Archive for February, 2020

VANCOUVER Feb 23, 2020 (Thomson StreetEvents) -- Edited Transcript of Eldorado Gold Corp earnings conference call or presentation Friday, February 21, 2020 at 4:30:00pm GMT

* Tanya M. Jakusconek

Thank you for standing by. This is the conference operator. Welcome to the Eldorado Gold Corporation Fourth Quarter and 2019 Year-End Results Conference Call. (Operator Instructions)

I would now like to turn the conference over to Peter Lekich, Manager, Investor Relations. Go ahead, Mr. Lekich.

Thank you, operator, and thank you, ladies and gentlemen, for taking the time to dial into our conference call today. With me in Vancouver this morning are George Burns, President and CEO; Phil Yee, Executive Vice President and CFO; Joe Dick, Executive Vice President and COO; Paul Skayman, Special Adviser to the COO; and Jason Cho, Executive Vice President and Chief Strategy Officer.

Our release yesterday details our 2019 fourth quarter and year-end financial and operating results. This should be read in conjunction with our fourth quarter and year-end financial statements and management's discussion and analysis, both of which are available on our website. They have also been filed on SEDAR and EDGAR. All dollar figures discussed today are in U.S. dollars, unless otherwise stated. We will be speaking to the slides that accompany this webcast. You can download a copy of these slides from our website.

Before we begin, I would like to remind you that any projections included in our discussion today are likely to involve risks, which are detailed in our 2018 AIF and in the cautionary note on Slide 1. I will now turn the call over to George.

Thanks, Peter, and good morning, everyone. It's fantastic to see the response to our release this morning. Here is the format for today's call. I'll give an overview of the highlights along with some comments, then I'll pass it over to Phil to go through the financials. Paul will follow by reviewing operational performance, and Joe will say a few words on 2020 plans. Then we'll open it up for questions.

Before we get into things, I want to say a warm welcome to Joe, our new COO. Joe has been with us for a few months and has had the opportunity to spend some time at our sites. He joins us from Newmont, where he was SVP for Latin America. He also has experience with Barrick and Rio Tinto. Welcome, Joe.

Moving on to the highlights on the next slide. It was another solid quarter for -- both operationally and financially. We produced a record 118,955 ounces of gold, our highest quarterly production in nearly 4 years. This was a result of increased production at Lamaque and Kisladag. Consolidated annual gold production came in on plan, and we ended the year with over 395,000 ounces, our highest total production in 3 years. Cash operating cost remained steady.

Looking back, 2019 was a pivotal year in Eldorado's 25-year history. We put our first Canadian mine into commercial production, we restructured the balance sheet and reduced our total debt by USD 100 million, and we received long-awaited permits in Greece. On top of these accomplishments, our cornerstone asset, Kisladag, is now back on track. We are confident that the results of recent test support and extended mine life of 15 years.

I'm proud of the benefit that will come to local communities and the Greeks. Kisladag will once again provide long-term value for Eldorado stakeholders. Over to Greece, our team is working with ministry officials to advance our investment. To recap, we have received the Skouries construction permits that held us up since 2017.

However, an updated investment agreement and permits for dry stack tailings are essential for the advancement of the investment and restart of the project. The revised investment agreement would not only provide a stable platform irrespective of future governing parties, it would also help in demonstrating Greece's commitment to working with foreign investors in order to attract capital needed to grow its economy.

Just to remind everyone, we view Skouries as a world-class asset that will create approximately 1,000 well-paying jobs over its current 23-year mine life and generate significant tax and export revenues for the benefit of local communities and the Greek state. Before I hand it over, you may have noticed that our logo is slightly different throughout this presentation. This refreshed logo is reflective of the evolution of our business and the new path forward.

The new green color highlights the company's continuing commitment to put sustainability at the core of our business. As evidence of this, we are currently building a global sustainability management system that outlines the common set of performance standards by which we will operate. This will allow us to simplify our existing systems through harmonizing the way we do things. It will also improve efficiencies and consistencies across our business that will drive productivity. That's it for me. Over to you, Phil.

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Philip Chow Yee, Eldorado Gold Corporation - Executive VP & CFO [4]

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Thank you, George. Good morning, everyone. Starting on Slide 4, we provide an overview of Eldorado Gold's financial results for the fourth quarter and year ended December 31, 2019. Eldorado generated $191.9 million in total metal revenue in the fourth quarter. This includes $176.1 million in gold revenue and is an increase of 107% over the comparative quarter in 2018. The increase resulted from higher gold sales volumes of 118,900 ounces versus 58,860 in Q4 of 2018 and a higher realized average gold price in the fourth quarter of $1,475 an ounce versus $1,245 per ounce in Q4 of 2018.

For the full year 2019, Eldorado generated total metal revenue of $617.8 million, of which $530.9 million was gold revenue. This represents a 35% increase over 2018 and also resulted from higher gold sales volumes and a higher average gold price in 2019. Net earnings to shareholders in the fourth quarter was $91.2 million or $0.57 per share compared to a net loss to shareholders of $218.2 million or $1.38 loss per share in the fourth quarter of 2018.

Net earnings in the fourth quarter reflect an impairment reversal of $85.2 million or $68.2 million net of deferred tax for the Kisladag leach pad and related assets, reflecting the Kisladag mine life extension to 15 years. There was also an increase in depreciation in the fourth quarter, in line with increased sales volumes.

Net loss in the fourth quarter of 2018 included an impairment adjustment of $330.2 million or $247.7 million net of deferred tax, which is related to Olympias. For the full year of 2019, net earnings to shareholders was $80.6 million or $0.51 per share, reflecting essentially the same drivers as outlined for the fourth quarter. This represents a significant improvement over the full year 2018 net loss of $361.9 million or $2.28 loss per share.

Adjusted net earnings for the fourth quarter was $20.3 million or $0.13 per share, which was a significant improvement over the fourth quarter 2018 adjusted net loss of $18.9 million or $0.11 loss per share. In both periods, net earnings were adjusted primarily to remove the impairments and the impairment reversal.

For the full year 2019, adjusted net earnings were $5.6 million or $0.04 per share, adjusted to adjusted net loss of $28.6 million or $0.17 loss per share for 2018. The strong sales in the fourth quarter resulted in EBITDA of $158.7 million and adjusted EBITDA of $80.3 million, an improvement over the loss before interest, taxes, depreciation and amortization of $327.9 million and adjusted EBITDA of $9 million in the fourth quarter of 2018.

For 2019, EBITDA amounted to $311.3 million, and adjusted EBITDA was $235.6 million. This is compared to a loss before interest, taxes, depreciation and amortization of $361.8 million and adjusted EBITDA of $99.6 million for 2018. Again, adjustments were primarily the impairment items discussed earlier.

Fourth quarter also represented a third consecutive quarter of positive free cash flow after achieving commercial production at Lamaque at the end of March of 2019. Finance costs were $8 million in the fourth quarter and $45.3 million for the year compared to $5.6 million for the full year of 2018. The significant increase in 2019 over 2018 primarily reflects interest no longer capitalized, following the commencement of commercial operations at Lamaque in the second quarter of 2019 and the transfer of Skouries to care and maintenance at the end of 2018.

Income tax expense amounted to $39.8 million for 2019 compared to a tax recovery of $86.5 million in 2018. The tax expense in 2019 primarily relates to income tax on operations in Turkey and mining duties for Lamaque. Deferred tax recoveries in 2019, relating to fixed asset movements, currency movements and a corporate tax rate reduction in Greece were almost fully offset by a $17 million deferred tax expense as a result of the impairment reversal for Kisladag. The tax recovery in 2018 primarily resulted from the impairment charges in that year.

Depreciation and amortization increased to $153.1 million in 2019 from $105.7 million in 2018. Reflecting the increase in sales volumes in 2019 as well as the commencement of commercial operations at Lamaque during the year.

Eldorado reported $64.2 million in net cash generated from operating activities in the fourth quarter and $165.8 million for the full year 2019. This was also a significant increase from the fourth quarter of 2018 of $4.9 million and $67.5 million for the full year 2018. We finished the year with approximately $366 million in available liquidity. Of this, $181 million was in cash, cash equivalents and term deposits as at December 31, 2019, and approximately $185 million remained available under the $250 million revolving credit facility, which remains undrawn. Approximately $65 million of this facility is allocated to secure certain reclamation obligations in connection with our operations.

I will now turn it over to Paul for a recap of operations.

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Paul James Skayman, Eldorado Gold Corporation - Special Advisor to the COO [5]

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Thanks, Phil. I'd like to echo George's comments and welcome Joe onboard as well. Here's a quick summary of our quarterly and year-to-date operating results. As George mentioned, we produced 118,955 ounces of gold in the quarter, a cash operating cost of $621 per ounce sold. And all-in sustaining costs of $1,110 per ounce sold. This was more or less in line with expectations.

Similarly, production for the year was also in line with expectations. We produced 395,331 ounces at a cash cost of $608 per ounce, and an all-in sustaining cost of $1,034 per ounce. This was our highest total production rate in 3 years.

Looking forward, our 2020 production is expected to grow approximately 35%. Forecasting annual production of between 520,000 and 550,000 ounces of gold at cash cost of $550 to $600 per ounce and all-in sustaining cost of $850 to $950 per ounce in 2020. We expect lower all-in sustaining cost in 2019 actuals as production is expected to increase this year.

That's it for me, a short section this time around. Over to Joe.

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Joseph Dennis Dick, Eldorado Gold Corporation - Executive VP & COO [6]

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Thanks, Paul, and good morning, everyone. It's a pleasure to be part of the Eldorado team, especially at such an exciting time in our business.

I'm going to Slide 6, we'll get a look at our 5-year outlook. Full year production figures remain the same for 2020, as what you saw in January 2019. And as we've talked before, production will decrease in 2021 as we mine lower grade at Kisladag. What I want to highlight is our sustained annual gold production beyond 2020. This is a sizable improvement over what you saw last year. In addition to the mine life extension at Kisladag, we are forecasting a step-up in production at Lamaque to 150,000 ounces per year through accelerated development. This does require an expansion to the existing permit for triangle underground extraction rates. We are also forecasting an increase in production from Olympias, and we'll discuss that a bit further later in this call.

Post-2020, we are now forecasting an annual average of over 450,000 ounces of gold per year from our base operations, and our key development projects provide potential growth to this production profile.

Over to Kisladag on Slide 7. The headline at Kisladag is an average of 160,000 ounces of gold per year for 15 years. The project is self-funding and reestablishes Kisladag as a cornerstone of our company. As you may remember, the company announced in January 2019 that it would suspend work on the mill in favor of resuming mining, crushing and heap leaching. The company also announced that it would continue test work on deeper material at Kisladag to see how it responded to longer leach cycles with the aim of extending mine life.

Later in 2019, the company announced that given the test work to date, it did expect to extend the mine life at Kisladag.

Additionally, the company conducted a high-pressure grinding roll, or HPGR, test work on several bulk samples. These samples were then tested to see how they would perform under a 250-day leach cycle. The results of the test work indicate that a combination of HPGR and longer leach cycles will yield recoveries of approximately 56%. This test work now complete and coupled with extensive test work covering the remaining reserve, we have a comprehensive understanding of how the ore body will behave going forward.

As a result, we collectively are confident -- very confident in our new mine plan. A 43-101 compliant report confirming our new reserves of over 4 million ounces of gold will be published before the end of this quarter.

Looking at Slide 8. We have an outline showing the scale of the new pit booking to the north. The darker yellow is the existing pit mine to date, and the shaded yellow is the new reserve pit. This new pit contains 173 million tonnes of ore, resulting in a 15-year mine life.

Slide 9 takes us to Lamaque. Our guidance for Lamaque increases to approximately 150,000 ounces per year by 2022. We will achieve this by increasing our mining rates to roughly 2,200 tonnes per day, which is the current capacity of the Sigma Mill.

This expansion requires no incremental capital and it simply accelerates underground development. Eldorado will continue to study ways to optimize the triangle deposit. Initially, we will focus on the decline from triangle to the Sigma Mill. Following that, we will look at debottlenecking the mill and a long-term tailings solution to enable us to go beyond 2,200 tonnes per day.

With the recent discovery of the Ormaque zone and continued exploration success at Triangle, the company has deferred release of a PEA. We feel that incorporation of new information into the study will allow us to better scope the full potential of Lamaque.

On to Olympias at Slide 10. 2019 was disappointing. Olympias finished the year with lower production and higher costs than planned. However, we did establish a positive trend in the second half of the year by improving the underground development and backfill cycles. During 2020, we will continue to focus on development and include additional initiatives aimed at further enhancing our productivity. The guidance we have issued shows continued positive trend and shows we are expecting to achieve higher production at lower costs than 2019.

We expect continued progress beyond 2020, resulting in improved cost performance over time. We still have a ways to go at Olympias. But we are making progress, and we expect the necessary step change in productivities over the next 2 years. On that basis, our 5-year plan includes an expansion at Olympias to 650,000 tonnes per year. Further details on the expansion will be outlined in a technical study that will also be published by the end of this quarter. With that, I'll turn it back to George for closing remarks.

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George Raymond Burns, Eldorado Gold Corporation - President, CEO & Director [7]

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Thanks, Joe. Before wrapping up, I want to take a moment to thank our global teams for their collaboration and drive in 2019, particularly the Kisladag team for putting the mine back on track and Lamaque team for an excellent first year.

Together, we achieved multiple significant milestones, making it a pivotal year for Eldorado. I'm very proud that we delivered our highest annual production in 3 years, while maintaining steady operating costs. We expect this positive momentum to continue with 2020 production forecasted to grow to between 520,000 and 550,000 ounces. The expected increased cash flow will give us options to invest in our growth projects and pay down our debt. We will continue to put safety, sustainability and governance at the core of our business as we seek ever better ways to operate.

Thank you, everyone. I will now turn it over to the operator for questions.

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Questions and Answers

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Operator [1]

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(Operator Instructions) The first question comes from Mike Parkin with National Bank.

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Michael Parkin, National Bank Financial, Inc., Research Division - Mining Analyst [2]

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With the Olympias expansion study coming out, should we be looking for that largely to be the addition of the ball mill that you've spoken to in the past?

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Paul James Skayman, Eldorado Gold Corporation - Special Advisor to the COO [3]

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Yes, that's correct. There's some subtle changes elsewhere in the plant, but the major changes that addition of a ball mill.

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Michael Parkin, National Bank Financial, Inc., Research Division - Mining Analyst [4]

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So are we still thinking on CapEx somewhere around like $20 million, $25 million?

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Paul James Skayman, Eldorado Gold Corporation - Special Advisor to the COO [5]

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Yes, a little bit more than that, Mike, but not significant.

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Michael Parkin, National Bank Financial, Inc., Research Division - Mining Analyst [6]

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Okay. Where do you see OpEx per tonne on an overall basis, kind of trending as whatever percent drop from where it's kind of been or however you want to kind of communicate it with that expansion?

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Joseph Dennis Dick, Eldorado Gold Corporation - Executive VP & COO [7]

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I see that we've been looking in the plus 30% improvements in OpEx roughly and perhaps more.

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Paul James Skayman, Eldorado Gold Corporation - Special Advisor to the COO [8]

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I guess, you've got a double whammy. You're increasing your lead and zinc as well. So that makes a big difference to cash operating costs, yes.

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Michael Parkin, National Bank Financial, Inc., Research Division - Mining Analyst [9]

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Okay. And then with Kisladag, can you just give us an update on the fleet there? Is it owner operated? And if it is, what's the condition of it, now that you're looking at such a massive mine life extension there? Will there be a need to replace the fleet in the next few years?

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Joseph Dennis Dick, Eldorado Gold Corporation - Executive VP & COO [10]

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Read the original:
Edited Transcript of ELD.TO earnings conference call or presentation 21-Feb-20 4:30pm GMT - Yahoo Finance

The Fulton County Health Department has scheduled the following health clinics and services.

CANTON The Fulton County Health Department has scheduled the following health clinics and services. Please call the number listed with each service for an appointment or more information.

Maternal child health: Health screenings, WIC nutrition education and supplemental food coupons for women, infants and children. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria clinic appointments call 329-2922.

Canton - Clinic - Monday, March 2 - 8-4 - Appt needed

Canton - WIC Nutrition Education - Tuesday, March 3 - 8-4 - Appt needed

Canton - Clinic/Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Clinic/Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Astoria - Clinic, WIC Nutrition Educ. - Wednesday, March 4 - 9-3 - Appt needed

Canton - Clinic - Thursday, March 5 - 8-4 - Appt needed

Adult Health Immunizations: Various vaccines are available. There is a fee for immunization administration. Medicaid cards are accepted. To make an appointment or for more information call 647-1134 (ext. 254).

Canton - Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Other times available by special arrangement at Canton, Cuba and Astoria.

Blood Lead Screening: Blood lead screenings are available for children ages one to six years. A fee is based on income. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria appointments call 329-2922.

Canton - Clinic - Wednesday, March 4 - 8-4 - Appt needed

Family Planning: Confidential family planning services are available by appointment at the Canton office for families and males of child-bearing age. Services provided include physical exams, pap smears, sexually transmitted disease testing, contraceptive methods, pregnancy testing, education and counseling. Services are available to individuals of all income levels. Fees are based on a sliding fee scale with services provided at no charge to many clients. Medicaid and many insurances are accepted. After hours appointments are available. To make an appointment or for more information call the 647-1134 (ext. 244). *Program funding includes a grant from the US DHHS Title X.

Pregnancy testing: Confidential urine pregnancy testing is available at the Canton and Astoria offices. This service is available to females of all income levels. A nominal fee is charged. No appointment is needed. A first morning urine specimen should be collected for optimal testing and brought to the health department. Services are provided on a walk-in basis on the following days each week:

Canton: Every Wednesday & Thursday, 8-3:30 (for more information call 647-1134 ext. 244)

Astoria: Every Wednesday, 9-2:30 (for more information call 329-2922)

Womens Health: A womens clinic for pap tests, clinical breast examinations and vaginal examinations is available by appointment. There is a nominal fee for this service. Medicaid cards are accepted. Financial assistance is available for a mammogram. Cardiovascular screenings may be available to age and income eligible women. To make an appointment or for more information call 647-1134 (ext. 244).

Mammograms: Age and income eligible women may receive mammograms at no charge. Speakers are available to provide information to clubs and organizations. For more information or to apply for financial assistance, call 647-1134 (ext. 254).

Mens Health: Prostate specific antigen (PSA) blood tests are available for men for a fee. To make an appointment or for more information call 647-1134 (ext. 224).

Sexually Transmitted Disease (STD) Clinic: Confidential STD and HIV testing services are available by appointment to males and females at the Canton office. Services include physical exams to identify STDs, a variety of STD testing, HIV testing, education, counseling, medications and condoms. There is a nominal fee for services. Services are available to individuals of all income levels. Medicaid cards are accepted. To make an appointment or for more information call 746-1134 (ext. 224).

HIV Testing and Counseling: Confidential HIV testing and counseling services are available by appointment through the sexually transmitted disease (STD) clinic at the Canton office. To make an appointment or for more information call 647-1134 (ext. 224).

Tuberculosis (TB) Testing: TB skin tests are available at no charge by appointment. To make an appointment or for more information call 647-1134 (ext. 254).

Blood Pressure Screenings: The Fulton County Health Department provides blood pressure screenings at no charge on a walk-in basis during the following times:

Astoria - Screening - Wednesday, March 4 - 9-12 - Walk in

Health Watch Wellness Program: The Health Watch Program provides low cost lab services. Through this program adults can obtain venous blood draws for a variety of blood tests. Blood tests offered without a doctors order Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), Lipid Panel, Prostate Specific Antigen (PSA) test, Hepatitis C test, and Thyroid Stimulating Hormone (TSH). A wide variety of blood tests are also available with a doctors order. There is a charge at the time of service. To make an appointment or for more information call 647-1134 (ext. 254).

Dental Services: The Dental Center offers a variety of basic dental services to children and adults. An appointment is needed. Medicaid and Kid Care cards are accepted. To make an appointment or for more information call 647-1134 (ext. 292).

See the article here:
Health Department announces services for the week of March 2 - Newton Press Mentor

When the transition to menopause starts, women can be plagued by uncomfortable symptoms such as hot flashes, night sweats, sleep problems, mood swings, weight gain, and vaginal dryness. The pharmacological approach to controlling menopausal symptoms (which occur when levels of estrogen, progesterone, andtestosteronedrop off in midlife) is hormone therapy (HT), medications with female hormones that replace the ones the body no longer produces. Lifestyle changes such as diet, exercise, layered clothing, smoking cessation, and vaginal moisturizers and lubricants have also been shown to be effective in coping with symptoms related to menopause.

RELATED: What to Eat and Avoid on a Plant-Based Diet, and a 14-Day Sample Menu

Many studies have looked at the positive effects of the Mediterranean diet (a diet rich in fruit, vegetables, whole grains, nuts and healthy fats) on these symptoms, especially hot flashes and weight gain. An Iranian study published in the journal of theNorth American Menopause Society (NAMS), Menopause, on February 19, 2020, looked at subgroups of fruits and vegetables to find which provide the biggest benefits. The study recruited 393 post-menopausal women between ages 40 and 76 years. Possible participants were excluded if they were overweight, smoked, had a medical history of cancer, diabetes, stroke, multiple sclerosis, dementia,hyper- or hypothyroidism, or had undergone hormone therapy in the previous six months.

Overall, participants who self-reported a higher intake of fruits and vegetables combined, total vegetables, or total fruits had more energy and physical activity compared with individuals who reported a lower intake. A previous study, published in June 2018 in Maturitas, looked at vegans, who do not eat animal products, and found that they report less bothersome vasomotor and physical menopausal symptoms than omnivores.

These results are consistent with other studies. The mechanism by which it works is not entirely clear, but we are assuming it is related to the antioxidant effects of the vitamin C, beta-carotene, and lycopene contained in the fruits and vegetables, said Neal Barnard, MD, author of Your Body in Balance.

RELATED: Coping With Hot Flashes and Other Menopausal Symptoms: What 9 Celebrities Said

The researchers also looked at specific subgroups of fruits and vegetables, including cruciferous vegetables, green leafy vegetables, dark yellow vegetables, berries, and citrus fruits.

In the results, the researchers found that in the vegetable groups, higher consumption of leafy greens and cruciferous vegetables led to a significant reduction in overall menopausal symptoms and specifically in physical symptoms.

Dr. Barnard, who is also the president of thePhysicians Committeefor Responsible Medicine, says, This study also fits a longer-term observation from years ago in Japan, when the diet was much lower in animal products and higher in rice and vegetables, and women rarely complained of menopausal symptoms. When the diet become more Westernized with more meat and dairy, menopausal symptoms were much more frequently reported.

RELATED: Vegetarian Diet Linked to Lowered Risk of Urinary Tract Infection

A higher intake of fruits across the board was found to have a slight impact on the psychological front, with high consumption respondents reporting somewhat less moodiness. Citrus fruits (oranges, limes, lemons, citrons, grapefruit, kumquats, ugli fruit) were also reported to help reduce overall menopause symptoms.

Acidic tomatoes and citrus fruits are known to act as bladder irritants. One concerning result from the study was that higher intakes of fruits and vegetable combined, total vegetables, green leafy vegetables, dark yellow vegetables, and citrus fruits were associated with higher urogenital issues, such as urinary tract infections (UTIs). However, further investigation is warranted to confirm the findings, wrote the researchers in the published papers.

RELATED: Home Remedies for Urinary Tract Infection (UTI) Symptoms

The researchers caution that the nature of Iranian society and characteristics of diet and food preparation there may limit the ability to generalize results to women worldwide. For example, frying as a method for vegetable preparation in Iran is very popular. Therefore, confirming the findings of the present study in different sociocultural and dietary behavior contexts will better illuminate the relationship between fruit and vegetable consumption and menopausal symptoms, wrote the researchers.

RELATED: Fitness After 40:Midlife Exercise Needs

This small cross-sectional study provides some preliminary evidence regarding the influence of fruit and vegetable intake on menopause symptoms. There is ample evidence that a healthy diet rich in fruits and vegetables has a beneficial effect on health in a myriad of ways, but additional study is needed to determine whether various menopause symptoms may be affected by dietary choices, said Stephanie Faubion, MD, the medical director of NAMS, and the Penny and Bill George Director at the Mayo Clinic Center for Womens Health in Rochester, Minnesota, in a news release about the study.

Barnard adds, This was not a randomized trial this was self-reported food intake, which makes it more likely that there was a [confounding factor]. However, the study does seem to be rigorously done. It suggests that the next step is to conduct a randomized trial in which people would be given a certain amount of food or asked to consume a certain diet, and [which would include] the presence of a control group.

See the article here:
Foods That Help Ease Menopausal Symptoms - Everyday Health

DEAR DEIDRE:I WANT a third baby but my husband has said hes not keen.

I fear it will all turn out badly with me to blame.

1

My contraceptive implant was due to be removed last week.

Ive decided I want to give my body a rest from hormone contraception.

Were both 35 and I explained to my husband wed have to use condoms instead.

Hes now refusing to wear one and says well use the withdrawal method.

If I end up pregnant, I fear he will blame it on me. I want having another baby to be a joint decision.

Get in touch with Deidre today

Got a problem?

Send an email to problems@deardeidre.org. Every problem gets a personal reply, usually within 24 hours weekdays.

You can also send a private message on the DearDeidreOfficial Facebook page.

Follow me on Twitter @deardeidre.

DEIDRE SAYS:Good for you. Its hugely important that a child is wanted by both parents.

Dont let him duck the responsibility of making a decision through laziness.

If he doesnt want to wear condoms, talk to your doctor or family planning clinic about other methods of non-hormonal contraception, such as female condoms, IUDs and diaphragms. See nhs.uk/contraception.

View original post here:
I want another baby but fear my husband will blame me if I end up pregnant - The Sun

By the time Bill Beatty made it to the Emergency Department in Howard County, he was already several hours into a major heart attack. His physicians performed a series of emergency treatments that included an intra-aortic balloon pump, but the 57-year-old engineers blood pressure remained dangerously low. The cardiologist called for a helicopter to transfer him to Johns Hopkins.

It was fortuitous timing: Beatty was an ideal candidate for a clinical trial and soon received an infusion of stem cells derived from his own heart tissue, making him the second patient in the world to undergo the procedure.

Of all the attempts to harness the promise of stem cell therapy, few have garnered more hope than the bid to repair damaged hearts. Previous trials with other stem cells have shown conflicting results. But this new trial, conducted jointly with cardiologist Eduardo Marbn at Cedars-Sinai Medical Center in Los Angeles, is the first time stem cells come from the patients own heart.

Cardiologist Jeffrey Brinker, M.D., a member of the Hopkins team, thinks the new protocol could be a game-changer. That's based partly on recent animal studies in which scientists at both institutions isolated stem cells from the injured animals hearts and infused them back into the hearts of those same animals. The stem cells formed new heart muscle and blood vessel cells. In fact, says Brinker, the new cells have a pre-determined cardiac fate. Even in the culture dish, he says, theyre a beating mass of cells.

Whats more, according to Gary Gerstenblith, M.D., J.D., the animals in these studies showed a significant decrease in relative infarct size, shrinking by about 25 percent. Based on those and earlier findings, investigators were cleared by the FDA and Hopkins Institutional Review Board to move forward with a human trial.

In Beattys case, Hopkins heart failure chief extracted a small sample of heart tissue and shipped it to Cedars Sinai, where stem cells were isolated, cultured and expanded to large numbers. Hopkins cardiologist Peter Johnston, M.D., says cardiac tissue is robust in its ability to generate stem cells, typically yielding several million transplantable cells within two months.

When ready, the cells were returned to Baltimore and infused back into Beatty through a balloon catheter placed in his damaged artery, ensuring target-specific delivery. Then the watching and waiting began. For the Hopkins team, Beattys infarct size will be tracked by imaging chief Joao Lima, M.D., M.B.A.,and his associates using MRI scans.

Now back home and still struggling with episodes of compromised stamina and shortness of breath, Beatty says his Hopkins cardiologists were fairly cautious in their prognosis, but hell be happy for any improvement.

Nurse coordinator Elayne Breton says Beatty is scheduled for follow-up visits at six months and 12 months, when they hope to find an improvement in his hearts function. But at least one member of the Hopkins team was willing acknowledge a certain optimism. The excitement here, says Brinker, is huge.

The trial is expected to be completed within one to two years.

--by Ramsey Flynn

Read more here:
A New Path for Cardiac Stem Cells - hopkinsmedicine.org

Whenever Harry Wuest has a doctors appointment in northern Atlantas hospital cluster dubbed Pill Hill, he makes sure to stop by the office of Dr. Douglas Doug Murphy for a quick chat.

And Murphy, unless hes tied up in the operating room, always takes a few minutes to say hello to his former patient. Remember when ... ? is how the conversation typically starts, and its always tinged with laughter, often joyful, sometimes bittersweet.

Its a reunion of two men who shaped a piece of Georgias medical history.

Almost 35 years ago, Murphy opened the chest of Wuest and sewed in a new heart, giving him a second shot at life. Wuest was the third heart transplant patient at Emory University Hospital.

Tall, lanky, with short curly hair and a quiet demeanor, Wuest is the longest-surviving heart transplant recipient in Georgia and one of the longest-surviving in the world. The 75-year-old accountant still plays golf twice a week and only recently went from working full-time to part-time. My heart is doing just fine, he says.

Murphy is now the chief of cardiothoracic surgery at Emory Saint Josephs Hospital and still in the operating room almost every day. He has moved on to become the worlds leading expert in robotically assisted heart surgery.

Harry Wuest is originally from Long Island, New York. After a stint in the Air Force, he moved to Florida to work and go to school. He wanted to become a physical education teacher. Then, in 1973, he fell ill. It started with some pain on his left side. He didnt think much of it, but when he got increasingly winded and fatigued, he went to see a doctor.

Several months and numerous specialists later, he received the diagnosis: Cardiomyopathy, a disease of the heart muscle that can make the heart become enlarged, thick and rigid, preventing it from pumping enough blood through the body.

They didnt know how I got it, says Wuest, sitting back in a brown leather armchair in the dark, wood-paneled living room of his Stone Mountain home. Maybe it was a virus. And back then, there wasnt much they could do to treat it, except bed rest.

For the next 12 years, Wuest lived life as best as he could. He got a degree in accounting from the University of Central Florida and worked for a real estate developer. There were good days, but there were more bad days. He was often too weak to do anything, and his heart was getting bigger and bigger.

Emorys first transplant surgeon

The first successful human-to-human heart transplant was performed in Cape Town, South Africa, in 1967 a medical breakthrough that catapulted the surgeon, Dr. Christiaan Barnard, onto the cover of Life magazine and to overnight celebrity status.

This highly publicized event was followed by a brief surge in the procedure around the world, but overall, heart transplants had a rocky start. Most patients died shortly after the surgery, mainly due to organ rejection. Back then, immunosuppressive drugs, which can counteract rejection, were still in their infancy. Many hospitals stopped doing heart transplants in the 1970s.

That changed with the discovery of a highly effective immunosuppressive agent. Cyclosporine got FDA approval in 1983 and altered the world of organ transplants.

It was shortly thereafter when Emory University Hospital decided to launch a heart transplant program, but none of the senior surgeons wanted to do it. Even with the new drug, it was a risky surgery, and mortality was still high.

Its an all-or-nothing operation, Murphy says, as he sits down in his small office overlooking the grayish hospital compound. Hes wearing light blue scrubs from an early morning surgery. At 70, he still has boyish looks, with a lean build and an air of laid-back confidence. If you have a number of bad outcomes initially, it can be detrimental to your career as a surgeon, he says.

But Murphy didnt really have a choice. He remembers that during a meeting of Emorys cardiac surgeons in 1984, he was paged to check on a patient. When he returned, the physicians congratulated him on being appointed the head of the new heart transplant program. He was the youngest in the group and had been recruited from Harvards Massachusetts General Hospital just three years before.

Yeah, thats how I became Emorys first transplant surgeon, says Murphy.

He flew to California to shadow his colleagues at Stanford University Hospital, where most heart transplants were performed at the time. Back home at Emory, he put together a team and rigorously rehearsed the operation. The first transplant patient arrived in April 1985. The surgery was successful, as was the second operation less than a month later.

Around the same time, Harry Wuest wound up in a hospital in Orlando. He needed a transplant, but none of the medical centers in Florida offered the procedure. One of his doctors recommended Emory, and Wuest agreed. I knew I was dying. I could feel it. He was flown to Atlanta by air ambulance and spent several weeks in Emorys cardiac care unit until the evening of May 23, when Murphy walked into his room and said, Weve got a heart.

I could finally breathe again

The heart, as the patient later learned, came from a 19-year-old sophomore at Georgia Tech who had been killed in a car crash.

Organ transplants are a meticulously choreographed endeavor, where timing, coordination and logistics are key. While Murphy and his eight-member team were preparing for the surgery, Wuest was getting ready to say farewell to his family his wife and three teenage sons, and to thank the staff in the cardiac ward.

I was afraid, he recalls, especially of the anesthesia. It scared the heck out of me. He pauses during the reminiscence, choking briefly. I didnt know if I was going to wake up again.

The surgery took six hours. Transplants usually happen at night because the procurement team, the surgeons who retrieve different organs from the donor, only start working when regularly scheduled patients are out of the operating room.

Despite the cultural mystique surrounding the heart as the seat of life, Murphy says that during a transplant surgery, its not like the big spirit comes down to the operating room. Its very technical. As the team follows a precise routine, emotions are kept outside the door. We dont have time for that. Emotions come later.

Waking up from the anesthesia, Wuests first coherent memory was of Murphy entering the room and saying to a nurse, Lets turn on the TV, so Harry can watch some sports.

Wuest spent the next nine days in the ICU, and three more weeks in the hospital ward. In the beginning, he could barely stand up or walk, because he had been bedridden weeks before the surgery and had lost a lot of muscle. But his strength came back quickly. I could finally breathe again, he says. Before the surgery, he felt like he was sucking in air through a tiny straw. I cannot tell you what an amazing feeling that was to suddenly breathe so easily.

Joane Goodroe was the head nurse at Emorys cardiovascular post-op floor back then. When she first met Wuest before the surgery, she recalls him lying in bed and being very, very sick. When she and the other nurses finally saw him stand up and move around, he was a whole different person.

In the early days of Emorys heart transplant program, physicians, nurses and patients were a particularly close-knit group, remembers Goodroe, whos been a nurse for 42 years and now runs a health care consulting firm. There were a lot of firsts for all of us, and we all learned from each other, she said.

Wuest developed friendships with four other early transplant patients at Emory, and he has outlived them all.

When he left the hospital, equipped with a new heart and a fresh hunger for life, Wuest made some radical changes. He decided not to return to Florida but stay in Atlanta. Thats where he felt he got the best care, and where he had found a personal support network. And he got a divorce. Four months after the operation, he went back to working full-time: first in temporary jobs and eventually for a property management company.

After having been sick for 12 years, I was just so excited to be able to work for eight hours a day, he recalls. That was a big, big deal for me.

At 50, he went back to school to get his CPA license. He also found new love.

Martha was a head nurse in the open-heart unit and later ran the cardiac registry at Saint Josephs Hospital. Thats where Wuest received his follow-up care and where they met in 1987. Wuest says for him it was love at first sight, but it took another five years until she finally agreed to go out with him. Six months later, they were married.

Harry Wuest and his wife, Martha. She was a head nurse in the open-heart unit and later ran the cardiac registry at Saint Josephs Hospital. Thats where Wuest received his follow-up care and where they met in 1987. Wuest says for him it was love at first sight, but it took another five years until she finally agreed to go out with him. Six months later, they were married.

Having worked in the transplant office, I saw the good and the bad, Martha Wuest says. A petite woman with short, perfectly groomed silver hair, she sits up very straight on the couch, her small hands folded in her lap. Not every transplant patient did as well as Harry. And I had a lot of fear in the beginning. Now he may well outlive her, she says with a smile and a wink.

Wuests surgeon, meanwhile, went on to fight his own battles. Two and a half years into the program, Murphy was still the only transplant surgeon at Emory and on call to operate whenever a heart became available. Frustrated and exhausted, he quit his position at Emory and signed up with Saint Josephs (which at the time was not part of the Emory system) and started a heart transplant program there.

At St. Josephs, Murphy continued transplanting hearts until 2005. In total, he did more than 200 such surgeries.

Being a heart transplant surgeon is a grueling profession, he says, and very much a younger surgeons subspecialty.

He then shifted his focus and became a pioneer in robotically assisted heart surgery. He has done more than 3,000 operations with the robot, mostly mitral valve repairs and replacements more than any other cardiac surgeon in the world.

Heart transplants "remain the gold standard"

Since Murphy sewed a new heart into Wuest 35 years ago, there has been major progress in the field of heart transplants, but it has been uneven.

There is improved medication to prevent rejection of the donor heart, as well as new methods of preserving and transporting donor hearts.

Yet patients requiring late-stage heart failure therapy, including transplantation, still exceed the number of donor hearts available. In 2019, 3,551 hearts were transplanted in the United States, according to the national Organ Procurement and Transplantation Network. But 700,000 people suffer from advanced heart failure, says the American Heart Association.

New technologies and continued research are providing hope to many of these patients. There has been significant progress in the development of partial artificial hearts, known as Left Ventricular Assist Devices, or LVADs. They can be used as bridge devices, to keep patients alive until donor hearts are available, or as destination therapy, maintaining patients for the remainder of their lives.

Also, total artificial hearts have come a long way since the first artificial pump was implanted in a patient in 1969. The technology is promising, says Dr. Mani Daneshmand, the director of Emorys Heart & Lung Transplantation Program. But its not perfect.

Long-term research continues into xenotransplantation, which involves transplanting animal cells, tissues and organs into human recipients.

Regenerative stem cell therapy is an experimental concept where stem cell injections stimulate the heart to replace the rigid scar tissue with tissue that resumes contraction, allowing for the damaged heart to heal itself after a heart attack or other cardiac disease. Certain stem cell therapies have shown to reverse the damage to the heart by 30 to 50 percent, says Dr. Joshua Hare, a heart transplant surgeon and the director of the Interdisciplinary Stem Cell Institute at the University of Miamis Miller School of Medicine.

All of these ideas have potential, says Daneshmand. But none of them are ready to replace a human donor heart. A heart transplant remains the gold standard, because you cant accommodate the same success with a machine right now, he says.

Efforts around expanding the donor pool are really the best way to address this problem, while we wait for technology to catch up, he adds.

Besides Emory, other health care systems in Georgia that currently have a heart transplant program are Piedmont Healthcare, Childrens Healthcare of Atlanta and Augusta University Health.

Organ rejection remains a major issue, and long-term survival rates have not improved dramatically over the past 35 years. The 10-year survival is currently around 55 percent of patients, which makes long-term survivors like Harry Wuest rare in the world of heart transplants.

The United Network of Organ Sharing, or UNOS, which allocates donor hearts in the United States, doesnt have comprehensive data prior to 1987. An informal survey of the 20 highest-volume hospitals for heart transplants in the 1980s found only a scattering of long-term survivors.

In for the long haul

Being one of the longest-living heart transplant recipients is something that Wuest sees as a responsibility to other transplant patients, but also to the donors family, which hes never met. If you as a transplant recipient reject that heart, thats like a second loss for that family.

Part of this responsibility is living a full and active life. Both he and Martha have three children from their previous marriages and combined they have 15 grandchildren. Most of their families live in Florida, so they travel back and forth frequently. Wuest still works as a CPA during tax season, and he does advocacy for the Georgia Transplant Foundation. In addition to golf, he enjoys lifting weights and riding his bike.

Hes had some health scares over the years. In 2013, he was diagnosed with stage 1 kidney cancer, which is in remission. Also, he crossed paths with his former surgeon, and not just socially. In 2014, Murphy replaced a damaged tricuspid valve in Wuests new heart. That operation went well, too.

Murphy says there are several reasons why Wuest has survived so long. Obviously, his new heart was a very good match. But a patient can have the best heart and the best care and the best medicines and still die a few months or years after the transplantation, the surgeon says. Attitude plays a key role.

Wuest was psychologically stable and never suffered from depression or anxiety, Murphy says. Hes a numbers guy. He knew the transplant was his only chance, and he was set to pursue it.

Wuest attributes his longevity to a good strong heart from his donor; good genetics; great doctors and nurses; and a life that he loves. Im just happy to be here, he says.

Quoting his former surgeon and friend, he adds: Doug always said, Having a transplant is like running a marathon. And Im in for the long haul.

More here:
34 years with a new heart and counting - MDJOnline.com

Houston TX (SPX) Feb 21, 2020A variety of science investigations, along with supplies and equipment, launch to the International Space Station on the 20th SpaceX commercial resupply services mission. The Dragon cargo spacecraft is scheduled to leave Earth March 2 from Space Launch Complex 40 at Cape Canaveral Air Force Station in Florida. Its cargo includes research on particle foam manufacturing, water droplet formation, the human intestine and other cutting-edge investigations.

The space station, now in its 20th year of continuous human presence, provides opportunities for research by government agencies, private industry, and academic and research institutions. Such research supports Artemis, NASA's missions to the Moon and Mars, and leads to new technologies, medical treatments and products that improve life on Earth.

High-tech shoes from spaceParticle foam molding is a manufacturing process that blows thousands of pellets into a mold where they fuse together. The shoe company Adidas uses this process to make performance midsoles, the layer between the sole of a shoe and the insole under your foot, for its products.

The BOOST Orbital Operations on Spheroid Tesellation (Adidas BOOST) investigation looks at how multiple types of pellets behave in this molding process. Using one type of pellet creates a foam with the same properties throughout the sole component. Using multiple pellet types can allow engineers to change mechanical properties and optimize shoe performance and comfort. Removing gravity from the process enables a closer look at pellet motion and location during the process.

Results of this investigation could demonstrate the benefits of microgravity research for manufacturing methods, contributing to increased commercial use of the space station. New processes for particle foam molding could benefit a variety of other industries, including packaging and cushioning materials.

New facility outside the space stationThe Bartolomeo facility, created by ESA (European Space Agency) and Airbus, attaches to the exterior of the European Columbus Module. Designed to provide new scientific opportunities on the outside of the space station for commercial and institutional users, the facility offers unobstructed views both toward Earth and into space. Experiments hosted in Bartolomeo receive comprehensive mission services, including technical support in preparing the payload, launch and installation, operations and data transfer and optional return to Earth. Potential applications include Earth observation, robotics, material science and astrophysics.

Airbus is collaborating with the United Nations Office of Outer Space Affairs to offer UN Member States the opportunity to fly a payload on Bartolomeo. Developing countries are particularly encouraged to participate, and the mission is devoted to addressing the UN's Sustainable Development Goals. Bartolomeo is named for the younger brother of Christopher Columbus.

Conserving water in the showerDroplet Formation Studies in Microgravity (Droplet Formation Study) evaluates water droplet formation and water flow of Delta Faucet's H2Okinetic showerhead technology. Reduced flow rates in shower devices conserve water, but also can reduce their effectiveness. That can cause people to take longer showers, undermining the goal of using less water. Gravity's full effects on the formation of water droplets are unknown, and research in microgravity could help improve the technology, creating better performance and improved user experience while conserving water and energy.

Insight gained from this investigation also has potential applications in various uses of fluids on spacecraft, from human consumption of liquids to waste management and use of fluids for cooling and as propellants.

Studying the human intestine on a chipOrgan-Chips as a Platform for Studying Effects of Space on Human Enteric Physiology (Gut on Chip) examines the effect of microgravity and other space-related stress factors on biotechnology company Emulate's human innervated Intestine-Chip (hiIC). This Organ-Chip device enables the study of organ physiology and diseases in a laboratory setting. It allows for automated maintenance, including imaging, sampling, and storage on orbit and data downlink for molecular analysis on Earth.

A better understanding of how microgravity and other potential space travel stressors affect intestine immune cells and susceptibility to infection could help protect astronaut health on future long-term missions. It also could help identify the mechanisms that underlie development of intestinal diseases and possible targets for therapies to treat them on Earth.

Toward better 3D printingSelf-assembly and self-replication of materials and devices could enable 3D printing of replacement parts and repair facilities on future long-duration space voyages. Better design and assembly of structures in microgravity also could benefit a variety of fields on Earth, from medicine to electronics.

The Nonequilibrium Processing of Particle Suspensions with Thermal and Electrical Field Gradients (ACE-T-Ellipsoids) experiment designs and assembles complex three-dimensional colloids - small particles suspended within a fluid - and controls density and behavior of the particles with temperature. Called self-assembled colloidal structures, these are vital to the design of advanced optical materials, but control of particle density and behavior is especially important for their use in 3D printing. Microgravity provides insight into the relationships among particle shape, crystal symmetry, density and other characteristics.

Functional structures based on colloids could lead to new devices for chemical energy, communication, and photonics.

Growing human heart cellsGeneration of Cardiomyocytes From Human Induced Pluripotent Stem Cell-derived Cardiac Progenitors Expanded in Microgravity (MVP Cell-03) examines whether microgravity increases the production of heart cells from human-induced pluripotent stem cells (hiPSCs). HiPSCs are adult cells genetically reprogrammed back into an embryonic-like pluripotent state, which means they can give rise to several different types of cells. This makes them capable of providing an unlimited source of human cells for research or therapeutic purposes. For MVP Cell-03, scientists induce the stem cells to generate heart precursor cells, then culture those cells on the space station for analysis and comparison with cultures grown on Earth.

These heart cells or cardiomyocytes (CMs) could help treat cardiac abnormalities caused by spaceflight. In addition, scientists could use them to replenish cells damaged or lost due to cardiac disease on Earth and for cell therapy, disease modeling and drug development. Human cardiac tissues damaged by disease cannot repair themselves, and loss of CMs contributes to eventual heart failure and death.

Related LinksISS National LabSpace Tourism, Space Transport and Space Exploration News

With the rise of Ad Blockers, and Facebook - our traditional revenue sources via quality network advertising continues to decline. And unlike so many other news sites, we don't have a paywall - with those annoying usernames and passwords.

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Improving shoes, showers, 3D printing: research launching to the Space Station - Space Daily

February 23, 2020 by Michael Kuttner

Read on for article

As we hurtle towards round three in our general elections the frenetic canvassing of voters by desperate political parties is in stark contrast to the switched-off interest shown by those targeted.

Thankfully the same cannot be said for the daily announcements of further advances in good news whether it is scientific, medical or social spheres. Israeli ingenuity continues to be a light unto the nations.

QUICKER RESULTS EQUALS QUICKER DIAGNOSIS

The Israeli innovation can test 100 saliva samples in 15 minutes as opposed to one blood test that takes an hour to confirm coronavirus.

Quick diagnosis can help prevent the spread ofcoronavirus by slashing the timeit takes to decide that patients need to be quarantined and treated.

The technology is already in use for diagnosing the Zika virus and is used at Israels Tel Hashomer Hospital in Ramat Gan by the Ministry of Healths central virology laboratory.

ANOTHER ADVANCE IN CARDIAC CARE

Researchers succeeded in producing 3D engineered cardiac tissues from chamber-specific heart cells derived from human stem cells. This medical development opens the door for creating personalized medications for cardiac patients and advances in new cardiac drug developments.

This research model simulates the most common irregular heartbeat (arrhythmia), called atrial fibrillation. It opens the door for testing the success of various drugs on individual patients to prevent or stop arrhythmia.

Because they were able to separate atrial and ventricular tissue models, researchers can discover which drugs improve atrial cell function without damaging ventricular cell function.

DEFEATING CYBER HACKERS

Researchers from Ben-Gurion University (BGU) presented at the Cybertech Global Tel Aviv conference the first all-optical stealth encryption technology. The innovation uses fibre-optic light transmissions to secure cloud computing and data centre network transmission.

The technology uses standard optical equipment to send data in a manner that cannot beintercepted by hackers, unlike conventional digital methods. Another aspect of the system is that data gets destroyed if a hacker tries to decode it.

Because an eavesdropper can neither read the data nor even detect the existence of the transmitted signal, the optical stealth transmission provides thehighest level of privacy and securityfor sensitive data applications.

The patented technology has multiple applications, including high-speed communication and sensitive transmission of financial, medical or social media-related information. According to the Senior Vice President, Exact Sciences & Engineering, BGN Technologies, An eavesdropper will require years to break the encryption key.

TWO THOUSAND YEARS LATER

Long after the Romans departed archeological discoveries continue to be made. Two thousand years later the descendants of the Jews they tried to ethnically cleanse, now restored in their homeland, walk again in the very places they were once exiled from.

RECLAIMING A LOST HERITAGE

One of the miracles one witnesses by living in Israel is meeting Jews long lost to their heritage somehow finding their way back to their Faith and People.

Whether it is the Bnei Menashe from India, tribes from Uganda, individuals from Kaifeng, China or Jews from Ethiopia the common theme is of a return to Zion.

Often overlooked but now becoming a frequent occurrence is the discovery by descendants of Conversos, those driven underground or forcibly converted by the Spanish and Portuguese Inquisition five hundred years ago, of their Jewish heritage.

Watch this moving video of one of the latest such personal dramas. We truly are living in amazing times when lost Jews from the four corners of the world are returning.

Visit J-Wire's main page for all the latest breaking news, gossip and what's on in your community.

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On the other hand - J-Wire Jewish Australian News Service

Minneapolis native Aliya Feroe recalls the flustered OB-GYN who referred her to another physician after learning she identified as queer. For Rhi Ledgerwood, who was designated female at birth, identifies as trans and doesnt have sex with men, it was a doctor advising about condoms and pregnancy prevention. For Tim Keyes, who came out as gay at age 17, its when doctors automatically assumed he sleeps with women.

Ask any LGBTQ patient about awkward doctor visits and chances are theyll have a story to tell.

When being heterosexual is presumed even in doctors offices, those who identify otherwise can feel marginalized and less likely to seek medical care, contributing to health problems that include high rates of depression, suicidal behavior, alcohol and drug use and inadequate health screenings, LGBTQ advocates say.

Now, moves are afoot to remedy that. The American Medical Association vowed in November to push for a federal ban on gay conversion therapy. Medical schools are beefing up education on LBGTQ health issues. And some schools are making a major push to recruit LGBTQ medical students, backed by research showing that patients often get better care when treated by doctors more like them.

Feroe, Keyes and Ledgerwood all pursuing medical careers are part of the trend.

LGBTQ physicians deserve an equal standing in the medical community and LGBTQ patients deserve the same quality of care awarded to anyone else, said Feroe, a third-year Harvard medical student.

Increasing LGBTQ enrollment and training in LGBTQ health issues in medical schools can help achieve those goals, advocates say.

Exact numbers of LGBTQ medical students and doctors are unknown. In 2018, the AMA added sexual orientation and gender identity as an option for members to include in demographic profiles the group compiles. Of the 15,000 doctors and students who have volunteered that information so far, about 4% identify as LGBTQ. Thats similar to Gallup estimates for the general U.S. population, although LGBTQ advocates believe the numbers are higher and rising as more people are willing to out themselves.

This past fall, Harvards entering class of medical students was 15% LGBTQ, a milestone that is no accident.

The Association of American Medical Colleges primary application used by U.S. schools began offering prospective students the option of specifying gender identity and preferred pronouns in 2018. Harvards school-specific application allows applicants to identify as lesbian, gay, bisexual, transgender or queer. A response is not required, but the option sends a message that youre wanted, said Jessica Halem, the medical schools LGBTQ outreach director.

We know that doctors need to look like and be a part of the communities they serve, Halem said.

We have gay Muslim students. Lesbians from China. Students who are survivors of conversion therapy, she said. "They are now out and very proud gay people and they are healing those wounds."

Feroe had intended to present herself as straight in medical school, fearing doing otherwise would be off-putting for patients and make her feel like an anomaly among her peers.

But Harvard has an active LGBTQ student group on campus, faculty members who ask students if they prefer being called her, him or they, and coursework addressing LGBTQ medical care. Halem said that includes what screening tests are needed for women who have sex with transgender men, the hormone treatments to prescribe for transgender patients, and what it means when someone identifies as pansexual.

Feroe said she was blown away during a recent surgery rotation at one of Harvards affiliated hospitals, where a few patients were accompanied by same-sex partners. The doctors she was training with smoothly asked about peoples lives and were completely comfortable when learning patients were queer, she said, important steps toward offering non-judgmental patient-centered care.

A 2017-18 Association of American Medical Colleges report found that while most schools include some LGBTQ coursework, half reported three or fewer lectures, group discussions or other learning activities.

And a study of medical residents published last March found a widespread lack of knowledge on LGBTQ health issues. Dr. Carl Streed, the lead author and an associate professor at Boston Universitys medical school, is among advocates pushing for a standardized, mandatory LGBTQ curriculum to fill the gaps.

Streed said a harrowing doctors visit nearly 15 years ago when he had symptoms of a cold and swollen lymph nodes motivated him to pursue a medical career.

When I explained I was a gay man, the physician became very brusque, suggested HIV testing, left the room and never came back, recalled Streed, who was an undergraduate at the time.

Testing elsewhere showed Streed did not have HIV, but no one suggested tests for illnesses more common among college students, including mononucleosis, and he never received a diagnosis.

Physicians personal beliefs should not determine the quality of care and compassion that is delivered to patients, he said.

Rhi Ledgerwood entered the University of Louisville medical school in 2014, the year it became the pilot site for coursework and training in LGBTQ health issues based on guidelines from the Association of American Medical Colleges.

At Louisville, LGBTQ health care topics are woven into the curriculum in classes that explore issues such as gender-affirming hormone therapy, taught along with more traditional coursework.

Ledgerwood, now a medical resident in pediatrics, remembers feedback from classmates who felt it didnt apply to them or their future practices. It went against their beliefs and they didnt feel like they should be wasting their time on this subject.

They were politely told the curriculum was here to stay, and Louisville now serves as a model for other medical schools.

When Tim Keyes enrolled in Stanford Universitys medical school in 2015, he was surprised to learn he was one of only two gay students in the first-year class who were out.

Because were here in the California Bay area, I was expecting the community to be a little bit different, Keyes said.

LGBT health issues were crammed into one elective class that attracted relatively few students, but now a broader focus is part of the mandatory curriculum.

Two years ago, Keyes was among six students at four universities who created the Medical Student Pride Alliance. The group has 31 chapters on U.S. campuses and works to promote recruitment of LGBTQ students in medical schools, more enlightened coursework and improvements in LGBTQ medical care.

A lecture he heard at Stanford in which a professor mentioned that nearly 1 in 2 teens under age 18 who identify as transgender will attempt suicide shows why the groups work is so important, Keyes said.

The professor went on to note that studies have shown the risk becomes much closer to zero, Keyes recalled, if a physician simply counsels them and offers affirmative care.

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Harvard med student from Minneapolis part of push to improve LGBTQ care - Minneapolis Star Tribune

Canadas Eldorado Gold has announced a 15-year mine life at Kisladag, in Turkey, to 2034, following the completion of long-cycle heap leach testwork and the replacement of the tertiary crushing circuit with a high-pressure grinding roll (HPGR) circuit.

The new mineral reserve for Kisladag includes proven and probable reserves of 173.2-million tonnes of ore at 0.72 g/t, containing four-million ounces of gold.

The mine is forecast to produce an average of 160000 oz/y at an average cash cost of $675/oz to $725/oz and an average all-in sustaining cost (AISC) of $800/oz to $850/oz.

Kisladag has been the cornerstone asset of Eldorado for over a decade, producing over three-million ounces of gold and generating significant value for all stakeholders during that period. Following the resumption of full operations last spring, and the significant work and testing undertaken by the Eldorado team over the past 18 months, we are pleased to announce a mine life extension at Kisladag that puts this asset back in the core of our portfolio, said president and CEO George Burns.

Eldorado reported that the project self-funds all development capital for waste stripping and the HPGR circuit. The cost for the HPGRcircuit, about $35-million, is spread over 2020 and 2021, while the cost of capitalised waste stripping, about $260-million, is spread over the life of the project, with heavier stripping in the first several years.

Meanwhile, Eldorado said it would produce 520000 oz to 550000 oz of gold in 2020, a substantial increase ofon the 395331 oz produced in 2019.

Average cash operating costs are forecast to decline from $608/oz of gold sold in 2019, to $550/oz to $600/oz of gold sold in 2020. The AISC for 2020 is forecast to be $850/oz to $950/oz of gold sold, down on the $1033/oz of gold sold in 2019.

With the extension of Kisladags mine life and continued operations at Lamaque, in Canada, Efemcukuru, in Turkey, and Olympias, in Greece, Eldorado is forecasting five-year production from its four current operations to average over 450 000 oz/y. In addition to the updated Kisladag technical report, the company is in the process of updating technical reports for Olympias and Efemcukuru, which will be published by the end of the first quarter.

Read the original here:
Mine life extension puts Kisladag back on the map - Creamer Media's Mining Weekly

Ducommun (DCO) came out with quarterly earnings of $0.80 per share, beating the Zacks Consensus Estimate of $0.64 per share. This compares to earnings of $0.06 per share a year ago. These figures are adjusted for non-recurring items.

This quarterly report represents an earnings surprise of 25%. A quarter ago, it was expected that this aerospace industry supplier would post earnings of $0.61 per share when it actually produced earnings of $0.70, delivering a surprise of 14.75%.

Over the last four quarters, the company has surpassed consensus EPS estimates four times.

Ducommun, which belongs to the Zacks Aerospace - Defense Equipment industry, posted revenues of $186.93 million for the quarter ended December 2019, surpassing the Zacks Consensus Estimate by 0.32%. This compares to year-ago revenues of $164.18 million. The company has topped consensus revenue estimates four times over the last four quarters.

The sustainability of the stock's immediate price movement based on the recently-released numbers and future earnings expectations will mostly depend on management's commentary on the earnings call.

Ducommun shares have lost about 17.5% since the beginning of the year versus the S&P 500's gain of 4.8%.

What's Next for Ducommun?

While Ducommun has underperformed the market so far this year, the question that comes to investors' minds is: what's next for the stock?

There are no easy answers to this key question, but one reliable measure that can help investors address this is the company's earnings outlook. Not only does this include current consensus earnings expectations for the coming quarter(s), but also how these expectations have changed lately.

Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions. Investors can track such revisions by themselves or rely on a tried-and-tested rating tool like the Zacks Rank, which has an impressive track record of harnessing the power of earnings estimate revisions.

Ahead of this earnings release, the estimate revisions trend for Ducommun was unfavorable. While the magnitude and direction of estimate revisions could change following the company's just-released earnings report, the current status translates into a Zacks Rank #5 (Strong Sell) for the stock. So, the shares are expected to underperform the market in the near future. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here.

It will be interesting to see how estimates for the coming quarters and current fiscal year change in the days ahead. The current consensus EPS estimate is $0.08 on $155.44 million in revenues for the coming quarter and $2.15 on $717.73 million in revenues for the current fiscal year.

Investors should be mindful of the fact that the outlook for the industry can have a material impact on the performance of the stock as well. In terms of the Zacks Industry Rank, Aerospace - Defense Equipment is currently in the bottom 16% of the 250 plus Zacks industries. Our research shows that the top 50% of the Zacks-ranked industries outperform the bottom 50% by a factor of more than 2 to 1.

To read this article on Zacks.com click here.

The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.

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Ducommun (DCO) Q4 Earnings and Revenues Top Estimates - Nasdaq

While Chris Pratt will always be the least best Chris in Hollywood, he did recently have quite the story to tell. While in Iceland shooting his latest film, The Tomorrow War, Pratt heard the story of a long-dead couple who were found completely preserved in ice. How fascinating, but also kind of creepy.

We shot on a glacier that has never before been shot on, he said during his appearance on The Ellen DeGeneres Show. Heres the full story, as Pratt tells it:

The story is admittedly tragic and heartbreaking, but also strangely cool. Sci-fi/fantasy films have often toyed with the idea of cryonics, the act of freezing someone at extremely low temperatures in hopes to preserve their remains and resurrect them. And yes, this story does indeed sound like the plot of Pratts movie Passengers, which also starred Jennifer Lawrence. It wasnt exactly well-received, though, but alas.

Pratt is currently on a press tour to promote Disney and Pixars animated film, Onward, which Ive heard good things about, though its arguably no Coco. As for The Tomorrow War, the film, which is set in the future and involves the military fighting an alien invasion, wont arrive in theaters until December 25, 2020. Hopefully, Pratt wont have anymore frozen people stories to tell in the meantime.

Watch Pratt tell the whole story to Ellen DeGeneres below!

Header Image Source: Getty Images

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Chris Pratt Shares the 'Crazy' Story of a Couple Found Completely Preserved in Ice - Pajiba

CHAMPAIGN, Ill. With a new CRISPR gene-editing methodology, scientists from the University of Illinois at Urbana-Champaign inactivated one of the genes responsible for an inherited form of amyotrophic lateral sclerosis a debilitating and fatal neurological disease for which there is no cure. The novel treatment slowed disease progression, improved muscle function and extended lifespan in mice with an aggressive form of ALS.

ALS unfortunately has few treatment options. This is an important first step in showing that this new form of gene editing could be used to potentially treat the disease, said bioengineering professor Thomas Gaj, who co-led the study with bioengineering professor Pablo Perez-Pinera.

The method relied on an emerging gene-editing technology known as CRISPR base editors.

Traditional CRISPR gene-editing technologies cut both strands of a DNA molecule, which can introduce a variety of errors in the DNA sequence, limiting its efficiency and potentially leading to a number of unintended mutations in the genome. The Illinois group instead used base editing to change one letter of the DNA sequence to another without cutting through both DNA strands, Perez-Pinera said.

Base editors are too large to be delivered into cells with one of the most promising and successful gene therapy vectors, known as adeno-associated virus, Gaj said. However, in 2019, Perez-Pineras group developed a method of splitting the base editor proteins into halves that can be delivered by two separate AAV particles. Once inside the cell, the halves reassemble into the full-length base editor protein.

By combining the power of AAV gene delivery and split-base editors, Gaj and Perez-Pinera targeted and permanently disabled a mutant SOD1 gene, which is responsible for roughly 20% of inherited forms of ALS. They published their results in the journal Molecular Therapy.

Many ALS studies are focused on preventing or delaying the onset of the disease. However, in the real world, most patients are not diagnosed until symptoms are advanced, said graduate student Colin Lim. Slowing progression, rather than preventing it, may have a greater impact on patients. Lim is the co-first author of the study along with graduate students Michael Gapinske and Alexandra Brooks.

CRISPR base editing decreased the amount of a mutant protein (blue) that contributes to ALS in the spinal cord. Left, a spinal cord section from an untreated mouse. Right, a spinal cord section from an animal treated by base editing.

Image courtesy of Thomas Gaj

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The researchers first tested the SOD1 base editor in human cells to verify reassembly of the split CRISPR base editor and inactivation of the SOD1 gene. Then they injected AAV particles encoding the base editors into the spinal columns of mice carrying a mutant SOD1 gene that causes a particularly severe form of ALS that paralyzes the mice within a few months after birth.

The disease progressed more slowly in treated mice, which had improved motor function, greater muscle strength and less weight loss. The researchers observed an 85% increase in time between the onset of the late stage of the disease and the end stage, as well as increased overall survival.

We were excited to find that many of the improvements happened well after the onset of the disease. This told us that we were slowing the progression of the disorder, Gapinske said.

The base editor introduces a stop signal near the start of the SOD1 gene, so it has the advantage of stopping the cell from making the malfunctioning protein no matter which genetic mutation a patient has. However, it potentially disrupts the healthy version of the gene, so the researchers are exploring ways to target the genes mutant copy.

Moving forward, we are thinking about how we can bring this and other gene-editing technologies to the clinic so that we can someday treat ALS in patients, Gaj said. For that, we have to develop new strategies capable of targeting all of the cells involved in the disease. We also have to further evaluate the efficiency and safety of this approach in other clinically relevant models.

The split base editor approach has potential for treating other diseases with a genetic basis as well, Perez-Pinera said. Though ALS was the first demonstration of the tool, his group has studies underway applying it to Duchenne muscular dystrophy and spinal muscular atrophy.

The Muscular Dystrophy Association, the Judith and Jean Pape Adams Foundation, the American Heart Association and the National Institutes of Health supported this work. Gaj and Perez-Pinera are affiliated with the Carl R. Woese Institute for Genomic Biology at Illinois. Perez-Pinera also is affiliated with the Carle Illinois College of Medicine and the Cancer Center at Illinois.

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New CRISPR base-editing technology slows ALS progression in mice - University of Illinois News

There is a new ongoing debate as to what plant breeding technologies constitute genetic modification. The transgenic GM crops introduced more than 20 years ago remain verboten for organic food production. If the pro-organic Cornucopia Institute and other organic food industry proponents have their way, all forms of gene editing and [New Breeding Techniques] would be classified as GM and join the list of practices prohibited for the production of food products eligible to be certified USDA Organic.

We strongly oppose any efforts to revisit the issue of any type of genetic engineering in organic certification, and we will work to ensure that all genetic engineering remains an excluded method, says Organic Farmers Association President David Colson. Any suggestion that we should explore gene-editing or any other type of genetic engineering, would distract from the core issues the organic market is facing right now.

On the other hand, some organic growers do see NBTs as a potential boon to their industry and are calling for revised rules that would allow growers to benefit from crop improvements created using gene editing. Klaas Martens, a prominent voice in the organic movement and a third-generation grain and livestock farmer, operates a 1,600-acre farm in New Yorks Finger Lakes region. He also owns a feed and seed business. Martens says he would be receptive to using CRISPR gene editing technology to grow versions of naturally occurring crops that restore soil health.

If it could be used in a way that enhances the natural system, and mimicked it, then I would want to use it, Martens says. But it would definitely have to be case by case.

The farmers who are opposed to an absolute ban of biotechnology for organic production underscore the belief held by many that USDA Certified Organic crops can help farming become more sustainable as a rising global population demands more food.

In my view, the use of genetic engineering technologies is the most powerful and honest organic tool we have, says Oliver Peoples, president and CEO of Yield10 Bioscience, an agricultural bioscience company focusing on the development of disruptive technologies to produce step-change improvements in crop yield for food and feed crops.

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Some organic farming advocates poised to embrace CRISPR and other New Breeding Techniques because of their sustainability benefits - Genetic Literacy...

The research study on Modest recovery in Global CRISPR Technology Market is inclusive of a detailed summary of this industry. A highly focused approach to subjective research has been undertaken, with the description of product scope and elaborate industry insights and outlook until 2025. Introduced by Research Reports Inc., this report delivers information about the product pertaining to the parameters of cost, demand and supply graph, market trends, and the nature of the transaction.

Also, the report is liable to help shareholders and prominent investors understand the demands of customers for efficiently marketing the products and services.

A detailed analysis of the CRISPR Technology market has been provided in the report. The analysis is undertaken on the basis of the overall historical data, valid projections on the market size, qualitative insights, and more. The predictions of this report have been inferred based on conclusive analysis techniques and assumptions. In essence, this research report works like a repository of analysis as well as information for all the aspects of the industry including and not limited to:

A detailed evaluation of the popular trends prevalent in the CRISPR Technology market has been given in the report, in tandem with the microeconmic pointers and regulatory mandates. With this analysis, the report projects the lucrativeness of every market segment over the forecast period, 2020-2025.

Important factors analyzed in worldwide CRISPR Technology market report

Revenue and Sales Estimation: Historical remuneration, as well as sales volume, have been specified in the report this helps in preparing an accurate budget. The data is segmented with the help of bottom-up and top-down approaches to predict the overall market share as well as to calculate forecast numbers for the major geographies in the report in tandem with the key Types and Applications.

Manufacturing Analysis: The report is presently evaluated in terms of the numerous product types and applications. The global CRISPR Technology market study delivers essential highlights of the manufacturing process analysis that has been verified through primaries. These primaries have been collected via industry professionals and also major representatives of all the firms profiled in the report, in order to prepare courses of action to support the industry growth effectively.

Competition: Major contenders have been studied on the basis of their company profile, product/service price, sales, capacity, product portfolio, and cost to find out the present competitors strengths as well as weaknesses.

Demand & Supply and Effectiveness: CRISPR Technology report also delivers information about the production, distribution, consumption & export/import, and break-even point & marginal revenue). ** If applicable

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Thermo Fisher Scientific, Merck KGaA, GenScript, Integrated DNA Technologies (IDT), Horizon Discovery Group, Agilent Technologies, Cellecta, GeneCopoeia, New England Biolabs, Origene Technologies, Synthego Corporation, Toolgen

Graphically, this report is split into numerous regions, with details on production, consumption, supply, and demand, growth rate, and market share of CRISPR Technology Market in these regions, between 2020 to 2025 (forecast), covering:- North America, Europe, Asia Pacific, Latin America, and Middle East & Africa

Brief introduction about CRISPR Technology Market:

Chapter 1. Global CRISPR TechnologyMarket Size (Sales) Market Share by Type (Product Category) [1,2,3,] in 2020

Chapter 2. CRISPR TechnologyMarket by Application/End Users [1,2,3]

Chapter 3. Global CRISPR TechnologySales (Volume) and Market Share Comparison by Applications

Chapter 4. Global CRISPR TechnologySales and Growth Rate (2020-2025)

Chapter 5. CRISPR TechnologyMarket Competition by Players/Suppliers, Region, Type, and Application

Chapter 6. CRISPR Technology(Volume, Value and Sales Price) structure specified for each geographic region included.

Chapter 7. Global CRISPR TechnologyPlayers/Suppliers Profiles and Sales Data

Chapter 8. Company primary Information and Top Competitors list are being provided for each vendor listed in the report.

Chapter 9. Market Sales, Revenue, Price and Gross Margin (2020-2025) table for each product type which includes Cost Structure Analysis, Key Raw Materials Analysis & Price Trends

Chapter 10. Supply Chain, Sourcing approach and Downstream Buyers, Industrialized Chain Analysis

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Researchers from the group of Vlad Cojocaru together with colleagues the Max Planck Institute in Mnster (Germany) have revealed how an essential protein helps to activate genomic DNA during the conversion of regular adult human cells into stem cells.A cells identity is driven by which DNA is read or not read at any point in time. Signaling in the cell to start or stop reading DNA happens through proteins called transcription factors. Identity changes happen naturally during development as cells transition from an undesignated cell to a specific cell type. As it turns out, these transitions can also be reversed. In 2012, Japanese researchers were awarded the Nobel prize for being the first to push a regular skin cell backwards to a stem cell.A fuller understanding of molecular processes towards stem cell therapiesUntil now, it is unknown how the conversion of a skin cell into a stem cell happens exactly, on a molecular scale. Fully understanding the processes with atomic details is essential if we want to produce such cells for individual patients in the future in a reliable and efficient manner, says research leader Vlad Cojocaru of the Hubrecht Institute. It is believed that such engineered cell types may in the future be part of the solution to diseases like Alzheimers and Parkinsons, but the production process would have to become more efficient and predictable.Pioneer transcription factorOne of the main proteins involved in the stem cell generation is a transcription factor called Oct4. It induces gene expression, or activity, of the proteins that reset the adult cell into a stem cell. Those genes induced are inactive in the adult cells and reside in tightly packed, closed states of chromatin, the structure that stores the DNA in the cell nucleus. Oct4 contributes to the opening of chromatin to allow for the expression of the genes. For this, Oct4 is known as a pioneer transcription factor.

The data from Cojocaru and his PhD candidate and first author of the publication Jan Huertas show how Oct4 binds to DNA on the so-called nucleosomes, the repetitive nuclear structures in chromatin. Cojocaru: We modelled Oct4 in different configurations. The molecule consists of two domains, only one of which is able to bind to a specific DNA sequence on the nucleosome in this phase of the process. With our simulations, we discovered which of those configurations are stable and how the dynamics of nucleosomes influence Oct4 binding. The models were validated by experiments performed by our colleagues Caitlin MacCarthy and Hans Schler in Mnster.One step closer to engineered factorsThis is the first time computer simulations show how a pioneer transcription factor binds to nucleosomes to open chromatin and regulate gene expression. Our computational approach for obtaining the Oct4 models can also be used to screen other transcription factors and to find out how they bind to nucleosomes, Cojocaru says.

Moreover, Cojocaru wants to refine the current Oct4 models to propose a final structure for the Oct4-nucleosome complex. For already almost 15 years now, we know that Oct4 together with three other pioneer factors transforms adult cells into stem cells. However, we still do not know how they go about. Experimental structure determination for such a system is very costly and time consuming. We aim to obtain one final model for the binding of Oct4 to the nucleosome by combining computer simulations with different lab experiments. Hopefully, our final model will give us the opportunity to engineer pioneer transcription factors for efficient and reliable production of stem cells and other cells needed in regenerative medicine.ReferenceHuertas et al. (2020) Nucleosomal DNA Dynamics Mediate Oct4 Pioneer Factor Binding. Biophysical Journal. DOI: https://doi.org/10.1016/j.bpj.2019.12.038

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Visualizing the Conversion of Adult Cells to Stem Cells - Technology Networks

The first time Bill Cronin Googled his own cancer diagnosis in 2016, his heart sank. He had Szary syndrome, a rare and aggressive form of cutaneous T-cell lymphoma and staring back at him were countless articles predicting a negative prognosis.

However, after receiving a stem-cell transplant at Dana-Farber/Brigham and Womens Cancer Center, Cronin is returning to the life he enjoyed before cancer.

Im at a place I never thought Id get to, Cronin says.

In 2015, Cronin, then 60, started feeling incredibly itchy and developed an accompanying rash. He went to his dermatologist, who diagnosed him with eczema and told him to return in five months. The rash continued to grow, however, and at the five month mark, Cronins dermatologist encouraged him to undergo further testing at Dana-Farber.

A blood test revealed that Cronins T-cells a type ofwhite blood cells that make up part of the immune system had becomecancerous. In the case of Szary syndrome, lymphoma cells will circulatethrough the blood stream and deposit in different areas of the skin. This willgenerally lead to a full-body rash and intense itchiness.

Cronin would need a stem cell transplant to combat the disease, but before he could receive one, his care team had to get him into remission. Patients who do not achieve remission prior to transplant have a high chance of relapsing.

When they first told me everything, I was really scared, says Cronin. But I knew I was in one of the best places in the world to figure out and treat this rare disease.

Cronins pre-transplant care was spearheaded by oncologists David Fisher, MD, and Nicole LeBoeuf, MD, MPH, clinical director of Cutaneous Oncology at Dana-Farber, with his transplant conducted by Corey Cutler, MD, MPH, medical director of the Adult Stem Cell Transplantation Program at Dana-Farber. Initially, Cronins disease was incredibly resistant; for nearly three years, mainstay drugs including steroids, monoclonal antibodies, and enzyme blockers all failed to put his disease into remission.

Ultimately, it would take a new drug, mogamulizumab (a type of immunotherapy that directly kills T-cells involved with Sezary Syndrome) to get Cronins disease into remission.

In May 2019, Cronin was cleared to undergo an allogeneic transplant, a type of transplant that uses a donors stem cells, in this case, Cronins brother. Since his transplant Cronin has remained in remission.

We had to use all of our big guns to get him totransplant, but Im pleased with where we are now, says Cutler.

I know the situation can always change, but it was great tobe able to share some good news with my family and friends, adds Cronin.

Patients like Cronin serve as a reminder of how stem cell transplants have improved and continue to impact patient outcomes, Dana-Farber experts note. Initially offered to only an incredibly small patient population when first performed at Dana-Farber in the 1970s, research advancements have, and continue to, broaden who is eligible for a transplant. In 2019, Dana-Farber/Brigham and Womens Cancer Center (DF/BWCC) surpassed 10,000 total adult transplants.

This milestone indicates our success as a program and our volume has allowed us to do the research to help move the field forward rather impressively, says Joseph Antin, MD, chief emeritus of Adult Stem Cell Transplantation at DF/BWCC.

In 1996, Dana-Farber Cancer Institute and Brigham and Womens Hospital merged their then separate transplant centers. By pooling together physical and intellectual resources, the new combined program was able to more than double the number of transplants each hospital could perform individually.

We always felt collaboration was better than competition, explains Robert Soiffer, MD, vice chair of Medical Oncology for Hematological Malignancies and chief of the Division of Hematologic Malignancies, who oversaw the merger with Antin. Each side could learn from the other, and that helped to catapult us into the leadership position we have today.

The Stem Cell Transplantation Program is also bolstered by the Connell and OReilly Families Cell Manipulation Core Facility (CMCF), which was established in 1996. The state-of-the-art center, led by Jerome Ritz, MD, not only processes the stem cells for transplant; it also assists researchers in developing new cell-based therapies for patients.

Another key component to the programs success has been the creation of the Ted and Eileen Pasquarello Tissue Bank. The Pasquarello Tissue Bank receives, processes, banks, and distributes research samplesof blood, bone marrow, and other tissues. Through a database overseen by Vincent Ho, MD, the Institute is able to log, assess, and later review every patients disease, including all complications and mutations. This technology allows researchers to explore the genetic makeup of past donors and better understand why a transplant was or was not successful.

Were still learning from biological specimens we collected 20 years ago, and it will continue to impact care 20 years from now, Soiffer says.

Today, there is a continuous push to develop new and more precise therapies to complement and improve stem cell transplants. The hope is to bring new treatment options to patients like Cronin who are facing rare and difficult diseases.

Before his diagnosis, Bill, and Barbara Finney, his partner ofnearly 30 years, were avid English Country dancers. English Country dancingevolved from the court dances of Europe in the early 17th century, and Croninand Barbara have friends from all over the country who share their passion forit.

While Cronin isnt dancing just yet, as hes stillrecovering from his transplant, he says he couldnt have gotten through thiswithout his partner on the dance floor and in life.

Barbara has been amazing and has helped take care ofeverything I couldnt do, he adds. Ive been fortunate and privileged to notonly have her, but to have been able to come to Dana-Farber.

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Transplant for Szary Syndrome is Patient's First Step in Returning to the Dance Floor - Dana-Farber Cancer Institute

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A case of reverse development: Dana-Farber scientists solve long-debated puzzle of how the intestine heals itself

Newswise BOSTON Deep within the lining of the human intestine lies the source of the organs ability to renew itself and recover from damage: intestinal stem cells (ISCs), lodged in pockets of tissue called crypts, generate the cells that continuously repopulate the intestinal lining. Even the stem cells themselves have a safety net: when theyre damaged, healthy replacements appear in less than a week.

For years, scientists have debated how the ISCs re-emergence occurs. Some have held that the intestine keeps a pool of ISCs on reserve a kind of backup-backup supply to replenish the cache of front-line ISCs that have been lost. Others have maintained that something more involuted is as work: The ISCs, like queen bees, give rise to more specialized, or differentiated, progeny in this case, daughter cells that form the inner lining of the intestine. When the ISCs are damaged, this school of thought held, the daughter cells reverse course and de-differentiate reverting into the ISCs from which they arose.

A new study by Dana-Farber Cancer Institute scientists comes down solidly on the latter option.

Published online today by the journalCell Stem Cell, the researchers found that ISCs and their daughter cells have a strikingly reciprocal relationship: under normal conditions, ISCs differentiate into daughter cells, and, if the ISCs are lost, the daughter cells simply reverse course and become ISCs. Our findings suggest that the restoration of intestinal stem cells occurs entirely by the process of de-differentiation, says the studys senior author, Ramesh Shivdasani, MD, PhD, of Dana-Farber, Brigham and Womens Hospital (BWH), and the Harvard Stem Cell Institute. We showed theres no need for a reserve set of ISCs.

Bolstering their findings, the researchers were also able to capture the de-differentiation process in real time. When cells begin to de-differentiate, they switch on a gene that that allows them to be isolated and collected with laboratory techniques, Shivdasani explains. Through this process, researchers were able to capture the cells along a continuum of de-differentiation. Shivdasani likens it to a baseball play in which a runner is tagged out between first and second base.

Heavy turnover

The intestine is one of just three tissues in the body, along with the skin and blood, in which cells are constantly turning over dying and being replaced by freshly made cells. They share this quality because they are the tissues most intimately in contact with material from the environment, and therefore with potentially harmful substances. The constant turnover, its thought, is a way to prevent toxic substances from having lasting effects on cells and their offspring.

The crypts that hold ISCs are, in a sense, misnamed. Far from being enclosures where dead cells are entombed, they are the sites where ISCs daily generate the billions of daughter cells that take the place of defunct intestinal cells.

One of the chief characteristics of ISCs is that they are extremely radiosensitive, or vulnerable to radiation. People exposed to high levels of radioactivity, in the form of nuclear fallout, for example, can suffer severe intestinal damage because the loss of ISCs halts production of cells to regenerate the damaged tissue. But if ISCs succumb easily to radiation, they also make a rapid return. Patients with radiation-induced intestinal damage who can be kept alive for a week often recover as their ISC levels bounce back.

To determine whether this rebound is due to a reserve stockpile of ISCs or to de-differentiation of daughter cells, Shivdasani and his collaborators performed a kind of time-lapse experiment. They treated a collection of ISC cells with the drug tamoxifen, which caused the cells and their offspring to become fluorescent. They waited 48 hours for the label to take hold, then killed the ISC cells. If the daughter cells were indeed de-differentiating, any ISC cells produced after that point would be fluorescent.Thats exactly what researchers found.

While scientists have been able to convert many kinds of differentiated cells into stem cells using laboratory techniques, Shivdasani and his colleagues discovery demonstrates that de-differentiation ismore than a curious act of nature; it is the principal means to restore damaged stem cell in the intestine. Its not known whether cells in other organs and tissues have this capability, but it remains an open avenue of investigation.

It also isnt clear how the crypt knows that stem cells have died and need to be replaced, Shivdasani remarks, or how the daughter cells receive the signal to de-differentiate. This is a subject were currently exploring.

The lead author of the new paper is Kazutaka Murata, PhD of Dana-Farber and BWH. Co-authors are Unmesh Jadhav, PhD, and Alessia Cavazza, PhD, of Dana-Farber and BWH; Shariq Madha, Justin Dean, Kai Wucherpfennig, MD, PhD, and Franziska Michor, PhD, of Dana-Farber; and Johan van Es, PhD, and Hans Clevers, MD, PhD, of Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences and University Medical Centre, Utrecht, the Netherlands. The research was supported by the National Institutes of Health (grants R01DK081113, U01DK103152, and P50CA127003) and gifts from the Lind family.

###

Dana-Farber Cancer Institute is one of the worlds leading centers of cancer research and treatment. It is the only center ranked in the top 5 of U.S. News and World Reports Best Hospitals for both adult and pediatric cancer care.

Dana-Farbers mission is to reduce the burden of cancer through scientific inquiry, clinical care, education, community engagement, and advocacy. We provide the latest in cancer for adults through Dana-Farber/Brigham and Women's Cancer Care and for children through Dana-Farber/Boston Children's Cancer and Blood Disorders Center.

Dana-Farber is dedicated to a unique and equal balance between cancer research and care, translating the results of discovery into new treatments for patients locally and around the world.

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A case of reverse development: Dana-Farber scientists solve long-debated puzzle of how the intestine heals itself - Newswise

He asked her for a list of dream projects she would love to investigate. What followed was a year of challenges, stresses and the ultimate reward guided intellectual freedom toward scientific discovery.

Ashley Kramer, a student at the Wayne State University School of Medicine, is enrolled in the schools M.D.-Ph.D. program, an eight-year commitment broken down into three parts the first two years of medical school, four years of graduate school, then the final two years of medical school. Like all M.D./Ph.D. students at the medical school, Kramer had to complete research rotations with faculty she thought would make good dissertation advisors.

Because I have always loved stem cell biology and had experience working with zebrafish in the past, I decided to do an eight-week rotation in Dr. Thummels lab between my medical year one and medical year two, and made the decision that this was absolutely the perfect lab for me, she said.

Ryan Thummel, Ph.D., is an associate professor of Ophthalmology, Visual and Anatomical Sciences. His lab focuses on retinal development and regeneration in zebrafish, an attractive model to study neurodegenerative diseases because of its ability to regenerate neuronal tissues. Zebrafish fully regenerate their retinas in just a matter of weeks, an ability mammals lack.

Zebrafish and mammals both have a cell called Mller glia that supports retinal neurons. In zebrafish, however, these cells convert to stem cells and are responsible for retinal regeneration.

At the end of the rotation, Dr. Thummel floated the crazy idea of starting to work on this grant, a 70-plus page monster undertaking, during my M2 year, and I immediately jumped at the opportunity. I was excited at the idea of having a four-year research project completely planned out by the time I started my Ph.D. after M2 so I could hit the ground running after the dreaded STEP 1, Kramer said.

I came to him two days later with a nine-page document of project ideas. We sat down for three hours discussing projects and came up with a top-two list of cohesive projects for me to move forward with as a grant and thesis, she said. From there, it was a nearly yearlong process of writing, meeting, revising and repeating for each of the many sections of the grant.

The effort was worth it. Kramer secured a five-year, $294,102 grant from the National Eye Institute of the National Institutes of Health last year to study the molecular mechanisms of retinal regeneration in zebrafish, an organism that exhibits a remarkable capacity for regeneration.

"Ashley is a dedicated young scientist and worked very hard on this grant application," Dr. Thummel said.

The grant is one of the NIHs Ruth L. Kirschstein National Research Service awards, also known as an F30. The project, Elucidating the role of DNA methyltransferases in epigenetic regulation of retinal regeneration in the zebrafish, started last month. She is the principal investigator.

This was an incredibly challenging experience that allowed me to grow immensely as a scientist. Grant writing, planning effective and novel longitudinal scientific investigations, and time management will all be critical skills for me moving forward in my career as a physician scientist, she said. I cannot thank Dr. Thummel and my past advisors enough for all of their mentoring and support in the last ten years who have gotten me to where I am today, and I am looking forward to the rest of my training here at Wayne State and beyond.

Kramer earned her bachelors degree in Genetics, Cell Biology and Development from the University of Minnesota in 2014. Her love of research and stem cell biology started when she was an undergraduate research assistant there.

Nearly a decade later, she is studying how epigenetic marks are added to, and removed from, genes in zebrafish retinal stem cells during the process of retinal regeneration. The role of epigenetics in the body is akin to traffic signs on the road.

If roads had no traffic lights, stop signs or barricades, it would be complete chaos. The same is true for your cells. If you used every single gene encoded in your DNA 100% of the time, your cells would be chaos. Epigenetics is what is responsible for telling your skin cell to be a skin cell and your liver cell to be a liver cell, while they both have the exact same underlying DNA sequence, Kramer said. There are various different epigenetic marks that decorate the DNA without actually changing the sequence. These marks come in many forms and can act to either start, stop or change the amount that a particular gene is used, similar to how a green light, road block or stop sign direct traffic rules.

The process is critical for normal embryonic development and everyday cell processes.

If we can gain a deeper understanding of how species like the zebrafish are able to regenerate tissues when mammals cannot, despite having the same cell types, we may be able to start working to translate those mechanisms to mammals, she said. It is possible that certain regeneration pathways have been epigenetically silenced through evolution and we may be able to use modern advances in gene therapy techniques to unlock regenerative capacity in mammals.

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Anatomy of a grant: Ashley Kramer's yearlong journey to finding her doctoral thesis - The South End

Stem Cell Therapy Market: Snapshot

Of late, there has been an increasing awareness regarding the therapeutic potential of stem cells for management of diseases which is boosting the growth of the stem cell therapy market. The development of advanced genome based cell analysis techniques, identification of new stem cell lines, increasing investments in research and development as well as infrastructure development for the processing and banking of stem cell are encouraging the growth of the global stem cell therapy market.

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One of the key factors boosting the growth of this market is the limitations of traditional organ transplantation such as the risk of infection, rejection, and immunosuppression risk. Another drawback of conventional organ transplantation is that doctors have to depend on organ donors completely. All these issues can be eliminated, by the application of stem cell therapy. Another factor which is helping the growth in this market is the growing pipeline and development of drugs for emerging applications. Increased research studies aiming to widen the scope of stem cell will also fuel the growth of the market. Scientists are constantly engaged in trying to find out novel methods for creating human stem cells in response to the growing demand for stem cell production to be used for disease management.

It is estimated that the dermatology application will contribute significantly the growth of the global stem cell therapy market. This is because stem cell therapy can help decrease the after effects of general treatments for burns such as infections, scars, and adhesion. The increasing number of patients suffering from diabetes and growing cases of trauma surgery will fuel the adoption of stem cell therapy in the dermatology segment.

Global Stem Cell Therapy Market: Overview

Also called regenerative medicine, stem cell therapy encourages the reparative response of damaged, diseased, or dysfunctional tissue via the use of stem cells and their derivatives. Replacing the practice of organ transplantations, stem cell therapies have eliminated the dependence on availability of donors. Bone marrow transplant is perhaps the most commonly employed stem cell therapy.

Osteoarthritis, cerebral palsy, heart failure, multiple sclerosis and even hearing loss could be treated using stem cell therapies. Doctors have successfully performed stem cell transplants that significantly aid patients fight cancers such as leukemia and other blood-related diseases.

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Global Stem Cell Therapy Market: Key Trends

The key factors influencing the growth of the global stem cell therapy market are increasing funds in the development of new stem lines, the advent of advanced genomic procedures used in stem cell analysis, and greater emphasis on human embryonic stem cells. As the traditional organ transplantations are associated with limitations such as infection, rejection, and immunosuppression along with high reliance on organ donors, the demand for stem cell therapy is likely to soar. The growing deployment of stem cells in the treatment of wounds and damaged skin, scarring, and grafts is another prominent catalyst of the market.

On the contrary, inadequate infrastructural facilities coupled with ethical issues related to embryonic stem cells might impede the growth of the market. However, the ongoing research for the manipulation of stem cells from cord blood cells, bone marrow, and skin for the treatment of ailments including cardiovascular and diabetes will open up new doors for the advancement of the market.

Global Stem Cell Therapy Market: Market Potential

A number of new studies, research projects, and development of novel therapies have come forth in the global market for stem cell therapy. Several of these treatments are in the pipeline, while many others have received approvals by regulatory bodies.

In March 2017, Belgian biotech company TiGenix announced that its cardiac stem cell therapy, AlloCSC-01 has successfully reached its phase I/II with positive results. Subsequently, it has been approved by the U.S. FDA. If this therapy is well- received by the market, nearly 1.9 million AMI patients could be treated through this stem cell therapy.

Another significant development is the granting of a patent to Israel-based Kadimastem Ltd. for its novel stem-cell based technology to be used in the treatment of multiple sclerosis (MS) and other similar conditions of the nervous system. The companys technology used for producing supporting cells in the central nervous system, taken from human stem cells such as myelin-producing cells is also covered in the patent.

Global Stem Cell Therapy Market: Regional Outlook

The global market for stem cell therapy can be segmented into Asia Pacific, North America, Latin America, Europe, and the Middle East and Africa. North America emerged as the leading regional market, triggered by the rising incidence of chronic health conditions and government support. Europe also displays significant growth potential, as the benefits of this therapy are increasingly acknowledged.

Asia Pacific is slated for maximum growth, thanks to the massive patient pool, bulk of investments in stem cell therapy projects, and the increasing recognition of growth opportunities in countries such as China, Japan, and India by the leading market players.

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Global Stem Cell Therapy Market: Competitive Analysis

Several firms are adopting strategies such as mergers and acquisitions, collaborations, and partnerships, apart from product development with a view to attain a strong foothold in the global market for stem cell therapy.

Some of the major companies operating in the global market for stem cell therapy are RTI Surgical, Inc., MEDIPOST Co., Ltd., Osiris Therapeutics, Inc., NuVasive, Inc., Pharmicell Co., Ltd., Anterogen Co., Ltd., JCR Pharmaceuticals Co., Ltd., and Holostem Terapie Avanzate S.r.l.

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Dubai: It's an industry on the rise. And it's accelerating the speed by which Dubai is fast becoming the "new Beverly Hills of the Middle East."

Already, cosmetic surgery has topped the list in medical tourism in Dubai. According to a Dubai Health Authority (DHA) report, the emirate has the highest number of cosmetic surgeons per capita in the region about 50 specialists for a million people.

Globally, the cosmetic surgery market size is projected to reach $21.97 billion with 7.8% annual growth rate by 2023, according to a Medgadget report.

These are the top surgery options:

To put this in perspective, we talked to several people.

Myra J., a belly dancer working at a Dubai hotel. She was unhappy. Saddle bags on her thighs were making her performance less graceful. She honestly feared she would be jobless soon.

On a weekend, she checked into a leading aesthetic clinic and the surgeon trimmed the pockets of fat around her thighs, sculpting her body back into perfect shape.

It took her a week to recover and get back to work, but she is delighted with her shapely thighs and feels happier than ever before.

'Ageing gracefully'

Nina M., (52), always loved how beautiful her eyes were and how youthful her cheeks looked.

Last year, nowever, as she got busy with her sons marriage preparations, she started to experience bouts of anxiety at the sight of slowly encroaching bags under her eyes and a slight droop in her cheeks.

I wanted to look and feel my best and thought a filler and a round of botox were harmless indulgences. It took me just an hour at the clinic and the results were amazing. I am glad I was able to stop the onslaught of aging in time.

"Its beautiful to age gracefully, but we all do use creams and gels to delay the process. I think of these minor injectibles as tools in our make-up bag.

"I have used fillers and Botox twice since last year, combined with my beauty regimen. I feel it has given me not just confidence but also psychological boost. I would recommend it to everyone.

Anna M was a physical trainer but vexed with her body shape as she had a masculine build.

- Anna M, a physical trainer

This was affecting her work. Most women were intimidated by her personality and she was losing self-confidence.

Four years ago, she went in for breast implants and her life changed.

Addiction to surgery?

People talk about getting addicted to cosmetic surgery. But that is not so. Most people approach a cosmetic surgeon only when they cannot deal with a physical issue themselves and just like one needs medicine when one is ill, cosmetic surgery acts as a solution to boost confidence and self-esteem.

"Look at how people have reclaimed their health with gastric bypass!

- Dr Sanjay Parashar, chairman, Scientific of the Emirates Plastic Surgery Society

Changing the world one person at a time and providing them with an incredible burst of confidence, aesthetic and cosmetic surgeons in the UAE have built a practice of reliability that can take as little as one hour to a day to transform your personality.

Welcome to the multi-million dirham cosmetic surgery industry in the UAE.

It is the toast of medical tourism in the region, with a high footfall of Gulf and Asian medical tourists as well as resident expatriates.

The industry has accelerated at a speed that is making Dubai be hailed as the new Beverly Hills of the Middle East.

Cosmetic or Plastic Surgery?

These are two different concepts. Cosmetic surgery refers to aesthetic surgery and revolves around enhancement of physical features of an individual and is elective.

This includes procedures such as:

Plastic surgery, on the other hand, is a surgical speciality dealing with life-saving procedures of re-construction of the face and body owing to congenital defects, disfigurement due to accident, trauma, burns, tumour removal due to diseases such as cancer.

In most cases, plastic surgery is not elective.

Dh12b Medical tourism sales in 2018

Since the time pop stars began to inundate Instagram with images of their perfect bodies, dazzling smiles, flawless skin and enviable hair volume, elective procedures have become commonplace with teenagers as young as 13 who are going in for instant fixes.

While some procedures require a couple of days of hospital stay and being out of circulation for a while, many quick fixes are carried out during lunch breaks in one-hour durations.

Highest per capita cosmetic surgeons in UAE

Dr Sanjay Parashar, chairman, Scientific of the Emirates Plastic Surgery Society, told Gulf News: Cosmetic surgery tops the list in medical tourism in Dubai and according to a 2015 report of Dubai Health Authority (DHA), Dubai has the highest number of cosmetic surgeons per capita in the region about 50 specialists for a million people.

- Dr Zuhair Al Fardan, President of the Emirates Plastic Surgery

Dr Parashar added: The field has grown beyond expectations and much of the credit goes to the development of a world-class infrastructure in this field and the corresponding health regulations.

"Today, in Dubai, most Day Care Surgery centres where most of the plastic surgery procedures are carried out have the best international accreditations.

Dr Zuhair Al Fardan, President of the Emirates Plastic Surgery, said: Much of the advancement in plastic and cosmetic surgery is work in progress as surgeons are constantly upgrading themselves with techniques, technologies.

The UAE is keeping abreast of the best that is taking place in the world. In the last five years or so, there have been tremendous advancements in cosmetic and plastic surgery in the UAE.

"We have the top plastic surgeons of the world come here to do surgeries and the UAE hosts two major international plastic surgery conferences each year.

Soaring revenues

With greater acceptance and broadening of scope for the discipline, it is evident that plastic surgery is a major revenue earner and places UAE as one of the leading medical tourism destinations in the region.

From a price range of Dh150-250 for a filler to Dh40,000 for a detailed body sculpting procedure, these procedures are money-spinners.

Together, the plastic and cosmetic surgery is a multimillion dirham business in the UAE. While there are no exact figures available, safe estimates can be made, say surgeons.

MULTIMILLION BUSINESS

There are 30 hospitals in Dubai, of which 70 per cent are internationally accredited. The emirate aims to build 22 hospitals by 2020 18 private and 4 public hospitals.

In Dubai, at least 50 per cent of its 30 hospital offer cosmetic and plastic surgery options.

30 number of hospitals in Dubai, of which 70 per cent are internationally accredited

Besides that there are about 150 Day Care Surgery centres and 400 aesthetic clinics in Dubai.

All of them offer a bouquet of cosmetic surgery procedures and their average annual revenue is between Dh4-6 million a year.

400 Number of aesthetic clinics in Dubai

If one were to compute that with the numbers of facilities including hospitals, the annual revenue from cosmetic surgery would run into many millions of dirhams annually.

High on medical tourism

Currently, Dubai aims to attract 500,000 medical tourists a year by end 2020.

In a short priod of time, Dubai has managed to be ranked 17 among the top 25 global destinations for medical tourism and cosmetic surgery, along with fertility, orthopaedic, dental and wellness disciplines in the list of most-billed medical procedures.

40% percentage of tourists who come to Dubai come only for medical tourism. Medical tourism sales topped Dh12 billion in 2018, a 5.5% jump in the number of medical tourists

Based on official data, about 46 per cent of the current medical tourists in Dubai come from Asian countries. About a quarter (25 per cent), come from GCC and Arab countries and 13 per cent from African countries, and the remaining 16 per cent from other countries, mainly the UK and Commonwealth of Independent States (CIS) countries.

In fact, 40 per cent of tourists who come to Dubai come only for medical tourism.

- Dr Francis Conroy, consultant plastic, cosmetic and reconstructive surgeon at the American Hospital, Dubai

Medical tourism sales topped Dh12 billion in 2018, with a 5.5 per cent overall increase in medical tourists.

Medical tourists

Dubai attracted a total of 640,542 international and domestic medical tourists in 2018 (51 per cent were international patients).

European tourists consisting mostly of UK, French and Italian citizens, share 16 per cent of health and wellness tourists. A substantial medical tourism revenue, it is evident, is earned through plastic and cosmetic surgery.

Dr Francis Conroy, consultant plastic, cosmetic and reconstructive surgeon at the American Hospital, Dubai, remarked: American Hospital Dubai, is one of the few facilities offering both comprehensive reconstructive and cosmetic surgery services.

"Our plastic surgeons are fully trained in both reconstructive and cosmetic surgery so we see a wide-ranging case mix, from severe trauma cases to cancer cases and of course, those opting for cosmetic surgery."

Most popular cosmetic surgery

Typically, these patients would be female, who done with having children and raising them, now wish to address the changes in their body. I also see a large number of male patients who want to correct problems associated with their chest with the help of liposuction.

Source: Dr Francis Conroy, consultant plastic, cosmetic and reconstructive surgeon at the American Hospital, Dubai

Most popular cosmetic surgery

"Typically, these patients would be female, who done with having children and raising them, now wish to address the changes in their body. I also see a large number of male patients who want to correct problems associated with their chest with the help of liposuction, said Dr Conroy.

Non-surgical treatments (neuro-modulators, fillers, etc) are still very popular and I have seen a trend in that patients are starting with such treatments at an earlier age.

Given the prestigious reputation of the hospital and the Dubai governments plan to promote medical tourism, I have noticed a huge influx of patients from Africa, Nigeria and Ghana in particular.

"These patients come mainly for cosmetic surgery, knowing that they are in the hands of a highly qualified surgeon, in a safe, luxurious facility, with standards second to none, said Dr Conroy.

Top six cosmetic surgery procedures in town

The procedures can be divided into categories:

Does health insurance cover plastic surgery?

"Reconstructive surgery such as correction of birth deformities such as a tuberous breast, cleft lip, hand deformities, skin transplant following burns, road trauma and breast augmentation and reconstruction following a mastectomy and rebuilding after a tumour resection is all covered under all leading health insurances. There is also new kinds of stem cell therapy being used to regenerate tissues and nerves especially in diabetic patients.

Know the rules:

The DHA has made it mandatory for all Day Care Surgery Centres, most of who carry out aesthetic procedures, to have one leading international accreditation from Canada, US, UK or Australia.

These accreditations were earlier mandatory for hospitals only, but from 2020, all Day Care Surgery centres compulsorily must have an international accreditation.

This ensures that an independent, international medical body enforces global health standards to grant them certification and in case of a sentinel event, conducts its independent inquiry and downgrades these places in case of a serious lapse.

DHA on its own has issued a 25-page manual on quality and regulations that is to be followed at all centres.

A close examination of the Day Care Surgery centres indicates several layers of quality control.

Pre surgery quality

This involves free consultation, especially in case of a second opinion or a first time patient seeking to enquire about a procedure based on his/her requirement. When a patient uploads a request on the website of a centre from anywhere in the world, the centre has to provide a detailed consultation free of charge.

Services available to a patient

Once the patient is convinced and comes in person to consult the doctor, quality is upheld in the pre-diagnostic tests that the patient has to undergo.

Infrastructure quality

DHA has graded Day Care Centres into A, B and C categories based on the level of medical facilities that can be accessed by a patient. Anaesthesia methods such as oral, epidural and general also help classify centres. For instance, hair transplant procedures can only be carried out in B and above grade clinics. Day Care Centres that conduct surgeries under general anaesthesia much be equipped with the Advance Cardiac Life Support (ACLS) with their surgeons and registered nurses being certified as trained in administering ACLS to a patient.

Patient safety protocol

There are very specific guidelines for patient safety and the doctor/surgeon must explain the procedure in detail to the patient and his/her family and obtain a written consent to go ahead after ascertaining that all risks and side-effects have been clearly explained to the patient.

Post-operative regulation

There are specific protocols for discharge of patients undergoing cosmetic surgery.

Although ambulatory care means the patient has to be discharged within the same day, there is a specification about asking the patient to desist from long-distance travel, specific rehabilitative work to be carried out from the next day for which the patient has to be within Dubai and also specific instructions when an overseas patient is declared fit to fly out of the country.

When a patient flies out, he or she is provided with a proper review and notes, with instructions for overseas rehabilitation protocol with reference notes for the rehabilitation instructor and instructions for medication and periodic reviews.

Accountability

The law is clear, said Dr Al Fardan, The DHA regulations constitutes an accountability committee and holds an enquiry to fix the liability. If the centre is found guilty, its licence can be suspended or cancelled depending on the extent of guilt. If the surgeon, anaesthesiologists, nurse and technicians are found guilty, their license to practice is suspended or cancelled. If the crime is lighter, then both the centre and the team are let off with serious warnings.

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Dubai is the 'new Beverly Hills of the Middle East': Here's why - Gulf News

The global Collagen and gelatin market for regenerative medicine will grow at a CAGR of 8.5% from 2017 to 2022 to reach USD 709.9 million by 2022, according to the latest publication from Meticulous Research. The global collagen and gelatin market for regenerative medicine is driven by rising prevalence of chronic diseases, rapid growth in aging population, and increasing funding for R&D of regenerative medicines. However, growing use of alternate biomaterials inhibits the growth of this market to some extent.

The global collagen and gelatin market for regenerative medicine is mainly segmented by type (collagen and gelatin), by source (porcine, bovine, marine, and other), by application (orthopedics, cardiovascular, wound care, and other), and geography. Based on source, bovine collagen and gelatin held the largest share of the market in 2016, owing to their abundant availability and wide range of applications in the tendon reinforcement, hernia repair, skin & wound healing, and plastic & reconstructive surgery. Further, on the basis of application, orthopedics accounted for the major share of the global collagen and gelatin market for regenerative medicines in 2016, owing to the high prevalence of osteoporosis across the globe due to aging population, growing obesity, and a poor level of physical activity.

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Geographically, this market is segmented into North America (U.S. and Canada), Europe (Germany, France, U.K., Italy, Spain, and RoE), Asia Pacific (China, India, Japan, and RoAPAC), Latin America, and Middle East & Africa. North America commanded the largest share in the global collagen and gelatin market for regenerative medicines in 2016, followed by Europe and Asia-Pacific. The large share of this region is mainly attributed to the increasing prevalence of osteoporosis, chronic wounds, heart diseases; growing meat processing; availability of funding; and presence of many key players in this market. However, Asia Pacific region is expected to witness significant growth during the forecast period due to increasing burden of chronic diseases such as osteoporosis, diabetes, and heart diseases; and growing meat processing.

The key players operating in the global collagen and gelatin market for regenerative medicines are Collagen Solutions Plc (U.S.), Royal DSM (Netherlands), Symatese (France), NuCollagen LLC (U.S.), GELITA AG (Germany), Nitta Gelatin Inc. (Japan), Tessenderlo Group (Belgium), Vornia Biomaterials (Ireland), Advanced BioMatrix (U.S.), Jellagen Pty Ltd (U.K.), EnColl Corporation (U.S.), and XIAMEN HYFINE GELATIN CO., LTD. These vendors have employed various strategies to expand their product and application offerings, global footprint, and augment their market share.

TOP 10 COMPANIES IN COLLAGEN AND GELATIN MARKET FOR REGENERATIVE MEDICINE MARKET

Key questions answered in the report-

Which are the high growth market segments in terms of type, source, application, and regions/countries?

What is the historical market for collagen and gelatin for regenerative medicine across the globe?

What are the market forecasts and estimates from the period 2015-2022?

What are the major drivers, restraints, and opportunities in the global collagen and gelatin market for regenerative medicine?

Who are the major players in the global collagen and gelatin market for regenerative medicineand what share of the market do they hold?

Who are the major players in various countries and what share of the market do they hold?

What are the competitive landscapes and who are the market leaders by sub-region in the global collagen and gelatin market for regenerative medicine?

What are the recent developments in the global collagen and gelatin market for regenerative medicine?

What are the different strategies adopted by the major players in the global collagen and gelatin market for regenerative medicine?

What are the geographical trends and high growth regions/ countries?

Who are the local emerging players in the global collagen and gelatin market for regenerative medicine and how do they compete with the global players?

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Microbubbles/Ultrasound Contrast Agents Market by Therapeutic Area (Cardiovascular Diseases, Renal and Associated Diseases, and others), by Application (Molecular Imaging, Gene Therapy, Drug Delivery, and Stem Cells Delivery) Global Forecasts to 2024

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Collagen and Gelatin Market for Regenerative Medicine is expected to reach USD 709.9 million by 2022 - PharmiWeb.com

The defense team for Jerry Lynn Burns rested its case Thursday, posing questions about whether key DNA evidence is simply circumstantial. The 66-year-old Manchester, Iowa man faces a first degree murder charge in the 1979 killing of Cedar Rapids high schooler Michelle Martinko, who was found stabbed to death in her familys Buick in the parking lot of the Westdale Mall.

Prosecutors have made DNA evidence central to their case against Burns. The defense team has worked to raise questions about whether crime scene materials have been properly handled over the past 40 years, and have questioned whether Burns genetic material could have been transferred to the crime scene by chance.

Analysts from the Iowa Department of Criminal Investigation and private firms engaged by the prosecution have testified that Burns DNA is consistent with a male genetic profile developed from a bloodstain on the dress Martinko was wearing when she died. Jurors have also heard testimony that a partial genetic profile developed from blood found on the car gear shifter is also consistent with Burns DNA.

DCI analyst Linda Sawer identified the profile during tested she conducted in 2005. It wasnt until years later that Cedar Rapids Police Department investigators, led by Officer Matt Denlinger, were able to upload the profile to family genealogy website GEDmatch. On the site they found a second or third cousin once removed of the subject and were able to establish a family tree, which ultimately led them to Burns in 2018.

On Thursday, the defense team called their first and so far only witness, private forensic genetics consultant Michael Spence. He was hired to review the case files, and genetic sampling and analysis conducted by DCI and private firms DNA Labs International and Bode Technology.

"At crime scenes there can be [DNA] transfer events from people who arrive at that crime scene, prior to the crime scene, during the crime scene, after the crime scene, there can be transfer events." - Michael Spence, forensic genetics consultant

Through his questioning of Spence, defense attorney Leon Spies worked to establish that DNA can be transferred from person to person simply in passing. Spence testified that there is a robust body of evidence on the secondary transfer of DNA, when one individuals genetic material is transferred to someone or something else, simply by touching items, or physically being in a place and naturally leaving behind millions of skin cells, each containing DNA.

Shaking hands is an easy example. Hugging, Spence said. If you touch the other people, if they talk around you, if they leave DNA on an item and you come over and sit down next to it or on it, those kinds of things. This is how transfer events do occur.

Spence did not dispute that Burns DNA is consistent with the male genetic profile developed from a bloodstain on Martinkos dress. But based on the genetic analyses that have been conducted, he said its not possible to know the exact sequence of events that night, or to say exactly when Burns DNA came into contact with the dress.

At crime scenes there can be transfer events from people who arrive at that crime scene, prior to the crime scene, during the crime scene, after the crime scene, there can be transfer events, he testified.

Under questioning by Spies, Spence testified that it is within the realm of possibility that Burns DNA ended up on the dress due to a secondary transfer, and not necessarily during the commission of the crime.

Is it, Dr. Spence, a plausible explanation that the DNA of Jerry Burns found on the dress or on the gear shift couldve come about by a transfer? Spies asked him.

Yes, thats a distinct possibility, Spence replied.

"It's extraordinarily difficult to reconstruct what happened 40 years ago, isn't it?" - Leon Spies, defense attorney for Jerry Lynn Burns

During cross examination, prosecutor Nick Maybanks challenged Spence repeatedly, questioning him about the body of peer-reviewed scientific evidence backing up his stances. Maybanks cited multiple journal articles by different authors in his questioning, pressing Spence on the myriad of factors that can affect whether and how much DNA could be transferred during a given interaction.

Through his questioning of Spence, Maybanks worked to establish that people are much more likely to leave behind more DNA by a wet transfer (of blood or other body fluids) than by a dry transfer (such as skin cells deposited during a handshake), as well as when theres a greater level of friction involved, as would occur in a physical attack.

Theres a pretty distinct difference here, that the transfer between wet and dry substances is 44 to 100 percent versus less than a 1 percent respectively, right? Maybanks asked.

It is a higher rate of transfer with body fluids and liquids, yes, Spence replied.

Maybanks questioned Spence on whether hes encountered any evidence supporting how Burns DNA couldve been transferred to the dress (other than by him physically Martinko).

Prosecutors have not been able to establish any previous relationship between Martinko and Burns, characterizing the crime as a random act of violence committed by a stranger."

In this case would you agree that based upon your analysis of the case that you didnt find any evidence whatsoever putting Jerry Burns in a position to transfer DNA other than speculating or creating events that that took place? Maybanks asked Spence.

Well, I refuse to speculate up here, Spence responded. And it would be incredibly difficult to do so, especially with a 40-year-old crime.

The defense team continued to press just this point: how can the prosecution definitively prove exactly what happened on that night in 1979?

Its extraordinarily difficult to reconstruct what happened 40 years ago, isnt it? Spies asked Spence.

Absolutely, Spence replied.

On Thursday, Burns formally waived his right to testify on his own behalf. The trial is slated to continue Friday, when prosecutors will have the chance to call rebuttal witnesses.

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Man Accused Of Killing Martinko Won't Testify As Defense Rests Its Case - Iowa Public Radio

Looking at generations of family is a common way to assume the sex of your child. The four March sisters of Little Women cant be a coincidence, right?

But a new study has found that families arent prone to birthing one sex over another its all up to chance, according to research from the University of Queensland in Australia.

The analysis looked at extensive data of the entire population of Sweden from 1932 to 2000 and challenges other past theories that the sex of a child is inherited.

Sex often refers to biological labels assigned at birth based on genitalia (which can exclude intersex individuals), while gender identity refers to how someone wants to be identified as which can include multiple identities outside of male or female.

Individuals dont have a generic predisposition to have children of a particular sex, said Dr. Brendan Zietsch, co-author of the new findings in a press release.

The chances are more like 51 to 49 of having a boy, but the genes of the mother and father dont play a role. These findings have crucial implications for biological and evolutionary theories of offspring sex ratios, he explained.

The research data pool included every Swede born since 1932, which is around 3.5 million people and their 4.7 million children. Using this information, Zietsch and the other authors determined whether siblings tended to have children of the same sex.

Even though siblings share half their genetics, the study found that when siblings have their own families, they do not have children of the same sex meaning that sex isnt inherited, the researchers explained.

Environment was also a factor taking into consideration, as some theories have examined whether the climate the mother lives in has an impact on the sex of her children. That cant be possible as siblings born and raised identical environments were not any more likely to have girls or boys, said researchers.

Past theories that have been scrutinized, including concepts like tall parents were more likely to have boys, or that attractive people were more likely to have girls have now been proven wrong, said Zietsch.

It was also thought that parents hormone levels at the time of conception were important, he said. Our results rule out all these possibilities.

Some reports from the past year from scientists in Japan found that climate change could impact the newborn sex ratio, with more boys likely to be born with rising temperatures. Another study from the same researches found that events like a major earthquake and added stress around that could impact gestation, as boys are more vulnerable in the womb.

Regardless, a rethink of offspring sex ratio theory is necessary to properly understand why offspring sex ratios appear to vary, for example, across countries, said Zietsch.

- Global News

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BEYOND LOCAL: Having a boy or girl doesn't run in the family, study says - ThoroldNews.com

captionPCOS affect 1 in 10 women of childbearing age.sourceCrystal Cox/Business Insider

Polycystic ovary syndrome, or PCOS, is a hormonal disorder in women that can cause irregular periods, abnormal amounts of facial and body hair, infertility, among other symptoms.

The Office on Womens Health reports that PCOS affects 1 in 10 women of childbearing age from 15 to 44 years old. And as we understand it, is a lifelong disorder, says Richard Legro, MD, Professor of Obstetrics and Gynecology and Public Health Services at the Penn State College of Medicine and Penn State Health.

Heres what you need to know about the causes, symptoms, and symptom relief from PCOS.

The name polycystic ovary syndrome is a slight misnomer because it doesnt involve traditional ovarian cysts. Instead, people affected by PCOS often have a larger-than-average number of tiny follicles in their ovaries that look like small cysts but are not like traditional ovarian cysts. These follicles grow but never fully develop to release eggs. And if no eggs are released, you dont ovulate.

The follicles themselves arent dangerous but the hormonal imbalance they cause can wreak havoc with the persons menstrual cycle. Your body may not produce enough of the female reproductive hormone progesterone to maintain a normal menstrual cycle. As a result, PCOS is the most common cause of infertility in women, according to the Endocrine Society.

Though the exact causes of PCOS are unknown, genetics seem to play a key role, though more research is needed to understand by how much this increases a persons risk.

There is also some evidence that environmental factors including exposure to toxins in the environment like plasticizers may contribute to the condition in rare instances.

Obesity has long been thought to be a cause of PCOS, but it may be the case that obesity only aggravates the condition, rather than causes it. That could be because PCOS causes insulin resistance in the body. Regardless of BMI, all women with PCOS have a degree of insulin resistance, but obesity seems to make the condition worse.

Many of the symptoms associated with PCOS are the result of an increase in male hormones, such as testosterone.

Thats because many people with PCOS have insulin resistance in their body, which inhibits the process of sending glucose to cells. As a result, the pancreas has to produce more insulin, which causes problems for the endocrine system and leads the body to ramp up the production of androgens, aka male hormones.

Consequently, you may start having very irregular periods or even stop having periods altogether. You may also put on some extra weight although not every woman with PCOS gains weight.

This excessive amount of androgens also tend to cause you to develop a few other symptoms, notably extra hair on your body and face. The extra hair is what Dr. Legro calls male-patterned hair. Meaning youre not developing a fine layer of hair all over your body. Its hair that appears in areas where men grow body hair, like the middle of the chest, the midline, and the back.

Excess facial hair, hair thinning and balding: thats not normal, says Dr. Legro. Get investigated.

While theres no cure for PCOS, the symptoms of the condition can be abated with various treatments. These treatments include weight loss, birth control pills, and anti-androgen medications.

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What is PCOS? Symptoms and treatments for polycystic ovary syndrome - Business Insider