Lab-grown snake venom glands are here. Dont worry; theyre for a good cause – Digital Trends

Every year, the equivalent of the total population of Tuscaloosa, Alabama slightly more than 100,000 people die worldwide as a result of snake bites. Provided a snake bite victim is able to get to the emergency room quick enough, antivenom can be used to counter the deadly effects of a bite. But antivenom isnt easy to manufacture. Its made by collecting venom from venomous snakes and injecting small quantities of it into a domestic animal such as a horse. The antibodies that form can then be collected from the horses blood and purified to make a finished antivenom. So far, so straightforward.

The problem is getting hold of enough venom to make it. Antivenom is currently manufactured by catching or breeding snakes, keeping them in captivity, and then regularly milking them to gather the venom they produce. Its a 19th century treatment thats made necessary by the fact that antivenom production has not developed as fast as other areas of biotechnology. With 600 species of venomous snake, its also a labour-intensive job which nonetheless struggles to create antidotes enough to meet the number of annual snake bites. Could genetic engineering be the answer?

A group of three researchers at Utrecht University in the Netherlands think so. And their idea for achieving it is kind of brilliant. Rather than creating lab-grown venomous snakes an idea that, frankly, would only sound good to one of the screenwriters of Sharknado theyve come up with an alternative solution: Simply grow the part of the snake that you need.

We were thinking about novel areas for [our] organoid technology, Hans Clevers, whose lab carried out the work, told Digital Trends. Snake venom glands were the most fascinating tissue to us. A main first hurdle was to obtain snake tissue. Luckily, a collaboration with snake experts Michael Richardson and Freek Vonk, as well as the Dutch reptile zoo Serpo and local breeders solved this issue. After some months of optimizing the protocols, we were successful in growing miniature venom glands. Since then, we have been optimizing the protocol to produce venom and have characterized the cells which make the toxins.

Aspidelaps lubricus hatching (individuals not used in study) Jeremie Tai-A-Pin

An organoid, for those unfamiliar with it, is a miniaturized and simplified version of an organ, complete with realistic micro-anatomy. Theyre made using stem cells, which let them self-organize in a three-dimensional culture to transform into the organ theyre supposed to replicate. The emerging organ is a clump of cells around 1 millimeter across. Organoids have been created by various labs around the world, approximating organs that range from kidneys to miniature, non-conscious brains. In this case, the venomous organoids resemble a tiny pea-sized balloon filled with liquid. One that would be particularly inhumane to fire across the classroom like a spitball wad.

Our group has been successful in the past 10 years in growing organoids from a variety of human tissues, Joep Beumer, another researcher on the project, explained. To generate these, we harvest stem cells from adult tissue and embed them into a gel in a petri dish. With the right growth factor mix, the stem cells will divide and give rise to mini-organs containing the different cell types of one tissue.

The tissue samples for the venom organoids were taken from gland tissue from snake embryos inside eggs or, in one instance, from a pet snake which had been put down as a result of illness. To grow the gland organoids, the team had to make a few changes to their normal approach. Snakes are cold-blooded. Mammalian organoid protocols are normally grown at a temperature of 37 degrees Celsius (99 degrees Fahrenheit). Unfortunately, this didnt work for the snake organoids. At this temperature, the organoids suffered heat shock response and died. As a result, they had to lower the temperature to 32 degrees Celsius. Its a demonstration of how, even at this scale, the concepts and signaling pathways of adult stem cells are conserved in organoids.

Every tissue has its own characteristics which we aim to model with organoids, said Yorick Post, the third researcher on the project. For the snake venom gland this was a very obvious case: would they make venom? We knew that the potential of this technology would hinge greatly on the ability to produce the different toxins which constitute snake venom. So we were very excited when we found toxins first on RNA, and later on [the] protein level.

This work is extremely promising. The researchers think it could potentially go beyond just cutting out the snake-farming part of the antivenom process as well. They believe it might be possible to grow the immune cells that are usually produced by animals inside a dish. Alongside antivenom, the approach could also be useful for helping develop drug compounds based on components found in snake venom. For instance, theres a certain type of blood pressure medicine thats created from a toxin produced by the venomous Brazilian pit viper.

And as to, no pun intended, the scaling up part of the project? This is one of the main advantages of organoid technology, Clevers said. Once established, we can expand the tissue [in a] pretty much unlimited [manner]. This can help to preserve viable cells of many snake species, as they can be frozen and thawed easily. [It can also help us] generate large numbers of venom producing cells. Further improvements in venom production and harvesting will be needed to make this approach cost efficient. We are actively working towards these aims.

A paper describing the work was recently published in the journal Cell.

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Lab-grown snake venom glands are here. Dont worry; theyre for a good cause - Digital Trends

Space might be the perfect place to grow human organs – Popular Science

Three-dimensional printers have now assembled candy, clothing, and even mouse ovaries. But in the next decade, specialized bioprinters could begin to build functioning human organs in space. It turns out, the minimal gravity conditions in space may provide a more ideal environment for building organs than gravity-heavy Earth.

If successful, space-printed organs could help to shorten transplant waitlists and even eliminate organ rejection. Though they still have a long way to go, researchers at the International Space Station (ISS) hope to eventually assemble organs from adult human cells, including stem cells.

The medical field has only recently embraced 3D printing in general, particularly in biomedical fields like regenerative medicine and prosthetics. So far, these printers have produced early versions of blood vessels, bones, and different types of living tissue by churning out repeated layers of bioinka substance comprised of living human cells and other tissue thats meant to mimic the natural environment that surrounds growing organs.

Recently, researchers are finding that Earth might not be the best environment for growing freestanding organs. Because gravity is constantly pushing down on these delicate structures as they grow, researchers must surround the tissues in scaffolding, which can often debilitate the delicate veins and blood vessels and prevent the soon-to-be organs from growing and functioning properly. Within microgravity, however, soft tissues hold their shape naturally, without the need for surrounding supportan observation thats driven researchers to space.

And one manufacturing lab based in Indiana thinks its tech could play a key role in space. The 3D BioFabrication Facility (BFF) is a specialized 3D printer that uses bioink to build layers several times thinner than human hair. It cost about $7 million to build and employs the smallest print tips in existence.

The brainchild of spaceflight equipment developer Techshot and 3D printer manufacturer nScrypt, the BFF headed to the ISS in July 2019 aboard the SpaceX CRS-18.

Currently, the project focuses on building increasingly thick artificial cardiac tissue and delivering it back to Earth. Once the printed cardiac tissue reaches a certain thickness, it gets harder for researchers to ensure that a printed structures layers effectively grow into one another. Ultimately, though, theyd like the organs to arrive here fully formed.

Printed organs would eventually require vasculature and nerve endings to work properly, though that technology doesnt yet exist.

The next stagetesting heart patches under microscopes and within animalscould span over the next four years. As for whole organs, Techshot claims it plans to begin production after 2025. For now, the project is still in its infancy.

If you were to look at what we printed, it looks very modest, says Techshot vice president of corporate advancement Rich Boling. Its just a cuboid-type shape, this rectangular box. Were just trying to get cells to grow one layer into the next.

Cooking organs like pancakes

Compare the manufacturing process to cooking pancakes, Boling says. The space crew first creates a custom bioink pancake mix with the cells sent from Earth, which they load with syringe-like tools into the BFF.

Researchers then insert a cassette into the BFF containing a bioreactora system that mimics the normal bodily functions essential for growing healthy tissue, like providing nutrients and flushing out waste.

Approximately 200 miles below in Greenville, Indiana, Techshot engineers connect with ISS astronauts on a NASA-enabled secure digital pathway. The linkup allows Techshot to remotely command BFF functions like pump pressure, internal temperature, lighting, and print speed.

Next, the actual printing process occurs within the bioreactor and can take anywhere from moments to hours, depending on the shapes complexity. In the final production step, the cell-culturing ADvanced Space Experiment Processor (ADSEP) cooks the theoretical pancake; essentially, the ADSEP toughens up the printed tissue for its journey back to earth. This step could take anywhere from 12 to 45 days for different tissue types. When completed and hardened, the structure heads home.

The researchers have gone through three testing processes so far, each one getting more exact. This March, theyll begin the third round of experiments.

The bioprinter space race

The BFF lab is the sole team developing this specific type of microgravity bioprinter, Boling says. Theyre not the only ones looking to print human organs in space, though.

A Russian project has also entered the bioprinting space race, however their technique highly differs. Unlike the BFFs bioink layering method, Russian biotechnology laboratory 3D Bioprinting Solutions uses magnetic nanoparticles to produce tissue. An electromagnet creates a magnetic field in which levitating tissue forms the desired structuretechnology that appears ripped from the pages of a sci-fi novel.

After their bioprinter fell victim to an October 2018 spacecraft crash, 3D Bioprinting Solutions rebounded; the team now collaborates with US and Israeli researchers at the ISS. Last month, their crew created the first space-bioprinted bone tissue. Similar to the US project, 3D Bioprinting Solutions aims to manufacture functioning human tissues and organs for transplantation and general repair.

Just because we have the technology to do it, should we do it?

If the 3D BioFabrication Facility prospers in printing working human organs, theyd be subject to thorough regulation here on Earth. The US approval process is stringent for any drug, Rich Boling says, posing a challenge for this unprecedented invention. Techshot predicts at least 10 years for space-printed organs to achieve legal approval, though its an inexact estimate.

Along with regulatory acceptance, human tissue printed in microgravity may encounter societal pushback.

Each country maintains varying laws related to medical transplants. Yet as bioengineering advances into the the final frontier, the international scientific research community may need to shape new guidelines for collaboration among the stars.

As the commercialization of low-Earth orbit continues to ramp up in the next few years, it is certainly true that were going to have to take a very close look at the regulations that apply to that, says International Space Station U.S. National Laboratory interim chief scientist Michael Roberts. And some of those regulations are going to stray into questions related to ethics: Just because we have the technology to do it, should we do it?

Niki Vermeulen, a University of Edinburgh science technology and innovation studies lecturer, has researched the social implications of 3D bioprinting experiments. Like any Earth-bound project, she urges scientists not to get peoples hopes up too early in the process; individuals seeking organ transplants could read about the BFF online and think it could soon be ready to meet their needs.

The most important thing now, I think, is expectation management, Vermeulen says. Because its really quite difficult to do this, and of course we really dont know if its going to work. If it did, it would be amazing.

Another main issue is cost. Like other cutting-edge biotechnology innovations, the organs could also pose a major affordability challenge, she says. Techshot claims that a single space-printed organ could actually cost less than one from a human donor, since some people must pay for a lifetime of anti-rejection meds and/or multiple transplants. Theres currently no telling how long the BFF process would actually take, however, compared to the conventional donor route.

Plus, theres potential health risks for recipients: Techshot chief scientist Eugene Boland says cell manipulation always presents a possibility of genetic mutation. Modified stem cells can potentially cause cancer in recipients, for example.

The team is now working to define and minimize any dangers, he says. The BFF experiment adheres to the FDAs specific regulations for human cells, tissues, and cellular and tissue-based products.

Researchers on the ground now hope to perfect human cell manipulation: Over 100 US clinical trials presently test cultured autologous human cells, and several hundred test cultured stem cells with multiple origins.

What comes next

After the next round of printing tests this March, Techshot will share the bioprinter with companies and research institutions looking to print materials like cartilage, bone, and liver tissue. Theyre currently preparing the bioprinter for these additional uses, Boling says, which could advance health care as a whole.

To speed things up for space crews, Techshot is now building a cell factory that produces multiple cell types in orbit. This technology could cut down the number of cell deliveries between Earth and space.

The ISS has taken in plenty of commercial ventures in recent years, Michael Roberts says, and its getting crowded up there. Space-based experiments ramped up between 40 and 50 years ago, though until recently they mostly prioritized satellite communications and remote observation technology. Since then, satellites have shrunk from bus-sized to smaller than a shoebox.

Roberts has witnessed the scientific areas of interest broaden over the past decade to include medicine. Organizations like the National Institutes of Health are now looking to space to improve treatments, and everything from large pharmaceutical companies to small-scale startups want in.

Theyve got something stuck on every surface up there, he says.

As the ISS runs out of space and exterior attachment points, Roberts predicts that commercial ventures will build new facilities built for specific activities like manufacturing and plant growth. He sees it as a good opportunity for further innovation, since the ISS was originally designed for far more general purposes.

Space, as a whole, may start to look quite different from the first exploration age.

Baby boomers may remember glimpsing at a grainy, black-and-white moon landing five decades ago. Within the same lifetime, they could potentially observe the introduction of space-printed organs.

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Injection Innovation May Improve Spinal Cord Repair Research – Technology Networks

An international research team, led by physician-scientists at University of California San Diego School of Medicine, describe a new method for delivering neural precursor cells (NSCs) to spinal cord injuries in rats, reducing the risk of further injury and boosting the propagation of potentially reparative cells.NSCs hold great potential for treating a variety of neurodegenerative diseases and injuries to the spinal cord. The stem cells possess the ability to differentiate into multiple types of neural cell, depending upon their environment. As a result, there is great interest and much effort to use these cells to repair spinal cord injuries and effectively restore related functions.

But current spinal cell delivery techniques, said Martin Marsala, MD, professor in the Department of Anesthesiology at UC San Diego School of Medicine, involve direct needle injection into the spinal parenchyma the primary cord of nerve fibers running through the vertebral column. "As such, there is an inherent risk of (further) spinal tissue injury or intraparechymal bleeding," said Marsala.

The new technique is less invasive, depositing injected cells into the spinal subpial space a space between the pial membrane and the superficial layers of the spinal cord.

"This injection technique allows the delivery of high cell numbers from a single injection," said Marsala. "Cells with proliferative properties, such as glial progenitors, then migrate into the spinal parenchyma and populate over time in multiple spinal segments as well as the brain stem. Injected cells acquire the functional properties consistent with surrounding host cells."

Marsala, senior author Joseph Ciacci, MD, a neurosurgeon at UC San Diego Health, and colleagues suggest that subpially-injected cells are likely to accelerate and improve treatment potency in cell-replacement therapies for several spinal neurodegenerative disorders in which a broad repopulation by glial cells, such as oligodendrocytes or astrocytes, is desired.

"This may include spinal traumatic injury, amyotrophic lateral sclerosis and multiple sclerosis," said Ciacci.

The researchers plan to test the cell delivery system in larger preclinical animal models of spinal traumatic injury that more closely mimic human anatomy and size. "The goal is to define the optimal cell dosing and timing of cell delivery after spinal injury, which is associated with the best treatment effect," said Marsala.ReferenceMarsala et al. (2019) Spinal parenchymal occupation by neural stem cells after subpial delivery in adult immunodeficient rats. Stem Cells Translational Medicine. DOI: https://doi.org/10.1002/sctm.19-0156

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Injection Innovation May Improve Spinal Cord Repair Research - Technology Networks

Robots don’t have to be so embarrassing – The Outline

Robots are pathetic. You need only watch a robot soccer fail compilation to see that humans ancient quest to build synthetic replicas of ourselves out of nuts, bolts and wiring has been a bust. Every new, groundbreaking robot inevitably turns out to be an ungodly abomination, either physically inept or utterly incapable of social interaction. Our latest attempt at a full-on humanoid, Sophia, looks like a pre-loved department store mannequin and sounds like a 2007-era chatbot dialed to the VERY DEPRESSED setting. Shed be a walking repudiation of brainless techno-optimism, if she could actually walk.

Even attempts to build simpler, dog-like droids, such as Boston Dynamics Spot, have produced robots barely worthy of the name. They dont look much better than what youd expect from an adult Erector set enthusiasts weekend garage projects. Some people find these things terrifying, but I take my cues from the manufacturers, who seem incredibly proud when one of their creations performs a task as easy as opening a door.

Imitating human intelligence in software has also proven a task more difficult than expected. Despite the well-financed wet dreams of companies like Uber, the automotive industry has begun to quietly admit that truly self-driving cars are going to happen in decades, not just a few years from now. The Blue Brain project, which received a billion euros from the EU in 2013 and promised to simulate a human brain by 2019, did not succeed. Blue Brain seems to have had some success building a 3D atlas of a mouse brain, but the projects supercomputer, which takes up an entire room, is heaving and groaning under the strain of doing the same for a human mind. Valiant efforts to simulate a transparent, one millimetre nematode called C. elegans, ongoing since 2004, have yielded similarly slow progress. C. elegans has 302 neurons. The human brain has 86 billion.

These stuff-ups are endlessly amusing to me. I dont want to mock the engineers who pour thousands of hours into building novelty dogs made of bits of broken toasters, or even the vertiginously arrogant scientists who thought they could simulate the human brain inside a decade. (Inside a decade! I mean, my god!) Well, okay, maybe I do want to mock them. Is it a crime to enjoy watching our cultures systematic over-investment in digital Whiggery get written down in value time and time again?

On the other hand, maybe the people doing this stuff have just figured out that attaching the terms robot or artificial intelligence to whatever youre up to is a great way of attracting investment from rich idiots. Sometimes I feel naive for thinking anyone takes these wild claims seriously, but that is precisely the power of a good ideology. The promises of robotics and AI are so seductive that people suspend their critical faculties. Whether you are a business like Uber striving to eliminate the messy and expensive production input known as human beings, or a normal person desperate for easy transportation or someone to keep your elderly relatives company, the way we talk about robots and AI suggests these smart solutions are just around the corner. Even people with their heads screwed on properly dont seem to understand how credulously the media hypes up their coverage of AI.

What these doomed overreaches represent is a failure to grasp the limits of human knowledge. We dont have a comprehensive idea of how the brain works. There is no solid agreement on what consciousness really is. Is it divine? Is it matter? Can you smoke it? Do these questions even make sense? We dont know the purpose of sleep. We dont know what dreams are for. Sexual dimorphism in the brain remains a mystery. Are you picking up a pattern here? Even the seemingly quotidian mechanical abilities of the human body running, standing, gripping, and so on are not understood with the scientific precision that you might expect. How can you make a convincing replica of something if you dont even know what it is to begin with? We are cosmic toddlers waddling around in daddys shoes, pretending to work at the office by scribbling on the walls in crayon, and then wondering where our paychecks are.

The world is an astonishing place, and the idea that we have in our possession the basic tools needed to understand it is no more credible now than it was in Aristotles day, writes philosopher Thomas Nagel. But accepting this epistemic knuckle sandwich doesnt mean abandoning the pursuit of robotics.

Enter the frogbot, a living machine synthesized by a research team at the Allen Discovery Center at Tufts University in Boston.

Frogbots (called xenobots by their creators, a stupid name I refuse to use), are tiny little artificial animals made out of stem cells from the African clawed frog. They cant do much yet move around on two stumpy legs, carry tiny objects in a pouch but to me, they are stranger and scarier than any robot weve made out of metal and plastic.

A "frogbot" developed by researchers at Tufts University.

There are three basic steps to the frogbot process. First, stem cells that will develop into frog skin and frog heart are grown in a dish. (The proto-heart cells produce rhythmic contractions, which is how the finished frogbots move around.) Second, a computer runs an algorithm that simulates thousands and thousands of different frogbot designs in a virtual environment to see which ones are capable of whatever action you want them to perform. Finally, the designs that are likely to work are physically produced from clusters of stem cells using microsurgery, then let loose in another dish to see what they actually do. So far, they do pretty much whatever we want them to do, within reason.

This is very cool. Even though frogbots are tiny and stupid at the moment, they impress me way more than the conga line of faildroids weve managed to cobble together so far. Of course it makes sense to use materials from existing animals; weve been doing this using selective breeding techniques since the dawn of time. What are pigs or cows or sheep but frogbots built over thousands of years? The key innovation here is modelling selective evolution quickly, instead of standing around like idiots for millenia, waiting for hundreds of generations of dogs to fuck.

It makes perfect sense. Why try to reinvent the wheel when you could simply hijack biological processes that already exist? This is a classically human way of solving a problem, cleverer and yet also lazier than the futile pursuit of purely artificial robotics. A big congratulations to the scientists who figured this out, using only keen wit, a positive attitude, and a gigantic pile of money from the U.S. military research agency.

Yes, naturally this exciting new field of science is being used to develop weapons of war. This, not simply the prospect of new intelligences, is the upsetting thing about groundbreaking developments in robotics and AI. Will frogbots be a military invention that simply slides into everyday life, like the internet, canned food, and microwaves? Or will they be used to administer dangerous MKULTRA hallucinogens to innocent populations America decides are in its way? In a world controlled by a small and powerful elite that can essentially do whatever it wants, were forced to be suspicious of new technologies. Will the frogbot become bigger, smarter, and stronger? Yes, probably. Will it be my comrade? Thats another question entirely.

Eleanor Robertson is a writer and editor from Sydney, Australia.

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Meet the 21-year-old who turned her love for animals into a successful petcare business – YourStory

Once a pet rescuer, forever a pet lover.

Twenty-one-year-old Anushka Iyers journey as a pet parent and the Founder and CEO of petcare startup Wiggles started on somewhat similar notes. It was around October 2018, and Anushka, who had always been keen on the state of pet healthcare (preventive petcare, to be more specific) in India, was busy planning a trip to the Blue Cross, an animal welfare charity.

Team Wiggles

The Blue Cross visit turned out to be an experience that she wouldnt forget. The state of petcare in India is beyond miserable. Millions of stray dogs survive on the streets of the country, according to HelpAnimalsIndia.org, and most happen to be abandoned pets.

Ignorance amongst pet owners about preventive pet healthcare often leads to high vet costs and finally abandonment, since its marred by information asymmetry and access to personalised products, she says.

To address this ignorance and petcare knowledge among first-time and seasoned pet parents, Anushka launched Wiggles in December 2018 along with her father Rajh Iyer and Co-founder Venky Mahadevan.

The Pune-based startups goal is simple: to introduce transparency associated with costs, medication, nutrition, and wellness options across the pet industry.

The platforms flagship offering is theWiggles Box, a monthly preventive healthcare subscription box that contains anti-parasitic medicines, nutritional products, and essential vitamins for pets.

This offering is further complemented with personalised alerts to ensure you never miss your pets supplement dosage. The subscription-based curated healthcare product box, however, is just one part of the three-pronged approach followed by the company. Vet-on-call and grooming services form the other two pillars of its services.

The grooming services have been created keeping in mind simplicity, affordability, and convenience for pets, and start at Rs 799. Apart from this, Wiggles has annual healthcare plans that ensure consistent vet and grooming visits every month along with basic and mandatory vaccines, tests etc. covered and done by us right when it has to be done.

The companys portfolio also includes a range of 18 petcare products curated keeping in mind the pain points of a first-time pet parent.

Indias pet care market, riding on growing disposable income and increasing humanisation of pets, continues to record double-digit growth. A trend that has, unsurprisingly, grabbed eyeballs of the investors and new players alike.

Many pet startups such as Heads Up for Tails, PetKonnect, Petcart, and Woofwoofnow have come up in recent years, claiming to solve one or the other pet-related concern. What this multi-player market has failed to achieve, however, is a personalised approach towards pet healthcare.

Right now this market is ripe for disruption since one size does not fit all, and every dog needs a personalised healthcare plan.

With this vision, Wiggles has set out to take a stronghold of the direct-to-consumer petcare market by administering a definitive first-mover advantage. We are not reinventing the wheel here, but manufacturingOTC products, keeping in mind simplicity, affordability and convenience, the founder says.

Currently a team of 72, most of whom are either pet parents or pet lovers, Wiggles is available on ecommerce platforms like Amazon, Flipkart, BigBasket, and Dunzo. Aimed at spreading awareness about preventive pet healthcare, the platform will soon launch the Wiggles App to simplify pet healthcare further.

In November 2019, Wiggles took the first step towards strengthening its presence, operations, distribution, and expanding its product range.

The petcare startup raised angel funding of $1 million from a clutch of high net-worth (HNI) individuals. The participating investors included Nachikhet Deshpande, COO of L&T Infotech; Aparna Badkundri, Director, Dell Computers; Sachin Phadke, MD of Vetbiochem India; Abhay Amrute, Senior Partner, IIFL Wealth Management Ltd; Satish Billakota, VP, Europe Cognizant; and Risshee Tandulwadkar, Founder, Solo Stem Cell Clinic.

The plan of taking Wiggles to all major Indian cities, however, is a vision marked by several key milestones, one of them being the moment they got their drug licence.

When we decided to create our own range of products, we were told by almost everyone that it would take months to acquire the licence and we were falling off track. However, we were relentless, and we received it in 24 days, the entrepreneur recalls.

In fact, Anushkas biggest milestone is also something that has, in a way, shaped her entire entrepreneurial journey, even lending the name for her startup: her own pet, Wiggles.

(Edited by Teja Lele Desai)

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Meet the 21-year-old who turned her love for animals into a successful petcare business - YourStory

On Holocaust Remembrance Day, the stories of two Jewish scientists – Massive Science

The 2019 novel coronavirus (2019-nCoV) outbreak has sparked a speedy response, with scientists, physicians, and front-line healthcare professionals analyzing data in real-time in order to share findings and call out misinformation. Today, The Lancet published two new peer-reviewed studies: one which found that the new coronavirus is genetically distinct from human SARS and MERS, related viruses which caused their own outbreaks, and a second which reports clinical observations of 99 individuals with 2019-nCoV.

The first cases of the coronavirus outbreak were reported in late December 2019. In this new study, Nanshan Chen and colleagues analyzed available clinical, demographic, and laboratory data for 99 confirmed coronavirus cases at the Wuhan Jinyintan Hospital between Jan 1 to Jan 20, 2020, with clinical outcomes followed until 25th January.

Chen and colleagues reported that the average age of the 99 individuals with 2019-nCoV is around 55.5 years, where 51 have additional chronic conditions, including cardiovascular and cerebrovascular (blood flow to the brain) diseases. Clinical features of the 2019-nCoV include a fever, cough, shortness of breath, headaches, and a sore throat. 17 individuals went on to develop acute respiratory distress syndrome, resulting in death by multiple organ failure in 11 individuals. However, it is important to note here that most of the 2019-nCoV cases were treated with antivirals (75 individuals), antibiotics (70) and oxygen therapy (75), with promising prognoses, where 31 individuals were discharged as of 25th January.

Based on this sample, the study suggests that the 2019 coronavirus is more likely to affect older men already living with chronic conditions but as this study only includes 99 individuals with confirmed cases, it may not present a complete picture of the outbreak. As of right now, there are over 6,000 confirmed coronavirus cases reported, where a total of 126 individuals have recovered, and 133 have died.

In a second Lancet study, Roujian Lu and their fellow colleagues carried out DNA sequencing on samples, obtained from either a throat swab or bronchoalveolar lavage fluids, from eight individuals who had visited the Huanan seafood market in Wuhan, China, and one individual who stayed in a hotel near the market. Upon sequencing the coronaviruss genome, the researchers carried out phylogenetic analysis to narrow down the viruss likely evolutionary origin, and homology modelling to explore the virus receptor-binding properties.

Lu and their fellow colleagues found that the 2019-nCoV genome sequences obtained from the nine patients were very similar (>99.98% similarity). Upon comparing the genome to other coronaviruses (like SARS), the researchers found that the 2019-nCoV is more closely related (~87% similarity) to two bat-derived SARS-like coronaviruses, but does not have as high genetic similarity to known human-infecting coronaviruses, including the SARS-CoV (~79%) orMiddle Eastern Respiratory Syndrome (MERS) CoV (~50%).

The study also found that the 2019-nCoV has a similar receptor-binding structure like that of SARS-CoV, though there are small differences in certain areas. This suggests that like the SARS-CoV, the 2019-nCoV may use the same receptor (called ACE2) to enter cells, though confirmation is still needed.

Finally, phylogenetic analysis found that the 2019-nCoV belongs to the Betacoronavirus family the same category that bat-derived coronaviruses fall into suggesting that bats may indeed be the 2019-nCoV reservoir. However, the researchers note that most bat species are hibernating in late December, and that no bats were being sold at the Huanan seafood market, suggesting that while bats may be the initial host, there may have been a secondary animal species which transmitted the 2019-nCoV between bats and humans.

Its clear that we can expect new findings from the research community in the coming days as scientists attempt to narrow down the source of the 2019-nCoV.

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On Holocaust Remembrance Day, the stories of two Jewish scientists - Massive Science

Lessons Learned on Listening to the Dying, World Cancer Day Reflections – MissionsBox

World Cancer Day 2020 by Karen Burton Mains

Years ago, traveling around the world in the role of a journalist at the invitation of the director of an international relief organization, we stopped to visit Mother Theresas Kalighat Home for the Destitute Dying. I will always remember, as have other journalists before me, particularly Malcolm Muggeridge, the soft light that embraced the building and the unusual peace. The calm in the eyes of the Sisters of Charity. The rows of cots with emaciated bodies on them. Brown eyes looking into the distance. The feeling of being poised at some edge. Mostly, I remember the enfolding light. The light.

By the time our son, Jeremy Mains, was rushed to the local hospitals emergency room, his bone marrow was filled with cancer cells. I noticed that April of 2013 that he had seemed unusually tired, but I chalked it up to holding down several part-time jobs and being a highly involved father of three small children, which entailed sharing home responsibilities with a working wife.

However, when the GP phoned Angela with an urgent message that bloodwork results indicated that Jeremy should go immediately to Central DuPage Hospitals ER, our son had already been admitted, his kidneys shutting down. He was quickly diagnosed as suffering from an acute form of a rare lymphoma. Quickly, he was transferred to the oncology unit of Rush University Medical Center in downtown Chicago.

I wish I had read Atul Gawandes Being Mortal before our son, Jeremy, died at age 41 of acute blastic mantle-cell lymphoma. Gawandes book is subtitled Medicine and What Matters in the End and is a practicing surgeons deeply affecting journey into examining how medicine can do better facilitating the last months, weeks, days and minutes of a patients life.

In order to write about this topic well, Gawande follows a hospice nurse on her rounds, visits with a geriatrician in his clinic and dialogues with people reforming nursing-home practices. Then he interviews patients and the elderly as to how they want to frame their last days. His conclusions are pertinent for all who face end-of-life scenarios, whether through disease or old age.

Gawande writes,

Two-thirds of terminal cancer patients in the Coping With Cancer study reported having no discussion with their doctors about their goals for end-of-life care despite being, on average, just four months for death. But the third who did have discussions were far less likely to undergo cardiopulmonary resuscitation or be put on a ventilator or end up in an intensive care unit. Most of them chose hospice. They suffered less, were physically more capable, and were better able, for a longer period, to interact with others.[1]

At this time, I and a handful of friends, all of us with decades of ministry experience behind us, were testing the concept of listening groups. Eventually, over the course of eight years, I would lead some 250 listening groups, the majority with three to four participants, meeting once a month over seven months. The listening groups were trialed in various other settingsone a weekend retreat with 90 attendees; another, a group of 26 people we took on a tour to France. A pastor friend experimented using the listening-group model with his church staffwith great success, he reported to me. The architecture of the listening groups that my friends and I were testing surprised us with how quickly the group members felt safe with one another.

The format was built around a listening structure that ensured space and time enough for each of the participants to feel not only heard but understood. A gentle discipline maintained that the response to each one who shared could only be in the form of a question, and that could be asked only when the person sharing was finished with what he/she wished to say. This eliminated the distresses many small groups facea dominant personality, for instance, or sermonettes that interrupt the individuals own capacity to analyze and determine their own paths to maturation. We even forbid the well-intended-but-interrupting, Oh, let me pray for you. I watched, often in surprise, at the development of this deepening capacity of the participants to hear and be heard, which appeared to result in measurable and unusually rapid personal growth.

Listening to your son, however, who has been given a diagnosis that most likely will be terminal, is another matter altogether. A dedicated team of oncologists at Rush University Medical Center in Chicago, headed by Dr. Parameswaran Venugopal, the head of the cancer unit (where Jeremy spent practically all of the last few months of his life), designed a strong chemotherapy-and-radiation treatment course with an accompanying pharmaceutical regimen. Our son was young (41 years old) and healthy (once the kidney failure had been reversed). Plus, he was determined to live. Because of all this, there was a slim chance of Jeremy beating the odds.

Rough notes in my quick-scrawl handwritingalmost unreadable even to meindicated that on June 10, in room 1058 of the ICU, Dr. Stephanie Christiansen walked us through the progress of his disease. I wrote in my notebook:

Blastic mantle cell lymphoma. Burkitt cell lymphoma. Blastic = immature white cells. Mass in colon/not typical. STAGE FOUR. Lymphoma.org. Mantle cell is slow growing. Lots of variations. Treatments (1) Chemotherapy/HyperCVac given in cycles of 3 or 4 days, up to 8 cycles. Cycle A drug regimen. Infection. White counts are low[indecipherable word](something?) count every day. Stem cell transfusion.

Perhaps this erratic series of words and phrases gives a sense of how confusing cancer-cell diagnosis and treatment can be to the average family member. Angela, Jeremys wife, was persistent in achieving a laypersons understanding. I tried to grasp what I could, but basically found myself deferring to her determined comprehension.

One day, thinking to myself, If I ever want to write about this, I need to keep better records, I looked over a medical page given us by the hospital staff. The headline was CYTOTOXIC / HAZARDOUS MEDICATION ORDER. At my request, a kind nurse pulled the website description of some of the drugs in Jeremys regimen. She also printed me off a copy of the HyperCVad A regime. The drugs listed were: Aloprim, used for stopping high uric acid levels during chemo; dexamethasone; used to treat leukemia and lymphoma; ondansetron, used to stop upset stomach and throwing up; Mesna, used to lower the bad effects of some cancer drugs on the bladder; doxorubicin, used to treat cancer, leukemia and lymphoma; and Vincristine, used to treat leukemia, lymphoma and cancer. These were only for the beginning stages of Jeremys pharmaceutical regimen.

I wont list all the negative side-effects each individual drug is capable of causing. All the printouts for each drug, often four pages long, however, include this question: What are some side effects that I need to call my doctor about right away? Then in caps: WARNING / CAUTION.

What follows on each page is a list comparable to the TV pharmaceutical ads where a narrator breathlessly races through possible detrimental responses from the drug the advertisement has just touted as a near-miracle cure. This voiceover invariably accompanies a visual montage of happy people being healed of whatever ailment. Or if not a cure, there are, at least, tantalizing promises of renewed health and vigor, well-being (inferred by the smiles and satisfaction on the actors faces) and some physical outcome that is much, much better than the other competitive drug on the market. Inevitably, somewhere in that rushed half-whispered cacophony of possible side effects, the phrase that can possibly result in death usually occur. The truth is this: There is almost no drug you put into your body that wont cause side effects, eventually, of some kind.

In these early days of treatment, Jeremy, with his wry sense of humor, noted that he had been warned that nausea and diarrhea would be side effects of the chemo: But no one told me I would explode from both ends at the same time! That night before this observation he had lain for some time, exhausted, on his hospital bathroom floor before a nurse found him. Chemo treatments are basically a controlled poisoning of the body.

My instinctpurely a personal uninformed lay opinion, most non-scientific to be sure, and one from a mother watching her child die a gruesome deathis this: One day we are going to look back, like we do now on the Greek physician Galens concept of four humors in the blood and the practice of bloodletting and purging and say, You mean they used to treat cancer by poisoning the body? And the treatment was often as dangerous as the disease?! How barbaric! I feel this in my bones (or perhaps I should say in my genes, since at this time gene manipulation is one of the possible cancer-cure frontiers). Still, I bow before the fact that chemotherapy and surgery are curatives for many cancers in many stages, and I understand that the knowledge to cure evolves in countless laboratories, scattered research centers and across the hospital wards of many countries. Sometimes cures take decades, even centuries, to discover.

Somewhere in this first month, Jeremy said to me, Mom, I dont know if I can do this. To my sons private confession of weakness, I shot back, Of course you can. And no wonder I reacted: We were only one month into the horror that is the cancer journey. Despite its ubiquitous presence in our modern world, for the patients and their families who succumb to the diseaseand believe me, this is a family affairwe were all impacted beyond our capacity to absorb and understand. Societal familiarityover 500,000 people die of cancers every year in the U.S.does not translate to personal capability when faced with this diagnosis in your own family.

Instead of my instinctive buck-up retort, I should, instead, have asked those gentle questions drawn from my experience with the listening groups and my consequent research into what happens in the brain when someone feels listening to and understood. I get it. Sometimes I dont know if any of us are going to get through all this. Tell me what youre thinking and what you are feeling.

The battle of being mortal is the battle to maintain the integrity of ones life, writes Dr. Gawande, to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be. Sickness and old age make the struggle hard enough.[2] In every way through those months of hospitalization, I watched my son become diminished and dissipated and subjugated and disconnected. To my great regret, I did not offer my son this opportunity of end-of-life discussions. Though my grief at losing a child was and is still a clean griefthere was no breach in relationship, no sorrows of alienation o displeasure with each otherI do wish I had read Being Mortal before Jeremy died. Gawandes remarkable book was released in 2014; Jeremy died the year before.

So, the team of oncologists, headed by Dr. Venugopal, valiantly designed treatments, the goals of which were to bring the active cancer into remission, to keep the toxicity manageable, and to find a donor for a bone-marrow transplant. Jeremys oldest brother, Randall, was a perfect match, but that life-supporting treatment was not to be.

I watched as the whole hospital system moved in concentrated efficiency to preserve my sons life. Siddhartha Mukherjee, writing about leukemia, captures this medical momentum beautifully in his Pulitzer Prize-winning book The Emperor of All Maladies:

The arrival of a patient with acute leukemia still sends a shiver down the hospitals spineall the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the basement. Its pace, its acuity, its breathtaking, inexorable arc of growth forces rapid, often drastic decisions; it is terrifying to observe, and terrifying to treat. The body invaded by leukemia is pushed to its brittle physiological limitevery system, heart, lung, blood, working at the knife-edge of its performance.[3]

This describes exactly what I observed about the medical teams working around our son.

Jeremy did go into remission, which Dr. Venugopal described to Angela as a miracle. But the treatment was so toxic to his system that he had no capabilities to fight off the highly contagious and antibiotic-resistant staph infection MRSAin medical terminology, Methicillin-resistant Staphylococcus aureusa potential killer for the immune system-deficient. Though present in general society, ironically it particularly loves to lurk in hospitals.

Jeremy succumbed to waves of infection. Ironically, the very PICC line inserted in a vein on his chest closer to his heart so intravenous treatments could be administered was the very source of many of these infections. Soon, Jeremys mouth and face became paralyzed. He couldnt eat, was fed through stomach tubes, his words were bumbled, and in truth, after the chemotherapy treatments, at least to my viewpoint, there was not one day when he was better than the day before.

Nor do I know, apart from Jeremys wife Angela, if any one on that whole oncology team, from nurses, to teaching fellows, to the head of the hematology department, to the social workers, to the visiting pastors, ever talked to Jeremy about what was important to him as far as how he wanted to die. This I do know: Our son basically spent the last five months of his life, going from debilitating physical crisis to demeaning physical incapability, longing to be home with his wife and three small children; Eliana age six, Nehemiah age three and the baby, Anelise, age six months. And he wanted to be home on his own terms, anyway, anyhow.

(Lest I forget, let me also mention the two English Bulldogs, Roxie and dArtagnan, from whom, during his few brief days at home, Jer also refused to be separated.)

Gawande makes it clear that a listening process is paramountone in which sensitive questions are asked of the patient as far as what kind of attention attendants and family should be giving to those near death. (This must be a situation in which the medical profession does not do all the talking, however, but learns to listen and to be patient in the listening processquite a stretch for most knowledgeable folk in any field.) He assesses the deficiencies of retirement and nursing home environments:

This is the consequence of a society that faces the final phase of the human life cycle by trying not to think about it. We end up with institutions that address any number of societal goalsfrom freeing up hospital beds to taking the burdens off families hands to coping with poverty among the elderlybut never the goal that matters to the people who reside in them: how to make life worth living when were weak and frail and cant fend for ourselves.[4]

Being Mortal takes a stunning turn into the personal when the writers father, Atmaram Gawande, a well-respected and successful surgeon himself, succumbs to cancer. The doctor/son realized that with all the research he had conducted on listening to those in end-of-life scenarios, and with all the insights he had achieved, it was most difficult to apply those principles to his own father. His medical training, his save-and-preserve-life mentality swooped in and crowded out empathy, driving him to find a cure, to perform some sort of intervention. Believe me, I understand.

The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had any incorrect view of what makes life significant, Gawande writes.

The problem is that they have had almost no view of it at all. Medicines focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yetand this is the painful paradoxwe have decided that they should be the ones who largely define how we live in our waning days This experiment has failed.[5]

The next death we go through as a family, if we have any choice at all, will not be done this way. Our son, brilliant and gifted, a multicultural specialist, an adjunct professor teaching college Spanish and who also was functional in conversational Mandarin, this young man with his own immigration counseling service who had achieved the skills and grasp of a paralegal, this funny and compassionate and intriguing young man, died a gruesome death. I shudder even now as I think about it.

Still, before toxicity blasted his nervous system and his mouth became paralyzed (closed for months, then frozen open before he died), this young man, our son, in the early stages of his own death, taught me to listen to the dying. He determined that the long hours spent on my shift would be devoted to catching me up on my woeful ignorance of popular music, or as his teasing explanation defined it, That would be the last fifty years of music history, Mom. His sly gotcha glance was only made more roguish by his drooping face. My father, after all, had been the director of the music department of Moody Bible Institutehardly a bastion of contemporary cultural musicology. I was raised in a home where the emphasis was onguess what?church music. Worship services. Choir practices on Thursday nights. Youth choir rehearsals on Sunday afternoons. Worship services. Sunday night signs. Candlelight carols. Easter cantatas.

Using his iPad to pull down samples from Pandora, I then realized Jeremy was looking at our study not so much as a pop-culture aficionado but through the understanding of an ethnomusicologist. There was no one I would rather have traveled around the world with as a guide than Jeremy. In high school, he found a native speaker to tutor him in Japanese and took himself off to Japan at age 16 for a summer of foreign culture and a conversational-language plunge. While in college and at his instigation, Jeremy met me at the Art Institute of Chicago to view an exhibit of ancient Japanese kimonos. This private gallery tour gave me a hint that this son was a compulsively curious scholar, a lifelong learner. He knew the styles and ages of the kimonos without looking at the wall plaques. It was here I learned about the Edo period between 1603 and 1868 under the rule of the Tokugawa shogunate, the last military feudal government. I also received an additional short and unasked-for briefing on the demise of the samurai.

Let us next move to China, where Jeremy lived and taught for a cumulative total of three yearstwo years before he and Angela wed and one after. Need to know about the Shang Dynasty? (Approximate duration? 16001000 B.C.). How about the Ming Dynasty? What about the Boxer Rebellion? Before visiting him for a month in the middle of his two-year teaching contract at the Petroleum Institute in the city of Nanchong, Sichuan Province, we were emailed a full reading list to study before embarking. Certainly, it was the equivalent of a college semester of learning.

Jeremy kept records by printing pertinent ideas in small black notebooks, those wrapped with black elastic bands. So, with his determination not to waste the hospital hours, still lying in bed, and with me, a captive student at hand, spending hours, sometimes day and all-night shifts, he introduced me to the American Music Idiom 101. The black books came out, then the iPod. It didnt take me long (probably on a train ride from the Chicago back to the suburbs) to realize I was being privately tutored in a spontaneous course in ethnomusicology. Initially, that was the study anthropologists made of non-Western music and the cultures and environments and customs that gave rise to them. Eventually, attention was turned toward Western music as well. In short, ethnomusicology has been described as the study of people making music. This is exactly what this son opened up for mehe helped me to understand contemporary popular music as a means to identify with the people who had either made or were now making it.

Totally unprepared for the learning curve ahead, seeking at first only to console a gravely ill son, to help assuage the boredom of long hours, to divert attention from the constant tests and blood draws and the impossible difficulty of swallowing pills (even before his mouth became frozen, when kind nurses crushed all the tablets, and even then the taste was so bitter he had difficulty), I began one of the most profound listening experiences of my life. Admittedly, my literacy in popular music consisted of the infrequent songs I heard that others were listening to, or occasional snatches of the tuning dial while drivingthe oldies radio station in Chicago, 94.7. The learning was delightful, and I began to see that much of popular music was a cry from the mean streets, sung evidence, in many cases, of what we faith-based folk consider true lostness; I am deeply grateful for the exposure. I learned to listen to the words and rhythms of another kind of dying in that hospital room of my dying child.

As a result of the early chemo rounds when an Ommaya Reservoir had been implanted in his skull to enable the toxic intrathecal brain drips, and because of this procedure, a bilateral droop developed, paralyzing a side of Jeremys face and his mouth. It became an excruciating exercise to catch what our son was attempting to say since the consonants b, d, f, m, n, p, v and w were unpronounceable. Sometimes Jeremy would actually press his lips together with his fingers to make the puffing effort for any of these sounds.

Of course, if asked, I would have made the decision to give my life for his in an instant. I would have made the decision for this exchange with such fierce love, such terrible tenderness and without a moments hesitation. But that was not a choice at hand for any of us who loved him. But what I could have done I wish I had done. I regret not opening up those conversations about life and its meaning, about death and its coming possibility. If death is facing you, my dear son, how do you want to frame your last days?

There is a curious thing about death, at least for me: The dead are not forgotten. Those we have known in love exist in flashes of vivid understanding after they are gone. My father died when I was 35, my mother when I was 39. The essence of who they were lives on in merarely a day goes by that I dont think of them. I am now in my 70s. We, the living, assess the meaning of the lives of loved ones now dead in ways we would never do had they still been living. We tell remember-when stories, and we often pause to analyze the impact of those family events in a way we do not if participants were still alive. Remember the working trip we took together in the Caribbean? What was your favorite part of the trip to Europe? Do you remember how you took on your dad when we arrived in Beijing? (As Jeremy was bartering with Chinese taxi-drivers at the airport after our long flight from the States, David, weary and jet-lagged protested, Jer, just get a cab, any cab. Jeremy asked, Do you speak Mandarin? Or is it I who speaks Mandarin? Point made.)

I am still processing the meaning of my sons life and of his death. What have I learned from him? What should I change about the way I approach the days aheadthose days of living and the inevitable days of dying? I have learned this muchone lesson among the manyDavid and I are saying to one another, my husband and I, Let us talk together about dying. Let us listen deeply to each other and learn what will make the passage from this world to the next bearable, compassionate and as much as possible for our offspring, considerate.

I do probably have some papillary cancer floating around in the cells of my own body. A cancerous thyroid was removed from my throat five months after Jeremys death. It is a slow-growing cancer. So, my wish at this almost octogenarian age is this: Should that cancer flourish and thrive, let me die. I dont want at this stage to go through the debilities and excruciating treatments of this current time. I have lived a rich and good life. Four beautiful children. Nine delightful grandchildren. A fruitful and meaningful marriage of some 59 years. A circle of friends. A deep and sustaining faith in God and His Son Jesus Christ. Travel to some 55 countries in the world. Board work with crucial faith-based development organization with corporate missions I was proud to serve. The accomplishment of writing twenty-some books.

This, apart from a magical plunge into ethnomusicology, is another of the lessons about dying I learned from a dying son. Living ends. We cannot always determine when or how that will happen. Yet, in small and remarkable ways, we can ready ourselves for that terminal status. We can be clear, apart from the freak and indubitable accidental, about how it is we want to die. That is not a morbid choice, to talk about our own deaths. End-of-life conversations are paramount to passing well. They fit into the Scriptural discourse of the Apostle Paul,

For I am already being poured out like a drink offering, and the time has come for my departure. I have fought the good fight, I have finished the race, I have kept the faith. Now there is in store for me the crown of righteousness, which the Lord, the righteous Judge, will award to me on that dayand not only to me, but also to all who have longed for his appearing. 2 Timothy 4:67.

I miss my son. Miss him every day. But then, I too am close. I am close.

Footnotes:

To read more news on World Cancer Day on Missions Box, go here.

For another blog on Patheos by Karen Burton Mains, go here.

For more blogs on Patheos by Gospel for Asia, go here.

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Lessons Learned on Listening to the Dying, World Cancer Day Reflections - MissionsBox

Spinal injury researchers find a sweet spot for stem cell injections – New Atlas

As they do in many areas of medicine, stem cells hold great potential in treating injured spinal cords, but getting them where they need to go is a delicate undertaking. Scientists at the University of California San Diego (UCSD) are now reporting a breakthrough in this area, demonstrating a new injection technique in mice they say can deliver far larger doses of stem cells and avoid some of the dangers of current approaches.

The research focuses on the use of a type of stem cell known as a neural precursor cell, which can differentiate into different types of neural cells and hold great potential in repairing damaged spines. Currently, these are directly injected into the primary cord of nerve fibers called the spinal parenchyma.

As such, there is an inherent risk of (further) spinal tissue injury or intraparechymal bleeding, says Martin Marsala, professor in the Department of Anesthesiology at UCSD School of Medicine.

In experiments on rodents, Marsala and his team have demonstrated a safer and less invasive approach. The scientists instead injected the stem cells in between a protective layer around the spine called the pial membrane and the superficial layers of the spinal cord, a region known as the spinal subpial space.

This injection technique allows the delivery of high cell numbers from a single injection, says Marsala. Cells with proliferative properties, such as glial progenitors, then migrate into the spinal parenchyma and populate over time in multiple spinal segments as well as the brain stem. Injected cells acquire the functional properties consistent with surrounding host cells.

Following these promising early results, the scientists are hopeful that stem cells injected in this way could one day greatly accelerate healing and improve the strength of cell-replacement therapies for several spinal neurodegenerative disorders, including spinal traumatic injury, amyotrophic lateral sclerosis and multiple sclerosis. But first will come experiments on larger animal models closer to the human anatomy in size, which will help them fine tune their technique for the best results.

The goal is to define the optimal cell dosing and timing of cell delivery after spinal injury, which is associated with the best treatment effect, says Marsala.

The research was published in the journal Stem Cells Translational Medicine.

Source: University of California San Diego

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Younger Age, Consolidation Therapy With Autologous SCT Associated With Improved OS in Patients With Primary CNS Lymphoma – Oncology Nurse Advisor

Resultsof a large population-based study of patients with primary CNS lymphoma diagnosedbetween 2011 and 2016 showed a higher proportion of patients 60 years and oldercompared with reports from studies conducted 1 to 2 decades earlier. The findings from this study were published inNeurology.

PrimaryCNS lymphoma is a rare, aggressive form of non-Hodgkin lymphoma that caninvolve the brain, spine, leptomeninges, and eyes. It is characterized by theabsence of systemic disease, and a poor prognosis.

Anumber of advances in the treatment of patients with this disease have beenmade over the past 3 decades. These have included replacement of conventional whole-brainradiotherapy (WBRT) alone with combined modality therapy including high-dosemethotrexate-based chemotherapy followed by WBRT consolidation, which was shownto prolong time to recurrence in these patients. Alternatively, the use of first-line,high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) consolidationis an approach designed to circumvent WBRT-associated toxicity.

Inaddition, studies of the safety and efficacy of combining first-line high-dosemethotrexate with other drugs, such as high-dose cytarabine or rituximab, haveshown promising results, although concerns related to toxicity, particularly inolder patients, remain with some of these approaches.

Thisretrospective study included patient-, disease-, and treatment-related data forall adult, HIV-negative patients with primary CNS lymphoma diagnosed between2011 and 2016 who were included in the French oculo-cerebral lymphoma network,a prospective, nationwide database.

Ofthe 1002 patients included in this analysis, the median patient age was 68years (range, 18-91 years), and the median Karnofsky Performance Status (KPS) was60. Patients at least 60 years old and at least 70 years old comprised 72% and43% of the study population, respectively.

Thesedata are in line with epidemiologic studies reporting a continuouslyincreasing rate in the elderly over the last decades, the study authorscommented.

Morethan 90% of patients were treated with high-dose methotrexate chemotherapy,including more than 80% of patients aged 80 years or older, although the dosewas more likely to be lower in the latter population.

Consolidationtherapy with WBRT or ASCT was received by 15% and 6% of patients, respectively,although the majority of these patients were younger than 60, with only 11% ofpatients aged 60 years or older receiving consolidation therapy.

Theobjective response rate (ORR) to first-line treatment was significantly higherin younger patients compared with older patients (73% vs 54%; P <.001), and ORRs for the overallpopulation and the population treated with consolidation therapy were 59% and92%, respectively.

Ata median follow-up of 44.4 months, the median overall survival (OS) for theoverall population was 25.3 months. Although the rates of 1-, 2-, and 5-year OSfor the overall population were 62%, 51%, and 38%, the 5-year OS rate for thosetreated with first-line high-dose chemotherapy followed by ASCT was 76%.

One-quarterof patients included in the study died within 6 months of primary CNS lymphomadiagnosis, and these patients were more likely to be older (P <.001) and to have a worse KPS atdiagnosis (P <.001). Cause ofdeath in this group was determined to be multifactorial in 44% of cases, andincluded impaired neurologic status due to lymphoma, complications (eg,infections), and/or treatment-related side effects.

MedianOS in patients 60 years or older at diagnosis of primary CNS lymphoma was 15.4months compared with 28.4 months in those younger than 60 years (P <.001).

Onmultivariate analysis, prognostic factors associated with longer OS includedage younger than 60 years (P <.001),KPS of 70 or higher at diagnosis (P<.001), female sex (P =.03), andresponse to first-line induction chemotherapy (P <.001).

Thefinding that age represents not only the strongest prognostic factor of thedisease, but also a major risk factor for severe treatment-relatedneurotoxicity, prompted the study authors to conclude that these resultsshould stimulate specific studies devoted to the elderly [with primary CNSlymphoma] to optimize the therapeutic management of this growing vulnerablepopulation.

Reference

Houillier C, Soussain C, Ghesquires H, et al. Management and outcome of primary CNS lymphoma in the modern era: an LOC network study [published online January 6, 2020]. Neurology. doi:10.1212/WNL.0000000000008900

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Younger Age, Consolidation Therapy With Autologous SCT Associated With Improved OS in Patients With Primary CNS Lymphoma - Oncology Nurse Advisor

Cardio Round-up: Nanoparticles and Stem Cells in the Spotlight – DocWire News

This weeks Round-up looks to the future, as nanoparticles and stem cell-derived cardiac muscle cells get a closer look. More good news for lovers of yogurt, and a smelly but effective treatment for atherosclerosis as well.

Using stem cells extracted from the patients own blood and skin cells, this Japanese research team completed the first-in-human transplant of cardiac muscle cells derived from pluripotent stem cells. The team achieved this by reprogramming them, reverting them to their embryonic-like pluripotent initial state. I hope that (the transplant) will become a medical technology that will save as many people as possible, as Ive seen many lives that I couldnt save, Yoshiki Sawa, a professor in the Osaka University cardiovascular surgery unit, said in apress report.

Stem Cell-Derived Heart Muscle Transplanted Into Human for First Time: Researchers

Like something from a sci-fi horror novel, this team of researcher examined the role that nanoparticles that eat dead cells and stabilize atherosclerotic plaque may be able to play in the future of atherosclerosis treatment. We found we could stimulate the macrophages to selectively eat dead and dying cells these inflammatory cells are precursor cells toatherosclerosis that are part of the cause of heart attacks, one of the authors said in press release. We could deliver a small molecule inside the macrophages to tell them to begin eating again. The authors noted that after a single-cell RNA sequencing analysis, they observed that the prophagocytic nanotubes decreased inflammatory gene expression linked to cytokine and chemokine pathways in lesional macrophages, thereby treating the cell from the inside out.

Are Nanoparticles Potential Gamechangers for Treating Clogged Arteries?

In this large analysis of more than 120,000 individuals, the authors reported multivariable-adjusted hazard ratios (95% CI for all) for mortality were reduced in regular (more than four servings per week) consumers of yogurt, and there was an inverse relationship between regular consumption and cancer mortality as well as cardiovascular-related mortality in women. In our study, regular yogurt consumption was related to lower mortality risk among women, the authors wrote. Given that no clear doseresponse relation was apparent, this result must be interpreted with caution.

Yogurt Consumption Associated with Reduced Mortality Risk (Plus a Caveat)

This research teamlooked human microphages and compared them to dying cells in a dish. They observed that macrophages reclaim arginine and other amino acids when they eat dead cells, and then use an enzyme to convert arginine to putrescine. The putrescine, in return, activates a protein (Rac1) that causes the macrophage to eat more dead cells, suggesting to the authors that the problem of atherosclerosis may be, in part, a problem of putrescine. The findings, according to the accompanying press release, suggest that the compound could be use to potentially treat conditions with chronic inflammation, such as Alzheimers disease.

The Nose Knows: Pungent Compound Associated with Improvements in Atherosclerotic Plaque

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Cardio Round-up: Nanoparticles and Stem Cells in the Spotlight - DocWire News