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UNCA and Asheville clinics priortize inclusive healthcare The Blue Banner – The Blue Banner

Posted: September 8, 2022 at 2:48 am

For young students, seeking reproductive health resources available in the area may be difficult to find.

Fosnight Center embraces the uniqueness of each individual in an effort to ensure all feel safe and welcome regardless of intersectional identities, said Casey Duncan, the director of administrative services for the Fosnight Center for sexual health in Asheville.

The director said the Fosnight Center provides inclusive healthcare for all bodies. The center covers gender affirming care, gynecology and urology services, sexual and integrative medicine and physical therapy.

At the Fosnight Center, we recognize the pieces and put them together to create an individualized treatment plan through a multidisciplinary team approach, Duncan said. You will have the opportunity to be evaluated by our medical providers, pelvic health physical therapist and sex therapist in order to look at the whole picture of your health concern.

The director said the sexual health center provides gender inclusive contraceptive care, gender affirming hormone therapies, STI testing and preventative care.

According to the CDC, before the overturning of Roe 65.3% of people born with a uterus were using contraceptives.

We pride ourselves on creating a safe space for all our patients and clients. Duncan said. We believe everyone deserves to love their body.

The Fosnight director said the center is passionate about reproductive freedom and bodily autonomy for all.

We are committed to cultivating an inclusive environment that benefits all our providers, staff, clients, patients and the community, Duncan said.

Duncan said the sexual health center accepts most commerical insurances and has self-pay discounts.

According to Planned Parenthood, after the overturn of Roe v. Wade on June 24, many Planned Parenthood centers were forced to close leavingmany low income young adults struggling to find affordable testing and sexual health clinics.

The staff understand the unique needs and challenges of being a college student, said Jay Cutspec, the director of Health and Counseling at UNC Asheville.

Cutspec said students receive basic reproductive care and services at UNCA comparable to a family physicians office.

We adapt our services to meet the unique needs of college students, Cutspec said. We have a diverse staff from a variety of backgrounds and experiences.

The health and counseling director said they advise students to make the Health and Counseling Center their first step. If they cannot provide specific services or have unmet needs, students will be referred to the most appropriate community provider.

The phone number for the Health and Counseling Center is (828)-251-6520.

We also understand that for many students, this may be the first time that they have to manage their own healthcare, Cutspec said. We try to educate them on how to manage the healthcare system.

Cutspec said the only charge for a visit to the Health and Counseling Center is for possible medication prescription or lab tests received during the visit.

The Menstrual Equity Club on UNCAs campus takes these matters into their own hands providing safer sex supplies, menstrual products and community health resources.

We have had the pleasure of partnering with organizations such as the Western North Carolina Aids Project and Planned Parenthood, said Samantha Mazze, a UNCA student studying psychology and co-president of the equity club.

Through these collaborations we have been able to provide the campus population with free HIV testing and guest speaker community health educators, Mazze said.

Mazze said the club members pride themselves on providing safe spaces for students to discuss reproductive justice, campus community needs and concerns.

The UNCA student said this was their third year being a part of the Menstrual Equity club.

The co-president said in the past year one of the biggest projects the club worked on was providing free menstrual products in all bathrooms on campus.

One of our goals for this next year is to make sure all students on campus have access to these essential supplies regardless of the bathroom they use, said Mazze.

Mazze said another project the club organizes is the packing party, a Halloween goodie bag filled with menstrual products, candies, stickers and more for students. The co-president said with events like packing parties the club donates supplies back to the community.

The UNCA student said the presence of organizations like the menstrual equity club are crucial because voices are not being heard.

We continue to see people of color and the LGBTQ+ community be consistently overlooked by our healthcare and justice systems, said Mazze.

Mazze said after their graduation they want to continue their efforts in reproductive health, and become a sex therapist.

The co-president said students wishing to get involved can follow the clubs instagram page @uncaforme or join the email list [emailprotected].

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tHE association between LAF-AGEs and osteopenia | MDER – Dove Medical Press

Posted: September 8, 2022 at 2:48 am

Shaoyun Li,1,* Yuefei Li,1,* Xiyan Xu,1 Jian Shao,2 Ruifeng Xie,3 Sheng Liu,1 Li Peng,1 Jin Wang,1 Kaixin Zhou,3 Huyi Feng1

1The Fifth Peoples Hospital of Chongqing, Chongqing, Peoples Republic of China; 2Guangzhou Laboratory, Guangzhou, Peoples Republic of China; 3Department of Life Sciences, University of Chinese Academy of Sciences, Beijing, Peoples Republic of China

Introduction: Simple non-invasive biomarker is urgently needed to detect the largely silent osteopenia in order to prevent osteoporosis-related fracture later in life. The accumulation of advanced glycation end products (AGEs) has been related to reduced bone density and osteoporotic fractures. Whether lens autofluorescence (LAF) based AGEs (LAF-AGEs) measurement could be used to assess the risk of osteopenia is aimed to investigate in this paper.Methods: Through routine health examination, 368 individuals under the age of 50 were enrolled. A dual-energy X-ray absorptiometry (DXA) device was used to measure bone mineral density (BMD) of the forearm and determine osteopenia. AGE levels were derived with LAF along with the other demographic and laboratory parameters. After deriving the age-adjusted AGE levels (AALs), a linear regression analysis and an ordered logistic regression analysis were applied to examine the associations between osteopenia and LAF-AGEs as well as AALs.Results: Negative correlations (Pearson r = 0.16, p Discussion: After reviewing the relevant studies, it is concluded that LAF-AGE is a more stable measure of long-term metabolic dysfunction than circulating AGE. LAF-AGEs are a valid, practical and non-invasive parameter for osteopenia risk evaluation. Further studies with longer follow-up will be helpful to clarify its effectiveness for osteoporosis risk assessment.

Keywords: lens autofluorescence, LAF, osteopenia, advanced glycation end products, AGEs, bone mineral density, T-scores

The prevalence of osteoporosis is 19.2% in people aged over 50 and increases to 65% for those over 65 in China.1 Osteopenia is the gradual loss in bone mineral density (BMD) prior to osteoporosis.2 Chronic osteopenia increases the risk of osteoporosis, fracture or stooped posture. Although early detection of osteopenia and intervention could reduce the risk for osteoporosis-related fracture later in life,3 the awareness rate of osteopenia is only 7% people in those aged over 50 and even lower in the young adults.1 This is largely due to the fact that osteopenia is asymptomatic and its diagnosis often relies on the hazardous X-ray scan.

Alternative biomarkers had been eagerly pursued to inform the early detection of osteopenia.4 Previous studies demonstrated that biochemical factors such as bone serum osteocalcin, alkaline phosphatase (ALP), and osteoprotegerin were associated with osteopenia.5,6 These biomarkers are useful to provide the early assessment of osteopenia and osteoporosis however they are invasive approaches and require laboratory to get the test results. On the other hand, efforts to combine multiple non-invasive measurements such as biceps brachii elasticity and percentage thigh muscle had been proven informative, but the clinical implementation had been severely hindered by its complexity.7 Simple non-invasive biomarkers of osteopenia are still on demand.

Advanced glycation end products (AGEs) include heterogeneous molecules that are nonenzymatically generated by glycation of proteins.8,9 Although distributed across multiple tissues, AGEs are well established to interact with proteins constituting extracellular matrix in bone to form covalent cross-links, damaging the bone properties. Since its distribution across tissues are correlated, AGEs from different compartments of the body had been examined for association with bone quality and fracture.7,8,10 Those from serum and urine were poorly associated due to the short half-life of AGEs related proteins in these tissues.7 Skin autofluorescence-based AGEs were also examined, but their association with bone strength was prone to confounding by renal function.11

Lens autofluorescence (LAF) measurement is a non-invasive technique for determining AGEs initially used for the evaluation of diabetes risk.12 This is largely driven by the fact that proteins in lens are long-lived and the uptake of glucose by lens is not regulated by insulin. Therefore, lens proteins are more likely to be carriers of glycosylation and the LAF-based AGEs (LAF-AGEs) levels are relatively stable. However, whether LAF-AGEs are associated with the risk of bone health and osteopenia is unknown.

In this study, we set out to examine the association between LAF-AGEs and osteopenia in a group of individuals under the age of 50, aiming to establish whether LAF-AGEs could inform early intervention of osteopenia to reduce its related risks later in life.

We recruited 773 adult participants from the Physical Examination Center of the Fifth Peoples Hospital of Chongqing between February and December 2019 while they took their annual physical check. Individuals were excluded if they were aged over 50 or suffer from crystal turbidity, or severe renal functional impairment, or diagnosed with osteoporosis. With the exclusion, 368 patients were selected in the study for the further analysis. In addition to the BMD test and the measurement of Lens Autofluorescence specific to this study, we also collected routine demographic and biochemistry measures such as age, sex, body mass index (BMI), serum creatinine and ALP. Both serum creatinine level and ALP were tested through a blood test where the amount of creatinine in blood and the amount of ALP were obtained. Estimated glomerular filtration rate (eGFR) was calculated by the chronic kidney disease epidemiology collaboration (CDK-EPI) equation.13 The study protocol was approved by the local appointed ethics committee and all participants gave their informed consent.

BMD was measured at the forearm with a dual-energy X-ray absorptiometry (DXA) device (SGY-I, TEDA Shenghong Medical Apparatus Co. Ltd., China). All scans were performed and verified by a trained technician who applied adjustments when necessary. The T-scores produced from each scan were used to identify participants with osteopenia or osteoporosis according the Manufacturer Instruction.14 Based on their T-scores, the participants were classified into five groups of normal (T-score 1), low level osteopenia (1.2 T-score < 1), medium level osteopenia (1.4 T-score < 1.2), high level osteopenia (2 T-score < 1.4) and osteoporosis (T-score < 2).

The AGEscan Lens Fluorescence Microscope (Sinocare Co. Ltd., China) was used to detect autofluorescence of lens. The equipment adopted the ClearPath DS-120 Lens Fluorescence Biomicroscope that had been most widely used in previous LAF studies.15,16 The system reported the ratio of green fluorescence to scattered light as the raw measurement of LAF-AGEs. The raw ratios were further adjusted by age and referenced against a normal population profile to derive four age-adjusted AGE levels (AALs):

Data was expressed as mean SD for continuous variables, and number of cases and percentage for categorical variables. Continuous variables were compared by the t or ANOVA test for normally distributed variables. Chi-Square test was used to compare categorical variables. The linear regression analyses were applied to examine whether T-scores were associated with LAF-AGEs as well as AALs. The co-impacts of the confounders, such as sex, BMI, eGFR and ALP were analyzed by the comparison between the values in two groups divided based on T-Scores. In addition, an ordered logistic regression analysis was applied to investigate whether the change of AALs between different levels affected impacts the different levels of osteopenia. p < 0.05 was considered statistically significant. Data processing was performed using Python (version 3.8.5) and statistical analyses were carried out using R (version 4.0.3).

After excluding individuals with existing osteoporosis (T-score < 2), the key characteristics of the remaining 368 participants in the study were summarized in Table 1. They were divided into the low osteopenia risk group (T-score 1.2) and the high osteopenia risk group (2 T-score < 1.2). In keeping with previous studies, individuals in the group with higher risk of osteopenia tend to be slimmer and older (both p < 0.001). No significant difference in ALP (p = 0.83) and eGFR (p = 0.13) was observed between the two groups. In addition, there was no significant gender ratio difference between the two osteopenia risk groups.

Table 1 Characteristics of the Participants

The joint distribution of osteopenia T-Scores and raw LAF-AGEs levels was plotted in Figure 1A. In a linear regression model, LAF-AGEs were significantly (Pearson r = 0.20, p < 0.001) and negatively correlated with T-Scores. As shown in Figure 1B, when LAF-AGEs were age standardized into AALs, there remained a significant (p = 0.025) negative correlation between AAL and T-score.

Figure 1 The correlation results: (A) Association between T-scores and LAF-AGEs; (B) association between T-scores and AALs.

In order to predict the transition between osteopenia severity levels with the LAF-AGEs, an ordered logistic regression model was employed with the AALs as the predicator and the leveled osteopenia diagnosis as the ordered outcome. This univariate analysis identified AAL was a factor for lower osteopenia level [p = 0.004, odds ratio (OR) = 1.28, 95% confident interval (CI) 1.081.51]. In the multivariate model with gender, BMI, eGFR and ALP as covariates, AAL remained a significant predictor [p = 0.02, OR = 1.22, 95% CI: 1.021.45].

In this cross-sectional study of 368 normal individuals under the age of 50, we showed an inverse association between LAF-AGE levels and osteopenia risk as measured by T-score. The age standardized LAF-AGE levels remained a statistically significant risk after adjusting for other known osteopenia risk factors.

The present investigation was set out to focus on the young adults. Abundant previous evidence had shown that people aged over 50 or menopausal women had increased risk of osteopenia.8,10,17 Yet the bone mass loss in young adults did not receive much attention with the osteopenia risk profile poorly defined.16 Early diagnosis and treatment of osteopenia for young people have been demonstrated to decrease fracture rates, improve life quality when they grow into elderly.18,19 Thus, we opted to extend existing knowledge by examining whether LAF-AGE could serve as a biomarker to inform early assessment of osteopenia.

AGEs are diverse compounds with tissue specific origin, reflecting the metabolic properties of multiple correlated tissues.17 The formation of covalant cross-links with collagen and other bone proteins which affect the mechanical properties of tissue and disturbs bone remodelling, deterioration and bone mass loss, underlying osteoporosis, is induced by the accumulation of AGEs within the bone. It is known that circulating AGEs plays a major role in the progression of osteopenia with a negative correlation of r = 0.26 to the T-score of lumbar spines.20 Here, we showed LAF-AGEs had a similar level of negative correlation (r = 0.16) with the T-scores of forearms. Thus, our study confirmed the LAF-AGEs, another form of AGEs existing in eyes, also had the inverse association with bone mass loss, raising the potential for osteopenia risk evaluation.

As with AGEs measured from other tissues, LAF-AGEs increase with natural aging. We then adopted the age standardized LAF-AGEs in this study to explore its association with T-score and osteopenia risk. The result of the ordinal logistic regression showed the transition between AALsalso resulted in a risk escalation of osteopenia, even after accounting for other known risk factors. Moreover, it has been shown that LAF-AGE is a more stable measure of long-term metabolic dysfunction than circulating AGE. Compared to skin measures of SAF-AGEs, it is less perturbed by short term physiological change which is relevant to the accumulating risk of osteopenia. Taken together, our results demonstrated LAF-AGEs as a valid and practical parameter for osteopenia risk evaluation, adding a non-invasive biomarker to the existing risk profile.

Our study references the bone mineral assessment at the forearm with the low radiation dose DXA which is commonly used in health care setting.21 In contrast, previous AGEs studies mostly measured bone mass at other body parts such as femoral neck and lumbar spine with higher accuracy.10,20 However, a recent study showed that BMD measured at different sites, including lumber, left hip and non-superiority forearm with DXA, were comparable in screening osteoporosis.22 Therefore, the association between LAF-AGEs and T-score observed in this study is likely to be a valid indicator of osteopenia risk.

The present study utilized a cross-sectional dataset and could only focus on the risk predication of osteopenia with LAF-AGEs. However, previous studies did suggest that skin measures of SAF-AGEs were associated with long-term outcomes of osteoporotic fractures and vertebral fractures in susceptible individuals.10,23 Given that LAF-AGEs and SAF-AGEs are significantly correlated,24 it would be reasonable for future studies to examine whether LAF-AGEs could serve as a valid indicator of fracture risk in longitudinal investigations of young cohort. On the other hand, this study used the BMD data measured by DXA at forearm which is widely in routine physical examinations. More analysis should be undertaken to explore whether and how strong the correlations are between LAF-AGEs and bone mass loss at other body sites such as lumbar spine and wards triangle. Further studies with longer follow-up will be helpful to establish whether LAF-AGEs could be used as a risk indicator of osteopenia and later osteoporosis.

In conclusion, this cross-sectional study of normal individuals under the age of 50 confirmed significant association between LAF-AGE levels and osteopenia. Together with other known risk of factors of osteopenia, the non-invasive and reliable measure of LAF-AGEs provides the possibility of more accurate risk profiling and early diagnosis of osteopenia.

Dr. Huyi Feng is a chief medical doctor in hepatobiliary surgery and the director of the Fifth Peoples Hospital of Chongqing. He received his MD in 1984 from West China Medical University and MMed in 2002 from Chongqing Medical University. He published 20 academic papers, had completed 9 research projects and is in charge of one on-going research project in medical science. He is the vice-chairman of Chongqing General Surgery Committee of Chinese Medical Association Integrative Medicine and a member of Chongqing Minimally Invasive Surgery Committee. He is also an editor of the journal Chongqing Medicine. He is expert in diagnosis and treatment of hepatobiliary and pancreatic diseases, especially in laparoscopic technique and laparoscopic cholecystectomy. His research interests include hepatobiliary and pancreatic diseases, endocrine system and advanced glycation end products.

Dr. Shaoyun Li is a data scientist working in the Big Data Laboratory of the Fifth Peoples Hospital of Chongqing. She received her PhD in computer science from De Montfort University in the UK in 2007. She has been working on the research and development in software engineering and data analysis for more than 20 years, especially focusing on medical science in the past 2 years. She has published more than 20 academic research papers in software engineering and medical science. Her current research interests include integration and analysis of medical data to discover the association between diseases and medication.

The electronic medical record data retrieved from the Fifth Peoples Hospital of Chongqing was anonymized for this study. Summary data that were used to support the findings of this study may be requested from the correspondent author.

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Fifth Peoples Hospital of Chongqing (protocol code: 2019CQSDWRMYYEC-003) on 10th March 2019.

We thank Sinocare Co. Ltd., China for providing the AGEscan Lens Fluorescence Microscope which was used to measure LAF-AGEs in our research.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

This research was funded by two National Key R&D Programs of China, grant numbers: 2018YFC2001003 and 2018YFC2001001.

The authors have declared that no competing interest exists.

1. National Health Commission of the Peoples Republic of China. Results of the first epidemiological survey of osteoporosis in China; 2018. Available from: http://www.nhc.gov.cn/wjw/xwdt/201810/d816a5c72f6b45e399a1e7214642cd47.shtml. Accessed August 26, 2022.

2. Varacallo M, Seaman TJ, Jandu JS, Pizzutillo P. Osteopenia. In: Statpearls. Treasure Island (FL): StatPearls Publishing; 2020.

3. Tucci JR. Importance of early diagnosis and treatment of osteoporosis to prevent fractures. Am J Manag Care. 2006;12:181190.

4. Kuo T-R, Chen C-H. Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives. Biomark Res. 2017;5:18. doi:10.1186/s40364-017-0097-4

5. Mekkawy ND, Elsaeed WF, Ahmed HS, Khaliel AM. Importance of serum osteocalcin as early biomarker for osteopenia in preterm neonates receiving total parenteral nutrition. Zagazig Univ Med J. 2019;28:497504.

6. Parveen B, Parveen A, Divya V. Biomarkers of osteoporosis: an update. endocrine. Metab Immune Disord Drug Targets. 2019;19:895912. doi:10.2174/1871530319666190204165207

7. Kida Y, Saito M, Shinohara A, Soshi S, Marumo K. Non-invasive skin autofluorescence, blood and urine assays of the advanced glycation end product (age) pentosidine as an indirect indicator of age content in human bone. BMC Musculoskelet Disord. 2019;20:627. doi:10.1186/s12891-019-3011-4

8. Tabara Y, Ikezoe T, Yamanaka M, et al. Advanced glycation end product accumulation is associated with low skeletal muscle mass, weak muscle strength, and reduced bone density: the nagahama study. J Gerontol: Med Sci. 2018;74:14461453. doi:10.1093/gerona/gly233

9. Steenbeke M, Bruyne SD, Aken EV, et al. Uv Fluorescence-based determination of urinary advanced glycation end products in patients with chronic kidney disease. Diagnostics. 2020;10:34. doi:10.3390/diagnostics10010034

10. Waqas K, Chen J, Koromani F, et al. Skin autofluorescence, a noninvasive biomarker for advanced glycation end-products, is associated with prevalent vertebral and major osteoporotic fractures: the Rotterdam study. J Bone Miner Res. 2020;35:19041913. doi:10.1002/jbmr.4096

11. Sim-Servat O, Planasa A, Ciudin A, Sim R, Hernndez C. Assessment of advanced glycation end-products as a biomarker of diabetic outcomes. Endocrinologa, Diabetes y Nutricin. 2018;65:540545. doi:10.1016/j.endien.2018.06.003

12. Cahn F, Burd J, Ignotz K, Mishra S. Measurement of lens autofluorescence can distinguish subjects with diabetes from those without. J Diabetes Sci Technol. 2014;8:4349. doi:10.1177/1932296813516955

13. Levey AS, Stevens LA, Schmid CH, et al. Equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604612. doi:10.7326/0003-4819-150-9-200905050-00006

14. Teda Shenghong Medical Apparatus Co. Ltd. C. Manufacturer Instruction: sgy-I. 2010.

15. Burd J, Lum S, Cahn F, Ignotz K. Simultaneous noninvasive clinical measurement of lens autofluorescence and Rayleigh scattering using a fluorescence biomicroscope. J Diabetes Sci Technol. 2012;6:12511259. doi:10.1177/193229681200600603

16. Pehlivanolu S, Acar N, Albayrak S, Karakaya M, Ofluolu A. The assessment of autofluorescence of the crystalline lens in diabetic patients and healthy controls: can it be used as a screening test? Clin Ophthalmol. 2018;12:11631170. doi:10.2147/OPTH.S164960

17. Yamamoto M, Sugimoto T. Advanced glycation end products, diabetes, and bone strength. Curr Osteoporos Rep. 2016;14:320326. doi:10.1007/s11914-016-0332-1

18. Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Rev Endocr Metab Disord. 2011;11:237251. doi:10.1007/s11154-010-9154-0

19. Teng Z, Zhu Y, Yu X, et al. An analysis and systematic review of sarcopenia increasing osteopenia risk. PLoS One. 2021;16:114. doi:10.1371/journal.pone.0250437

20. Yang D-H, Chiang T-I, Chang I-C, Lin F-H, Wei -C-C, Cheng Y-W. Increased levels of circulating advanced glycation end-products in menopausal women with osteoporosis. Int J Med Sci. 2014;11:453460. doi:10.7150/ijms.8172

21. Augat P, Fuerst T, Genant H. Quantitative bone mineral assessment at the forearm: a review. Osteoporosis Internationa. 1998;8:299310. doi:10.1007/s001980050068

22. Wang Y, Zhang Z. Comparision forearm bone mineral density between lumbar spine and hip: a useful tool to screen osteoporsis in female patients with rheumatoid arthritis. Ann Rheum Dis. 2019;78:1634.

23. Waqas K, Chen J, Koromani F, et al. Dietary advanced glycation end-products (Dages) intake and bone health: a cross-sectional analysis in the Rotterdam study. Nutrients. 2020;12:2377. doi:10.3390/nu12082377

24. Skrha J, Soupal J, Prazny M, Skrha J. Lens autofluorescence relates to skin autofluorescence but poorly to glycated haemoglobin in patients with diabetes. Diabetologia. 2015;58:560.

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Kid Captain Eli Belser takes the field with Hawkeyes, celebrating two years cancer free – UI The Daily Iowan

Posted: September 8, 2022 at 2:46 am

Eli Belser is living out a dream this weekend.

When the first Kid Captain of the 2022 Hawkeye football season was too sick to watch games, his mom Katie promised he would one day see Kinnick from the field, not from the halls of the University of Iowa Stead Family Childrens Hospital.

Katie said she struggled making a promise she was unsure she could keep.

Every day, I am scared of relapse because he still has a high chance, she said. But I promised him he would wave someday. And I asked him what seat he would sit in. He said well, why cant I be on the field? And I said, you have to pick a seat. I promised him, but then COVID happened, and no one was in the stands. Last year was a crazy year without regular treatments, so he never got to go to a home game. Now that its happening, its super exciting.

The seven-year-old and his family first took the near-two-hour drive from Elkader, Iowa, to Iowa City when he was four. Eli had been limping and a pediatrician referred him to Stead Family Childrens Hospital once a few potential ailments were dismissed as causes of his symptoms.

Katie and her husband, Marcus, were frustrated when they had to wait for the appointment as their sons condition worsened quickly. Katie said they hit a breaking point in June, as they waited for the August appointment.

I have five kids, so Ive dealt with the fevers, kids being sick, and all the different illnesses, she said. I knew this was definitely different. I asked the pediatrician and he said, if I knew something was wrong, to take him to Iowa City. So, thats what we did. We showed up at the ER and told them everything and they took him in for testing and they noticed something.

Initially, Eli was diagnosed in 2019 with a rare bone disease called chronic recurrent multifocal osteomyelitis, or CRMO. After choosing a treatment plan, Eli didnt get better. The family returned to the UI with continuing symptoms a month later, and Eli received more testing.

Katie and Marcus then heard the words of a scarier diagnosis: stage 4 neuroblastoma.

Neuroblastoma is a cancer that develops from immature nerve cells. It has one of the most aggressive treatment plans given to children. Thats when Advanced Registered Nurse Practitioner Mary Schlapkohl came into the Belsers lives.

Schlapkohl works in the pediatric oncology department; Eli calls her grandma. She said its normal for neuroblastoma patients to receive misdiagnoses.

Sometimes, symptoms mimic other childhood illnesses, and in his case, his symptoms looked like CRMO, she said. It depends on how sick they are and how aggressive providers are when looking for a cause.

Eli was treated with biopsies, surgeries, five cycles of chemotherapy, stem cell transplants, radiation, and immunotherapy.

In May 2022, the Belsers celebrated two years of Eli being cancer free.

Since his diagnosis and treatments, Katie said Eli has been a big advocate for childhood cancer awareness and he takes the field with the Hawkeyes during Pediatric Cancer Awareness Month.

We were talking about something for school recently and he asked if he should ask for yellow ribbons since Pediatric Cancer Awareness month is September, she said. He cares about other kids still fighting and he still asks about the families we met.

As the first Kid Captain this fall, Eli also is the first child to pick a song for the Hawkeye Wave. When fans take the stands on Saturday, Katie wants them to know the song is extremely important to her, Marcus, and their five children.

The song that is going to be played at Kinnick was a song that got him through treatment, and it helped his siblings a lot, she said. They all love it.

Eli is ecstatic to see his favorite player, Kaevon Merriweather, again when he joins the Hawkeyes as they take on South Dakota State. He already started telling friends at school and is looking forward to coming back to Iowa City.

Im excited about everything, he said. Im ready.

The Belsers plan to go to Texas Roadhouse to celebrate if the Hawkeyes win, something Eli is looking forward to.

With dreams of being a quarterback, Eli said he will one day be a Hawkeye or a member of the Alabama Crimson Tide. Those are his only two options, he said. Marcus is a big Alabama fan and head coach Nick Saban sent Eli signed gear when he was in the hospital for treatment.

Marcus said his son being a Kid Captain is a once in a lifetime experience and hes thankful the Hawkeye Football Team changes kids like Elis lives.

To pick Eli as a Kid Captain, its amazing, he said. Im grateful for it all.

Whenever Katie travels to Johnson County, she knows it could be the moment her fears come true, and she might hear her son has cancer again. Coming down to the UI this Saturday is a break in her normal pace an exciting, fun, and needed break.

After Kids Day, it was a whole different feeling weve never felt. It was like closure, she said. Families go through so much. When you go down there, its for very serious things and a lot of it is traumatic. Its one of those things you sugar coat, and you dont tell people how you really felt. For once, were going down there for fun To go down there and feel loved and happy and not once think about a scan coming back bad, the experience is completely different. It was closure.

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Is There Enough Phosphorus for Us? – Discovery Institute

Posted: September 8, 2022 at 2:45 am

Photo: Hunga-Tonga blast from space, by NASA

Not long ago I consideredthe element phosphorusas a test case for Michael Dentons hypothesis of prior fitness of the environment for complex beings of our size. Phosphorus is a vital element on which lifes genetic and metabolic processes depend every picosecond. And yet P is not as easily cycled through the environment as are other elements like nitrogen and carbon. Phosphorus, therefore, can be considered a limiting factor for a productive biosphere. We left the issue as a work in progress, although ample circumstantial evidence exists that P bioavailability has not been a problem throughout Earths history (consider trilobites in an ancient ocean, sauropods in a tropical rain forest, or tropical fish in a lagoon consuming phosphorus with impunity in different eras).

Phosphorus has been in the news since that article. A paper inNatureadmits that the extent to which phosphorus availability limits tropical forest productivity is highly uncertain because of intertwined effects with other limiting factors such as nitrogen. The authors experimented with adding phosphorus to a small patch of old growth rainforest in Amazonia, where soils are depleted in phosphorus. After two years, they saw increases in primary productivity, but not in stem growth. Disentangling the effects of phosphorus from other factors still seems uncertain.

At Charles University in the Czech Republic, two paleontologists investigated the phosphorus cycle over geological time by investigating the abundance of phosphatic marine shells in the fossil record as a proxy. Innews from the Faculty of Science, they ascribe a transfer of phosphorus from shelly creatures to vertebrates in the Devonian:

M. Mergl laconically remarked that phosphorus was stolen by vertebrates. This remark actually became the starting shot. The question of theradical loss of phosphorusin the environment proved so exciting that both authors set about studying in detail the various corners of the cycle of this element. [Emphasis added.]

Their tale begins with abundant phosphorus supporting the Ediacaran fauna. Then they attribute the Cambrian Explosion in part to still-plentiful phosphorus.

The Early Paleozoic was acritical era of phosphorus cycledue to the intense involvement of biota in its dynamics. At the beginning, phosphorus was easily available in great amount and therefore many groups had the opportunity to build external phosphatic shells.This very likely contributed to the story of the Cambrian explosion, a period when representatives of almost all animal phylaappeared in the fossil record within a relatively short period of time. The Cambrian was thus a golden age for organisms with external phosphatic shells.

Like theoxygen theory, this explanation transfers the explanation for the origin of genetic information to the abundances of blind elements in the periodic table hardly a logical idea. That would be like attributing the origin of books to the availability of movable type in a print shop with no Gutenberg.

In Act Two of their biological opera, phosphorus divorced the shelly creatures and married the vertebrates. Marine shells declined in size because large phosphatic shells became a luxury. This process has been accelerated by the emergence and evolutionary diversification of vertebrates, which, although they need a lot of phosphorus, are better at managing it, the paleontologists surmise. But the plot thickens when anomalies emerge:

The subsequent era from the end of the Paleozoic to the present is characterized bylimited but also selective availability of phosphorusin the seas and oceans.Geological processessuch as the Variscan (400-300 Ma) and the Alpine orogenies (80 Ma to the present)have greatly aided the supply of phosphorus to the oceans.However, the ability of phosphorus to reach the oceans from its main source in the rocks of the denuded continents washampered by the spreading of vegetation on land and other influences such as climateduring this times [sic].

Climate change should not be used as a skeleton key for incomplete answers. In combination with other influences, storytellers can make any plot work. Kraft and Mergl published their ideas in an Opinion article, Struggle for phosphorus and the Devonian overturn, last month inTrends in Ecology & Evolution.

Most instructive is their proposal that geological processes have aided the supply of phosphorus to the oceans and land. The role of volcanoes and orogenic processes in keeping phosphorus plentiful throughout Earths history deserves elaboration by design theorists. Consider what happened on January 14, when one of the most powerful volcanic eruptions ever recorded, theHunga-Tonga volcano, surprised scientists with a massive plume visible from space (see the photo above). A new paper inGeophysical Research Lettersreports a massive phytoplankton bloom that was visible from space as well following the eruption.

Two independent bio-optical approaches confirmed that the phytoplankton bloom was a robust observation and not an optical artifact due to volcanogenic material. Furthermore, the timing, size, and position of the phytoplankton bloom suggest thatplankton growth was primarily stimulated by nutrients released from volcanic ashrather than by nutrients upwelled through submarine volcanic activity. The appearance of a large region withhigh chlorophyll a concentrations less than 48 hours after the largest eruptive phase indicates a fast ecosystem response to nutrient fertilization.However, net phytoplankton growth probably initiated before the main eruption, whenweaker volcanism had already fertilized the ocean.

Although chlorophyll itself does not contain phosphorus, the availability of phosphorus in the ash may have stimulated rapid proliferation of the plankton.

Does phosphorus availability impact predator-prey relationships? In a research article inPNAS, Guilloneauet al.investigated Trade-offs of lipid remodeling in a marine predatorprey interaction in response to phosphorus limitation.

Microbial growth is oftenlimited by key nutrients like phosphorus (P)across the global ocean. A major response to P limitation is thereplacement of membrane phospholipids with non-P lipidsto reduce their cellular P quota. However, thebiological costs of lipid remodelingare largely unknown. Here, we uncover a predatorprey interaction trade-off wherebya lipid-remodeled bacterial prey cell becomes more susceptible to digestion by a protozoan predatorfacilitating its rapid growth. Thus, we highlighta complex interplaybetween adaptation to the abiotic environment and consequences for biotic interactions (grazing), whichmay have important implications for the stability and structuring of microbial communitiesand the performance of the marine food web.

Themagical thinkingin this story becomes evident when the authors opine that marine microbeshave evolved sophisticated strategiesto adapt to P limitation such as replacing phospholipids with non-P lipids. One must imagine microbes holding committee meetings, thinking out strategies as if they were business managers worried about maintaining their products under duress from shortages in the supply chain. But if we do that, one manager worries, we become susceptible to organized crime.

The low availability of key nutrients like Pin marine surface waters representsa grand challenge for microbes, particularly those inhabiting oligotrophic gyres. Although lipid remodeling enables these microbes to survive better in these potentially P-limited environments, as well as facilitating greater avoidance of ingestion by ciliate grazers, once ingested, these lipid-remodeled cells are unable to survive phagolysosomal digestion (Fig. 6). Therefore, these microbes facean unsolvable dilemma.

The managers panic; what to do? Each option is potentially disastrous. Thus, it is clear that adaptation to a specific niche can come with consequences to an organisms viability, the storytellers continue. Stay tuned for the next exciting episode! it remains to be seen what other trade-offs in predatorprey interactions exist following adaptation of cosmopolitan marine microbes to P limitation.

Speculation like this is not particularly helpful in science, especially when the story is so evidence-starved as to depend on one single example of a microbe and its predator. Global change is expected to exacerbate P limitation in the surface ocean due to water-column stratification accelerated by global warming, they say at one point. Maybe that was the motivation to ensure their story got funded and published. But what do they know from their observations? And how can they extrapolate one predator-prey interaction to the whole globe?

Moreover, given that the effects of remodeling on predatorprey interactions we report here are ultimately controlled by in situ P concentrations (which controls lipid remodeling), thensuch interaction effects are also likely to be dynamic in their nature, given the often-seasonal nature of P limitation e.g., in the Mediterranean Sea, PlcP-mediated lipid remodeling occurs across an annual cycle, whereby P limitation intensifies during spring and summer, but starts to become alleviated from September.Nonetheless, this work clearly highlights the complex interplay between the abiotic nutrient environment, microbes, and their grazers and how predatorprey dynamics aregoverned by abiotic controlof prey physiology, which hasimportant implications for how we model trophic interactionsin marine ecosystem models,particularly in a future scenariowhere nutrient-deplete gyre regions are set to expand.

Readers should note that both predator and prey have not gone extinct, which would make a stronger case for P limitation in their limited ecological case.

While agriculturalists worry about phosphorus for commercial fertilizers, none of these papers above suggest that the natural biosphere has ever suffered from a deficiency of phosphorus. The plankton bloom after the Tonga eruption shows how volcanoes can fortify marine environments with inorganic nutrients. Another paper inNature Scientific Reports suggests that terrestrial environments, too, can take advantage of volcanic phosphorus. Pioneering plants can absorb phosphorus from volcanic ash and supply it to secondary growth through their leaf litter. This is interesting because many terrestrial soils contain volcanic ash containing insoluble inorganic phosphorus that was thought unavailable to plants. Volcanic islands like Japan and Hawaii, however, seem to have thriving ecosystems.

Despite volcanic ash soil covering about 20% of the land in Japan,and phosphorus deficiency being a serious problem in Japanese agriculture,net primary productionin Japanese forests is primarily isnot lowcompared to other temperate zones of the world.This suggests that natural vegetation on the infertile volcanic ash soil obtain sufficient nutrition including phosphorus.

Geology, therefore, appears to offer a supply chain for elemental nutrients built into our planet by means of plate tectonics coupled with thermodynamics the availability of heat near the surface. Since a planets internal heat decreases over time, there may be temporal constraints on this supply chain. If so, one implication is that cold, dead worlds might not have a functioning biosphere even if they orbit in the habitable zone. Is Earth operating in a Goldilocks time as well as a Goldilocks location? These are good questions for design theorists to investigate. Meanwhile, Earths biosphere seems to be functioning tolerably with its natural phosphorus supply.

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Money on the Move: Arsenal, ILiAD and a Hefty Gift to UCSD – BioSpace

Posted: September 8, 2022 at 2:44 am

Funding rounds this week will help Arsenal and ILiAD move forward with their lead programs, while a philanthropic donation will allow UC San Diego to advance its space-based stem cell research.

UC San Diegos Largest Single Gift Earmarked for Stem Cell, Regenerative Medicine Research

After receiving a $150 million donation from businessman and philanthropist T. Denny Sandford, theUniversity of California, San Diego,announcedTuesday that it would use these funds to boost its stem cell and regenerative medicine research.

The stem cell studies, in particular, will be conducted aboard the International Space Station, allowing researchers to better understand the impacts of aging on stem cells and how this may prompt cells to become cancerous. Space-related research could yield better therapies not just for cancers but for diseases like Alzheimers and Parkinsons, as well.

Sanford also donated $100 million in 2013, allowing UCSD to establish the Sanford Stem Cell Clinical Center. His donations also enabled UCSD to create the T. Denny Sanford Institute for Empathy and Compassion in 2019.

Arsenals Programmable Cell Therapies Win $220M in Series B

Arsenal Biosciencesclosedits Series B round of financing Tuesday and reported earnings of $220 million. The privately held company will use these proceeds to bolster research into its programmable cell therapies and deepen its pipeline of solid tumor candidates across a wide range of cancers. Arsenal gained new investors during the oversubscribed funding round, including Bristol-Myers Squibb Company, Hitachi Ventures and Emerson Collective Investments.

Alongside its Series B round, the California-based company is preparing to initiate clinical studies for AB-1015, its lead candidate for ovarian cancer. Arsenal aims to clear an Investigational New Drug application and dose the first AB-1015 patient later this year.

Arsenal also welcomes Valentin (Vali) Barsan, M.D., attending pediatric oncologist at the Stanford University School of Medicine and an investor for SoftBank Investment Advisers, into its board of directors.

Class D Funding Pumps $42M into ILiADs Pertussis Shot

The company announced Tuesday that its recent Class D round of financingearnediLiAD Biotechnologies$42.8 million in proceeds. Family office hedge fund Knott Partners led the Class D round.

The New York biotech is channeling almost all of these funds into BPZE1, its next-generation pertussis vaccine candidate, establishing and improving the manufacturing process for BPZE1, as well as supporting its research and development.

In particular, the earnings will allow LiAD to proceed with a Phase IIb human challenge study to assess if BPZE1 can prevent the nasopharyngeal colonization ofBordetella pertussis.

To date, more than $100 million have already gone into the research and development of BPZE1. The candidate has cleared four human clinical studies and has been granted the FDAs Fast Track designation.

ILiAD also plans on using its earnings to power its current operations.

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How surviving cancer changed this 34-year-olds attitude toward work: The concept of checking email was laughable – CNBC

Posted: September 8, 2022 at 2:44 am

Liya Shuster-Bier had always been a high achiever. The 34-year-old Soviet Union refugee immigrated to New York with her parents in 1989. She attended Dartmouth on a scholarship and throughout her 20s worked at Goldman Sachs and a social impact startup in Boston, and completed her MBA at Wharton.

"All that was on my radar was the next exam, the next internship, the next job," she says. But in January 2018, six months after graduating from Wharton, she learned she had a rare form of non-Hodgkin lymphoma, a cancer that affects the body's immune system.

"Suddenly, me turning 30 was no longer a guarantee," she says.

Her year-and-a-half-long battle with the disease would ultimately change her priorities in life and attitude toward work completely.

When she was first diagnosed, Shuster-Bier was working at philanthropic fundraising company the Overton Project.

She went through six rounds of chemotherapy to eliminate the cancer, trying to maintain a normal life and work schedule even as the procedure landed her in the hospital. "I was literally taking the six train to Soho with chemo strapped to me," she says.

Though by summer it seemed Shuster-Bier's life could get back to normal, that October, the cancer came back. Now, treatment would require both radiation and a stem cell transplant which would force her to put a pause on life.

A stem cell transplant is, "a procedure in which a patient receives healthy stem cells (blood-forming cells) to replace their own stem cells that have been destroyed by treatment with radiation or high doses of chemotherapy," according to the National Cancer Institute.

"My doctor made me sign an affidavit that I would not work during the 100 days that I was a bubble girl after the transplant," says Shuster-Bier, who went on medical leave. This wasn't just because her doctor wanted to ensure that Shuster-Bier rested. The treatment is so aggressive she couldn't function on an elemental level.

Shuster-Bier recovering from her stem cell transplant in the Hudson Valley in 2019.

Courtesy Liya Shuster-Bier

"I could not walk around the block," she says, "I just didn't have the lung capacity." Reading was a challenge. Math was a challenge.

"The concept of checking email was laughable," she says.

Even as she tried to heal, that period set off a mini crisis.

She'd so long invested most of her time producing, without work, "I was like, who am I?" she says. But it also made her start to question this attitude. She'd text her friends to take a walk or watch some Netflix and realize people were working as late as 8 p.m.

"We are literally spending the vast majority of our awake hours and the vast majority of our time at work," she says she thought. "For what?"

Shuster-Bier realized her way of life, "was literally just destroying me," she says. "Destroying my health, destroying my mental state, pushing me to the brink." As she regained her strength, she began paying attention to how much she slept, what she ate and how much time she spent with her husband. She even reexamined her spirituality.

"I started to see a new Rabbi," she says.

Instead of "destruction," she thought about a new attitude toward life, "How do I actually pivot to nourishment?"

Shuster-Bier's mother had landed in remission from breast cancer just months before Shuster-Bier was diagnosed herself. Both experiences made her realize that beating the disease is not just about treating the cancer but about managing the symptoms following treatment.

Shuster-Bier recovering from chemotherapy in 2018.

Courtesy Liya Shuster-Bier

"No one was helping me manage my constipation, my headaches, my dehydration," she says, adding that, "I was motivated to start a place where this all existed."

Shuster-Bier went back to the Overton Project after recovering from the transplant but within months founded Alula, a product marketplace for patients navigating these and other symptoms. She began working on it full-time in December 2019. The cancer forced her to go into medically induced menopause, and she and her husband agreed that she could invest the money they had saved for starting a family to found the company. She's also raised $2 million to run it since.

Though the life of an entrepreneur is traditionally nonstop and hectic (25 hours per day if you ask Kevin O'Leary), Shuster-Bier has continued applying the attitude she built after treatment and focuses on nourishment and health.

Instead of being out until 11 p.m. and back at her desk by 5 a.m., as she'd sometimes done in the past, she wakes up naturally every day between 5:30 and 7:45. She starts her workday at 10 a.m. and finishes no later than 6 or 7. She makes ample time for her husband, puppy and friends, and for taking walks and cooking.

"The new compass for me," she says, is "what feeds your being versus what feeds your doing?" Three years into remission, the new attitude appears to be working.

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Garuda Therapeutics Announces Appointment of Roger Sawhney, M.D., as Chief Financial Officer – Benzinga

Posted: September 8, 2022 at 2:44 am

Garuda Therapeutics (Garuda), a company creating off-the-shelf, durable blood stem cell therapies, today announced the appointment of Roger Sawhney, M.D., as Chief Financial Officer. Dr. Sawhney previously served as Chief Financial Officer and Chief Business Officer at Omega Therapeutics, a pioneer in mRNA-based therapeutics for precision gene modulation.

"The Garuda team is so pleased to have Roger join in our efforts to democratize blood stem cell transplants and ensure this vital, and often curative, therapy is made accessible to eligible patients in need," said Dhvanit Shah, Ph.D., Co-Founder, President and Chief Executive Officer of Garuda. "Roger's experience in biopharma and health care investing coupled with his expertise in operational management and commercialization will be instrumental in helping to advance our efforts to create off-the-shelf, durable blood stem cell therapies."

Most recently, Dr. Sawhney served as Chief Financial Officer and Chief Business Officer at Omega Therapeutics, where he led finance, strategy, business development and data/analytics. During his tenure at Omega, Dr. Sawhney led capital raises of more than $300M, including Omega's crossover round and initial public offering. Prior to Omega, Dr. Sawhney served in a variety of prestigious roles including Partner at Bain Capital and Boston Consulting Group. He was also a Director at KKR in health care private equity and growth equity investing and Senior Vice President and Global Head of Corporate Strategy at Novartis, Basel. Dr. Sawhney has held board appointments for Ebb Therapeutics, New York Institute of Technology and Arcellx, Inc. He received his M.D. at Harvard Medical School and an B.A. in Economics with Distinction at Stanford University.

Garuda's platform for generating off-the-shelf, self-renewing blood stem cells is designed to provide patients with rapid and broad access to consistent, durable, HLA-matched, transgene-free blood stem cell therapies. Currently, patients seeking a blood stem cell transplant must find a suitable human donor as a source of blood stem cells. Racial minority patients face greater barriers than white patients in finding suitable blood stem cell matches. Like bone marrow transplants, Garuda's technology has the potential to address, and possibly cure, more than 70 diseases.

"I am absolutely thrilled to join Garuda to help bring this potentially life changing therapy to patients," Dr. Sawhney said. "Eliminating the need for donor or patient cells while gaining the ability to exploit stem cell engineering would democratize blood stem cell transplants and has potential to revolutionize cell therapy."

About Garuda TherapeuticsGaruda Therapeutics seeks to create a world that eliminates the dependency on donor or patient cells for blood stem cell transplants. Our platform technology for generating off-the-shelf, self-renewing blood stem cells is poised to provide patients with rapid and broad access to consistent, durable, HLA-compatible and transgene-free blood stem cell therapies. Like bone marrow transplants, our technology could provide potentially curative therapies for more than 70 diseases. https://garudatx.com/

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Garuda Therapeutics Announces Appointment of Roger Sawhney, M.D., as Chief Financial Officer - Benzinga

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6 Ingredients to Avoid Putting on Your Skin – Healthline

Posted: September 8, 2022 at 2:44 am

What we put in our bodiesfoodis regulated by the Food and Drug Administration and the U.S. Department of Agriculture.

What we put on itskin care and beauty productsis not.

That could be an issue.

In one 2021 report, scientists tested 231 popular makeup products from the U.S. and Canada and found that more than 100 had Per-and poly-fluoroalkyl substances (PFAS). These are chemicals that dont break down and build up in the body over time.

They include perfluorooctanoic acid, which may cause cancer, according to the American Cancer Society.

Clean skin goes beyond washing your face.

Your skin is a living, dynamic organ, says Nava Greenfield, M.D. of Schweiger Dermatology Group in New York City. Just like you consider carefully what you put into your mouth, you should take care in what you place on your skin.

Understanding whats in your products can help you achieve long-term health thats more than skin-deep.

Heres what the science says you should avoidand what to use instead.

The skin is our largest organ, notes Marianna Blyumin-Karasik, board-certified dermatologist, co-founder of Precision Skin Institute, and founder of Stamina Cosmetics.

The skin has high absorption, so skin care products that can be absorbed and enter our bloodstream can have detrimental effects on our overall health, Blyumin-Karasik says.

Some ingredients like synthetic or highly concentrated fragrances or chemicals in personal care products can trigger skin sensitivity, irritation, or a more intense allergy.

Symptoms can include:

Other ingredients have been linked to more serious problems, like:

For example, a 2018 review suggested that phthalates found in certain personal care products could adversely affect male fertility.

A 2021 study indicated that exposure to formaldehyde, sometimes used in keratin hair treatments, could lead to heart malformations in a developing fetus.

In 2020, California became the first state to issue a statewide ban on 24 chemicals, including methylene glycol and formaldehyde.

Other states dont have these bans, leaving consumers to analyze and interpret labels themselves.

Complicating things, some recommendations to avoid specific ingredients arent one-size-fits-all. Different people may have different (or no) reactions to certain ingredients, even if theyre common allergens.

Aside from real toxins and dangerous chemicals, a list like this will be different for each person, Greenfield says. Unfortunately, its not all black and white.

Having an idea of whats potentially toxic and whats more likely to cause skin irritation can help you make informed decisions about the products you choose.

From common allergens to potential carcinogens, here are the ingredients Blyumin-Karasik and Greenfield suggest avoiding:

Blyumin-Karasik and Greenfield warn that PEGs are a potential skin irritant.

Theyre most often found in lotions, creams, and hair products because they can act as skin conditioners and humectants, a common moisturizing agent.

A small 2021 case study examined six cases of acute sensitivity to PEGs. However, researchers also noted the allergy was rare.

Blyumin-Karasik notes that methyl and propyl parabens are preservatives with reputations for being hormone disruptors. However, research is mixed.

A 2017 study on gerbil prostates indicated that methylparaben could disrupt estrogenic and androgenic receptors that might affect the prostate.

Another 2017 study suggested parabens, including methyl and propyl parabens, posed little health risk. However, researchers noted that parabens could inhibit compounds with anti-estrogenic properties.

The FDA wrote in 2022 that it didnt have enough evidence to warn that parabens affect human health. The American Academy of Dermatology (AAD) reported similarly in 2019, noting that allergic reaction risks were low.

Found in some eye make-up products, lipsticks, and deodorants, aluminum can cause skin irritation, according to Greenfield.

Theres also been discussion as to whether aluminum is a carcinogen, or cancer-causing agent.

A 2015 study suggested aluminum can increase the migration of breast cancer cells and called for more research.

In 2013, the Cosmetic Ingredient Review said alumina and aluminum hydroxide was safe to put in cosmetics, noting that it doesnt get absorbed into the skin and less than 1 percent is absorbed orally.

This ingredient is a preservative commonly found in soaps and shampoos and may cause skin irritation or allergies, Blyumin-Karasik explains. Greenfield agrees with avoiding formaldehyde, saying its a common irritant.

A 13-year retrospective study of patch tests published in 2020 indicated that a polymer known as toluene-sulfonamide-formaldehyde resin (R-TSF or TSFR), often used in nail polish, was one of the most common allergens. Its also known as a carcinogen, but data shows its only hazardous if a person inhales a significant amount.

The American Cancer Society says formaldehyde in personal care products like shampoos typically contains formaldehyde levels that are far below hazardous to health. The organization says keratin hair smoothing treatments can raise indoor air concentration to hazardous levels.

Phthalates are typically used to make sure plastic doesnt break. They can also be used in fragrances in skin products. Blyumin-Karasik warns they may disrupt hormones.

A 2020 literature review indicated that phthalates could lead to:

A 2018 study suggested phthalates could lead to pregnancy loss and fertility issues.

However, its important to note that neither piece of research above was specific to phthalates in beauty products.

Key West and Hawaii recently banned oxybenozone, which is commonly found in sunscreen. Blyumin-Karasik says it can disrupt hormones and cause allergic reactions.

A 2020 review of 29 studies indicated no a link between fertility issues and oxybenzone and called for more research.

However, an older 2016 study indicated that men with higher levels of benzophenone-type ultraviolet (UV) filter concentrations had lower sperm concentrations.

Avoiding fragranced products and using a mineral-based sunscreen can help avoid harmful chemicals, Blyumin-Karasik says. Looking for preservative-free items can also cut down on risks of irritants and health hazards.

The main purpose of preservatives is to maintain the integrity of the personal care products, Blyumin-Karasik says. The natural alternatives may not attain as long of the shelf-life as the chemical ones, but theyre better for our well-being.

To clean up your beauty regimen, Blyumin-Karasik suggests looking for products that contain these safer ingredients instead.

Blyumin-Karasik suggests using tea tree oil, an essential oil found in shampoos, skin care items, hand sanitizers, and first aid products.

A 2021 study suggested tea tree oil could help disinfect hands when used in sanitizer.

Research from 2015 indicated it could aid wound healing, and a 12-week pilot study published in 2017 suggested it could reduce acne.

Instead of PEGs, opt for a humectant with fewer potential side effects. Blyumin-Karasik recommends glycerin.

One small 2017 study of women indicated that products with a mix of hyaluronic acid, glycerin, and Centella asiatica (gotu kola) could boost skin hydration for 24 hours.

A 2019 safety assessment suggested glycerin was safe to use in cosmetic practices.

Coconut oil, or Cocus nucifera, is extracted from the meaty part of a coconut fruit.

Blyumin-Karasik recommends it because its moisturizing and can reduce mold growth in skin care products.

A 2022 study indicated that a coconut oil-based serum combined with deer antler stem cell extract for two weeks could:

A 2019 study indicated virgin coconut oil had anti-inflammatory properties and supported its use in skin care products.

Blyumin-Karasik says elderberry, or Sambucus nigra extract, often found in serums, has versatile benefits for our skin.

She notes these benefits include antimicrobial effects and high levels of vitamin C.

Research on elderberry is limited, particularly in topical products. However, a 2019 study suggested it had anti-aging benefits when ingested as a supplement.

Blyumin-Karasik says willow bark, or Salix nigra extract, is an excellent source of skin preservation. She recommends it for its anti-inflammatory and antimicrobial properties.

Besides that, willow bark contains a potent salicin ingredient which has gentle exfoliating properties to cleanse pores and reduce skin surface oil, she says.

A 2019 study suggested willow bark total extract may have antioxidant and anti-inflammatory benefits.

An older 2010 study suggested that salicin, which is extracted from white willow bark, may have benefits when applied to the skin topically.

When shopping for personal care products, there are a few things youll want to keep in mind, depending on your age and any conditions you have.

Leave the layering for sweater weather, not skin care. Blyumin-Karasik says the biggest issues she sees in her clinic happen when people try to cake on too many products or ingredients.

Trying to be innovative or frugal, young individuals play with potentially hazardous ingredients such as baking soda or lemon juice which can lead to significant skin irritation, Blyumin-Karasik says. Older individuals try to layer too many products onto their skin such alpha hydroxy acids and potent retinoids and as a result, create skin allergy or irritation.

Blyumin-Karasik recommends working with a dermatologist to find the correct ingredients for your skin type and beauty goals.

A long ingredients list doesnt necessarily mean there are a ton of items working to boost your skins health. Sometimes, simple ingredient lists are most effective.

In general, if a skin care product has too many chemicals or fragrances, it can irritate the skin and cause skin rashes, and its best to avoid, Blyumin-Karasik says.

Individuals with sensitive skin, eczema, dermatitis, or rosacea will want to pay particular attention to product labels and the less is more mantra, Blyumin-Karasik says, as people with these conditions are more prone to irritation.

Theyre best served by using fragrance-free, sensitive skincare lines such as Avene and Bioderma, and definitely avoiding any of the above skin allergens, Blyumin-Karasik says.

Blyumin-Karasik advises acne-prone individuals to opt for products that wont clog pores. She suggests looking for words like oil-free and noncomedogenic and minimizing the use of occlusive moisturizers or make-up.

These can cause more breakouts and blemishes, Blyumin-Karasik warns.

When purchasing skin care products, youre making an investment in your bodys largest organ.

But some ingredients may not serve your skin or overall health.

Though research in some cases is minimal and others are mixed, Phthalates and some parabens are linked to hormonal disruption. Other ingredients are carcinogens or may cause irritation.

Speaking with a dermatologist can help you figure out the best and safest products and ingredients for your skin and overall health.

Beth Ann Mayer is a New York-based freelance writer and content strategist who specializes in health and parenting writing. Her work has been published in Parents, Shape, and Inside Lacrosse. She is a co-founder of digital content agency Lemonseed Creative and is a graduate of Syracuse University. You can connect with her on LinkedIn.

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6 Ingredients to Avoid Putting on Your Skin - Healthline

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Ancient Viking poop helped scientists map the genetics of a 5000-year-old parasite – Interesting Engineering

Posted: September 8, 2022 at 2:37 am

Preventing serious negative effects

The research team then examined the ancient stool samples gathered from various locations and compared them with contemporary samples received from people with whipworms from around the world. This provided them an insight into the evolution of the worm over ten-thousands of years.

"Unsurprisingly, we can see that the whipworm appears to have spread from Africa to the rest of the world along with humans about 55,000 years ago, following the so-called 'out of Africa' hypothesis on human migration," stated Kapel.

As mentioned above, a whipworm infection can have a beneficial impact on a healthy host. When it comes to severe infections, on the other hand, it can lead to dysentery, anemia, and rectal prolapse, and in children, it can impede healthy growth.

The researchers believe that this new research could help develop new ways to prevent such effects.

The findings have been published in the journal Nature Communications.

Abstract:

The neglected tropical disease trichuriasis is caused by the whipworm Trichuris trichiura, a soil-transmitted helminth that has infected humans for millennia. Today, T. trichiura infects as many as 500 million people, predominantly in communities with poor sanitary infrastructure enabling sustained faecal-oral transmission. Using whole-genome sequencing of geographically distributed worms collected from human and other primate hosts, together with ancient samples preserved in archaeologically-defined latrines and deposits dated up to one thousand years old, we present the first population genomics study of T. trichiura. We describe the continent-scale genetic structure between whipworms infecting humans and baboons relative to those infecting other primates. Admixture and population demographic analyses support a stepwise distribution of genetic variation that is highest in Uganda, consistent with an African origin and subsequent translocation with human migration. Finally, genome-wide analyses between human samples and between human and non-human primate samples reveal local regions of genetic differentiation between geographically distinct populations. These data provide insight into zoonotic reservoirs of human-infective T. trichiura and will support future efforts toward the implementation of genomic epidemiology of this globally important helminth.

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Project Uses OpenCDS, Chatbots to Broaden Genetic Testing’s Reach – Healthcare Innovation

Posted: September 8, 2022 at 2:37 am

A clinical trial involving University of Utah Health and NYU Langone Health in New York is seeking to identify patients who qualify for genetic risk assessment using a clinical decision support algorithm to automatically evaluate family history of cancer. The BRIDGE Trial also is testing the use of a chatbot for patient outreach.

At last weeks National Human Genome Research Institute meeting on genomic learning healthcare systems, Guilherme Del Fiol, M.D., Ph.D., associate professor and vice-chair of research in the University of Utahs Department of Biomedical Informatics, described the BRIDGE (Broadening the Reach, Impact, and Delivery of Genetic Services) Trial.

This randomized controlled trial has been funded by two grants from the National Cancer Institute, one of them focused on a software platform for population-level, genomic clinical decision support, and the other one is a randomized multi-site trial using this platform for a specific use case.

Kimberly Kaphingst, ScD,a professor in the Department of Communication and the director of Cancer Communication Research at the Huntsman Cancer Institute (HCI) at the University of Utah, is the principal investigator on the project.

The original motivation for this project was the finding that about 13 percent of individuals are at elevated risk for familial breast and colorectal cancer, and that most of these individuals are unaware of their risk, Del Fiol said, and at the same time, there are evidence-based guidelines recommending genetic testing based on their family history.

The goals of the project were essentially to enable a population health management platform that allows clinicians to use computable logic to identify patients who meet evidence-based criteria for genetic testing, and then to use a registry-based approach with patient outreach tools to manage the risk, he explained.

We leverage family history that's available in the EHR, and we do not try to collect or improve the collection of family history, Del Fiol stressed. Another essential part of the strategy is that in order to minimize primary care effort, primary care providers are kept into the loop of this whole process, but they are not asked to do anything extra.

Part of the innovation is to try to use automated chatbots for the patient outreach process, which includes patient education, in offering genetic testing. The BRIDGE Trial is about to finish enrollment at University of Utah Health and New York University Langone Health.

From the project website, here is information on the BRIDGE Trials goals:

The researchers hypothesize that uptake of genetic counseling and genetic testing will be equivalent between the chatbot and the genetic services delivery models. They also plan to explore how race, ethnicity, and geographic location modify the effects of the cancer genetics services delivery models on the outcomes.

Del Fiol said the project involves use of the OpenCDS platform. OpenCDS is a multi-institutional, collaborative effort to develop open-source, standards-based clinical decision support (CDS) tools and resources that can be widely adopted to enable CDS at scale.

Del Fiol explained how the system works: The population coordinator system identifies a screening population, which in this case is basically everyone who meets a certain age range and has been seen in a primary care at University of Utah or NYU-Langone. The population coordinator retrieves data from these patients and transforms everything into FHIR from the EHR. Next, FHIR data is transmitted to OpenCDS in bulk. OpenCDS has an interface based on the CDS Hooks standard, which is a clinical decision support services standard that allows an independent service to receive a request to analyze patients according to certain logic, and then respond with the results of those analyses all in a standard format. CDS Hooks uses FHIR as the data standard both for requests and responses.

The results are then exported back into the EHR. In our case, for Epic, it uses Epics population registry solution, Del Fiol said. We load patients who meet criteria into the registry, and then the genetic counseling assistants uses that registry functionality to manage the population and conduct patient outreach activities.

This platform is supporting the BRIDGE trial, which is comparing two approaches for patient education and outreach, with the goal of offering genetic testing for patients who meet family history-based criteria. There are two arms of the study, Del Fiol explained. One is our usual care, which basically involves genetic counselors making phone calls to those patients, one by one, providing some education over the phone, in trying to schedule a genetic counseling appointment. The alternative approach in the second arm of the study is using an automated chatbot, which provides education about genetics and then at the very end of a chatbot conversation, it offers the option to receive genetic testing. If they decide to do testing, they receive a kit in the mail, collect the sample at home, mail the sample back to the lab, and an outreach note is written back into Epic with the patient's decision and the transcript of that conversation.

For patients who test positive, they get a genetic counseling appointment, and are basically back to the usual care workflow. But most patients test negative and are managed in an automated fashion using the chatbot. In both cases, a note is written into the EHR, with clinical recommendations. For patients who test negative that's an automated note, and for patients whose test positive, the note is written by a genetic counselor.

So far, more than 3,000 patients have received outreach in one of the two study arms. I'm not going to make comparisons here because the trial hasn't been completed yet, he said, but so far, 23 percent of the people who received an offer to use the chatbot or receive the phone call for genetic counseling completed the entire process they either completed the chatbot interaction, or they scheduled a genetic counseling appointment and had that appointment completed.

Del Fiol described some early lessons learned in this process. We found that using chatbots does seem to be a scalable approach for patient outreach and engagement. It minimizes the genetic counseling efforts, he said.

Overall, family history data is incomplete in the EHR. But when you have a family history assertion in the EHR, we found that it's largely correct, and rarely leads to false positive patient identification, he added.

Regarding clinical workflow, they tested interoperability using two EHR systems at three institutions, two on Epic and one on Cerner. At Intermountain Healthcare, we demonstrated that this works with a Cerner system, but we found there are significant disparities in family history documentation across different patient populations," he added. In addition, one problem with the chatbot is that it really relies on smartphone technology, and higher percentages of the people in low-SES and rural populations don't have a smartphone.

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Project Uses OpenCDS, Chatbots to Broaden Genetic Testing's Reach - Healthcare Innovation

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