Buckingham Palace, London

University of Birmingham academics Professor Kalwant Bhopal, Professor John Nolan and Dr Melrose Stewart have been named in the 2020 New Year Honours for services to race equality in education, construction and physiotherapy.

Former chief medical officer for England Professor Dame Sally Davies has been appointed Dame Grand Cross of the Order of the Bath for services to public health and research, whilst Birmingham Royal Ballet former director David Bintley receives a KBE for services to dance both are honorary graduates of the University.

Birmingham alumnus Professor Leslie Brent, whose research work helped pave the way for organ transplantation, has received an MBE for his work around Holocaust commemoration.

Professor of education and social justice Kalwant Bhopal becomes an MBE. Director of the Universitys Centre for Research in Race and Education, Professor Bhopal's research focuses on the achievements and experiences of minority ethnic groups in education.

Professor Bhopal has conducted research into the lives of Black minority ethnic groups, as well as Gypsies and Travellers. Her research explores how processes of racism, exclusion and marginalisation operate - being used to inform policy making in higher education, particularly development of the Race Equality Charter mark.

Professor John Nolan receives the CBE for services to structural engineering and the construction industry. A visiting Professor in the Department of Civil Engineering, John Nolan has over 40 years experience in the construction industry - starting as a labourer, followed by working as a contractors engineer and then as a consulting engineer.

Dr. Melrose Stewart has been awarded an MBE. She appeared in an expert role in the Channel 4 TV programme, Old Peoples Home for 4 year Olds and delivered a TEDx talk entitled Connecting Generations for Healthy Ageing.

A former Vice-President of the Chartered Society of Physiotherapy (CSP), Dr. Stewart lectures in physiotherapy at the University. She has a keen interest in the development of the subject within physiotherapy education and professional practice.

Throughout her career, Dr. Stewart has consistently promoted diversity issues and was instrumental in setting up a network group within the CSP for ethnic minority members to raise awareness of discrimination.

Born in Birmingham, Professor Dame Sally Davies was awarded an honorary Doctor of Medicine degree by the University in 2008. Dame Sally is UK Special Envoy on Antimicrobial Resistance (AMR) a particular research strength at the University of Birmingham.

She was Chief Medical Officer (CMO) for England and Chief Medical Adviser to the UK government from March 2011 to September 2019.

Professor Leslie Brent, 94, was born in Germany but ferried to England on the first Kindertransport, becoming a British citizen and enrolling at the University of Birmingham.

Mr Brent has for many years returned to Berlin to speak to school children about his experiences. He spoke at Westminster Abbey on the anniversary of Kristallnacht and at the Quakers 80th Kindertransport anniversary event in London.

A Birmingham zoology graduate, Mr Brents early work in immunology helped pave the way for organ transplantation. In the early 1950s, he began working with Sir Peter Medawar and, along with biologist Rupert Billingham, started carrying out the research that would lead to Sir Peter winning the 1960 Nobel Prize in Physiology or Medicine.

University of Birmingham Vice-Chancellor Professor Sir David Eastwood commented: We are proud that the achievements of our academics, honorary graduates and alumni have been recognised in the latest New Years Honours. These individuals have made outstanding contributions to society and thoroughly deserve the accolades bestowed upon them.

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University of Birmingham academics, honorary graduates and alumni in New Year Honours - University of Birmingham

Morton Kern, MD, of VA Long Beach Healthcare System and University of California, Irvine, often engages his colleagues via email in brief, informal dialogue on clinically relevant topics in interventional cardiology. With permission from the participants, TCTMD presents their conversations for the benefit of the cardiology community. Your feedback is welcomefeel free to comment at the bottom of the page.

David Cox, MD (Brookwood Baptist Health, Birmingham, AL), asks:

I need help with another question posed by many of the docs at my site. While I agree fully with Sunil Rao that 70% of what most of us do is ACS, and that was my practice in Pennsylvania and North Carolina, I find myself in a situation in Birmingham with my hospital on a hill surrounded by a number of PCI hospitals who get most of the ACS.

Consequently and surprisingly, about 80% of this practice is elective stable ischemic heart disease (SIHD) PCI with much less ACS.

The conundrum exists, of course, like the patient I saw yesterday in office whose chest pain has heated up the past few weeks. He has gone from angina 2x/week to now daily angina with minimal exertion and some pain at rest. I wanted to admit. He will come in electively this AM.

1. Count him as crescendo angina/Class III, and this doesnt become a ISCHEMIA patient.

2. The question at hand is, lets say he did have a recent nuclear scan with moderate ischemia and Class II angina, what is the role of FFR after ISCHEMIA?

3. Are all the data in FAME and FAME 2 now superseded by this trial? I know not all patients with SIHD needed FFR, but the goodmajority did.

4. If you do an FFR and its positive in a patient who met entrance criteria for ISCHEMIA (lets leave the truly asymptomatic patientsaside) and the FFR is done well and is positive . . . then what?

Kern replies:

Dave is struggling with the approach to SIHD in his area. Here is my response to Dave:

I'm not sure why you're struggling so much.

I don't think I missed the main point of the ISCHEMIA trial. Colleagues?

Jeffrey Moses, MD (NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY), replies:

Good summary, but I would add three concepts.

So the conversation with the patient can be built around these facts.

Bonnie Weiner, MD (Saint Vincent Hospital, Worcester, MA), replies:

I agree with all your comments, Mort. The critical issue here is that in the stable patient, it has not been about MI/death prevention but quality of life (QoL). We know that patient compliance and tolerance with complex medical therapy regimens outside of a clinical trial is less than optimal. The importance of patient preference and patient/doctor discussion remains the important message.

David Cohen, MD (University of Missouri-Kansas City), replies:

Here are my thoughts:

Technically, this is correct. But the truth is that the difference between Class II and Class III angina is pretty subtle, and I wouldn't hang my hat on it. The main reason why patients with accelerating angina were excluded from ISCHEMIA was not medical but more related to a desire to keep the rate of crossover to cath down among patients randomized to the conservative arm.

To me, the main role of FFR after ISCHEMIA is the same one it had before ISCHEMIAto identify which lesions in patients with significant angina do NOT need revascularization (ie, the key take-home messages from both DEFER and FAME). I agree with Mort that if the lesion causing the ischemiais clear from precath testing, theres no need to do FFR/iFR/etc to reconfirm. But if there is ambiguity, a key benefit of intracoronary physiology is sorting out which lesions are truly hemodynamically significant.

FAME is still as important as it was before ISCHEMIAuse physiology to identify which lesions to treat and which to leave alone in patients with multivessel disease requiring revascularization (ie, those with unsatisfactory symptom control). IMHO, the potential late spontaneous MI benefit in ISCHEMIA reinforces the same finding in FAME 2 (which previously seemed like a bit of an outlier). However, there is still no evidence that PCI saves any lives in the stable population, and the late MI benefit needs to be balanced against the early excess MI rate from PCI.

Then you can either treat with optimal medical therapy (OMT) alone or offer revascularization, depending on the patient's preferencebalancing the side effects from obligatory dual antiplatelet therapy (for some duration) versus those of antianginal therapy.

In my opinion, the main messages from ISCHEMIA are that not every patient with moderate-to-severe ischemia on functional testing needs to go to the cath lab. The cath lab should be reserved mainly for the following situations:

Kirk Noel Garratt, MD (Christiana Care, Newark, DE), replies:

Jeffs summary is a great distillation of the takeaways from ISCHEMIA. Weve been treating SIHD patients chiefly for symptom improvement for more than a decade, and this study confirms the appropriateness of our practice.

I thought the most provocative finding from ISCHEMIA was the reduction in spontaneous MIs. Lets remember that the big knock on COURAGE was the concern that the most at-risk patients were never enrolled. Presumably, those would be the folks at greatest risk of events like MI. Now that weve got a trial of SIHD that absolutely enrolled some high-risk people, we see an MI benefit from PCI and CABG. Sunil Rao, Tim Henry, and a couple others reminded me this was also observed in FAME 2 and COMPLETEsomewhat different populations but a signal of MI reduction benefit with revascularization nonetheless. Well have longer follow-up, but for now, Im comfortable telling patients that a lower risk of spontaneous MI is a potential benefit of early revascularization.

David R. Holmes Jr, MD (Mayo Clinic, Rochester, MN), replies:

I agree entirely with KNG. It is part of a strong data set.

Farouc Jaffer, MD, PhD (Massachusetts General Hospital, Boston), replies:

Great questions and insights. Would also offer that a spontaneous, unpredictable MI is a greater clinical stress to patients and physicians compared to a periprocedural MI occurring in-house.

William Fearon, MD (Stanford University, CA), replies:

I agree completely with Jeffs comments. ISCHEMIA in fact reinforced much of what FAME 2 showed: in patients with stable CAD, compared with medical therapy, FFR-guided PCI reduced spontaneous MI at 5-year follow-up (same as revascularization in ISCHEMIA) at a cost of a small bump in peri-PCI MI (same in ISCHEMIA), decreased urgent revasc (revascularization significantly decreased unstable angina in ISCHEMIA), improved quality of life and angina relief (same as ISCHEMIA), without a change in overall mortality (same is ISCHEMIA). ISCHEMIA did not show a relationship between the degree of ischemia on stress imaging and outcomes, but I think this is simply a reflection of the lack of precision of the noninvasive tests (as mentioned by Jeff); numerous previous studies have shown a clear gradation between FFR values (degree of ischemia) and risk for events in medically treated patients. Of note, one-quarter of patients in ISCHEMIA had treadmill tests alone.

Since 35% of patients in ISCHEMIA were asymptomatic, it will be interesting to see how these patients fare as a subgroup. The forest plot suggested that more symptomatic patients received a greater benefit over asymptomatic. However, this substudy from FAME 2 suggests that symptomatic patients randomized to medical therapy were protected by their symptoms because they crossed over to PCI and avoided hard events. On the other hand, asymptomatic patients with low FFR randomized to medical therapy had increased death/MI compared with those who received PCI, presumably because they had no warning system.

George Vetrovec, MD (VCU Pauley Heart Center, Richmond, VA), replies:

At least one unanswered question for the ISCHEMIA trial is the impact of completeness of revascularization on the results. Dr. Judith Hochman noted that this was still awaiting analysis. There is significant data that shows the completeness of revascularization, ie, the effectiveness of alleviatingischemia is an important factor in PCI outcome. PCIs limitations in the most complex disease are often the reason that surgical revascularization is more effective. Until we know those results, I think we are somewhat limited in being certain of the outcome results. Even later follow-up will also provide importantlate resultson MI prevention and, I believe, for completeness of revascularization. However, the current completeness of revascularization data should be availablehopefully by the time of publication or for an upcoming scientific meeting like the ACC.

Keith Oldroyd, MBChB (Golden Jubilee National Hospital, Glasgow, Scotland), replies:

Great discussion. There is also a potentially important issue in relation to complete relief of ischemia or, if you prefer, functionally complete revascularization. For various reasons, we all know that significant numbers of patients are left with potential ischaemia even after revascularization, whether by PCI or CABG. FAME 3 will shed some further light on thisit should finally complete recruitment next month.

Gregg W. Stone, MD (Icahn School of Medicine at Mount Sinai, New York, NY), replies:

We plan on reporting the impact and implications of complete versus incomplete and anatomic and functional revascularization at the ACC in 2020.

Ajay Kirtane, MD (NewYork-Presbyterian/Columbia University Irving Medical Center), replies:

All great points. Dave, regarding your patient, one thing to remember about QoL is that the number need to treat to render a patient with weekly angina completely angina-free with the invasive approach versus the conservative one is three. Also, only 29% of patients in ISCHEMIA had angina that started or became more frequent in the last 3 months, with the median angina frequency being monthly.

Beyond your patient, some take homes from the trial for me:

Neal Kleiman, MD (Houston Methodist Hospital, TX), replies:

Another parallel question is adequacy of revascularization. Based on ULTIMATE and DEFINE-PCI, Id want to know how often stents were optimized and would also be concerned about not truly eliminating the ischemia.

David Kandzari, MD (Piedmont Heart Institute, Atlanta, GA), replies:

My two additional takeaway messages from ISCHEMIA:

Augusto Pichard, MD (MedStar Washington Hospital Center, Washington, DC), replies:

In addition, most of them had 50% lesions by CT, with some 70%. We know physiology has proven most of these do not need intervention! No wonder the PCI arm ended up similar (in some respects) to OMT.

Cohen replies:

I don't think we know what the lesion severity was by CT, Gus. We know the patients had to have at least one 50% lesion to qualify for the study and about half had "3Vdz" by this definition. But the CT results were blinded to the investigators, and I haven't seen any data on the actual lesion severity(yet).

John Hirshfeld Jr, MD (Penn Medicine, Philadelphia, PA), replies:

Im waiting for later follow-up.

Note that all the Kaplan-Meier curves cross at 1-2 years follow-up and continue to diverge. With the follow-up available at the time of this report, P values are in the 0.2-0.3 range (so not significant"). Only half of the cohort followed up at 3 years and one-third at 4 years.

It will be interesting to see what happens to this trend in the next several years.

Hopefully whatever effect there is will not be obscured by too much crossover from the conservative group to the revascularization group (already at 23%).

Cohen replies:

Let's hope that the extension gets funded by the NIHotherwise, there won't be longer follow-up.

Also, one thing that has not been appreciated is that fully half of the crossovers occurred AFTER a primary endpoint had already occurred (I don't know the details, but presumably in most cases, the patient presented with a NSTEMI and underwent PCI during the hospitalization). Given the sequence, those types of crossovers actually have no effect on the primary endpoint Kaplan-Meier curves (although they could lead to some erosion of the antianginal benefit). So from the standpoint of CV death/MI, the effective crossover rate is only around 10-11%, which isn't bad for a 4-year trial.

Larry S. Dean, MD (UW Medicine, Seattle, WA), replies:

Thanks to David for starting the conversation. Very interesting to read everyones take on the trial, and it will be helpful as our patients begin to ask the questions we know will come. I guess my main concern is all we have so far is whats been presented without the publication.

Kirtane replies:

But Dave: either of those things is failing the strategy. Whether the patient crosses over OR has an MI event (because death is low), both are not great.

Cohen replies:

Yes, but most people worry about crossover because it dilutes the treatment effect. In the case of an MI preceding a revasc, the event is counted correctly and theres no dilution.

Stone replies to Cohen:

Only 8% of patients of the 28% who underwent angiography by 4 years in the conservative arm crossed over for nonadherence to the protocol (ie, without a valid reason a protocol violation). The remainder had valid reasons such as development of refractory angina or an actual or suspected endpoint event. Hard to argue any of these crossovers affected the absolutely neutral mortality outcomes or the markedly positive QoL benefits (100% certainty of effect by Bayesian in patients with baseline angina).

Stone replies to Hirshfeld:

It is difficult to describe the overall treatment effect when the curves are crossing. The HR is not completely accurate given the nonproportional hazards, and Cox models are invalid. There were actually statistically fewer events in the invasive arm at 4 yearsthe CV death/MI risk difference was -2.2% (95% CI -4.4%, -0.1%). However, given the upfront risk of periprocedural MI, the total event-free time in both groups was not different.

The Bottom Line (According to Kern):

The ISCHEMIA trial reinforces some of our beliefs in the need for better anti-ischemic medical therapy prior to revascularization in SIHD patients and that absent objective ischemic findings FFR still applies to decision-making. What may be in question is what will be the best noninvasive ischemic testing: FFRCT, PET, or something else? The longer-term follow-up of ISCHEMIA will be warmly welcomed to this debate.

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Conversations in Cardiology: In the ISCHEMIA Era, What Role for FFR? - TCTMD

Whats the purpose of dreamsthe experiences we feel while we sleep?

Neuroscience has shown that emotions felt during dreams help us resolve emotional distress and prepare for future affective reactions.

But whether fear in dreams links adaptive responses to threatening signals while we are awake is unclear.

Now, researchers have identified brain regions activated when experiencing fear in dreams. Notably, frightening dreams adjusted the response of these same regions to threatening stimuli during wakefulness.

These findings support that emotions in dreams and wakefulness engage similar brain regions. This physically links emotional processes occurring during sleep and emotional brain functions during wakefulness.

These results lay the groundwork for studying how sleep and dreaming influence therapies for psychological disorders, such as anxiety.

Evidence from human and animal research suggests functional links between sleep and emotional processing. Chronic sleep disruption can lead to increased aggressiveness and negative mood states, whereas affective disorders such as depression and posttraumatic stress disorder (PTSD) are frequently associated with sleep abnormalities, such as insomnia and nightmares.

Together these findings indicate that sleep physiology may offer a permissive condition for affective information to be reprocessed and reorganized. Yet, it remains unsettled whether such emotion regulation processes also happen at the subjective, experiential level during sleep, and maybe expressed in dreams.

Researchers have proposed that memories from a persons affective history are replayed in the virtual and safe environment of the dream so that they can be reorganized.

From a neuroscience perspective, one key principle of these models is that experiencing emotions in dreams implicates the same brain circuits as in wakefulness.

Like during wakefulness, people experience a large variety of emotions in their dreams. For example, rapid eye movement (REM) dreaming being usually more emotionally loaded than nonrapid eye movement (NREM) dreams.

While some studies found negative emotions like fear and anxiety in dreams, other studies reported a balance of positive and negative emotions or found that joy and emotions related to approach behaviors may prevail.

When analyzing large data sets of dream reports, a clear disconnection between dreams containing basic, mostly fearrelated emotions and dreams with other more social emotionssuch as embarrassment, excitement, and frustrationwas found. This highlights the distinct dream modes, with fear in dreams representing a prevalent and biologicallyrelevant emotional category.

So, if fearcontaining dreams serve an emotion regulation function, the stronger the recruitment of fearresponsive brain regionsthe amygdala, cingulate cortex, and insuladuring dreaming, the weaker the response of these same regions to actual feareliciting stimuli during wakefulness should be.

This regulatory mechanism may also be followed by enhanced recruitment of brain regions linked to regulating emotions during wakefulness, like the medial prefrontal cortex implicated in fear extinction.

Researchers had recently reported that specific dream contentssuch as faces, places, movement, speech, and thoughtsengage similar brain networks during wakefulness.

Yet two major questions remained. First, do emotions in dreamsin particular, fearrelated emotionsengage the same neural circuits as during wakefulness? Second, is there a link between emotions experienced in dreams and brain responses to emotional stimuli during wakefulness?

In a recent study, researchers collected dream reports and functional brain measures using imaging technology with sufficient accuracy for the detection of the signal originating from deep brain structures.

Here, for the first time, researchers have shown that fearrelated experiences activated the same brain region during both dreaming and awake consciousness.

This region, the insula, is thought to contribute to the social-emotional experience and linked visceral states, possibly giving rise to conscious feelings. The insula also participates in the emotional response to distressing thoughts or gut feelings.

Insula activation during dreaming could, therefore, reflect the integration of internally generated sensory, affective, and bodily information culminating in a subjective feeling of danger.

REM sleep is characterized by activation across brain regions linked to sensation and movement. Also, REM sleep is characterized by paralysis in muscle preventing movement. So, this sleep stage provides a proper condition for the activation of threatening situations with linked emotional and motor reactions.

During REM sleep, the researchers also found activation of a brain region critically involved in responses to dangers.

After finding the brain regions linking fear in dreams and wakefulness, the researchers then asked whether frequently experiencing fear in dreams might affect sensitivity to fear during wakefulness. They found decreased activity in the insula and amygdala, both associated with fear and the perception of negative emotions during wakefulness.

Conversely, activity was increased in the regions thought to regulate the response to threatening stimuli by modulating the activity of the fear-linked amygdala. Precisely, the medial prefrontal cortex prevents expressing fear by decreasing the amygdala output.

On top of that, the medial prefrontal cortex has been linked with extinction learningwhen a neutral conditioned stimulus that previously predicted an aversive unconditioned stimulus no longer does so and the conditioned response subsequently decreases.

Consistent with the suggestion that dreaming may regulate emotion, participants who frequently but not excessively experienced frightening dreams showed a stronger inhibition of the amygdala. This may be mediated by the medial prefrontal cortex.

This interpretation is further supported by the results showing that participants who frequently reported fear in their dreams had reduced autonomic responses to aversive stimuli during wakefulness. In total, this suggests a better ability to regulate defensive and alerting reactions to threatening signals in those individuals.

Contrasting with this potentially beneficial role of negative but benign dreams, recurrent nightmares could represent a failure of the fear extinction function of dreaming. So, patients with nightmares, like those with PTSD, would be more prone to emotional dysregulation.

Besides, exerting ineffective emotional regulation strategies, like fear suppression, and elevated anxiety during wakefulness may lead to increased excitability of negativelyloaded memories at sleeponset or even during sleep. Such disruption in the regulation of emotions during wakefulness and sleep has been proposed as a major contributing factor to insomnia.

The findings in this study show that, beyond sleeping, experiencing negative emotions during dreaming is linked to betteradapted emotional responses during waking life.

The researchers show opposing neural effects of fear experience in dreams and during wakefulness. These results show that individuals who reported a high prevalence of fearrelated emotions in their dreams had stronger fear inhibition during wakefulness.

These results also support claims that dreaming beyond sleep benefits emotion regulation processes by achieving overnight recalibration to foster adapted emotional responses to dangerous reallife events.

Studying the role of positive emotions like positive social interactions in dreams and their potential links with emotional brain responses during wakefulness may be needed to further refine existing models.

See the rest here:
Fears in dreams prepare you for threats while awake - Science 101

Dr Antony Dodd joined the John Innes Centre from the University of Bristol towards the end of 2019.

With his research covering circadian rhythm and signalling in plants, we asked him how do plants tell the time and, if they have a circadian rhythm, whether plants suffer from jet lag?

Yes, plants can suffer from jet lag. If you were to fly a plant from China to London, that plants circadian rhythm would be temporarily incorrect for the time zone. The evidence we have suggests that plants are much better than mammals at readjusting their internal body clocks to their local time zone, so they get back in-sync much more quickly than we do.

Circadian rhythms are what our bodies and many other living organisms use to measure the passage of time in order to co-ordinate their daily responses to the environment around them.

My lab studies the circadian rhythms of plants, because they affect a number of important factors in plant performance; things like growth rates, seasonal flowering and the accumulation of various chemicals like starch are all controlled by the plants internal circadian clock. Understanding how these clocks work and the signalling pathways connecting a plants circadian rhythm and the rest of the organism are therefore important on both a fundamental level but can also be applied to improving crops.

The genes that encode the circadian clock in plants have a lot of commonality between plant species, and most of the key underpinning work to understand the circadian clocks in plants has been done on the model species Arabidopsis. We are now beginning to learn more about circadian rhythms in crop species and is becoming apparent that, while there are lots of similarities, there are some important differences as well.

Recently, we had a significant breakthrough when we were able to show that a plants circadian rhythm can affect the responses of plants to some herbicides that are very commonly used in agriculture. The paper; Plant circadian rhythms regulate the effectiveness of a glyphosate-based herbicide was published in Nature last year and we are now building on that work.

Other things we are interested in at the moment include the signalling pathways between a plants circadian clock and those areas of that plants physiology that are controlled by that clock, such as photosynthesis and the plants responses to environmental stress. We would like to understand the communication that happens between those aspects of the lives of plants.

We are also interested in how circadian rhythms function in natural environments. Currently, most of the work in this area has been done in the lab under tightly controlled conditions, so we are currently collaborating with the Professor Hiroshi Kudoh lab in Kyoto to conduct field studies of circadian rhythms in naturally fluctuating conditions.

Throughout my life I have been really fortunate to meet a number of really inspiring people, that have led me to pursue different paths.

When I was an Undergraduate at Newcastle University, one of my lecturers was Professor Howard Griffiths, who was a fantastic lecturer and was at the time working on a specific type of photosynthesis known as CAM which is found in cacti and other succulents and allows them to open their stomata at night. This in-turn allows them to conserve lots of water and survive in the arid conditions, they are famous for thriving in. A key feature of CAM photosynthesis is the strict timing that governs when different processes can occur and different types of enzymes can be active, all of which relies on circadian rhythms. I was hooked.

During my PhD I worked in his lab and became increasingly interested in how circadian rhythms control metabolism and signalling. I then became a Postdoc in the Professor Alex Webb lab in Cambridge that looked at circadian rhythms of signalling. This led me to the question I work on now; how can plants tell the time?

It is something we see all around us. For example, it was documented by Charles Darwin who recorded that plants shifted the positions of their leaves during the day, which he described in a book that he wrote called The Power of Movement in Plants.

Outside the lab, I love hiking particularly mountain hiking. Norfolk doesnt quite offer that, so I am really keen to head down to South America and hike there in the future. Back at home, I have recently started growing vegetables, particularly pumpkins. I am fascinated by the amazing variety of form and the diversity of the fruit you can get.

More:
How do plants tell the time? - The John Innes Centre

Tottenham have a short turnaround for their trip to Norwich City, with their manager far from happy with the Premier League fixture list

Jose Mourinho has criticised the hectic festive fixture listin the Premier League, describing it as a "crime" that clubs will be playing again on December 28.

Spurs were involved in the early kick-off on Boxing Day, rallying from a half-time deficit at home to record a hard-fought 2-1 triumph over Brighton and Hove Albion.

However, the victory came at a cost, with Harry Winks andMoussa Sissoko both picking up yellow cards that mean the duo will be suspended forSaturday's game at Norwich City.

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Son Heung-min is also banned following his red card against Chelsea, leaving Mourinho with a lack of options -as well aslittle preparation time -for the trip to Carrow Road.

However, before his focus switched to the next game, the Portuguese took aim at the schedule.

"I cannot imagine these boys, not just my boys, but the [Graham] Potter's boys, how they can play in 48 hours," Mourinho told the media.

"If you go to control the distances they run, the intensity, the breaks, if you are going to control that and if we are going to tell anyone who understands physiology, it is a crime that they are going to play football again on the 28th.

"It is against every rule of physiology, biology, biochemistry, every rule. But that is the way it is, even with three guys suspended.

"I think from the three, two of them are unfair, Sonny unfair, Winks unfair, I can only say Sissoko had a reason for the fifth yellow card. We have to go."

Tanguy Ndombele may provide a solution to the absences inmidfield after the Frenchman was not involved against Brighton.

Mourinho clarified that while the record signing from Lyon was not injured, the player had raised concerns over his physical condition prior to the game.

"I cannot say he is injured, in five minutes we start a training session and you can go to the stands and watch it, he is going to be training normally so I cannot say he is injured," Mourinho said.

"I can say that yesterday he told me he was not feeling in condition to play the game. Not based on injuries, based on fears of previous injuries that he has had since the beginning of the season.

"Feeling not ready to start the game, but I cannot say he is injured, I can say he is not in condition to start the game, which is different."

The rest is here:
Mourinho: Festive schedule against every rule of physiology, biology, biochemistry - Goal.com

From drinking ones own urine as a cure for broken bones to blood-letting to sending electrical shocks through a persons body as a cure for mental illness healthcare has a somewhat jaded past. Fortunately, as technology has improved our ability to study human physiology, medical professionals have become increasingly adept at diagnosing and curing many different illnesses. Here are four trends that are transforming the future of healthcare.

Still, theres plenty of room for improvement to be made. Almost 20% of Americans cant afford healthcare, according to ABC News. And millions of people die from diseases like cancer and diabetes every single year.We might not ever reach immortality, but some trends can radically transform the future of healthcare in some promising ways.

In almost every industry, imaginable from gaming to every-day transportation artificial intelligence is making a big splash. And it didnt skip healthcare. One example of artificial intelligences impact on the healthcare industry is OWKIN Socrates, an AI-based technology platform created for medical professionals and their businesses.

The bot can monitor symptoms, diagnose disease, recommend treatments, and even predict outcomes, all much faster than a human can. Were probably far from being wholly dependent on artificial intelligence for medical services, but who knows what the bots will be doing next performing surgeries? Will bots be managing pharmacies? How many bots does it take to run a test? How long before bots are diagnosing disease?

One things for sure: AI is going to play a significant role in the future of healthcare the size and scope of that role are yet to be determined.

Perhaps virtual reality is having a more significant impact on healthcare than any other technological advancement. If thats the case, it would seem to be for a good reason: its working. Already, medical students are using virtual technology to learn and perform mock-surgeries. Its also being used in physical therapy to help people recover from injury or trauma.VISUALIZE reports on research that shows VR immersion for those undergoing physical therapy. VR has been used for physical therapy has also been shown to be effective in speeding up recovery time.

Overall, virtual reality is being used to calm patients, relieve pain, and adjust a patients awareness of bodily signals. The effectiveness of this tech on healthcare will likely improve as medical professionals have more time to explore its applications.

If youre disabled, a senior with low mobility, or at home alone in serious physical pain, what are you supposed to do? You cant easily drive yourself to the hospital, and calling an ambulance might be unnecessary for the symptoms youre experiencing. According to the Centers for Disease Control and Prevention, 25% of older adults fall every year, and 20% of those falls are severe.

Companies like Heal let people schedule an appointment with a licensed and certified doctor at their place of residence. Not to mention the advancements of assistive technology some of which can detect falls and automatically request immediate assistance for seniors who may have been injured due to a fall. And why not? That feels like a natural and necessary progression of the healthcare process. Some unwell people cant easily leave their home, and they shouldnt have to.

It might sound overly ambitious, but Prellis Biologics is a company thats dedicated to solving the shortage of human organs and tissues for transplantation. And theyve got at least one thing right: there is undoubtedly a shortage of organs and human tissue for transplantation. Every single day, about 20 people die waiting for a life-saving transplant that never happened. This information is according to the American Transplant Foundation.

Using laser printing technology, Prellis Biologics has managed to mimic the human cell and replicate human organs. This technology is still partly experimental, but who knows how far it will come if given a few more years or even a decade. Professionals might be able to print a new human organ as easily as prescribing medication.

All of these innovations are exciting trends but ones that still need more time to develop fully.

"Marketer to Watch" (Forbes). "Industry leader" (SAP). "Top 100 FinTech Influencer" . Tech blogger with exposure to millions. Advising startups across Europe, NYC, and Tel Aviv.

The rest is here:
4 Trends that are Transforming the Future of Healthcare - ReadWrite

For a complete list of our obituaries, seehere.

SYDNEY BRENNER SCIENTIFIC SYMPOSIUM

Nobel laureate Sydney Brenner died in April at the age of 92.

Brenner was best known for his discovery of sequences that stop protein translation, mRNA, and his investigation of the nematode C. elegans, which he realized would be an ideal model organism to study cell differentiation and organ development. That work won him the 2002 Nobel Prize for Physiology or Medicine.

[H]is great strength was in experiments, and in particular the choice and execution of ones that were both important and ingenious, Francis Crick, the codiscoverer of DNA who shared an office with Brenner at the MRC Laboratory of Molecular Biology (LMB) in the UK, wrote in atribute to Brenner in The Scientist in 2002.

US DEPARTMENT OF ENERGY, OAK RIDGE NATIONAL LABORATORY

American geneticist Liane Russell, famous for her work on the deleterious effects of prenatal radiation exposure and the chromosomal basis for sex determination in mammals, died in July at age 95.

She and her husband William Russell established the Oak Ridge National Laboratorys (ORNL) Mouse House, an extensive colony of mutant mice bred to model the effects of exposure to radiation.

Russells work led to a healthcare policy to ask women if they are pregnant before X-raying them and also to avoid X-rays shortly after menstruation in women of childbearing age.

Inventor of the polymerase chain reaction technique and winner of the Nobel Prize in Chemistry in 1993, Kary Mullis, died in August at age 74.

Mullis was known as a weird figure in science and a flamboyant philanderer who evangelized the use of LSD, denied the evidence for both global warming and HIV as a cause of AIDS, consulted for O.J. Simpsons legal defense, and formed a company that sold jewelry embedded with celebrities DNA, according to a 1998 profile in The Washington Post.

Mullis wrote in The Scientist in 2003 that his first attempt at PCR in 1983 was a long-shot experiment. . . . so [at midnight] I poured myself a cold Becks into a prechilled 500 ml beaker from the isotope freezer for luck, and went home. I ran a gel the next afternoon [and] stained it with ethidium. It took several months to arrive at conditions [that] would produce a convincing result.

Even still, Science and Natureboth rejected the resulting manuscript, which was ultimately published in Methods in Enzymology in 1987 and helped earn Mullis his Nobel.

Chemical engineer George Rosenkranz, the director of the pharmaceutical company that first synthesized a synthetic form of the hormone progesterone, died in June at the age of 102.

He and colleagues developed norethindrone, a synthetic version of progesterone, which was then used in the combined oral contraceptive pill and approved by the US Food and Drug Administration in 1959. The work, along with efforts in biotech, earned him many awards from scientific organizations and from the Mexican government.

Despite that, he was a very humble man, Roberto Rosenkranz, one of his sons, told the Los Angeles Times. He never was out to take credit.

Ophthalmologist and inventor Patricia Bath, whose research on lasers advanced cataract surgery, died in May at the age of 76.

During her medical internship in New York, she conducted an epidemiological study on blindness and found the rate of the condition among the black population was twice that of the white population. The finding led her to start the field of community ophthalmology, caring for underserved populations. She promoted the field by traveling to perform surgeries, training clinicians, and donating equipment.

Bath then moved to the University of California, Los Angeles, medical center in 1974 and in the 1980s began studying lasers for their potential to treat eye disorders. In 1988, she patented a device called Laserphaco Probe, which removes cataracts.

I had a few obstacles but I had to shake it off, Bath told ABC News in 2018. Hater-ation, segregation, racism, thats the noise you have to ignore that and keep your eyes focused on the prize, its just like Dr. Martin Luther King said, so thats what I did.

Nobel laureate Paul Greengard, who discovered that the brain communicates with chemical signals, died in April. He was 93.

Paul was an iconic scientist whose extraordinary seven-decade career transformed our understanding of neuroscience, Richard Lifton, president of Rockefeller University, where Greengard had been a faculty member, said in a statement. His discoveries laid out a new paradigm requiring the understanding of the biochemistry of nerve cells rather than simply their electrical activities. This work has had great impact.

Greengards work revealed how the brain uses dopamine and other chemicals to send signals from one nerve cell to another, discoveries that won him a Nobel Prize in Physiology or Medicine in 2000. Greengard used the prize money to establish an award for women doing outstanding biomedical research and named the prize after his birth mother. Drawing attention to the achievements of women working in science, he and Baylor College of Medicine professor Huda Zoghbi wrote in The Scientist in 2014, sets a powerful example for those women still dreaming of their own success.

Public health whistleblower, physician, and researcher, Shuping Wang, died in September at the age of 59.

Wangs career started in China in the 1980s, where she was a doctor and hepatitis researcher. In 1992, she was testing blood serum samples from a plasma collection station where she worked and realized that unsanitary blood collection methods had led to a hepatitis C epidemic among people who donated and received plasma at the clinic. She reported the findings to officials and was fired, the Salt Lake Tribune reported.

She took a job at the Zhoukou Health Bureau and, analyzing the blood samples there, she found 13 percent of donors had HIV and the cross-contamination there was also leading to the spread of the virus. Officials challenged her results and asked her to change the data for a report that would be sent to the provincial Department of Health. Again, she refused.

Her findings lead to the shutdown of her clinic and the establishment of HIV testing for donors. Still, roughly 1 million farmers were infected with HIV from selling their blood plasma at Chinese collection sites during the epidemic, according to The Washington Post.

In September, a few days before Wangs death, a play about her life, The King of Hells Palace, opened at Hampstead Theatre in London.

COURTESY OF RUTGERS UNIVERSITY

The developer of a widely used DNA analysis technique called shotgun sequencing, Joachim Messing, died in September. He was 73.

Jos approach to the development of his DNA sequencing tools was to spread them freely and widelythat is, he did not patent them, Robert Goodman, the executive dean of agriculture and natural resources at Rutgers University, where Messing was a faculty member, told The New York Times. He was an incredibly generous man.

His development of the DNA analysis technique and his use of it made Messing the most-cited scientist of the 1980s, according to the Institute for Scientific Information. He went on to study crop modifications, such as boosting amino acids in corn to make it more nutritious and increasing crops drought resistance.

TUFTS UNIVERSITY SCHOOL OF MEDICINE

Tufts University researcher Stuart Levy died in September at the age of 80.

Levy studied antibiotic resistance and in the 1970s showed that bacteria resistant to the drugs could move from the intestine of farm animals to farm workers, a discovery that had implications for bacterial spread in facilities such as hospitals. After Levy published his findings, other researchers started to study antibiotic resistance in hospitals.

It is hard to overstate his importance in limiting the spread of antibiotic resistance, particularly in hospital settings, Ralph Isberg, a professor of molecular biology & microbiology at Tufts, and his colleague John Leong wrote in a statement sent to The Scientist.

Neuroscientist Rahul Desikan, who developed an MRI-based map of the human cortex and identified genetic risk factors for neurogenerative diseases, died in July from amyotrophic lateral sclerosis. He was 41.

The MRI-based map, which quickly became one of the most widely-used tools in the neuroscience community, has been cited more than 4500 times, Christopher Hess, a colleague of Desikan at University of California, San Francisco, wrote in a memorial. Color figures of the atlas in its various forms still fill the pages of our leading scientific journals.

Desikan and his colleagues had just started, in 2016, what was then the largest study on the genetics of amyotrophic lateral sclerosis (ALS) when he began to experience his first symptoms the disease. He was diagnosed with ALS a few months later.

I went into medicine to take care of patients with brain diseases. Now, I have one of the diseases that I study, Desikan said in a press release earlier this year. Even with the disease, he said, he continued to find neurology fascinating and beautiful.

Ashley Yeager is an associate editor atThe Scientist. Email her at ayeager@the-scientist.com. Follow her on Twitter @AshleyJYeager.

Read the rest here:
Those We Lost in 2019 - The Scientist

On Monday, 13 months after He Jiankui announced that he had created the worlds first gene-edited babies, the Chinese scientist was sentenced to three years in prison and fined $430,000.

Working with two embryologists, who were also sentenced to fines and imprisonment, and an unsuspecting doctor, He used in vitro fertilization to create single cell embryos, whose DNA he then altered with the gene editing tool CRISPR-Cas9 to carry a gene variant thought to confer resistance to HIV. Couples recruited for the experiment included HIV positive men, who, He reasoned, would understand the value of resistance to the virus.

Edited embryos were transferred to their intended mothers. Twin girls were born in October 2018 and, we learned yesterday, a baby girl was born in 2019.

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He Jiankui was proud of his experiment, which he deemed a success even though one of the twin girls was born with a mix of edited and unedited genes. The scientist likened his achievement to the work of Dr. Robert G. Edwards, the British physician who won the 2010 Nobel Prize in Physiology or Medicine for the development of IVF.

The international scientific community didnt see it that way. Its reaction was almost uniform condemnation. Scientific leaders called it irresponsible and premature, saying it failed to conform with international norms.

Whether the work was also a violation of Chinese law wasnt immediately clear to the international community. Several months later, however, a task force of the Health Commission of China in Guangdong Province reported that He Jiankui had violated general clinical research laws and rules, such as using a fake ethical review certificate and misleading participants about the studys risks, and also violated an ethics guidance from 2003 that barred the reproductive use of research embryos. At yesterdays sentencing, those violations were bundled together under the crime of illegal medical practice essentially practicing medicine without a license which in China carries a maximum sentence of 10 years in prison.

If He Jiankui had been a U.S. scientist, his alleged misleading of research participants and forging an ethics approval would have been considered unethical, and he would likely have been subject to sanctions from his employer, loss of research funding, and disqualification from clinical research. But the work would also have been illegal, although in a somewhat circuitous and distinctly American way.

In the 1990s and 2000s, well before the latest gene editing tools were developed but following advances in reproductive technology and completion of the human genome project, many countries passed national laws prohibiting the reproductive use of genetically modified human embryos. In the United Kingdom, which since 1990 has had one of the most developed legal frameworks for reproductive technology, transferring a genetically modified human embryo for gestation carries a penalty of up to 10 years in prison.

No directly analogous laws were ever passed in the U.S. until December 2015, when Congress included a brief 101-word provision in a budget appropriations bill that effectively outlawed human germline editing in the U.S.

The provision is a budget rider a condition of federal funding for the U.S. Food and Drug Administration. For the past four years, it has prohibited the FDA from considering any application to conduct research in which a human embryo is intentionally created or modified to include a heritable genetic modification.

The 101 words amount to a ban because the FDA has asserted jurisdiction over all clinical uses of genetically manipulated human cells. As a result, anyone planning to use gene-edited cells in humans must submit an investigational new drug (IND) application to the FDA.

If the application proposes transfusing gene-edited cells into adults with sickle cell disease or some other genetic condition as certain ongoing and proposed studies do then the FDA will consider whether to issue the application or a waiver. But if the IND application involves transferring a genetically modified human embryo for gestation even if only in one patient or one research subject the FDA is absolutely barred from even considering it.

Sanctions for proceeding without an IND application include administrative actions like disqualification by the FDA from ongoing and future research. But violations of the Federal Food, Drug and Cosmetics Act also carry criminal penalties, including fines of up to $250,000 and imprisonment for up to 10 years.

Budget riders, however, expire. Since 2015, Congress has a chance every year to alter the language in this defacto germline editing ban or remove the provision altogether and turn the question over to the FDAs regular decision-making processes. But it hasnt done this.

In the summer of 2019, the U.S. House of Representatives was urged to amend the rider to carve out from the general prohibition a procedure that aims to prevent transmission of mitochondrial disease. Although Congress ultimately left the rider unchanged, it was, apparently for the first time, openly discussed by the House Appropriations Committee. Several members called for a fuller debate of the issue, noting that the prospect of germline genome modification raises profound questions that go well beyond where the federal government should spend its money.

If and when that fuller debate occurs, American lawmakers and the American public will have a chance to engage with the scientific and ethical complexities of gene editing technologies and to consider together how best to police its use in humans.

Until then, researchers in the U.S., like He Jiankui in China, risk prison time if they attempt germline gene editing.

Josephine Johnston is director of research and research scholar at The Hastings Center, and co-editor of the book Human Flourishing in an Age of Gene Editing (Oxford University Press, 2019).

Continued here:
He Jiankui is going to jail. Would the US criminally prosecute a rogue gene-editing researcher? - STAT

Know a UI alum youd like us to track down? Were taking requests at jdalessio@news-gazette.com.

Among the 1,974 former students and faculty members featured on our Gies College of Business-powered UI at 150 & Beyond website: two-degree alumna, Champaign architect and Parkland professor BRIDGETT WAKEFIELD.

***

This Illini memory is dedicated to the late, great James Warfield, who saw the world with different eyes and invited his students into that world, says one of those students, Bridgett Wakefield.

The view of architecture that he professed was people-centric, and his methods were intimately effective, adds the Parkland College professor and Reifsteck Reid & Company architect, who earned her UI bachelors degree in 1996 and her masters two years later.

Professor Warfield was the advisor for my thesis, Through the Eyes of a Child: Building Environments that Work. The first six months flew by as my research easily flowed into place. I combined psychology, education theories and physiology of children to determine what their ideal environment would be at each elementary grade level.

However, since I had so much great research, I found myself stumbling when trying to translate it into the design. I will never forget the day that Professor Warfield raided my desk removing all of the drawing utensils and paper.

He handed me a large sumi-e brush, a well of black ink and a pad of thick paper. Only draw with this for a week.

I thought he was insane. But of course, I did as he requested. The result was an award-winning design.

Professor Warfield has since passed away, but his memory will definitely live on through the students he guided.

Excerpt from:
UI at 150 & Beyond: 'His memory will definitely live on' - Champaign/Urbana News-Gazette

Leaders have specific characteristics that define them as figures that others look up to and as people. Effective leaders typically have a routine with key habits and processes practiced daily. While most people have heard about The 7 Habits of Highly Effective People by Stephen Covey, many leaders don't follow that model. Truly great leaders develop their own set of habits that dictate how their days go and how they can reach their fullest potential.

What are some of the practices that define today's great leaders? Fifteen members of Forbes Coaches Council explain the patterns of behavior that they think good leaders should adopt, and how those actions can make them into more successful individuals in the long term.

Forbes Coaches Council members offer insight on the customs of good leaders.

1. Take Time To Be

As a society, we are focused on the next goal and the never-ending to-do list. We do not spend enough time just being. This means complete silence at times to let your thoughts flow through you, write thoughts down and listen to what your subconscious is trying to tell you. Some of the best ideas I have come up with have not been when I am doing, but when I am just being. - Galit Ventura-Rozen, Empowering U

2. Start Each Day Offline

Its amazing how many clients jump on their phone or tablet first thing in the morning to check the markets, see what emails arrived overnight or simply browse their Twitter feed. Consider starting each day free of online activities. You might meditate, pray, exercise, read or spend time with your spouse or kids instead. The possibilities for starting the day healthier are endlessjust not online. - John Hittler, Evoking Genius

3. Take Time To Connect With Yourself

As leaders, the stuff we do drives us to show up determined, focused and decisive. Leaders push down uncertainties and emotions and we do everything we can to be free of or ignore gut feelings. Spend time connecting with your heart, gut and head each day. The people you are leading are fully human and they deserve to have you show up in the same way. - Brian Gorman, TransformingLives.Coach

4. Establish A Morning Routine

Begin each day with a morning routine that sets you up for success. Your morning routine might include meditation, exercise or a gratitude practice. By taking care of yourself first, you will be able to contribute to others, navigate difficult situations effectively and increase your ability to lead and listen. It's best if you finish your routine before you turn on your phone and computer. - Gina Lavery, Gina Lavery Inc.

5. Track Your Physiology

We tend to overlook our physiology in the world of leadership. We talk about having emotional intelligence, providing motivation and increasing the likes, but a lot of our ability to do these effectively lies in our physiology. I use tools and techniques with my clients so they can scientifically track their physiology and make actual beneficial improvements they can see to have more impact as a leader. - Cody Dakota Wooten, The Leadership Guide

6. Walk Around

Most leaders get set into a routine where they talk and meet with the same people every day. Great leaders break that habit by walking around and meeting new peopleespecially employeeswhen they're not expected to. Informally dropping in on a team or part of the organization you seldom interact with will make you a more authentic, grounded and approachable leader. - Eric Beaudan, Odgers Berndtson

7. Set Your Intention For The Day

Before checking the various mediacalendar, voicemail, emailthat will distract you and demand your time or attention, set your intention for the day. Activate the mindset that will drive your actions to create the leadership impact and influence you want to have rather than getting bogged down merely reacting to external forces. Lead your day before it leads you. - Mia Eng, Cognascent Inc.

8. Implement Reading Time

I have had the pleasure to work with many entrepreneurs over my career. The single factor that all the successful ones had in common was their reading habits. It goes something along the lines of there being a time block set aside to catch up on readings. Short of a disaster that has to be dealt with, that time is nonnegotiable and will stay off limits for any other activity. - Kamyar Shah, World Consulting Group

9. Embrace Relentless Learning

Effective leaders understand the value of continuous learning and also realize that it can happen anywhere and at any time. Commit yourself to learning something new each day, whether it be from your barista, frontline employees, board or grandchildren. Intentionally adopting a learning mindset creates the space for openness and curiosity and allows you to show up as a relentless learner. - Palena Neale, Ph.D, unabridged

10. Practice Daily Meditation

Meditation is like a Swiss army knife that has more unpredictably positive outcomes than any other good habit, but take the time to learn the right way to do it. It's not about not thinking as many people believe; it's about realizing you're not your thoughts. The result is more energy, less friction due to judgment, clearer decision making because you don't need to be right and much more. - Josef Shapiro, Clear and Open

11. Create A Meaningful Habit

Im from the village that says you should create your own habit. Someone elses habits may not necessarily be a fit for you. Create a habit that has meaning to you and your employees and acknowledges their contributions. I pass out a chocolate square at least two afternoons a week to each employee every week. It keeps me conscious of who Im leading and how much I appreciate their contributions. - Thomas Larkin, Communico, Westport CT

12. Prioritize The Habit Of Gratitude

Committing to a daily gratitude journal practice where you write a list of three or more things you're grateful for each day can be transformative for leaders. It's simple, quick (mine takes about 90 seconds) and orients you toward positivity every single day. When you journal about positive stuff at night, it helps you sleep better. Journaling in the morning can help you get off to a great start! - Kate Dixon, Dixon Consulting

13. Practice The Art Of Visualization

One natural ability to develop is the art of visualization, which can be extraordinarily powerful on top of a regular habit of meditation. Our capacity to use our imagination through purposeful visualization can be a differentiator for leaders, and layering visualization on top of meditation adds a multiplying effect. As a starter, try visualizing various scenarios from a relaxed state. - James Glasnapp, James Glasnapp Coaching

14. Ask How Questions

Leaders make tons of decisions daily, so it's crucial that they have good problem-solving skills. What doesn't help is asking too many "why" questions that cause you to dwell on the problem. For example, "Why did this happen to me? Ask more "how" questions instead, like "How can I fix this issue? You can go from powerless to powerful and successful. - Lizette Ojeda, Dr. Lizette LLC

15. Lead With Energy

Integrating a daily physical fitness routine prepares leaders for the mental and intellectual challenges they face. Regular exercise is one form of self-care needed for a leader's well-being as it allows them to sustain the emotional energy required to lead an organization. By modeling self-care, leaders encourage similar behaviors in their employees, which in turn impacts their well-being. - Jonathan Silk, Bridge 3 LLC

Link:
15 Daily Habits Of Great Leaders - Forbes