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Meet the Culprits of Cell Culture Contamination – Technology Networks

Posted: January 24, 2020 at 12:47 am

The air is warm and humid, there is an abundance of food, and your friends come and go with their shiny toys. What sounds like a dreamy summer holiday is also the reality of in vitro cell culture experiments, and a golden opportunity for contaminants to intrude. Every person, reagent, and piece of equipment in the laboratory is a potential vehicle for invasive microbes, unwelcome cells and chemical impurities, which can create costly issues in both bench research and manufacturing. Cell culture contamination is a problem on many levels, creating immediate implications for experiments and wider issues for the scientific community.Consequences of cell culture contaminationContaminants can affect all cell characteristics (e.g. growth, metabolism, and morphology) and contribute to unreliable or erroneous experimental results. Cell culture contamination will likely create a need for experiments to be repeated, resulting in frustrating time delays and costly reagent wastage. Data derived from undetected contaminated cultures can end up published in scientific journals, allowing others to build hypotheses from dubious results. The pervasiveness of cross-contaminated and misidentified cell lines is a decades-long issue; in 1967, cell lines thought to be derived from various tissues were shown to be HeLa cells, a human cervical adenocarcinoma cell line.1 However, studies involving these misidentified cell lines continued to feature in hundreds of citations during the early 2000s.2This pattern is a well-acknowledged problem and threatens to undermine scientific integrity. The first published retraction in Nature Methods was due to cell line contamination3, and one conservative estimate of contaminated literature in 2017 found 32,755 articles reporting on research with misidentified cells.4 While many scientists may have been blissfully ignorant in the past, awareness of misidentified cell lines is growing.Deciding how best to deal with this knowledge is not straightforward and has been discussed extensively.4 In the interest of preventing further data contamination, a certificate of authentication of the origin and identity of human cells is now required by the International Journal of Cancer, and encouraged by funding agencies. Others have questioned whether mandatory testing really is the best way forward.3But what should be done about existing contaminated literature? Mass retraction of affected articles may disproportionately punish the careers of a few scientists, and could be a waste of resources containing potentially valuable data. One recently proposed system of self-retraction recommends replacing blame with praise in order to encourage self-correction.5 Post hoc labeling of published articles in the form of an expression of concern allows existing findings to remain accessible, while giving readers a chance to form their own judgement.

Lastly, pathogens carried by cells (either intentionally or accidentally) or in components of the culture medium are potential health hazards, and laboratory-acquired viral infections have been reported.6-8 Indeed, the stakes are higher when cells are to be introduced into patients, highlighting the critical importance of quality control in cell therapies.

While pipetting is a key part of everyday laboratory work, it is also one of the stages most prone to contamination. As sample contamination can affect the reliability of results, it is important to know how it can be avoided, saving both time and money. Download this poster for ten tips to avoiding contamination in pipetting.

Avoid leaving your cultures out of the incubator for extended periods

Label all cultures clearly and unambiguously

Disinfect work surfaces before and after use

Check disinfectants are effective and appropriate choices for the job

Work with only one cell culture at a time

Use separate media and reagents for each individual cell line

Quarantine new cell lines until tested negative for mycoplasma

Avoid overusing and relying on antibiotics

Record how long a cell line has been kept in cultureThe design of the laboratory can also play a role; cabinets should be placed away from through-traffic, doors and air-conditioning inlets.6 Restricting area access to allow only essential laboratory personnel to enter reduces disturbances of airflow around the microbiological safety cabinet.

Water baths, CO2 incubators, shelves and water pans are common culprits and should be cleaned or autoclaved regularly, using a chemical disinfectant where appropriate. Other routes of infection include accidental spillages, contact with non-sterile surfaces, splash-back from pipetting or pouring, microscopic aerosol, and infestation by vertebrates, dust and mites.Research groups isolating stem cells use unique cell properties to filter out undesired cells, explains Dr Mei-Ju Hsu, postdoctoral researcher in stem cell therapy at Leipzig University. Dr Hsu notes that: one of the most important features of mesenchymal stem cells is the attachment and growth on the plastic surfaces without prior coating. This step serves as a good way to eliminate the non-adherent cells (e.g. blood cells) by the removal of supernatants.

Mycoplasma is one of the most common cell culture contaminants, with six species of mycoplasma accounting for 95% of all contamination. Therefore, it is important to improve our understanding of where mycoplasma contamination can stem from and how best to prevent it. Download this infographic to discover more about mycoplasma contamination in cell culture labs.

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Celularity Announces FDA Clearance of Landmark IND for CYNK-001, an Allogeneic, Off-the-Shelf Cryopreserved NK Cell Therapy | DNA RNA and Cells | News…

Posted: January 24, 2020 at 12:47 am

DetailsCategory: DNA RNA and CellsPublished on Wednesday, 22 January 2020 18:41Hits: 421

WARREN, NJ, USA I January 22, 2020 I Celularity, Inc. (Celularity or the Company), a clinical-stage company developing allogeneic cellular therapies from human placentas, today announced the U.S. Food and Drug Administration (FDA) has cleared the Companys Investigational New Drug (IND) Application for CYNK-001 in patients with glioblastoma multiforme (GBM).

The clinical investigation of CYNK-001 in patients with GBM is expected to be the first clinical trial in the U.S. to investigate intratumoral administration of an allogeneic NK cell therapy. The Company plans to initiate first-in-human clinical testing of CYNK-001 administered either intravenously or intratumorally. This study is expected to evaluate the safety, feasibility, and tolerability of multiple doses of CYNK-001 in subjects with relapsed GBM.

The FDA clearance of our IND validates the versatility of our allogeneic, off-the-shelf, placental-derived NK cell therapy platform to generate novel clinical candidates against a broad range of devastating cancers. This IND represents a significant step toward a potential immunotherapy option that is more accessible and tolerable to patients with glioblastoma multiforme, said Robert Hariri, M.D., Ph.D., Founder, Chairman and CEO at Celularity. We will continue to work diligently to advance our investigational and development programs, and to deliver the next-generation of scalable, high quality immunologic approaches for the treatment of devastating cancers.

Nonclinical safety and efficacy data presented at the 2019 Society for Neuro-Oncology (SNO) Annual Meeting, demonstrated that a single administration of CYNK-001 was well-tolerated and showed enhanced in vivo anti-tumor activity against glioblastoma multiforme (GBM). CYNK-001 is currently being investigated as a treatment for acute myeloid leukemia (AML), multiple myeloma (MM), and as a potential treatment option for various solid tumors.

About CYNK-001 CYNK-001 is the only cryopreserved allogeneic, off-the-shelf NK cell therapy being developed from placental hematopoietic stem cells as a potential treatment option for various hematologic cancers and solid tumors. NK cells are a unique class of immune cells, innately capable of targeting cancer cells and interacting with adaptive immunity. NK cells derived from the placenta are intrinsically safe and versatile, allowing potential uses across a range of organs and tissues.

About Celularity Celularity, headquartered in Warren, N.J., is a clinical-stage cell therapeutics company delivering transformative allogeneic cellular therapies derived from the postpartum human placenta. Using proprietary technology in combination with its IMPACT platform, Celularity is the only company harnessing the purity and versatility of placental-derived cells to develop and manufacture innovative and highly scalable off-the-shelf treatments for patients with cancer, inflammatory and age-related diseases. To learn more, please visit http://www.celularity.com.

SOURCE: Celularity

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Celularity Announces FDA Clearance of Landmark IND for CYNK-001, an Allogeneic, Off-the-Shelf Cryopreserved NK Cell Therapy | DNA RNA and Cells | News...

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Cell therapy trialed in mice offers diabetes treatment hope – SelectScience

Posted: January 24, 2020 at 12:47 am

New cell treatment could help maintain healthy blood sugar levels

A new cell treatment to enhance islet transplantation could help maintain healthy blood sugar levels in Type 1 diabetes without the need for multiple transplants of insulin producing cells or regular insulin injections, research suggests.

In Type 1 diabetes the insulin-producing cells of the pancreas are destroyed. Insulin injections maintain health but blood glucose levels can be difficult to control. Currently in the UK it is estimated that approximately 400,000 people in the UK have type 1 diabetes.

The current recommendation for people with type 1 diabetes who have lost awareness of low blood glucose levels is the transplantation of islets the insulin producing part of the pancreas.

A study in mice found that transplanting a combination of islets with connective tissue cells found in umbilical cords known as stromal cells - could potentially reduce the number of pancreases required for the procedure.

Mice that received the islet-stromal cell combination were found to have better control of blood glucose and less evidence of rejection of islets after seven weeks, compared to those that received islets alone.

In humans, more than two donor pancreases, which are scarce, are often needed because islets can be rejected and are slow to form new blood supplies.

Therefore, multiple islet transplantations and anti-rejection medication are required to control blood sugar levels in people with Type 1 diabetes. Scientists at the University of Edinburgh hope their findings could be a way of overcoming these issues.

The researchers found that islets combined with stromal cells successfully returned normal blood glucose levels just three days after transplantation.

Other studies have used cells sourced from bone marrow and fat. This is the first to use stem cells from umbilical cords and has produced superior results.

The research is published in the journal Science Translational Medicine and funded by Chief Scientist Office in Scotland and Diabetes UK.

Shareen Forbes, Professor of Diabetic Medicine at the University of Edinburgh and Lead Physician for the Islet Transplant Program in Scotland, said: Should this research prove successful in humans, we could reduce the number of islets needed to control blood sugar levels using this co-transplantation approach. This would mean more people with Type 1 diabetes could be treated using islet transplantation while significantly reducing the waiting time on the transplant list.

John Campbell, Professor and Associate Director Tissues, Cells & Advanced Therapeutics at the Scottish National Blood Transfusion Service has said that further work is needed to establish the long-term safety of using this type of stromal cell in this setting before proceeding to clinical trials in humans.

Dr. Elizabeth Robertson, Director of Research at Diabetes UK, said: Islet transplants have been life changing for some people with Type 1 diabetes, treating dangerous hypo unawareness. But there currently arent enough donated pancreases to go around, and the procedure itself isnt yet as effective as it could be.

This new research from the University of Edinburgh is a promising step forward, and one we hope will lead to islet transplants becoming both more effective and more widely available in the future.

Register for your free SelectScience membership today to receive the latest editorial articles and technology news direct to your inbox>>

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Gene Therapy for Sickle Cell Disease Receives Orphan Drug Designation – Monthly Prescribing Reference

Posted: January 24, 2020 at 12:47 am

Home News Drugs in the Pipeline

The Food and Drug Administration has granted Orphan Drug designation to ARU-1801 (Aruvant) for the treatment of sickle cell disease.

The investigational gene therapy is expected to increase functioning red blood cells through proprietary technology that inserts a modified fetal hemoglobin gene into autologous stem cells via a lentiviral vector. A phase 1/2 clinical study in 10 individuals with sickle cell disease is currently examining the efficacy and safety of ARU-1801.

For patients suffering from sickle cell disease, we believe the ultimate promise of gene therapy is a one-time cure without the side effect profile of high intensity myeloablative conditioning. We are committed to providing patients with that option and look forward to presenting more data on our Reduced Intensity Conditioning (RIC) approach, said Will Chou, MD, Chief Executive Officer of Aruvant.

Orphan Drug status is granted to new therapies that treat diseases impacting 200,000 individuals in the US.

For more information visit aruvant.com.

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Global Animal Stem Cell Therapy Market Trends, Size, Analysis and Forecast from 2020 to 2025 – Fusion Science Academy

Posted: January 24, 2020 at 12:47 am

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The various contributors involved in the value chain of the product include manufacturers, suppliers, distributors, intermediaries, and customers. The key manufacturers in this market includeABBHoneywell InternationalSchneider ElectricSiemens AGSTMicroelectronicsTexas Instrument IncorporatedArveniCymbet CorporationFujitsu LimitedMicrochip TechnologyNextreme Thermal SolutionsEnocean GmbhG24 InnovationsBy the product type, the market is primarily split intoLight Energy HarvestingElectromagnetic Energy HarvestingVibration Energy HarvestingThermal Energy HarvestingOther

By the end users/application, this report covers the following segmentsConsumer ElectronicsBuilding and Home AutomationIndustrialTransportation and SecurityOther

We can also provide the customized separate regional or country-level reports, for the following regions:North AmericaUnited StatesCanadaMexicoAsia-PacificChinaJapanSouth KoreaIndiaAustraliaIndonesiaThailandMalaysiaPhilippinesVietnamEuropeGermanyFranceUKItalyRussiaCentral & South AmericaBrazilMiddle East & AfricaTurkeyGCC CountriesEgyptSouth Africa

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To split the breakdown data by regions, type, companies and applications

To analyze the global and key regions Energy Harvesting market potential and advantage, opportunity and challenge, restraints and risks.

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Global Animal Stem Cell Therapy Market Trends, Size, Analysis and Forecast from 2020 to 2025 - Fusion Science Academy

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Stem Cell Therapy Market : Segmentation, Industry Trends and Development to 2019-2026 – Fusion Science Academy

Posted: January 24, 2020 at 12:47 am

In this report, the global Energy Harvesting market is valued at USD XX million in 2019 and is projected to reach USD XX million by the end of 2025, growing at a CAGR of XX% during the period 2019 to 2025.

For top companies in United States, European Union and China, this report investigates and analyzes the production, value, price, market share and growth rate for the top manufacturers, key data from 2019 to 2025.

The Energy Harvesting market report firstly introduced the basics: definitions, classifications, applications and market overview; product specifications; manufacturing processes; cost structures, raw materials and so on. Then it analyzed the worlds main region market conditions, including the product price, profit, capacity, production, supply, demand and market growth rate and forecast etc. In the end, the Energy Harvesting market report introduced new project SWOT analysis, investment feasibility analysis, and investment return analysis.

Request Sample Report @ https://www.marketresearchhub.com/enquiry.php?type=S&repid=2590410&source=atm

The major players profiled in this Energy Harvesting market report include:

Geographically, this report is segmented into several key regions, with sales, revenue, market share and growth Rate of Energy Harvesting in these regions, from 2014 to 2025, coveringNorth America (United States, Canada and Mexico)Europe (Germany, UK, France, Italy, Russia and Turkey etc.)Asia-Pacific (China, Japan, Korea, India, Australia, Indonesia, Thailand, Philippines, Malaysia and Vietnam)South America (Brazil etc.)Middle East and Africa (Egypt and GCC Countries)

The various contributors involved in the value chain of the product include manufacturers, suppliers, distributors, intermediaries, and customers. The key manufacturers in this market includeABBHoneywell InternationalSchneider ElectricSiemens AGSTMicroelectronicsTexas Instrument IncorporatedArveniCymbet CorporationFujitsu LimitedMicrochip TechnologyNextreme Thermal SolutionsEnocean GmbhG24 InnovationsBy the product type, the market is primarily split intoLight Energy HarvestingElectromagnetic Energy HarvestingVibration Energy HarvestingThermal Energy HarvestingOther

By the end users/application, this report covers the following segmentsConsumer ElectronicsBuilding and Home AutomationIndustrialTransportation and SecurityOther

We can also provide the customized separate regional or country-level reports, for the following regions:North AmericaUnited StatesCanadaMexicoAsia-PacificChinaJapanSouth KoreaIndiaAustraliaIndonesiaThailandMalaysiaPhilippinesVietnamEuropeGermanyFranceUKItalyRussiaCentral & South AmericaBrazilMiddle East & AfricaTurkeyGCC CountriesEgyptSouth Africa

You can Buy This Report from Here @ https://www.marketresearchhub.com/checkout?rep_id=2590410&licType=S&source=atm

The study objectives of Energy Harvesting Market Report are:

To analyze and research the Energy Harvesting market status and future forecast in United States, European Union and China, involving sales, value (revenue), growth rate (CAGR), market share, historical and forecast.

To present the Energy Harvesting manufacturers, presenting the sales, revenue, market share, and recent development for key players.

To split the breakdown data by regions, type, companies and applications

To analyze the global and key regions Energy Harvesting market potential and advantage, opportunity and challenge, restraints and risks.

To identify significant trends, drivers, influence factors in global and regions

To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the Energy Harvesting market.

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Stem Cell Therapy Market : Segmentation, Industry Trends and Development to 2019-2026 - Fusion Science Academy

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The selling of CTE: How the ‘Concussion’ doctor has built a career on distorted science – Stars and Stripes

Posted: January 24, 2020 at 12:45 am

In 2017, Bennet Omalu traveled the globe to accept a series of honors and promote his autobiography, "Truth Doesn't Have A Side."

In a visit to an Irish medical school, he told students he was a "nobody" who "discovered a disease in America's most popular sport."

In an appearance on a religious cable TV show, he said he named the disease chronic traumatic encephalopathy, or CTE, because "it sounded intellectually sophisticated, with a very good acronym."

And since his discovery, Omalu told "Sports Illustrated," researchers have uncovered evidence that shows adolescents who participate in football, hockey, wrestling and mixed martial arts are more likely to drop out of school, become addicted to drugs, struggle with mental illness, commit violent crimes and kill themselves.

A Nigerian American pathologist portrayed by Will Smith in the 2015 film, "Concussion," Omalu is partly responsible for the most important sports story of the 21st century. Since 2005, when Omalu first reported finding widespread brain damage in a former NFL player, concerns about CTE have inspired a global revolution in concussion safety and fueled an ongoing existential crisis for America's most popular sport. Omalu's discovery initially ignored and then attacked by NFL-allied doctors inspired an avalanche of scientific research that forced the league to acknowledge a link between football and brain disease.

Nearly 15 years later, Omalu has withdrawn from the CTE research community and remade himself as an evangelist, traveling the world selling his frightening version of what scientists know about CTE and contact sports. In paid speaking engagements, expert witness testimony and in several books he has authored, Omalu portrays CTE as an epidemic and himself as a crusader, fighting against not just the NFL but also the medical science community, which he claims is too corrupted to acknowledge clear-cut evidence that contact sports destroy lives.

After more than a decade of intensive research by scientists from around the globe, the state of scientific knowledge of CTE remains one of uncertainty. Among CTE experts, many important aspects of the disease from what symptoms it causes, to how prevalent or rare it is remain the subject of research and debate.

But across the brain science community, there is wide consensus on one thing: Omalu, the man considered by many the public face of CTE research, routinely exaggerates his accomplishments and dramatically overstates the known risks of CTE and contact sports, fueling misconceptions about the disease, according to interviews with more than 50 experts in neurodegenerative disease and brain injuries, and a review of more than 100 papers from peer-reviewed medical journals.

Omalu did not discover CTE, nor did he name the disease. The alarming statistics he recites about contact sports are distorted, according to the author of the studies that produced those figures. And while Omalu cultivates a reputation as the global authority on CTE, it's unclear whether he is diagnosing it correctly, according to several experts on the disease.

Omalu's definition for CTE, as described in his published papers, is incredibly broad and all-encompassing, describing characteristics that can be found in normal, healthy brains, as well as in other diseases, according to experts including Ann McKee, lead neuropathologist for Boston University's CTE Center.

"His criteria don't make sense to me," McKee said. "I don't know what he's doing."

McKee's assessment was supported by three neuropathologists who worked with her to develop guidelines for diagnosing CTE used by researchers around the world.

"My God, if people were actually following [Omalu's] criteria, the prevalence of this disease would be enormous, and there's absolutely no evidence to support that," said Dan Perl, one of those experts and professor of pathology at the Uniformed Services University.

McKee and other experts confirmed, in interviews, something that long has been an open secret in the CTE research community: Omalu's paper on Mike Webster the former Pittsburgh Steelers great who was the first NFL player discovered to have CTE does not depict or describe the disease as the medical science community defines it.

McKee and other experts believe Webster had CTE, based on his history of head trauma and his mental disorders. But the paper Omalu published shows images that are not CTE and could have come from the brain of a healthy 50-year-old man, they said.

"This is the problem," McKee said. "People lump me with him, and they lump my work with him, and my work is nothing like this."

Omalu declined several requests for an interview and refused to answer any questions for this report. In an email, he dismissed questions raised by experts as coming from "a minority of doctors who are seeking very cheap and bogus popularity ... who work directly or indirectly with these sports organizations."

"Your paper engaging in such bogus controversies will bolster some people's allegations of 'Fake News,' " Omalu wrote.

This is typically how Omalu responds to criticism: by claiming it comes from scientists corrupted by relationships with sports leagues. But his depiction of the science of CTE and his prominence in the CTE research community have yielded his own financial benefits.

Billing himself as the man who discovered CTE, Omalu has built a lucrative business as an expert witness for hire in lawsuits including in the growing CTE-related litigation field charging a minimum of $10,000 per case, according to his testimony. He also maintains a busy schedule of paid speaking engagements, charging $27,500 per appearance, records show, as he delivers his sermon against contact sports.

A deeply religious man, Omalu has said he believes he is on a mission from God, and he views scientists who question him with suspicion and hostility.

"As a Christian, I believe after death there is judgment," Omalu told a lawyer in a deposition once, when asked about experts who raised doubts about his theories. "They will all answer for this on judgment day."

***

Omalu first drew national news attention in 2007 as the diminutive, quirky local coroner in Pittsburgh declaring he had identified a new brain disease in former NFL players.

"We are calling it football-induced chronic traumatic encephalopathy," Omalu told ESPN.

Contrary to Omalu's claims, doctors have been studying what we now call CTE since 1928, when New Jersey pathologist Harrison Martland described a phenomenon he observed among several boxers that he termed "punch drunk."

Over the next 70 years, doctors around the globe encountered similar ailments in boxers, and the syndrome became commonly known as "dementia pugilistica." In 1949, British neurologist MacDonald Critchley was the first to use the term chronic traumatic encephalopathy. By the early 2000s, the term CTE was in common usage among the then-small community of experts who researched the disease.

In 2005, Omalu published his first paper, in collaboration with doctors at University of Pittsburgh Medical Center, reporting he found CTE in Webster, who had died of a heart attack after enduring an array of behavioral disturbances for years after his retirement.

To the medical science community, the significance of Omalu's paper was that CTE had been found for the first time in a former NFL player. But over the years, Omalu has repeatedly claimed that he discovered CTE.

"I said to myself ... you need to give it a sexy name," Omalu said in 2013. "You need to give it a name that has a good acronym that people would remember. ... That was how CTE came about."

In 2009, McKee and her colleagues at BU published their first CTE paper, describing what they found in the brains of two former boxers and a former NFL player John Grimsley, a linebacker for the Houston Oilers and Miami Dolphins. McKee's paper described the long history of CTE research and referenced Omalu's Webster paper.

In "Truth Doesn't Have A Side," Omalu falsely accused McKee of trying to take credit for his discovery, referring to her as "the blonde white woman who claimed she discovered CTE."

Asked by email whether she ever has claimed to have discovered CTE, McKee replied: "Ha. No."

Steven DeKosky, a neurologist and deputy director of the McKnight Brain Institute at the University of Florida, was one of Omalu's early collaborators. In a phone interview, DeKosky said he and Omalu knew in 2005 they had not discovered a new disease. DeKosky knew the disease as dementia pugilistica, however, and agreed with Omalu that they should rename it because Webster hadn't been a boxer. Omalu suggested CTE.

DeKosky believed then that Omalu had come up with the name, he said, until he later learned researchers had been using the term for years.

"I was a bit embarrassed," DeKosky said. He said he has no idea why Omalu continues to claim he discovered and named the disease.

"Maybe, like me, he just didn't realize that it had been called by that same name before," DeKosky said. "He's a complex guy. All of us are."

In a 2018 deposition in a CTE-related lawsuit against the NCAA, Omalu acknowledged he did not discover CTE.

"Some people who give me credit of discovering CTE, that is not true, really," he said. Later, Omalu said he had only been "successful in rebranding this disease concept."

***

CTE became a national news story in 2009 as Omalu and McKee diagnosed the disease in several former NFL players who died young, prompting congressional hearings.

As Omalu and McKee publicized their findings, they dealt with attacks from NFL-allied doctors. Scientists who wanted to conduct their own CTE research, meanwhile, dealt with another problem: Omalu and McKee had different definitions for what CTE looked like and how to diagnose it, a disagreement they have never resolved.

Omalu often uses the phrase "tested positive for CTE," implying the diagnostic process is black and white, akin to a pregnancy test. In reality, diagnosing CTE is far more complicated, more like looking out into a starry night and spotting a constellation.

There is no reliable technology to detect CTE in the living; the disease can be diagnosed only after someone dies and their brain can be dissected and analyzed.

CTE is marked by accumulations of an abnormal or defective form of a protein called tau in the brain. Tau is a normal protein found in the brain and the central nervous system that has a stabilizing effect on cells.

Tau can become abnormal, however, and clump into formations called tangles.

This can happen as people get older, and small amounts of abnormal tau in the brain are thought by some experts to be benign and part of the aging process. In significant amounts, however, abnormal tau is a sign of brain damage or disease, such as Alzheimer's disease, as well as CTE.

Even under the microscope, diagnosing CTE is complicated by another factor: Abnormal tau is also found in more than a dozen other diseases. Tau also accumulates in healthy brains as people age, with no apparent effect on brain function or behavior.

Scientists can distinguish brains with benign accumulations of abnormal tau from brains with damage and disease based on the amount, pattern and location of the tau, among several factors.

In 2014, the National Institutes of Health stepped in to answer the question of how to diagnose CTE by funding a study overseen by McKee and seven other neuropathologists from around the world. They concluded that CTE's unique characteristic its signature, essentially is clusters of tau around blood vessels deep in the folds of the cortex, the brain's outermost region. CTE experts around the globe use this definition in their research.

Omalu's definition for CTE, described in his published papers, is different than the NIH's definition. Omalu has identified four types of CTE. In interviews with The Washington Post, experts said two of Omalu's types could be CTE. The other two types, however, experts found problematic.

Omalu's third CTE type is marked by "moderate to frequent" tau tangles in the brain stem, and "none to sparse" tau tangles in the cerebral cortex. Brains can develop tau in these areas through normal aging, experts said, as well as through other diseases.

Omalu's fourth CTE type, which he called "incipient CTE," is marked by "a combination of none to sparse" tau tangles in the cerebral cortex, brainstem and basal ganglia. Tau also can accumulate, in small amounts, in these areas through normal aging and other diseases.

Experts found Omalu's fourth type nonsensical, noting that, as written, it suggested he would diagnose CTE in a brain with no tau.

"It sort of sounds like he's saying, if you had someone who had a history of playing contact sports, it's OK to diagnose them with CTE even if you don't have any" tau, said Perl, an internationally known expert in brain diseases. "That doesn't make any sense."

In a deposition in 2018, Omalu displayed ambivalence when asked whether he followed the NIH guidelines.

"The final decision is still with the doctor who is examining," Omalu said. "Not every CTE case will have all those guidelines."

McKee said she does not believe what Omalu calls "incipient CTE" is actually CTE.

"His criteria for diagnosing CTE are all over the map," McKee said.

McKee and other experts in brain disease have held doubts about Omalu's diagnostic methods since his first, and most famous, CTE paper.

***

The tragic decline of the man known around Pittsburgh as "Iron Mike" has been told and retold over the years, in magazine articles, books and in the opening scenes of "Concussion."

Before he died in 2002, at 50, Webster had struggled for years with depression, paranoia and chronic pain so agonizing that he sometimes needed to shock himself unconscious with a stun gun just to get some sleep.

CTE experts, in interviews, did not dispute football damaged Webster's brain. He probably played through many concussions, and the NFL's retirement board acknowledged Webster suffered from football-related brain damage in 1999.

But whether the man who was essentially "Patient Zero" for CTE in football actually had the disease, according to experts, is an unanswered question.

In medical research papers, it is customary to publish, as photos, the most compelling, striking images that depict the paper's subject. The images Omalu published in the Webster paper do not show CTE, nor do they show alarming amounts of tau for a 50-year-old man, experts said.

The images show tau in formations called tangles. One image shows a single tangle, highly magnified, and another shows a similarly magnified image of two tangles, according to the paper. Both images come from the cortex.

McKee and other experts said one or two tangles can be found in the cortexes of otherwise healthy 50-year-olds. If surrounded by several other tangles, they could be part of a disease. But in isolation, they could be benign. It was as if Omalu had claimed to have found a rare species of bird and then, as proof, published a paper that included only a few close-up images of the tip of the beak.

In the text of the paper, Omalu described more tau than doctors would expect to find in the brain of a 50-year-old, experts said, but for reasons he has never explained, he selected images that could have come from the brain of a healthy 50-year-old man.

"What Omalu described is just some tau ... [with] not enough details to know what kind of tau it was or what the disease was. ... From reading that paper, I would have no idea the guy had CTE," McKee said.

"I'm 50. I would expect my brain would have a few tangles here and there," said Willie Stewart, Britain's leading CTE researcher, a neuropathologist and honorary clinical associate professor at the University of Glasgow. "The images that Bennet has in that paper, they don't show CTE."

In interviews, two of Omalu's co-authors had conflicting memories about what they saw in Webster's brain.

DeKosky, the Florida neurology professor, said he recalls seeing the signature CTE pattern but was unsure why the correct images weren't selected for the paper. Ronald Hamilton, a retired former Pittsburgh neuropathologist, said he does not recall seeing the signature pattern and no longer has his research material from the case.

"There's a 100 percent chance" Webster had CTE, Hamilton said. "But, yes, I can't prove it."

There is one other person who examined Webster's brain tissue in the 2000s. But his recollection of what he saw only deepens the mystery.

In 2008, Peter Davies, an Alzheimer's researcher and professor at the Albert Einstein College of Medicine in New York, met with Omalu, who let him take some tissue from Webster's brain, as well as from five of his other early CTE cases, back to his lab.

Davies said Omalu was right; Webster did have a disease he had never seen, with "buckets of tau." Tissue from two of the other brains one from another former NFL player, the other from a former professional wrestler also had the same widespread tau.

Davies believes, however, that the disease he saw in Webster's brain and the two others was "extremely rare" and different from the CTE described by other researchers, because of the overwhelming amount of tau he saw under the microscope.

"In my mind, it's a separate disease," Davies said.

The reason Omalu picked the wrong images, Davies said, was that Omalu "was not any kind of an expert."

"He would be very upset to hear me say something like that," Davies said.

BU's McKee has never examined Webster's brain, but she said she has asked doctors at Pittsburgh labs where Omalu worked if they know where the tissue is, with no success.

In "Truth Doesn't Have A Side," Omalu wrote that he confiscated the Webster tissue and other CTE brains from the coroner's office in Pittsburgh because of an attempt by "detractors" to destroy them. DeKosky said he believes Omalu still has Webster's brain, either at his home or in his private lab outside Sacramento, California.

Omalu has not published a paper describing refinements to his definition for CTE since 2011. He continues to examine brains of suspected CTE cases, however, and his diagnoses prompt lawsuits and news coverage.

***

In Omalu's words, CTE is an epidemic, a risk for anyone who plays any contact sport, at any level, and likely affecting every former NFL player.

"No single concussion is safe regarding the risk of developing gridiron dementia," Omalu wrote in his first book, "Play Hard, Die Young."

"I believe there is a very good chance that every person who plays (or has played or will play) in the NFL will suffer from some degree of CTE," he wrote in "Truth Doesn't Have A Side."

In recorded medical literature, there are no documented cases of someone developing CTE from a single concussion. And while mounting scientific evidence suggests CTE is a significant risk for NFL players, studies examining groups of athletes who played other sports suggest it remains possible, if not likely, that Omalu is significantly overestimating the population potentially afflicted with CTE.

Several studies have found former NFL players die with brain disease at significantly higher rates than comparison populations, but nothing approaching 100%, with figures ranging from 5% to 8%. There have been no published studies examining rates of brain disease among former college football players, but one sizable research project, overseen by the NCAA and the Department of Defense, is underway. Three studies of former high school football players who played in Minnesota and Wisconsin between 1946 and 1970 found they had no higher rates of brain disease than their classmates.

Studies examining the rates of brain disease among athletes who played other sports have produced mixed results. A study published late last year of thousands of former professional soccer players in Scotland found higher rates of players dying with brain disease 11.4% among soccer players, compared with 3.2% among the general population. But smaller studies examining groups of former NHL players and professional rugby players found no signs of higher rates of brain disease.

At BU, McKee and her colleagues focus criticism on football, which they believe has a relationship with CTE similar to smoking and cancer. They support banning tackle football before age 12 and rules changes in other sports to reduce head hits. They have not echoed Omalu's call for the abolition of youth wrestling, hockey and mixed martial arts.

"I don't know where he's coming up with those recommendations," McKee said. "I don't think he is basing them on any data."

Omalu repeatedly has cited data that he claims show children who play these sports are at increased risk to see their lives unravel from mental illness, substance abuse or other struggles.

"Studies have shown that if a child plays a high-impact, high-contact sport," Omalu wrote in "Truth Doesn't Have A Side," "that child stands a higher risk of dropping out of high school, not attending college, not doing well in life . . . developing psychiatric and psychological problems ... and even dying at a younger age."

No studies have found that merely playing a contact sport increases the risk of the tragic life outcomes Omalu has described. In some settings, when citing these figures, he has mentioned "a paper that came out of Sweden." This appears to be a reference to research led by Seena Fazel, professor of forensic psychiatry at the University of Oxford, examining what happened to more than 1.1 million people in Sweden who suffered brain injuries before turning 25.

Fazel was unaware of how Omalu had been interpreting his studies until contacted by a reporter last year.

"That's definitely not what we said. ... You can't extrapolate that from our work," Fazel said in a phone interview.

Fazel's research examined a population that included people who had suffered concussions in sports but also people who had survived much more severe injuries, such as head impacts during car crashes that resulted in lengthy hospitalizations.

"We're not just talking about someone who's had a bang on the head at a sports match. ... We're talking about the more severe end of the spectrum," Fazel said. "These papers don't say, 'Don't play sports.' ... They support good [head safety] policies in sports."

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The selling of CTE: How the 'Concussion' doctor has built a career on distorted science - Stars and Stripes

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HEALTH: Timing and food can be important in effectiveness of Viagra – Rockdale Newton Citizen

Posted: January 24, 2020 at 12:44 am

DEAR DR. ROACH: My husband and I are very fortunate to have had a happy relationship for many years. Our lovemaking has always been a pleasure for both of us. Now, we have to add Viagra to the mix. Sometimes it works; sometimes it doesnt, which is a disappointment to both of us. Is there anything we can do to enhance its effectiveness? Or is there something else you can recommend that would do what we wish Viagra would do consistently? Anon.

ANSWER: Sildenafil (Viagra) and similar medicines have been very effective treatment for many men who have difficulty achieving and maintaining adequate erections for sexual intercourse. However, they are not effective for all men, and many people have a misunderstanding about how they work.

Most importantly, Viagra does not increase libido, the desire for sexual contact, in men or women. It works by changing the way blood flows in and out of the penis. Erectile dysfunction can be caused by circulation problems such as blockages in the arteries; neurological problems; endocrine problems, especially low testosterone; and relationship issues. Viagra helps to some extent for men with any of these problems, but its worth reconsidering whether there is an underlying medical issue going on, both before prescribing it and periodically while taking it, especially if it doesnt seem to be working as well.

Still, oftentimes the problem with Viagra working intermittently is that it is affected by food, which many men dont appreciate fully. Food slows down absorption of the medication, making the optimal time of administration more difficult to determine.

I have often repeated the advice I heard from a urologist: Take Viagra at 6, have dinner at 7, and you are good until midnight. Viagra does become progressively less effective in some men, requiring higher doses to have the same results. Or, your husband could switch to one of the other Viagra-like drugs, which have greater flexibility with timing and food. They work better for some men.

DEAR DR. ROACH: I am a 69-year-old male in good health except for a low testosterone count of 109 on a recent test. I am wondering about the benefits and risks of therapy. I have read that injection can lead to very high and then very low counts, but the patch can be potentially dangerous to my spouse. Can you clarify these issues for me?

ANSWER: Testosterone is an important hormone for men and women, although men have much higher levels. It has many critical functions. This includes promoting bone and muscle strength, and generally favorable effects on blood cholesterol types and levels. Plus, it is necessary for healthy sexual function.

Although very high levels of testosterone, such as those taken illegally by athletes, are associated with significant risks, replacement of testosterone in a man with low levels and symptoms of low testosterone has not been shown to be risky, and most evidence suggests an overall benefit from getting the testosterone back into the normal range. There are oral forms, injection and transdermal (patch and gel) formulations. Early injections showed problems with high levels after the injection followed by low, but there are better formulations to minimize that risk.

Most men now prefer the gels or patches, which tend to have pretty consistent levels.

Women and children should not handle the medication directly. Your spouse is at low risk if you wash your hands carefully after application and avoid skin contact until it has dried completely, such as by wearing clothing. You should avoid getting the area of application (usually the shoulder) wet for five hours after application.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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Timing and food can be important in effectiveness of Viagra – Lewiston Sun Journal

Posted: January 24, 2020 at 12:44 am

DEAR DR. ROACH: My husband and I are very fortunate to have had a happy relationship for many years. Our lovemaking has always been a pleasure for both of us. Now, we have to add Viagra to the mix. Sometimes it works; sometimes it doesnt, which is a disappointment to both of us. Is there anything we can do to enhance its effectiveness? Or is there something else you can recommend that would do what we wish Viagra would do consistently? Anon.

ANSWER: Sildenafil (Viagra) and similar medicines have been very effective treatment for many men who have difficulty achieving and maintaining adequate erections for sexual intercourse. However, they are not effective for all men, and many people have a misunderstanding about how they work.

Most importantly, Viagra does not increase libido, the desire for sexual contact, in men or women. It works by changing the way blood flows in and out of the penis. Erectile dysfunction can be caused by circulation problems such as blockages in the arteries; neurological problems; endocrine problems, especially low testosterone; and relationship issues. Viagra helps to some extent for men with any of these problems, but its worth reconsidering whether there is an underlying medical issue going on, both before prescribing it and periodically while taking it, especially if it doesnt seem to be working as well.

Still, oftentimes the problem with Viagra working intermittently is that it is affected by food, which many men dont appreciate fully. Food slows down absorption of the medication, making the optimal time of administration more difficult to determine. I have often repeated the advice I heard from a urologist: Take Viagra at 6, have dinner at 7, and you are good until midnight. Viagra does become progressively less effective in some men, requiring higher doses to have the same results. Or, your husband could switch to one of the other Viagra-like drugs, which have greater flexibility with timing and food. They work better for some men.

DEAR DR. ROACH: I am a 69-year-old male in good health except for a low testosterone count of 109 on a recent test. I am wondering about the benefits and risks of therapy. I have read that injection can lead to very high and then very low counts, but the patch can be potentially dangerous to my spouse. Can you clarify these issues for me? A.D.

ANSWER: Testosterone is an important hormone for men and women, although men have much higher levels. It has many critical functions. This includes promoting bone and muscle strength, and generally favorable effects on blood cholesterol types and levels. Plus, it is necessary for healthy sexual function.

Although very high levels of testosterone, such as those taken illegally by athletes, are associated with significant risks, replacement of testosterone in a man with low levels and symptoms of low testosterone has not been shown to be risky, and most evidence suggests an overall benefit from getting the testosterone back into the normal range. There are oral forms, injection and transdermal (patch and gel) formulations. Early injections showed problems with high levels after the injection followed by low, but there are better formulations to minimize that risk. Most men now prefer the gels or patches, which tend to have pretty consistent levels.

Women and children should not handle the medication directly. Your spouse is at low risk if you wash your hands carefully after application and avoid skin contact until it has dried completely, such as by wearing clothing. You should avoid getting the area of application (usually the shoulder) wet for five hours after application.

* * *

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [emailprotected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

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Genome Medical Adds Population Genomics Offering to Enable Increased Access for Individuals Nationwide – P&T Community

Posted: January 23, 2020 at 9:46 am

SOUTH SAN FRANCISCO, Jan. 23, 2020 /PRNewswire/ --Genome Medical, a leader in telegenomics-based clinical care, today announced that it has expanded its services to enable collaborative population genomics programs with health systems across the country. To support this augmented offering, the company has appointed renowned geneticist Huntington Willard, Ph.D., as Chief Scientific Officer and SVP, Medical Affairs.

Genome Medical uses its Genome Care DeliveryTM platform to drive large scale population genomics programs that will increase the understanding of genetic factors within specific populations. The information gleaned from these programs has the potential to help health systems and their clinicians understand how genetics and genomics contribute to the overall health and well-being of patients within the communities they serve.

The comprehensive range of services offered to health systems includes strategic advice and guidance; program development and implementation support; engagement of patients and providers; genetic testing coordination; and return of results to both patients and providers. Health systems will be able to create programs supported by a national network of licensed medical geneticists and genetic counselors, who are accessible on-demand through the company's telemedicine platform. This benefits not only patients and their families, but also clinicians who can receive consultation to determine appropriate clinical action plans.

"I am thrilled to bring new talent to the Genome Medical team as we expand our services," said Lisa Alderson, co-founder and CEO of Genome Medical. "Hunt has led multiple significant initiatives in genomics, including launching the National Precision Health program at Geisinger. Under his leadership, this team will help us execute on key partnerships with hospitals and health systems to further democratize genomics for all populations."

Willard brings decades of leadership experience in genetics and genomics to his position at Genome Medical, where he will oversee various strategic initiatives including clinical and research partnerships in population genomics with hospitals and health systems. He is an elected member of the National Academies of Medicine and of Sciences, a former president of the American Society of Human Genetics, and founding director of the Duke Institute for Genome Sciences and Policy. Most recently, he served as founding director of Geisinger National Precision Health.

"Genome Medical's business needs as a leading medical practice and telegenomics company align well with my expertise in developing and operating precision health initiatives," Willard said. "I look forward to working with Lisa and the team to transform the way hospitals and health systems utilize population genomics programs to improve the quality of clinical care."

In addition to Willard, Genome Medical also announced expansion of its population genomics team by welcoming two other former team members from Geisinger National, one of the world leaders in population genomics and precision health:

Genome Medical's network of genetic specialists and cloud-based Genome Care Delivery technology platform overcome the service delivery challenges in genetics. More than 50 clinicians are available for on-demand, virtual care in all 50 states across six specialty areas; this level of reach is paramount to the successful implementation of population genomics. The platform delivers education, engagement and provider-to-provider e-consultations, as well as genetic wellness assessments and screening for population health management.

About Genome MedicalGenome Medical is a national telegenomics technology, services and strategy company bringing genomic medicine to everyday care. Through our nationwide network of genetic specialists and efficient Genome Care DeliveryTM technology platform, we provide expert virtual genetic care for individuals and their families to improve health and well-being. We also help healthcare providers and their patients navigate the rapidly expanding field of genetics and utilize test results to understand the risk for disease, accelerate disease diagnosis, make informed treatment decisions and lower the cost of care. We are shepherding in a new era of genomic medicine by creating easy, efficient access to top genetic experts. Genome Medical is headquartered in South San Francisco. To learn more, visit http://www.genomemedical.comand follow @GenomeMed.

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SOURCE Genome Medical

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