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Prime Minister Justin Trudeau says he’s excited about having two ministers teaming up on the Indigenous Affairs … – TheChronicleHerald.ca

Posted: August 29, 2017 at 7:45 am


TheChronicleHerald.ca
Prime Minister Justin Trudeau says he's excited about having two ministers teaming up on the Indigenous Affairs
TheChronicleHerald.ca
Canadian golfer Brooke Henderson finished tied for 12th at the CP Women's Open in Ottawa on Sunday. The 19-year-old from Smiths Falls, … Jadine Baldwin says some people don't see her as a person due to her cerebral palsy. Baldwin and another teen, …

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Prime Minister Justin Trudeau says he’s excited about having two ministers teaming up on the Indigenous Affairs … – TheChronicleHerald.ca

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FDA Cracks Down On Stem-Cell Clinics Selling Unapproved Treatments – NPR

Posted: at 7:44 am

Adult stem cells can be extracted from human fat. Patrick T. Fallon /The Washington Post/Getty Images hide caption

Adult stem cells can be extracted from human fat.

The Food and Drug Administration is cracking down on “unscrupulous” clinics selling unproven and potentially dangerous treatments involving stem cells.

Hundreds of clinics around the country have started selling stem cell therapies that supposedly use stem cells but have not been approved as safe and effective by the FDA, according to the agency.

“There are a small number of unscrupulous actors who have seized on the clinical promise of regenerative medicine, while exploiting the uncertainty, in order to make deceptive, and sometimes corrupt assurances to patients based on unproven and, in some cases, dangerously dubious products,” FDA Commissioner Scott Gottlieb said in a statement Monday.

The FDA has taken action against clinics in California and Florida.

The agency sent a warning letter to the US Stem Cell Clinic of Sunrise, Fla., and its chief scientific officer, Kristin Comella, for “marketing stem cell products without FDA approval and significant deviations from current good manufacturing practice requirements.”

The clinic is one of many around the country that claim to use stem cells derived from a person’s own fat to treat a variety of conditions, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and lung and heart diseases, the FDA says.

The Florida clinic had been previously linked to several cases of blindness caused by attempts to use fat stem cells to treat macular degeneration.

The FDA also said it has taken “decisive action” to “prevent the use of a potentially dangerous and unproven treatment” offered by StemImmune Inc. of San Diego, Calif., and administered to patients at California Stem Cell Treatment Centers in Rancho Mirage and Beverly Hills, Calif.

As part of that action, the U.S. Marshals Service seized five vials of live vaccinia virus vaccine that is supposed to be reserved for people at high risk for smallpox but was being used as part of a stem-cell treatment for cancer, according to the FDA. “The unproven and potentially dangerous treatment was being injected intravenously and directly into patients’ tumors,” according to an FDA statement.

Smallpox essentially has been eradicated from the planet, but samples are kept in reserve in the U.S. and Russia, and vaccines are kept on hand as a result.

But Elliot Lander, medical director of the California Stem Cell Treatment Centers, denounced the FDA’s actions in an interview with Shots.

“I think it’s egregious,” Lander says. “I think they made a mistake. I’m really baffled by this.”

While his clinics do charge some patients for treatments that use stem cells derived from fat, Lander says, none of the cancer patients were charged and the treatments were administered as part of a carefully designed research study.

“Nobody was charged a single penny,” Lander says. “We’re just trying to move the field forward.”

In a written statement, U.S. Stem Cell also defended its activities.

“The safety and health of our patients are our number one priority and the strict standards that we have in place follow the laws of the Food and Drug Administration,” according to the statement.

“We have helped thousands of patients harness their own healing potential,” the statement says. “It would be a mistake to limit these therapies from patients who need them when we are adhering to top industry standards.”

But stem-cell researchers praised the FDA’s actions.

“This is spectacular,” says George Daley, dean of the Harvard Medical School and a leading stem-cell researcher. “This is the right thing to do.”

Daley praised the FDA’s promise to provide clear guidance soon for vetting legitimate stem-cell therapies while cracking down on “snake-oil salesmen” marketing unproven treatments.

Stem-cell research is “a major revolution in medicine. It’s bound to ultimately deliver cures,” Daley says. “But it’s so early in the field,” he adds. “Unfortunately, there are unscrupulous practitioners and clinics that are marketing therapies to patients, often at great expense, that haven’t been proven to work and may be unsafe.”

Others agreed.

“I see this is a major, positive step by the FDA,” says Paul Knoepfler, a professor of cell biology at the University of of California, Davis, who has documented the proliferation of stem-cell clinics.

“I’m hoping that this signals a historic shift by the FDA to tackle the big problem of stem-cell clinics selling unapproved and sometimes dangerous stem cell “treatments” that may not be real treatments,” Knoepfler says.

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ICMR’s stem cell research guidelines soon to be released – ETHealthworld.com

Posted: at 7:44 am

Representative imageBy Priyanka V Gupta

New Delhi: Indian Council of Medical Research (ICMR) will soon release the final document on guidelines for stem cell research, the draft of which was available on the ICMR and the DBT (Department of Biotechnology) websites for public reviews till July 31 this year. The guidelines are expected to help in curbing the unethical practices in regenerative medicine. The information was shared by Dr Geeta Jotwani, deputy director general, ICMR, at a recent event where MoU was signed between ABLE (Association of Biotechnology Led Enterprise) and FIRM (Forum for Innovative Regenerative Medicine) for industry research collaborations.

Dr Jotwani said, On the directives of DCGI (Drug Controller General of India), ICMR has been framing the guidelines for stem cell research and therapy since 2001. Unfortunately, there is no therapy available other than bone marrow transplantation, for which also no standard of care has been laid out. In that direction, we have been making periodic efforts by releasing the guideline documents in 2002, 2007, 2013 and now the updated documentation for 2017 is under finalization.

ICMR has been proactively working towards educating the stakeholders about the ethical practices in stem cell research and therapy, for which a special committee, called National Apex Committee for Stem Cell Research and Therapy (NAC-SCRT), has been formed to advise the scientists community. Regenerative medicine is an innovative science. As part of ICMR, more research is involved than getting into conclusion that we are ready for application. We are proactively making efforts to educate, create awareness and give directions to our scientists community and clinicians on how they should go about the research part of stem cell therapy, said Dr Jotwani.

There are many clinicians entering into unethical practices and promising general public about the available care in almost all sorts of incurable conditions, including autism, according to Dr Jotwani.

She said, We are always concerned about what the end users are getting and the promises that are being made to them. Hence, we are proactively being involved in interacting with different government agencies as well as the industry to curb the unethical practices for which we also established NAC-SCRT under the Department of Health Research, Government of India. The committee, which comprises of different government agencies as well as ethics and social groups, legal experts, representatives of drug controllers office and CDSCO (Central Drug Standard Control Organization), deliberates on the issues of upcoming technologies and takes proactive role in the regenerative medicine.

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Bone Marrow Protein May Be Target for Improving Stem Cell Transplants – Penn: Office of University Communications

Posted: at 7:44 am

Bone marrow contains hematopoetic stem cells, the precursors to every blood cell type. These cells spring into action following bone marrow transplants, bone marrow injury and during systemic infection, creating new blood cells, including immune cells, in a process known as hematopoiesis.

A new study led by University of Pennsylvania and Technical University of Dresden scientists has identified an important regulator of this process, a protein called Del-1. Targeting it, the researchers noted, could be an effective way to improve stem cell transplants for both donors and recipients. There may also be ways to modulate levels of Del-1 in patients with certain blood cancers to enhance immune cell production. The findings are reported this week in The Journal of Clinical Investigation.

Because the hematopoetic stem cell niche is so important for the creation of bone marrow and blood cells and because Del-1 is a soluble protein and is easily manipulated, one can see that it could be a target in many potential applications, said George Hajishengallis, the Thomas W. Evans Centennial Professor in the Department of Microbiology in Penns School of Dental Medicine and a senior author on the work.

I think that Del-1 represents a major regulator of the hematopoetic stem cell niche, said Triantafyllos Chavakis, co-senior author on the study and a professor at the Technical University of Dresden. It will be worthwhile to study its expression in the context of hematopoetic malignancy.

For Hajishengallis, the route to studying Del-1 in the bone marrow began in his field of dental medicine. Working with Chavakis, he had identified Del-1 as a potential drug target for gum disease after finding that it prevents inflammatory cells from moving into the gums.

Both scientists and their labs had discovered that Del-1 was also expressed in the bone marrow and began following up to see what its function was there.

In the beginning, I thought it would have a simple function, like regulating the exit of mature leukocytes [white blood cells] from the marrow into the periphery, Hajishengallis said, something analogous to what it was doing in the gingiva. But it turned out it had a much more important and global role than what I had imagined.

The researchers investigations revealed that Del-1 was expressed by at least three cell types in the bone marrow that support hematopoetic stem cells: endothelial cells, CAR cells and osteoblasts. Using mice deficient in Del-1, they found that the protein promotes proliferation and differentiation of hematopoetic stem cells, sending more of these progenitor cells down a path toward becoming myeloid cells, such as macrophages and neutrophils, rather than lymphocytes, such as T cells and B cells.

In bone marrow transplant experiments, the team discovered that the presence of Del-1 in recipient bone marrow is required for the transplanted stem cells to engraft in the recipient and to facilitate the process of myelopoesis, the production of myeloid cells.

When the researchers mimicked a systemic infection in mice, animals deficient in Del-1 were slower to begin making myeloid cells again compared to those with normal Del-1 levels.

We saw roles for Del-1 in both steady state and emergency conditions, Hajishengallis said.

Hajishengallis, Chavakis and their colleagues identified the protein on hematopoetic stem cells with which Del-1 interacts, the 3 integrin, perhaps pointing to a target for therapeutic interventions down the line.

The scientists see potential applications in bone marrow and stem cell transplants, for both donors and recipients. In donors, blocking the interaction between Del-1 and hematopoetic stem cells could enhance the mobilization of those progenitors into the bloodstream. This could be helpful for increasing donor cell numbers for transplantation. Transplant recipients, on the other hand, may need enhanced Del-1 interaction to ensure the transplanted cells engraft and begin making new blood cells more rapidly.

In addition, people undergoing chemotherapy who develop febrile neutropenia, associated with low levels of white blood cells, might benefit from the role of Del-1 in supporting the production of immune-related blood cells such as neutrophils.

Its easy to think of practical applications for these findings, said Hajishengallis. Now we need to find out whether it works in practice, so our studies continue.

Ioannis Mitroulis, Lan-Sun Chen and Rashim Pal Singh of TU-Dresden were co-lead authors on the study, and Ben Wielockx of TU-Dresden was a co-senior author along with Hajishengallis and Chavakis. They were joined by coauthors Tetsuhiro Kajikawa, Kavita Hosur, Tomoki Maekawa and Baomei Wang of Penn Dental Medicine; Ioannis Kourtzelis, Matina Economopoulou, Maria Troullinaki, Athanasios Ziogas, Klara Ruppova, Pallavi Subramanian, Panayotis Verginis, Malte Wobus, Martin Bornhuser and Tatyana Grinenko of TU-Dresden; Torsten Tonn of the German Red Cross Blood Donation Service in Dresden; and Marianna Di Scala and Andrs Hidalgo of the Spanish National Center for Cardiovascular Research.

The study was supported by the Deutsche Forschungsgemeinschaft, European Commission, European Research Council and National Institutes of Health (grants AI068730, DE024153, DE024716, DE0152 54 and DE026152).

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It’s Not a Rat’s Race for Human Stem Cells Grafted to Repair Spinal Cord Injuries – UC San Diego Health

Posted: at 7:44 am

More than one-and-a-half years after implantation, researchers at University of California San Diego School of Medicine and the San Diego Veterans Administration Medical Center report that human neural stem cells (NSCs) grafted into spinal cord injuries in laboratory rats displayed continued growth and maturity, with functional recovery beginning one year after grafting.

The findings are published in the September issue of the Journal of Clinical Investigation.

The NSCs retained an intrinsic human rate of maturation despite being placed in a traumatic rodent environment, said Paul Lu, PhD, associate professor of neurosciences and lead author of the study. Thats a finding of great importance in planning for human clinical trials.

Neural stem cells differentiate into neurons and glia or support cells. Researchers like Lu and colleague, Mark Tuszynski, MD, PhD, professor of neuroscience and director of the UC San Diego Translational Neuroscience Institute, have explored their potential as a sort of patch and remedy for spinal cord injuries, implanting NSCs derived from induced pluripotent stem cells into animal models of spinal cord injuries to repair damage. In previously published animal studies, Lu and Tuszynski have shown NSCs can survive implantation and make new connections, even beginning to restore limited physical function, such as foot movement, that had been lost to paralyzing injury.

But major questions remained: At what rate do the NSCs mature? And for how long? Rat biology works at a much faster pace than human. The gestational period for a human is 280 days; for a rat, its 21. The brain of a 2- or 3-year-old human child is comparable in body/brain weight ratios to a 20-day-old rat. It was possible that human NSCs in animal models would not accurately reflect functioning in future human patients.

Most NSC grafting studies have been short-term, measuring survival times in weeks to a few months, said Tuszynski. Thats not enough time to fully measure the growth and maturation rate of human NSCs or what changes might occur farther out from the original grafting. These are important considerations, not just for the basic science of stem cell biology, but for the practical design of translational human trials using NSCs for spinal cord injuries. We need to better understand the long-term nature and time course so that we can accurately assess results and success.

Lu and colleagues used the widely available, well-characterized H9 human NSC line derived from human embryonic stem cells. The H9 NSCs were modified to express green fluorescent protein and embedded in fibrin matrices containing a growth factor cocktail. The matrices were then transplanted into spinal cord lesions of immunodeficient rats two weeks after injury, which had impaired functioning of the forelimb. Control rats underwent a similar process, but without the NSCs.

The scientists then monitored growth and development of the implanted grafts over time, noting significant early, unrefined growth followed by the appearance of markers indicating maturing nerve cells after several months. As the grafts aged, the cells continued to display gradual, normal development processes, including natural pruning and redistribution to focus development on fewer but more mature cells.

To our surprise, we found evidence of continued stem cell maturation throughout the period, said Lu. It was clear that these neural stem cells retained their intrinsic maturation programs despite a prolonged presence in a challenging environment. The recovery of forelimb function in the rats supports the basic therapeutic idea, but importantly, improvement occurred only after mature cell markers of both neuronal and glial lineages were expressed.

The lengthy study reported other findings of note: Implanted NSCs did not migrate from their lesion sites, but supportive astrocytes did, a potential safety concern. However, the scientists did not observe any adverse effects from glial outgrowth, such as tumor formation or deterioration of forelimb function over time. Tuszynski said modified grafting procedures could minimize cell leakage.

The bottom line is that clinical outcome measures for future trials need to be focused on long time points after grafting, said Tuszynski. Reliance on short time points for primary outcome measures may produce misleadingly negative interpretation of results. We need to take into account the prolonged developmental biology of neural stem cells. Success, it would seem, will take time.

Co-authors of this study are: Steven Ceto, Yaozhi Wang, Lori Graham, Di Wu, Hiromi Kumamaru, and Eileen Staufenberg, all at UC San Diego.

Funding for this research came, in part, from the Veterans Administration, the National Institutes of Health (NS09881, EB014986), the Craig H. Neilsen Foundation, the California Institute for Regenerative Medicine, the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation and the Bernard and Anne Spitzer Charitable Trust.

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Lynchburg fire captain spearheads calendar featuring ladies of the LFD – Lynchburg News and Advance

Posted: at 7:43 am

Endurance, strength, enthusiasm, persistence those are some of the key themes of the retro-styled Women of the Lynchburg Fire Department calendar that will bring some Lynchburg firefighting flair to peoples walls in 2018 and 2019.

Abbey Johnston, a captain whos been with the Lynchburg Fire Department for 13 years, said the 18-month calendar hits a number of highlights for the department. For one, she said its the first time the department has had enough women to feature in a calendar all 14 who were employed at the time of the photo shoots are included in the calendar. Two more have joined the department since.

Not everyone was all in for the calendar at first, though. Johnston said some firefighters or their families had reservations about the proposed pin-up nature of the photos. But, as Johnston assured them, the pictures would be fashionable and feminine, yet classy, with a retro, 1950s feel.

We wanted it to be respectful, she said. We wanted it to focus on strength, the different strengths that it takes to do the job, and to be honorable to all of our members: retired and current, male and female.

Other women featured in the calendar include administrative personnel and three women whove retired from the department.

One of those is Linda Eagle, the first woman to sign on with the fire department in 1980 after taking an EMT course and developing an interest in working there. Then in her early 20s, Eagle said a number of the older men who had been fighting fires for years met her with contempt, and she was a little intimidated to tread new ground at the time.

I think theyre a whole lot more accepting now than they were then, she said. It was a new thing and they didnt know how to really act and talk around the women.

She said some thought the physical demands of the job were too much for a woman to handle.

Other women had joined the department by the mid-80s when Eagle was transitioning from work in the Fire Marshals Office to the line, and she recalled a discussion with the chief about the departments social dynamic with women now in the mix.

Looking back on it now, it seemed kind of ridiculous, but they didnt know what to expect, she said. I think the perception of women has changed in the fire service. Its gotten a lot better.

The calendar also celebrates the Lynchburg Fire Departments 135th anniversary by featuring fire department relics dating back to the 1800s things like old equipment and helmets or a horse-drawn truck.

Johnston consulted with former firefighter Rod Smith to pick out and coordinate how the relics would be worked into the calendar and some pieces hadnt seen the light of day in quite a while. For some photos, she also touched base with individuals and businesses to arrange for horses and a Dalmatian to be brought into the shot and complete the classic firefighting tableau.

I kind of looked at [the firefighters] personalities and their requests … and matched them up with settings and tools that would really show who they are, she said.

Many of the photos were shot in public places around the city, but Johnston said they made sure only historical structures were pictured to fit in with the feel of the pictures.

Johnston said the prime motivation for setting the calendar plans in motion last spring was the medical diagnosis and resulting retirement of fellow firefighter David Cox.

Cox has been an avid supporter of the LFDs fundraising efforts as a Muscular Dystrophy Association partner through the International Association of Firefighters, she said. The department holds a Fill the Boot campaign at area businesses every year, and Johnston has coordinated LFDs collections for the Muscular Dystrophy Association since 2010.

Cox was diagnosed with Myasthenia Gravis, a rare disease that affects muscle control and strength, in the spring, and friends and family have set up GoFundMe accounts to help with continuing treatment. Johnston said the idea to boost Muscular Dystrophy Association fundraising with sales of the calendar was formed with Cox in mind.

Hes this guy whos spent almost a decade and a half going out every year filling the boot and then hes diagnosed with this debilitating neuromuscular disease, she said. So this year, I wanted to step up our collections, our efforts, in honor of Dave.

For each $20 calendar sold, Johnston said $16 will go straight to the Muscular Dystrophy Association, while the remaining $4 will be recouped for the cost of printing.

A number of businesses and professionals in the city lent a helping hand to the project: Bee Line Transport offered to tow the antique vehicles into place for free; Lynchburg City Communications & Marketing personnel helped with graphic design work for the calendar; Bison Printing in Bedford offered discounted and deferred-cost printing; and Rhiannon Kathleen Studios took the photos pro bono in June and July.

The firefighters themselves have taken on organizing sales and shipping of the calendars themselves in their spare time, Johnston said.

Emily Harris, manager of Body Works Day Spa and Salon, said this was the first large-scale professional venture shed set out on with Johnston, a longtime friend. With Johnstons retro vision and the cause behind the calendar, Harris said she was on board immediately to offer her skills as a stylist to the project, free of charge.

The firefighters would turn up at her door at 6 and 7 a.m. for hair and makeup prior to the photo staging some of them after their 24-hour shifts on the job. While pampering and dolling them up, Harris said shed hear stories about their duties and methods of coping when the job gets tough.

It was really psychologically a great experience and I can now say that Ive met every single female firefighter in Lynchburg, she said. I would say theyre kind of trailblazers I didnt realize the history was so young.

Harris said Johnston came to the planning table armed to the nines with spreadsheets and schedules, and the other women of the LFD showed their professionalism throughout the process with their diligence and punctuality.

It was the most well-oiled machine Ive ever experienced, and that is not an exaggeration, she said.

When someone sees the women of the LFD sitting on an old fashioned fire truck in the calendar, Johnston said she wants them to see the sense of family that exists in the department and recognize the diversity of those that work there, knowing that firefighters are from all different walks of life.

On some level, we hope that itll be a good representation to young women to other people in the community, male and female alike, that it takes all different ages, body types and talents to do the job we do, she said. I think people have in their mind that everybody looks like somebody off the Chicago Fire [TV show] and thats just not true.

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Clinic helps Lily walk – Bendigo Advertiser

Posted: August 28, 2017 at 11:44 am

Every six months, Bendigos Lily-Rose Sparkes dons a happy mask.

ALL SMILES: Five-year-old Lily-Rose Sparkes with Associate Professor Adam Scheinberg at Bendigo Health. Picture: DARREN HOWE

Lily-Rose Sparkes, 5, with Associate Professor Adam Scheinberg. Picture: DARREN HOWE

Lily-Rose Sparkes, 5, with Associate Professor Adam Scheinberg. Picture: DARREN HOWE

Lily-Rose Sparkes, 5, with Associate Professor Adam Scheinberg. Picture: DARREN HOWE

Every six months, BendigosLily-Rose Sparkes dons a happy mask as she undergoes treatment to allow her to walk properly.

The bubblyfive-year-old says as she goeson tippy toes she has to visit the hospital, where doctors give her a mask for happy gas and follow through with a series of injections in her calves to help her walk.

Lily has cerebral palsy and has been receivingbotulinum toxintreatments since she was two years old.

Mum,Mia Smith, said they first realised Lily was having trouble about six months after she started to walk.

Without this treatment, she wouldnt be able to walk correctly, she said.

She would be always walking on her tippy toes and wouldnt be able to climb or do some of the basic things people think kids can just do.

Ms Smith said the treatments gave Lilythe opportunity to be able to take part in life as a child socially and academically at a normal standard.

Lily is one of about 15 children receiving treatments through a clinic at Bendigo Health.

Typically, the patients are between three to seven years old and have cerebral palsy, but the clinic also seesothers with brain injuries.

Ms Smith said Lily had a great team of health professionals helping her in her journey.

Weve got about six different people but theyre all linked in with each other, which we find amazing because they all speak to each other, she said.

There are a lot of other children [that have cerebral palsy] who dont have the opportunities like we do, that don’t have a full blown team thats linked in together.

About 30 patients have been through the clinic in its three-year history and Victorian Paediatric Rehabilitation Service statewide medical director Adam Scheinberg said it was incredibly important for a childs development.

Without the treatment the muscles become almost frozen, incredibly stiff and that can inhibit the way they walk, he said.

They can end up with whats called contracturesor permanent stiffening of the joints and that can also lead to problems like arthritis.

Associate Professor Scheinberg said having the clinic visit Bendigo Health once a monthmeant children didnt have to travel toThe Royal Childrens Hospital in Melbourne.

The treatment is typically given every six to 12 months during the first five to 10 years of life, so its a lot of trips saved, he said.

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A New Way for Doctors to Share Their Medical Mysteries – WIRED

Posted: at 11:44 am

In Gerald Grants line of work, there isnt such a thing as an average patient. As a chief of pediatric neurosurgery at Stanford University Medical Center, the children that come into his operating room are unique, each requiring a complex surgical procedure tailored to the architecture of a young brain.

But that doesnt mean he cant learn from what other people have done. Grants always searching for similar cases to give his patients the best possible shot. And more and more hes finding those answers not in prestigious, paywalled publications like the Journal of Neurosurgery (of whose editorial board he is a member), but on the freely available pages of an upstart publishing platform modeled after, of all things, Turbotax.

The Cureus Journal of Medical Science (thats pronounced curious) is the brainchild of one of Grants colleagues at Stanford, a fellow neurosurgeon named John Adler. Hes on a mission to build the worlds most comprehensive library of medical case studies. Cureus is the first and only peer-reviewed publication with step-by-step article templates for authorswhich dramatically speeds up publication times. (Just like your tax software!) If case studies are published in weeks instead of months, that means millions more medical lessons to learn from.

The science of medicine is all about power in numbers. Big cohorts, long-term trials, and lots of money ensure that most treatments will work for most people with a disease. But the practice of medicine is all about individuals. And case reportsdetailed accounts of an individual patients symptoms, diagnosis, and treatment responseare, by definition, outliers. So theres a healthy (and long-standing) debate about where in the hierarchy of evidence they should sit.

Practicing physicians like Grant and Adler tend to argue for the educational value of case reports. What seems like a one-off might actually fall into a patternbut how will anyone know if no one writes it down? Most case reports are undocumented beyond just two surgeons talking over a scrub sink, says Adler. Not enough of those stories get told. Biomedical researchers and subscription-based journal editors tend to spurn case reports, in no small part because of how rarely they get cited. Paywalled journals, like dead tree newspapers, only have so much space to print articles. And they want to make every column count.

But the digitization of peer-reviewed publishing is changing that. Since 2011, the number of journals that focus on case reports has tripled. Thirty years ago we didnt have ways to do it, says Adler. But now we have control over the floodgates. Most case report journals are open accessmeaning the articles arent behind a paywall. Instead, the authors pay a publishing fee, usually a few thousand dollars, to cover editors salaries and other overhead expenses.

As WIRED has covered, this model is easily and often exploited by predatory publishers, companies that solicit authors directly, collect their fees, and then dont follow through with promises of proper peer-review and article indexing. According to Katherine Akers, a biomedical research specialist at Wayne State University and editor in chief of the Journal of the Medical Library Association, approximately half of the publishers of medical case report journals engage in predatory practices. Thats why she tends to view any new publications, including Cureus, with a healthy dose of skepticism. For the most part, this one actually looks okay, she says, noting that Cureus is totally fee-free and indexed in PubMedthe database most used by biomedical researchers to find interesting papers relevant to their interests.

But there is one red flag.

For most reputable biomedical journals, the process of reviewing an article takes about three hours. Cureus boasts that with its easy-to-use form, reviews take no more than an hour to complete. Thats really fast, says Akers. Usually thats a warning sign that these articles arent being looked at that rigorously. Cureus says its review process only verifies the basic scientific credibility of a report. And Grant agreed that the bar to peer review might indeed be a little bit lower on Cureus than elsewhere. But when it comes to case reports, he says that might actually be OK.

In our world, were missing a lot of the science because so many journals dont see case reports as publishable, says Grant. But these rare one-offs could become really interesting if they were all reported, instead of just passed around by word of mouth. I dont think it dilutes the literature at all.

Adler, with his goal of publishing tens of millions of articles a year on Cureus, is obviously ambivalent on the dilution question. But thats because his team built another tool for telling the good from the bad. Once a paper has been published, any of the platforms 10,000-some users can leave comments and rate the papers quality and clinical significance on a scale of one to ten. The idea, Adler says, is not unlike estimating the number of marbles in a jar. If you ask a few people to guess, you get wildly different numbers. But ask enough people you eventually wind up with an average thats close to the real answer.

With enough data, Cureus could be more than just a publishing platform: It could become a prediction engine. Because case reports are mostly about rare, isolated events, it can take years, even decades to find patterns. Adler envisions his crowd-sourced metric as a way to arrive at that answer sooner.

But to do that, he needs a lot more articles, and a lot more data. Since launching in December of 2012, Cureus has published about 1,600 articles, and it currently publishes about 25 per week. At that rate, it will take more than 100 years to hit 1 million reports. And its hard to get doctors to spend as much time rating reports as they do liking Facebook posts and Twitter threads. Right now less than 60 percent of Cureus articles have been rated more than once.

On the other hand, articles dont need upvotes to be useful in operating rooms. A few months ago, a family brought their 13-year-old daughter in to see Grant. She was suffering from cerebral palsy; Her muscles were in a near constant state of contraction because of a missed connection between sensory nerves in the spinal cord and the brain. Grant realized the best course of action was probably a procedure called a selective dorsal rhizotomy, which would require him to separate out the nerves that worked from the ones that were misfiring, and then cut out only the dysfunctional ones. But because its so invasive (and expensive), he wanted to make sure the effects would last long after the operation.

So he logged on to Cureus. Doctors at the Washington University School of Medicine in St. Louis, he found, had performed the same procedure on 94 patients between the years 1989 and 1999. And they followed up with them 20 years later. Nearly 90 percent of the patients said theyd recommend the procedure; they could move better, they had less pain, and the effects were indeed long lasting. That kind of data is hard to get into a high impact journal, says Grant. But in the clinic, this is the kind of stuff my patients are asking me. These are practical questions. And these reports are able to address them.

Grant performed the surgery. And so far, his patient is doing very well.

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UT Southwestern Research Reveals Dual Benefits in Vitamin C for Cell Function, Cancer Prevention – D Healthcare Daily

Posted: at 11:42 am

Childrens Medical Center Research Institute at UT Southwestern researchers have discovered that stem cells absorb unusually high levels of vitamin C, which reportedly regulate function and suppress the development of leukemia.

While research currently shows people with lower levels of vitamin C are at increased risk for cancer, this study indicated why vitamin C is inherently important for the blood-forming system by routinely measuring metabolite levels in stem cell populations.

The techniques used in the study led researchers to find that every type of blood-forming cell in the bone marrow had distinct metabolic signaturestaking up and using nutrients in their own individual way. To further understand vitamin Cs importance in stem cell function, researchers tested mice that lacked the enzyme used to synthesize vitamin C in order to see its effects when added.

According to the research, scientists controlled the vitamin C intake on mice so that they could only obtain the supplement exclusively through their diet, like humans do. They tested mice absorbing vitamin C levels seen in 5 percent of healthy humans. To the researchers surprise, the depletion of vitamin C meant the stem cells gained function, but also increased the mices chances of leukemia.

Dr. Michalis Agathocleous, lead author of the study, said stem cells use vitamin C to regulate chemical modifications on DNA, which turn genes on and off. When stem cells dont receive enough vitamin C, these [DNA-regulating mechanisms] can become damaged in a way that increases stem cell function but also increases the risk of leukemia. Thus, if humans take up more vitamin C than normal, this will regulate and stabilize stem cell function and suppress the chances to develop leukemia.

Researchers plan to use the techniques to find other metabolic pathways that control stem cell function and cancer development, and further explore vitamin Cs role in stem cell function and tissue regeneration.

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What is brain pressure? Symptoms of life-threatening intracranial hypertension revealed – Express.co.uk

Posted: at 11:41 am

Chronic IH can result in a blood clot on the brain, a brain tumour, a brain infection or a blood clot on the brain.

It can be life threatening if it is not diagnosed or treated.

Idiopathic Intracranial Hypertension – also known as IIH mainly affects women in their 20s and 30s and has been linked to being overweight, hormone problems such as Cushings syndrome, taking the contraceptive pill, lack of red blood cells, lupus and kidney disease.

The cause of the condition is unclear.

Symptoms of chronic IH can include a constant headache – which can be worse in the morning and can occur while coughing, blurred or double vision, temporary loss of vision, feeling and being sick, drowsiness and irritability.

If IH comes on suddenly, it could be as a result of stroke, severe head injury, or a brain abscess.

Scientists have now discovered common obesity and diabetes drug reduces rise in brain pressure.

New research

Research led by the University of Birmingham, published in Science Translational Medicine, has discovered that a drug commonly used to treat patients with either obesity or Type 2 diabetes could be used as a new new way to lower brain pressure.

IHH causes disabling daily headaches and severely raised pressure around the nerves in the eye. It also causes permanent vision loss in 25 per cent of untreated people.

Over three years, researchers at the University of Birmingham examined whether GLP-1 agonist drugs – existing drugs used in the treatment of diabetes and obesity – could reduce intracranial pressure in an animal model of raised brain pressure.

Treatments to lower brain pressure are lacking and new treatments are desperately needed, said Dr Alexandra Sinclair, of the University of Birmingham’s Institute of Metabolism and Systems Research.

The current primary treatment in IIH is acetazolamide and this does not work well for many patients, while also having such severe side effects that our previous trials have shown that 48 per cent of patients stop taking it.

We have shown that the GLP-1 agonist extendin-4 significantly reduces brain pressure rapidly and dramatically, by around 44 per cent with significant effects from just ten minutes of dosing the biggest reduction we have seen in anything we have previously tested.

“Whats more, we found that the effects last at least 24 hours.

These findings are rapidly translatable into a new novel treatment strategy for IIH as GLP-1 agonists are safe and widely-used drugs used to treat diabetes and obesity.

They are also potentially game-changing for other conditions featuring raised brain pressure, including stroke, hydrocephalus and traumatic brain injury.

We are very excited that this novel treatment strategy could make a landmark change for future patient care.

The findings are due to be presented on September 8th and 9th in Vancouver at the International Headache Society Meeting, followed by the British Endocrine Society meeting in the UK.

The University of Birmingham is now due to begin a clinical trial to test GLP-1 agonist drug in patients with raised brain pressure.

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