A solid eight hours can be hard to come by in our non-stop, tech-saturated world. But the modern science of sleep shows that shut-eye is just as critical as diet and exercise in shaping both mental and physical health.

Host Rao is joined by Mary Ellen Wells, the director of the neurodiagnostics and sleep science program at the University of North Carolina School of Medicine; Jade Wu, a licensed clinical psychologist at Duke University specializing in behavioral sleep medicine; Roger Ekirch, a university distinguished professor in the department of history at Virginia Tech; and Sheena Faherty, a science communicator who conducted doctoral research into hibernation in lemurs at the Duke Lemur Center to talk about sleep on this edition of 'Embodied.'

On this episode of The State of Things series Embodied: Sex, Relationships and Your Health, host Anita Rao speaks with experts in psychology, neurology, history and even lemur biology to better understand what is actually happening when we sleep and how we can learn to sleep better.

If I had no social obligations, no work and I lived in a cave, I would just want to go to bed later and later each day and wake up later and later each day. -Jade Wu

Rao is joined byMary Ellen Wells, the director of the neurodiagnostics and sleep science program at the University of North Carolina School of Medicine;Jade Wu, a licensed clinical psychologist at Duke University specializing in behavioral sleep medicine and the host of the Savvy Psychologist podcast;Roger Ekirch, a university distinguished professor in the department of history at Virginia Tech and the researcher who brought to light an ancient pattern of segmented sleep; andSheena Faherty, a science communicator who conducted doctoral research into hibernation in lemurs at the Duke Lemur Center.

The sleep experts break down the latest research into the science of sleep, how our ancestors used to sleep in two shifts with a period of wakefulness in between, and why lemurs may hold the key to human hibernation and deep space travel.

Interview Highlights

Jade Wu on whats happening to our brains and bodies during deep sleep:

Human growth hormone peaks in how much it's being released in the body during deep sleep. So that's why kids need a lot of sleep, need a lot of deep sleep because they're growing. Sex hormones are also being released during this stage. That's why teenagers also need a lot of sleep, because they're going through puberty. And we're also consolidating memories The brain is also doing some janitorial work very important janitorial work. We're clearing out debris from the cerebrospinal fluid, just basically junk in the brain that we don't need. And with this clearing out, we're sort of resetting and we're maintaining brain health.

Wu on how we are programmed to have different circadian rhythms:

We are all biologically wired to be either a morning lark, a night owl or somewhere in the middle. And this is largely driven by genetics, so we can't help it. And there's actually differences in the length of our cycles depending on what we have. So for example, I'm a night owl. So I probably don't have a 24 hour cycle I probably have something more like a 24.3 hour cycle. Meaning if I had no social obligations, no work and I lived in a cave, I would just want to go to bed later and later each day and wake up later and later each day. Whereas people who are morning people tend to have closer to a 24 hour cycle. Though the average I believe, is about 24.1 hours.

Mary Ellen Wells on the science behind sleepwalking:

So sleepwalking, it can be surprisingly common about one to 15% of the population can suffer from sleepwalking at any point. And it's more common in children. And it's one of what we call a parasomnia, [those] are essentially acting out or movements, odd things that are happening during the night ... And there are certain parasomnia that happen during REM sleep and certain parasomnia that happen during non-REM sleep. Sleepwalking is one of those that happen during non-REM sleep. REM sleep is essentially your dreaming state. And sleepwalking it's not entirely understood exactly why this happens to people. But there are many things that can spark it to happen, such as sleep deprivation Sleepwalking is very, very dangerous. The person [is] not aware that this is happening. So there's a misperception out there that you should never wake a sleepwalker.

It was a prime time for petty crime. -Roger Ekirch

Roger Ekirch on what people did in the break between segmented sleep:

There were special prayers to be said after your first sleep. They meditated, many reflected upon dreams from whence they had just awakened. Others of course, used chamber pots. But then, still others left their beds, they performed chores. There's a wonderful passage in Virgil's Aeneid describing this. [They] performed chores that required very little light and virtually no skill in the dead of night. Some left their homes, visited neighbors or I think even more commonly pilfered apples from a neighbor's orchard. It was a prime time for petty crime. It was also, in the view of physicians writing in the 16th, 17th and 18th centuries, a prime opportunity in which to conceive children, after the first sleep when a couple would be more rested. In the words of Laurent Joubert, a French physician in the 16th century: It is after the first sleep when couples and I'm quoting him verbatim do it better and enjoy it more.

Sheena Faherty on the question of whether humans could possibly hibernate one day:

NASA is really interested in it because of things like space travel. And these types of things have applications to emergency medicine and organ transplantation....What we find is that the same metabolic pathways, and genes that are involved in these metabolic pathways that are regulating these changes in metabolism [during lemur hibernation], are the same genetic pathways and genes that humans have already. And so in theory, humans have the capability to enter a torpor-like state based on this finding.

Original post:
Embodied: The Elusive Science Of Sleep - WUNC

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When the Below Deck crew from Valor went out on the town, bosun Ashton Pienaar observed that it seems easy to get into a lot of trouble in Thailand. Thailand is a lot of fun, he says in a confessional. But you can get into a lot of trouble. I think they put something different in their vodka?

The next day after sleeping on the deck, Pienaar exclaims, I feel rough. Meanwhile, chief stew Kate Chastain, who didnt appear to be overly intoxicated the night before searches for medicine to help with her hangover. She is filmed in the fetal position on a couch. I think the vodka in Thailand is different, she says in a confessional. This is like 18-year-old Kate partying and hungover. Its not a good look.

Later one of the guests on the next charter gets extremely drunk before she even boards the yacht. Previews for an upcoming episode catch her being so drunk in another instance, she needs medical attention. What is it about Thailand that has the crew and guests getting so drunk?

While yachties may be used to tropical conditions, Below Deck cast members often remark about the intense heat in Thailand. The problem with drinking in extreme heat is that booze becomes a diuretic, which drains the body of fluids. People think of alcohol as a thirst-quencher because it comes in a refreshing, cold liquid. But in hot weather, youre already losing fluids through sweat and through exercise, Dr. Josef Thundiyil, an emergency physician with Orlando Regional Medical Center told The Epoch Times.

What ends up happening is people urinate more often in the hot weather and get dehydrated faster. You end up peeing out more than you take in, he said. Once you start drinking alcohol, you shut that hormone off, so its not as simple as making up for it by drinking more water. Youre going to continue to urinate more than you normally would if you hadnt been drinking alcohol.

Combine heat with booze and it could be a recipe for trouble. Thundiyil says that alcohol depresses the hypothalamus, which is the gland thatregulates body temperature. As a result, drinking in the heat means youll feel hotter (and perhaps drink more). Impaired judgment is a big issue because a lot of times people dont know exactly how unclear their decisions actually are, he said. Even if people may not achieve the legal driving limit, .08 in most states, you can still have ill effects. You can lose judgment and coordination, and that can give way to things like more significant inebriation.

The heat sounds pretty brutal just from the comments coming from the crew. Thailand is an especially hot destination but extremely hot during the months when Below Deck was filming.

The weather doesnt cool off much at night, although higher elevations in some areas make it more bearable than in the rest of the country, according to Trip Savvy. During the hot season, visitors can expect highs to reach above 90 degrees Fahrenheit (32 degrees Celsius), with some sweltering days even hotter.

Like many places in the world, Thailand experienced an increase in temperatures over the last several years. Temperatures have reached such significant heights in the past, animals at the Dusit Zoo in Bangkok were at risk of overheating.

More here:
'Below Deck': Why Is Drinking Alcohol in Thailand Getting the Crew and Guests so Drunk? - Showbiz Cheat Sheet

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Consumer genetic tests could be giving false reassurance to those at heightened risk of cancers, according to findings presented at an international conference this week.

The study, by clinical genetic testing company Invitae, revealed that tests for breast and bowel cancer risk by direct-to-consumer companies such as 23andMe give negative results to the vast majority of those carrying DNA mutations in the genes under investigation.

These tests should not be taken at face value at all, whether they are positive or negative, said Edward Esplin from Invitae ahead of the annual meeting of the American Society of Human Genetics in Houston, Texas.

The data really underscores that there needs to be increased awareness that results from this type of screening may not be wrong but theyre woefully incomplete.

The research also showed that those from Asian and African-American backgrounds were more likely to carry mutations that were not designed to be detected by the consumer tests.

The research focused on DNA-based tests relating to breast, ovarian and bowel cancer that were recently approved by the US Food and Drug Administration.

The tests operate by a subject sending a DNA swab in the post for analysis and then receiving results with information about how their genetics could influence their health.

In the case of breast and ovarian cancer, the FDA has approved a screening test for three specific mutations on the BRCA1 and BRCA2 genes, which are most common in people of Ashkenazi Jewish heritage. However, these mutations are rare in people from other backgrounds.

Similarly, for bowel cancer, 23andMe offers FDA-authorised tests for two mutations, which are most common among individuals of northern European ancestry. The company explains the limitations of these tests to consumers and on its website.

Esplin said that despite this, consumers could be wrongly reassured by a negative result.

The study analysed the DNA of 270,806 patients who had been referred by healthcare providers for testing of the MUTYH gene, and 119,328 who had been referred for BRCA1/2 genetic testing.

It showed that for both tests, the majority of those carrying mutations would not be spotted, which Invitae describes as a clinical false-negative result.

For MUYTH, 40% of individuals with mutations in both copies of their MUTYH genes consistent with an almost 100% lifetime risk of bowel cancer had different mutations to those screened for in the FDA-approved test. This figure rose to 100% for those from Asian backgrounds and 75% for African-Americans.

For BRCA genes, 94% of non-Ashkenazi Jewish individuals and 19% of those of Ashkenazi heritage had a mutation that would be missed. Again, the figures were highest for those of Asian (98%) and African-American (99%) ancestry. Its performing a disproportionate disservice to individuals of these underrepresented groups, Esplin said.

A clinical false-negative result can be incorrectly reassuring, excluding a patient from receiving the preventive care they need based on their risk, he added. It could be the difference between preventing cancer and developing cancer.

In response to the findings, 23andMe said in a statement: The claims made by a competitor that we are returning clinical false negatives is incorrect and a false characterisation of 23andMes test. Our test is extremely accurate. As part of the FDA authorisation process weve demonstrated over 99% accuracy for the variants we test for in our health product.

The company said it makes clear to customers that it tests only for certain genetic variants and that customers should not forgo any recommended testing based on 23andMe results. 23andMe is not a diagnostic test, the company said. If an individual has a family history of cancer or other indications for clinical testing we always recommend consulting a healthcare provider first.

Prof Anneke Lucassen, a clinical geneticist at the University of Southampton, said that, in her experience, non-specialists would be likely to wrongly interpret negative results as an all-clear.

I do think the false-negative rate is an issue, not necessarily through the companies fault but through low general awareness, she said. Most people who come to clinic ask: Have I got the gene for breast cancer? and imagine its a single test, not that the test involves looking through around 20,000 letters of the genetic code to see if any one of them might be different.

Read more:
Genetic testing kits 'may wrongly reassure those at risk of cancer' - The Guardian

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Myriad Genetics is among a handful of companies that make a genetic test to help doctors choose psychiatric medicines for patients. Evidence that the tests are effective has been called "inconclusive." Myriad Genetics hide caption

Myriad Genetics is among a handful of companies that make a genetic test to help doctors choose psychiatric medicines for patients. Evidence that the tests are effective has been called "inconclusive."

As a teenager, Katie Gruman was prescribed one mental health drug after another. None seemed to help her manage symptoms of anxiety and bipolar disorder, so she self-medicated with alcohol and illicit drugs.

It would take five years, and trying more than 15 different medications, before she found meds that actually helped.

Now 28 and in recovery, Gruman has been on the same drugs for years. But when a clinician recommended a genetic test to see which drugs work best for her, she took it.

Reading the test results "was definitely vindicating," she says. Medications that hadn't worked for her as a teenager were the same ones the results marked as bad fits.

She says she wishes she had taken the test as a teenager. "I could have avoided a lot of disaster in my life," she says.

Psychiatric medications are known to be hard to match to symptoms, and many patients like Gruman live through years of trial and error with their doctors.

Companies that make genetic tests like the one Gruman used say they can save patients and doctors from prolonged searching for the right medication and save insurance companies from paying for ineffective drugs. But many researchers say the tests don't have enough evidence backing them up. The Food and Drug Administration has warned that the tests could potentially steer patients towards the wrong medications. Nonetheless, UnitedHealthcare, the nation's largest insurer, began covering them October 1 for its 27 million individual and group plans.

Test makers hailed the announcement of United's coverage, the first from an insurance company to apply to all of its commercial plans across the country.

"We expect this to be a tipping point," says Shawn Patrick O'Brien, CEO of Genomind, a company that makes one of the tests. Other insurers will cover the tests "because they don't want to be uncompetitive in the marketplace," he predicts.

If the prediction is correct, it would likely fuel a market that has seen its largest test maker, Myriad Genetics, sell about 375,000 of its psychiatric medicine tests in the 2019 fiscal year, according to Jack Meehan, an industry analyst for Barclays. Myriad reported that it sold $113 million worth of the tests.

In addition to UnitedHealthcare's coverage, Myriad Genetics' test is covered by Medicare, a regional Blue Cross Blue Shield affiliate, and the insurance network for the grocery chain Kroger, a spokesperson says.

Genomind has discussed coverage with insurers including Anthem and Blue Cross Blue Shield, O'Brien says.

Debates over efficacy

As the field of genetic testing to help diagnose and treat disease grows, medicine has embraced certain tests, such as that for the BRCA gene linked to breast cancer. But many researchers say there is not enough evidence tying genetic variants to better outcomes for most psychiatric medications.

James Potash, the head of psychiatry at Johns Hopkins Medicine and an expert on psychiatric genetics, says of all the tests claiming to improve depression treatment, GeneSight's has the most proof. That isn't saying much, though.

"I wouldn't say there's no evidence that it works," he says. "It's just the evidence at this point is still weak."

The idea behind the tests is that in some cases, people can have different reactions to the same drug, even at the same dose, because they have different gene variants. Which variant a person has can affect how quickly or slowly a medicine moves through their body.

This link between genes and drug metabolism has been known for decades, says Francis McMahon, who leads genetic research into mood and anxiety disorders at the National Institutes for Mental Health.

Usually, the longer it takes your body to process a drug, the easier it is for that medication to have an effect. But in psychiatry, McMahon says, how fast someone processes a drug, or metabolizes it, and how well they respond to the drug "are sometimes not strongly related."

This skepticism is shared by some insurance companies. "Anthem considers these tests investigational and not medically necessary," says a spokesman for the carrier, which covers 41 million people. The Blue Cross Blue Shield Federal Employee Program, which covers about two-thirds of government workers and their families, said "there is not enough evidence at this time to determine the effect of genetic testing on health outcomes," according to a spokeswoman.

Test makers are also facing FDA objections that they haven't proven some of the claims underpinning genetic tests for medications, including that antidepressants work better with some gene variants.

"Changing drug treatment based on the results from such a genetic test could lead to inappropriate treatment decisions and potentially serious health consequences for the patient," the agency warned in late 2018. It told companies to stop naming specific drugs, in marketing materials or test results, for which its tests "claim to predict a patient's response" without "scientific or clinical evidence to support this use."

Most test makers complied. One, Inova Genomics Laboratory, stopped selling a range of tests, including its test for mental health disorders, after the FDA followed up with a warning letter in April.

Several mental health advocacy groups, including the National Alliance on Mental Illness, have sided with test makers in their dispute with the FDA. Keeping the names and types of medication off of genetic test reports, as the FDA has required, will "impede the ability of psychiatrists and other front-line health care professionals to personalize medication decisions" for patients with depression, the groups wrote the FDA in September.

Some have argued that genetic tests like these shouldn't be regulated by the FDA at all. Tests conducted in a lab are a medical service, not a medical device that's shipped like a product, says Vicky Pratt, president of the Association for Molecular Pathology. As a medical service, she says, clinical laboratories are already regulated by the Centers for Medicare and Medicaid Services.

"It would be redundant to have dual regulation by both the FDA and CMS," says Pratt.

Cost-benefit analysis

Research into the tests' efficacy is ongoing and continues to be debated.

Myriad hoped to bolster evidence for its test, GeneSight, in a study it funded that was published this year in the Journal of Psychiatric Research, but the results were mixed.

In the study, doctors used genetic tests to help prescribe medications for one group of patients with depression, while another group of patients received usual care. There was overall no difference between the groups in the study's primary measure of symptom improvement, though some patients showed improved response and remission rates.

Responding to criticisms of its clinical trial results, Myriad Genetics spokesman Ron Rogers says the trial population whose average participant had tried more than three unsuccessful medications for depression was uniquely difficult to treat. He says he expects to see stronger outcomes in a forthcoming review of the trial data.

In a statement on the use of genetic testing in psychiatry, the International Society of Psychiatric Genetics, calls the existing evidence "inconclusive," and notes that if 12 patients take such a test for antidepressants, just one will benefit from it.

A low rate of success means insurers will have to pay for a lot of tests for one useful result, says Barclays analyst Meehan. Meehan pointed to a letter about the recent GeneSight study that was published in the same journal, which found that 20 patients would need to take the test for one to recover as a result. At $2,000 for a GeneSight test, the authors wrote, that means patients and insurers would have to cover $40,000 worth of tests. (While competitor Genomind does not share pricing information, a spokeswoman confirmed that it has an active contract with the Department of Veterans to supply tests for $1,886.)

Still some clinicians value the tests. Skeptics often misunderstand how the tests should be used, argues Daniel Mueller, a professor at the University of Toronto who researches how genes and drugs interact. (Mueller is involved in research comparing Myriad's GeneSight to another test developed by a University of Toronto-affiliated hospital.) Most of the time, he says, doctors who order the test already plan to prescribe medication. The test is just another tool to help them decide which one to prescribe.

"It's not an alternative intervention," Mueller says. "It's additional information." He orders the test for most patients who do not respond to at least one antidepressant.

"If you think about the cost of depression and weeks of suffering that you can potentially avoid for some patients," Mueller says, he thinks anyone who can afford a test should take it. (Myriad says 95% of patients pay less than $330 for their test, the cost remaining after insurance and possible financial assistance; Genomind says most privately insured customers pay no more than $325.)

A lack of watertight evidence for the tests should not stop doctors from using it to inform their choice of medication, says Reyna Taylor, who leads public policy for the National Council for Behavioral Health, one of the advocacy groups that defended the tests in a letter to the FDA. "You use the science that you currently have," she says.

"Whether our providers choose to use [a genetic test] or not, we want them to have that choice," she adds.

Disagreement among experts hasn't dissuaded UnitedHealthcare from paying for the tests.

In a statement, UnitedHealthcare spokeswoman Tracey Lempner says they "frequently review our coverage policies to ensure they reflect the most current published evidence-based medicine and specialty society recommendations."

Graison Dangor is a journalist in Brooklyn.

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Genetic Tests For Psychiatric Drugs Now Covered By Some Insurers : Shots - Health News - NPR

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According to study findings presented at the American Society of Human Genetics (ASHG) 2019 Annual Meeting, health reports from direct-to-consumer (DTC) genetic tests that adopt a limited variant screening approach are producing clinically false-negative results.The advances in next-generation sequencing (NGS) technologies that have occurred since the "Genomic Era" mean that DTC genetic testing is now increasingly affordable and more of us are opting to do it. These genetic tests are marketed directly to consumers via an array of advertising platforms, print, television, or the internet; and the tests can be purchased online or in shopping stores. A customer purchases the test, sends the company a DNA sample and receives their results directly there is no intervention from a healthcare provider. DTC companies offer genetic tests for an array of purposes, be it to make predictions about an individual's health, to provide information on common genetic traits, or to offer insight on an individual's ancestry.The popularity of DTC genetic testing has grown to the extent that The U.S. Food and Drug Administration (FDA) has authorized marketing of health reports from DTC genetic screens for genetic risk of breast, colorectal and ovarian cancer.DTC "It's like reading a book"Typically, the tests search for variants in a consumer's genome, such as single nucleotide polymorphisms (SNPs), that can increase an individual's susceptibility to disease. However, concern has arisen as to whether the variant screening provided by DTC companies is thorough enough to yield true clinical value.While limited variant screens may be informative for the variants they detect, they are not designed to detect every variant that has been linked to the disease in question, explained Edward Esplin, MD, of Invitae, who presented the research. "Thus, these health reports may provide a false sense of reassurance and should not be used for making any health decisions without confirmation testing."Esplin told Technology Networks, "The limited health screens available direct-to-consumer state they should not be used for healthcare decision-making, consistent with FDA recommendations. Clinical tests are designed expressly for healthcare decision-making. Rather than looking at a few variants in a few genes, clinical tests provide comprehensive information on the relevant genes and variants proven to confer increased risk of disease. Its like proofreading a book. If each gene is a chapter, a clinical test proofreads the entire chapter on that gene, whereas a DTC test may look for errors in only a few letters."

In the presented study, Esplin and colleagues wanted to quantify the clinical false negatives that result from a limited screening strategy. They therefore focused on two FDA-authorized limited variant screening tests, one for MUTYH gene, which detects to variants linked with colorectal cancer, and one for BRCA1 and BRCA2, which identifies three variants associated with breast cancer.I ask Esplin how we define "limited screening". He tells me, "For tests using limited screening strategies only a small portion of the clinically relevant genetic variants are reported. For example, there are thousands of variants in BRCA1 and BRCA2 that have been shown to increase risk of breast and ovarian cancer in women. Screening tests that provide information on just 2 or 3 of those variants, such as those limited to the 3 BRCA1/2 variants most common in individuals of Ashkenazi Jewish descent, are highly limited. Again, the book analogy is helpful."The scientists studied 270, 806 patients who had been referred by healthcare professionals for MUTYH genetic testing, and 119, 328 who had been referred for BRCA1/2 genetic testing.

For both tests, they identified that if only the limited variant screenings had been performed, then most patients would have received a clinical false-negative result.

Specifically, for MUTYH genetic testing, 40% of individuals with mutations in both of their MUTYH genes (which is consistent with 100% lifetime risk of developing colorectal cancer) would have been missed. 22% of carriers of one MUTYH mutation, which is consistent with a 2-fold increased risk of colorectal cancer, also would have been missed.

When analyzing BRCA1/2 the variants tested were significantly more common amongst Ashkenazi Jewish study participants. However, even among these individuals, 19% would have received a false-negative result, and 94% of non-Ashkenazi Jewish individuals carried a BRCA1/2 mutation that would have been completely missed.

Esplin tells me, "Our study did not evaluate the reasons behind the variation in these populations that we observed. This is an important area for further study. That said, it stands to reason that if a test is looking at just 2 or 3 variants associated with a specific population, such those of Ashkenzai Jewish descent, populations likely to have substantially less of that heritage will exhibit substantially fewer of those variants."

He continues, "A clinical false-negative result can be incorrectly reassuring, excluding a patient from receiving the preventive care they need based on their risk. It could be the difference between preventing cancer and developing cancer."Analyzing differences among populationsEsplin's team analyzed the rate of false-negatives among patients of different ethnic backgrounds. Their results show that for MUTYH, 100% of Asians, 75% of African-Americans, 46% of Hispanics and 33% of Caucasians would have received a clinical false-negative. In parallel, for BRCA1/2, 98% of Asians, 99% of African-Americans, 94% of Hispanics, and 94% of Caucasians would have also received a clinical false-negative.

Collectively, these findings emphasize the medical worth of conducting in-depth, comprehensive clinical genetic testing. "The results from this type of DTC genetic screening may not be wrong but they are woefully incomplete, particularly when viewed against the health question a patient may be asking - am I at risk for cancer. We hope our research underscores the need for consumers to understand the deep limitations of these health reports and seek out appropriate clinical genetic testing when trying to understand their risk of health conditions like cancer," says Esplin.I ask Esplin what his advice would be to individuals considering a DTC genetic test. He tells me: "Think about the question you hope to answer by taking the test. If you are interested in whether you are at risk for a disease, you need a comprehensive, medical grade genetic test that can answer that question and be used by you and your physician to take action on the result. So if you want to know if youre at risk for cancer, you need a comprehensive clinical genetic test that evaluates all of the gene changes that can increase your risk. It is easier than ever before to get the tests genetic experts trust thanks to offerings like ours that link patients to clinicians via telemedicine. If youre interested in getting a health answer, get a medical test."

Reference: ED Esplin et al. (2019 Oct 17). Abstract: Limitations of direct-to-consumer genetic screening for hereditary breast, ovarian, and colorectal cancer risk. Presented at the American Society of Human Genetics 2019 Annual Meeting. Houston, Texas.Edward Esplin, M.D., was speaking with Molly Campbell, Science Writer, Technology Networks

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Limitations of Health Reports From Direct-to-Consumer Genetic Tests Are Identified - Technology Networks

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Matthew Knowles, the father of the artists Beyonc and Solange, recently announced that he had been told that he has a breast cancer caused by a BRCA2 gene mutation and that his children have a 50 percent chance of inheriting it.

In 2007, my mother was in a similar position. She learned after receiving a breast cancer diagnosis at age 42 for a second time her first bout with cancer came when she was 28 that she carried a BRCA2 mutation. It meant that as her daughter, I had even odds of having inherited it from her.

BRCA1 and -2 gene mutations can elevate a carriers lifetime risk of developing breast cancer up to 72 percent, compared to a 12 percent lifetime risk among the general population. They can also elevate a carriers lifetime risk of ovarian, pancreatic or prostate cancers along with melanoma. Although he had a family history of breast cancer, Mr. Knowles had never been referred for genetic counseling or testing to evaluate his risk of having a BRCA mutation.

His story is all too common among African-Americans. Black women are substantially less likely to undergo genetic counseling and testing for BRCA mutations as compared to white women, even though research suggests that the rate of BRCA mutations is higher among black women than it is for white.

Researchers at the Moffitt Cancer Center in Florida found that among young breast cancer patients who met the national guidelines for receiving genetic counseling, only 37 percent of black women had discussed it with a provider compared to 86 percent of white women. Just 36 percent of black women received testing for BRCA compared to 65 percent of white women. A study showed that only 58 percent of black women who were eligible for genetic testing under the national guidelines received testing as a part of their routine care.

Although there is no clear answer as to why the disparity exists, one reason may be the lack of awareness among doctors that black people are at risk for carrying BRCA mutations. Ohio State University researchers interviewed black and white women at higher risk for breast cancer. One study participant, a black woman in her 20s, reported that when she had expressed interest in genetic counseling, her gynecologist told her that only Jewish women tested positive for BRCA mutations.

Although its true that Ashkenazi Jews have an especially high risk of carrying a mutation (the rate is estimated to be one in 40), people of all racial backgrounds run a risk. The same study also found that black women are less likely have seen a specialist who could provide information on genetic counseling and testing: only 15 percent of black women in the study had met with a genetics, cancer or breast specialist as against 70 percent of white participants.

Although there have not been any published studies that I know of on genetic counseling and testing rates among black men, a 2016 report found that among men diagnosed with prostate cancer, black men may be more likely to have BRCA1 and BRCA2 mutations than white men.

The discovery of the BRCA1 and -2 mutations in 1994 and 1995 was a huge breakthrough that allowed for us to get better at treating and preventing cancer. That makes the low levels of BRCA testing among African-Americans especially troubling, because people who know they are carriers can possibly reduce the risk of getting cancer by getting a preventive mastectomy or oophorectomy.

I know this myself. When I was 29, I was tested and discovered that my mother had passed on her BRCA2 mutation to me. I decided to have a preventive double mastectomy, which shrank my risk of developing breast cancer from 80 percent to less than 5 percent.

Even if a person decides not to do what I did, enhanced surveillance, like an MRI and mammogram every six months, can help detect cancer at an early stage when its more treatable. If black women and men arent receiving genetic testing, theyre potentially missing out on the chance to catch breast cancer early on. This is crucial because black women are more likely than white women get diagnoses of breast cancer at a later stage, which has lower survival rates. Similarly, black men are also more likely than white men to be told they have prostate cancer when it has reached a more advanced stage.

As the use of personalized medicine and genomics in treating cancer increases, knowing whether a patient has a BRCA mutation allows for individualized treatment. It also lets the patient to take steps to prevent a recurrence or a second cancer elsewhere. For example, once my mother learned that she carried a BRCA2 mutation, which is also associated with a higher risk of ovarian cancer, she underwent an oophorectomy. She has been cancer-free for 12 years.

Knowing that a person carries a BRCA mutation also provides an opportunity to test and identify relatives who may carry a harmful mutation potentially preventing and detecting cancer early in a whole family.

We need a large-scale effort to improve genetic counseling and increase testing rates in the black community. The first step is to make medical providers more aware that black women and men are at risk for carrying BRCA mutations. Numerous studies have shown that the biggest indicator of whether someone undergoes genetic testing is a recommendation from a doctor.

An educational effort would also help to dispel myths that genetic testing is financially prohibitive. Most insurance will cover the costs of testing for people who meet the national guidelines. When I underwent testing in 2014, I paid only $80 after insurance kicked in.

Cancer awareness organizations also need to do a better job of reaching out to the black community about BRCA mutations and the benefits of genetic counseling and testing. Research shows that black women are highly interested in undergoing testing for BRCA mutations once they are presented with information regarding its benefits.

Only one percent of genetic counselors in the United States are black. We need more black health care professionals who have undergone specialized training to provide risk assessment and interpret genetic testing results. This could also help to increase the number of black women who receive genetic testing.

I cannot imagine what it must have been like for my mother to have faced her first cancer diagnosis when she was not even 30 and had a young daughter. What I do know is that I was able to substantially lower my chance of having to battle the same disease because I knew about her BRCA2 mutation. More black families should be empowered with the same information.

Erika Stallings (@quidditch424) is a lawyer.

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Beyoncs Dad Has a Mutation More African-Americans Should Be Tested For - The New York Times

Recommendation and review posted by Bethany Smith

NEW YORK - Singer Beyonce Knowles poses with her father and manager Matthew Knowles June 23, 2005 ... [+] (Photo by Frank Micelotta/Getty Images)

Beyonces father, Matthew Knowles, recently went public with the announcement that he has breast cancer and carries a mutation in a gene called BRCA2.He joinsAngelina Jolieas a celebrity who has shared his private medical and genetic history in order to raise awareness and potentially help millions of patients and health care providers.

Knowless story has several unusual twists. First,he is a man with breast cancer. Many people still dont realize that men can develop the disease,which affects approximately 1 in every 1,000 men every year. Because men, and their health care providers, are not as aware of the prevalence of the disease in men, male breast cancer is often diagnosed at later stages and is associated with aworse prognosis.Any male who has bloody nipple discharge, changes in the breast or nipple, or a lump in his breast, armpit, or chest wall, should bring these findings to the attention of his health care provider, and breast cancer should be considered in the differential diagnosis. Too often, both men and their health care providers ignore the signs that would immediately be explored and treated in a woman presenting with the same findings.

The second twist: Knowles had genetic testing and was found to carry a mutation in thegene called BRCA2. We all have two BRCA2 genes, but people born with a mutation in one of those genes are atincreased risk for several cancers, including breast, ovarian, pancreatic, and prostate cancer.Male breast cancer is seen at higher rates in men who carry a BRCA2 mutation, with a lifetime risk of seven percent as opposed to less than one percent in the general population. BRCA2 carriers also have a higher risk of developing multiple breast cancers.Consequently, Knowles, who currently has breast cancer in only one breast, plans to have both breasts removed to reduce his risk of developing a new breast cancer in the future.

Knowles also acknowledged that his children each have a 50% risk to carry the same BRCA2 mutation. The same is true for his siblings. When someone is found to carry a BRCA2 mutation, their family membersshould each be offered genetic counseling and testing by a trained professional.

The third twist:Knowles is of African American ancestry. Many patients and providers wrongly believe that BRCA mutations are only found in white Jewish women. While it is true that there are three BRCA mutations that are common in men and women of Jewish ancestry, there are thousands of other mutations in the BRCA genes that can be found in people ofallethnic backgrounds. We must begin to offer genetic counseling and testing consistently toallwomen and menwith significant personal or family histories of cancer.

So,who should be offered genetic counseling and testing? ALL men with breast cancer, period. Since Matthew Knowless story broke, Ive read multiple false accounts stating that men with breast cancer should be offered genetic testing onlyif they have a strong family history of cancer or are of Jewish ancestry. Wrong. ALL men with breast cancer are strong candidates for genetic counseling and testing. And importantly, most BRCA and other cancer gene mutations would be missed by the popular at-home direct-to-consumer genetic testing kits. If you need genetic testing for medical reasons,speak to a certified genetic counselor who can help you order a medical-grade test.

Angelina Jolie, Rome (Italy), October 7th, 2019 (photo by Marilla Sicilia/Archivio Marilla ... [+] Sicilia/Mondadori Portfolio via Getty Images)

When Angelina Jolie came out with her story in 2013, referrals to my clinic increased by 40% overnight and awareness of genetic testing and BRCA mutations changed forever. Matthew Knowles has just done the same for male breast cancer, BRCA2, and genetic testing of non-white women and men. His courageous decision to share something so personal will save lives.

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What Beyonces Dad And Angelina Jolie Have In Common - Forbes

Recommendation and review posted by Bethany Smith

Ancestry, the genealogy-focused genetics testing company, on Tuesday announced two new products that will provide consumers with health information based on DNA test resultsa move that places the company "in direct competition with 23andMe," according to STAT News.

What providers need to know about genetic testing and other new clinical innovations

The two AncestryHealth products AncestryHealth Core and AncestryHealth Pluswill look at 17 genes, including:

The products will also test for traits like lactose intolerance and caffeine metabolism. In addition, the tests will include clinical reports that consumers can give to their physicians.

However, the two products provide significantly different services. AncestryHealth Core will provide a one-time report with data based on consumer's DNA microarray. The product will cost consumers $49.

Meanwhile, AncestryHealth Plus will provide a more detailed report to consumers using next-generation DNA sequencing technology. While the AncestryHealth Plus product will initially focus on the 17 genes that the AncestryHealth Core product focuses on, it will technically sequence a consumer's "exome," or" all of the known genes that code for proteins in the body," according to STAT News. However, Ancestry will share only a limited portion of the resulting data with consumers. Consumers interested in the product will pay a one-time fee of $199, plus a $49 subscription fee every six months to receive quarterly reports with updates.

For the new products, Ancestry is teaming up with PWNHealth, a national network of physicians located in New York. For both products, consumers will order a DNA test from the company and complete a survey of their medical history, which is then reviewed by a PWNHealth physician for DNA test approval. The test results, when ready, are then reviewed by PWNHealth providers to ensure that consumers get the right educational materials along with the findingsfor instance, a consumer whose DNA test has potentially worrisome results would also receive an educational video about the condition.

Consumers will also receive video material on DNA testing before getting their results, and, after receiving their results, they will have access to both online resources and, if needed, genetic counselors also from PWNHealth.

According to Business Insider, 23andMe sells many of the same tests Ancestry plans to offer, including reports on carrier status for sickle cell anemia, cystic fibrosis, and Tay-Sachs Diseaseand more than 40 other conditionsfor about $200. 23andMe's tests can also tell consumers if they have an increased risk of Alzheimer's disease or Parkinson's disease, which Ancestry elected not to include.

However, since AncestryHealth will require physicians, rather than consumers, to order the DNA tests, AncestryHealth will operate under CMS' rules for physician-ordered diagnostic testing. In comparison, 23andMe applied for and received FDA approval so that it could make its DNA tests available directly to consumers without a prescription.

Margo Georgiadis, Ancestry's CEO, said the company elected to have doctors order the DNA tests "so that the consumer not only can find out a risk factor, but they can seamlessly take a lab report with clinically recommended guidelines into the doctor's office so that there's a clear next path for action."

Some experts expressed concern over how many genetic diseases the tests will provide information on, and said it's unclear how the patient counseling component of the program will work.

Eric Topol, director and founder of the Scripps Research Translational Institute, voiced concerns about the AncestryHealth Plus product in particular, noting that the American College of Medical Genetics advises providers to share information about harmful mutations in 58 genes with patients who have had their exomes sequenced. The AncestryHealth Plus product is "minimal," he said, adding that while it's "a step in the right direction," it's "not in keeping with consensus and practice in the medical community."

However, Catherine Ball, Ancestry's chief science officer, said the company decided to have its tests focus on only highly actionable diseases because it only wanted to include tests that can "improve outcomes for our customers and for their families."

Separately, David Agus, a professor at the University of Southern California, said, "What people don't get is that genetics are a tiny piece of the puzzle." He noted a study Ancestry and Google published in Genetics that found genes account for less than 10% in differences in people's lifespans.

Laura Hercher, director of research in human genetics at Sarah Lawrence College, said just 2% of patients who don't have a family history of disease would be expected to learn something medically useful from a DNA test. "Some people will get medically useful information from this," she said. But "[f]or most, the idea that DNA testing will help your doctor guide your health decisions is an overstatement" and "premature at best."

Robert Cook-Deegan, a professor at the University of Arizona who studies genome ethics and law, worried that many consumers may not understand their own DNA tests. "A lot of whether this is a good thing or a bad thing depends on the quality of their testing," he said. "It depends on the degree to which those physicians are really involved and the degree to which the genetic counseling is truly incorporated into the process."

Others expressed concerns of whether consumers will know they should be getting a different DNA test than the one they chose. For example, if patients wanted a BRCA1 or BRCA2 test because they had a family history of breast cancer, the AncestryHealth Core test will only tell them if their gene has a common "misspelling," meaning that several specific, cancer-causing mutations could be overlooked, STAT News reports. And while the AncestryHealth Plus test would be more likely spot such an issue if it's present, patients could be better off receiving a DNA test, such as those offered by Myriad Genetics, because those might be covered by insurance.

Robert Green, director of the Genomes2People research program at Brigham and Women's Hospital, said he's concerned patients may wrongly think they're at low risk of a disease because of an incomplete DNA test. "The risk, as with other the consumer genomics, is that patients will think this is somehow a comprehensive and encyclopedic investigation of your entire genomic health," he said. However, he added that "[d]iscovering some people who are carrying significant and actionable mutations is better than finding none of them" (Herper, STAT News, 10/15; Ramsey, Business Insider, 10/15; Brown, Bloomberg, 10/15).

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Ancestry will offer health DNA tests, setting its sights on 23andMe - The Daily Briefing

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Breast cancer survivor: I focused on God's promise, not the problem

Sherry Connelly has kept a positive outlook on as she takes her journey through the healing process from breast cancer.

Taylorsville native Sherry Connelly found out she had breast cancer on February 14, 2018.

Happy Valentines day to me, right? I was distraught. I was angry, Connelly admitted. She made sure to get a mammogram every year, but somehow it still slipped through the cracks.

I was like, How in the world did we miss this? She said she first discovered a lump in her breast, and had it checked by her primary care physician. She (Connellys doctor) said it was probably just a cyst, but to be on the safe side she had me go get an ultrasound and tests, she said.

The next doctor told Connelly she also needed a biopsy, which confirmed that she had breast cancer. It was hard, but I just had to look at the bright side; God had something for me to do, she said.

As she went through many chemotherapy and radiation treatments, she kept her mind on God. I just prayed and asked God to give me something to do so I wouldnt just focus on the problem. I wanted to focus on His promise, and not on the problem, she said.

During this time, Connelly played a part in a film called, Black Widows, produced by John Robinson. It was an amazing experience, she said. It kept my mind concentrated on something else, instead of wallowing and thinking, Oh no, am I going to make it?

Sherry Connelly displays her movie "Momma's Baby Boy" that she was working on when she was diagnosed with breast cancer.

Connelly also plans to act in two more films produced by Robinson. More information on the films can be found at http://www.bddentertainment.com.

Another factor that played into Connellys treatment was her support system. My mom shes 88-years-old she came to every treatment and every doctor's appointment. She was right there beside me, she said. My brother came when he could, too.

Connelly said the staff in the oncology department at Frye Regional Medical Center in Hickory was, just amazing.

If I came in and looked like I was not feeling the way I should be feeling, they would call the doctors and let them know," she said. "They would get me anything I needed, and it meant the world to me."

She remembers one nurse in particular Sherri Stone.

She has been amazing," Connelly said. "She would be off, and I could inbox her or call her and she would tell me what I needed to do.

When Connelly was in treatment, Stone was an infusion nurse in the oncology department, but would go above and beyond her job description to help patients like Connelly.

If I needed something, she (Stone) could just tell and she would make that call for me. She made sure that I got what I needed, Connelly said. I love her.

Today, Stone is an oncology nurse navigator and continues to support cancer patients at Frye. Connelly said without that support, battling cancer is much harder.

It means everything for you to have a support system, she said. Youre going to have those days where you just feel like giving up, throwing in the towel. I felt like that, but you have to keep fighting and push through.

People think that cancer is a death sentence, she continued. Its not now. There is so much technology out there to help, and you cant give up. Youve got to keep going.

Connelly is now in remission and plans to continue her acting career as long as she can.

Cancer navigators guide breast cancer patients through the early stages of diagnosis

Cancer navigator Crystal Deese at Catawba Valley Medical Center, discusses how she helps cancer patients navigate the numerous levels of patient care.

Throughout her nursing career, Crystal Deese has played many roles, but oncology has always had a special place in her heart.

Thats the whole reason I went into nursing was for oncology, Deese said. I was in high school when my grandmother was diagnosed with cancer. And I just remember her saying, I wont be here for you to help me, but you can help someone else.

For the last 20 years, Deese has worked with cancer patients in one way or another, whether that is at the start of the cancer journey, at the end of treatment or at the end of the battle with hospice care.

Now, Deese is the interim breast cancer navigator at Catawba Valley Medical Center.

The navigator, I guess you can say, is the middle person that connects them to the surgeon or the oncologist after the initial diagnosis, Deese said. Im the first person that makes contact with them. Me along with the radiologist, when we get the positive pathology report back, we bring them in and then point them to the surgeon.

Deese calls working with cancer patients a calling.

I have a strong faith, she said. ... Its not something that I would have ever chosen to do for money or write anything that way.

She feels the same way about her time working in hospice care.

It was a great honor to be invited into someones home and you be able to be there to take care of them, Deese said. It was a privilege more than anything. Then you get to see them where theyre happy and theyre comfortable, and where they want to be. Not in the hospital setting.

Working as a breast cancer navigator does have its challenges, especially since Deese doesnt have many answers for patients when theyre first diagnosed.

Deese and a radiologist are usually first to tell breast cancer patients that their biopsy came back positive for cancer. They cant really tell them exactly what type of treatment theyll receive or how long, but they can sometimes let the patient know that chemotherapy, radiation and maybe surgery are on the horizon.

Youre the first person to make contact with these ladies, and telling them whenever they get the diagnosis that yes, you have cancer, Deese said. But then we also like to say, yes, you have cancer, but now we know what were dealing with. And no, nobody has this as part of their plan, but now we can get you going in the right steps as to whats next.

When someone is diagnosed with breast cancer, Deese said, the reaction can vary. Sometimes the patient has many questions, and other times they are silent.

Cancer navigator Crystal Deese displays some of the cancer publications that she uses to help cancer patients with their journey.

The initial response, its so mixed, but most of the time its: Am I going to have to have chemotherapy? Will I have to have radiation? Or will I lose my breast altogether? What happens when you meet the surgeon? Deese said. Some have no questions. Some are just so overwhelmed. Theyre like Ill have to call you back, and then there are some that come in with questions.

If a patient has a financial hardship, Deese and the other cancer navigators can assist the patient in finding the right financial assistance programs as well as support groups, transportation services and more.

Deese says keeping up with your yearly breast exams is essential.

I dont think you can stress enough the importance of doing your screening mammograms, she said. Because I believe with the changes and the advances that weve made in treatment, its a very curable diagnosis, if we catch it early enough. So its the screening and prevention I think that can make the biggest difference.

Assessing your risk may help prevent breast cancer from affecting you and your family

By Melissa L. Teague, Frye Regional Medical Center

Most cancers start with abnormal cells growing out of control. Sometimes you will experience symptoms, but often you will not. Thats why cancer high-risk assessment programs are so important. Finding and treating cancer in its earlier stages is potentially lifesaving.

Frye Regionals clinic is staffed by a specially trained high-risk coordinator who helps assess your genetic risk for certain types of cancer including breast, ovarian, colon and uterine cancer. The coordinator gathers information about your background and family history and can help determine if further testing is necessary.

What is genetic testing?

Genes are found in chromosomes and are made up of DNA. We inherit genes from our parents. Our gene structure dictates how our body grows and regulates. When genes are normal, they work properly. When genes are abnormal or damaged, they can lead to disease. These are called gene mutations or changes. Some changes run in families (hereditary), and some happen by chance. A gene mutation can be the sole cause of disease. However, most diseases occur from a mixture of genetic and environmental factors.

Genetic testing looks at your genes to check for any mutations. The test is done with a sample of blood or saliva. There are several reasons why you might do genetic testing:

To diagnose a disease or a type of disease.

To determine the cause of a disease.

To determine treatment options for a disease.

To find your risk of getting a certain disease that possibly can be prevented.

To find your risk of passing a disease to your children.

How can a genetic counselor and/or high-risk coordinator help me know if I should have the screening?

Talk to your doctor if you think you are at risk for an inherited disease. They may refer you to a genetic counselor, who can review your family history and provide advice. They will ask you questions about your health and the health of your blood relatives. This information can calculate what your risk may be. It can help you decide whether you want to get testing. It also may determine if your insurance will pay for the testing.

How do you know who should be tested?

If one of your family members already has the disease, that person should get genetic testing first. This will show if their disease was passed down or occurred by chance. People from different ethnic groups are more at risk of certain diseases.

What does it mean if you are positive or negative?

A positive test result means that you have the gene change. This increases your risk of the disease. However, it does not guarantee that you will get the disease. It does mean you could pass the mutation to your children.

A negative test result means that you dont have the gene change. This may mean the disease doesnt run in your family or wasnt passed down to you. A negative result does not guarantee that you wont get the disease. It means that your risk of the disease is the same as it is for other people.

What about my children?

If your test is negative, you cannot pass a gene to your children; however, if you are positive, you could pass down the gene mutation to your children. It also means your daughters or sons may need closer surveillance for early detection.

Things to consider

Genetic testing has pros and cons. These can change depending on your situation. Keep in mind that genetic testing is voluntary. You should not feel forced to do it.

Some benefits of genetic testing include:

You may be less worried about developing a certain disease.

You may be motivated to change your lifestyle to reduce your risk.

You may be better prepared to move forward with family planning.

You may be able to get treatment to prevent the disease. This could include medication or surgery.

Your doctor will know how often to check for the disease.

Questions to ask your doctor

How do I know if I should see a genetic counselor?

If my genetic testing result is positive, what is my risk of getting the disease?

What can I do to prevent or treat the disease?

Should my genetic testing be done in a clinical setting or can I do it from home?

Breast cancer patients form special bond during treatment

photos Courtesy of Catawba Valley Medical Center

Courtesy of Catawba Valley Medical Center

When nurses noticed the uncanny similarities between breast cancer patients Kathy Rector and Cheryl Kiser, they decided to seat the women together during a chemotherapy treatment at Carolina Oncology Specialists in Hickory.

Rector and Kiser became fast friends, forming a bond over battling the potentially fatal disease and coining a name, Chemo Country Club, with the tagline now accepting short-term members only in honor of the place they met.

We were basically therapists for each other, Kiser said. We shared a wide range of emotions and strength in our determination to beat cancer. We inspired each other, lifted one another up, and found ways to belly-laugh through the process.

Both elementary school teaching assistants, Rector, 63, works with exceptional students at West Alexander Middle School and Kiser, 51, helps in kindergarten and first grade at Sherrills Ford Elementary, where she also drives a bus route.

The women synchronized treatment appointments and remained in touch through texts and calls along the way.

We found empathy, hope and companionship in the common ground of side effects hair loss, nausea, vomiting, nerve pain, and chemo brain, Rector said.

They also drew strength from their husbands, children and faith in God.

How they were diagnosed:

Notably, both women discovered suspicious lumps by self-exam despite having clear 3D mammograms within eight months before diagnosis.

Rector:My sister faced breast cancer two years ago, but we didnt have a family history of the disease before then. When I felt a lump about 2 inches in diameter in the center of my breast during vacation last September, I saw my gynecologist the following week and got the news a diagnosis of triple-negative T2 breast cancer with positive lymph nodes.

Kiser:My mother and grandmother both had breast cancer, so I took the BRCA genetic test to see if I was prone to the disease. Results showed no, but when I felt a lump, I made a beeline to Dr. Elizabeth Restino at Catawba Valley Family Medicine-Southeast Catawba, my primary care physician. She ordered a breast ultrasound and biopsy at Catawba Valley Imaging Center which confirmed the presence of T3 invasive ductal carcinoma, meaning cancer had spread to the tissue under my arm. A PET scan also revealed tumors on my ovaries.

Rector and Kiser both recall the quick transition of initial shock to fierce determination. After the sadness of delivering such emotional news to family and friends over the holidays, they faced the difficult process of telling faculty, parents and students at their schools, which triggered additional worry and a more public form of concern.

Rector continued working through treatments, wearing a mask to minimize germ exposure in the smaller setting of her classroom. But Kiser took a leave of absence given the extended population she came in contact with daily. From here, the battle ensued.

Rector:I had a breast lumpectomy in November, started chemo in December and then began 32 radiation sessions at Catawba Valley Health System Radiation Oncology. Two days after Christmas, my hair started coming out. The more I brushed, the more I cried. I tried wearing a wig, but it gave me such a headache, I decided just to wear hats. Late February, my first grandchild, Aubrey, was born when I was sick. I had to wait two long weeks before traveling to Ocean Isle and hold her in my arms.

Kiser:For me, processing my diagnosis was a God thing. He allowed me to absorb things one at a time. I didnt do research on my own. Instead, I protected my mind and trusted Dr. Orlowskis recommendations to first shrink the breast tumor with chemo before having surgery to remove that breast and my ovaries. As radiation began, Kathy and I had radiation mapping done to identify precise targets for the True Beam radiation system to prevent damage to surrounding healthy tissue. Kathy wanted to compare maps, so we laughed about where they marked an X on my treasure map, and that her map had a whole lot of hills!

Prayers and acts of kindness enveloped the newfound friends during the long and challenging months of their respective cancer treatments. From extended family to people in their church and school communities, both expressed deep gratitude for the uplifting support that saw them through.

Rector:Im extremely grateful for all the people who lifted me up in prayer and the churches that sent handcrafted prayer shawls, which I draped over me during treatments. I was also touched when West Alexander Middle School initiated a fundraiser and wore Team Rector T-shirts in the Cancer Relay for Life.

Kiser:I didnt think I was very vain. But when I lost my hair, I didnt want to leave my room. Austin, my oldest son, had an ongoing bet with his college roommate about who would first cut their hair. Guess what? Austin cut his hair and made a wig for me!

As the women reached key milestones and learned that treatments worked, they celebrated with each other and their whole care teams.

The pair has fond memories of the doctors and nurses who worked to save their lives:

Courtesy of Catawba Valley Medical Center: Kathy Rector (left) and her friend Cheryl Kiser celebrate the end of their chemotherapy treatment for breast cancer at Catawba Valley Medical Center. The two became friends while undergoing treatment.

Debbie, at Catawba Valley Health System Radiation Oncology, who inspired them with her personal story of survivorship; Dr. Reggie Sigmon, radiation oncologist and Len Hurst, medical physicist; Dr. Richard Orlowski, oncologist and Diane Fox, physician assistant, both at Carolina Oncology Specialists; and Wake Forest Baptist Health general surgeon Dr. Kenneth Parrish, general surgeon.

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PINK: Stories and photos devoted to the warriors who fight breast cancer - Hickory Daily Record

Recommendation and review posted by Bethany Smith

Blind and partially sighted people no longer have to wait passively for a research breakthrough in hope of treatment options. In fact, people living with genetic eye conditions can now actively drive vision research forward by enrolling in a patient registry and getting their genes tested.

There are 2.2 billion people living with visual impairment globally. Some are living with inherited retinal diseases that are progressive and can lead to complete blindness. Up until recent years, blind and visually impaired people were told that no treatment is available. This is changing as genetic testing is paving the way for a surge of gene therapies.

My doctoral dissertation at the University of British Columbia was on drug therapy for retinitis pigmentosa. This progressive, blinding eye condition is the most common type of inherited retinal disease.

In people affected by retinitis pigmentosa, the light sensing cells in their retina photoreceptors die early. Unlike skin cells that regenerate, the body does not make more photoreceptors once they are damaged.

As a vision scientist affected by retinitis pigmentosa, I am passionate about finding the truth about the disease. Why do photoreceptors die? How can we stop it? How can science and medicine help?

When I was 12 years old, I realized while at summer camp that my night vision was disappearing. In the last two decades, I lost my peripheral vision, contrast sensitivity and depth perception.

I worked in Dr. Orson Moritzs lab at the UBC department of ophthalmology and visual sciences, which focuses on research using tadpoles that contain known human mutations for retinitis pigmentosa to understand the disease.

I made an alarming discovery in our animal model: knowing the genetic cause of retinitis pigmentosa is vital for treatment with one class of drugs histone deacetylase inhibitors. These determine how genes are switched on or off.

A similar study in mice showed that the same drug reacted differently to variations in a single mutant gene that also causes retinitis pigmentosa.

Treating retinitis pigmentosa is like extinguishing fire. To stop a fire, you need to know whether its water-based or grease-based. If you try to use water to stop a grease fire, the damage gets worse.

Blind and visually impaired people can advocate for eye health by enrolling in a patient registry. Participation in a registry benefits researchers by offering more information about the disease.

In Canada, individuals can self-refer to Fighting Blindness Canadas secure, clinical patient registry. This database is dedicated to connecting people living with retinal eye diseases to clinical trials and research.

When a gene therapy trial arises, researchers draw participants from this database. Since gene therapy aims to correct an underlying genetic mistake in DNA that causes disease, knowing the genetic cause of a disease is a criteria for most gene therapy trials.

Globally, other registries include My Retina Tracker in the United States, Target 5000 in Ireland, MyEyeSite in the United Kingdom, the Australian Inherited Retinal Disease Registry and Japan Eye Genetics Consortium. In New Zealand, Dr. Andrea Vincent has established the Genetic Eye Disease Investigation Unit. There is even a Blue Cone Monochromacy Patient Registry for one rare eye condition.

In the last two decades, the number of gene therapy trials has blossomed. Currently, 250 genes on inherited retinal diseases have been identified. In 2017, the first gene therapy for inherited retinal disease Luxturna was approved by the United States Federal Drug Administration.

To date, there are trials for: retinitis pigmentosa; Usher syndrome, a condition that involves hearing and vision loss; achromatopsia, a disease that causes colour blindness; X-linked retinoschisis, a dystrophy that causes splitting of the retina and affects mostly in males; and age-related macular degeneration, the third-largest cause of vision loss worldwide, caused by the interplay between genetics and environment.

Enrolment in a patient registry and genetic testing advance the design of gene therapy trials. This in turn benefits blind and visually impaired people.

Research advancement is a concerted effort across the globe blind and partially sighted people should know they have the power to push it forward.

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The blind and visually impaired can help researchers by getting their genes tested - The Conversation CA

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Stem cell therapy for animals has seen breakthroughs

Stem cell therapy is increasingly becoming a more mainstream form of medicine. Usually applied to humans, the use of this regenerative treatment is now also being extended to animals including cats and dogs. Regenerative medicine, particularly stem cell treatment has seen many advancements in recent years with some groundbreaking studies coming to light.

Taking the cells from bone marrow, umbilical cords, blood or fat, stem cells can grow to become any kind of cell and the treatment has seen many successes in animals. The regenerative therapy has been useful particularly for treatment of spinal cord and bone injuries as well as problems with tendons, ligaments and joints.

Expanded Potential Stem Cells (EPSCs) have been obtained from pig embryos for the first time. The cells offer groundbreaking potential for studying embryonic development and producing transnational research in genomics and regenerative medicine, biotechnology and agriculture.

The cells have been efficiently derived from pig preimplantation embryos and a new culture medium developed in Hong Kong and Cambridge enabled researchers from the FLI to establish permanent embryonic stem cell lines. The cells have been discovered in a collaboration between research groups from the Institute of Farm Animal Genetics at the Friedrich-Loeffler-Institut (FLI) in Mariensee, Germany, the Wellcome Trust Sanger Institute in Cambridge, UK and the University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Biomedical Sciences.

Embryonic stem cells (ESC) are derived from the inner cells of very early embryos, the so-called blastocysts. Embryonic stem cells are all-rounders and can develop into various cell types of the body in the culture dish. This characteristic is called pluripotency. Previous attempts to establish pluripotent embryonic stem cell lines from farm animals such as pigs or cattle have resulted in cell lines that have not really fulfilled all properties of pluripotency and were therefore called ES-like.

Dr Monika Nowak-Imialek of the FLI said: Our porcine EPSCs isolated from pig embryos are the first well-characterized cell lines worldwide. EPSCs great potential to develop into any type of cell provides important implications for developmental biology, regenerative medicine, organ transplantation, disease modelling and screening for drugs.

The stem cells can renew themselves meaning they can be kept in culture indefinitely, and also show the typical morphology and gene expression patterns of embryonic stem cells. Somatic cells have a limited lifespan, so these new stem cells are much better suited for long selection processes. It has been shown that these porcine stem cell lines can easily be modified with new genome editing techniques such as CRISPR/Cas, which is particularly interesting for the generation of porcine disease models.

The EPSCs have a high capacity to develop not only into numerous cell types of the organism, but also into extraembryonic tissue, the trophoblasts, making them very unique and lending them their name. This capacity could prove valuable for the future promising organoid technology, where organ-like small cell aggregations are grown in 3D aggregates that can be used for research into early embryo development, various disease models and testing of new drugs in petri dishes. In addition, the authors were able to show that trophoblast stem cells can be generated from their porcine stem cells, offering a unique possibility to investigate functions or diseases of the placenta in vitro.

A major hurdle to using neural stem cells derived from genetically different donors to replace damaged or destroyed tissues, such as in a spinal cord injury, has been the persistent rejection of the introduced material (cells), necessitating the use of complex drugs and techniques to suppress the hosts immune response.

Earlier this year, an international team led by scientists at University of California San Diego School of Medicine successfully grafted induced pluripotent stem cell (iPSC)-derived neural precursor cells back into the spinal cords of genetically identical adult pigs with no immunosuppression efforts. The grafted cells survived long-term, displayed differentiated functionality and caused no tumours.

The researchers also demonstrated that the same cells showed similar long-term survival in adult pigs with different genetic backgrounds after only short course use of immunosuppressive treatment once injected into injured spinal cord.

Senior author of the paper Martin Marsala, MD, professor in the Department of Anesthesiology at UC San Diego School of Medicine said: The promise of iPSCs is huge, but so too have been the challenges. In this study, weve demonstrated an alternate approach.

We took skin cells from an adult pig, an animal species with strong similarities to humans in spinal cord and central nervous system anatomy and function, reprogrammed them back to stem cells, then induced them to become neural precursor cells (NPCs), destined to become nerve cells. Because they are syngeneic genetically identical with the cell-graft recipient pig they are immunologically compatible. They grow and differentiate with no immunosuppression required.

Co-author Samuel Pfaff, PhD, professor and Howard Hughes Medical Institute Investigator at Salk Institute for Biological Studies, said: Using RNA sequencing and innovative bioinformatic methods to deconvolute the RNAs species-of-origin, the research team demonstrated that pig iPSC-derived neural precursors safely acquire the genetic characteristics of mature CNS tissue even after transplantation into rat brains.

NPCs were grafted into the spinal cords of syngeneic non-injured pigs with no immunosuppression finding that the cells survived and differentiated into neurons and supporting glial cells at all observed time points. The grafted neurons were detected functioning seven months after transplantation.

Then researchers grafted NPCs into genetically dissimilar pigs with chronic spinal cord injuries, followed by a transient four-week regimen of immunosuppression drugs again finding long-term cell survival and maturation.

Marsala continued: Our current experiments are focusing on generation and testing of clinical grade human iPSCs, which is the ultimate source of cells to be used in future clinical trials for treatment of spinal cord and central nervous system injuries in a syngeneic or allogeneic setting.

Because long-term post-grafting periods between one and two years are required to achieve a full grafted cells-induced treatment effect, the elimination of immunosuppressive treatment will substantially increase our chances in achieving more robust functional improvement in spinal trauma patients receiving iPSC-derived NPCs.

In our current clinical cell-replacement trials, immunosuppression is required to achieve the survival of allogeneic cell grafts. The elimination of immunosuppression requirement by using syngeneic cell grafts would represent a major step forward said co-author Joseph Ciacci, MD, a neurosurgeon at UC San Diego Health and professor of surgery at UC San Diego School of Medicine.

Other recent advancements include the advancement toward having a long-lasting repair caulk for blood vessels. A new method has been for generating endothelial cells, which make up the lining of blood vessels, from human induced pluripotent stem cells. When endothelial cells are surrounded by a supportive gel and implanted into mice with damaged blood vessels, they become part of the animals blood vessels, surviving for more than 10 months.

The research was carried out by stem cell researchers at Emory University School of Medicine and could form the basis of a treatment for peripheral artery disease, derived from a patients own cells.

Young-sup Yoon, MD, PhD, who led the team, said: We tried several different gels before finding the best one. This is the part that is my dream come true: the endothelial cells are really contributing to endogenous vessels.

When cells are implanted on their own, many of them die quickly, and the main therapeutic benefits are from growth factors they secrete. When these endothelial cells are delivered in a gel, they are protected. It takes several weeks for most of them to migrate to vessels and incorporate into them.

Other groups had done this type of thing before, but the main point is that all of the culture components we used would be compatible with clinical applications.

This research is particularly successful as previous attempts to achieve the same effect elsewhere had implanted cells lasting only a few days to weeks, using mostly adult stem cells, such as mesenchymal stem cells or endothelial progenitor cells. The scientists also designed a gel to mimic the supportive effects of the extracellular matrix. When encapsulated by the gel, cells could survive oxidative stress inflicted by hydrogen peroxide that killed unprotected cells. The gel is biodegradable, disappearing over the course of several weeks.

The scientists tested the effects of the encapsulated cells by injecting them into mice with hindlimb ischemia (restricted blood flow in the leg), a model of peripheral artery disease.

After 4 weeks, the density of blood vessels was highest in mice implanted with gel-encapsulated endothelial cells. The mice were nude, meaning genetically immunodeficient, facilitating acceptance of human cells.

The scientists found that implanted cells produce pro-angiogenic and vasculogenic growth factors. In addition, protection by the gel augmented and prolonged the cells ability to contribute directly to blood vessels. To visualise the implanted cells, they were labelled beforehand with a red dye, while functioning blood vessels were labelled by infusing a green dye into living animals. Implanted cells incorporated into vessels, with the highest degree of incorporation occurring at 10 months.

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Stem cell therapy is for animals too - SciTech Europa

Recommendation and review posted by Bethany Smith

Hematopoietic stem cell transplantation (HSCT), popularly known as bone marrow transplantation (BMT), is a curative modality for a number of benign and malignant blood disorders, said Dr. Murali Krishna Voonna, surgical oncologist and managing director of Mahatma Gandhi Cancer Hospital and Research Institute.

Speaking at an awareness programme on stem cell donation organised here by the hospital, in association with Datri Blood Stem Cell Donor Registry, he said hematopoietic stem cells are immature cells that can develop into all types of blood cellswhite blood cells, red blood cells, and platelets. They are found in the peripheral blood and bone marrow.

A sizeable population are diagnosed to have benign diseases such as thalassemia major, sickle cell anaemia and aplastic anaemia, and the HSCT is among the efficient curative measures. Acute leukaemia and other blood cancers also need this procedure, he said.

Highlighting that stem cell donation and a registry are vital, Dr. Muralikrishna explained for a successful hematopoietic stem cell transplant, the patients genetic typing (HLA typing) needs a close match with that of the donor. Every patient has 25% chance of finding a match within the family, he said.

Dr. Muralikrishna stated that in such cases, finding a donor is a pressing need. There are over 80 donor registries and more than 30 million registered donors across the globe, with a very few Indians being a part of it. This reduces the chances of finding a possible match for patients of Indian origin. Patients are more likely to find a possible match within their ethnicity, which means people sharing the same cultural linguistic and biological traits, he explained.

The problem can be solved if the donors enroll themselves with a registry which will store the stem cell details and the details. Pledging to donate stem cells is easy like swabbing the inner-cheek. The donors are contacted if patients have HLA matching, he said, adding that the stem cell donation was carried out only when a match was found for a patient, not when one pledge to donate.

A blood stem cell collection centre was inaugurated at the hospitals premises on the occasion. Earlier, to avail of such service and for HLA-typing, one has travel to Hyderabad and Chennai, Dr. Muralikrishna said.

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Recommendation and review posted by Bethany Smith

Bhubaneswar: The advanced treatment of using stem cells for treating Autism and other neurological ailments have come as a ray of hope for the people living with some of these ailments. Medical experts working in the sector claim that the use of the technology improved the lives of many.

According to experts who practice stem cell therapy, the results have been overwhelming. Many of the patients have either been able to fight a deadly disease with the help of stem cells while many have been able to improve their quality of lives by using it. However, the technology is still not used widely in state hospitals.

Medical experts claim that stem cells could be used to treat neurological disorders like Autism, cerebral palsy, mental retardation, brain stroke, muscular dystrophy, spinal cord injury, head injury, cerebellar ataxia, dementia, motor neurone disease, multiple sclerosis while it has also been used to treat cancers like blood cancer with the help of bone marrow transplant when assisted by stem cell therapy.

However, treatment of Autism with stem cells is a new developing sector where visible changes are said to have been reported among children treated with this technology. However, the advanced technology which is now confined to only private sector is a bit expensive.

Autistic kids are usually treated with drugs for symptomatic relief, special education, occupational speech and behavioural therapies. In Autism, despite the best available medical and rehabilitative treatments satisfactory relief is still a far cry, said Dr Nandini Gokulchandran, Head Medical Services, NeuroGen Brain and Spine Institute, Mumbai.

Dr Gokulchandran claims that she has treated many cases of Autism in kids with stem cells which helped in overcoming their limited abilities. Under the treatment regime, an insertion procedure is undertaken followed by training to improve the skills and abilities of autistic kids.

Another neurologist, Dr Richa Bansod said that in India it has been reported that 1 in every 250 children have Autism and this number in increasing with better recognition and awareness of the condition. On the other hand, stem cells are now been used to fight deadly diseases.

Dr Joydeep Chakaborty, an oncologist and stem cell expert from HCG Cancer Hospital, Kolkata said, Stem cells and bone marrow transplants are now being used to cure blood cancer in many cases. It is also widely used to treat blood disorders like Thalassemia, Sickle Cell Anaemia and others.

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Stem cells treatment gives hope in fighting Autism, blood disorders - OrissaPOST

Recommendation and review posted by Bethany Smith

For anyone who has had hip replacement surgery, Im sure they will agree that it is better to get hit by a bus than to undergo another one. Last year after several years of suffering, I decided to take the leap and go for the hip replacement that my specialist recommended. I was told that it was a common surgery and that it was the best solution for me. Between us; it was probably the most painful thing I have ever gone through. So much so, that at the time, I just wanted to die. Not only did the pain persist for several weeks after the operation, but I was on painkillers for days, which eventually added to my suffering. I had to use a walker for the first 2 weeks and then depended on a cane for over 2 months before I could walk on my own.

My entire demeanor changed, as well as the way I dealt with what once were minor things in life. I feared slipping in the shower, going down the stairs or walking my dogs. No one had prepared me for this. Ive had my share of surgeries including a double mastectomy when I was diagnosed with breast cancer but pain wise; this one was by far the worse. I was hoping after a very long recovery that I would never have to face this situation again. Unfortunately, a year later, I am starting to feel pain on the other side and dread the re-experience of my nightmare.

Although, I heard about Stem Cell, I did not know much about it. So I started to investigate for myself, speak to people, enquire about the procedure and look for a doctor in my area who specialized in Stem Cell. I was willing to do just about anything before considering another hip replacement. After extensive research, I came across Dr. Raj, a Double-Board Certified Orthopedic doctor in Beverly Hills, CA. Going to his website; I learned that he has been in private practice for 10 years. He has been named as one of Americas Top Orthopedists, been featured on the Best of LA and has received numerous other accolades and awards as one of the Top Orthopedic doctors. Providing the ultimate in state-of-the-art orthopedic care, Dr. Rajs practice is always on the cutting-edge of surgical and nonsurgical technologies, such as PRP (Platelet Rich Plasma) injections, stem cell injections for tendinitis and arthritis, minimally invasive surgery and more.

He is Board Certified as a Medical Legal Specialist in America, as well as, Canada and Dubai (Trial, Testimony, Deposition, IME) with a Subspecialty in Hip and Knee Surgery in Los Angeles, including Sports Surgeries.

He is also an Undergraduate from Dalhousie University in Halifax and Canada. He pursued his medical education at Memorial University PGME, before doing his internship and residency in the Department of Orthopedic Surgery. Now that I had found Dr. Raj, all I needed was to get myself educated. So lets start by what are stem cells? This is what I read: Mesenchymal stem cells (MSCs), commonly called stem cells, are precursor cells that havent decided yet what they are going to be in the body. They can differentiate into multiple forms including bone, cartilage, fat and other connective tissues. They play a significant role in the reparative processes throughout the human body.

Where do we find stem cells?

They may be harnessed from fat tissue, bone marrow, synovial tissue or umbilical cord tissue. While stem cell therapy is a promising technology, there is much we are still learning about the causes and pathways that lead to symptomatic osteoarthritis. We have not optimized the factors found in stem cell therapies. To be sure, only the good cells and growth factors are injected into a specific joint. And that is why further research is necessary before being approved by the FDA.

My next move would be to consult with Dr. Raj who would tell me the medical truth, beginning with this question:

What is the current state of Stem Cells and its success rate?

It's relatively new. It's been popular for about 20 years, internationally. In areas like Germany and Korea, it was utilized a lot more. It became popular here when athletes like Kobe Bryant started going to Germany for modified versions of PRP, which led on to regenerative technologies. We have a stigma correlating stem cells with abortions and issues like that. This in itself is completely different. We are not utilizing amniotic stem cells or placenta stem cells. We're utilizing your own stem cells. For issues such as a hip replacement, the most powerful stem cells are the ones in your body. Bone marrow stem cells work well on joints. Joints have zero blood supply. So, if God or the higher power created us where we had blood supply going through our joints, like a cut in our skin - we would constantly replenish or repair. A break in our bone would repair. If you get stem cells and you're in decent enough shape, you will heal no matter what because these stem cells will deposit. Will you heal straight? Probably not - that's where we come into play.

The reason why joints; hips, knees and shoulders degenerate is because there is no blood supply. So, if you have a cut or a loss of cartilage, it stays like that and accumulates overtime. The only way you can control it is externally. You get stronger, you lose weight and you increase your range of motion. But you can't control anything internally.

So regenerative technology is basically utilizing these cells to regenerate cartilage and repair. These are the same cells that flow through our body - and upon signal of an injury will heal skin to skin, bone to bone, tendon to tendon, muscle to muscle. Our joints are just an alcove of joint fluid and no blood supply. The whole concept is - throughout the years, we did steroid injections - they're like band aids. Basically they mask pain. What does masking pain do? It propagates injury. Because we put the band aid on, we don't feel it and we do more. We take this little cut or loss of cartilage and we make it even more over time.

Why is it that specialists do not recommend seeing a surgeon at a certain stage?

There are a lot of people who think one way and everyone is entitled to their own opinions. You can't change opinions.

Are people afraid of stem cells?

Some people are afraid because of stem cells causing cancer. But that's embryonic stem cells.

What is the process?

Bone marrow stem cells are the best because there is a higher chance of live stem cells. Less manipulation, meaning that - in a Mayo Clinic study 4 or 5 years ago, which has a two year follow through on people who are ready to get replacements for joint or knee - they had an 80% success rate where they didn't need it. I do replacements and I do stem cells.

How do you determine what's better for the patient?

My knowledge and years of experience. Also, my knowledge with fitness and being athletic myself. Understanding at a certain point, someone is mechanically compromised. Bone on bone is a term that's been used for years. There are a lot of people who think they are 'bone on bone." Coming from Canada, the US is notorious for doing unnecessary surgeries and replacements. It's the highest rate of replacements in the world. I do not like the term 'bone on bone' because a surgeon will look at an x-ray and say you're bone on bone because that's all they do: replacements. They become a 7-11 or 99 Cents store, lining up 21 people a day. That's not the right way to do things. You don't want to be one of those 21 people getting a replacement because you're not getting that surgeon's full attention. The reality is - you have a PA or an old plastic surgeon who's doing most of your surgery and there is more likelihood of issues. Amongst every specialty there is a lot of ignorance. The whole concept is - you preserve what you have for as long as you can. You have beauty on the outside; you need beauty on the inside too. What's beauty on the inside? Feeling good, you're less inflamed and your joints are healthy.

How does it work with a stem cell procedure?

I extract bone marrow from your pelvis. Take approximately 6 ccs. Under slight sedation, it takes about 5 minutes to take it. Then we separate it via an FDA approved technique. Per FDA, we cannot add anything to it, nor would I want to. We cannot harvest it because the longer it's outside of the body, the better it is. Basically, we then inject those pure cells right away into the joint. It's a four month process for an 80% of regeneration. So, it's not just reduction of inflammation, it's regeneration. It will be a year for a 100% effect. I've had probably about 20% of patients who have taken 6 months+. I've had over a 95% success rate with this technology.

Are you one of the only doctors doing this in LA?

I'm one of them. There are some family and pain management doctors who are doing it. I'm the only Orthopedic surgeon doing it. I'm sure different practitioners are starting to.

Dr. Raj and patient Paula Abdul

How often do you do the stem cell procedure?

You do it one time. It's a powerful injection and there are people Ihave 6 years out who are doing well.

Does it hurt after the fact?

No, not at all. You can walk and move. For example, with your hip - I would combine it with physical therapy to increase your range of motion. Once you have the anti-inflammatory effect, you have to take advantage of it. If you don't increase your range of motion - what happens is - you're walking on one nail vs. 100 nails. You want to dissipate the force over a greater area so that there's a higher chance of external success. Then you strengthen the muscles.

Are there people who are not good candidates for it?

Yes, when it's too far gone. Like I said, people are told they're bone on bone when they're not. They show you different views. It's a marketing gimmick. That person is lined up and ready to sell. Age is relative. There's physiologic age. It really depends on the person. Hypothetically, if you're an inflamed mess, a drinker and abusive to your body, then nothing is going to work. If you take care of yourself and you're motivated with the right protoplasm, then it's going to work.

What about the skeptics or the ones who think it's bad for you?

Don't get me wrong; amniotic stem cells are good for certain situations. Embryonic is bad. It means that it's too far gone. You want live stem cells in an area that does not have blood supply. The data is out there. How can you argue against a Mayo Clinic study with an 80% success rate? How can you argue against the hospitals for special surgery in New York that's doing it, or the Steadman Hawkins Clinic, I'm doing it. Top facilities in the world are doing it and a number of top athletes who are getting it done with success rates. Who's ignorant? Is it that one surgeon or everyone else?

Does insurance cover it?

No, not yet. Insurances are very backwards in terms of their understanding. They would rather cover a replacement.

Is it expensive?

If you break it down par and par and avoid a replacement, not really. On average, you're talking about $7,000, versus hospital, surgeon, facility fees+++,which can be about $25,000.

You're very progressive.

There are a lot of things that I do to try and reduce pain significantly.When I use screws, I use screws that are made out of calcium so they dissolve in your body. Some of my colleagues use tourniquet, I don't use one. I control bleeding and do it in less than an hour. The whole concept is, you don't have atourniquetsqueezing your leg and toxins causing significant pain.

And there you have it. Everything is a risk in life, we do not know if we will wake up tomorrow or if you will get hit by a car and so on so why not try this procedure. I believe that I am lucky enough to have met Dr. Raj. I have taken the decision to undergo the stem cells therapy FDA approved or not, anything before going under the knife one more time. Stay tuned, I will give you a report on the progress.

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Dr. Raj & Stem Cell Therapy Innovation - LATF USA

Recommendation and review posted by Bethany Smith

The Testosterone Replacement Therapy Market report provides an unbiased and detailed analysis of the on-going trends, opportunities/ high growth areas, market drivers, which would help stakeholders to device and align Testosterone Replacement Therapy market strategies according to the current and future marketThe Testosterone Replacement Therapy Market report covers the Global market and regional market analysis. The Testosterone Replacement Therapy industry report examines, keep records and presents the worldwide market size of the important players in each region around the globe. Also, the report offers information of the leading market players in the Testosterone Replacement Therapy market.

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The global average price of testosterone replacement therapy is in the decreasing trend, from 45.4 USD/Unit in 2012 to 34.9 USD/Unit in 2016. With the situation of global economy, prices will be in decreasing trend in the following five years.

The classification of testosterone replacement therapy includes gels, injections, patches and other types, and the proportion of gels in 2016 is about 72%.

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Analysis of Testosterone Replacement Therapy Market Based On Market Capacity, Technological Advancement, Production and Growth Rate 2024 - eBurban

Recommendation and review posted by Bethany Smith

Eighteen-year-old Aisha Choudhary was just like any other adolescent eyes filled with dreams and a heart brimming with energy. The only difference was she was battling a rare genetic disease, Severe Combined Immune Deficiency (SCID). Diagnosed when she was six months old and undergoing medical treatment for years, she was iron-willed in playing the cards she was dealt.

Since one of the most effective cures for SCID is a stem cell transplant (grafting of the parent cells from which all blood cells develop), Aishas parents, Niren and Aditi, decided to opt for that treatment mode. But their cells were not a complete match with their daughters, and they had to look at external donors. However, due to a low number of voluntary, registered stem cell donors, Aisha could not get a compatible donor whose genetic markers were a close enough match to hers. With no other alternative treatment available, Aisha had a bone marrow transplant. But, it came with a side-effect that cost her life Pulmonary Fibrosis, a disease known to damage the lung tissues.

Aishas Choudhary's role has been played by Zaira Wasim in The Sky is Pink.

Aishas journey has been captured in The Sky is Pink, a recent Bollywood movie starring Priyanka Chopra, Farhan Akhtar, Zaira Wasim, and Rohit Saraf.

The 18-year-olds life story is mirrored in the experiences of many who await stem cell donation as treatment for blood-related illnesses likeleukemia, lymphoma, and sickle cell anemia every year. With very few individuals signing up as donors and the probability of finding a match being a dismal 0.0008 percent in India (against a lean 16 percent abroad), fatalities are mounting year on year.

However, in recent times, there has been one small break in the clouds a number of youngsters, non-governmental organisations, and medical professionals have come forward and are working to spread awareness about stem cell donation and motivate a larger number of people to register as donors.

The stem cells in a human body mainly comprise red blood cells, platelets, and white blood cells. These are found in the umbilical cord of newborns and in the peripheral or circulating blood and bone marrow.

A stem cell donation is as simple and painless as a blood donation.

Certain diseases like blood cancer and leukemia tend to destroy the bone marrow or affect its functioning.For these, treatments like chemotherapy and radiotherapy are tried initially. However, in some cases, they do not prove effective for a cure. The only recourse then is replacing the patients stem cells with those of a healthy person.

One of the main criteria for a successful transplant is a good match between the stem cells of the donor and those of the patient. Therefore, a donor registry will administer a cheek swab test (tissue samples extracted from the cheek) on all potential donors to match cell characteristics. This procedure of pairing generic markers is called Human Leukocyte Antigen (HLA) in medical terms.

A cheek swab test in progress.

Each potential donors tissue is entered in the registry and given an identification number after the test is done. If the registry finds a match at any point in time, the donor is contacted to initiate the transplant.

There are many organisations today that are leading the charge in saving the lives of people suffering from serious blood disorders like cancer, thalassemia, and anaemia.

For instance, Datri, an Ahmedabad-based NGO, is working to create a wide and diverse database of potential stem cell donors by organising donation drives. Founded in 2009 by two doctors and an engineer, the organisation focuses on conducting awareness campaigns and helping individuals sign up on its registry as a committed and voluntary benefactor.

The team of the NGO Datri.

The idea for Datri was initially born in the minds of doctors Nezih Cereb and Soo Young Yang, who run a laboratory, Histogenetics, for determining tissue matches between patients and donors. Since pairing tissue types is imperative for any stem cell transplant, and confronting a severe shortage of donors, the doctor duo would run from pillar to post to meet hospitals requirements. Working with a number of the hospitals in India, they realised just how acute the shortfall was in people willing to donate stem cells. They recognised the immediate need to create a donor registry here.

Soon after, Raghu Rajagopal, an engineer from BITS Pilani and Director of ready-to-eat venture Millets and More, connected with them and they decided to start Datri.

Today, the functioning of the registry, its maintenance, and even the substantial costs involved in conducting the HLA matching are taken care of by the lab. In the last 10 years, Datri has gotten over four lakh people to register as donors and has saved around 600 lives through successful transplantation.

Every day, about 40 people are diagnosed with blood disorders in India. Though these can be cured through a stem cell transplant from a genetically matched donor, there is only a 25 percent chance of finding a match from within the family. Others have no option but to rely on unrelated donors. But the chances of getting a match is anywhere between one in 10,000 and one in two million. There is an urgent need to rope in as many potential donors as possible, which is precisely what Datri is trying to do, Raghu explains.

Another organisation that is dedicated to fighting blood disorders with stem cell treatment is DKMS-BMST. It was formed through a joint venture between two renowned NGOs DKMS, which is one of the largest international blood stem cell donor centres globally, and the Bangalore Medical Services Trust (BMST).

The team of DKMS-BMST.

DKMS was founded in Germany in 1991 by businessman Dr Peter Harf, after he lost his wife to leukemia. BMST was born in 1984 from the vision of Dr Latha Jagannathan, a medical director and managing trustee. Since both organisations had a common goal to find a matching donor for every patient with a blood disorder, they decided to come together to achieve it.

A group of youngsters registering to be stem cell donors.

So far, more than 37,000 people in India have registered as potential donors after attending DKMS-BMSTs donor drives.

In highly populous countries like India, thousands of people are in need of stem cell transplants every year to survive. Though donating stem cells is a painless and non-invasive process, it remains a lesser-known medical concept in India, with only 3.6 lakh people willing to play a part in it. Besides, the chances of stem cells of people of the same ethnicity matching are higher than those of individuals from different ethnic backgrounds. But, it is due to sheer lack of awareness that India lags severely in stem cell donations, say experts.

Students taking a cheek swab test at one of the colleges in Bengaluru.

Dr Govind Eriat, a reputed hematologist and bone marrow transplant specialist, says,

With a major hurdle to stem cell donation in India proving to be the myths surrounding the subject, the youth are coming forward to deconstruct common misconceptions.

For instance, 21-year-old Tejaswini Patel, a student of Information Science at New Horizon College of Engineering, Bengaluru, has been busting the false ideas on stem cell donation, starting among her family and friends. She says,

She adds, with a notable sense of pride, In the last two years alone, around 400 students from my college have registered themselves as donors.

(Edited by Athirupa Geetha Manichandar)

See the article here:
How Young India is fuelling the future of stem cell therapy and signing up to save lives - YourStory

Recommendation and review posted by Bethany Smith

Stories of using the little blue pill for bone marrow transplants, how pregnancy stress is related to the baby's sex, and a vaccine for breast cancer proliferated on the Internet this week. Here's why you didn't read about them on Medscape.

Researchers at the University of California, Santa Cruz, seem to think Viagra has more to offer in medicine. In a recent study of mice, they tested whether the vasodilator couldspeed up the migration of hematopoietic stem cells and progenitor stem cells from the bone to the blood, where the cells could be harvested noninvasively.

The standard protocol for preparing bone marrow donors for the harvesting procedure, a 5-day regimen of granulocyte-colony stimulating factor (G-CSF),is "complex, costly, unsuccessful in a significant proportion of donors," the study authors write, and typically results in fatigue, nausea, and bone pain. Using a two-drug strategy, oral Viagra and a single injection of the CXCR4 antagonist AMD3100 (plerixafor), elicited the same mobilization of stem cells in 2 hours.

We didn't cover the study because it's still too early to say whether this strategy might be effective in people. After this mouse study, the next step is testing the approach in larger animals before human clinical trials.

A study of 187 healthy pregnant women age 18 to 45 years suggests that preterm mental and physical stress may be related to the baby's sex and increase the risk for preterm birth. In the study, 16% of women were physically stressed, as measured by higher blood pressure and calorie intake; and 17% were mentally stressed with high levels of depressionand anxiety; 66% of the women were in the healthy (nonstressed) group.

Women who were stressed during pregnancy were more likely to give birth to a girl. Typically, 105 males are born for every 100 females, but the study authors found that the male-to-female ratio decreased to 2:3 in psychologically stressed patients and 4:9 in physically stressed patients. Physically stressed mothers also gave birth an average of 1.5 weeks earlier than mothers in the healthy group, with 22% giving birth preterm compared with 5% in the healthy group.

The study authors say the findings demonstrate the importance of maternal mental health. Medscape has covered the consequences of maternal stress extensively, including preterm birth, neurobehavioral risks, and potential links to hyperactivity during the offspring's teen years. However, the sample size in this study was small: the mentally and physically stressed groups combined only included about 60 women. That's not sufficient to inform clinical practice in counseling women who want to get pregnant about how stress may affect the sex of their baby, so we didn't cover it.

News spread this week that Floridian Lee Mercker became the first woman to "beat" breast cancer with the help of a new vaccine. The vaccine, which stimulates the immune system to fight off early-stage breast cancer, was developed and administered by researchers at the Mayo Clinic in Jacksonville, Florida. The vaccine is currently in an early trial.

Reports of Mercker's success raise hopes, but she's reportedly the first participant in the trial. The news report also says she underwent a double mastectomy after her diagnosis in March, so it's unclear what evidence of the vaccine's efficacy the researchers measured. Before this experimental vaccine is relevant to Medscape readers, we need to see additional detailed data from more patients in the clinical trial published in a peer-reviewed journal.

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See original here:
The Week That Wasn't: Viagra BMTs, Pregnancy Stress, Breast Cancer Vaccine - Medscape

Recommendation and review posted by Bethany Smith

150,000 POTENTIAL STEM CELL DONORS ARE GIVING BLOOD CANCER PATIENTS HOPE THANKS TO ONE UNIVERSITY SOCIETY -1 in 4 stem cell donors are now recruited by Marrow university societies

Students from over 50 universities across the UK have helped blood cancer charity Anthony Nolan recruit an incredible 150,000 students to the Anthony Nolan stem cell register, since the first Marrow group was created 21 years ago.

Marrow is the name given to blood cancer charity Anthony Nolans network of student volunteer groups.

The first Marrow society was created at the University of Nottingham, with the aim of recruiting students to the Anthony Nolan stem cell register. For many people with blood cancers or blood disorders, receiving stem cells from a stranger is their best chance of survival.

Research has found that younger donors are more likely to save the lives of patients, so the work done by Marrow is invaluable. Over a quarter of all stem cell donations that have occurred in the last two years were from donors recruited by Marrow. University students across the country are continually giving people with blood cancer and blood disorders a second chance of life.

Liam Du Ross, 24, from North Wales is a research chemist and signed up to the Anthony Nolan register in September 2014, while at Bangor University.

Liam said: I was at my university freshers fair and stopped to talk to the volunteers running the Marrow stall. I wanted to help someone in need, and I had already signed up to donate blood at this point, so the Anthony Nolan stem cell register seemed like the next step.

Earlier this year Liam received a call to say that he had been found to be a match for someone in desperate need of a stem cell transplant.

When I found out that I was a match for someone, I felt really lucky. I had absolutely no doubts about going through with the donation at all, the whole experience was a pleasure. The nurses involved in the process were exceptional, and they helped to put me at ease. I donated via PBSC (peripheral blood stem cell collection) so I was able to lie there and catch up on podcasts and TV shows!

I thought about my recipient a lot during my donation and how I would feel if I were in their situation. I would love to meet them one day and I hope they feel the same.

To anyone thinking of signing up to the register, I would say that you should absolutely sign up. If someone you knew was that person who needed a transplant, you'd want to doeverythingin your power to help them.

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Shaswath Ganapathi, 21, is a 4th year medical student at Birmingham University and the secretary of Birmingham Marrow. He decided to volunteer with Marrow after his friend, Rohan, sadly died from leukaemia last year. Shaswath and the other committee members hold events across their university, where they encourage students to sign up to the Anthony Nolan stem cell register, any of whom could go on to donate their stem cells in the future.

Shaswath said: The donors I have spoken to have said that its the most life changing thing they have ever done, and they would never have thought that spending a few minutes signing up at a stand and doing a quick cheek swab could lead to potentially saving someones life.

Aisling Cohn, Youth Programmes Manager at Anthony Nolan, said: Marrow really are the unsung heroes helping Anthony Nolan give hope to patients with blood cancer, by signing up an incredible number of potential donors to the stem cell register. Any one of these people could save the life of someone with blood cancer.

It costs 40 to add each new person to the Anthony Nolan register, any money raised by Marrow will directly help save lives. They really are lifesavers!

If a patient has a condition that affects their bone marrow or blood, then a stem cell transplant may be their best chance of survival. Doctors will give new, healthy stem cells to the patient via their bloodstream, where they begin to grow and create healthy red blood cells, white blood cells and platelets.

Marrow

Key statistics

Link:
Students from over 50 universities across the UK help blood cancer charity - FE News

Recommendation and review posted by Bethany Smith

BRIDGEPORT, Conn. (WTNH) The Gift of Life Marrow Registry organized the meeting Thursday between a bone marrow donor from Connecticut and the recipient whose life was saved by the donation.

Jennie Bunce, 25, of Redding donated her marrow. According to a representative for Gift of Life, Bunce was studying physical therapy and joined Gift of Life through a sorority event at North Carolinas High Point University in 2016.

I never win or get picked for anything, but it just felt like the right thing to do, Bunce told Gift of Life. Im just incredibly happy and grateful to be part of something so special. Its similar to holding the door open for someone or helping a friend in a time of need.

Across the country in Mesa, Arizona, father-of-6, Mark Roser, 33, was battling Acute Lymphoblastic Leukemia. He found out about the diagnosis after he broke a hip in 2018 and had continued weakness. Roser was told he needed a bone marrow transplant to survive.

The hardest part was knowing, no matter how hard I worked, that what I did would not be a deciding factor in my ability to receive this gift, said Roser.

The match was made by Gift of Life in about six months, and the transplant took place in Phoenix.

She is a hero to all the people in my life, said Roser.

She gave me life, she gave my children a future with their dad, she gave my wife a chance to hold her husband, to have someone hold her back. She allowed me to go to work, to play, to see things from a different perspective. I am grateful for every moment I have, and its because of her.

According to Gift a Life, medical privacy laws dictate that recipients and donors must remain anonymous and wait at least a year before meeting.

The two came face-to-face for the first time Thursday in Bridgeport at the Boca Oyster Bar.

Since its start in 1991, the Gift of Life Registry 349,000 individuals who have donated blood stem cells or bone marrow to save a life. The program has facilitated 16,800 matches and over 3,500 transplants.

To learn more about the organization and/or how to donate: https://www.giftoflife.org/.

Read the original post:
Bone marrow recipient comes face-to-face with CT donor for the first time - WTNH.com

Recommendation and review posted by Bethany Smith

A fresh report titled Stem Cell Banking Market has been presented by KD market insights. It evaluates the key market trends, advantages, and factors that are pushing the overall growth of the market. The report also analyzes the different segments along with major geographies that have more demand for Stem Cell Banking Market. The competition analysis is also a major part of the report.

The global stem cell banking market was valued at $1,986 million in 2016, and is estimated to reach $6,956 million by 2023, registering a CAGR of 19.5% from 2017 to 2023. Stem cell banking is a process where the stem cell care isolated from different sources such as umbilical cord and bone marrow that is stored and preserved for future use. These cells can be cryo-frozen and stored for decades. Private and public banks are different types of banks available to store stem cells.

Request for Sample @ https://www.kdmarketinsights.com/sample/3947

Increase in R&D activities in regards with applications of stem cells and increase in prevalence of fatal chronic diseases majorly drive the growth of the global stem cell banking market. Moreover, the large number of births occurring globally and growth in GDP & disposable income help increase the number of stem cell units stored, which would help fuel the market growth. However, legal and ethical issues related to stem cell collections and high processing & storage cost are projected to hamper the market growth. The initiative taken by organizations and companies to spread awareness in regards with the benefits of stem cells and untapped market in the developing regions help to open new avenues for the growth of stem cell banking market in the near future.

The global stem cell banking market is segmented based on cell type, bank type, service type, utilization, and region. Based on cell type, the market is classified into umbilical cord stem cells, adult stem cells, and embryonic stem cells. Depending on bank type, it is bifurcated into public and private. By service type, it is categorized into collection & transportation, processing, analysis, and storage. By utilization, it is classified into used and unused. Based on region, it is analyzed across North America, Europe, Asia-Pacific, and LAMEA.

KEY MARKET BENEFITS

This report offers a detailed quantitative analysis of the current market trends from 2016 to 2023 to identify the prevailing opportunities.

The market estimations provided in this report are based on comprehensive analysis of the key developments in the industry.

In-depth analysis based on geography facilitates in analyzing the regional market to assist in strategic business planning.

The development strategies adopted by key manufacturers are enlisted in the report to understand the competitive scenario of the market.

KEY MARKET SEGMENTS

By Cell Type

Umbilical Cord Stem Cell

Cord Blood

Cord Tissue

Placenta

Adult Stem Cell

Embryonic Stem Cell

By Bank Type

Public

Private

By Service Type

Collection & Transportation

Processing

Analysis

Storage

By Utilization

Used

Unused

By Region

North America

U.S.

Canada

Mexico

Europe

Germany

UK

France

Spain

Italy

Rest of Europe

Asia-Pacific

Japan

China

Singapore

India

South Korea

Rest of Asia-Pacific

LAMEA

Brazil

Saudi Arabia

South Africa

Rest of LAMEA

KEY PLAYERS PROFILED

Cord Blood Registry

ViaCord

Cryo-Cell

China Cord Blood Corporation

Cryo-Save

New York Cord Blood Program

CordVida

Americord

CryoHoldco

Vita34

Browse Full Report With TOC@ https://www.kdmarketinsights.com/product/stem-cell-banking-market-amr

Table of Content

CHAPTER 1: INTRODUCTION

1.1. Report description1.2. Key benefits for stakeholders1.3. Key market segments1.4. Research methodology

1.4.1. Secondary research1.4.2. Primary research1.4.3. Analyst tools and models

CHAPTER 2: EXECUTIVE SUMMARY

2.1. CXO perspective

CHAPTER 3: MARKET OVERVIEW

3.1. Market definition and scope3.2. Key findings

3.2.1. Top investment pockets3.2.2. Top winning strategies

3.3. Porters five forces analysis3.4. Top Player Positioning3.5. Market dynamics

3.5.1. Drivers

3.5.1.1. Large number of newborns3.5.1.2. Increase in R&D activities for application of stem cells3.5.1.3. Increase in prevalence of fatal chronic diseases3.5.1.4. Growth in GDP and disposable income

3.5.2. Restraints

3.5.2.1. Legal and ethical issues during collection of stem cells3.5.2.2. High processing and storage cost3.5.2.3. Lack of acceptance and awareness

3.5.3. Opportunities

3.5.3.1. Initiatives to spread awareness3.5.3.2. Untapped market in developing regions

CHAPTER 4: STEM CELL BANKING MARKET, BY CELL TYPE

4.1. Overview

4.1.1. Market size and forecast

4.2. Umbilical Cord Stem Cells

4.2.1. Key market trends and growth opportunities4.2.2. Market size and forecast4.2.3. Market analysis, by country4.2.4. Cord Blood

4.2.4.1. Market size and forecast

4.2.5. Cord Tissue

4.2.5.1. Market size and forecast

4.2.6. Placenta

4.2.6.1. Market size and forecast

4.3. Adult stem cells

4.3.1. Key market trends and growth opportunities4.3.2. Market size and forecast4.3.3. Market analysis, by country

4.4. Embryonic stem cells

4.4.1. Key market trends and opportunities4.4.2. Market size and forecast4.4.3. Market analysis, by country

Continue

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About KD Market Insights

KD Market Insights offers a comprehensive database of syndicated research studies, customized reports, and consulting services. These reports are created to help in making smart, instant and crucial decisions based on extensive and in-depth quantitative information, supported by extensive analysis and industry insights.

Original post:
Stem Cell Banking Market was valued at $1986 million in 2016 - Markets Gazette

Recommendation and review posted by Bethany Smith

Among the new modernization priorities that have become cross functional teams, the top priority listed by top Army leadership was the long range precision fires work.

The Army has become, by its own admission, overly reliant on a permissive air environment and the blessings that unfold with close air support, Air Force long-range strike and golden hour capable casualty evacuation.

Those decades of uncontested airspace that previous generations of soldiers enjoyed can no longer be counted upon.

And its not just in the close fight that air is challenged. Advanced, interlocking networks of air defense strung along the borders and beyond by near-peer competitors such as Russia and China mean that at times the joint force can be hamstrung in even gaining access, leaving the Army far from the fight.

To get after that problem set, Brig. Gen. John Rafferty has his team looking at everything from increasing range and accuracy of the tried-and-true base of the artillery 155mm to a new Precision Strike Missile and hypersonic that will put the Army back in the strategic fires game for the first time in a long time.

Rafferty spoke recently with Army Times about those developments and what is headed to fires formations in the coming years.

First, the newly promoted brigadier general had to tip his hat to a combination of efforts in both structure, new organizations such as the CFTs and Army Futures Command, and focused centers that are finding new ways to solve the distance and accuracy problems of expanding how the fires community contributes to the maneuver fight.

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Shortly before an interview with Army Times, Rafferty had just been briefed by the Readiness and Analysis Center at AFC at White Sands Missile Range, New Mexico. They provided a lethality analysis of near peer threats in fires. While he couldnt disclose details of the briefing for obvious reasons, he did say that the renewed efforts on tactical, operational and strategic fires are meeting previously identified gaps.

Conclusions? Were in the right place and (Artificial Intelligence) and sensor investment could improve that, he said.

Rafferty said that developments by adversaries to negate U.S. advantages have meant the development of coastal defense, long range air defense and extremely long range artillery.

The U.S. solution has multiple answers.

Strategic fires include the Armys Space and Missile Commands Long Range Hypersonic Weapon and the Strategic Long Range Cannon.

And while putting steel on target is one method, the future will likely combine the kinetic with cyber and electronic warfare to both disable enemy systems and combine to create windows of opportunity for the kinetic strike and maneuver.

Over the past year, Rafferty said, the joint forces science and technology community has been working with commercial industry and NASA on some specific tech challenges. The Armys Science Board has deemed what theyre trying to do in the hypersonic arena as entirely feasible. Tests coming soon at White Sands will try to get through an early technology gate.

Those efforts could result in a full-fledged Army program before 2023, he said.

He couldnt speak to specific ranges, due to security concerns, but said that hypersonics are looking at ranges in the thousands of kilometers, while the strategic cannon is in the hundreds of kilometers range.

Operational-level fires is focused on the Precision Strike Missile, or PrSM.

The existing Army Tactical Missile System has its limits. It has been in service since the 1980s. While its been upgraded several times and will continue to be upgraded under a service life extension program to keep it in the inventory for another decade, it is seeing the horizon of its usefulness.

And theres the range. The ATACMS pushes out to about 300km. Which was fine under past conditions but cant keep up with current competition.

The PrSM will push its range out past 500km now that the United States no longer has to restrain its systems to under that range due to the break of the INF Treaty.

The PrSM will be cheaper to produce than the ATACMs and provide two missiles per pod where now its only one per pod with the ATACMs, Rafferty said.

That helps logistics, the number of launchers needed for certain mission sets and flexibility for commanders on how to load out their force. They expect initial fielding of some of those systems by 2023, with another add-on technology spiral two years later that will add in ways to hit precision emitting targets and operate more effectively in maritime environments and more contested areas.

Tests later this year will establish which companies will continue to the end of the competition. The next wave of development will push the missiles range past the 650km range, he said.

Were committed to the shape and size and keeping two per pod, Rafferty said. But we have to be a little bit patient with the technology.

Thats, in part, because the pre-existing INF treaty didnt just limit fielding but also limited investment in research and development for improving those systems, especially long range propulsion.

Down at the tactical level, where most soldiers get to hear things go boom, is work on Extended Range Cannon Artillery. The ERCA program is putting a lot of changes to both the self-propelled howitzer system and the round it uses.

The big project is one thats been moving along for more than a year now, thats Paladin Integration Management. The PIM program is modernizing the self-propelled howitzer with a robust chassis, safety improvements, electrical system improvements, an auto-loader and longer cannon for longer ranges.

Rafferty announced that shift earlier this year. The cannon will push from a 39 caliber to a 58 caliber length, extending the barrel from 20 feet to 30 feet. Cannon calibers are also a function of length, unlike with rifle caliber barrels.

And the Paladin now has a sliding block breech, like what the tanks use. That means it can withstand more powerful charges in its round and a higher rate of fire without breaking.

Essentially, its an indestructible type of breech, Rafferty said.

But whats inside that breech is what makes the impact.

The 155mm round is undergoing changes it likely hasnt seen in decades. New propellants, precision guidance kits and other technologies are pushing the round out to the 70km range in testing, thats more than double the standard limit of about 30km.

Rafferty said the team expects the first battalions worth of the new system fully fielded by 2023.

But, there are hurdles. Pushing the limits of physics comes with its own set of challenges.

Theyre having to do more gun hardening work to help the systems withstand the increased pressures and stresses.

Even precision guidance brings novel obstacles to overcome. For example, by firing such long ranges, the 155mm rounds are reaching altitudes they had not previously reached.

That means that their guidance kits mush bear the temperature changes and also move through thinner air, which changes the calculus by which theyre set to hit their targets.

And new propellants are pushing muzzle velocities and chamber pressures to numbers that theyve not had to operate before.

Were on the margin of what cannon artillery can do but were going forward with those margins, he said.

And all of these tech changes are having their own ripple effects as far reaching as how the Army fights.

We view fires as essential to (multi-domain operations), Rafferty said. It absolutely changes whats possible for the Army to do and what fires can do to enable that.

View original post here:
The team that is transforming Army fires leads the service's priorities - ArmyTimes.com

Recommendation and review posted by Bethany Smith

Sorry, we cant help you, said the Apple store Genius. My AirPods were dying. After just 15 minutes of use, the wireless headphones I use daily chirp a sad little battery-depleted alert. I came to Apple to get them repaired.

The employee said there were lots of people like me, with $159 AirPods purchased in 2016 and 2017 that now cant hold a charge. But even though Apple promises battery service, the store had no way to fix my AirPods. It didnt even have a way to test them.

Cupertino, we have a problem: AirPods are comfortable and convenient headphones that have attracted tens of millions of customers. But each one of those white sticks contains a rechargeable battery marching toward an untimely death in as little as two years. Apples plan to deal with that reality is just to sell us new ear buds. When your AirPods day comes, the only option is to ask Apple for discounted replacements but youll need to know its code word to even get that.

Not long ago, headphones were among the most universal, long-lasting electronics. We shouldnt let Apple turn them into expensive, disposable electronics. Its hurting our wallets and the environment.

Apple doesnt dispute that the lithium-ion batteries inside AirPods wear out. All rechargeable batteries have a limited life span and may eventually need to be serviced or recycled, Apple says on its website. Replacing batteries is very common on phones and laptops. In 2018, Apple stores got deluged when the company offered to replace the batteries in older iPhones for $29.

But with AirPods, Apple offers far less help. First, theres no way to determine the health of the batteries in the ear buds or their charging case. Apple wont even share guidelines on their life expectancy. AirPods are built to be long-lasting, said Apple spokeswoman Lori Lodes, without specifics. Mine went for 34 months; others have reported they die as soon as 18 months.

When your AirPod batteries finally go, even Apples employees are confused about your options. Across three separate support encounters in the store and online, they told me I had to buy a replacement pair for $138, nearly the price of a whole new set. But I remembered Apple had once told me it would service depleted batteries for $49.

After weeks of back-and-forth with Apple I finally got answers:

A $98 battery fix is still mighty expensive. Apple will replace the battery on an iPhone for as little as $49. An Apple Watch battery costs just $79. What makes AirPods so different? Because Apples battery service for AirPods is code for throwing it away. Apple isnt repairing AirPods its just replacing the ear buds and recycling your old ones.

To understand why, I performed an autopsy on a dearly departed pair. Inside, I found the design of AirPods makes them inevitably obsolete.

What could be so hard about replacing the battery in an AirPod? I dont ordinarily go CSI on gadgets, so I sought advice from some folks who do.

Kyle Wiens, the CEO of repair website iFixit, offers instructions on how to disassemble electronics and sells replacement parts. The first time Wiens tried to get inside an AirPod, he cut himself and bled all over it. Another time, the battery combusted in a poof of smoke on his team.

AirPods were never meant to be opened, Wiens warned me.

But I wanted to see for myself. With Wiens watching, I began the operation with the silver cap at the end of the AirPod stick. You might think it unscrews to let you get inside. No such luck. Its glued in there, and I couldnt yank it out even after carefully heating the AirPod to loosen the glue. That meant I had to cut in. To save my fingers, Wiens loaned me a special vibrating knife that slices plastic.

Inside the AirPod, I found so much glue I couldnt even tug out the now-exposed end of the battery with tweezers. So I cut very carefully along the edges of the AirPod stick, to crack open a section like the top of a coconut. There, at last, was the battery, about as thick as a large spaghetti noodle.

I had avoided spilling blood, but after all the cutting I still had a problem: My AirPod was now a Humpty Dumpty in so many pieces Id never be able to reassemble it again. Wiens said hed tried this five times, across both the first- and second-generation AirPods, and awarded AirPods a repairability score of zero out of 10.

The cause of death on my AirPods was clear: bad product design.

Earlier this year, the website Vice called AirPods a tragedy of disposable wealth. I see them as a symptom of Apples preoccupation with thin products. Its the tech-world version of fashions fixation on skinny models, where Apple sets the trend and other manufacturers feel pressure to follow.

Excessive thinness isnt healthy for gadgets, either. Apples desire to shave a few millimeters off designs has resulted in MacBook keyboards that fail, iPads that catch fire at recycling centers and now millions of AirPods that will probably end up in the trash.

Sealing up electronics with glue instead of screws and latches can help make devices lighter and more resistant to moisture and dust. But great ear buds dont have to be impenetrable. iFixit found a way to pop open Samsungs $129 Galaxy Buds, so replacement batteries can slip in kind of like on a watch. Samsung doesnt officially offer this repair option, but iFixit sells a pair of replacement batteries for $29.

Apples disposable AirPod design is expensive for us. But its doing permanent damage to our environment. Thats not how Apple talks about it, though.

Apples products are designed with the environment in mind, said Lodes, the Apple spokeswoman. Everything from the materials we select to the way we approach recycling is meant to leave the world better than we found it.

How exactly are AirPods designed with the environment in mind? Because you can bring them to Apple to be recycled. We work closely with our recyclers to ensure AirPods are properly recycled and provide support to recyclers outside of our supply chain as well, said Lodes.

Thats like saying your daily paper coffee cup habit is good for the environment because you always put it in the recycling bin. AirPods may actually be worse than that: Theyre so small, theres isnt much material that can be recycled from them. Significant energy, water and materials go just into the process of making AirPods.

The golden rule for helping the earth is to produce less new stuff. Electronics companies can do that by making their products last as long as possible through repair and reuse.

In the Greenpeace 2017 Guide to Greener Electronics, Apple got a B- grade overall because of its commitments to using renewable energy and efforts to create a closed-loop supply chain. But the environmental group gave Apple a D in the category of product life extension, because it has consistently made it more difficult for customers to repair their devices, replace their batteries, or upgrade the devices so that they continue to stay in use.

Apple isnt the only tech company guilty of pushing consumption over repair. New $130 headphones from Amazon called Echo Buds contain batteries that cant be repaired, the company told me. (Amazon CEO Jeff Bezos owns The Washington Post.) Microsoft says it would also replace an entire unit when the battery fails on its $249 Surface Earbuds.

Before this trend continues, lets agree on a common-sense rule suggested by Wiens: The life span of an expensive, resource-intensive gadget shouldnt be limited to the life span of one consumable component. You wouldnt buy an electric toothbrush where you couldnt replace the brush. Or a car with glued-on tires.

Apple kept fundamentally the same design for AirPods between its first- and second-generation of the headphones, which debuted in March. Now, the Apple rumor mill has lit up with hints of forthcoming third-generation AirPods in pre-release code for iOS 13.2.

Lets hope this time around, AirPods really are designed with the environment in mind. Not to mention our wallets.

More:
Everyone's AirPods will die. We've got the trick to replacing them. - Roanoke Times

Recommendation and review posted by Bethany Smith

Tern Alpha (file image courtesy TAQA)

By The Maritime Executive 2019-10-15 15:56:04

On Monday, a fire broke out at TAQA's Tern Alpha platform, located about 90 nm to the northeast of the Shetland Islands in the UK North Sea. One worker was injured and medevaced by helicopter to Lerwick for treatment.

According to local media, a small fire started on Tern Alpha on Monday afternoon. The platform shut down temporarily and the fire was quickly extinguished. One worker suffered an arm injury due to the fire, prompting a medevac request to the Maritime and Coastguard Agency. An HM Coastguard helicopter out of Sumburgh flew to Tern Alpha to carry the injured worker to shore.

An investigation into the cause of the incident is under way, and production was expected to resume Tuesday. TAQA told media that the worker has already been discharged from the hospital.

The Tern platform was built by Shell in the late 1980s, and it handles production from its own reservoir and from the nearby Hudson, Kestrel, Cladhan and Falcon fields. It was operated under a joint Shell / Exxon license until 2008, when it was sold to Abu Dhabi state oil company TAQA.Tern and the nearby Eider, North Cormorant, South Cormorant, Kestrel and Pelican fields were in decline, and Shell offered them to TAQA as a package for about $680 million. At the time of sale, the fields produced a combined 25-40,000 bpd, down from a peak of 200,000 bpd in the early 1990s.

TAQA has been investing in both plug-and-abandonment work and life extension measures for its North Sea holdings, including a conversion of the aging Eider production platform to a "utility" support role. Today, the firm's entire European portfolio produces about 40,000 bpd.

Fire breaks out on Heather Alpha

In a separate incident Monday, a fire broke out on EnQuest's Heather Alpha platform, a 1978-built installation about 25 nm south of Tern Alpha. The fire was quickly put out, EnQuest told media, but two workers were injured and had to be evacuated. Both have already been discharged from the hospital.

Last March, several gas detectors were triggered on Heather Alpha after a release from a flare system which was extinguished during operation. Gas detectors picked up the leak, triggering an immediate automated shutdown.The UK Health and Safety Executive determined that the incident exposed 131 workers on Healther Alpha to the risk of a fire or explosion.

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One Injured in Fire on Tern Alpha Platform - The Maritime Executive

Recommendation and review posted by Bethany Smith

Flexographic Printing Machine market report 2019 to 2024 is the definitive study of the global Flexographic Printing Machine market. The report content includes orientation technology, industry drivers, geographic trends, market statistics, market forecasts, producers, and equipment suppliers of Flexographic Printing Machine industry.

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Analyst projects that the Flexographic Printing Machine market size will grow from XX Million in 2018 to XX Million by 2024, at an estimated CAGR of XX %. The base year considered for the study is 2017, and the market size is projected from 2018 to 2023.

Increasing global packaging demand and growing printing requirements for advertising and print media will drive the growth of the global flexographic printing machine market over the forecast timeline. Increasing trend of converting simple package formats to flexible packaging due to benefits such as shelf life extension, lightweight nature, and easy open/close has increased the demand for flexographic printing machines and the trend is expected to continue over the forecast timeline.

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Key Players in this Flexographic Printing Machine market are:

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By StructureSemi-Automatic, Automatic ,

By TechnologySingle Start, Double Start ,

By Printable SubstancePolyethylene, Papers, Others

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Various marketing channels like direct and indirect marketing are portrayed in Flexographic Printing Machine market report. Important marketing strategical data , Marketing Channel Development Trend, , Pricing Strategy, Market Positioning, Target Client Brand Strategy and Distributors/Traders List

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Global Flexographic Printing Machine Market Comprehensive Insights and Growth Potential In The Future - Materials Post

Recommendation and review posted by Bethany Smith

An Ottawa astrophotographer who has been fascinated with space for years has earned recognition from NASA scientists for a dramatic image of the aftermath of two galaxies colliding.

In the photo, what looks like a pale but fiery strip of orange curls around a blue and purple swirl of stars. The two forms meet in a bright flare in the middle, creating the impression, as NASAs Astronomy Picture of the Day description puts it, that this galaxy is jumping through a giant ring of stars.

Rudy Kohl, the Ottawa man behind the processing of the image, said that theres a gravitational force that has been set up between them, sort of pulling it apart, though he was quick to add that he was not an astronomer himself.

In a phone interview with CTVNews.ca, Kohl said he was thrilled to have his photo chosen by NASAs Astronomy Picture of the Day -- his second image since he started submitting to NASA.

It's really extraordinary to get one of those, he said. Hundreds of images get submitted every day to NASA for this.

Astronomy Picture of the Day has been running since 1995, and each photo comes with an explanation of the image, provided by a professional astronomer.

Although it appears as though two galaxies are wrestling in front of our eyes, both the blue and orange arms in the picture are all part of the same galaxy: NGC 7714.

According to the description, the image shows how NGC 7714 has been stretched and distorted by a recent collision, with NGC 7715, a smaller, neighboring galaxy, that is off to the left out of the frame of the image.

Scientists believe that NGC 7715 charged right through NGC 7714.

The ring of golden light in the image is made up of millions of older stars thought to be similar to our sun, the description says, while the bright centre of NGC 7714 is the nexus of a new star formation for the galaxy.

Youd never guess it, looking at the vibrant colours in the picture, but this image started out life as a series of black and white photos taken by NASAs Hubble telescope.

It took hours of work to process the image, but it was work that Kohl, 69, was happy to do.

Kohl is part of an online community of astrophotographers who create stunning colour photographs of space. Although some have their own telescopes and equipment to take photos of the sky themselves, others rely on free archives, such as the Hubble Legacy Archive, to find the source images to create their masterpieces.

If the source images are black and white, does that mean those who process the images are choosing colours at random?

Not according to Kohl. The colour clues are in the filters used by Hubble, he said.

What they do is they put a colored filter in front of that black and white camera. In this case there are three colors, red, green, and blue. It's called RGB imaging. It's the same imaging as in our computer monitors and in our televisions, he explained.

Every single pixel is made up of a percentage of red, percentage of green and percentage of blue.

So the Hubble camera first puts a red filter in front of it, which means it blocks out everything but the red, and so the red wavelength hits the camera and you get an image.

Although the image still comes out looking black and white, it is effectively a picture of what the galaxy would look like if it was composed of only red light.

The process is repeated with blue filters and green filters, Kohl said, producing numerous images that -- while technically greyscale images -- contain a massive amount of information regarding where different wavelengths of light, and thus different colours, are concentrated in the image.

Astrophotographers take these different greyscale images and fill them with colour corresponding to the filter they were taken with, so they end up with numerous red, blue, and green layers of the same deep space object. When they line the different images up on top of each other, thats when the real picture of a galaxy, star or nebula starts to form.

It takes a lot of processing and refining of the different layers to filter out the noise in the images and produce a final photo that looks as crystal clear as Kohls picture of NGC 7714. Kohl said it can take anywhere from 12 to 16 hours to finish an image.

He used to have his own telescopes and equipment to image the heavens with, but when chronic illness advanced on him, he said he had to sell his gear.

Broke my heart to do it, he said.

Working with public archives of space images allowed him to hold onto his passion.

A love of science is something that has informed almost his entire life. Kohl got his undergraduate degree in molecular genetics at Carleton University, and met his wife while he was at it, who was also studying science. He only started posting astrophotography pictures within the last few years, but he's not slowing down now.

I'm going to be doing it for the rest of my life now, he said. I am so blown away, like when I think of the vastness of space.

NGC 7714 is around 100 million light years away from Earth, which makes it a relatively close cosmic neighbor.

According to APOD, NGC 7714 and NGC 7715 first started interacting around 150 million years ago, and are expected to continue for several hundred million years more, possibly resulting in the two combining into a single galaxy.

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This image shows the aftermath of two galaxies colliding - CTV News

Recommendation and review posted by Bethany Smith