Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, February 19, 2018

Cesarean Section's Unforeseen Consequences

"At the moment, breast-feeding is the best and safest way to expose babies born by cesarean to their mother's bacteria."
"Breast milk contains many of the same beneficial bacteria found in a woman's vagina."
"Even small amounts of formula supplementation [can shift the microbiota away from a breast-fed pattern."
Dr. Suchitra Hourigan, pediatric gastoenterologist, director, Inova Translational Medicine Institute, Falls Church, Virginia

"In vaginally-born babies, the bacteria destined for the gut microbiota originate primarily in the maternal birth canal and rectum. Once these bacteria are swallowed by the newborn, they travel through the stomach and colonize the upper and lower intestine, a complicated process that evolves rapidly."
"Infants born by cesarean section—particularly cesareans performed before labor begins—don’t encounter the bacteria of the birth canal and maternal rectum. (If a cesarean is performed during labor the infant may be exposed to these bacteria, but to a lesser degree than in vaginal birth.) Instead, bacteria from the skin and hospital environment quickly populate the bowel. As a result, the bacteria inhabiting the lower intestine following a cesarean birth can differ significantly from those found in the vaginally-born baby."
Dr. Mark Sloan, pediatrician, author of Birth Day: A Pediatrician Explores the Science, the History and the Wonder of Childbirth
Baby born by caesarean section
Babies born by caesarean section have different gut bacteria to those born conventionally   Lesley Magno/Getty
A Danish study of two million children who were born in the years between 1977 and 2012 concluded that the children born by cesarean delivery were more significantly prone to development of asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies and leukemia. It is well known that babies fed on their mother's breast milk have a certain immunity to some childhood disorders, but this more widespread connection to serious health complications is something else altogether.

There exists now a number of studies that emphatically suggest cesarean deliveries and limited breast-feeding have the potential to completely disturb microorganisms present in a baby's intestines, going some way to explaining the problematical rise of troubling health conditions arising in children and adults; problems inclusive of asthma, allergies, celiac disease, Type 2 diabetes, and obesity. A move to persuade more mothers to set aside plans for cesarean deliveries and to breast feed exclusively for the first six months of a baby's life to ensure the transference of vital bacteria is now underway.

The issue of the bacterial organisms present in an infant's gut is critical for their capacity to perform necessary functions including digesting unused nutrients, producing vitamins, stimulating normal immune development, counteracting the presence of harmful bacterial, along with fostering maturation of the gut. While in utero, babies are exposed to some of these organisms, but it is those encountered during the birth process and the first months of life that have the greatest influence on babies' health futures resulting from their permanent status in the gut.

Vaginally delivered babies acquire the microbes inhabiting their mother's vagina and bowel, while babies surgically delivered before membranes rupture and labor begins, then acquire microbes for the most part from their mother's skin -- as well as from the personnel and environment present in the newborn nursery. In the performance of an emergency cesarean once membranes have ruptured and labor has been initiated, the baby acquires more of the mother's microbes in this scenario, but still vastly less than it would when a vaginal birth takes place.

According to a study that took place in Finland and was published in 2005, these critical differences in the gut microbiota persisted in children until at minimum seven years of age.  In an effort to amend the situation and make up for the differences in gut microbiota resulting from a scheduled surgical birth, women have been encouraged to ensure that medical staff transfer microbes from the mother's vagina to their infants following birth, with some women undertaking that transfer of the microbe exchanges on their own.

The practise, known as vaginal seeding, has earned a huge cautionary note by an expert committee of the American College of Obstetricians and Gynecologists; that the practise is premature and quite possibly dangerous. The potential risk of transferring pathogenic organisms from mother to neonate was cited by the committee.

asthma
Creative Commons
photo by hemangi28
The evolutionary norm represents a twinning of gut microbiota acquired during normal vaginal birth so that when the microbiota is compositionally unbalanced, or germs such as Clostridium difficile are present, the immune system reacts. This results in a low-grade, long-lasting inflammatory response targeting intruders from birth forward, which can lead to "leakiness" of the intestinal lining, weakening it.

 The normal process of absorbing proteins and carbohydrates from intestinal contents, with the inclusion of incompletely-digested food molecules make their way instead into the infant's bloodstream. It is the resulting inflammation along withe abnormal processing of food that apparently increases the risk of developing asthma and eczema, as well as diabetes and other chronic health conditions, as the infant matures into adulthood.
  • Probiotics. Though administering healthful probiotic bacteria to correct an imbalanced microbiota makes intuitive sense, studies to date have been disappointing, with only minor, short-lived changes changes to the gut microbiota. However, research into “good” bacteria and how they become established in the intestine is active and ongoing.
  • Direct transfer of maternal secretions. Placing maternal vaginal and rectal material into the newborn’s mouth has been proposed—more or less mimicking natural colonization—but to date there are no published studies to support the practice.
  • Fecal transplantation. Direct transfer of fecal material from healthy adults into the gastrointestinal tracts of people suffering from Clostridium difficile infections has shown promise. Could healthy parents serve as “donors” for their babies? Applying such technology to otherwise healthy newborns is highly impractical at present, to say the least. Still, refinements may someday make this a viable option.
iStock_000064266035_Large.jpg
Mom and baby share a lot, including their microbial ecosystems. (Halfpoint/iStock)


 

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Sunday, February 18, 2018

"The whole species is essentially female," Mutant Clones : Procambarus virginalis

"It's extremely impressive. Three of us once caught 150 animals [marbled crayfish] within one hour, just with our hands."
"People would start out with a single animal, and a year later they would have a couple hundred."
"Maybe [as a singular species] they just survive for 100,000 years. That would be a long time for me personally, but in evolution it would just be a blip on the radar."
Frank Lyko, biologist, German Cancer Research Center

"If you have one animal, essentially, three months later, you will have 200 or 300. The whole species is essentially female."
"In 2017, they occupy the area [in Madagascar] the size of Ohio. That's a hundred-fold increase in just a decade."
Wolfgang Stein, neurophysiologist, Illinois State University

"Based on what is known about the reproductive behaviour of the marbled crayfish, we do not recommend Canadians keep these animals as pets."
"Human release of animals is one of the ways invasive species are introduced and become established in new areas."
"Unauthorized release of any aquatic animal into a waterbody from which they did not originate is illegal under the regulations."
Becky Cudmore, regional manager, aquatic invasion species program, Fisheries and Oceans Canada 
The all-female marbled crayfish reproduces by cloning — and while it's a relatively new species, there are already huge populations around the world.
The all-female marbled crayfish reproduces by cloning — and while it's a relatively new species, there are already huge populations around the world. (Submitted by Wolfgang Stein)
Crayfish enthusiasts have the option of going along to their favourite pet store to poke about in the aquariums there and pick up a new pet for themselves, a marbled crayfish. In the late 1990s the marbled crayfish attracted the attention of aquarium hobbyists in Germany. Professor Lyko tracked down one individual who bought what the shop owner described to him as a "Texas crayfish", back in 1995. The size of the beast amazed the hobbyist, but nowhere near as much as the enormous batches of eggs it produced.

Hobbyists eventually realized that their female crayfish hadn't come in contact with a male of the species, yet was producing hundreds of eggs at a time. The person whom Dr. Lyko interviewed described his desperate efforts to give away resulting crayfish to friends. They were called marmorkrebs and were available in pet shops throughout Germany. With their popularity, owners realized these crayfish never stopped laying eggs yet had no mates, all their progeny were female and each capable of reproducing.

It was a short distance from acquiring these unique little beasts, observing their reproduction, running out of friends to gift them with, and taking them finally in desperation to local streams, rivers, lakes where they effortlessly and studiously multiplied. And it is these crayfish that Dr. Lyko and his research crew have studied in the past five years, managing to sequence the genomes. The study published recently in the scientific journal Nature, Ecology and Evolution, pointed out that the marble crayfish, now commonly seen around the world, is one of nature's most remarkable species.

A scientific marvel, in the sense that twenty-five years ago they didn't exist. Their amazing proliferation represents one of nature's true anomalies. In that a sole drastic mutation in one lone crayfish produced, in an instant of time, the marbled crayfish as it is known today. The mutation is credited with the capability of the creature to clone itself, and in that quarter-century of existence it has spread through Europe and has entered other continents to spread there as well. Its presence in Madagscar threatens native crayfish; it arrived in 2007 and now numbers in the millions.


"We may never have caught the genome of a species so soon after it became a species", marvelled biologist Zen Faulkes, of the University of Texas Rio Grande Valley, commenting on the study. Scientists, in 2003, confirmed the marbled crayfish absolutely were producing selfclones. Small portions of DNA were sequenced from the animals and a similarity found to a crayfish species called Procambarus, native to Central and North America. It took another ten years and Dr. Lyko and colleagues determined the entire genome of the marbled crayfish.

The Marmorkrebs thrived wherever they landed; initially taken by hobbyists out of their crowded aquariums to local waterways. The crayfish, it would appear, took themselves out of the lakes and streams they began to populate, and walked themselves over to uninhabited waterways to begin colonizing them as well. Marbled crayfish colonies turned up in the Czech Republic, Hungary, Croatia and Ukraine in Europe, and soon enough in Madagascar and Japan. They are now, as well, in North America.

Scientists hypothesize that two slough crayfish likely mated, one of which had a sex cell mutation. The mutant crayfish sex cell had two copies of each chromosome, where normal sex cells contain only one. The two sex cells managed to fuse and the result was the capacity to produce a female crayfish embryo with three copies of each chromosome rather than the normal two.

What is also notable is that no deformities resulted out of that extra DNA. The new mutant crayfish had no need of normal sexual reproduction since she was able to induce her own eggs to divide into embryos, all of which resulted in females inheriting the identical copies of her three sets of chromosomes and themselves capable of multiplying. The rest is scientific history.
Marbled crayfish
An ad selling the marbled crayfish appeared on Kijiji in the Toronto area. (Kijiji)


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Saturday, February 17, 2018

"Generation Zapped"

"The system is broken with regard to protecting consumers from wireless signals."
"Studies around the world have clearly shown that it is the nonthermal, indirect effects that are of most concern today."
"The industry responds to what people want in their gadgets: more data, faster downloads, more pixels. But there is not an incentive toward changing the signal forms, for example, so that these biological cascades are not triggered."
George Carlo, industry scientist, critic, wireless technology

"It's like the tobacco, chemical, or pharmaceutical industries. They tell us this stuff is safe, and then, decades later, you find out that they were hiding all this evidence that it was causing us harm."
"It's an accomplishment for me [that "Generation Zapped" was featured at the Silicon Valley International Film Festival for Google employees], because the movie is showing right where the technology is invented."
"These are the guys who can make the difference." 
"I made the movie because no one would believe me. But that's the power of media. When it's well done, well documented, and doesn't go into conspiracy theories or fake news, then people listen to the information and are willing to make lifestyle changes for the health of their family."
"Netflix, for instance, they do streaming, so they're not going to show this film because of the nature of their business."
Sabine El Gemayel, filmmaker
"Generation Zapped" Still from Trailer

The revelatory film that resulted when El Gemayel felt it was past time for the purported harm produced by wireless systems on the public, features scientists discussing the dangers inherent in wireless exposure. Also featured are people whose claims of having become ill from that exposure support what the scientists claim. The story of a powerful wireless industry shaping public policy to ensure their devices and the field powering them receive little scrutiny or government oversight is the message in full.

In 2015, the National Toxicology Program of the U.S. released a report resulting from its 16-year. $25-million examination of the health impacts of wireless radiation. According to the researchers involved, the microwave field emanating from cellphones is "proven to be harmful to humans and the environment". Those harmful effects encompass the increased risk of cancer, a rise in harmful free radicals, genetic damage, structural and functional alterations in our reproductive system, neurological disorders along with learning and memory deficits; and finally a totally negative effect on general well-being.

Unsurprisingly, the 4.8-billion cellphones currently in use worldwide functioning through wireless radiation is such a commonplace that we rarely give a thought to possible consequences of flooding the atmosphere and ourselves heedlessly with radiating effects. We have received assurances since the 1990s through industry announcements, augmented by governmental validation, that there are no studies revealing any problems that might be associated with wireless exposure.
Our bodies are subjected to one quintillion (1,000,000,000,000,000,000) times more electromagnetic radiation compared to just a decade ago, according to Olle Johansson, associate professor in neuroscience at the Karolinska Institute in Sweden.(jamesteohart/shutterstock)

Public health officials in much of the developed world where authorities in the sphere of public health are in possession of evidence of harm have, on the other  hand, taken the issue seriously for years; where in the United Kingdom, France, Belgium, Russia -- among other countries -- children in particular are urged to make minimum use of wireless devices. In 2014, the Centers for Disease Control in the United States issued a reluctant public statement recommending cellphone use caution, yet retracted it a mere few weeks later.

The California Department of Public Health released consumer guidelines on how best to manage exposure to wireless radiation, in particular for children, citing the possibility of a link to conditions such as cancer and low sperm count. Although the CDPH produced their recommendation years ago it was not made public until recently, when a lawsuit forced the agency to alert the public. Industry scientist George Carlo headed a $27-million research project in the 1990s funded by the cellphone industry.

His research results failed to support the goal of the industry to give it a clean bill of health so it could continue to assure the public its technology wasn't harmful. When Dr. Carlo's team discovered a correlation between cellphone emissions and DNA damage, along with a slightly higher rate of brain tumours in those habituated to the use of cellphones compared to non users, the industry dismissed his findings and initiated a campaign to discredit his findings and his scientific expertise.

Through a band of frequencies known as microwaves, communication is accomplished in the manner that we recognize as wireless technology. There is general agreement among most scientists that microwave with its tiny wavelengths has the capacity to damage human biology; how much exposure is required to cause illness is the unknown factor. The assumption is that only microwaves sufficiently intense to cause a thermal reaction; the production of heat, as in a microwave oven; can be considered harmful.

Wireless radiation remits below the thermal threshold, enabled officials to automatically consider these frequencies to be in a safe realm. That consideration, in turn, resulted in cellphones never having been subjected to testing for radiation effects prior to market distribution. There are now roughly a hundred scientific reviews indicating that microwave exposure at non-thermal levels cause deleterious health effects, however.
In the United Kingdom, France, Belgium, Russia, and other nations, wireless users, especially children, are urged to minimize their exposure to microwave radiation.   (Subbotina Anna/Shutterstock)

Olle Johansson, associate professor in neuroscience at the Karolinska Institute in Sweden, points out that humans are subjected to one quintillion times more electromagnetic radiation today compared to a mere decade earlier. The leading question among those who fail to support the need for caution is that if that radiation is so prevalent how can it be explained that there is no avalanche of symptoms among newly-discovered radiation sufferers? Proof of health problems related to wireless technology is abundant everywhere, but most doctors cannot recognize the signs, according to the advocacy group We are the Evidence.

The World Health Organization has formally recognized the controversial condition called electromagnetic hypersensitivity (EHS), since 2005, noting that measuring how widespread this condition is, presents a problem. EHS is characterized through a wide number of nonspecific physical and dermatological symptoms including headaches, fatigue, skin rashes or burning sensations. All of which symptoms are common enough to be attributed to other causes. In France, a woman succeeded in her 2015 lawsuit for disability benefits related to her EHS.

"Generation Zapped" makes a number of simple recommendations for simple enough habits we can develop which would reduce our exposure to microwave radiation. Turning a cellphone to airplane mode when not in use, for example, or taking the precautionary measure before turning in for the night of turning off one's Wi-Fi router. We do not, the film emphasizes, need to allow ourselves to be washed in microwave radiation every hour of every day.


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Friday, February 16, 2018

Infiltrating, Navigating the Human Body

"The array of behaviours and capabilities is certainly impressive and sets this robot apart from most others."
"These critters are very cute!. Love how the authors put the little guy through mini-obstacle courses."
"My other thought is that the pilot, who we don’t see, is also quite impressive. Clearly whoever is controlling the magnetic fields has gained some hard-earned intuition and fine skills based on a lot of experience and trial-and-error."
Leif Ristroph, mathematician, Courant Institute, New York University

"Our robot is made of an elastomer rubber, which is filled with many magnetic, small particles. We program the magnetic properties of these particles so that from outside, when we apply a magnetic field, the elastic sheath-shaped robot changes its shape to anything we want."
"Then it does different motions. When you look at this tiny thing crawling and jumping, it looks like a creature."
"The robots already are small enough for our digestive system and urinary systems. We'd like to go smaller, even down to tens of microns, so that we can reach almost anywhere inside your body."
"It can navigate across solid, partially or fully water-filled terrains. Such solid terrains can be fully rigid or soft."
 "Drugs can be targeted to a specific location inside our body and delivered in more controlled doses, which could make the drug delivery more efficient and minimize the drug side effects. [And because the robots are so small and soft], they can’t damage any tissue they are interacting with."
Metin Sitti, head, physical intelligence department, Max Planck Institute for Intelligent Systems, Stuttgart Germany
1_24_Robot
The tiny robot pictured with a coin to scale. Max Planck Institute for Intelligent Systems

It is a tiny object. Purpose-designed by engineers in Germany to be enabled to move within the human stomach or urinary system. Seeing it, one could be forgiven for mistaking it for an insignificant piece of plastic, inanimate, uninteresting. Until it begins moving. For this tiny strip of material is actually a centimeter-long robot with a rubbery appearance. And this robot can walk, jump, crawl, roll -- even swim; a wonder to behold. It is a prototype of a robot that the engineers whose study was recently published in the journal Nature, plan to make infinitesimally smaller, capable of entering the most constricted areas of the human body.

To see it is to marvel at the human ingenuity that could construct this tiny worm-like robot that can walk, roll and jump. A soft, tiny worm that can even skid along the surface of water. Its purpose, however, is not to entertain, but eventually to deliver targeted drugs around the human body. The engineers who pitted their expertise and brains to emulate nature found inspiration in soft-bodied creatures such as larvae, roundworms, jellyfish and caterpillars -- all of which are endowed with the capacity to navigate complex surfaces easily; wet, dry, rough, smooth.

The robot has no legs; like a worm or a snake, its body moves through repetitive undulating motion. And using that motion, it is capable of climbing out of a pool of water, to move from that wet environment toward a dry one. The most unusual aspect of this robot, apart from its minimalist appearance and moving features emulating a natural creature in a variety of backgrounds, is its "motion possibilities to navigate in complex environments", explains Dr. Sitti who supervised the project.

The most immediate goal is to place the minuscule robot into a digestive system or urinary system -- eventually the vascular system -- to enable it to navigate across all these complex tissues. Currently in the realm of purpose-designed, usefully invasive medical devices are catheters, a millimeter in diameter representing the only available tools, tethered for retrieval purposes. The goal with this tiny robot is to access difficult-to reach areas in the body with minimal invasion.

To explore its full potential -- the function of drug delivery -- loading a cargo into the robot which it could deliver by the shape of the robot opening to discharge its cargo is the eventual goal. Alternately, producing a robot with a small pocket opening only on 'instruction' with an especial shape change that could be controlled by the transmission of an order, is another option.

A fully biodegradable version of the robot is envisioned. So that, when its function has completed its purpose, the robot could dissolve within the body leaving no side effects, no toxicity and no foreign material to cause irritation or any other issues within the body.

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Thursday, February 15, 2018

Building Green

"It smells like comfort."
"It smells a little like lime. We're using the stock. You cannot smell cannabis -- it has nothing to do with smoking weed or cannabis plants."
"It's an industrial agriculture crop."
Sergiy Kovalenkov, 33, Ukrainian civil engineer
A self-built hempcrete house, combining timber cladding and lime render finishes.   The Last Straw

Industrial hemp contains a minuscule 0.3 percent of tetrahydrocannabinol (THC), the substance linked to the effect of smoking marijuana to get high. In comparison, cannabis contains up to 20 percent of THC. Cannabis plants produce hemp which since ancient times has been recognized as a useful material for a multitude of purposes, for not only do the fibers produce strong rope, and clothing, but used in combination with lime it makes for an enduring building material.

In sixth-century Gaul (now France), a bridge was constructed with hemp mortar, a sustainable building material felt to be more reliably durable than concrete or steel. Hemp's woody fibers combined with lime produce a natural, light concrete with thermal mass that is insulating to a high degree. Hemp mortar does not attract pests, nor mould. It has sound acoustics, results in low humidity and no pesticide is required to grow the plant.

It takes four months for the plant to mature from seed to harvest time. It is not yet considered a useful crop for building purposes in North America, but that is set to change as botanists and builders begin increasingly to evince interest in its qualities. In the United States less than 4,000 hectares is devoted to hemp. That crop is deemed sufficient to build five thousand single-family homes with.
Diagram illustrating how hempcrete is created - What is hempcrete
Green Building Materials, Canada

In Canada double the arable land as opposed to the U.S. is devoted to producing hemp. Spain, Austria, Russia and Australia are now seeing an increased interest in growing hemp, among the 30 nations that now produce it. In China's Yunnan province no fewer than ten thousand farmers devote their agricultural holdings to growing hemp. In 1980s Europe cultivation of hemp was rediscovered.

The largest hemp producer in the European Union is France. The growing appreciation of its properties as a sustainable-yield construction crop has resulted in hundreds of buildings across Europe using hemp as insulation between walls and roofs, and under floors in wood-framed buildings. Cannabis sativa, ubiquitously grown, flourishes in a variety of climates where it can grow as tall as five meters and close to three centimeters in diameter.

Rope, sails and paper are sourced from the tough fibre of the plant's tough layer. The inner layer, the pith, is surrounded by the woody core, called the hurd which produces the tough fiber.  To address an absence of international standards related to building with hemp, ASTM International, a technical standards organization, set out in 2017 to form a committee that would perform that function.



The Hemp Industries Association estimated the retail market for hempcrete in 2014 at $573-million in the United States. Roughly fifty hemp homes have been built in the United States and in Israel its first hemp house was built on the slopes of Mount Carmel. Israel, as it happens, is in the forefront of studying and experimental research of cannabis. Hemp ventures have risen in Nepal and Ukraine.

It is considered by manufacturers to be ideal for low-rise construction, attractively stucco-like in appearance and toxin-free. Those who promote it emphasize its reduced carbon footprint with its lower requirement of heat in its creation than standard limestone concrete. Typically planted in March and May in northern climes or between September and November below the Equator, plants are cut by hand then left to dry for several days before being bundled and placed in vats of water, swelling the stalks.

The block-like bricks produced by blending dried fibers with lime have a variety of uses, the product known as hempcrete. What its promoters are concerned with at this juncture is the normalization of recognizing the plant for its utilitarian purposes and legalizing it as an agricultural-building crop, separate and apart from its other, more acknowledged and familiar purposes as a narcotic agent. In the U.S. that meant taking it out of the Controlled Substances Act.

In Britain, HAB Housing built five homes last year with hempcrete, while Just-BioFiber in Canada completed a house with an interlocking internal framed hemp-block on Vancouver Island. In New Zealand 500 bales of Dutch hemp constructed a property that sold for $650,000. A four-meter hempcrete wall can produce 15-degree Celsius year-round temperatures absent heating or cooling systems.

"The overall environmental footprint is dramatically lower than traditional construction", noted Joy Beckerman, a hemp law specialist and vice-president of the Hemp Industries Association.

New build hempcrete housing in Swindon, UK (built by Haboakus)  The Last Straw

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Wednesday, February 14, 2018

Accurately Replicating a Face Mask

"Maybe a silicone mask approximates 75 percent accuracy. A 3-D printed mask can approximate 95 percent."
"[The finished mask is rushed to the hospital] because we want to procure the face while it is still being perfused by a beating heart."
"Their [donor relatives] primary focus was to see their son help out as many people as possible."
"We try to respect the dignity of an individual who gave up his face or her face."
Eduardo Rodriguez, director, NYU Langone face transplant program
The mask is made of hard plastic but captures the subtleties of a flesh and blood face.  3DPrint.com

And to accomplish what Dr. Rodriguez described, it was conceived that a more accurate-in-appearance and -texture mask of a deceased's face, true to the original, removed for the purpose of a face transplant operation, would allow the grieving family of the dead donor to see the body apparently undisturbed, to enable them to have a last long, lingering look at the remains of what recently was a living, loving family member. Its verisimilitude would give the mourners a feeling of closure.

To accomplish this last farewell with the respect and dignity it deserves, the brain-dead individual is wheeled into the plastic surgery department at New York University Langone Medical Center in Manhattan where a technician runs a scanner over the face which then minutely records the most minuscule detail of a face that will be repeated with the greatest degree of visual accuracy at a laboratory associated with the university, through the medium of a 3-D printer.

A 3D printer puts down thousands of layers of plastic to build the mask

This will give the green light to awaiting surgeons to detach the dying person's face and prepare to attach it to another person who has been on a wait-list for a face transplant. Printing experts attached to New York University will then aim their expertise at generating a facial replica of the scanned face of the donor, sufficiently lifelike to enable his family members to feel confident in its use in an open coffin during the subsequent funeral.

At the present time, silicone masks cast from moulds with painted features have been available; not as lifelike nor as faithful to the original. Dr. Rodriguez in 2015 performed an extensive transplant for a former firefighter from Mississippi whose face, exposed directly to fire through his line of duty, melted away. Consequently he has lived in a waiting game, his name on a list for over a year, for the opportunity to regain a new face, through the generosity of a donor.

A 26-year-old Brooklyn bicycle mechanic by the name of David Rodebaugh, victim of a cycling accident, remained comatose when his family met with Dr. Rodriguez asking how their dying family member's body would appear, understanding when he responded that the silicone mask had its limitations. Nonetheless they agreed to proceed with the face removal. That anxiety led to Dr. Rodriguez's search for a more accurate face mask to preserve the dignity of the dead donor.

On the donor's death, the mask is placed atop his stripped face; covering the seam where mask meets hairline it is difficult to discern that it is a mask and not the individual's original face. When the face printing is set to proceed, a hand-held device scans the donor's face pre-detachment, with five camera lenses, capturing details from multiple angles, then projects a grid onto the face to produce a three-dimensional 'map'. Hours are then spent arranging files on computers to send them to a printer full of acrylic-based photopolymer cartridges.

At this point layers so compressed that 600 of them makes up a centimeter are laid down by the printer. It takes over 24 hours for the printer to complete a face mask that might require ten thousand infinitesimally thin layers. On completion, technicians rush the mask to the hospital where the donor's face will have been removed while he is on life support. With this more accurate reproduction of an individual's face, the hope is that more families will be encouraged to agree to permitting a loved one's face to be used for transplant purposes.

Leslie Bernstein, an NYU Langone administrator, had her face scanned to make a demonstration mask

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Tuesday, February 13, 2018

Not the Kind of CHIP Anyone Might Crave

"It is beginning to appear that there are only two types of people in the world; those that exhibit clonal hematopoiesis [CHIP] and those that are going to develop clonal hematopoiesis."
Kenneth Walsh, director, hematovascular biology center, University of Virginia School of Medicine

"This clearly wasn't happening by chance."
"We knew we were onto something, but what were we onto?"
Steven McCarroll, geneticist, Broad Institute and Harvard Medical School

"It is almost like a Ph.D in letting go of control. As much as you want to have a plan and a destiny, you also have this thing."
"It's scary and it's terrifying. I don’t want to use the word time-bomb, yet that is how the idea feels."
"There are things I love in life and people I love. You try to live that life."
Brian Gear, project manager, analytical health care data, Boston, diagnosed with CHIP

"Some mutations are just markers of past events without any lasting consequence. Yet others, especially those linked to leukemia, seem to give stem cells a completely new ability to accumulate inside the marrow. The result is actually a sort of survival of the fittest, or fastest growing, stem cells inside the marrow."
"Some mutations may alter the growth properties of the stem cell. Some may just make the stem cell better at surviving in certain less hospitable parts of the bone marrow where some other stem cells can’t thrive."
Dr. David Steensma, blood cancer specialist, Harvard Medical School
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CHIP : The bone marrow where mutations are believed to occur
Researchers reported in 2014 discovering that close to the entire supply of white blood cells in a 115-year-old woman's bone marrow was generated by mutated stem cells. They hypothesized that she had at first simply developed two mutated stem cells. Over time those two stem cells multiplied to the extent that they dominated her bone marrow. Although this woman had lived as long as any human might be expected to in an extraordinarily long lifespan, when she died, it was because of a tumour.

Researchers examined medical records of people with these unusual white blood cell mutations to discover these people had a 54 percent increase in the chance of dying within the following decade in comparison with people without CHIP. They would die of heart attacks and strokes. This discovery answered a question that had long vexed the medical profession; how could it be that most people who have heart attacks or strokes have no or few conventional risk factors? What might account for that?

Patients with normal cholesterol and blood pressure levels, for example. People with no familial history of cardiovascular disease. People who had no background of smoking. People who never suffered from diabetes. People whom, logically, heart attacks and strokes should never have targeted. Then scientists discovered the presence of mutated stem cells bizarrely accumulating in bone marrow, the presence of which increases a person's risk of dying within a decade, from a heart attack or stroke, by 40 or 50 percent.

As hugely indicative of the potential for heart attack and stroke is predicatively with high LDL cholesterol levels, or high blood pressure, CHIP has entered the medical picture as an equally high risk, one that presents independently of the usual cholesterol and blood pressure markers. What's more the presence of CHIP is not rare, a condition that becomes more prevalent with age. An estimated 20 percent of people over 60 have CHIP, and likely 50 percent of those in their 80s.

These are mutations that are not genetically endowed, but rather acquired; simply a matter of luck or alternately exposure to toxins such as cigarette smoke. Several groups of researchers independently discovered the presence of CHIP even though they were not involved in heart disease investigation. They had searched databases involving genetic studies of tens of thousands of people whose DNA had been obtained through their white blood cells.

They discovered that large numbers of study participants had blood cells with mutations linked to leukemia, but the same people weren't suffering from cancer; only one or two of the cluster of mutations. It occurred to the investigators that the attack dogs of the immune system -- white blood cells -- are created from stem cells in bone marrow as each day a few hundred stem cells produce blood cells which divide rapidly into the ten billion required to replace the expired ones. And occasionally a stem cell acquires a mutation.

The first to recognize the link between mutated stem cells and the potential for an increased risk of heart attack and stroke was Dr. Benjamin Ebert, chair of medical oncology at the Dana-Farber Cancer Institute, who then turned to Dr. Sekar Kathiresen, a cardiologist and genetics researcher at Massachusetts General Hospital who had genetic data resulting from four more studies. Together they confirmed that CHIP doubled the risk in typical patients of heart attack.

What was missing Was how that came about. They inferred the possibility that mutated white cells caused atherosclerosis. Mutated blood cells began proliferating in laboratory mice given bone-marrow transplants containing stem cells with  CHIP mutation. The mice developed rapidly growing plaques rampant with inflammation as the mutated blood cells proliferated. "For decades people have worked on inflammation as a cause of atherosclerosis, but it was not clear what initiated the inflammation", explained Dr. Ebert.

For the present, since there is no specific protocol that can be advanced to reduce the increased risk that CHIP confers, doctors don't advise that people be tested for its presence. As far as Dr. Steensma is concerned, he would himself, if diagnosed with CHIP, make certain to do his utmost to control heart disease risks, like cholesterol and blood pressure, and ensure a healthy diet intake and exercise be part of his revised lifestyle. Also mentioning that in the near future drugs may be developed to stem artery inflammation.

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