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Will Cautero prepares to teach his 11th grade English class to Las Lomas High School students remotely from his home in Oakland, Calif. on Thursday, April 16, 2020.

Paul Chinn | The San Francisco Chronicle via Getty Images

Working from home has become the norm, and if the trend continues even after the pandemic abates, it could pose a big risk for oil, analysts are warning.

"The biggest threat to oil demand is the rise of remote working," Bernstein said in a recent note to clients. "A decrease in commuting and business air travel is clearly negative for oil demand."

Gasoline represents a sizable portion of overall oil demand within each barrel of refined crude about 45% is used for gasoline and, according to RBC,about 28% of gasoline demand in the U.S. is from people driving to and from work.

Oil prices are, of course, driven by supply and demand dynamics, so a change on one side of the equation can send prices into a tailspin.

Oil took a hit in April as billions of people around the world were subjected to some form of lockdown measures in an effort to slow the spread of Covid-19. With air and road travel coming to a virtual standstill, oil demand fell off a cliff. West Texas Intermediate, the U.S. oil benchmark, plunged below zero and into negative territory for the first time on record since no one wanted to take physical delivery of crude with demand expected to remain depressed.

Now, WTI is on track for its best month ever as economies have started to reopen, and as producers have announced record output cuts.

But demand might not ever fully recover. Twitter and Shopfiy are among the companies that have announced permanent work-from-home options, and more companies are expected to follow suit.

"Pretty much every company out there with a sizable commercial real estate footprint is thinking about this now," said Dan Klein, head of scenario planning at S&P Global Platts. "While it's probably too early to tell how prevalent this structural shift in working from home will become after the restrictions are lifted, it's clear that a certain percentage of workers will never go back to commuting, at least every day," he added. The firm believes between 1 million barrels per day and 1.5 million bpd will be permanently lost.

A man wearing a protective mask crosses an empty street during the coronavirus pandemic on May 18, 2020 in New York City.

Cindy Ord | Getty Images

Prior to the outbreak of Covid-19, worldwide demand stood at roughly 100 million bpd, according to the International Energy Agency.

Klein said an even bigger risk could be the impact on business air travel, especially over the longer-term, as employees get used to using Zoom, Skype and Microsoft Teams. "Right now you're challenging that notion that business travel is the cost of doing business," he said, noting that the demand hit could be 1.5 million bpd to 2 million bpd.

Raymond James added that heightened unemployment as well as online education will also eat away at demand. "We assume that vehicle fuel consumption in 2021 will be impacted by 1.6 million bpd versus pre-COVID levels, all else held constant, with the impact decreasing to 400,000 bpd in 2022." When it comes to jet fuel consumption, the firm believes a slowdown in business travel will mean 2 million bpd of demand loss in 2021, before recovering slightly to 800,000 bpd in 2022.

To be sure, all forecasts come with the caveat that it's still early to determine the potential long-lasting impacts. The coronavirus led to unprecedented demand loss between one fourth and one third of overall demand by many estimates but the announced production cuts have also been unprecedented. With so many moving parts, it's difficult to forecast how human behavior will change.

Some behavioral changes could also be supportive for oil prices. People might be wary of taking public transport which could lead to a boost in driving, for instance, while low gas prices could slow the adoption of electric vehicles. Oil demand is also highly sensitive to the overall economic backdrop so a slowdown in trade and shipping, for example, will also contribute to demand loss.

In its closely-watched monthly report released earlier in May, the IEA said it expects demand to fall by 8.6 million bpd to 91.2 million bpd for the year. This would be the biggest demand drop in history, although it's slightly more optimistic than the agency's prior forecast of a 9.3 million bpd loss.

While estimates vary as to when the world will reach peak oil, the consensus is that we are heading in that direction. And if more and more people shift to remote work, it could accelerate this change.

"If you take this amount of demand loss on top of that trending lower demand already, it makes it all the more steep," Klein said.

- CNBC's Michael Bloom contributed reporting.

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Rise of remote working is 'biggest threat to oil demand,' says analyst - CNBC

Human Behavior

There Are 3 Things We Have to Do to Get People Wearing Masks – The New York Times

May 30, 2020 medical

Hong Kong has so far reported a grand total of four coronavirus-related deaths, while New York City has reported over 20,000.

Heres another striking comparison: Close to 99 percent of Hong Kong residents have been wearing masks, to prevent the wearer from spreading the virus, since early February. According to a mid-April Gallup poll, only a third of Americans say they always wear a mask or cloth face covering outside the home. Another third of us sometimes wear a mask in public, and a third never do.

Universal face mask adoption isnt the only difference between Hong Kong and the United States, and its not a substitute for physical-distancing, hand-washing and other preventive practices. But masks even just a scarf, bandanna or an old T-shirt and two rubber bands are widely viewed as critical to stopping the transmission of the novel coronavirus.

Nevertheless, face-mask compliance on this side of the Pacific has been uneven. This is especially worrisome in closed, crowded spaces like subways and buses, grocery stores and offices where its not easy to maintain a distance of six feet from other people and avoid spontaneous coughs and sneezes.

The most obvious path to universal masking is to pass laws and punish infractions. But enforcing legal edicts to wear masks in public can be difficult and costly, and amid widespread ambivalence can lead to backlash and even violence. So edicts are not a complete solution.

As experts in public health and human behavior, we propose a complementary approach: Make wearing a mask easy, understood and expected.

From effortful to easy: Where can you get face masks? You can search for them online, you can now buy them in drugstores and yes, you can make them yourself. But none of these options are effortless.

Imagine if every city and town in this country had an Adrian Cheng, the real estate developer in Hong Kong who had a manufacturing line set up in one of his empty properties and made the masks available free to the needy in vending machines devised specifically for the purpose. Not long after, the Hong Kong government set up a website where any household can register to have reusable masks delivered free. Or consider Utah, where residents can likewise register online and receive a free fabric face mask by mail. The cheaper and more ubiquitous face masks are, the easier it will be for Americans to get our hands on them, and the more likely well do so and wear them.

From unclear to understood: Not long ago, the Centers for Disease Control and Prevention and the surgeon general were lecturing the American public on why they shouldnt wear face masks. That recommendation flipped once it became clear that people infected with the coronavirus can spread it before they know they have it and, therefore, everyone should wear a mask to reduce the chances of infecting others. Since its hard for people to update their beliefs once a message has been received, its no surprise that misinformation and outdated news continue to ricochet in the echo chambers of social media.

Unfortunately, it is often easier to dig our heels in than to change our minds, defending our original position and discounting new information to justify our behavior. Therefore, it can be helpful to supply people with a rationale to change their behavior without looking like a hypocrite. For example, officials can emphasize that at the start of this crisis, nobody could have known how important it is to wear a mask when you have no symptoms, and that day by day, new scientific evidence is demonstrating the efficacy of masks in the fight against the coronavirus.

From unconventional to expected: It is human nature to adhere to social norms. When uncertain about what to do, people tend to look around and copy what other people are doing. For instance, if you were in Hong Kong right now, even if you werent up to date on the public health imperative, youd very likely follow the lead of everyone around you and put one on.

How do we create a social norm of mask-wearing when, in fact, so many Americans are doing exactly the opposite? One common mistake is drawing attention to the lack of compliance. For instance, highlighting littering as a commonplace problem can inadvertently lead to more littering because it strengthens the perception that littering is the norm. Instead, in press releases and public service announcements, officials should emphasize that the clear trend in this country is toward universal mask-wearing.

According to a recent Qualtrics study, a majority of surveyed Americans now say they wont return to the office unless their company makes wearing face masks mandatory. And in just one week in April, the percentage of Americans who said they wore a mask outside the home increased by more than half.

The story of face masks in this country is still being written. We may lack the wisdom Hong Kong earned weathering prior epidemics, but its not too late to apply three basic principles from behavioral science: make it easy, understood and expected, and well soon see face masks everywhere, saving lives.

Angela Duckworth, founder and chief executive of Character Lab, is a professor at the University of Pennsylvania, where Lyle Ungar is a professor of computer and information science, and Ezekiel J. Emanuel, author of the forthcoming Which Country Has the Worlds Best Health Care?, is a professor of health care management, medical ethics and health policy.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

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There Are 3 Things We Have to Do to Get People Wearing Masks - The New York Times

Human Behavior

To fly or not to fly tips from experts on how to minimize risk – ThePrint

May 30, 2020 medical

We dont know about you, but were ready to travel. And that typically means flying.

We have been thinking through this issue as moms and as anexposure scientistandinfectious disease epidemiologist. While weve decided personally that were not going to fly right now, we will walk you through our thought process on what to consider and how to minimize your risks.

A secondary concern is contact with contaminated surfaces. When an infected person contaminates a shared armrest, airport restroom handle, seat tray or other item, the virus can survive for hours though it degradesover time. If you touch that surface and then touch your mouth or nose, you put yourself at risk of infection.

While there is no way to make air travel 100% safe, there are ways to make it safer. Its important to think through the particulars for each trip.

One approach to your decision-making is to use what occupational health experts call thehierarchy of controls. This approach does two things. It focuses on strategies to control exposures close to the source. Second, it minimizes how much you have to rely on individual human behavior to control exposure. Its important to remember you may be infectious and everyone around you may also be infectious.

The best way to control exposure is to eliminate the hazard. Since we cannot eliminate the new coronavirus, ask yourself if you can eliminate the trip. Think extra hard if you areolder or have preexisting conditions, or if you are going to visit someone in that position.

If you are healthy and those you visit are healthy, think about ways to substitute the hazard. Is it possible to drive? This would allow you to have more control over minimizing your exposures, particularly if the distance is less than a day of travel.

Also read: I took one of Indias first flights in months. It was surreal

Youre going, now what?

If you choose to fly, check out airlines policies on seating and boarding. Some areminimizing capacity and spacing passengersby not using middle seats and having empty rows. Others are boarding from the back of the plane. Some that were criticized for filling their planes to capacity have announced plans to allow customers to cancel their flights if the flight goes over 70% passenger seating capacity.

Federal and state guidance is changing constantly, so make sure you look up the most recent guidance from government agencies and the airlines and airport you are using for additional advice, and current policies or restrictions.

While this may sound counterintuitive, consider booking multiple, shorter flights. This will decrease the likelihood of having to use the lavatory and the duration of exposure to an infectious person on the plane.

After you book, select a window seat if possible. If you consider the six-foot radius circle around you, having a wall on one side would directlyreduce the number of people you are exposedto during the flight in half, not to mention all the people going up and down the aisle.

Also, check out your airline to see their engineering controls that are designed or put into practice to isolate hazards. These include ventilation systems, on-board barriers and electrostatic disinfectant sprays on flights.

When the ventilation system on planes is operating, planes have avery high ratio of outside fresh air to recirculated air about 10 times higher than most commercial buildings. Plus, most planesventilation systems have HEPA filters. These are at least 99.9% effective at removing particles that are 0.3 microns in diameter and more efficient at removing both smaller and larger particles.

Also read: More than 1.65 lakh people have travelled in 2,198 flights after resumption of air travel

How to be safe from shuttle to seat

From checking in, to going through security to boarding, you will be touching many surfaces. To minimize risk:

If you are thinking about flying with kids, there are special considerations. Getting a young child to adhere to wearing a mask and maintaining good hygiene behaviors at home is hard enough; it may be impossible to do so when flying. Children under 2 should not wear a mask.

Each day, we are all constantly faced with decisions about our own personal comfort with risk. Arming yourself with specific knowledge about your airport and airline, and maximizing your use of protective measures that you have control over, can reduce your risk. A good analogy might be that every time you get in the car to drive somewhere there is risk of an accident, but there is a big difference between driving the speed limit with your seat belt on and driving blindfolded, 60 miles an hour through the middle of town.

This article was republished from the World Economic Forum

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To fly or not to fly tips from experts on how to minimize risk - ThePrint

Human Behavior

Coronavirus has killed more than 100000 people in the US in less than four months – The Philadelphia Tribune

May 30, 2020 medical

In less than four months, coronavirus has killed more than 100,000 people in the United States.

It's as if every person died in Boca Raton, Florida. Or almost everyone in South Bend, Indiana.

When the first coronavirus-related death was reported in February, no one could have fathomed the numbing stream of grim news that followed. Since then, an average of nearly 900 people have perished every day from Covid-19.

Now, more than ever, the world needs trustworthy reportingbut good journalism isnt free.Please support us by making a contribution.

With social distancing rules keeping families apart, many of the sick died alone in hospital rooms as loved ones were forced to say goodbye through phone screens.

Others died at home, too sick or too scared to go to the hospital for coronavirus tests. Their stories never made it to the roster of deaths, which means the tolls could be much higher.

Families have lost fathers, mothers, siblings, grandparents and even children. America has lost the best of humanity, with victims including an ER doctor who risked his life trying to save others, a 36-year-old principal who helped grow produce for the needy and a Holocaust survivor who saved families from genocide.

Understanding the massive scale of coronavirus in the US

Health officials have struggled to make sense of the highly contagious and poorly understood disease even as coronavirus circulates in the United States, where nearly 1.7 million have tested positive. And experts are still learning new things.

For months, public health officials have urged people to stay six feet apart to slow its spread through respiratory droplets. But three experts are warning that six feet may not be enough -- and are asking the world to take airborne transmission of the virus seriously.

In a commentary published in the journal Science, the experts highlighted the importance of masks and regular, widespread testing.

They pointed to places such as Singapore, Hong Kong and Taiwan, where mask wearing is universal and the virus has been controlled.

"Evidence suggests that [the novel coronavirus] is silently spreading in aerosols exhaled by highly contagious infected individuals with no symptoms," wrote Chia Wang of National Sun Yat-sen University in Taiwan, and Kimberly Prather and Dr. Robert Schooley of the University of California, San Diego.

"Increasing evidence for [the coronavirus] suggests the six-foot WHO recommendation is likely not enough under many indoor conditions where aerosols can remain airborne for hours, accumulate over time and follow air flows over distances farther than six feet," they wrote.

The three experts are specialists in chemistry and infectious diseases. They said aerosols from breathing and speaking can accumulate and remain infectious in indoor air for hours, and can be easily inhaled into the lungs.

That makes wearing masks all the more essential, they said, even when people are keeping their distance.

The US Centers for Disease Control and Prevention has addressed the issue of respiratory droplets produced when a person coughs or sneezes. It has said they "can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs."

Spread is more likely when people are in close contact with one another, or "within about 6 feet," the CDC says.

While health officials have focused on droplets, the three experts said "a large proportion" of the spread of coronavirus disease appears to be occurring through airborne transmission of aerosols produced by asymptomatic people during breathing and speaking.

The US did not have to lose 100,0000 people in the first five months of the coronavirus pandemic, according to an expert on viruses and biotechnology.

Better preparation and guidance could have helped lower the death toll, said Dr. William Haseltine, president of the think tank ACCESS Health International.

"We already know how to control the virus in a big population. It can be done through human behavior," the former professor at Harvard Medical School told CNN's Anderson Cooper. "It didn't have to happen if we had been prepared."

Experts had worked with the US Department of Defense and Homeland Security to plan and protect the country from bioterrorism, as well as from threats like the coronavirus.

"It was totally predictable that another coronavirus was on its way," Haseltine said. "The mechanism exists, the stockpile, the drugs," he said. "There was a hole in our safety net."

China, New Zealand, and Australia have effectively dealt with coronavirus outbreaks, bringing their cases down through testing, contact tracing and isolation, Haseltine said.

The key to their success was behavior change without the benefit of a vaccine or effective drug.

While the nation tries to keep infection rates down, some states are doing better than others.

Illinois appears to be entering a "downward trend," with the week ending May 16 being its first with a lower number of coronavirus deaths than the week before.

Washington, DC will move Friday into Phase 1 of reopening after it had a 14-day decline in cases of coronavirus community spread, , Mayor Muriel Bowser said.

But other regions did not fare as well. As of Wednesday, there were 14 states in which the number of cases was still trending upward.

Mississippi Gov. Tate Reeves warned residents to stay vigilant because the state is still seeing a steady number of cases.

California became the fourth state Wednesday with more than 100,000 cases. New York, New Jersey and Illinois were the first three to reach the milestone.

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Coronavirus has killed more than 100000 people in the US in less than four months - The Philadelphia Tribune

Neuroscience

Students deliver care packages to refugee children at the end of Ramadan – The South End

May 30, 2020 medical

Celine Bazzi places a handwritten card inside a care package for Syrian refugee children and their families for Eid al-Fitr, the festival of breaking the fast at the end of Ramadan.

When COVID-19 hit Southeast Michigan, Dr. Arash Javanbakht and his crew of student researchers were forced to halt their studys data collection. It was a setback, certainly.

For nearly four years, Javanbakht and his team have been exploring the mental health impact and biological correlation of war trauma on Syrian refugees, many of them children, now living in the United States. But all Javanbakht could think about was the outbreaks impact on the families who have become so much more than research participants.

Given it was Ramadan, and especially during this stressful time of the pandemic, I thought of a way to bring a smile to the kids, said Javanbakht, associate professor of Psychiatry and Behavioral Neurosciences and director of the Stress, Trauma and Anxiety Research Clinic. We brainstormed and decided to make gift packages for the children and their families, and deliver them to their doors for Eid al-Fitr [the festival of breaking the fast at the end of Ramadan].

With the parents permission, Javanbakht and the team of undergraduate, graduate and postdoctoral students most of whom have Arabic backgrounds, and some who are also refugees created care packages of snacks and school supplies for the children and delivered it to their doors on May 22. In addition, Wayne State Marketing and Communications donated backpacks, pens and T-shirts.

While Javanbakht covered all the costs, he said the team did the hard work of choosing, purchasing, packaging and delivering the age-appropriate gifts.

Tailoring the box with respect to each specific family and their children provided such a valuable experience, said Celine Bazzi, 22, who graduated in spring 2020 with a bachelors in biological sciences and minors in philosophy and health care ethics. Being able to tend to each child individually, as well as brainstorm ideas of what they might enjoy, made the process that much more special.

While Bazzis last semester at Wayne State didnt end according to plan, she said she will take with her the memory of being sprawled out on her living room floor, surrounded by immense amounts of goodies, anticipating iftar [the time in which fast is broken], while handwriting the beautifully crafted cards.

For postdoctoral researcher Bassem Saad, 30, seeing the families reactions hit him deeply. As a person coming from the Middle East, an immigrant, my cause has always been supporting people who had suffered a lot through civil war, he said. I was over the moon that they feel recognized, accepted and understood in the academic scene.

Lana Grasser, a 24-year-old Ph.D. candidate going into her fourth year of Wayne States translational neuroscience program, hoped the care packages would bring a little joy during a time of hardship.

We have worked with these families not only in the labs, but also in the home. It felt like seeing my own family, but it was hard to not give them all hugs, she said. Through our Eid gift-giving, we were able to make a small part of the world in our own personal circles a little bit better and brighter. We are so grateful for all the time they have given us and stories they have shared. This was the least we could do.

That feeling was shared among the entire team.

As a research assistant, I have visited the homes of the families involved in our study and they always welcome us with so much hospitality, said Rajaa Shoukfeh, 22, who graduated in December 2019 with a bachelors in nutrition and food science. When Dr. Javanbakht first brought up the idea at one of our weekly team meetings, it was so heartwarming. Its such a kind gesture to repay their kindness and show them how much we appreciate their participation.

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Students deliver care packages to refugee children at the end of Ramadan - The South End

Neuroscience

Studies advance the understanding of sensory disconnection during sleep and anesthesia – News-Medical.Net

May 30, 2020 medical

During sleep and under anesthesia, we rarely respond to such external stimuli as sounds even though our brains remain highly active.

Now, a series of new studies by researchers at Tel Aviv University's Sackler Faculty of Medicine and Sagol School of Neuroscience finds, among other important discoveries, that noradrenaline, a neurotransmitter secreted in response to stress, lies at the heart of our ability to "shut off" our sensory responses and sleep soundly.

"In these studies, we used different, novel approaches to study the filtering of sensory information during sleep and the brain mechanisms that determine when we awaken in response to external events," explains Prof. Yuval Nir, who led the research for the three studies.

The first study, published in the Journal of Neuroscience on April 1 and led by TAU doctoral student Yaniv Sela, calls into question the commonly accepted idea that the thalamus -- an important relay station for sensory signals in the brain -- is responsible for blocking the transmission of signals to the cerebral cortex.

"The shutdown of the thalamic gate is not compatible with our findings," says Sela whose study compares how neurons in different brain regions respond to simple and complex sounds while asleep or awake.

Using rat models, he found that the responses of neurons in the auditory cortex were similar when the rodents were awake or asleep. But when he examined the perirhinal cortex, related to complex conscious perception and memory associations, he found that neurons showed much weaker responses during sleep.

"Basic analysis of sound remains during sleep, but the sleeping brain has trouble creating a conscious perception of the stimulus," Sela adds. "

Also, while we found that initial and fast responses are preserved in sleep, those that occur later and require communication between different regions in the cortex are greatly disrupted."

The second study, published on April 8 in Science Advances, finds that the locus coeruleus, a tiny region of the brainstem and the main source of noradrenaline secretions in the brain, plays a central role in our ability to disconnect from the environment during sleep.

Led by TAU doctoral student Hanna Hayat at Prof. Nir's lab, the research was conducted in collaboration with Prof. Tony Pickering of Bristol University, Prof. Ofer Yizhar of the Weizmann Institute and Prof. Eric Kremer pf the University of Montpellier.

The ability to disconnect from the environment, in a reversible way, is a central feature of sleep, Our findings clearly show that the locus coeruleus noradrenaline system plays a crucial role in this disconnection by keeping a very low level of activity during sleep."

Hanna Hayat, Doctoral Student, Tel Aviv University

For the purpose of the research, the scientists used rat models to determine the level of locus coeruleus activity during sleep and which sounds, if any, would be responsible for waking up the rodents.

They found that the rats' varying levels of locus coeruleus activity accurately predict if the animals would awaken in response to sounds.

The team then silenced the locus coeruleus activity through optogenetics, which harnesses light to control neuronal activity, and found that the rats did not readily awaken in response to sound.

"When we increased the noradrenaline activity of the locus-coeruleus while a sound played in the background, the rats woke up more frequently in response, but when we decreased the activity of the locus coeruleus and played the same sound in the background, the rats only rarely woke up," says Hayat.

"So we can say we identified a powerful 'dial' that controls the depth of sleep despite external stimuli."

"Importantly, our findings suggest that hyperarousal in some individuals who sleep lightly, or during periods of stress, maybe a result of continued noradrenaline activity during sleep when there should only be minimal activity."

The third study, published on May 12 in the Proceedings of the National Academy of Sciences (PNAS), led jointly by TAU doctoral student Dr. Aaron Krom of Hadassah Hebrew University Medical Center and TAU doctoral student Amit Marmelshtein, focuses on our response to anesthesia and finds that the most significant effect of loss-of-consciousness is the disruption of communication between different cortical regions.

The study was the fruit of a collaboration between Prof. Nir, Prof. Itzhak Fried and Dr. Ido Strauss of TAU's Sackler Faculty of Medicine and Tel Aviv Sourasky Medical Center, and a team at Bonn University.

"Despite the routine use of anesthesia in medicine, we still do not understand how anesthesia leads to loss of consciousness; this is considered a major open question in biomedical research," explains Dr. Krom.

For the research, the scientists recorded the brain activity of epilepsy patients who had previously shown little to no response to drug interventions. The patients were hospitalized for a week and implanted with electrodes to pinpoint where in the brain their seizures originated.

They were then anesthetized for the removal of their electrodes and their neuron activity recorded while they listened to sounds through headphones.

They were asked to perform a task until they lost consciousness, which allowed the researchers to examine how their brain activity changed, down to individual neurons, in response to sounds at the very moment they lost consciousness.

"We found that loss-of-consciousness disrupted communication between cortical regions such that sounds triggered responses in the primary auditory cortex, but failed to reliably drive responses in other regions of the cortex," adds Marmelshtein.

"This is the first study to examine how anesthesia and loss of consciousness affect sensory responses at a resolution of individual neurons in humans."

"We hope that our results will guide future research, as well as attempts to improve anesthesia and develop instruments that can monitor the level of consciousness in anesthesia and other states of altered consciousness such as vegetative states and severe dementia."

"These studies advance our understanding of sensory disconnection during sleep and anesthesia," concludes Prof Nir. "Sleep disturbances are a major health issue and are frequent in aging, as well as in neurological and psychiatric disorders."

"It is important to test if our findings on varying noradrenaline levels can explain hyperarousal that characterizes conditions such as anxiety disorders and PTSD and if so to build on these findings to develop novel methods to improve sleep quality."

Source:

Journal reference:

Krom, A.J., et al. (2020) Anesthesia-induced loss of consciousness disrupts auditory responses beyond primary cortex. Proceedings of National Academy of Sciences. doi.org/10.1073/pnas.1917251117.

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Studies advance the understanding of sensory disconnection during sleep and anesthesia - News-Medical.Net

Cell Biology

Nanodevices Track Cells From the Inside, Show How They Develop With Time – SciTechDaily

May 30, 2020 medical

At this point in development, the embryo chromosomes (which appear red in the center) are preparing to separate during the first cell division. The device prongs can be seen fluorescing green, with green-fluorescing actin around the periphery. Credit: Professor Tony Perry

For the first time, scientists have added microscopic tracking devices into the interior of cells, giving a peek into how development starts.

For the first time, scientists have introduced minuscule tracking devices directly into the interior of mammalian cells, giving an unprecedented peek into the processes that govern the beginning of development. This work on one-cell embryos is set to shift our understanding of the mechanisms that underpin cellular behavior in general, and may ultimately provide insights into what goes wrong in aging and disease.The research, led by Professor Tony Perry from the Department of Biology and Biochemistry at the University of Bath, involved injecting a silicon-based nanodevice together with sperm into the egg cell of a mouse. The result was a healthy, fertilized egg containing a tracking device.The tiny devices are a little like spiders, complete with eight highly flexible legs. The legs measure the pulling and pushing forces exerted in the cell interior to a very high level of precision, thereby revealing the cellular forces at play and showing how intracellular matter rearranged itself over time.

Five mouse embryos, each containing a nanodevice that is 22-millionths of a meter long. The film begins when the embryos are 2-hours old and continues for 5 hours. Each embryo is about 100-millionths of a meter in diameter. Credit: Professor Tony Perry

The nanodevices are incredibly thin similar to some of the cells structural components, and measuring 22 nanometres, making them approximately 100,000 times thinner than a pound coin. This means they have the flexibility to register the movement of the cells cytoplasm as the one-cell embryo embarks on its voyage towards becoming a two-cell embryo.

This is the first glimpse of the physics of any cell on this scale from within, said Professor Perry. Its the first time anyone has seen from the inside how cell material moves around and organizes itself.

The activity within a cell determines how that cell functions, explains Professor Perry. The behavior of intracellular matter is probably as influential to cell behavior as gene expression, he said. Until now, however, this complex dance of cellular material has remained largely unstudied. As a result, scientists have been able to identify the elements that make up a cell, but not how the cell interior behaves as a whole.

From studies in biology and embryology, we know about certain molecules and cellular phenomena, and we have woven this information into a reductionist narrative of how things work, but now this narrative is changing, said Professor Perry. The narrative was written largely by biologists, who brought with them the questions and tools of biology. What was missing was physics. Physics asks about the forces driving a cells behavior, and provides a top-down approach to finding the answer.

We can now look at the cell as a whole, not just the nuts and bolts that make it.

Mouse embryos were chosen for the study because of their relatively large size (they measure 100 microns, or 100-millionths of a meter, in diameter, compared to a regular cell which is only 10 microns [10-millionths of a meter] in diameter). This meant that inside each embryo, there was space for a tracking device.

The researchers made their measurements by examining video recordings taken through a microscope as the embryos developed. Sometimes the devices were pitched and twisted by forces that were even greater than those inside muscle cells, said Professor Perry. At other times, the devices moved very little, showing the cell interior had become calm. There was nothing random about these processes from the moment you have a one-cell embryo, everything is done in a predictable way. The physics is programmed.

The results add to an emerging picture of biology that suggests material inside a living cell is not static, but instead changes its properties in a pre-ordained way as the cell performs its function or responds to the environment. The work may one day have implications for our understanding of how cells age or stop working as they should, which is what happens in disease.

The study is published this week in Nature Materials and involved a trans-disciplinary partnership between biologists, materials scientists and physicists based in the UK, Spain, and the USA.

Reference: Tracking intracellular forces and mechanical property changes in mouse one-cell embryo development by Marta Duch, Nria Torras, Maki Asami, Toru Suzuki, Mara Isabel Arjona, Rodrigo Gmez-Martnez, Matthew D. VerMilyea, Robert Castilla, Jos Antonio Plaza and Anthony C. F. Perry, 25 May 2020, Nature Materials.DOI: 10.1038/s41563-020-0685-9

The study is published this week in Nature Materials and involved a trans-disciplinary partnership between embryologists in Bath and the USA led by Professor Perry, and materials scientists and physicists led by Professor Jos Antonio Plaza at the Instituto de Microelectrnica de Barcelona (IMB-CNM) in Spain.

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Nanodevices Track Cells From the Inside, Show How They Develop With Time - SciTechDaily

Cell Biology

Cells Inside Cells: The Bacteria That Live in Cancer Cells – Technology Networks

May 30, 2020 medical

Cancer cells are comfy havens for bacteria. That conclusion arises from a rigorous study of over 1,000 tumor samples of different human cancers. The study, headed by researchers at the Weizmann Institute of Science, found bacteria living inside the cells of all the cancer types from brain to bone to breast cancer and even identified unique populations of bacteria residing in each type of cancer. The research suggests that understanding the relationship between a cancer cell and its mini-microbiome may help predict the potential effectiveness of certain treatments or may point, in the future, to ways of manipulating those bacteria to enhance the actions of anticancer treatments.

Dr. Ravid Straussman of the Institutes Molecular Cell Biology Department had, several years ago, discovered bacteria lurking within human pancreatic tumor cells; these bacteria were shown to protect cancer cells from chemotherapy drugs by digesting and inactivating these drugs. When other studies also found bacteria in tumor cells, Straussman and his team wondered whether such hosting might be the rule, rather than the exception. To find out, Drs. Deborah Nejman and Ilana Livyatan in Straussmans group and Dr. Garold Fuks of the Physics of Complex Systems Department worked together with a team of oncologists and researchers around the world. The work was also led by Dr. Noam Shental of the Mathematics and Computer Science Department of the Open University of Israel.

Ultimately, the team would produce a detailed study describing, in high resolution, the bacteria living in these cancers brain, bone, breast, lung, ovary, pancreas, colorectal and melanoma. They discovered that every single cancer type, from brain to bone, harbored bacteria and that different cancer types harbor different bacteria species. It was the breast cancers, however, that had the largest number and diversity of bacteria. The team demonstrated that many more bacteria can be found in breast tumors compared to the normal breast tissue surrounding these tumors, and that some bacteria were preferentially found in the tumor tissue rather than in the normal tissue surrounding it.

To arrive at these results, the team had to overcome several challenges. For one, the mass of bacteria in a tumor sample is relatively small, and the researchers had to find ways to focus on these tiny cells-within-cells. They also had to eliminate any possible outside contamination. To this end they used hundreds of negative controls and created a series of computational filters to remove the traces of any bacteria that could have come from outside the tumor samples.

The team was able to grow bacteria directly from human breast tumors, and their results proved that the bacteria found in these tumors are alive. Electron microscopy visualization of these bacteria demonstrated that they prefer to nestle up in a specific location inside the cancer cells close to the cell nucleus.

Different cells for different bacteria

The team also reported that bacteria can be found not only in cancer cells, but also in immune cells that reside inside tumors. Some of these bacteria could be enhancing the anticancer immune response, while others could be suppressing it a finding that may be especially relevant to understanding the effectiveness of certain immunotherapies, says Straussman. Indeed, when the team compared the bacteria from groups of melanoma samples, they found that different bacteria were enriched in those melanoma tumors that responded to immunotherapy as compared to those that had a poor response.

Straussman thinks that the study can also begin to explain why some bacteria like cancer cells and why each cancer has its own typical microbiome: The differences apparently come down to the choice of amenities offered in each kind of tumor-cell environment. That is, the bacteria may live off certain metabolites that are overproduced by or stored within the specific tumor types. For example, when the team compared the bacteria found in lung tumors from smokers with those from patients who had never smoked, they found variances. These differences stood out more clearly when the researchers compared the genes of these two groups of bacteria: Those from the smokers lung cancer cells had many more genes for metabolizing nicotine, toluene, phenol and other chemicals that are found in cigarette smoke.

In addition to showing that some of the most common cancers shelter unique populations of bacteria within their cells, the researchers believe that the methods they have developed to identify signature microbiomes with each cancer type can now be used to answer some crucial questions about the roles these bacteria play: Are the bacteria freeloaders on the cancer cells surplus metabolites, or do they provide a service to the cell? At what stage do they take up residence? How do they promote or hinder the cancers growth? What are the effects that they have on response to a wide variety of anticancer treatments?

Tumors are complex ecosystems that are known to contain, in addition to cancer cells, immune cells, stromal cells, blood vessels, nerves, and many more components, all part of what we refer to as the tumor microenvironment. Our studies, as well as studies by other labs, clearly demonstrate that bacteria are also an integral part of the tumor microenvironment. We hope that by finding out how exactly they fit into the general tumor ecology, we can figure out novel ways of treating cancer, Straussman says.

Reference:Nejman, D., Livyatan, I., Fuks, G., Gavert, N., Zwang, Y., Geller, L. T., . . . Straussman, R. (2020). The human tumor microbiome is composed of tumor typespecific intracellular bacteria. Science, 368(6494), 973-980. doi:10.1126/science.aay9189

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Cell Biology

NASA researcher provides overview of science on the ISS – SpaceFlight Insider

May 30, 2020 medical

Laurel Kornfeld

May 29th, 2020

ISS as photographed by Expedition 56 astronauts from a Soyuz capsule. Image Credit: NASA

Research conducted on board the International Space Station (ISS) encompasses numerous science fields, such as biology and biotechnology, human research, the physical sciences, technological demonstrations, Earth and space science, and public education, noted Brandon Redell of NASAs ISS Integration Office at the Johnson Space Center.

Redell discussed scientific research currently being conducted on the ISS in a NASA Night Sky Network Webinar livestreamed on Wednesday, May 27, titled International Space Station Research and Technology 101.

The Night Sky Network is a national group of amateur astronomy clubs whose purpose is to inspire the public about NASAs missions and the science and technology that go into them.

The ISS is an orbiting laboratory. Its a space station thats been going around the Earth. Its been a continuous presence with humans for at least 20 years now. We conduct research to aid space exploration and for human benefits here on Earth as well as developing new technologies, Redell said.

Research on the ISS has helped scientists learn about a wide range of subjects, from human health to black holes, he added. Scientific discoveries made there provide benefits for humanity and enable future space exploration.

Four international space agencies have laboratories on the ISSNASA, the European Space Agency (ESA), the Japan Aerospace and Exploration Agency (JAXA), and Roscosmos, Russias space agency.

Close to 3,000 scientific investigations have been conducted on the ISS, resulting in more than 1,800 scientific journal papers published.

In 2005, Congress passed a law designating the ISS as a national laboratory, enabling non-NASA research, including student projects, to be conducted there.

David Saint-Jacques places bubble monitors (inset) in various locations around the International Space Station for the Canadian Radi-N2 experiment. The Radi-N2 experiment is designed to measure the amount of neutron radiation received by astronauts on board the Station, help create a map of the ISS to identify areas that offer the most protection in case of a major solar event, and help develop countermeasures to health risks for future long-duration space explorers. (Credit: Canadian Space Agency/NASA)

Redell outlined several major reasons for conducting scientific research on the ISS. First, the micro-gravity environment removes all conditions driven by gravity, letting scientists understand other factors involved in their studies. Second, being in low-Earth orbit provides a unique vantage point, along with support services for Earth and space science missions.

Third is the extreme environment in space, including vacuum, thermal variations, radiation, atomic oxygen, and micro-meteoroids. Finally, the ISS serves as a unique platform for educating and inspiring the next generation, which is an investment in future scientific exploration and advancement.

Redell cited the example of cell biology research, noting that on Earth, cells live in a fluid environment and respond to the force of gravity. When brought into micro-gravity, cells that have irregular shapes on Earth suddenly become spherical and swell up, much like blobs of water do on the ISS. Cells also alter their gene expressions, structure, and the mechanisms by which they communicate with one another in micro-gravity.

To learn more about health and physiological changes in micro-gravity, worms, insects, fish, and rodents are studied on the ISS. Learning about rodents biological processes in space helps scientists better understand how human space travelers will respond to that environment.

Understanding plant biology in micro-gravity will someday be key for astronauts on long space missions. On Earth, plants roots instinctively move downward due to gravity while their stems and leaves reach upward toward the Sun. In the absence of gravity, they get confused; for example, moss grown in the dark on a space shuttle flight grew in all directions.

Plant Habitat-01 (PH-01: An Integrated Omics Guided Approach to Lignification and Gravitational Responses in Plants) is a multi-omic, multi-growth stage plant experiment designed to compare early versus late gene expression in Arabidopsis using the Advanced Plant Habitat (APH) facility. Credit: NASA

Furthermore, growing plants in space is difficult because soil structure is different in micro-gravity than it is on Earth. Water does not settle down in micro-gravity, often causing plants to drown.

If were trying to grow our own food sources on a long-duration mission, this is something we need to understand for long-duration flights, Redell emphasized.

Especially important to the future of human space travel is a better understanding of the effects micro-gravity has on people. Both during spaceflight and afterwards, astronauts have experienced balance disorders, cardiovascular de-conditioning, decreased immune function, muscle atrophy, and bone loss.

Long duration human performance in space is a big research area, Redell noted.

Through ISS research, scientists learned that 60 percent of astronauts who spend long durations in space experience a decline in eyesight that in some cases is permanent. Some researchers believe this is due to fluid shifts to the head in micro-gravity while others attribute it to a genetic predisposition. Whether one or both are true, scientists will have to resolve this issue in order for long-term human space missions to go forward.

The unique orbit of the ISS enables it to observe all geographic locations between 51.6 degrees North and 51.6 degrees South in latitude. This covers 85 percent of the Earths surface and 95 percent of its populated landmasses. Using high-definition cameras, ISS astronauts take a variety of photos, from still ones to hyper-spectral images.

From the ISS, astronauts can monitor natural disasters and climate change effects. Science instruments use remote sensing to study climate science, hydrology, soil mapping, geomorphology/landscape configuration, hazard assessments, and many other phenomena. One such experiment monitors water content in the worlds rainforests.

In the field of astrophysics, astronauts work with scientists to explore the universes origin, identify and study neutron stars and black holes in X-ray wavelengths, and learn more about cosmic rays, dark matter, and even anti-matter.

Anyone interested in learning more about the many science experiments being conducted on the space station is encouraged to visit an ISS website known as the Space Station Research Explorer.

Tagged: education International Space Station ISS laboratory Science The Range

Laurel Kornfeld is an amateur astronomer and freelance writer from Highland Park, NJ, who enjoys writing about astronomy and planetary science. She studied journalism at Douglass College, Rutgers University, and earned a Graduate Certificate of Science from Swinburne Universitys Astronomy Online program. Her writings have been published online in The Atlantic, Astronomy magazines guest blog section, the UK Space Conference, the 2009 IAU General Assembly newspaper, The Space Reporter, and newsletters of various astronomy clubs. She is a member of the Cranford, NJ-based Amateur Astronomers, Inc. Especially interested in the outer solar system, Laurel gave a brief presentation at the 2008 Great Planet Debate held at the Johns Hopkins University Applied Physics Lab in Laurel, MD.

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NASA researcher provides overview of science on the ISS - SpaceFlight Insider

Cell Biology

Liver Cancer Surgery: Types, Recovery and What’s Next – WTOP

May 30, 2020 medical

Cancer is an unfortunate fact of biology that arises when cellular mutations lead to unchecked proliferation. Cancer can occur in

Cancer is an unfortunate fact of biology that arises when cellular mutations lead to unchecked proliferation. Cancer can occur in virtually any cell in the body, from blood and brain to skin and lungs.

One particularly dangerous form of cancer is liver cancer. Cancer of this large, wedge-shaped organ located under the right ribs and lung is often diagnosed in later stages, once its started spreading to other organs. Later-stage cancers are more difficult to treat than if the cancer is caught early. Thus, the five-year relative survival rate for all stages of liver cancer is 18%, the American Cancer Society reports. However, that rate rises to 33% in early-stage cases of liver cancer because surgical procedures can help people recover.

[See: 10 Innovations in Cancer Therapy. ]

Types of Liver Cancer

Cancerous tumors can develop on the liver and spread to other parts of the body, and this may occur without the patient realizing it because sometimes symptoms are vague or mild and go undetected.

But liver cancer isnt a singular entity. There are two main types of cancer that can form directly from the liver itself, says Dr. Aslam Ejaz, a surgical oncologist with the Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus.

These two primary types of liver cancer are:

Hepatocellular Carcinoma

The most common type of primary liver cancer, HCC usually occurs in people who have another chronic liver disease such as cirrhosis (scarring of the liver that may be related to alcohol abuse or another issue), hepatitis B or hepatitis C infections.

Dr. James J. Lee, a gastroenterologist with St. Joseph Hospital in Orange, California, says hepatitis B and C infections are dangerous because they cause progressive liver damage, which can result in cirrhosis and liver failure as well as hepatoma, another name for HCC. These diseases are caused by blood-borne viruses that are highly contagious. They cause acute inflammation in the liver that leads to scarring (cirrhosis) and may open the door cancer.

No matter the cause, treatment for HCC may include surgery, liver transplant, chemotherapy, radiation, immunotherapy, targeted drug therapies or ablation (destruction) of cancer cells through the application of heat, cold or electrical current. You may undergo a combination of several treatments depending on your specific diagnosis.

Cholangiocarcinoma

This form of cancerous tumor develops in the bile ducts, the slender tubes that connect the liver to the gallbladder and small intestines. These ducts carry bile, a digestive fluid. Cholangiocarcinoma is also called bile-duct cancer, and its the second most common liver cancer, accounting for about 10% to 20% of primary liver tumors.

Tumors may develop in the bile ducts after small mutations in cells add up to rapid proliferation of malignant cells. Risk factors for developing this kind of cancer include:

Chronic liver disease. Cirrhosis caused by a history of chronic liver disease is a major risk factor for bile-duct cancer.

Primary sclerosing cholangitis. This disease causes the bile ducts to harden and scar.

Malformed bile ducts. Some people have congenital defects to the bile ducts that increase risk of developing cancer there.

Parasites. Infestation with certain organisms, such as liver flukes which are very rare in the U.S. but can be introduced to the body via consumption of undercooked or raw fish can damage the liver and bile ducts and potentially lead to cancer.

Age and lifestyle. This type of cancer is more common in adults over age 50. Its also experienced more commonly among smokers.

Bile-duct cancer tends to be more aggressive than HCC, and thus has a worse prognosis. However, it may be treated with surgery, radiation, chemotherapy or other targeted drug therapies.

[SEE: Alcoholic Hepatitis Symptoms: Heres What You Need to Know.]

Types of Surgery for Liver Cancer

If your doctor suspects you have liver cancer, youll undergo extensive testing to determine what type and stage cancer you have and to determine the location of the tumor or tumors. Ultrasound or CT scans of the liver may be part of that process, Lee says.

If youre diagnosed with liver cancer, your doctor may have the option of a few types of surgical procedures to treat them. The choice of procedure will depend on the general health of the patient as well as the type, size and number of liver tumors there are, Ejaz says.

Surgery for liver cancer generally takes one of the following forms:

Partial Hepatectomy

This procedure, also called a liver resection, removes part of the liver. Its only for patients who have good liver function and have a single tumor that hasnt yet grown into blood vessels.

Surgical removal of liver cancer is performed on patients who are in good health and those that have tumors that, once removed, would leave a healthy amount of liver behind, Ejaz notes.

Its not a good option for someone who has severe cirrhosis, a condition that causes scarring of the liver. The ACS reports that most people who have liver cancer also have cirrhosis, so your doctor will perform some additional imaging tests, such as an MRI or CT scan and blood test to check your liver function and determine the size and location of the liver tumor prior to recommending this form of surgery. If its determined that youll have at least 30% of liver function remaining after surgery, you may get the green light for this procedure.

This surgery can be performed either as open surgery or using a minimally-invasive approach. Minimally-invasive liver surgery is performed through small keyhole incisions whereas an open operation requires a large incision on the abdomen, Ejaz says.

Liver surgery is serious business, and while it can extend your life, there are also risks. The main risks of liver removal include bleeding, infection, leakage of bile and liver failure, although this is a rare occurrence, Ejaz says. Some patients also experience complications of anesthesia or may develop pneumonia.

If youre undergoing a partial hepatectomy for liver cancer, expect to be in the hospital anywhere from one day to one week, Ejaz says. In general, recovery is dependent on how healthy you are going into surgery, as well as the amount of liver removed. In some cases, physical therapy may be indicated, especially if you have other, compounding medical problems or physical limitations. Physical therapy can be used to enhance your recovery after surgery, Ejaz says.

Your doctor will follow up with you regularly to check for recurrence of the cancer and other health issues that could arise. But, if you follow your doctors orders, most patients return to their previous health state and quality of life after surgery for liver cancer, Ejaz says.

A 2016 study in the World Journal of Surgical Oncology found that patients who underwent liver resection surgery had good long-term survival rates. The one-year survival rate was 89.0%, the three-year survival rate was 64.3%, and the five-year survival rate was 53.0%.

Ablation

Ablation procedures use heat, cold or electrical current to kill cancerous liver cells. These procedures are usually best suited for patients who have a few small tumors and when surgery is not a good option because of poor overall health or reduced liver function because of chronic liver disease.

There are several ways that ablation can be conducted, including:

Radio-frequency ablation. This form of ablation uses high-energy radio waves to destroy small tumors on the liver. A 2016 study of 320 patients who had radio-frequency ablation found that the cancer eventually came back in 73 (64%) patients. The five- and 10-year overall survival rates were 38.5% and 23.4%.

Microwave ablation. This approach uses electromagnetic waves to heat up tumor cells and destroy them. A 2015 study found that this procedure also has good long-term survival outcomes, and that local recurrence rates were low for tumors of less than 3 cm in diameter.

Ethanol ablation. Also known as percutaneous ethanol injection, this procedure uses concentrated ethanol, a type of alcohol, which is injected into the tumor. This is one of the least invasive and least expensive ways to treat liver cancer, and its best suited for tumors of 3 cm diameter or smaller. One study noted that among 746 patients with HCC, the 1-, 2-, 3-, 4-, and 5-year survival rates after ethanol ablation were 93%, 77%, 60%, 40% and 33% respectively.

Irreversible electroporation. A recently developed therapy, IRE uses electrical pulses to damage tumor cells. This type of treatment may be best suited for patients who have tumors smaller than 5 cm that are located near blood vessels. Heat ablation techniques can damage those vessels, so low-energy ablation such as can be achieved with IRE may be a better option. However, a 2017 study in the journal Medicine noted that its still not the first choice of ablation procedure for many patients with HCC because it requires general anesthesia and muscle blockers because the electrical current can cause muscle stimulation during the procedure that could become dangerous. Another 2017 study found that the median survival rate for HCC patients was 26.8 months post-procedure. Patients with primary HCC, rather than liver metastases that have spread from another primary cancer, seemed to have better results from IRE according to that study, likely because of a difference in cellular biology between primary and metastatic tumors.

Cryoablation. Cryoablation uses extreme cold produced by liquid nitrogen to freeze cancerous tissue. One-year survival rates range from 82.4% to 94% for cryoablation. The three-year survival rate ranged from 32.3 to 40%, and five-year rates are between 13.4% to 20% depending on the report. Cryoablation may have higher complication rates, but can be used on larger tumors than some of these other approaches.

Ablation techniques use a long needle or probe to penetrate the tumor through the abdomen. As such, its a less invasive procedure than other forms of surgery for liver cancer. Patients can often go home the same day.

You may have some pain in your abdomen or right shoulder a condition called referred pain for a few days after the procedure. Your doctor will follow up with tests soon after the procedure to see how well it worked.

Youll need to take it easy for several days after the procedure and avoid lifting heavy objects and strenuous exercise. You may be advised not to drive or go to work for up to a week or two, depending on your specific situation.

[READ: 5 Ways to Detox Your Liver That Really Work.]

Liver Transplant

In certain cases, a liver transplant might be the best option for tumors that cant be removed or would not leave enough functional liver tissue behind after removal. In this procedure, the surgeon removes your entire liver and replaces it with healthy liver tissue from a donor. Procuring a healthy liver matching the patients blood type in a timely fashion can be a major difficulty.

But, unlike other organs that must be harvested from a recently deceased donor, its possible to transplant a piece of a live donors liver. The liver has a miraculous ability to regenerate, and if a section is removed and implanted in a patient, both the donor and the recipient can regenerate whats missing and return to normal function within several weeks.

Still, a liver transplant is major surgery that carries risks. If youre going to have a liver transplant, expect to remain in the intensive care unit for a few days. You may be in the hospital for up to two weeks in total, and youll need frequent check-ups with your surgical team afterwards to ensure that the transplant is taking and liver function is resuming normal levels. Physical therapy may be part of your recovery plan.

Youll also have to remain on powerful immunosuppressant medications for the rest of your life to subdue the bodys urge to reject the new organ. These medications can cause side effects, including gastrointestinal problems. They may also make you more susceptible to other infections, so these powerful medications must be managed carefully.

Aftercare

After surgery for liver cancer, its important that you take good care of your health. This includes:

Getting plenty of rest. Sleep is a powerful healer. Strive to get plenty of good-quality shut-eye.

Exercising. Once your doctor has cleared you for physical activity, you should aim to move as much as you can. Getting the body moving has been shown to reduce the chances of blood clots forming or developing pneumonia.

Eating right. To support your body as it heals, be sure to provide it with healthy, nutritious food and plenty of water. Within the first few days of surgery, youll likely be on a liquid diet, to put less strain on your body and digestive system. When you can transition back to a more standard diet, be sure to avoid alcohol and high-fat foods that can be difficult for the liver to process.

Managing constipation. Constipation can become a problem for some patients post-surgery. Your surgical team will likely brief you on how to manage this potential problem ahead of time, but speak up if it becomes uncomfortable.

Keeping your incision clean. For those who have open surgery or a transplant, caring for your incision and preventing infection is vitally important. Follow your doctors post-surgical orders carefully.

Communicating with your health care team. If youre having pain or other issues, be sure to let your doctor know right away.