
She believes she’s a part of something special.
Said Everitt: “It’s human history in the making.”
Everitt, who received a bachelor’s degree in marketing (Magna Cum Laude) from Warrington at Saturday’s Commencement, serves as the Marketing, Public Relations and Sponsorship Lead for Gatorloop, UF’s entry in Hyperloop. Out of a field of more than 1,500 teams worldwide, Gatorloop is one of only 29 entrants to advance to the final round.
Hyperloop is the brainchild of SpaceX and Tesla Chief Executive Officer Elon Musk, whose vision is to build a high-speed, ground transportation system run almost entirely on solar power. Passengers and cargo would travel in pods at transonic velocities. The speeds are so great it would, for example, reduce a six-hour drive from San Francisco to Los Angeles to 30 minutes.
Everitt heard about Gatorloop in the fall, but her studies and other commitments kept her from participating. She came aboard in the spring when she noticed the team’s GoFundMe page had stalled around $1,200. Fortuitously, Everitt was enrolled in Professor Dennis DiPasquale’s Sales Management course, which centers on a semester-long fundraising project, and believed she could apply some of the tactics she learned to help Gatorloop.
Since Everitt took over Gatorloop’s fundraising duties, donations have quintupled and have reached $6,000-plus. But costs to purchase parts and manufacture the pod are steep, so Everitt’s new goal is to raise $20,000 before the competition scheduled for January 2017.
Relying on the tactics she learned in Sales Management, Everitt sought out smaller donations from a large pool of supporters to give an immediate boost to the fund. But with the competition a few months away and approximately $14,000 still to be raised, Everitt is shifting her focus to the corporate sector in hopes of attaining larger-size gifts.
“This has been a great opportunity to flex my skills, and practically apply what I’ve learned,” Everitt said.
Everitt’s enthusiasm for Gatorloop and space transport and exploration is palpable. While some may view ideas like Hyperloop as lofty and unattainable, Everitt said these types of projects are closer to becoming reality than most might think. She also has an affinity for Musk, not only for his grandiose vision but because he comes from the South African province of Transvaal, where Everitt’s family has roots.
“When you go see a movie like ‘The Martian’ with Matt Damon, that’s not fantasy,” Everitt said. “We’re definitely moving in a direction where that’s a real possibility.”
Everitt said her work with the Gatorloop team has impacted her career aspirations as well.
“I always assumed that there wasn’t room for me in the space exploration industry because I wasn’t a STEM person, but that’s simply not true, and I want to share this awareness with other business students who also might have varied interests,” Everitt said.
Misty mountains, glistening forests and blue-green lakes make Cameroon, the wettest part of Africa, a tropical wonderland for amphibians. The country holds more than half the species living on the continent, including dozens of endemic frogs — an animal that has been under attack across the world by the pervasive chytrid fungus (Batrachochytrium dendrobatidis). Africa has been mostly spared from the deadly and rampant pathogen that wiped out entire species in Australia, Madagascar and Panama — until now.
University of Florida herpetologist David Blackburn and colleagues at the Museum für Naturkunde in Berlin have documented declines in frog species on Cameroon’s Mount Oku and Mount Manengouba over a span of more than 12 years. The scientists link the decline of at least five species of frogs found only in these mountains to chytrid, which may have been exacerbated by habitat destruction, pollution and climate change resulting in weaker and more susceptible frogs, said Blackburn, an associate curator of herpetology at the Florida Museum of Natural History on the UF campus.
“There’s been this perception that frogs in Africa are not affected by chytrid at all, but we have evidence of the disease in some animals,” said Blackburn, co-author of a new study appearing online this week in PLOS ONE. “This is the first real case of a decline across multiple amphibian species in Africa.”
The road up Mount Oku, the second highest mountain in Cameroon and an important center of amphibian diversity in Central Africa.
Photo by David BlackburnStudy scientists collected and documented abundance and diversity of frog species living on the two mountains before and after the immergence of chytrid in the area between 2008-2010. The persistent pestilence latches onto the frog’s skin, affecting the function of internal organs and quickly leading to death.
Blackburn said many of the once common species, like the bright red Cardioglossa manengouba, a frog he discovered and named during graduate fieldwork in the early 2000s, are now scarce and nearly impossible to find.
“It’s looking like some of these frogs may not be around by the time my kids are old enough for me to take them to Cameroon to see them,” he said.
While chytrid is to blame for most of the patterns of decline in frogs worldwide, Blackburn said scientists have linked the fungus to climate change, which may drive the emergence of chytrid in some places.
In studies exploring declines of amphibians in Latin America, University of South Florida herpetologist Jason Rohr has shown that unpredictable climate fluctuations associated with climate change can increase chytrid-related die-offs.
“Our research has shown there may be an underappreciated link between climate change, disease and biodiversity losses,” Rohr said. “Global warming and the severity of unpredictable variations in temperature increase chytrid growth on amphibians.”
Blackburn said extreme temperature changes may affect the biology of the frogs by making them more, or less, susceptible to pathogens. He said this could easily be a factor in Cameroon, though he and colleagues have not yet collected enough data to make that call.
A view of the forests on Mount Oku where some frog populations now experiencing declines once flourished.
Photo by David BlackburnIn captivity, frogs with chytrid are treated with an effective fungicide bath. In the Sierra Mountains of California, scientists have successfully released frogs inoculated with bacteria that make them less vulnerable to chytrid. But these methods are less practical in the mountains of Cameroon.
“Even if a cure was found, it would be hard to inoculate all of the individual frogs out there,” Backburn said. “Promoting a healthier environment in general for Africa’s amphibians in terms of water quality and habitat protection is our best shot for keeping these species around.”
In the 2012 presidential election, 15.6 million people with disabilities reported voting, leaving people without disabilities to make up the remaining 110 million votes cast. The turnout rate for voters with disabilities was 5.7 percent lower than for people without disabilities. If voters with disabilities had voted at the same rate as those without a disability, there would have been three million more voters weighing in on issues of local, state and national significance.
In 2012, 30.1 percent of voters with a disability reported difficulty in voting at a polling place, as compared to 8.4 percent of voters without disabilities. People reported difficulty in reading or seeing the ballot, or understanding how to vote or use voting equipment. This disparity wasn’t supposed to exist after the Help America Vote Act (HAVA) passed in 2002. That law provided US$3.9 billion for states to upgrade their voting equipment after the issues in Florida during the 2000 presidential election. Furthermore, the HAVA required every voting place to have at least one voting machine that is “accessible” to individuals with disabilities, so they could vote privately and independently.
So why, a decade after HAVA passed, did these problems still exist? With the HAVA funds and accessible voting machines, they were supposed to be solved – or at least much less common.
To figure out what was going on, my team and I investigated, speaking both to voters with disabilities and election officials. We learned there were various problems, such as voting machines not being set up, poll workers not knowing how to use the equipment and even that people weren’t sure how to operate various features of the machine, such as how to use the audio or the touchscreen interface.
But the fundamental problem is that voters with disabilities are being offered a “separate but equal” approach to voting. And, as ever, separate is not equal. When a voting place has a separate accessible voting machine, it’s not used as frequently as the primary method of voting. Therefore, poll workers don’t spend as much time using the accessible voting equipment. As a result of this minimal use, poll workers will forget how to set up the equipment and how to instruct someone with a disability how to use it.
In my estimation, the best way to remedy the disparity in voting between voters with disabilities and those without is to provide a voting machine that can be used by all voters, no matter their disability, or lack of a disability. This goal relies on “universal design” – the principle of designing a system or environment such that it has the broadest access for as many people as possible. For example, wheelchair ramps have a universal design because they can be used by people with wheelchairs and those who can walk.
One voting machine for all
The idea of creating a universally designed voting machine isn’t new. In 2003, our research lab created the first universally designed voting machine, called Prime III. At that time, conventional wisdom suggested that universal design was not possible in voting. Recall that the HAVA, passed in 2002, required just one accessible voting machine in each voting place. This was how lawmakers, election officials and voting machine experts conceived accessibility in voting. With HAVA funding long since run out, states and municipalities must find cost-efficient ways to expand voting access. One way to do this is to integrate accessibility into every voting machine.
With the Prime III, voters can mark their ballots using touch, voice or both. They can touch the computer screen directly, or use a keyboard, button switches, joysticks or other input devices to interact with the voting interface. Other voters can use a microphone and headset to respond to verbal prompts. These options allow people who cannot read, cannot hear and even lack arms to all vote on the same machine as someone with perfect sight, dexterity and hearing. It’s one machine for everyone, independent of their ability or disability.
After Prime III was developed in 2003, my lab’s research team conducted several experiments and elections to test its accessibility and usability. For example, the National Council on Independent Living (NCIL) used Prime III in its national organizational election. NCIL has members who have various levels of disabilities. Self Advocates Becoming Empowered (SABE) is an organization that represents people with cognitive disabilities or limitations. SABE used Prime III in two of its national organizational elections. This was a critical test for Prime III as the team used candidate pictures on the ballot to accommodate people with shortcomings in reading literacy. The election was very successful: the people running those elections told us there were no failures of equipment, everyone was able to vote, the results were accurate and when there were mistakes, they were corrected.
Other states have also vetted the system and found it useful. For example, in 2012, Oregon used Prime III in the presidential primaries. In 2014, the state of Wisconsin did a pilot with Prime III in two voting places. There were many other tests as well with the aging population, blind voters and children who could not read.
Giving it away for free
Prime III was the first, but many others are following, such as the ES&S ExpressVote.
In September 2015, Prime III was released as open-source software. This allows anyone in the world to download and use the Prime III software for free. They still do need to have a computer, printer and accessibility hardware such as a joystick and microphone, but our system works with a wide range of commercially available products.
People can also extend Prime III, such as making modifications to observe specifics of local election laws. For the February 9, 2016, presidential primaries, New Hampshire was the first state to use Prime III at every polling place. Initial results were positive, with vision-impaired voters telling news media that it was a major improvement over prior systems.
All New Hampshire polling places will use the system again in November’s general election, including for the presidential race. It will be the primary system for people who need an accommodation to be able to vote, but will also be available for use by voters without disabilities. That’s a big step toward the goal of having all voting machines usable by all people.
Universal design is necessary in voting. According to the US Census, one in five Americans has a disability. Even disabilities people might not think of as causing voting problems can: voting machines can be set up too high for easy use from a wheelchair, for example. It is every citizen’s right to have accessible elections; in addition, it is the law. Universally designed voting technologies will have the greatest impact in accomplishing this goal. Making independent, private voting accessible for all voters regardless of their ability or disability is achievable now.
This article originally appeared in The Conversation on May 2, 2016.
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