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Friends play 100 holes for golf to help a child with cerebral palsy … –

Posted: June 27, 2017 at 5:47 am

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ST. LOUIS You may not think of golf as a marathon but Monday it is for a very special cause.You`ll have to forgive Scott Thomas for feeling a little dj vu in Forest Park Monday afternoon.

This is hole number 72 so we`ve finished. This is our 8th loop of the 9-hole course.

That`s right since sun up Thomas and friends have been swinging and swinging and putting over and over and over again.

And they`re not using any golf carts on their mission to play 100 holes of golf.

I would love to be in those but the whole purpose of this is the 100-hole hike. It`s the physical challenge of walking. Golf is a sport that is enjoyed when it`s walking and enjoyed when it`s in a cart. But Charlie is trying to walk and it seems silly for us to be in modernized carts when we`re trying to raise awareness for him and his ability to walk again.

Sure, a hole in one would be nice, but Scott Thomas and friends are driven by something else.

Through pledges, the persistent players are hoping to help raise the $130,000 for the Farragher family from England.

Their son Charlie has cerebral palsy and in need of a surgery at St. Louis Children`s Hospital to be able to walk.

The Hawthorne Course at Forest Park is where Thomas and friends will continue to drive for show and put for dough for a little boy, even if they might get a little dj vu down the hill from the Art Museum.

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Guitarist Brandon Mendenhall Doesn’t Let Cerebral Palsy Stop Him From Rocking Out – L.A. Weekly

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Brandon Mendenhall, left, with his band, The Mendenhall Experiment

Courtesy of the band

If theres one thing 33-year-old Los Angeles musician Brandon Mendenhall doesnt want, its your sympathy. Mendenhall, originally from Illinois, was born with cerebral palsy, a neurological condition that affects the muscles, movement, speech, coordination and balance.

The cerebral palsy causes my muscles to not function properly. I have motor coordination difficulties it affects my speech, the movement in my left hand and the way I walk, Mendenhall says during a recent phone interview.

The biggest misconception a lot of people have about people with disabilities is that we arent capable and they need to feel sorry for us, he continues. I think a lot of people feel so bad they dont even want to talk to us or approach us.

Mendenhall is the guitarist and main songwriter for The Mendenhall Experiment, a band whose mission, he says, is to remove the social stigma that comes with having a disability. The Mendenhall Experiment began in 2008 and currently features Mendenhall, lead guitarist Michael Lira, Michael’s brother Bruce Lira on drums, vocalist Mario Valadez and bassist Nate Stockton.

This band is about trying to change that initial perception when you meet someone with a disability, so you dont automatically assume they are not capable of doing something or being a good person or a good friend or even able to function in life, Mendenhall explains.

Growing up with cerebral palsy was far from easy, and Mendenhall faced a plethora of hardships, including a family that didn’t always support his dream of being a musician. Growing up, everyone told me that I couldn’t do this or that, that my body was not cut out for this, he says. His grandparents raised him and his grandfather was adamantly against his dreams of being a musician, discouraging him from even trying.

Understandably, this left a young Mendenhall angry and hurt, but he used these emotions as motivators. I took all that negativity, pain and anger and turned it into inspiration, to fire my passions of music and guitar playing.

Mendenhall says that he was drawn to music from a young age, dealing with the emotional ups and downs of being a teenager, along with the physical limitations his body faced due to his condition. He gravitated early toward metal. Of course I was into the heavier bands, like the Big Four: Megedeth, Anthrax, Metallica and Slayer. But for me, the ‘Big Three’ were Korn, Pantera and Nine Inch Nails. It was just something about those three bands their use of guitar tuning, dissonance, chords and the emotion in their music [that] I could really relate to. I used their music as emotional therapy to overcome my disability and still love them to this day.

At age 19, Mendenhall got his first guitar and it changed his life. He began to slowly rehabilitate his paralyzed left hand and got formal guitar lessons but after 14 months, he decided to go down his own path as a musician. I did research and read about open tunings and drop tuning, and I realized that I can use those formats to maneuver around my disability as a guitar player and songwriter, he said. For me, songwriting and the arrangement is the most important part of music.

The Mendenhall Experiment recently released their self-titled debut EP to much critical acclaim, and have thus far shared stages with and opened for acts including P.O.D., Alien Ant Farm and Kill Devil Hill. They even played the Rocklahoma festival in May.

The six-song EP features guest appearances from Danny Lohner, formerly of Nine Inch Nails and A Perfect Circle, and Munky from Korn. Munky is a personal guitar hero of mine since I was a teenager,” Mendenhall says, “and seeing them perform all these times, I was fortunate enough to get to meet him and maintain a friendship with him over the years.”

There is a documentary aboutMendenhall’slife story in the works called Mind Over Matter, slated for release in 2018, and plans for a tour to support the band’s debut album. Nothing is 100 percent yet, so I cant really say, but there will be extensive touring this summer,” he says.

With a condition that puts such physical limits on the body, Mendenhall has a secret for maintaining his optimistic attitude and drive to succeed. I believe in the law of attraction in the universe, he says. Putting out positive brings you positive things in this life in return, and I feel like my story is a true testament to that.

Mendenhall hopes people will enjoy his bands music, a mixture of hard rock and catchy, melodic heavy metal. But just as important, he hopes The Mendenhall Experiement will raise awareness for people with disabilities. He invites anyone with a disability to come to the shows, promising they will get VIP treatment. People with disabilities are just that were people. Were oftentimes just as capable if not more capable of doing things [as] people who arent disabled.”

He sums up The Mendenhall Experiment’s message: Never give up and keep going, because you only fail if you give up. So dont ever stop, keep pushing. It will be a roller coaster with lots of ups and downs, but if you keep at it long enough, good things will happen for you.

The Mendenhall Experiment play Molly Malone’s on Friday, June 30. For more information and additional tour dates, visit

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Woman uses her experience with cerebral palsy to help others … –

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By AMELIA HARPER, Rocky Mount Telegram

SPRING HOPE, N.C. One local woman has turned the challenges of her life into a way to serve others.

Spring Hope native Jesse Sykes, 26, graduated last month from the University of North Carolina-Chapel Hill with a master’s degree in clinical rehabilitation and mental health. Her master’s thesis dealt with the impact of cerebral-palsy on care-givers during the transition from adolescent to adulthood.

At first glance, this looks like a fairly typical story of intelligent young woman succeeding in a challenging and beneficial field. But Sykes is far from typical. She has dealt with the challenges of cerebral palsy since birth and now hopes to parlay that lifetime of experience into way to help others deal with challenges in their own lives.

Sykes credits her success so far to family support and her own perseverance.

“If you tell me I can’t do something, I have to prove I can,” Sykes said. “This is the way I was brought up. My parents always told me that the only thing I can’t do is the thing I tell myself I can’t do. I was tempted to quit at times, but a lot of people in my family and at Chapel Hill believed in me, and that kept me going.”

Sykes, who graduated from Nash-Rocky Mount Early College High School in 2010, went on to earn her bachelor’s degree in psychology at UNC-Chapel Hill before heading to graduate school. However, tragedy struck her as she began her college career. Her mother, Donna Sykes, died accidentally while she was staying in her daughter’s dorm room, helping her prepare for the new chapter in her life.

However, Sykes sees all of these life events as ways to make her more empathetic to others. After studying psychology as an undergrad, Sykes wanted to focus on a master’s degree that would give her more skills to help others. Over the past few months, she has been working at the accessibility office at UNC-Chapel Hill. Her work there has taught her that many people face a variety of challenges in their lives.

“During my internship, I learned that a lot of students faced challenges. Some were not aware of the resources that are available. Others were afraid to ask for help for fear of being looked down upon,” Sykes said.

Sykes said she likes solving problems for people who are disabled or facing other challenges in their lives.

“I love hearing them say ‘Thank you.’ Most people are really grateful for the help,” Sykes said.

Even though Sykes’ challenges are obvious to most people who meet her, her sweet and open spirit is apparent as well. Sykes has a more positive attitude toward life than most people who have endured far fewer struggles in their lives. In fact, Sykes said she feels that people who face challenges that are not as obvious fare worse in life.

“I think that people with disabilities that are not obvious are treated worse,” Sykes said. “There seems to be sort of a stigma there,”

For now, Sykes is back home in Spring Hope while she looks for job that will allow her to put her considerable skills to work. However, even that is challenge, Sykes said.

“I finding it hard to slow down,” Sykes said.

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Researchers Provide the First Evidence That a New Kind of Paralysis Treatment Is Effective – Futurism

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In Brief A new study has revealed the potential for cortical targets to improve motor function in those struggling with paralysis. Cortical targets are relatively unexplored territory for treatment, so building off this research could lead to even more exciting discoveries. A New Target

Monica A. Perez, P.T., Ph. D. and her colleagues at the University of Miami have produced the first evidence that cortical targets could improve motor function in patients who are paralyzed, specifically by spinal cord injury (SCI). The results of their studyhave been published in Brain.

In previous treatments and studies, sites within the central nervous system have been targeted to try to improve motor function. However, whether or not cortical targets areas on the outer layer of the brains cerebrum could improve motor function in patients was unknown.

To explore this potential relationship, the research group noninvasively stimulated the area using magnets. They found that, after this stimulation, the finger muscles of thosewith SCI exerted more force and produced more electromyographic activity, and the patients ability to grasp objects with their hands wassignificantly improved.

Dr. Jonathan R. Wolpaw, M.D. Director of the National Center for Adaptive Neurotechnologies Albany, New York, sees great promise in Perezs groups research.

This study is a major contribution to the realization of a powerful new class of rehabilitation therapies that can target beneficial plasticity to crucial sites in the nervous system, he said in a news release from The Miami Project. By taking advantage of recent scientific and technical advances, Dr. Perezs group produced beneficial change in the cortical circuitry and spinal connections underlying voluntary movement.

This study could be a game-changer for those paralyzed or otherwise coping with SCI. Cortical targets are relatively unexplored territory as far as treatment options are concerned, so asfurther studies are conducted, newways to improve motor function in paralyzed patients could emerge.

Even beyond that, we could learn new information on howcertain cortical targets could be related to motor function in general, and the more we learn about how our brains function, the closer we come to being able to treat all neurological disorders and create advanced brain computer interfaces (BCIs), mind-controlled exoskeletons, and other technologies.

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A Vote of Conscience and Courage – New York Times

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This week, these senators will face a career-defining choice.

It is not an easy one for many of them. Republicans have spent years promising to repeal Obamacare. Now the Senate is nearing a decision on whether to do so. Opposing the bill risks marking any Republican as a traitor to the party.

By late Monday, enough Republicans were nonetheless expressing skepticism about the bill to put its success in serious doubt. Susan Collins of Maine, Rand Paul of Kentucky and Dean Heller of Nevada have all distanced themselves from the bill. But weve seen a version of this story before. House Republicans also expressed serious doubts only to wilt after party leaders made superficial changes to the bill. The Senate bill remains alive until its dead.

In the meantime, I hope that each senator takes some time away from the daily swirl of Capitol Hill to think back to the reasons they entered politics. I hope they understand that this bill is a test of conscience and of courage.

A yes vote is still the politically easy vote for any Republican. But it is also a vote that will come back to haunt many senators when they reflect on their careers and when more objective observers pass historical judgment on those careers.

There is little precedent for a bill like this one. Thats why Mitch McConnell kept it secret for as long as possible. Americans have often fought bitterly about how large our safety net should be and about the precise forms it should take. But once the country commits to a fundamentally more generous, decent safety net, it becomes an accepted part of society. Poverty, disease and misfortune that had been accepted as normal became rejected as cruel.

Once we stopped allowing 10-year-olds to work in factories and fields, we didnt go back on it. Once we outlawed 80-hour workweeks at miserly pay, we didnt reinstate them. Once we made health insurance and Social Security a universal part of old age, we didnt repeal them.

The Senate health care bill would be a reversal on that scale.

Yes, Obamacare is flawed, and it needs to be improved. But the Senate bill would not fix those flaws. It would instead take away health insurance from millions of Americans middle class and poor, disabled and sick, young and old largely to finance tax cuts for the wealthy. Ultimately, the bill would lead many Americans to lose medical care on which they now depend.

I hope the senators will listen to some of these peoples stories. The most affecting that Ive read recently is about Justin Martin, who has overcome cerebral palsy to become a thriving student at Kenyon College. As the HuffPosts Jonathan Cohn reported, Martin depends on Medicaid to pay for a wheelchair that helps him get around and for health care aides who help him in the bathroom.

When history comes to judge todays senators, do they want to have made life harder on Justin Martin?

I hope the senators will also take the time to ask themselves why virtually no health care expert supports the bill. Conservative health care experts have blasted it, along with liberal and moderate experts. The Congressional Budget Office says it will do terrible damage. Groups representing doctors, nurses, hospitals and retirees oppose the bill. So do advocates for the treatment of cancer, heart disease, lung disease, multiple sclerosis, cystic fibrosis and, yes, cerebral palsy.

I hope the senators will watch a two-minute video created by doctors around the country. In it, each one looks into the camera and explains how the bill would damage medical care. This bill would dramatically affect my patients, said Dr. Gregory Lam of Circleville, Ohio, and my ability to care for them.

I hope the senators grasp the weight of the decision they face, for the country and for themselves.

It takes only three Republican senators to prevent millions of their fellow citizens from being harmed. Which of them has the courage to make the right choice over the easy one?

A Vote of Conscience and Courage – New York Times

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Prevacus Inc., Announces the Addition of Randy Travis to its Advisory Board – GlobeNewswire (press release)

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June 26, 2017 09:01 ET | Source: Prevacus, Inc.

TALLAHASSEE, Fla., June 26, 2017 (GLOBE NEWSWIRE) — Prevacus, Inc., a leading biopharmaceutical company focused on developing treatments for concussion (mild traumatic brain injury (mTBI)) and other neurological disorders, today announced a partnership with country music legend Randy Travis and The Randy Travis Foundation.

“I am delighted to have the support of Randy and his foundation,” said Dr. Jake VanLandingham, CEO of Prevacus. “Randy suffered a significant neurological injury and has worked hard to recover. He is a passionate fighter and a powerful voice for others in need, especially for members of our military struggling with neurological conditions associated with brain injury. With Randys support, we will continue developing PRV-002, our novel concussion treatment, to help make the world safer for members of our military, professional athletes and the general populace.”

Randy and his Foundation will join others at Prevacus including Brett Favre, Jay Saldi, Roger Staubach, Leigh Steinberg, James Bus Cook, Abby Wambach, Dale Jarrett, Steve Mariucci, Eddie DeBartolo Jr., Matt Hasselbeck, Warren Moon and Kerri Walsh-Jennings.

About Prevacus Prevacus, Inc. is a biopharmaceutical company developing drug candidates with the potential to advance treatment in the fields of traumatic brain injury and other neurological disorders. The Company’s first development candidate (PRV-002) represents a breakthrough strategy for treating concussion working at the molecular level to simultaneously reduce inflammation, swelling, ischemic injury and oxidative stress.

About The Randy Travis FoundationThe Randy Travis Foundation is a charity dedicated to raising awareness for viral cardiomyopathy and providing arts and music enrichment for children. The two-part purpose connects a diverse group of people to support and find a cure for viral cardiomyopathy resulting in neurological damage along with providing opportunities for at-risk children to participate in arts and music programs. The foundation mission is to serve those affected by viral cardiomyopathy by facilitating research and support for individuals affected by the condition along with creating opportunities for involvement in enrichment programs for children.

About Concussion A concussion is a type of traumatic brain injury caused by a significant force to the head or upper body causing the brain to shake inside the skull. The injury is defined as a concussion when it causes a change in mental status such as amnesia, disorientation, mental fogginess, confusion, nausea/vomiting, blurred vision, headache, balance deficits or loss of consciousness. There are 21 symptoms demonstrated to be associated with concussion. Loss of consciousness does not indicate injury severity. Because no two concussions are exactly alike, effects and recovery are sometimes difficult to assess. Therefore the condition requires a compound that can work to reduce multiple pathological issues.

About PRV-002 PRV-002 is a fully synthetic non-naturally occurring neurosteroid administered through the nasal cavity. PRV-002 carries with it equivalent, if not superior, neuroprotective effects compared to related neurosteroids. Animal models of concussion demonstrated that PRV-002 reduces the behavioral pathology associated with brain injury symptoms such as memory impairment, anxiety, and motor/sensory performance. Additionally, PRV-002 is lipophilic and can easily cross the blood-brain barrier to rapidly eliminate swelling, oxidative stress and inflammation in the brain while restoring proper blood flow.

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Attorney general supports Montgomery County Veterans’ Treatment Court – Montgomery Newspapers

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NORRISTOWN >> Pennsylvanias top law enforcement officer showed his support for treatment courts during an appearance at Montgomery County Veterans Treatment Court shortly before the specialty courts latest graduation ceremony.

I am humbled by your service and grateful for your service, Attorney General Josh Shapiro, who is a former county commissioner, said Monday as he addressed veterans and the specialty courts organizers. I believe in problem solving courts and know how critical they are in our justice system and I believe in you.

Established in April 2011, the veterans treatment court addresses the needs of veterans cycling through the court and prison system. Judge Todd D. Eisenberg, who currently presides over veterans treatment court, held a graduation ceremony on Monday for four veterans who completed the program.

This is an exciting day here in veterans treatment court, said Eisenberg, who also was joined by recently Retired Judge William J. Furber Jr., who helped spearhead the development of the specialty court.

The veterans treatment court is a collaboration of the county judicial system, the district attorneys office, the public defender, the county jail, the adult probation office, community-based treatment providers and county and federal departments of Veterans Affairs.

Shapiro said Pennsylvania has 872,000 veterans, the fourth highest total in the U.S., and about 20 veterans treatment courts. He said one of his goals is to have more problem-solving courts available in all 67 counties in the state.

These problem-solving courts work, said Shapiro, characterizing them as a smart on crime approach.

Officials have said the specialty court has the goals of enhancing public safety and reducing recidivism rates among veterans who are charged with crimes. Under the program, veterans are connected with community treatment services through the U.S. Department of Veterans Affairs while receiving appropriate dispositions to their criminal charges.

The program, officials said, decreases time spent in jail by moving offenders expeditiously into appropriate treatment settings, promotes employment among the offenders and helps veteran defendants become productive members of their communities.

To be eligible, a veteran must suffer from traumatic brain injury, post-traumatic stress disorder, military sexual trauma or psychological or substance abuse problems that require treatment and which contributed to their crimes.

We know these issues can have a negative effect on veterans when they come home, Shapiro said.

Eligible offenders must agree to follow a court approved treatment plan and routinely meet with probation officials and the judge. When offenders are released from the court or prison system, Veterans Affairs officials are available to assist them.

Know that Im as committed to you as you are to yourself and your community, Shapiro addressed the veterans. I wish you all the very best. Were here for you.

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Five ways virtual reality is improving healthcare – The Independent

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Virtual reality is much more than just a new form of entertainment, it is increasingly being used in a wide range of medical applications, from treatments to training. Here are a few of them.

1. Pain management

There is good scientific evidence that virtual reality (VR) can help relieve pain. The parts of the brain that are linked to pain the somatosensory cortex and the insula are less active when a patient is immersed in virtual reality. In some instances, it can even help people tolerate medical procedures that are usually very painful.

Other studies have shown that amputees can benefit from VR therapy. Amputees often feel severe pain in their missing limb, which can be hard to treat with conventional methods, and often doesnt respond well to strong painkillers like codeine and morphine. However, a technique called virtual mirror therapy, which involves putting on a VR headset and controlling a virtual version of the absent limb,seems to help some patients cope better with this phantom pain.

2. Physical therapy

VR can be used to track body movements, allowing patients to use the movements of their therapy exercises as interactions in a VR game. For example, they may need to lift an arm above their head in order to catch a virtual ball.

Its more fun doing exercises in virtual reality than it is in a gym, so people are more motivated to exercise. It can help in other ways too. For example, we found that for patients who are anxious about walking, we can control their virtual environment so that it looks as though they are moving much slower than they actually are. When we do this, they naturally speed up their walking, but they dont realise they are doing it and so it isnt associated with pain or anxiety.

Virtual reality can be used in physical therapy (Wendy Powell)

Studying how people perceive and interact with VR systems helps us design better rehabilitation applications.

3. Fears and phobias

If you have an irrational fear of something, you might think the last thing you need is to see it in virtual reality. However, this is one of most established forms of medical VR treatment. Phobias are often treated with something called graded-exposure therapy, where patients are slowly introduced to their fear by a therapist. Virtual reality is perfect for this as it can be adjusted precisely for the needs of each patient, and can be done in the doctors office or even at home. This is being used to treat phobias such as fear of heights and fear of spiders, but also to help people recover from post-traumatic stress disorder (PTSD).

4. Cognitive rehabilitation

Patients with brain injury from trauma or illness, such as stroke, often struggle with the everyday tasks that we take for granted, such as shopping or making plans for the weekend. Recreating these tasks within virtual environments and allowing patients to practise them at increasing levels of complexity can speed up recovery and help patients regain a higher level of cognitive function.

Doctors can also use these same virtual environments as an assessment tool, observing patients carrying out a variety of real-world complex tasks and identifying areas of memory loss, reduced attention or difficulty with decision-making.

5. Training doctors and nurses

In the future your doctor may prescribe one of these (Shutterstock)

Virtual reality is, of course, not just for patients. It also offers benefits to healthcare professionals. Training doctors and nurses to carry out routine procedures is time-consuming, and training generally needs to be delivered by a busy and expensive professional. But virtual reality is increasingly being used to learn anatomy, practise operations and teach infection control.

Being immersed in a realistic simulation of a procedure and practising the steps and techniques is far better training than watching a video, or even standing in a crowded room watching an expert. With low-cost VR equipment, controllable, repeatable scenarios and instant feedback, we have a powerful new teaching tool that reaches well beyond the classroom.

Wendy Powell is a reader in virtual reality at University of Portsmouth. This article was originally published on The Conversation (

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Madras HC allows transgender’s plea for gender change in school records – Hindustan Times

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A transgender software engineer, who underwent sex reassignment surgery from female to male, would be able to change the sex as male in school and college records as the Madras High Court has issued a directive to this effect.

Justice Pushpa Sathyanarayana passed the order on a petition by the engineer, who was born a woman and named S Rekha Kaliamoorthy, seeking a direction to authorities to change the sex as male and name as K Gowtham Subramaniam in school/college and other records consequent to the surgery.

Rekha, as she was then known, passed out of Anna University with a B.E (computer science and engineering) degree in 2012 with distinction. She said though identified as a female at the time of birth, she had always felt and lived like a man.

She consulted a surgeon who advised hormone therapy followed by sex reassignment surgery. After completion of hormone replacement therapy and psychology test, she was issued a certificate stating that she was a transgender.

The petitioner then underwent sex reassignment surgery and changed the name to Gowtham Subramaniam. Subsequently, the name change was published in the Tamil Nadu government gazette and he got employed in a private company as a male.

Since his requests to authorities to change the name and sex in school and college records were not considered citing the absence of any precedent or provision, he moved the court.

Pulling up the officials, the judge said merely because the petitioner belongs to the third gender, he or she cannot be made to run from pillar to post on the ground that there were no rules available permitting such changes.

The petitioner had relevant medical certificates issued by doctors and hospital and authorities were expected to verify the records and make consequential changes, the judge said.

He has also produced sufficient documents to prove his identity and the authorities ought to have considered his application on merit. In fact, the authorities, in the nature of the present case, should readily extend their helping hand rather than denying the same looking down upon them, the judge said.

Necessary changes should be made within eight weeks, the judge ordered.

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Osteoarthritis is more common among women than men. Blame it on gender differences – Hindustan Times

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Osteoarthritis a disease of joints is reported more among women than men. According to experts, fluid in the knee holds clues why women are more prone to it. They have found in the synovial fluid of this joint, clear differences in the messages cells are sending and receiving via tiny pieces of RNA, called microRNA, in males and females with the common and debilitating condition osteoarthritis.

The differences may help explain why the disease is more common in women as it points toward a more targeted way to diagnose and treat this wear and tear arthritis, said Dr. Sadanand Fulzele, bone biologist in the Department of Orthopaedic Surgery at the Medical College of Georgia at Augusta University. Osteoarthritis, which affects more than 30 million Americans, is fundamentally a destruction of the cartilage that provides padding between our bones. In the past, obesity has also been considered a factor.

Its a huge problem, says Dr. Monte Hunter, chair of the MCG Department of Orthopaedic Surgery and a co-author of the study in the journal Scientific Reports. Todays treatment addresses symptoms, like inflammation and pain, and the bottom line for some patients is knee replacement. Synovial fluid is known to provide clues about joint health, so MCG researchers decided to look at what messages cells in the region were sending and receiving by looking inside travelling compartments in the fluid called exosomes, says Fulzele, corresponding author.

Men are less impacted by osteoarthritis than women and estrogen is a key factor for that. (Shutterstock)

What we found is there is no change in the number of exosomes, but a change in the microRNA cargo they carry, Fulzele says. They isolated the mostly round exosomes in discarded human synovial fluid from patients with and without osteoarthritis. They found in the males that 69 microRNAs were significantly downregulated and 45 were upregulated. In females, however there were 91 downregulated versus 53 upregulated.

Females just seemed more impacted: In total, they had more than 70 biological processes altered compared to males who had closer to 50, the researchers report. Fulzele and Hunter suspect that the gender differences they found in exosome content helps explain gender differences in disease incidence and that estrogen was key to the differences.

Particularly in the females, they found microRNA that should be sending messages that are good for the joints, like promoting estrogen signaling and collagen-producing cells, turned off or otherwise altered. Lower estrogen levels, like those that occur following menopause, prompt production of more cells that destroy bone. In this environment, those bone-consuming cells also tend to live longer, which can result in a net bone loss. Conversely, reduced osteoarthritis risk is considered a benefit of hormone replacement therapy.

MCG researchers hypothesize that estrogen plays an important role in determining which microRNAs the exosomes contain. In fact, when they used aromatase inhibitors to reduce the availability of estrogen, they found a small lineup of microRNAs decreased in number. When they treated cartilage cells from healthy females with exosomes from males and females with osteoarthritis, significantly fewer healthy cartilage cells lived after exposure to the exosomes from patients with disease.

All cells excrete exosomes as one way to communicate. They carry cargo like protein, lipids as well as microRNA, which can impact the expression and actions of many different genes. In the case of the synovial fluid, Fulzele says the exosome source is likely cells in the synovial membrane that lines the joints and produces the fluid. Wear and tear that comes with aging, and can be accelerated and aggravated by injury, can inflame the membrane, which may alter the cargo in the exosomes and the messages they carry, Fulzele says.

Knee replacement becomes the endgame for patients whose dwindling cartilage can literally translate to one bone rubbing against another. People understand bone on bone when they hear that, Hunter says of the potentially excruciating and debilitating pain that may result. Early interventions include icing a swollen knee, taking anti-inflammatories and avoiding activities that are hard on the joints, says Hunter.

Treatment for osteoarthritis addresses symptoms like inflammation and pain. (Shutterstock)

They can also inject hyaluronic acid, the major component of synovial fluid, into the knee in an attempt to normalize the environment. Today, a diagnosis is made based on the joint pain and stiffness patients report, a physical exam and X-ray. Physicians also often examine the synovial fluid, Hunter says. When a knee is swollen and warm to the touch, they will extract some of the fluid to look for problems other than wear and tear, like an infection and/or uric acid crystals, Hunter says.

The crystals could be an indicator of gout, a type of arthritis that results from the bodys reaction to excessive levels of uric acid, which results from the breakdown of purines, chemicals found in meat, poultry and seafood. Hunter hopes that soon he and his colleagues will also examine exosomes in the fluid for indicators of that patients specific instigators of cartilage destruction. They then hope to devise a cocktail potentially a mix of microRNA inhibitors and joint health promoting microRNA mimics delivered in manmade exosomes that can be injected into the knee to target and help resolve the debilitating destruction. MCG researchers already are exploring ways to block the microRNAs that are causing destruction.

While osteoarthritis is considered normal wear and tear, its multifactorial, says Hunter, the Dr. Charles Goodrich Henry and Carolyn Howell Henry Distinguished Chair at MCG. There is a genetic component. Some of us have stronger cartilage than others. Some of us are made differently so the angle of our joints puts more pressure in some places.

Risk factors include injury, overuse, increasing age, obesity, a family history, as well as being female, according to the Centers for Disease Control and Prevention. Sports with repetitive high impact, like running and basketball, can increase the risk.

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Osteoarthritis is more common among women than men. Blame it on gender differences – Hindustan Times

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