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Human Fertilisation and Embryology Authority annual report and accounts: 2019 to 2020 - GOV.UK
Ahmed Salman,1 Amany Sholkamy,1 Mohamed Salman,2 Mahmoud Omar,1 Amr Saadawy,3 Ahmed Abdulsamad,4 Mohamed Tourky,5 Mohamed D Sarhan,2 Hossam El-Din Shaaban,6 Nesrin Abd Allah,7 Mohamed Shawkat8
1Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 4Surgical Oncology, Alzahra Cancer Center, Dubai, United Arab Emirates; 5General Surgery Department, Omm Elmisrien General Hospital, Cairo, Egypt; 6Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 7Anatomy and Embryology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt; 8Internal Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt
Correspondence: Ahmed Salman Tel + 201000468664Email awea844@gmail.com
Background: Adult-to-adult living donor liver transplantation (LDLT) has been a common practice because of the deficiency of deceased donor liver transplants. Liver hemodynamics differ substantially between cases with end-stage liver disease undergoing LT because of various degrees of hepatic affection, nature of implicated causative factors, and pathogenesis of the hepatic disorder. The present retrospective study primarily aimed to study the early postoperative doppler changes after adult to adult LDLT. The secondary aim was to assess these hemodynamics impact on early in-hospital deaths and small for size syndrome (SFSS) development.Methods: This retrospective work was done on 123 adult cases with end-stage liver disease for whom adult LDLT was performed after exclusion of pediatric patients and those with vascular complications.Results: Postoperative (PO) mean portal vein velocity (PVV), hepatic artery (HA) peak systolic velocity (PSV), and HA resistivity index (RI) declined gradually but significantly post adult LDLT. Phasicity of hepatic veins changes towards the triphasic waveform gradually in the early PO period. There is a notable negative relationship between PO mean PVV with PO mean HA PSV. Higher PO HA RI affected PO mortality, while higher PO PVV and lower HA PSV increased the incidence of SFSS.Conclusion: Early postoperative Doppler changes post-LDLT (PO PVV, HA RI, and HA PSV) can affect both mortality and SFSS development.
Keywords: postoperative doppler, LDLT, small-for-size syndrome, mortality
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
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Study of Early Postoperative Doppler Changes Post Living Donor Liver T | IJGM - Dove Medical Press
Many of todays biological innovations are complex, and we need to understand them fully to gauge their impact on our lives and societies. Only by working together can governments, scientists, businesses, and the public unleash the power of biology for good while effectively managing the risks.
HAMBURG Last November, the world cheered the news that three gene-based COVID-19 vaccines one developed by German biotech company BioNTech in collaboration with Pfizer, another by US-based biotech firm Moderna, and a third by the University of Oxford and AstraZeneca had proved effective in clinical trials. But in October, researchers revealed that off-target effects of the CRISPR-Cas9 gene-editing tool used to repair a blindness-causing gene in the early stages of human embryo development often eliminated an entire chromosome or a large part of it.
The two announcements, coming just a month apart, illustrate the promise and peril of biological engineering.
As a recent report from the McKinsey Global Institute (MGI) makes clear, current breakthroughs in biological science and advanced data analytics could help us solve major human challenges, from reducing climate risk and strengthening food security to fighting pandemics. But realizing the revolutions potentially huge benefits will require us to think carefully about how to mitigate the potentially severe risks.
The scope of todays bio-innovation wave is large. Some 60% of physical inputs to the world economy are either already biological, or could be produced using biological processes in the future. Nylon, for example, can already be made using genetically-engineered yeast, rather than petrochemicals. Many such bioroutes to production potentially will use less energy and water, and generate fewer greenhouse-gas (GHG) emissions. Just 400 biological applications currently in the pipeline could reduce annual average GHG emissions by as much as 9% by 2050.
CRISPR-Cas9 stands out as an increasingly accessible technology for manipulating genetic material, and is complemented by rapid and low-cost genetic sequencing and advances in data analytics that enable scientists to understand biological processes better. Our deepening knowledge of biology genes, microbiomes, and neural signals is making it increasingly possible to engineer life.
But modifying biology is inherently risky. With CRISPR kits now available for sale on the internet, anyone with some degree of biological knowledge could potentially create and release a new living entity, including harmful bacteria or viruses.
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Biological organisms are self-replicating, self-sustaining, and interrelated. Moreover, as the rapid global spread of COVID-19 has demonstrated, they do not respect political borders. For example, so-called gene drives applied to infectious-disease vectors (such as Anopheles mosquitoes in the case of malaria) could save many lives, but we may not be able to control them. The next generation of genetically-edited mosquitoes in one field experiment in Brazil were supposed to die, but are still breeding five years later.
Another concern is data privacy. The rapid spread of digital technologies has triggered an intense debate about technology companies use of personal data, such as that relating to purchasing habits and social-media activity. But access to biological data from our bodies and brains represents another level of intimate knowledge.
Moreover, the bio-revolution could entrench inequality, at least while applications such as breakthrough therapies, performance enhancements, and reproductive selection remain expensive and thus accessible only to the well-off. MGI estimates that about 70% of the reduction in disease in the next 10-20 years could be in high-income countries, despite the fact that they collectively account for only around 30% of the global disease burden.
Thus, unless managed carefully, the risks of some new biological applications may outweigh the potential benefits. Scientists cannot pursue innovation in a vacuum: societys concerns matter, and innovators must exercise consistent and effective oversight. Fortunately, they have a track record of doing so.
Back in 1975, for example, prominent scientists, lawyers, and medical professionals gathered at the Asilomar Conference in California to draw up voluntary guidelines to ensure the safety of recombinant DNA technology. More recently, the American biochemist Jennifer Doudna, who, together with French microbiologist Emmanuelle Charpentier, was awarded the 2020 Nobel Prize in Chemistry for inventing CRISPR, responded to the tools use to gene-edit twin human embryos by calling for stricter regulation of the technology.
Governments that regulate bio-innovations and the businesses that develop and use them need to be part of the sustained conversation on risk. In fact, we estimate that as much as 70% of the bio-revolutions potential impact will be in uses that fall under existing regulatory regimes.
Regulation today is uneven. For example, as of late 2019, the American Society for Reproductive Medicine largely was leaving it up to clinics and parents to decide what genetic testing and diagnosis is permissible in identifying defects within embryos before they are implanted. But the United Kingdoms Human Fertilisation & Embryology Authority regulates the procedure tightly, permitting its use only for medical purposes and, even then, only for certain disorders.
Ideally, citizens also need to be involved in the debate, because their level of comfort with how science is applied influences regulators. In the UK, for example, the independent Nuffield Council on Bioethics was established in 1991 to advise policymakers and stimulate public debate on bioethics.
Many of todays biological innovations are complex, and we need to understand them fully to gauge their impact on our lives and societies. Only by working together can governments, scientists, businesses, and the public unleash the power of biology for good while effectively managing the risks.
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The Promise and Peril of the Bio-Revolution by Matthias Evers & Michael Chui - Project Syndicate
By Caitlin Painter
In October 1992, an embryo was frozen by an anonymous couple. It remained frozen for over 27 years until thawed by the National Embryo Donation Centre (NEDC) in Knoxville, Tennessee, and transferred into the uterus of a woman unable to conceive naturally. Born in October 2020, Molly Gibson is believed to hold the record for the longest frozen embryo to result in a birth.
The embryo remained frozen for over 27 years until thawed
Embryo freezing has been practised since the early 1980s, but it was initially unclear how long they could be frozen. The typical duration is 10 years, but as proven by Molly Gibson, decadesold embryos can still lead to successful births. The majority of stored embryos that can be adopted have been donated by individuals who have undergone in vitro fertilisation (IVF), after a successful implantation.
IVF is a popular technique available to help people with fertility problems become pregnant. After hormone treatments, a womans eggs are collected and fertilised, and the highest quality embryos can then be implanted, with unused ones typically frozen for further IVF attempts.
As proven by Molly Gibson, decades-old embryos can lead to successful births
A standard freezing process involves replacing water in the cells with a cryoprotectant, and then freezing the embryo extremely quickly to temperatures around -200C (known as vitrification) to prevent ice crystals forming. However, IVF creates a surplus of embryos, and the parent(s) have the decision of what becomes of them. Many choose to discard them. Some are donated for research and training purposes, whilst others are stored for embryo adoptions.
Dr Fiona MacCallum of the University of Warwick believes that the term embryo adoption is misleading, arguing that viewing embryo donations akin to adoptions could shift the public perspective of embryos more towards personhood status.
Dr Fiona MacCallum believes the term embryo adoption is misleading
This could have a great impact on stem cell research, where embryos are frequently used and subsequently destroyed. With this attitude, there is the possibility that embryos could undergo pre-implantation genetic screening. This is currently applied to check an embryo for specific genetic conditions, but could be misused to determine the future characteristics of the child.
Under the Human Fertilisation and Embryology Act of 2008, it is illegal in the UK to select the sex of embryos for non-medical purposes, whether during IVF with a persons own embryos or adopting them. It is common, however, for prospective parents to choose donated embryos of the same ethnicity as themselves, as well as from donor parents they share features with. It was only after they had chosen their desired embryos that Molly Gibsons parents discovered when they had been frozen.
Embryo freezing is the most effective way to preserve fertility, more than freezing eggs
For parents who are unable to conceive, embryo donations provide the opportunity of experiencing pregnancy and birth, with a 75% success rate of donated embryos surviving thawing and transferring. Of these embryos, 25 to 30% are implanted successfully, according to the NEDC.
Embryo freezing is also used by women about to undergo cancer treatments that may result in infertility, but who want a child afterwards. The UKs Human Fertilisation and Embryonic Authority evidences that embryo freezing is the most effective way for women to preserve fertility, more so than freezing eggs. Hence some women choose to freeze their fertilised eggs to increase their chances of a successful pregnancy later in life.
Older mothers are at a much greater risk of complications during pregnancy
Women may choose to postpone pregnancy until they feel more secure in their job and personal life, and having the means to do this has significantly increased womens reproductive freedom. A womans fertility decreases naturally with age, however, the advances in fertility treatments mean its increasingly common for older women to become pregnant. Despite this, older mothers are at a much greater risk of complications during pregnancy, prompting the discussion of whether those who otherwise would not be able to conceive and safely carry a baby should, just because it is scientifically viable.
Conversely, reproductive rights defined by the World Health Organisation (WHO) state that everyone has the right to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so. For most cases, there is a 10- year limit on freezing embryos, leaving people with a difficult decision once this time is up: destroying their embryos or beginning fertility treatment.
For some, 10 years later is still too soon to have a child. If we know embryos can survive for at least 27 years, why is this arbitrary limit still imposed? Does it really increase womens reproductive freedom as much as we think? Despite this, fertility Science & Technology treatments are life-changing, and the law rightly allows infertile couples and individuals the chance of having a family with their own or donated embryos. These treatments also provide the chance for same-sex couples to have children through means other than adopting, by using donated embryos or donated eggs/sperm. In December 2020, a 61-year-old gave birth to her own granddaughter by acting as a surrogate for her son and his husband.
A 61-year-old gave birth to her own granddaughter by acting as surrogate
The scientific advancements made during the last 40 years regarding fertility treatments have given many parents the chance of having a child. The record-breaking case of Molly Gibson has highlighted the prevalence and importance of these treatments being a possibility in todays society, meaning embryo adoption could become much more popular.
Image: Amber Conway
Excerpt from:
Embryo freezing is revolutionary for those who can't conceive - Palatinate
Before wolves were reintroduced to Yellowstone National Park in the mid-1990s, they were vaccinated for common diseases and treated for any parasite infections they already carried. As a result, the first few generations of wolves were relatively disease-free, but over the years, various diseases have found their way into the population.
Both of these Yellowstone wolves display the hair loss and skin lesions associated with mange. By analyzing 25 years of wolf observations and geneticsamples from 408 Yellowstone wolves, a Princeton-led research team found that genetics playa role in the severity of the mite-borne disease.Theyfound support for the "monoculture theory":wolves with severe mange, like the one on the left, tendto have less genetic variation than wolves with mild symptoms, as seen on the right.
Photos by Rebecca Raymond/National Park Service and Dan Stahler/National Park Service
Sarcoptic mange, caused by the microscopic mite Sarcoptes scabiei, first crawled its way into the reintroduced Yellowstone wolves in 2007. Mange is characterized by itchy skin lesions and hair loss, but there is huge variation between individuals in terms of how sick wolves actually become some experience mild mange symptoms and are able to clear the mites within a few months, while others experience massive hair loss, emaciation andsecondary bacterial infections, and eventually die of the disease. Mange isnt exclusively a disease of wolves, either. Sarcoptic mange mites infect more than 100 different mammalian species, including humans (where the disease is better known as scabies), and similar inter-individual variation in disease severity occurs in all of these host species.
Little is known about what causes thevariation in manginess, but a team of researchers, led by then-Princeton graduate student Alexandra DeCandia, sought to uncover this mystery. Their study, published in Evolutionary Applications, brings together schools of thought from molecular biology, disease ecology and conservation biology.
Genetics provide us with a really powerful tool for understanding wildlife health and conserving at-risk species, said DeCandia, who completed her Ph.D. in 2020 and is now a postdoctoral researcher at the Smithsonian Conservation Biology Institute. We can learn more about the causes of disease, the short- and long-term effects on individual animals and populations, and how best to respond as wildlife biologists and managers. For widespread diseases like mange, we can even gain insights into common processes that affect other host species including our own for a larger-scale One Health perspective that ultimately improves both human and wildlife health.
Though the researchers focused on wolves, the genetic pathways they uncovered will help pave the way for research into human scabies, which infects some 200 million people.
The premise of their research is based on a phenomenon known in agriculture as the monoculture effect, which predicts that the ability of individuals and populations to combat disease is related to genetic diversity. Individuals with higher genetic diversity are more resistant to disease, or more likely to experience mild disease, because they have more genetic tools with which to fight off diverse pathogens. Similarly, at the population scale, populations with higher genetic diversity may be less likely to experience disease outbreaks and more likely to survive outbreaks if they do occur.
Think of an agricultural monoculture. In a field of genetically identical bananas, for example, if a parasite is capable of infecting one banana tree, it has the tools needed to infect all of the banana trees. Of course, populations of wild animals are never monocultures, but they do vary in the amount of genetic variation they contain. And if the population in question originates from a small number of individuals, the amount of genetic variability available may be limited. Such is the case with the reintroduced wolves of Yellowstone National Park.
Leveraging over 25 years of wolf observational data and genetic samples from 408 individual wolves, the research team led by DeCandia and her adviser Bridgett vonHoldt, an associate professor in ecology and evolutionary biology at Princeton Universitylooked for patterns in overall genetic diversity associated with mange: Is the degree of individual-level genetic diversity associated with disease severity? Are specific genes involved? How did the introduction of mange impact genetic diversity at the population level? Using their years of observations, the researchers analyzed the genetic results in the context of broader wolf biology to see how genetic variation interacts with other factors behavioral, environmental and demographic to determine mange severity.
In individual wolves, the researchers found support for their hypothesis: wolves with severe mange tended to have less genetic variation than wolves with mild symptoms. Additionally, the study identified 410 genetic variants that are significantly associated with mange severity. These variants are known to play roles in inflammation, immunity and skin barrier integrity, and could potentially be molecular targets for mange or scabies treatment in other host species.
Professor Bridgett vonHoldt (center) isflanked by her graduate studentsin Yellowstone National Park in this photo from January 2019. From left: Dhriti Tandon, Elizabeth Heppenheimer, Alexandra DeCandia and Christopher Lawrence.
Photo by Axel Haenssen, Research Computing, Office of Information Technology
The researchers found that the best model of mange severity included not only genetic variation, but also took into account the age and breeding status of the wolf in question, and the season. Wolves tend to experience more severe mange in winter, when it is more difficult to thermoregulate; older wolves tended to have worse mange than younger wolves, although pups were not included in the study; and non-breeding wolves tend to be more mangy than breeders (though the direction of causation here is unclear it could be their manginess that prevents them from breeding).
At the population scale, overall genetic diversity has decreased in the Yellowstone wolves over the years.
Such changes in diversity are not unexpected, said vonHoldt, the senior author on the study. We have found that genetic diversity has been preserved well through mechanisms that shape pack and breeding pair formations. This recent opportunity to incorporate immunity and mange prevalence has really given us insights into the genetic dynamics shaped additionally by disease in a social carnivore.
Interestingly, gene variants that are associated with more severe mange have become less common in the population since mange emerged in 2007. This finding indicates that the disease is placing strong evolutionary selection pressure on the wolf population, weeding out those wolves most likely to succumb todeath from mange.
The findings are also significant for conservation biology, since maintaining healthy and genetically diverse individuals is one of the keys to conservation.
Conservation genetics has traditionally relied on a handful of genetic markers to inform captive breeding or wild population management, DeCandia said. For species of conservation concern, this research highlights the importance of examining both summary metrics of genome-wide variation and specific genes associated with disease.
In addition to DeCandia and vonHoldt, the other authors involved in the study were Edward Schrom, a 2020 graduate alumnus who is now a postdoctoral researcher at the National Institutes of Health; Ellen Brandell, a postdoctoral researcher at the University of Wisconsin-Madison; and Daniel Stahler, the lead wolf biologist at Yellowstone National Park.
Sarcoptic mange severity is associated with reduced genomic variation and evidence of selection in Yellowstone National Park wolves (Canis lupus), by Alexandra DeCandia, Edward C. Schrom, Ellen Brandell, Daniel R Rahler, and Bridgett vonHoldt, was published Sept. 10, 2020, in Evolutionary Applications (DOI: 10.1111/eva.13127). This work was supported by Princeton University's Department of Ecology and Evolutionary Biology and Center for Health and Wellbeing; the National Science Foundation (DEB0613730, DEB-1245373and DGE1656466); the Yellowstone Park Foundation (now Yellowstone Forever); and key donors, especially Annie and Bob Graham, Valerie Gates, and Frank and Kay Yeager.
Continued here:
Mange in Yellowstone wolves reveals insights into human scabies and conservation biology - Princeton University
ABC has firmed up its midseason lineup, slotting premiere dates for new series Rebel, Home Economics and Pooch Perfect and setting new March return dates for its Thursday dramas.
Greys Anatomy, Station 19 and A Million Little Things, which originally were scheduled to come back from winter hiatus on March 4, will now be back March 11. The additional week is being provided as extra cushion amid unpredictable production interruptions and delays during the pandemic.
New drama Rebel, starring Katey Sagal and created by Krista Vernoff inspired by the life of Erin Brockovich today, will join ABCs Thursday lineup starting April 8. It will replace 10 PM anchor A Million Little Things, which will return to its former Wednesday 10 PM time slot, succeeding For Life after its 10-episode Season 2 concludes.
With Shondalands Station 19 at 8 PM and Greys Anatomy at 9 PM as well as Rebel at 10 PM, ABC will have an entire night from the same executive producer/showrunner, Vernoff, who runs all three series.
Starring Topher Grace, new comedy series Home Economicswill join ABCs Wednesday night comedy block, premiering April 7. It will succeed veteran American Housewife, which has a 12-episode Season 5 season order.
On the unscripted side, new eight-episode dog grooming competition Pooch Perfect, hosted by Rebel Wilson, will take over the Tuesday 8 PM hour, currently home of To Tell the Truth, on March 30.
ABC Is coming off a strong fall when it ranked as the most watched entertainment network for the first time In 20 years.
Here are the newly announced ABC midseason premiere dates followed by descriptions of the networks new shows:
THURSDAY, MARCH 11
8:00-9:00 p.m. Station 19 (new return date)
9:00-10:01 p.m. Greys Anatomy (new return date)
10:01-11:00 p.m. A Million Little Things (new return date)
TUESDAY, MARCH 30
8:00-9:00 p.m. Pooch Perfect (series premiere)
WEDNESDAY, APRIL 7
8:30-9:00 p.m. Home Economics (series premiere)
10:00-11:00 p.m. A Million Little Things (new day)
THURSDAY, APRIL 8
10:01-11:00 p.m. Rebel (series premiere)
POOCH PERFECT
Hosted by award-winning actress Rebel Wilson, Pooch Perfect is a dog grooming competition series. The eight-episode series will showcase 10 of the best dog groomers in the country, along with their assistants, competing in a series of paw-some themed challenges.
Each week on Pooch Perfect, teams will compete in the Immunity Puppertunity challenge, where one team will earn immunity from elimination. Then, in the Ultimutt Challenge showdown, the remaining teams will face off in an epic grooming transformation, which they will show off on the illustrious dogwalk. The trio of all-star celebrity judges Lisa Vanderpump, Jorge Bendersky and Dr. Callie Harris will be tasked with voting on the incredible creations and ultimately force one team back to the doghouse every week. It all leads up to the season finale where the top three teams compete for a giant cash prize and the coveted Pooch Perfect first place trophy.
Pooch Perfect is produced by Beyond Media Rights Limited. Elan Gale, Sonya Wilkes and Rebel Wilson serve as executive producers. Nicole Anthony, Mike Rosen, Carley Simpson and Matthew Silverberg serve as co-executive producers. ABCs Pooch Perfect is based off of the Australian format.
HOME ECONOMICS
Starring and executive produced by Topher Grace, Home Economics takes a look at the heartwarming yet super uncomfortable and sometimes frustrating relationship between three adult siblings: one in the 1%, one middle-class and one barely holding on. The comedy is inspired by the life of writer and executive producer Michael Colton.
The series stars Topher Grace as Tom, Caitlin McGee as Sarah, Jimmy Tatro as Connor, Karla Souza as Marina, and Sasheer Zamata as Denise. Also starring is Shiloh Bearman as Gretchen, Jordyn Curet as Shamiah, Chloe Jo Rountree as Camila and JeCobi Swain as Kelvin.
Home Economics was created by writers Michael Colton & John Aboud. They serve as executive producers alongside Topher Grace and Eric and Kim Tannenbaum of The Tannenbaum Company, whose Jason Wang will co-executive produce. The series is produced by Lionsgate and ABC Signature. ABC Signature, alongside 20th Television, is a part of Disney Television Studios.
REBEL
Inspired by the life of Erin Brockovich today, Annie Rebel Bello is a blue-collar legal advocate without a law degree. Shes a funny, messy, brilliant and fearless woman who cares desperately about the causes she fights for and the people she loves. When Rebel applies herself to a fight she believes in, she will win at almost any cost.
The series stars Katey Sagal as Annie Rebel Bello, John Corbett as Grady Bello, James Lesure as Benji, Lex Scott Davis as Cassidy, Tamala Jones as Lana, Ariela Barer as Ziggie, Kevin Zegers as Nate, Sam Palladio as Luke and Andy Garcia as Cruz.
Rebel is executive produced by Krista Vernoff and Alexandre Schmitt of Trip the Light, Erin Brockovich, John Davis and John Fox of Davis Entertainment, Andrew Stearn, Marc Webb and Adam Arkin. The series is produced by ABC Signature in association with Sony Pictures Television. ABC Signature, alongside 20th Television, is a part of Disney Television Studios.
On the left is an image of the Jewel Bug Nebula (NGC 7027) captured by the Hubble Space Telescope in 2019 and released in 2020. Further analysis by researchers produced the RGB image on the right, which shows extinction due to dust, as inferred from the relative strength of two hydrogen emission lines, as red; emission from sulfur, relative to hydrogen, as green; and emission from iron as blue. Credit: STScI, Alyssa Pagan
Images of two iconic planetary nebulae taken by the Hubble Space Telescope are revealing new information about how they develop their dramatic features. Researchers from Rochester Institute of Technology and Green Bank Observatory presented new findings about the Butterfly Nebula (NGC 6302) and the Jewel Bug Nebula (NGC 7027) at the 237th meeting of the American Astronomical Society on Friday, January 15, 2021.
Hubbles Wide Field Camera 3 observed the nebulae in 2019 and early 2020 using its full, panchromatic capabilities, and the astronomers involved in the project have been using emission line images from near-ultraviolet to near-infrared light to learn more about their properties. The studies were first-of-their-kind panchromatic imaging surveys designed to understand the formation process and test models of binary-star-driven planetary nebula shaping.
Were dissecting them, saidJoel Kastner, a professor inRITs Chester F. Carlson Center for Imaging ScienceandSchool of Physics and Astronomy. Were able to see the effect of the dying central star in how its shedding and shredding its ejected material. Were now seeing where material that the central star has tossed away is being dominated by ionized gas, where its dominated by cooler dust, and even how the hot gas is being ionized, whether by the stars UV or by collisions caused by its present, fast winds.
On top is an image of the Butterfly Nebula (NGC 6302) captured by the Hubble Space Telescope in 2019 and released in 2020. Further analysis by researchers produced the RGB image on the bottom, which shows extinction due to dust, as inferred from the relative strength of two hydrogen emission lines, as red; emission from nitrogen, relative to hydrogen, as green; and emission from iron as blue. Credit: STScI, APOD/J. Schmidt; J. Kastner (RIT) et al.
Kastner said analysis of the new HST images of the Butterfly Nebula is confirming that the nebula was ejected only about 2,000 years agoan eyeblink by the standards of astronomy and established that the S-shaped iron emission that helps give it the wings of gas is even younger. Surprisingly, they found that while astronomers previously believed they had located the nebulas central star, that previously-identified star is actually not associated with the nebula and is instead much closer to Earth than the Butterfly Nebula. Kastner said he hopes that future studies with the James Webb Space Telescope could help locate the real dying star at the heart of the nebula.
The teams ongoing analysis of the Jewel Bug Nebula is built on a 25-year baseline of measurements dating back to early Hubble imaging. Paula Moraga Baez, an astrophysical sciences and technology Ph.D. student from DeKalb, Ill., called the nebula remarkable for its unusual juxtaposition of circularly symmetric, axisymmetric, and point-symmetric (bipolar) structures. Moraga noted, The nebula also retains large masses of molecular gas and dust despite harboring a hot central star and displaying high excitation states.
The RGB image on the right reveals the spatial separation of molecules CO+ (red) and HCO+ (blue), indicative of UV and X-ray processes, respectively. The much deeper optical image of [O III] (green) provides a juxtaposition of the ionized atomic structure and that of radio molecular observations. Credit: STScI, Alyssa Pagan; J. Bublitz (NRAO/GBO) et al.
Were very excited about these findings, said Bublitz. We had hoped to find structure that clearly showed CO+ and HCO+ spatially coincident or entirely in distinctive regions, which we did. This is the first map of NGC 7027, or any planetary nebula, in the molecule CO+, and only the second CO+ map of any astronomical source.
Meeting: 237th meeting of the American Astronomical Society
In addition to Kastner, Moraga, and Bublitz, the research team involved in the HST imaging work includes Rodolfo Montez Jr. 10 Ph.D. (astrophysical sciences and technology) from Harvard-Smithsonian CfA; Bruce Balick from University of Washington; as well as Adam Frank and Eric Blackman from University of Rochester. Bublitzs international team of collaborators on radio molecular line imaging of NGC 7027 includes Kastner, Montez Jr., and astrophysicists from Spain, France, and Brazil.
Continue reading here:
Dissecting the Anatomy of Planetary Nebulae Using the Hubble Space Telescope - SciTechDaily
Trouble flies inCharter flights carrying more than 1,200 people from seven separate cities began to arrive in Melbourne on January 14. With positive tests recorded by non-playing personnel on flights from Los Angeles and Abu Dhabi, 72 players, including Britains Heather Watson and Victoria Azarenka, of Belarus, were deemed as close contacts and ordered to remain inside their hotel rooms for two weeks. Videos soon emerged of players hitting balls against mattresses and windows.
Grumbling over grubFor some players, the food in quarantine was not up to scratch. Fabio Fognini, the world No 17 from Italy, was among those to post uncomplimentary photographs of the meals being delivered to his room, while Frances Benot Paire decided to order a McDonalds delivery for breakfast
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Anatomy of... the Australian Open Covid crisis | Sport | The Sunday Times - The Times
With increasing complexity of interventional structural heart disease and congenital heart disease interventions, 3-D printing of the anatomy is being used for pre-planning and practicing procedures, device sizing and as a visual reference for the soft tissue during procedures. 3-D printing has become more popular within the medical space as it has been shown to help prevent, fix and foresee procedural errors.
Many lather hospitals are integrated 3-D printing services to better personalized patient care. These centers have 3-D printing labs to create accurate anatomical models from a patient's computed tomography (CT) scans.
However, printed models of the heart show one momement frozen in time from a dynamic organ that changes shape and twists throughout the cardiac cycle. For this reason, some centers are now also using computed aided design (CAD) software that can virtually model the anatomy during the entire cardiac cycle. This enables more accurate valve sizing and to model what happens when a device is placed in a moving heart.
In the setting of paravalvular leaks around failed surgical devices, many times patients are not candidates for a second or third redo operation due to progressive underlying frailty. The leaks are often plugged using off-label transcatheter occluder devices. These highly complex procedures once took five to seven hours in duration, but 3-D printed models of patient-specific anatomy now offers a better understanding of the leaks and can help preplan procedures with device sizing and how these occluder devices will interact with adjacent anatomy. Use of 3-D models can decrease procedural time by up to a half.
A 2018 study by the University of Minnesota in Minneapolis examined the effectiveness of 3-D printing and computer modeling to predict paravalvular leak (PVL) in patients undergoing transcatheter aortic valve replacement (TAVR). A common risk of TAVR is an ill-fitting valve which can lead to PVL. The study used 3-D printing technology to help confirm and detect the location of the leak. CT scans allowed researchers to see a 360-degree view of the location of the calcium build up while the 3D models allowed researchers to further evaluate the ill-fitting valves. The 3D aortic root models were then virtually implanted with the valve to determine if the size was correct and revealing where there were leaks around the areas of heavy calcium. The models were ethen compared to in-vivo implanted TAVR echocardiograms.
Every leak seen on the 3D models were confirmed on the CT digital scans. The 3D models allowed researchers to use prototypes to personalize valve placement, size and location to stop leaks and lower calcium build up.
We are very encouraged to see such positive outcomes for the feasibility of 3D printing in patients with heart valve disease. These patients are at a high risk of developing a leak after TAVR, and anything we can do to identify and prevent these leaks from happening is certainly helpful, said lead author Sergey Gurevich, M.D., assistant professor of medicine, Cardiovascular Division at the University of Minnesota in Minneapolis, Minn. Like any other new technology, as 3D printing evolves, we hope to see an increase in accessibility and opportunity for the use of this technology to help improve patient care.
For transcatheter left atrial appendage (LAA) occlusion procedures, 3-D printing can be used to understand the best location of a transeptal puncture to enable the delivery catheter to enter the LAA, explained Dee Dee Wang, M.D., director, structural heart imaging at Henry Ford Hospital, Detroit. She said these models also can help determine which catheters are best suited to that particular patient's anatomy. This preplanning can save procedure time and the need to exchange multiple devices.
"It allows us to be able to feel a patient's heart that we otherwise could not, because we are not surgeons, and that tactile sensation and concept of special resolution in being able to turn the heart outside the body, really gives us a better idea of the procedure before we go into it," Wang explained.
Another use case for in-house medical 3-D printing is to create surgical models to help cardiac surgeons plan complex cases. This is especially true with multidisciplinary cases in interventional radiology, cancer surgery and pediatric cardiac surgery. These types of models are used at Florida-based Nemours Childrens Health System as a pre-planning blueprint and roadmap for surgeons and proceduralists. The hospital said these help increase confidence, reduce procedure times and minimizing unexpected findings while in the operating room.
The simulation aspect of 3-D modeling is a game changer. To be able to look at a model of a tumor from all angles, without the restrictions of a 2-D image on a computer screen, is completely changing how we are planning complex surgery, said Craig Johnson, DO, chair of medical imaging and enterprise director of interventional radiology.
Using modified models from volumetric 2-D CT and magnetic resonance imaging (MRI), physicians can run simulations of the surgery and more accurately determine the tools they will need, with the multidisciplinary team involved, cutting down on waste. For example, certain models enable surgeons to drill holes in them to measure and select the appropriate medical equipment to use during the procedure.
Three-dimensional modeling prepares us by helping us know exactly what were going to do. We do not have to plan on the spot if we come across something unexpected. Instead weve had imaging from radiology as well and the model, said Tamarah J. Westmoreland, M.D., Ph.D., a pediatric surgeon at Nemours Childrens Health System. The surgery is almost like a musical concert. It is rehearsed, planned and then executed without complication.
Nemours also found 3-D models are invaluable in explaining procedures to patients and their families. An echo, MRI or CTR can be difficult for a parent to conceptualize, so the Nemours team uses a true-to-size 3-D model of that patient. In many cases, the patients have the high-fidelity models next to them in their room as care teams explain their treatment plan.
When we use a model to explain to a parent or a child a procedure, its clear, this approach is different, Johnson explained. They are able to visualize what we are going to do and it sets them at ease.
Jessica Lewis is the mother of a Nemours patient and experienced this firsthand. Her 13-year-old son, Malachi, had a rare congenital coronary artery anomaly and needed cardiac surgery at Nemours.
I was able to turn the model of my sons artery around and look at it from all sides, said Lewis. The more educated you are about the procedure, the more empowered you feel because you completely understand what is going on with your child.
One of the most import applications for CAD currently is to determine if there will be left ventricle outflow tract obstruction when placing a transcatheter metal valve. This is especially true with devices like the Edward Sapian transcatheter aortic valve replacement (TAVR) device used in the mitral valve position. The Sapian is frequently used in very sick patients with dysfunctional mitral valves who cannot undergo surgery, and currently there is no FDA cleared transcatheter mitral valve available.
She said experience with implanting Sapian in mitral valves, recording LVOT gradients and looking at post-procedure CTs allowed Henry Ford to developing computer modeling using CAD software from 3-D printing vendor Materialise to better predict which patients will have poor outcomes, or require more advanced procedures to better fit the valve using alcohol septal ablation or use of the LAMPOON procedure to cut the mitral leaflet to prevent LVOT obstruction.
"When we made a 3-D printed model it made perfect sense to us, but after doing so many prints we realized we can visualize the valve without having to actually physically print it," Wang said from Henry Ford Hospital's experience. "We do both computer modeling and printing so we can have better communication between the surgeon, implanter and the patient prior to the procedure. This enables everyone to speak the same language, because a surgeon may explain something differently than an interventionists who does not actually cut into the patient."
Henry Ford has now used 3-D printing and CAD in well over 1,000 patients.
She said CAD and 4-D CT imaging also has had a major impact on Henry Ford's LAA occlusion outcomes. "We have shown from our structural heart experience that using 3-d CT, 4-D CT and 3-D printing that we could actually have zero complications compared to the clinical trial average, which was 16 percent," Wang said. In addition to improving outcomes, she said they were able to reduce the number of devices used and the procedural time. "From a hospital administrator standpoint means a faster, more efficient lab. They can do more procedures, and for an implanter, they have the confidence they need to do the procedure."
As more hospitals use 3-D printing and CAD technologies, many medical imaging vendors have partnered with established 3-D vendors to offer their software integrated into their advanced visualization, PACS or enterprise imaging platforms.
An example of this include Philips integrating software from both 3D Systems and Stratasys, two global leaders in the 3-D printing industry, into its IntelliSpace Portal. The embedded 3-D modeling application can create and export 3-D models intuitively into the clinical workflow. The suite of clinician-focused rendering and editing tools helps assure the model reflects the true patient anatomy.
3D Systems precision healthcare capabilities include virtual reality simulators, 3-D-printed anatomical models, virtual surgical planning, patient-specific surgical guides, instrumentation and implants. Their solutions help to speed care and treatment and reduce costs.
Stratasys is a supplier of applied additive technology solutions, from 3-D-printed surgical planning models and medical device prototyping to advanced education and training. Stratasys' PolyJet-based full-color, multi-material 3-D printing solutions drive high-quality realism. Interfacing with Philips, customers can now rapidly design, order, and produce 3-D-printed anatomical structures on-demand from Stratasys Direct Manufacturing.
Some larger advanced visualization vendors offer partnerships with 3-D printing companies where STL (standard triangle language) files for printing can be created from medical imaging and then sent to an outside company for custom printing orders. This can save costs by outsourcing 3-D printing rather than deleting an in-hospital printing lab.
Other vendors have developed their own software or partnered with hospitals with advanced 3-D printing programs to integrate the technology into their own platforms. GE Healthcare is one of the vendors that has such software, allowing files for printing to be created from CT datasets using the AW Advanced Visualization software.
See and example of the GE technology for a hip fracture repair
In August 2017, the U.S. Food and Drug Administration (FDA) announced that software intended to create output files used for printing 3-D patient-specific anatomical models used for diagnostic purposes is a Class II medical device and requires regulatory clearance.
The FDA has approved 3-D applications for medical use. The first FDA clearance came in March 2018 for Materialise NV became the first company in the world for 3-D printing anatomical models for diagnostic use. Materialise Mimics inPrint software is used for pre-operative planning and the fabrication of physical models for diagnostic purposes, including patient management, treatment and surgeon-to-surgeon communication.
Bioengineers at several academic centers have been refining 3-D printing technologies to print replacement biological tissues to implant in the human body. The eventual goal is in the future is to print replacement organs.
In the realm of cardiovascular medicine, a couple of these 3-D printing technologies to expect on the horizon soon will be bioprinted heart valves, of blood vessels for use in bypass procedures and tissue patches that might be used to repair areas of infarct.
This science fiction-like technology is rapidly developing. The biggest obstacle has been being able to print very detailed, complex structures, such as tissue vasculature. In 2019, bioengineers collaborating from Rice University, University of Washington, Duke University and Rowan University cleared a major hurdle on the path to 3-D printing replacement organs with a breakthrough technique that enabled exquisitely entangled vascular networks. The technique can mimic the body's natural passageways for blood, air, lymph and other vital fluids.
Layers are printed from a liquid pre-hydrogel solution that becomes a solid when exposed to blue light. A digital light processing projector shines light from below, displaying sequential 2-D slices of the structure at high resolution, with pixel sizes ranging from 10-50 microns. With each layer solidified in turn, an overhead arm raises the growing 3-D gel just enough to expose liquid to the next image from the projector.
"One of the biggest road blocks to generating functional tissue replacements has been our inability to print the complex vasculature that can supply nutrients to densely populated tissues," said bioengineer Jordan Miller, assistant professor of bioengineering at Rice University's Brown School of Engineering. "Further, our organs actually contain independent vascular networks like the airways and blood vessels of the lung or the bile ducts and blood vessels in the liver. These interpenetrating networks are physically and biochemically entangled, and the architecture itself is intimately related to tissue function. Ours is the first bioprinting technology that addresses the challenge of multivascularization in a direct and comprehensive way."
To Access the Online 3-D Printing and Printing Services Comparison Chart
VIDEO: Applications in Cardiology for 3-D Printing and Computer Aided Design
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Developments in Transcatheter Mitral Valve Replacement
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See the article here:
3-D Printing and Computer Aided Design Aids Structural Heart Interventions - Diagnostic and Interventional Cardiology
After being on the air for more than 15 years, Greys Anatomy has covered lots of interesting and important topics. Regardless of what has gone on in the world, theyve always found a way to creatively incorporate current events. All of the things that went on in 2020 were no exception. The shows 17th season got off to a very eventful start, and it was clear that the writers wanted to include some real world issues that have been going on lately. In two episodes early in season 17, Greys has already tackled two very difficult subjects: human trafficking and systemic racism. Although both of these topics can be very sensitive, the show did a great job of navigating each issue. Continue reading to see how Greys Anatomy has shed light on human trafficking and racism in one season.
Human trafficking certainly isnt new. But in recent years more and more light has gotten shed on the horrendous realities of the situation. Although weve all heard the phrase and have a basic understanding of what it is, most people would agree they dont really have a strong understanding of the different ways human trafficking can work.
The series initially introduced the subject at the end of season 16 when a teenage girl came to Grey-Sloan Memorial Hospital complaining of stomach pain. Dr. Andrew DeLuca was immediately suspicious of the situation. He became even more concerned when the girls aunt continued to interject and wouldnt let the patient talk. Unfortunately, however, DeLucas suspicions were quickly brushed aside because everyone at the hospital believed that he was suffering through a mental health break down.
At the end of season 16, viewers were left wondering whether or not DeLuca was right or if his accusations really were the result of his faltering mental health. At the start of season 16, it became clear that DeLuca was, in fact, right. The doctors were eventually able to determine that the teenage patient was actually the victim of human trafficking. The episode helped to shine light on how these traffickers operate and how common these things happen.
Ellen Pompeo, the star of the show, expressed that the human trafficking storyline was one of her favorites. She told The Sun, The human trafficking that was in last weeks episode to this mental illness storyline with Giacomo Gianniotti, its really important stuff.
The United States has a very long and sad history when it comes to race. Although some people think that racism is a thing of the past, recent history has shown that isnt the case at all. Greys decided to put this issue front and center during season 17 in more than one way.
In one episode, the show highlighted how black patients tend to be overlooked by the medical system. During the pandemic, this means that many COVID positive black and brown patients are often put on the back burner in favor of treating white patients. During the episode, Maggie said, I want outrage for the fact that we are seen as disposable and rarely seen as victims that Black girls are less likely to be seen as innocent as white girlsAnd now, there is a plague that is killing Black people at a rate that should make everyone outraged. If COVID were killing white people at the rate that it is killing Black people, you better believe that everyone would be wearing masks because it would be the damn law.
The show also highlighted similar effects of racism in another scenario. In an episode, Dr. Hunt, who generally always gets things right, made an error when diagnosing an Asian patient. Dr. Hunt failed to realize that certain conditions are more common in Asian people.
For Dr. Hunt, this became a teaching moment. It was a chance for him to realize that although he has good intentions, he still needs to be mindful of the inherent biases he carries with him. Something as simple as not being aware of or acknowledging differences can easily become a life or death situation in the medical world.
While thinking about the issue of racism can be very uncomfortable for some, bringing this conversations to the forefront is the first step in the journey of making change.
At Greys Anatomy has been on the air for longer than some of its fans have been alive. Still, the show is showing no signs of slowing down. One thing we do know, however, is that season 17 will likely shine light on lots of over important issues. Unfortunately for all of the Greys fans out there, the show is on hiatus until March 2021. Once it returns, however, I have a feeling well all think it was worth the wait.
Originally posted here:
How "Grey's Anatomy" Tackled Human Trafficking and Systemic Racism - TVOvermind