Ruminations

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

Tuesday, January 31, 2017

CRISPR Foods, Everyone?

"This is not Frankenfood."
"There is nothing taken out or added to the plant. It's what nature would have produced."
"[Edits in crop plants] alter the mix of fatty acids to produce soybeans to make, for example, an improved cooking oil]. Better than olive oil."
 Dr. Andre Choulika, chief executive, Cellectis
CRISPR illustration
Popsci.com files -- CRISPR illustration

"We've never been against any of this technology. We don't say it's inherently bad or these crops are inherently dangerous."
"It's just [that] they raise safety issues, and there should be required safety assessments."
Michael K. Hansen, senior staff scientist, Consumers Union

"The objection that people have is a more visceral and vague objection to messing with DNA."
"It's hard to see that the public would see the difference [in this alternate type of gene-editing, as opposed to genetically modified]."
Richard C. Mulligan, professor of genetics, Harvard Medical School
Pasta with CRISPR-edited cabbage
Photo: Stefan Janssen -- The first CRISPR meal, featuring genetically altered cabbage

Soon to appear on supermarket shelves everywhere is a new generation of crops identified as gene-edited, not genetically modified. New precision instruments capable of snipping and tweaking DNA at exact places on  a plant's cells. And the new process of editing is capable of producing non-browning mushrooms, or longer-lasting potatoes, or soybeans where the fatty acids are 'healthier'.

The older methods so discredited in the consuming public's mind of engineered genes, not permitted entry to some countries and certainly not into the European Union, the newer techniques such as CRISPR do not add genes from other organisms into the host plants. Gene-edited crops are already being raised in several U.S. states, not requiring oversight or regulations; some have even been eaten, unbeknownst to the consumer.

Cellectis, one company that is developing gene-edited crops, introduced the world to them when it hosted a dinner at an upscale restaurant, inviting scientists, journalists and celebrities to attend and eat dishes produced from gene-edited soybeans and potatoes. The potatoes were edited to remain fresher and not result in the production of carcinogens when fried.

A subsidiary of Cellectis, Calyxt is in the developmental stages of a new version of wheat crops, including one enhanced to greater fungal diseases resistance. And yet another wheat crop that will be less carbohydrate-intensive, and higher in dietary fibers. DuPont Pioneer is another company developing gene-edited crops, using the technology for a new type of corn -- not for consumption, but for producing starch, to be used in adhesives.

Regulations as they currently exist were originally written with the earlier generation of genetically modified organisms in mind. That technology saw scientists using bacteria and viruses -- usually from plant pests -- to insert new genes into the nuclei of plant cells to merge with the plant's DNA. While it was a successful merging, it was realized that there was no way to control where the new genes would be inserted, leading to concerns of possible genetic disruptions or crossbreeding occurring with non-GMO crops.

A comparison has been made, to help people better understand the new process . . . to moving a cursor in a word processor to a specific location to insert a small text alteration . . . and this is the way that edited food crops work. The European Commission has mounted a scientific panel, as part of the ongoing debate over this new technique, commissioning it to study gene-editing.

Calyxt uses a technique named Talen in its gene-editing, to create molecules to act as a template matching a specific area of DNA, and making an incision at that point. For the soybeans using the Calyxt method, turning off two genes was the only alteration required.




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Monday, January 30, 2017

Brave New World of Bioscience and Application

"We are still in the early stages [of stem cell research/application]. In 2014, [scientists] at the Riken Center for Developmental Biology [Japan] had great success using iPS cells to treat macular degeneration. They took skin cells from a 70-year-old patient and derived iPS cells from them. They then differentiated the stem cells [directed them 'back down' the normal developmental path] to become adult retinal cells. These were transplanted into the patient's eye. That was a huge success."
Shinya Yamanaka, scientist, director, Kyoto University Center for iPS Cell Research and Application
Dr. Shinya Yamanaka, CiRA Director, Kyoto University

A decade ago at Kyoto University, scientist Shinya Yamanaka pioneered a technique whereby adult cells could be "reprogrammed" back to their "pluripotent" condition at which point they had the potential to become any body cell ranging from a heart muscle cell to a neuron in the brain. This scientific process made it possible to bypass the controversy raging over the kind of research that made use of human embryos, offending the moral susceptibility of many.

And at the same time, presenting a method by which there would be no shortage of stem cells.

For this groundbreaking work, Dr. Yamanaka took his share of the 2012 Nobel Prize in Physiology or Medicine for his work in setting the stage for science to reprogram mature cells back into their former earliest stage now known as induced pluripotent stem cells [iPS cells]. Dr. Yamanaka now directs the Center for iPS Cell Research and applications at Kyoto University, Tokyo, Japan.

This internationally renowned Laureate explained in an interview some of the roadblocks encountered along the way to simply assuming that these iPS cells could be used, once successfully altered using an individual patient's cells, to be placed back into that patient's body to correct a condition related to age or chronic disease. It had been discovered through investigating the genome sequence of a patient's iPS cells that a mutation existed.

And that discovery put a stop to a process that was planned to get underway similar to the one Dr. Yamanaka spoke of in the treatment of macular degeneration for a 70-year-old patient. The realization that the pluripotent stem cells, having the capability of rapid proliferation ad infinitum posed a risk, after multiple cell cycles of mutations increasing and in the process possibly causing cancer posed a risk too great to proceed as planned.

Because of this realization Dr. Yamanaka's research laboratory addressed the issue by developing allogenic stem cell lines from donors, which would be compatible cells ready for transplantation into a patient, similar to a blood transfusion. Rigorous quality tests must be performed, with the inclusion of sequencing the stem cells' genomes to ensure the cells would be free from the presence of cancer-causing mutations.

Crudely put, stem cell treatments, originally imagined as in theory representing the kind of "personalized" medicine where the patient's own stem cells would be used in the generation of adult cells to bypass the risk of the body's immune system springing into action to reject cells other than those recognized as their own, solving an everpresent problem in transplantation.  While that personalized track could still be pursued, it would be both time-consuming and hugely expensive.
CiRA - Center for iPS Cell Research and Application

Dr. Yamanaka also explained that the exciting prospect of stem cell therapy solving all ills had been initially rather overstated. Pointing out the limitations where roughly ten conditions only could be treated by stem cell therapy; which included Parkinson's, retinal and corneal diseases, heart and liver failure, diabetes and spinal cord injury, joint disorders and some blood disorders.

Even limited to those conditions, however, it is more than obvious that much good could come of its use, since those ten encompass quite a panoply of body malfunctions hugely impacting quality of life  and for most, leading to early death.

And the reason ascribed to stem cell application limits seems simple enough, that those diseases are typically caused by loss of function of one type of cell, whereas other diseases are the result of multiple types of cell failures and thus cannot be treated with stem cell therapy. Direct cellular reprogramming describes a new strategy reprogramming adult cells back to a state specific to the organ the cells were derived from.

If, for example all the cartilage in an elderly patient's knee required replacement that is the kind of process that may improve prospects over iPSC [induced pluripotent stem cells], even while iPS would represent the first choice when treating a younger patient with only a small lesion where good cartilage could be produced from iPSCs then transplanted the purified cartilage to that small lesion.

This is most definitely an evolving, time-consuming and costly process to be fully understood and reliable before it becomes mainstream.

  • Induced pluripotent stem cells (iPSCs) are a new type of pluripotent stem cells first generated in 2006 in mouse. They represent a potentially important resource for applications in regenerative medicine;
  • PS cells generated from patient cells can be used to create cells that replicate the tissue affected by disease. This technique offers the prospect of using iPS cells to test drug efficacy, side effects, and toxicity and to develop new drugs and therapies.

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Sunday, January 29, 2017

Vitamin A Deficiency and Cognition

"We have known for some time there is less vitamin A in the blood of people with Alzheimer's compared with people who have normal cognitive function. What we didn't know was how important it could be in early childhood development."
"Vitamin deficiency during pregnancy is much more harmful [to the fetus] than a vitamin deficiency later in life."
"If you give vitamin A supplements in the first month or two of life, you can reprogram the brain and restore most of the cognitive function. If you wait two months, the supplements don't work as well."
"The World Health Organization report says there are 250 million preschoolers in the world with vitamin A deficiency. In developing countries, vitamin A deficiency is quite common and likely affects many pregnant women."
Weihong Song, Canada Research Chair, Alzheimer's disease, University of British Columbia
[beta amyloid plaques]
New research shows that mice deprived of vitamin A in the womb may have higher levels of beta amyloid (here shown as plaque in the brain of an Alzheimer's patient). Medical News Today

In 2015, international researchers discovered a link between vitamin D deficiency and the onset and development of Alzheimer's and dementia, by studying and observing over one thousand, six hundred seniors for a period of six years. It is estimated that between 40 and 75 percent of all adults are deficient in vitamin D, representing a group of secosteroids responsible for the absorption of calcium, iron, magnesium, phosphate and zinc. Essentially vitamin D has a hormonal action.

Only a few foods confer the benefits of vitamin D, though the human body absorbs it through exposure to sunlight. Most people require the use of vitamin D supplements to boost the body's critical store.

Now, researchers at the University of British Columbia in Vancouver have published a study appearing in the journal Acta Neuropathologica, pointing out that vitamin A deficiency may trigger Alzheimer's disease late in life. Even mild vitamin A deficiency in animal models had the effect of increasing production of amyloid beta, protein fragments which form plaques in the brain. People with Alzheimer's suffer from amyloid plaques which smother and in time kill neurons as dementia steadily advances.

A new study has found that mice deprived of vitamin A before birth are more likely to develop symptoms of Alzheimer's disease.
A new study has found that mice deprived of vitamin A before birth are more likely to develop symptoms of Alzheimer's disease. (Robert F. Bukaty/The Associated Press)

Gene mutations and environmental factors over a prolonged period of time cause Alzheimer's disease. Mice engineered with a mutated human gene to render them susceptible to Alzheimer's were used in this laboratory study which discovered that fetal malnutrition leads to learning problems that will last a lifetime. Deprived of vitamin A through their mother's diet, fetal mice performed poorly on tests of learning and memory when they reached adulthood.

And this was so irrespective of their being exposed to a normal diet directly post-birth.

Dr. Song and his research collaborators at the Children's Hospital of Chongqung Medical University in China "rescued" brain function in mice with vitamin A supplements applied directly after birth.

Brain health in the developing world and in remote parts of China and elsewhere in the world where food choices are limited, point out why those not obtaining sufficient vitamin A in the diet severely compromises cognitive health. Vitamin A can be found in fish and in brightly coloured fruits and vegetables, all of which may be in short supply in deprived areas where lack of essential foods and fruits deprive people of vitamin A.


"We have known for some time there is less vitamin A in the blood of people with Alzheimer's compared with people who have normal cognitive function," said researcher Weihong Song. "What we didn't know was how important it could be in early childhood development." Martin Dee / Vancouver Sun

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Saturday, January 28, 2017

Crime and Punishment : Victims of Incest

"It's a relief. I am very satisfied with the number of years that I think is appropriate for what we endured."
"As long as he's alive, he'll be in the registry as a sexual predator. That's what he is, a sexual predator." 
Nathalie Lesage, 49, Gatineau, Quebec courtroom

"Reassertion of control can be very important to women who have been raped. They're [the three daughters of Jacques Lesage, Val-des-Monts, Quebec] ensuring that their father can't disappear into anonymity, and that he will be named and exposed."
Elizabeth Sheehy, law professor, University of Ottawa

"We've turned a page/"
"Don't hesitate. Don't hesitate to denounce those who are trying to keep [their abuse] a secret."
Lucie Lesage, 53, Gatineau, Quebec courtroom
Lucie Lesage, left, and her sister Nathalie at their father sentencing for incest Jan. 27, 2017
Lucie and Nathalie Lesage speak to reporters after their father was sentenced to 15 years in prison. (Amanda Pfeffer/CBC)

Justice, according to three sisters who were mercilessly set upon by their father when they were children, has finally been done. But after all the years of their lives living with the bitter memories and the vicious harm the man who is their father imposed upon them as he victimized them by viewing his daughters as  his sexual prey, it might seem to come as a hollow victory. Their lives were destroyed; they had no normal childhood and their adulthood was fraught with misery.

A week ago a jury convicted 79-year-old Jacques Lesage of three counts of incest and one of indecent assault. And then days later, he was sentenced to 15 years in prison. For the unspeakable crimes of raping children. Children who had every reason to trust their father to protect them from the evils that the world sometimes visits on children. From time to time society is made aware that children are horribly abused by those they are most dependent on for emotional support and love.

This case of a man selecting his children for sexual gratification before they were ten years of age, impregnating one for the first time at age 13, then following that pregnancy up with another two resulting from violently forced sex, is unusual in the severity of its degrading wretchedness. Three little girls in one family living in fear of their father's constant predations on them; how much more vulnerable can children be?

His sentence is said to reflect the crime in its severity. And perhaps given his age, it might be considered so. Yet he ravaged three lives and those decades of loss cannot be retrieved. In his own defence at his sentencing hearing he sought compassion by claiming to have been a victim of incest himself; that a sister was also his mother. Would that normalize what he did to his children in any rational mind?

He married he said, at age 16 because his wife, at 13, was being sexually abused by her father, and he had a wish to rescue her. Obviously then, he was well aware that incest and sexual abuse are horrendous crimes against the innocent. Yet knowing that, he embarked on his own journey of imposing fear and pain on his children.Seeking to elicit sympathy for his spectacular failure as a human being?

He fathered eight children. He spoke of the abuse meted out by his father, and from brothers at a Catholic orphanage, as though his experiences should be viewed as a reasonable explanation for his own horrible lapse at humanity in his relationship with his dependent children. But just in case his experience as a child himself did not melt the hard hearts sitting in judgement of him as a disgustingly blemished human being he divulged that he had cancer and to halt the spread of the cancer had his genitals removed.

Nathalie Lesage had testified that she was five years of age when her father began molesting her. That molestation culminated in the first rape attack by her father when she turned eight. Which was followed by a childhood of never-ending panic resulting in an adult who felt her life was hell, leaving her with depression and post-traumatic stress disorder.

A third daughter, Chantal Knippenburg, 45 gave evidence against her father, but the judge acquitted the man of sexual assault and indecent assault in her instance. He is yet to be tried on one count of sexual assault and one count of sexual interference relating to an 11-year-old girl, in 2001. The daughters took steps to publicly reveal their names to ensure that in turn their father's name would be publicly revealed so he would not remain an anonymous offender.

And while prosecutors had preferred a sentence of between 20 to 22 years in prison, lawyer for the defence Antonio Cabral argued for a prison term of no more than five to seven years. But Quebec Superior Court Justice Michel Pennou felt it necessary to impose a sentence reflecting the serious nature of this man's crimes.

The lengthy prison term is lessened given credit for time served prior to trial. Should he live that long, he will serve 11 years and 8 months in prison. Jacques Lesage has been in prison since 2014, when his daughter Lucie went to police to report her father's criminal past. She did so just after her mother died. 

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Friday, January 27, 2017

Fears of Creating a Monster Animal Cross-over

"The first concern is public perception: does it violate some notion of boundaries, or the natural order of things."
"You're going to have to watch carefully what is happening during the course of development, and be ready to shut down something that looks like it's an unintentional outcome."
"Can you control where these cells go. There's less worry about growing an islet cell to help somebody with diabetes than there is finding out human cells migrated into the animal's brain and grew some structures there."
"It doesn't mean that the animal is all of a sudden going to wake up and sign up to take a bioethics course. It just means there are some human cells in there."
"But still, that bothers us more because that's where we think the mental states that identify our identity are."
"Most people don't say, well, the way I know who I am is by thinking about the cells that are in my pancreas or spleen or something. But we do when it comes to the brain."
"Forget about [the Salk researchers'] work. What if somebody said, 'I think it would be interesting or fun to see what would happen if I did try to make a pig with some element of a human brain'?"
Arthur Caplan, bioethicist, Langone Medical Center, New York University

 "...And in some of them [hybrid human-pig embryos], we observed human cells were there. They turned into the progenitors for many different tissues and organs."
"And these organs will probably function better than the organs we've already had for 30 or 40 years. We might have the ability [through harvesting chimera organs] to rejuvenate our physiology."
Jun Wu, Salk Institute scientist

"This [research succeeding in creating human-pig chimera embryos] required a tour de force. But in the end we were able to answer a key question -- can human cells grow in an animal."
"The ultimate goal is to grow functional and transplantable tissue or organs, but we are far away from that. This is an important first step." 
"It's like when you try to duplicate a key. The duplicate looks almost identical, but when you get home, it doesn't open the door. There is something we are not doing right."
"We thought growing human cells in an animal would be much more fruitful. We still have many things to learn about the early development of cells."
Juan Carlos Izpisua Belmonte, lead investigator, Salk Institute for Biological Studies, La Jolla, California
This photograph shows injection of human iPS cells into a pig blastocyst. A laser beam (green circle with a red cross inside) was used to perforate an opening to the outer membrane (Zona Pellucida) of the pig blastocyst to allow easy access of an injection needle delivering human iPS cells. Credit: Courtesy of Juan Carlos Izpisua Belmonte


But part of that goal has been achieved, according to research resulting in the successful pilot creation of a human-pig hybrid and described in a publication appearing in the scientific journal Cell, this week. Although lead researcher in this project, Juan Carlos Izpisua Belmonte modestly cautioned that there is much left to learn on how to proceed from this point, the first hurdle has been set aside. Scientists have been attempting for quite awhile to grow inter-species embryos; this is the first to date to succeed.

And the first successful 'chimera', an animal created with parts of different animals which owes its legendary presence to ancient folklore, has been developed. The goal in this development is to eventually solve the intractable problem of procuring enough body parts to be used for transplants when original body parts have failed due to disease or other functionality compromising factors. Ultimately perhaps even replacing worn out viscera in an aging human body to gain additional years of life for the recipient.
A 4-week-old pig embryo that was injected with human stem cells. The experiment was a very early step toward the possibility of growing human organs inside animals for transplantation. Salk Institute via AP

Up to now the creation of animals in their various forms has been a monopoly practised by the ultimate creatrix, Nature. It can perhaps be viewed as the last word in hubris for humans to devise biological methods by which nature can not only be emulated but manipulated in ways never meant to occur by natural means. And this dabbling about in nature's preserve raises concerns of bioethicists: "But of course the more we humanize an animal, the more we raise questions about animal ethics", pointed out Timothy Caulfield, Canada Research Chair in health law and policy.

The article published in Cell described how researchers at the Salk Institute for Biological Studies injected human stem cells into pig embryos in an experiment they hoped would result in the stem cells which have the capacity to become any other type of cell the body harbours, to mature to the point where they could eventually be harvested, and used to regenerate damaged or diseased tissue in a human subject on transplantation.

But this research is still at its dawn stage and many technical elements of the strategy are yet to be explored and refined. The researchers aspire to be able to inject human stem cells into a fertilized pig egg so that a given organ can be developed for transplantation into a waiting human whose organ has failed and requires a replacement. After the fetus is born, the animal is to be raised until the organ reaches optimum size for harvesting and transplantation.

The researchers envision pig farms reflecting a "clinical grade" of environment, to incubate the human organs. Dr. Wu points out the obvious, that any organ generated in a pig will be a 'young' organ, one that will function as a young organ, in contrast to one that has been in use in a human body for many years and whose life expectancy for usefulness has become compromised by age. Another plus would be that the body's immune response would not be called into rejection action since the organ would have been grown from the individual's own cells.

Ethicists, in a paper published in Stem Cell Research & Therapy, last year warned that a worrying worst-case scenario "would be that a pig producing human sperm could incidentally mate with a sow or vice versa". The very thought of a "humanized pig brain", sends shudders down the spines of ethicists. Though the concern of a man-pig child emerging is beyond remote, considering the "interspecies reproductive barrier is strong", concerns yet remain.

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Remembering the Holocaust

  • To ruminate upon exile, to make critical notes upon injuries, and be too acute in their apprehension, is to add unto our own tortures, to feather the arrows of our enemies, and to resolve to sleep no more. Sir Thomas Browne
  • It is more wretched to commit than to suffer an injury. Seneca
  • It is the mark of a good man not to know how to do an injury. Publilius Syrus
  • It is a principle of human nature to hate those whom you have injured. Tacitus
  • But when I observed the affairs of men plunged in such darkness, the guilty flourishing in continuous happiness, and the righteous tormented, my religion, tottering, began once more to fail. Claudian
  • To do injustice is more disgraceful than to suffer it. Plato
 The Home Book of Quotations
  • Still on Israel's head forlorn, Every nation heaps its scorn. Emma Lazarus
  • Who hateth me but for my happiness? Or who is honoured now but for his wealth? Rather had I, a Jew, be hated thus, Than pitied in a Christian poverty. Marlowe
  • He hath . . . laughed at my losses, mocked at my gains, scorned my nation, thwarted my bargains, cooled my friends, heated mine enemies; and what's his reason? I am a Jew. Shakespeare
  • If my theory of relativity is proven successful, Germany will claim me as a German and France will declare that I am a citizen of the world. Should my theory prove untrue, France will say that I am a German and Germany will declare that I am a Jew. Albert Einstein 
  • Yes, I am a Jew, and when the ancestors of the right honourable gentleman were brutal savages in an unknown island, mine were priests in the temple of Solomon. Benjamin Disraeli
  • The Jews are among the aristocracy of every land; if a literature is called rich in the possession of a few classic tragedies, what shall we say to a national tragedy lasting for fifteen hundred years, in which the poets and the actors were also the heroes. George Eliot
  • When people talk about a wealthy man of my creed, they call him an Israelite; but if he is poor they call him a Jew. Heinrich Heine
 The Home Book of Quotations

  •  April 20, 1943: Near Krakow, Poland, Jewish women attack their male SS guards while being transferred from one person to another. Most are killed.
  • April 30, 1943: Two thousand Jews deported from Wlodawa, Poland, to Sobibor attack the death camp's SS guards on arrival at the unloading ramp. All of the Jews are killed by SS machine guns and grenades.
  • May 6, 1943: Hajj Amin al-Husseini, grand mufti of Jerusalem, suggests to the Bulgarian foreign minister that Bulgarian-Jewish children should be sent to Poland rather than to Palestine.
  • May 7, 1943: Nearly 7000 Jews are killed in Novogrudok, Belorussia; a group of Jewish fighters in the Warsaw Ghetto is ambushed by German troops while travelling through the city's sewer system; Sephardic Jewish homes in Tunisia are ransacked and looted by departing German troops.
  • August 11, 1945: Anti-Jewish riots erupt in Krakow, Poland.
  • November 19, 1945: Anti=Jewish riots erupt in Lublin, Poland.
  • November 20, 1945: The Nuremberg Trials open. Defendants include Hermann Goring, Alfred Rosenberg, Rudolph Hess, and Julius Streicher.
  • December 1945: Antisemitic Poles murder 11 Jews in the town of KosowLacki, Poland, less than six miles from the Treblinka extermination camp.
  • December 22, 1945: The American Displaced Persons Act makes it easier for Nazi war criminals to immigrate to the United States; particularly benefiting Baltics, Ukrainians and ethnic Germans many who engaged in a "high level of collaboration:" with Germany.

  • 1945 -- 1950: Between 250,000 and 300,000 Jews survive German concentration-camp incarceration. About six million Jews have perished; 1.6 million nonincarcerated European Jews also survive. Jews emigrate from Europe en masse: 142,000 to Palestine/Israel; 72,000 to the U.S.; 16,000 to Canada, 8000 to Belgium and about 20,000 to other countries.
The Holocaust Chronicle

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Thursday, January 26, 2017

Special K

Special K  Image result for special K


"I was suicidal. I was desperate."
"I am able [now] to spend time with my kids, to at least feel like a normal human being. Before, I was one step away from getting into another world. Now those thoughts don't bother me."
"These thoughts [of suicide] don't bother me anymore. I am extremely grateful."
John (last name withheld), patient, Royal Ottawa Hospital

"[Ketamine represents] the biggest breakthrough since the introduction of antidepressants [in the treatment of depression and suicidal thoughts]."
"Our work has shown a direct effect [in a remarkable decrease in suicidal thoughts]."
"Some of our patients have failed many treatments. This gives us the opportunity to not hospitalize them. It has basically changed their lives."
"By acting on the glutamate system, you produce a cascade effect on other systems that can have a beneficial action on the treatment of depression."
"Clinicians must be vigilant [in prescribing ketamine, a known street drug] to the potential for drug-seeking behaviour."
Dr. Pierre Blier, director, mood disorders research unit, Royal Ottawa Hospital
Person Under Stress
CTV  News photo

Dr. Blier, a professor at the University of Ottawa, wrote a paper, published in the Journal of Psychopharmacology on the use of the drug ketamine on a severely depressed patient. A 37-year-old mother, suicidal and whom other treatments did not help. This is a drug which, in street parlance, is known as 'Special K', not to be confused with a popular breakfast cereal whose name is indeed, Special K. Ketamine, however has been used as date-rape drug. Clinically it had a medical use as an anesthetic.

Dr. Blier's research on the use of the drug has been some six years in the making to finally recognize its efficacy in putting a stop to suicidal thoughts in a high percentage of depressed patients. Given intravenously, John, an Ottawa father of three, is only one of many suicidal patients who have experienced profound relief from their symptoms, enabling them to return to life as close to normal as possible.

The research that Dr. Blier has focused on has been funded by the Ontario Brain Institute and the federal government. What excites Dr. Blier, his colleagues and the patients who have been introduced to the intravenous injection of ketamine is that it works so quickly, in the space of a day. Moreover, 90 percent of patients have been able to report a dramatic decrease in their suicidal ideation. Dr. Blier is researching a potential nasal spray of the drug, with positive results.

For patients whose negative reactions with the use of other drugs has been disappointing, the ketamine breakthrough appears to be a spectacular rescue to patients resistant to other modes of treatment. The treatment of virtual last-resort -- electroconvulsive therapy, with its potential for long-lasting side-effects, is infinitely more invasive, requiring hospitalization in the process.

The dramatic effects of ketamine are not matched by a lengthy after-effect since ketamine can begin losing its effectiveness within a week or less, for some patients. The drug appears safe for most otherwise-healthy patients, but Dr. Blier recommends advanced cardiac life support be available with the use of ketamine as a treatment for severe depression.

It also concerns him that since ketamine is also a street drug, some patients might go out of their way to convince doctors they need this treatment when they actually do not, by pretending to have symptoms consonant with its need. John, remembering his first reaction after ketamine was administered recalls  an "extreme feeling of peacefulness". Although his depression has not been entirely lifted, suicidal thoughts no longer plague him.

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Wednesday, January 25, 2017

Visionary Food

"One of the best things you can do for your eyes is to eat a balanced diet high in fruits and vegetables, but also low in saturated fats and sugar."
"Along with the vitamins, you should be sure to take in adequate amounts of the minerals zinc and selenium, both of which help protect the retina -- the light-sensitive part of the back of the eye. You also need some fatty acids -- usually from fish -- to ensure adequate moisture in your eyes."
Dr. Leland Carr, professor of optometry, Northeastern State University, Oklahoma

"Most people still think that carrots are the best food for our visual health, and while beta carotene does supply the retina with an essential form of vitamin A, it's not the super vision food we once thought [it to be]."
"With our eyes enduring more physical stress than ever before, they need a bountiful supply of power foods rich in antioxidants -- leafy green vegetables, acai and blueberries, and eggs, which contain zeaxanthin which helps prevent or slow age-related macular degeneration, a potentially blinding retinal disease." 
"Eggs are also rich in lutein and zinc [along with] other macular-degeneration protectors. Fatty fish such as tuna, salmon and mackerel are packed with omega 3 and DHA, which are shown to promote healthy brain function, also [to] protect the back of our eyes and help [to] prevent dry-eye syndrome. I always tell my patients -- what's good for the brain is good for the eyes."
Dr. Kevin Anderson, chair, Cycle For Sight, Foundation Fighting Blindness, Markham, Ontario

"You can be proactive and help preserve your vision by adding such nutrients as lutein, zeaxanthin, vitamin C, vitamin E, beta carotene and zinc to your daily diet. By adding key foods that contain these nutrients into your daily diet, you can help maintain your eyes as you age. These are naturally occurring pigments that are found in the central part of the retina, and studies prove that antioxidants lower the risk of developing macular degeneration and cataracts. Collard greens, broccoli, corn and bright-coloured fruits like kiwis and grapes are great ways to get your fill of antioxidants as well."
"You don't need a lot as one handful [of almonds] contains half of your daily dose of E. Sunflower seeds, pecans, vegetable oil or adding a tablespoon of wheat germ oil to  your salad dressing are also good sources."
Dr. Helen Brandenborg, doctor of optometry, Herzig Eye Institute, Toronto
Related image
wisegeek.com : anthocyanins and flavonoids provide the bright colors in certain fruits and vegetables

We are a generation addicted to cellphones, smartphones, laptops, ereaders, with our eyes fixed on these devices continuously, both during our working hours and throughout our leisure hours. People nowadays, of all generations in society, no longer spend quality time in the out-of-doors, giving our eyes a rest from concentrated searching of the Internet. Where once television took up a lot of our leisure time, confining us to our homes and our comfy sofas, these days television too is viewed through our laptops and smartphones.

We are so busy we lose track of time. We are so engaged with our electronic devices that so many of our friendships take shape through social media, accessed on line. So many of us are so involved that we also become sleep-deprived because of shorter night-time breaks to sleep and refresh ourselves as nature intended us to do. We are less physically active and more inclined to remain physically inert as our minds and our eyes attach themselves relentlessly to smartphones which so many of us would never dream of leaving behind.

In the process we are straining our eyesight. It is one of our most precious senses. When we reach the age of 40, inevitable changes begin to take place and we strain to read fine print, eventually requiring the aid of magnifying lenses to guide our eyes. There are estimates that over 25 million people globally suffer the effects of age-related macular degeneration and cataracts. In many people, as they age, there is that debilitating progression of failing eyesight to mar our well-being.

With the knowledge that our focus on long working hours behind a computer and complementary focus on social media, while vital to our lives, also threaten our health, it makes sense to alter some elements of our lifestyle, notably the sedentary aspect of lack of physical exercise as we drive everywhere and seldom walk to any destination, preferring to take elevators over climbing stairs and missing out on opportunities to allocate a small part of the day to exercising or just simply walking around a neighbourhood.

And the other element that likely needs an upgrade is the realization that convenience and fast foods consumed on a regular basis do little to sustain physical health, all the more so as we age. Brightly coloured fruits and vegetables are not only attractive in appearance, but they are vital to good health and to sustaining oneself in good health, from youth to maturity and beyond. Squash, kale, colourful  bell peppers, pumpkin, sweet potato, are superb sources of beta carotene, along with carrots.

Citrus fruits and soft berries, stuffed with vitamin C, proven to reduce the risk of developing macular degeneration and cataracts should be high on our list of foods to appreciate. Along with Brussels sprouts, broccoli, papaya and green peppers. Almonds are a terrific source of vitamin E shown by studies to  help slow macular degeneration. What's more all of these foods take little preparation time, and taste good as well.

We just have to train our minds to be conscious of the need to consume them, and in the process appreciate them as healthful whole foods.

Image result for photos, bright fruits and vegetables for healthful living
Tripatini, brightly coloured fruits and vegetables are known as 'superfoods'

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Tuesday, January 24, 2017

End-of-Life Health Costs

"Neither patients nor physicians should consider costs when making the very personal decision to request, or provide, this intervention."
"As death approaches, health care costs increase dramatically in the final months. Patients who choose medical assistance in dying may forgo this resource-intensive period."
"Providing medical assistance in dying in Canada should not result in any excess financial burden to the health care system and could result in substantial savings."
Report, University of Calgary research

"There was no agenda to this cost analysis. We're definitely not suggesting that medical assistance in dying be chosen over any other way of dying."
"We're just trying to describe the reality that may exist in Canada [under a new law]."
Dr. Aaron Trachtenberg, resident, internal medicine, study co-author

"[The difference between one and four percent of all deaths] represents a grey zone of about 8,000 Canadians. The very notion of costing end-of-life care and estimated savings with medical aid in dying is a bitter ethical quandary for some."
"We should quickly move past counting dollars saved from medical aid in dying, and count instead the days of unbearable suffering that result from missed opportunities to provide palliative care."
Dr. Peter Tanuseputro, Bruyere Research Institute
New research suggest medically assisted dying could result in substantial savings. But the study's author says costs should not be considered when individual patients consider the option.
New research suggest medically assisted dying could result in substantial savings. But the study's author says costs should not be considered when individual patients consider the option. (Chris Kreussling)

Indeed, the conclusion reached by the research team out of the University of Calgary, published in the Canadian Medical Association Journal of the economic efficacy in savings up to $139-million annually in aiding dying patients to kill themselves before the natural process of dying completes its journey -- as a remedy to high health costs associated with the last living days of people moving toward the final days, weeks, months of their lives -- does leave an acrid taste in one's sensibilities.

The analysis, based on those Canadians expected by the system to choose an assisted death, and the amount of time a person's end-of-life might be quickened, the costs of care immediately preceding death based on emergency department trips, dialysis treatment and hospital admissions led to the calculation that the cost of offering doctor-hastened death would lead to a gross medical-health savings that would more than balance the cost of doctor-aided death as opposed to continued health care until death.

With the experience of the Netherlands and Belgium as a guide, the researchers were able to estimate medical assistance in dying would play a role in one to four percent of all deaths in Canada, resulting in approximately 10,722 deaths annually. Of those deaths, an estimated eighty percent would be struggling with cancer; fifty percent would be between 50 to 80 years of age, and sixty percent would have had their lives cut short by an average of one month. Based on physician fees in Ontario the calculation was that direct total cost of doctor-hastened death would range from $269 to $756.

Medical assistance in dying (MAID) in practise, has the potential to reduce annual health spending by $35-million to $139-million. For 2016, Canada was projected to spend $228-billion on health care. According to one Ontario study, the average person is responsible for generating $14,000 in health-care costs through the last thirty days of their life, inclusive of receiving intensive treatment which, in the end, serves frequently to temporarily delay otherwise-imminent death.

"Canadians die in hospitals more often than, say, our counterparts in America or Europe and … we have a lack of palliative care services even though we are trying to improve that. And therefore people end up spending their final days in the hospital", explained Dr. Trachtenberg further. "Hospital-based care costs the health care system more than a comprehensive palliative care system where we could help people achieve their goal of dying at home."

Hospice volunteers caress the hands of terminally ill patient
John Moore / Getty Images   Hospice volunteers caress the hands of terminally ill patient

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Monday, January 23, 2017

Educating Afghanistan's Children : Or So We Think

"Canada is currently undertaking the necessary due diligence to ensure that in the event that Canada's funds have been misappropriated, that such funds are recovered and that the guilty parties are held to account."
"Canadian funds provided to EQUIP are administered by the World Bank through the Afghanistan Reconstruction Trust Fund." 
"Canada's longstanding support to education in Afghanistan has contributed, along with other donors, to more than 8.4 million Afghan children being enrolled in formal and community-based schools, 39 percent of whom are girls."
Jessica Seguin, spokeswoman, Global Affairs Canada

"Earlier this month, the Minister of Education Assadullah Hanif Balkhi said that a recent study found that only six million Afghan children are in fact at school -- contrary to the 11 million as previously stated by the former government [of previous Prime Minister Hamid Karzai]."
Report, TOLOnews, Afghanistan

"[Allegations of nonexistent] ghost students, teachers and schools [in Afghanistan are not new, in a country swept by corruption]. [A report issued in January by the U.S. Special Inspector General for Afghanistan Reconstruction (SIGAR), points to a] high risk list [vulnerable to] significant waste, fraud and abuse."
"Corruption continues to be one of the most serious  threats to the U.S.-funded Afghanistan reconstruction effort."
"SIGAR has launched a new ARTF performance audit to assess the extent to which the World Bank and the Afghan government monitor and account for U.S. contributions to the ARTF, evaluate whether ARTF-funded projects have achieved their stated goals and objectives, and utilize and enforce any conditionality on ARTF funding."
"There may be problems with student and teacher absenteeism that warrant further investigation by the Afghan government."
U.S. Special Inspector General for Afghanistan Reconstruction


Yasamina, 14  "I fetch water every day - it takes about an hour. But, I also go to my school. I walk with my 
friends for four kilometres every day but I like walking to my school with my friends. I want to be a nurse when 
I finish my school here." BBC News

At one time the ruling Taliban issued an edict that Afghan girls had no need of education, and only boys were permitted to attend schools. Neither were women permitted to be seen outside their homes without wearing an all-enveloping burqa that also covered their faces, allowing eyes to peer out from behind a netting on the top half of the niqab, or veil. Women were not permitted to work, even if there was no one else to support them financially, even if they had dependent children. Men were expected not to shave their facial hair. Music was not permitted, nor was celebratory gatherings.

After the ouster of the Taliban, when the U.S.-led NATO mission to find Osama bin Laden and disperse both al-Qaeda and their supporters the Taliban from Afghanistan, the international mission undertook a transformation of Afghan society. Schools were built and medical clinics were established; where previously girls were not permitted to study, schools were built solely for girls to attend, and no longer would male physicians be restricted from treating female patients, nor female physicians forced to wear burqas themselves, while undertaking surgical procedures.


Humanitarian aid organizations flooded into Afghanistan with the intention of serving its people. Afghan women, now permitted to work, did just that, priding themselves on their new freedom and determined to move forward. And the international community, preparing to leave Afghanistan, invested in training Afghan police and the military to Western standards to enable them to meet conflict situations in self-defense. In the process, discovering how deeply-engrained corruption in Afghanistan was, permeating the entire society.

Current President Ashraf Ghani had campaigned for the presidency several years back, with one of his primary promises being to sweep endemic corruption out of Afghanistan. Had the U.S. agency not delved deeply into the problem of unaccountability and corruption in the education ministry, in preparation for a presentation of an updated report for the new American administration, the depth to which the ministry was corrupted might never have been fully revealed, even though the Afghan government had arrested workers in the ministry for embezzlement at an earlier date.


Mohammad Zaman, 13, studies in Sherzad high school. He says most
of his schoolmates study in the open 
air because there are not many 
rooms in his school which is over-crowded. "I want to study wherever I can, I wish we had rooms but I learn a lot of things every day. I want to be an engineer in the future." BBC News

Half the number of children that the previous government of Afghanistan under former president Hamid Karzai, reported to be attending school, actually did. International aid for that specific purpose has been set aside, purloined and found its way into the pockets and bank accounts of various Afghan officials, to the detriment of Afghanistan's children. What the Taliban did in depriving the children of Afghanistan, particularly the girls, of an education, as an institutional edict, the trusted and legally, democratically elected government has carried forward through inattention to the funding dispersal and the actual implementation of what the funding was meant to accomplish.


Billions of dollars representing international aid are unaccounted for. The issue of "widespread corruption", now front and centre again will have consequences in the international community which had expectations that its dedicated efforts and its treasury meant to fund an impoverished and embattled nation would have positive results for the future, not enrich corrupt officials. The result of which will be felt on future investments in the country.

These boys walk to Kodi Khel village from a nearby mountain. They say they walk in a group and rest on the way every day. They cross rivers and mountainous valleys before they arrive at Sherzad high school. BBC News

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Sunday, January 22, 2017

Early Warning System : Avoiding Drug Overdoses

"What we're seeing right now, I think, are responses to overdoses after the overdose has happened. What I'm interested in is trying to prevent the overdoses before they happen."
"Our plan is to purchase advertising time on Facebook so we can get warnings out really quickly with a webpage."
"What's happening now is, because it's cheaper than heroin and cheaper than cocaine, it's being mixed with those drugs to make better profit for the drug dealers."
Lynne Leonard, assistant professor, research scientist, University of Ottawa

"People have been concerned about the quality of their drugs. These are interventions that we can put into place that would reduce a lot of those extreme risks and adverse health effects that we have been seeing and are seeing in greater numbers now."
Caleb Chepesiuk, harm reduction co-ordinator, AIDS Committee of Ottawa
drug diversion
Drug diversion is a growing concern within the medical field and healthcare settings are increasingly turning to spectrophotometry to detect abuses.
Image Source: Flickr user L. Andrew Bell
It's not an antidote like naloxone but it is a preventive device, or an alerting tool, one capable of detecting the presence of hidden substances proven to be lethal, that have become a huge problem throughout North America, in street drugs that users trust are the pure heroin or cocaine they think they have in their hands, unadulterated by fentanyl. The machine, called a spectrometer, has been in use in the United States, at musical festivals, among other venues.

And its use can save lives. Its use reveals the quality of the drug being tested, and whether or not that drug has been adulterated, cut with another drug, and usually the substance of concern is powerful fentanyl. What's worse is the concern that another drug in the fentanyl class, carfentanil, even more powerful than the deadly fentanyl, is about to enter the picture in Canada. These drugs, openly available on the Internet through Chinese exporters, are the source of innumerable overdose deaths in North America.

An application was submitted to the federal government to permit a supervised injection site in downtown Ottawa. At the same time, a research funding proposal has been submitted to the Canadian Institutes of Health Research for the purpose of evaluating the efficacy of the technology used by the spectrometer. Depending on the type of results and the speed of results, a spectrometer's price tag ranges from $30,000 to $100,000.

This powerful drug-testing machine has the capability of revealing the strength and purity of opioids. At the present time, a kit is available for drug  testing whereby a drop of a solution on the drug in question exposes unknown substances, triggered by a change in colour. The AIDS committee offers the kits through a pilot project to test drugs such as cocaine, speed, MDMA and crystal meth. But it is of a limited value with opioids.

Oxycontin pills are also circulating, which contain fentanyl. And the hugely potent carfentanil, 10,000 greater in toxicity than morphine though not yet seen locally, is expected to surface: "I think it's only a matter of time", said Dr. Leonard.

Organizers of the Shambhala music festival have launched a crowdfunding campaign to buy a mass spectrometer for drug testing.
Organizers of the Shambhala music festival have launched a crowdfunding campaign to buy a mass spectrometer for drug testing. (CBC)

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Saturday, January 21, 2017

The Complex Medical Issues of Too Much vs Too Little

"We say routinely that asthma has gone from being chronically underdiagnosed to being misdiagnosed and overdiagnosed."
"It is a huge issue."
"It is not simple. There is not a genetic test, there is not a blood test [for diagnosis]."
"It used to be underdiagnosed. Now it is the worst of both worlds. It is still underdiagnosed and also overdiagnosed. We still see  kids with recurrent bronchitis that turns out to be asthma."
Dr. Ian MacLusky, chief respirologist, Children's Hospital of Eastern Ontario, Ottawa

"Doctors wouldn't diagnose diabetes  without checking blood sugar levels, or a broken bone without ordering an X-ray."
"But for some reason many doctors are not ordering the spirometry tests that can definitely diagnose asthma."
Dr. Shawn Aaron, senior scientists, respirologist, The Ottawa Hospital
Dr. Shawn Aaron gives a patient a spirometry test. THE CANADIAN PRESS

Much scientific commotion arose this week when research results found by Dr. Aaron, a professor at University of Ottawa, was reported in headlines worldwide reflecting his conclusion published in the Journal of the American Medical Association, that 33 percent of adults diagnosed with asthma in recent years did not in fact suffer from asthma. Over 90 percent of those incorrectly diagnosed patients who were studied and discovered not to be asthmatic, as a result ceased taking asthma-specific medication.

Dr. Aaron's study brought to the fore that diagnoses of these patients were based on symptoms and the observations of their physicians, in ignorance of the fact that a spirometry test, whose accuracy in diagnosing asthma is completely reliable, should be done, but in these instances, spurned. The test can be conducted in a doctor's office, assessing how proficiently a patient's lungs operate. It can diagnose asthma, chronic obstructive pulmonary disease, as well as other conditions that complicate normal breathing.

Mere days later it has now been revealed that it is not only adults who have been incorrectly diagnosed with asthma, but children as well. The Asthma Society of Canada refers to the situation affecting some 13 percent of Canadian children as a major cause of hospitalization, reflecting how common a condition it is among children. Yet relatively little research has been undertaken on asthma overdiagnosis in children.

file picture of child with asthma inhaler and spacer device
Science Photo Library : Too many children are being incorrectly diagnosed with asthma, with inhalers being dispensed for no good reason and becoming almost "fashion accessories", say two specialists in the illness.

Last year, a retrospective study out of the Netherlands was published that came to the conclusion that childhood asthma, common in primary care, is vastly overdiagnosed, resulting in unnecessary treatment protocols and subsequent deleterious impact on children's quality of life. Asthma, the research reported, was appropriately confirmed with tests on lung function in a small number of the children who had been diagnosed.

Under the age of six, children's diagnosis is complicated by the fact that they cannot be given spirometry tests. Apart from which asthma can generally prove difficult to diagnose. According to Dr. MacLusky, diagnoses are reached too quickly and without appropriate testing, even when that testing can be performed. One study discovered a mere eight percent of children who had been diagnosed with exercise-caused asthma were in fact asthmatic.

A small subset of people who have life-threatening asthma may be missing out on the care they need. Photograph: Image Source/Getty Images

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