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Diet or diabetes: You decide.

An estimated 34 million people in the U.S. -- or just over 1 in 10 -- have diabetes. Diet is a crucial tool for managing the disease, and weight loss can help people who are overweight prevent Type 2 diabetes. Prevention is particularly important when you consider that diabetes brings complications such as high blood pressure and cholesterol, plus increased risk for heart attack and stroke, kidney disease and blindness.

Consider one of the U.S. News 2021 Best Diabetes Diets, as evaluated by nutrition experts:

No. 1 (tie) The Flexitarian Diet

The Flexitarian Diet marries flexibility with a vegetarian eating plan -- eat like a vegetarian most of the time, but when the urge for a double cheeseburger hits, go for it. Cutting back on meat will likely help you lose weight, which means you stand a better chance of staving off diabetes. Plus, vegetarianism is linked to a lower diabetes risk, according to the Academy of Nutrition and Dietetics.

"The amount of information and guidance in the Flexitarian diet is just enough to make the dieter feel informed without feeling restricted," a U.S. News reviewer says. "Focusing on a plant-based diet has been shown in research to be beneficial for your heart and brain and can help reduce the risk of diabetes and certain cancers."

No. 1 (tie) Mediterranean Diet

Fruits, veggies, whole grains. Fish and seafood. Oh yeah, and wine. The Mediterranean diet is a healthy all-around choice -- and a clear winner when it comes to diabetes management and prevention. One study, for example, found that about 30% of heart attacks, strokes and deaths from heart disease could be prevented by adopting the approach. Another study suggests the Mediterranean diet can help prevent diabetes, since the short-chain fatty acids (a product of fiber fermentation in the gut) the diet promotes are linked to a decreased risk of the disease. As one expert said, "Overall, this is the best diet for long-term health and disease prevention."

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No. 3 (tie) DASH Diet

The DASH diet -- Dietary Approaches to Stop Hypertension -- was designed to curb high blood pressure, but chances are, it can help prevent and manage diabetes, too. It's generally viewed as an ideal eating pattern for both, and it echoes dietary advice touted by the American Diabetes Association. One large 2017 study even linked diets that closely mirror DASH and other healthy eating patterns with an 18% reduced risk of Type 2 diabetes. Better yet, "because it uses regular food and does not depend on supplements or smoothies, it is relatively easy to incorporate into a dietary plan and it provides satiety," one U.S. News panelist said.

No. 3 (tie) Mayo Clinic Diet

The Mayo Clinic Diet aims to recalibrate eating habits and promote weight loss. It emphasizes the right foods (fruits, veggies and whole grains), discourages the wrong ones and mandates physical activity -- all good standards for diabetes prevention. The guidelines mirror those of the American Diabetes Association, and our expert panelists said the plan is better than most other approaches for those worried about diabetes.

No. 3 (tie) Vegan Diet

Going vegan will likely help you lose weight and fend off chronic diseases like diabetes. Research suggests the approach can lower A1C levels, and a small pilot study published in the journal Nutrition & Diabetes in 2015 suggests it can help ease diabetes-related nerve pain. In late 2016, the Academy of Nutrition and Dietetics released a position statement declaring vegetarian diets -- including vegan ones -- to be healthy, nutritionally adequate and potentially able to prevent and treat diseases, including Type 2 diabetes.

A U.S. News reviewer concurs: "If followed in a healthy way, (a vegan) diet has a lot of potential for treating and managing diabetes and for preventing heart disease."

No. 6 Jenny Craig

Jenny Craig offers a lower-carb program for people with Type 2 diabetes. U.S. News panelists suspect the Jenny Craig for Type 2 program can work for diabetes care and applaud its support component, but caution that the cost and packaged foods approach aren't ideal long term. "The lack of preparation (doesn't teach) people to eat a healthy diet for the rest of their lives," one expert said.

No. 7 (tie) The Engine 2 Diet

Experts were impressed with the Engine 2 Diet, a low-fat, vegan plan designed to prevent and perhaps reverse diseases like diabetes caused by the so-called standard American diet. It will almost certainly help you lose weight, which can stave off Type 2 diabetes. Plus, one study found that those on a similar diet were able to ease up on their diabetes medications and lower their A1C hemoglobin levels.

But, as with any restrictive plan, careful planning to consume the right amount of various nutrients is key. "Following this diet alone will not reverse diabetes; you'd still have to pay attention to carbohydrate intake," one reviewer said.

No. 7 (tie) MIND Diet

The MIND diet -- which blends two all-star plans, the DASH and Mediterranean diets -- is designed to prevent Alzheimer's disease with brain-healthy foods such as leafy green vegetables, berries, nuts, beans and whole grains.

While research focuses on brain health, the plan's parent diets may have diabetes-preventive effects. Just make sure you get moving, too. Exercise is one of the most important aspects of preventing diabetes and other chronic diseases, one expert says, "so it's unfortunate that an exercise recommendation is not included with this diet plan."

No. 7 (tie) Ornish Diet

Experts applauded the Ornish Diet as a way to prevent or control diabetes, giving it an impressive rating in this category. The plan's basic principles of emphasizing whole grains and produce and shunning saturated fat and cholesterol are right in line with American Diabetes Association guidelines. And in one study, Ornish dieters decreased their A1C levels (blood sugar measure) by 0.4 percentage points after a year, which was considered meaningful. "I appreciate that this diet takes a more holistic approach to health, including supporting relationships with others and stress reduction," one U.S. News panelist said.

No. 7 (tie) Volumetrics

Filling up on fibrous, bulky foods (think raw carrots) over easy-to-overeat foods (like Cheetos) is tied to weight loss -- and, quite likely, diabetes prevention and management, experts agreed. Research suggests such low-density diets help prevent insulin resistance -- a frequent precursor to Type 2 diabetes.

The Volumetrics diet is flexible, too. "From a behavioral standpoint, it is one of the most reasonable plans to follow over the long term because it is not overly restrictive and allows people to make 'better' choices rather than trying to follow strict guidelines," one U.S. News panelist said.

No. 7 (tie) WW (Weight Watchers)

Want to eat your cake and be able to prevent or manage diabetes, too? WW (Weight Watchers) -- which offers specific plans for people with diabetes and prediabetes -- allows dieters to strategically indulge using a point system. Still, making mindful choices is important, an expert notes: "Since fruits and vegetables are zero points, those with prediabetes and diabetes may be adversely affected by this if they overindulge in these foods."

One yearlong randomized controlled trial of 563 American adults with Type 2 diabetes found that nearly twice as many people who followed WW (Weight Watchers) and received counseling from a certified diabetes educator met their A1C level treatment target in comparison to those who received standard diabetes nutrition counseling and education. WW (Weight Watchers) participants were also more than twice as likely to reduce their diabetes medications. The program also led to greater weight loss and more reduced waistlines.

No. 12 (tie) Nutritarian Diet

The Nutritarian diet's focus on plant foods and limiting of animal proteins is in line with diabetes prevention and management protocols. Research, too, links diets high in fruits, vegetables, whole grains, legumes and nuts with a lower risk of Type 2 diabetes, while diets high in red meat and other animal protein have been linked with higher diabetes prevalence in women. "The Nutritarian diet seems radical," one expert said, "but it's really just trying to pack as many of the healthiest foods as possible and minimize those that have been associated with disease."

No. 12 (tie) Vegetarian Diet

Going vegetarian can help shed pounds and fend off chronic diseases, including diabetes. A meat-free eating plan will likely help you lose weight and keep it off, which can stave off Type 2 diabetes. Research links vegetarianism with a lower diabetes risk, and the American Diabetes Association and the Academy of Nutrition and Dietetics agree it's a healthful option.

Best Diets to Prevent and Manage Diabetes

-- Flexitarian Diet.

-- Mediterranean Diet.

-- DASH Diet.

-- Mayo Clinic Diet.

-- Vegan Diet.

-- Jenny Craig.

-- Engine 2 Diet.

-- MIND Diet.

-- Ornish Diet.

-- Volumetrics.

-- WW (Weight Watchers).

-- Nutritarian Diet.

-- Vegetarian Diet.

More:
The Best Diets to Prevent and Manage Diabetes - Yahoo News

This article was originally published here

J Diabetes Complications. 2020 Nov 27:107808. doi: 10.1016/j.jdiacomp.2020.107808. Online ahead of print.

ABSTRACT

We searched whether the accumulation of Advanced Glycation End-products (AGEs), reflected by the skin autofluorescence (SAF), could predict diabetic foot ulcers (DFUs) during the long-term follow-up of people with type 1 diabetes. During year 2009, we measured the SAF with an AGE-Reader in 206 subjects with type 1 diabetes. DFU and amputations were registered during the 10 following years. The relation between the SAF and later DFU was analyzed by Cox model regression, adjusted for vascular risk factors. The 206 participants were mainly men (55.8%), 51 15 years old, with a 22 13 years diabetes duration. Twelve subjects presented a DFU. Their SAF were higher: 2.61 0.89 AU vs 2.11 0.53 for the others (p = 0.003), related to the risk of DFU (OR:3.69; 95% CI: 1.06-12.79) after adjustment for age, gender, diabetes duration, initial HbA1c, arterial hypertension, history of smoking, blood lipids and use of a statin. Five subjects were amputated, also related to the initial SAF: OR: 11.28 (95% CI: 1.76-79.97) after adjustment for age, gender, duration of diabetes, and HbA1c. The SAF has already been related to diabetic neuropathy and peripheral arterial disease. It predicts DFU in type 1 diabetes, which suggests that AGEs play a role in this highly specific and feared complication.

PMID:33386214 | DOI:10.1016/j.jdiacomp.2020.107808

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For diabetic type 1 patients, the skin autofluorescence predicts ulcers and amputations - DocWire News

Texas AgriLife Extension Services next diabetes education program will be held virtually on Wednesday in February.

Do Well, Be Well with Diabetes is a program is designed to help people with Type 2 diabetes learn how to manage their blood glucose through basic nutrition and self-care management.

The class was originally scheduled to be start Wednesday, Jan. 4. However, the class has been moved to Wednesdays in February.

The diabetes education program is offered free from 2 to 4 p.m. Feb. 3, 10, 17 and 24 over Zoom, thanks to grant funding.

To register, contact Texas AgriLife Extension Family & Community Health Agent Agent for Hopkins County Johanna Hicks at [emailprotected] or 903-885-3443 by Jan. 30. They will then receive registration forms, materials and a participation link to log into the Zoom sessions facilitated by medical experts and professional educators.

Hicks has collaborated with colleagues in Fannin, Titus, and Rockwall Counties to offer the course.

If individuals are not comfortable with Zoom, or if they dont have reliable internet, they are welcome to view the sessions at my office, Hicks said.

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Diabetes Education Class To Be Held Virtually In February - KSST

CHARLOTTESVILLE, Va. A researcher at the University of Virginia School of Medicine is testing what he calls a radically different approach to managing type 2 diabetes for those who cant or dont want to lose weight.

Daniel Cox, PhD, professor of psychiatry and internal medicine, said his program flies in the face of conventionality in that it doesnt insist on weight loss as a key component of controlling blood sugar.

Instead, it combines continuous glucose monitoring with well-informed eating choices, to understand the effect of different foods on blood-sugar levels, and well-timed exercise, to reduce those levels as needed.

The convention is lose weight. And if you lose weight, you lose belly fat, and if you lose belly fat, you lose adipose tissue in the liver. And that, in turn, reduces insulin resistance, Cox said. Thats all fine and good. And if you can, in fact, lose a significant amount of weight and keep it off for a long time a lifetime youre golden. You can even put diabetes in remission. Theres nothing wrong with that approach, and its a very effective approach.

But some people dont need to lose weight, and some people dont want to lose weight, and other people want to lose weight but they cant, or they cant keep it off for a lifetime.

Coxs approach relies on continuous glucose monitoring to help people understand how their food choices affect their blood sugar. Different foods may affect people differently, he notes.

Continuous glucose monitoring involves wearing a sensor on the back of the arm that continually sends a signal to a receiver that shows the persons blood glucose level, without the need for finger sticks.

Continuous glucose monitoring lets people see how a particular food affects their blood-glucose levels, whether its a sugary slice of cake or a seemingly healthy bowl of oatmeal, Cox said. Understanding that lets them make smart choices to keep their blood sugar under control.

If they do choose to indulge in a sugar-spiking food, the program encourages them to use light exercise, such as walking, to help bring their blood sugar back into check.

This is the innovation: One, you dampen how much (blood sugar) goes up by minimizing the amount of carbohydrate you eat, and, two, you hasten its recovery by becoming more physically active, Cox said.

Physical activity does two things: One, the skeletal muscle burns blood glucose as fuel, and, two, physical activity reduces your insulin resistance for a short period of time, about 24 hours.

Instead of fixing supper and having a great dinner and then plopping in front of the TV for the rest of the night, the alternative is becoming more physically active, Cox said. Do your shopping after you eat, walk the dog after you eat, clean your house after you eat.

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'Radically different' approach to managing Type II diabetes tested - The Union Leader

Type 2 diabetes is a serious disease. Its what happens when your body cant make enough insulin or use it properly. Insulin is the hormone that regulates blood sugar. Too much sugar in the blood causes a lot of complications. People with diabetes are at high risk for nerve damage, kidney disease, skin infections, eye problems, and developing a serious case of COVID-19, should they become infected. All of these problems can be very painful and debilitating. And once you have diabetes, it doesnt go away. You have to manage it for the rest of your life.

All of this sounds pretty bleak, but there is good news. The most common type of diabetes, type 2, can sometimes be prevented. The body sends up a warning flag called prediabetes. Those who are tested and find out they have prediabetes can take action to prevent the onset of irreversible diabetes.

The first step is to know your risk. The most significant risk factor is being overweight, especially if you carry more weight around your waist. Men with a waist measurement of 40 inches or more and women with a waist measurement of 35 or more are at greater risk of diabetes.

Age is also a risk factor. Because people tend to exercise less and gain weight as they age, those over 45 are at greatest risk. Pay attention to your family history, as well. If a parent or sibling has been diagnosed with type 2 diabetes, you are more likely to get it.

For a quick and easy screening test from the Centers for Disease Control and Preventions National Diabetes Prevention Program, visit https://www.cdc.gov/diabetes/prevention/pdf/Prediabetes-Risk-Test-Final.pdf.

If you find that you are at risk, ask your primary care provider to test for diabetes. The test your provider will most likely recommend is called a glycated hemoglobin (A1C) test. Its a blood test that shows your average blood sugar level for the past 2 to 3 months. Your provider is looking for a number below 5.6 percent. Measurements 5.7 to 6.4 are an indication of prediabetes. Higher than 6.5 percent on two tests indicates that you have diabetes.

If your test indicates that you already have type 2 diabetes, ongoing visits with a diabetes educator and a very focused and committed approach to diet and exercise can help you manage the effects of the disease. Medications and other therapies are sometimes recommended too.

If you find that you have prediabetes, the most important thing you can do is learn more. Understanding how the disease works will help you make some important life changes. The CDC offers a proven-effective diabetes prevention program specifically designed for people with prediabetes. Local health and fitness professional Andrea Malinowski is conducting a session starting in February. Its free, but you must have a prediabetes diagnosis to join. Ask your primary care provider to connect you with the local diabetes educator for more information.

Paula Haytko, RN, CDE, is a certified diabetes educator at Southwestern Vermont Medical Center.

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Health Matters: How to prevent type 2 diabetes - Bennington Banner

Cox partners with UM Extension to help keep community healthy

Cox Health and the University of Missouri Extension are teaming up to give residents who may be at risk of type 2 diabetes another resource to stay healthy in 2021.

The new diabetes prevention program is scheduled to begin Monday, Jan. 11 with online classes. Classes will be held from 6:30-7:30 p.m. every Monday for the first six months, and once a month for the final six months of the year-long program.

Community Health Field Specialist Kelsa Ferguson said a grant from the Department of Health and Senior Services is providing a grant that allows the partnership to offer this program for free of charge.

One in three adults are pre-diabetic, and 90 percent are unaware, Ferguson said. By participating in this class, it will reduce their risk of getting type 2 diabetes by 58 percent.

The goal of the program is to help participants lose 5-7 percent of their bodyweight and work up to 150 minutes of physical activity per week by the end of the 12-month course.

Ferguson also said the program will also function as a support group, where members can work together to share information.

We are going to talk a lot about how to heat healthy, how to exercise and stress management, Ferguson said. A lot of it is going to be about getting support as a group.

While the program will begin this month with online meetings, if COVID-19 restrictions are eased later down the road, Ferguson said the group may begin to meet in-person.

This program is being specifically designed for community members who are at risk of contracting diabetes, which could include people with a family history of diabetes, those who are overweight, residents who have been diagnosed with pre-diabetes and women who have been diagnosed with gestational diabetes.

There are 79 million Americans who have pre-diabetes, which increases their risk of heart disease and stroke risk, Ferguson said. Without intervention, 30 percent will develop type 2 diabetes within five years.

Anyone who is interested in enrolling in the program is invited to contact Ferguson at 417-635-4562 or kelsaferguson@missouri.edu.

More:
Local News: Beat diabetes in the new year (1/2/21) - Monett Times

Conceptual vector illustration. Human diseases. Stop cancer

Its now well established that obesity, visceral (belly) fat and type 2 diabetes (i.e., metabolic dysfunction) increase a persons risk for developing certain cancers. What is only beginning to be appreciated is that cancer patients that have underlying metabolic dysfunction have much worse outcomes and seriously increased mortality rates. This suggests that metabolic hormones play an important role in cancer progression, and could be valuable targets in cancer treatment.

A variety of chronic, adverse health issues are associated with metabolic dysfunction, including type 2 diabetes, cardiovascular diseases, Alzheimers, and most notably cancer. Metabolic dysfunction is linked with worse outcomes for at least 13 types of cancers and is associated with a 33% elevated risk of death from cancer in the US. Of all the various cancer types, some of the most common are highly sensitive to dysregulated metabolic hormones (insulin, leptin, adiponectin) and chronic inflammation stemming from overweight/obesity, pre-diabetes, type 2 diabetes and metabolic syndrome. An estimated 630,000 patients in the United States alone were diagnosed in 2014 with an obesity-related cancer, including breast, prostate, and colorectal cancers. Yet, only now are oncologists and researchers beginning to pay close attention to the profound influence systemic metabolic dysfunction has on cancer progression and patient outcomes.

The nexus of cancer and metabolic dysfunctionMetabolic dysfunction leads to dysregulated hormones that impact known oncogenic pathways causing tumors to grow faster with greater metastatic potential, and may even be implicated in cancer treatment resistance. The metabolic hormone insulin, as well as leptin and adiponectin (aka adipokines), signal through validated oncogenic pathways, including PI3K/Akt/mTOR, MAPK, ERK, JNK, Notch, and STAT3, and trigger deleterious downstream effects such as cell proliferation, migration, angiogenesis, stem cell protection, and metastatic potential. Ultimately, these downstream effects drive tumor growth and metastasis. Moreover, systemic metabolic dysfunction dysregulates the tumor immune microenvironment leading to immune suppression possibly rendering the tumor resistant to cancer treatment.

Sadly, you dont have to be overweight to have metabolic dysfunction. People who maintain a healthy weight according to their body mass index (or BMI) can still have systemic metabolic dysfunction, depending on how their body fat is distributed. These individuals are also at a higher risk of developing cancer, one major example of this being in post-menopausal women and breast cancer. Furthermore, cancer therapies themselves can induce metabolic dysfunction (e.g., hyperglycemia, hyperinsulinemia, weight gain, insulin resistance) which can impact the patients quality of life and even lead to treatment failure.

Why targeting gene mutations isnt enoughCurrent cancer treatments tend to target specific mutations or dysregulated pathways in tumor cells with the goal of blocking cell proliferation and reducing tumor burden. However, as long as metabolic dysfunction is stimulating key oncogenic pathways, oncologists administering these treatments will be fighting a losing battle. Studies with diet and exercise suggest that standard treatments may be more effective if they are administered simultaneously with measures to reduce metabolic dysfunction in cancer patients. This approach addresses the disease on two fronts: molecularly targeted chemotherapeutics arrest cell proliferation and can shrink the tumor size, while restoring normal metabolic hormone levels relieves the external stimulation on oncogenic signaling pathways. Not only does this combination approach impede multiple cancer drivers at both the systemic and cellular levels, but it also improves patients quality of life by boosting their strength and possibly lessening side effects from treatment.

It is now more important than ever that standard cancer treatments account for the critical role that metabolic dysfunction plays in patients prognosis. Rates of obesity, pre-diabetes and type 2 diabetes are on the rise worldwide, driven by poor diets, sedentary lifestyles, and even reduced activity during the Covid-19 pandemic. Furthermore, metabolic dysfunction and cancer are associated with aging, and retiring baby boomers make up a massive aging segment of our population. This growing population of aging individuals combined with an increase in metabolic dysfunction creates the perfect storm in which many more people are likely to develop highly aggressive forms of cancer in the coming years.

How to treat a cancer patient with metabolic dysfunction?When a person with metabolic dysfunction discovers they have cancer, they can work with an endocrinologist or dietician to develop healthier lifestyle habits, such as weight loss, better diabetes control, improved nutrition, and regular physical activity all of which help the patient better tolerate chemotherapy, and improve the treatment outcomes. However, sticking to a rigorous diet and exercise regimen can be challenging for patients, especially while they are undergoing chemotherapy. While adopting healthy habits should always be a goal, cancer patients could benefit from pharmacological options that treat systemic metabolic dysfunction more predictably and reliably to provide a complementary, one-two punch with standard of care cancer therapies so they have a better shot at working. Although there are no drugs on the market specifically targeting this population, the type 2 diabetes drug metformin has been clinically studied in this population, with mixed results.

Treating the patient, not just the cancerWeinbergs The Hallmarks of Cancer got it right a multi-faceted approach to treating cancer is the way forward. Metabo-oncology is the emerging area of research dedicated to understanding and developing treatments for cancers that are sensitive to metabolic dysfunction. A steadily-growing body of clinicians are speaking out on the role of metabolic dysfunction and its implications on cancer patient treatment and clinical outcomes.

Justin Brown PhD, assistant professor and director of the Cancer Metabolism Program at the Pennington Biomedical Research Center in Louisiana is a leader in the field researching how metabo-oncology principles can be put into clinical practice. From Dr. Browns perspective, the diagnosis of cancer triggers two reactions: on one hand, an individual becomes motivated to do everything in their power to maximize the probability for a good outcome; on the other hand, the diagnosis is overwhelming, stressful, and terrifying. Most patients experience some combination of both reactions, and this is where healthy lifestyle habits can be a powerful, enabling tool.

Dr. Brown believes that oncologists should provide the right information about lifestyle choices to the right patient at the right time. When a patient indicates that they are ready, physicians could then initiate a patient-centered discussion about the benefits of pursuing a healthy lifestyle. Once a patient decides they want to adopt a healthier lifestyle, doctors should put the patients in contact with experts (endocrinologists, dieticians) to help improve clinical success.

In reality, however, while oncologists and their patients generally recognize the importance of healthy lifestyle habits, in a 2019 survey conducted by the American Society of Clinical Oncology, oncologists only reported counselling patients about weight management, healthful eating, and physical activity about 40-60% of the time, due to a lack of training, limited referral options, and lack of third-party reimbursement for diet and exercise counseling.

Thats why treating cancer patients with concomitant metabolic dysfunction remains a major challenge for oncologists. The work of a key opinion leader in this field, Emily Gallagher, MD, PhD demonstrates this well. Dr. Gallagher is an endocrinologist at Mount Sinai in New York who specializes in treating cancer patients with metabolic dysfunction. When Dr. Gallagher treats her patients, she never takes a one-size-fits-all approach to addressing their metabolic issues. Instead, she considers the underlying medical reason patients were referred to her, the type of cancer they have, and the type of treatment they are receiving. She considers pre-existing conditions, like type 2 diabetes, current lifestyle, and disease symptoms when devising a treatment regimen that she believes will be most effective. She sets short-term and long-term goals for her patients and follows up regularly to help keep them on track, and encourages them to see a diabetes educator/dietitian to further encourage positive lifestyle changes.

From Dr. Gallaghers perspective, when patients have metastatic cancer, their non-cancer background conditions often go under-treated. But, by ignoring systemic metabolic dysfunction, clinical oncologists may inadvertently be contributing to their patients disease progression. Therefore, its important that oncologists pay close attention to the metabolic health of their cancer patients and monitor for endocrine side effects (hyperglycemia, hyperinsulinemia, obesity/weight gain) induced by the cancer drugs they prescribe. This is why it makes sense to refer these patients to endocrinologists who may have already developed strategies to address these problems. Whats more, by having the oncology team reinforce the importance of systemic metabolic health, it communicates to the patients that their treatment strategy is being administered by a team of doctors using a whole-patient strategy.

While treating physicians know that obesity/systemic metabolic dysfunction leads to worse outcomes for their cancer patients, they face multiple challenges in addressing it: limited pharmacologic interventions that can effectively treat patients metabolic issues, lack of training in the methods endocrinologists use to address these issues, and no payer incentives to encourage better lifestyle choices. While we wait for effective pharmaceutical interventions that can reliably address these issues, anti-diabetic medications and diet and exercise will have to do. Addressing systemic metabolic dysfunction in cancer patients requires communication between diverse medical experts and scientific disciplines. Incorporating a multi-disciplined approach to treating cancer should help foster better clinical practices for cancer patients and improved outcomes for patients with cancers sensitive to metabolic hormones.

Photo: Main_sail, Getty Images

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Are metabolic hormones the next frontier in cancer treatment? - MedCity News

New Delhi: People with diabetes face a real challenge during the winter season. The cold weather coupled with reduced physical activity puts stress on the body, causing it to go into a fight-or-flight mode. This results in the release of natural survival hormones like adrenaline and cortisol. Consequently, the liver releases more glucose for energy leading to increased blood sugar levels.

Dr H.P. Bharathi, Deputy Chief Medical Officer, Jindal Naturecure Institute says: Presently, more than 50 million people in India have diabetes and it is expected to go over 6 crores by 2025. So, theres a big challenge in front of the country to tackle this rising concern. A naturopathic approach recommending specific behavioural changes can help in the effective management of diabetes during the winters. He shares six naturopathy and yoga tips that can help people with diabetes during the cold season.

1. Diet: A well-balanced diet is crucial to keep diabetes in control no matter the season. It is recommended to include plenty of vegetables, fruits, whole grains, lentils, beans, and oatmeal. Sweets and fatty foods should be avoided. Also, diabetics should refrain from consuming dry fruits as the fructose in them may spike the sugar level.

2. Yoga: The ancient practice of yoga can work wonders on the body, helping people with diabetes to keep the disease under control and lead a normal, happy life. Science has shown that specific yoga poses that involve the twisting and stretching of the internal muscles and organs stimulate the pancreas and endocrine system. This facilitates insulin secretion, which keeps the blood glucose levels under check.

3. Alternative treatments: Alternative treatment methods like acupuncture, physiotherapy, hydrotherapy, etc., can restore harmony to the body in several ways. Acupuncture, where thin needles inserted into specific points in the body, can help with weight loss, control blood sugar levels, and reduce insulin resistance. Physiotherapy and hydrotherapy promote neurological and musculoskeletal functions that aids in weight loss, reduces stress levels, and lowers blood pressure.

4. Mental health: Those affected with diabetes live with a lot of stress. It can cause spurts of anxiety, mood change, confusion, and depression. The American Diabetes Association says that Seasonal Affective Disorder (SAD) may occur during winters; however, it is treatable. Spending time with loved ones, indulging in hobbies, or getting professional help are some of the ways through which diabetics can find relief.

5. Lose weight: Obesity can increase the risk of developing type 2 diabetes by 80-85 percent. For people with obesity, the pancreas cannot produce enough insulin to meet the body's needs. Therefore, losing weight becomes the only option to stay healthy and fit. Regular exercise, brisk walks, etc., should be incorporated into daily life to get rid of excess weight.

6. Avoid immune suppressing foods: Diabetics should stay away from high-fat food, alcohol, caffeine, and white sugar, suppressing the immune systems effects. Too much high-fat foods can block the lymphatic system, hindering the bodys ability to fight infections.

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Know how to boost well-being in winters if you are diabetic - Free Press Journal

NEW YORK When youre trying to lose weight, it may not seem like theres such a thing as good fat. Despite this, scientists say brown fat is something everyone needs more of and it can even make you healthier. Aside from burning more energy, a new study reveals having brown fat makes it less likely someone will develop several conditions including diabetes and heart disease.

Researchers from Rockefeller University Hospital say brown fat is much different than the more common white fat. While white fat stores calories and makes up about 90 percent of the bodys fat cells, brown fat is key in energy consumption, fat burning, and generating heat. The one problem with studying the health benefits of brown fat is it can be hard to find. A reason for this is its buried deep inside the body and even gets mistaken for tumors.

The study of over 52,000 participants finds those who have detectable levels of brown fat in their bodies suffer from fewer health problems.

For the first time, it reveals a link to lower risk of certain conditions, says Paul Cohen, a senior attending physician at Rockefeller, in a media release. These findings make us more confident about the potential of targeting brown fat for therapeutic benefit.

While scientists have been researching brown fat for decades in animals and infants, they discovered in 2009 that adults still have these cells as well. Typically, brown fat is located in the neck and shoulders. Unfortunately, researchers ran into a problem when it came to scanning for these cells using PET medical imaging.

These scans are expensive, but more importantly, they use radiation, says study first author Tobias Becher. We dont want to subject many healthy people to that.

The team quickly realized there was an alternative nearby at the Memorial Sloan Kettering Cancer Center. There, patients undergoing evaluation for possible cancers regularly take PET scans. The scan easily detects brown fat and radiologists must make a note of it so doctors dont mistake it as a cancerous mass.

Working with Heiko Schoder and Andreas Wibmer at Memorial Sloan Kettering, the study examined 130,000 PET scans. Those scans reveal nearly 10 percent of the more than 52,000 patients have brown fat tissue. The results find only 4.6 percent of patients with brown fat have type 2 diabetes. That number is 9.5 percent among people who do not have visible brown fat deposits.

Additionally, just 18.9 percent of patients with brown fat have abnormal cholesterol levels, compared to 22.2 percent of those without brown fat. Patients with brown fat tissue also have lower risk for high blood pressure, heart failure, and coronary artery disease. The results even point to brown fat negating some of the health impacts of obesity in overweight patients.

It almost seems like they are protected from the harmful effects of white fat, Cohen says.

Study authors note the number of adults in the general population with brown fat is likely higher. This is because patients at Memorial Sloan Kettering are commonly advised to avoid the cold, exercising, and caffeine. Scientists are still looking for the reasons why brown fat is able to reduce the risks of these conditions. The study says there are some clues though.

Brown fat cells consume glucose as they burn calories. Researchers believe its possible this is lowering the blood glucose levels, which is a major determining factor for diabetes patients. There are fewer clues tying brown fat to hypertension, but its link to the hormonal system may hold the answer.

We are considering the possibility that brown fat tissue does more than consume glucose and burn calories, and perhaps actually participates in hormonal signaling to other organs, Cohen explains.

The natural question that everybody has is, What can I do to get more brown fat?' he adds. We dont have a good answer to that yet, but it will be an exciting space for scientists to explore in the upcoming years.

The study appears in the journal Nature Medicine.

Read the rest here:
Brown fat may protect adults from chronic conditions, including diabetes and heart failure - Study Finds

Wow, what a year 2020 has been

Weve had to learn to live in ongoing pandemic crisis mode as COVID-19 remains a public health emergency across the globe.

Pretty much everything is seen through that lens, and as a result, our annual diabetes year in review also looks a bit different this time around.

Traditionally, DiabetesMine has featured a month-by-month breakdown of the biggest happenings of the year.

But 2020 isnt like any other year. Every week and month has felt extraordinarily long, and the days seemed to blend together in ways we just havent ever experienced before.

As such, weve focused our annual review on the big themes defining 2020, along with a handful of notable news items.

The pandemic has hit our Diabetes Community on so many different levels, including but not limited to the following:

We cant overlook the mental health effects all of the above both individually and collectively had on people with diabetes (PWDs).

Mental health has been a lesser-discussed aspect in official research and diabetes care until recently. (This has prompted some community advocates to devote themselves to helping.)

A new study by a team of diabetes experts published in the December 2020 edition of the Journal of Diabetes and Its Complications examined the early effects of COVID-19 nationally on U.S. adults with both type 1 and type 2 diabetes.

The researchers concluded that: There is a substantive increase in level of diabetes-related and general life stress and worry about being vulnerable to the virus, and significant social isolation [and] there is a significant impact on disease management.

Changes in the medium of healthcare delivery were only modest during the early stages of social restriction, but satisfaction with these changes was generally low, they added.

These findings suggest the need for greater attention to the emotional and psychosocial impact of the pandemic on this population and its implications for disease management and diabetes-related healthcare delivery.

The United States endured one of the most volatile presidential administrations and intense elections in modern history.

And with that, it seems everything was viewed through a political lens including the efforts to prevent and respond to the pandemic itself.

This made everything even more confusing and concerning for PWDs. For instance:

Of course, recognition and representation of BIPOC (Black, Indigenous, and People of Color) became a hot-button issue in 2020 following the police killing of George Floyd, sparking historic protests across the country.

Some PWDs were among those arrested, which brought up the issue of whether police were discriminatory or negligent with diabetes care and personal safety on the line.

Meanwhile, there was a great deal of introspection about racial disparities, in COVID-19 responses and beyond, and the implicit bias and systematic racism that exists in our U.S. healthcare system.

As everything began boiling over, some key diabetes advocacy organizations like JDRF and Beyond Type 1 came under fire for lacking diversity and not addressing the issue properly. See the JDRFs response here.

There were many panel discussions and studies presented on this topic at conferences, and a new nonprofit called Diversity in Diabetes (DiD) was formed by advocates of color to elevate efforts.

We at DiabetesMine conducted a survey on BIPOC experiences with diabetes technology and care in fall 2020, and found that more than 50 percent of respondents currently do not feel represented at all.

See also our video of BIPOC advocates expressing their desires for change.

Thankfully, 2020 also brought our D-Community a handful of highlights worth mentioning. Here they are, in no particular order:

Announced in late 2019, a long-awaited policy change finally took effect that allows people with insulin-dependent diabetes to legally pilot commercial airplanes.

Pietro Marsala became the first T1D licensed commercial pilot.

Ironically, this came to be just as the global pandemic sucker punched the travel industry.

Still, its an important change that puts the United States on par with other countries, and it takes away one more cant do for PWDs following their dreams.

While insulin affordability and access remains at crisis level in the United States, we saw two new forms of insulin finally get clearance from the Food and Drug Administration (FDA) and launched this past year:

A few important new diabetes devices were launched this past year as well:

Despite the economic struggles and effects on diabetes nonprofits, weve seen a few new orgs born during 2020 to address specific needs: the aforementioned Diversity in Diabetes (DiD), Beta Cell Foundation, and Mutual Aid Diabetes (MAD).

The latter two are grassroots orgs formed to help people in need get diabetes meds and supplies, beyond whats offered by existing industry-based financial assistance programs.

This year of content streaming gave us the Netflix reboot of The Baby-Sitters Club, once again featuring a main character who wears an insulin pump.

Also in the limelight was the passing of actor and famous diabetes supply spokesman Wilford Brimley. Pop singer Meghan Trainor also shared her gestational diabetes story publicly.

Be on the lookout for the new movie Greenland, written by Chris Sparling, husband of well-known diabetes advocate and author Kerri Sparling.

The movie features a T1D character and was released for on-demand viewing in December 2020. Its heading to HBO Max in 2021.

This past year has been extremely tough for all of us on so many fronts Heres to looking forward to a brighter, less stressful 2021 ahead.

Read more:
A Look Back on 2020: Diabetes Year in Review - Healthline

At the molecular level all cancers are genetic, they start as your normal breast cell or ovaries and overtime pick up small genetic changes. When talking about inherited testing or hereditary testing only a small portion of cancer can be passed down in a family. We roughly quote 5-10% can be due to hereditary reasons or something we might find in an inherited genetic test, explained Dr. Tong at the CURE Educated Patient Womens Cancer Summit.

Genetic testing is a critical part of understanding these cancers, as well as how to treat, and Ill be discussing today about how we think about how genetics fits in cancer development, how genetic testing plays a role and how genetic counseling can help induvial and families come to decisions around genetics, says Dr. Tong.

Some exceptions include, up to 20% of negative breast cancers that can be hereditary and up to 25% of ovarian cancers can be hereditary, which is why genetic testing is recommended for all ovarian cancers.

When talking about hereditary cancer Dr. Tong says clinicians and genetic counselors are thinking about if that person has a higher chance of developing cancer, because nobody is at a 0% of developing cancer. Genetic testing will look at to see if they can identify what is elevating the persons risk of developing cancer, and can you potentially explain why a person developed certain cancer.

Part of what we learn from genetic testing, is not only could it have been due to a hereditary cause, such as a mutation in a gene, but which gene mutation and how can we differentially take care of people depending on which gene mutation did cause that, says Dr. Tong.

Guidelines recommend that all women diagnosed with epithelial ovarian cancer and breast cancer should be offered genetic testing.

Beginning in 2015 technology has brought three different types of gene testing or as they call it, Multi-Gene Panel Testing. Then there is a decision about how much genetic testing to do. For genes that they know are associated with inherited risk, those are high and moderate risk genes, they have actionable guidelines for treatment, risk reduction or prevention.

As technology develops you think about if the low-risk genes should also be looked at, the most likely have no impact on your health, such as a recessively inherited cancer risk, the information from these genes may be relevant to your family members or future generations. Some panel offers looking at newly described genes, they have limited evidence that they may impact inherited cancer risk, and they dont have actionable guidelines yet but could in the future.

We think that pretest counseling with a genetic counselor can help an induvial better understand how genetics impacts or plays a role in their cancer diagnosis or in their family history. Genetic counselors will take a look at family history and go many generations to look at distant relatives to see if there is a pattern to the cancers of that family that can be inherited, or does it look more like sporadic risks, then that counselor can discuss what the testing options are, how much testing to have or if its even right for you or not, says Dr. Tong about genetic testing counseling.

Types of results include a negative, the most important to be working with a genetic counselor, meaning there was no change found in the gene, it is considered a normal result and cancer treatment, screening and prevention decisions can be based on personal and family history of cancer. The next is a variant or uncertain significance, also considered a normal result, a change was found but is most likely due to normal human variation. The last result is positive result, where they find a change or genetic mutation that is associated with cancer, cancer treatment, screening and prevention decisions will be based on the risks specific to the change found.

Some may fear that they may be discriminated against due to their genetic testing results. There are laws in place that will protect you and your family members from employment or health insurance discrimination such as the Genetic Information Non-Discrimination Act of 2008, or GINA. In addition, there is the Americans with Disabilities Act, ADA, and the Health Information Portability and Accountability Act, HIPPA. However, there are limitations, how these laws dont protect against other types of discrimination such as life insurance, disability or long-term care, which would be discussed in your genetic counseling session.

Genetic testing can help thinking about what the path forward is for you and your family when we do learn the results, Dr. Tong concludes. He says going to a genetic counselor can help medically keep you healthy and also emotionally, connecting you with different resources and support organizations.

Read the original post:
What is Genetic Cancer Testing and How Do Patients Get Tested? - Curetoday.com

Every week there are numerous scientific studies published. Heres a look at some of the more interesting ones.

Antibodies Respond Differently to Severe Versus Mild COVID-19

Researchers at Stanford Medicine found that COVID-19 antibodies preferentially target different parts of the SARS-CoV-2 virus in mild COVID-19 cases than they do in severe cases. In addition, they fade differently based on the severity of the case. People with severe COVID-19 have low proportions of antibodies that target the spike protein. In milder cases, the antibodies seem to do a better job of binding to the spike protein. The spike protein binds to the ACE2 receptor on human cells, which allows the virus to enter the cell. Once inside, the virus gets rid of its outer coat, takes over the cells protein-making machinery and churns out more viral particles that then infect other cells. Antibodies that bind to the spike protein block the ability to bind to ACE2. Antibodies that bind to other parts of the virus dont seem to prevent viral spread.

Antibody responses are not likely to be the sole determinant of someones outcome, said Scott Boyd, associate professor of pathology at Stanford. Among people with severe disease, some die and some recover. Some of these patients mount a vigorous immune response, and others have a more moderate response. So, there are a lot of other things going on. There are also other branches of the immune system involved. Its important to note that our results identify correlations but dont prove causation.

Understanding Brain Plasticity in Adults

When brains develop, they constantly grow new neuronal connectionssynapsesas they learn and remember. Important connects are nurtured and reinforced while seemingly unnecessary ones are pruned. Adult brains undergo similar treatment, but its not well understood why adult synapses are eliminated. A group of researchers at The Korean Advanced Institute of Science and Technology (KAIST) have found the underlying mechanism of plasticity, which could be related to neurological disorders in adult brains. The brains gray matter contains microglia and astrocytes. Microglia are a frontline immune defensethey eat pathogens and dead cells. Astrocytes are star-shaped cells that help structure the brain and maintain homeostasis with involvement in neuronal signaling. It was long thought that microglial eat synapses as part of their clean-up effort, a process called phagocytosis. But their research, using a new molecular sensor, found that it was actually the astrocytes that are constantly eliminating excessive and unnecessary adult excitatory synaptic connections.

New Class of Antibiotic Works Against Range of Bacteria

Investigators withThe Wistar Institute have identified a new class of antibiotics that have a broad range of antibacterial effects, including against microbes with antimicrobial resistance (AMR). They focused on a metabolic pathway essential for bacteria but absent in humans, called methyl-D-erythritol phosphate (MEP) or non-mevalonate pathway, which is responsible for biosynthesis of isoprenoids. Isoprenoids are required for cell survival in most pathogenic bacteria. The researchers targeted the IspH enzyme, essential in isoprenoid biosynthesis. They screened several million commercially available compounds using computer models to find ones that could bind with the enzyme and chose the most potent ones. Most IspH inhibitors cant penetrate the bacterial cell wall, so the researchers worked to identify and synthesize novel IspH inhibitors that could get inside the bacteria.

Rhesus Macaque Genome Reference Includes 85 Million Genetic Variants

Researchers at Baylor College of Medicine, the University of Missouri and the University of Washington created a new reference genome assembly, identifying more than 85 million genetic variants in the rhesus macaque. This makes it the largest database of genetic variation for any single nonhuman primate species. It is a big improvement over the first reference assembled in 2007, and they believe it can help analyze and answer fundamental questions in molecular genetics, cell biology and physiology, not just in rhesus macaques, but in humans and other primates and mammals.

This is a major step forward in the amount of information we have about genetic variation in the rhesus macaque, said Jeffrey Rogers, associate professor at the Human Genome Sequencing Center and Department of Molecular and Human Genetics at Baylor. We have actually identified thousands of new mutations in the population of research animals. Now colleagues all over the country who are investigating various aspects of health and disease using rhesus macaques can begin to make use of that information.

Common Diabetes Drug Linked to Rare COVID-19 Complications

Although diabetes is a known risk factor for COVID-19, researchers with Brigham and Women's Hospital have identified a rare COVID-19 complication with common diabetes drugs. The side effect is called euDKA, or euglycemic diabetic ketoacidosis. DKA occurs when the bodys cells do not absorb enough glucose and begin metabolizing fats instead, which results in a build-up of ketones. EuDKA is marked by lower blood sugar levels, making it harder to diagnose. The researchers evaluated five unusual euDKA cases that was a significantly higher level of incidence, all seen in COVID-19 patients taking sodium-glucose cotransporter 2 inhibitors (SLGLT2i). They believe that COVID-19 may increase the risk of euDKA by binding to cells on the pancreas that produce insulin. The three SGLT2 inhibitors approved by the FDA are Janssens Invokana (canagliflozin), AstraZenecas Farxiga (dapagliflozin) and Eli Lilly and Boehringer Ingelheims Jardiance (empagliflozin).

Whats Going on in the International Space Station?

The Expedition 64 crew took the day off for Christmas, but immediately afterwards went back to work on a variety of biological and medical research. Two studies evaluated new treatments for joint injuries and cancerone looked at bone, cartilage and synovium in artificial gravity chambers to better understand bone loss and joint damage; the second studied protein crystals grown in space and their ability to target cancer cells. A different study on several dozen mice evaluated the vascular changes in space on eyesight functionabout 40% of people working in space have vision changes from fluid shifts and radiation. Another experiment studied genetic changes in space and their impact on the growth and deterioration of bone tissue.

See the article here:
Research Roundup: Different Antibody Responses to COVID-19 and More - BioSpace

People wear face masks as they walk by an art installation in Montreal, Dec. 27, 2020, as the COVID-19 pandemic continues in Canada and around the world.

Graham Hughes/The Canadian Press

The emergence of a more contagious variant of the virus that causes COVID-19 does not require individuals to take new precautions, but it is now more important than ever that they follow existing public-health guidelines, doctors and scientists say.

While new variants of the virus SARS-CoV-2 have recently been detected in South Africa, Nigeria and Britain, the latter countrys version, called B117, has caused particular concern, as scientists estimate it is more transmissible than other mutations of the virus. This new variant has also been identified in people in Ontario, British Columbia, Alberta and Quebec, and the Canadian government has suspended flights from Britain until Jan. 6. Meanwhile in Britain, there are growing calls to impose another national lockdown and shut down schools and universities.

In a study, yet to be peer-reviewed, British scientists estimated B117 is 56 per cent more transmissible than pre-existing variants of the virus. Although they found no clear evidence that it affects the severity of illness, they warned that the increased transmissibility would likely lead to a surge in hospital admissions and deaths. They suggested strict lockdown measures may not be sufficient, unless primary schools, secondary schools and universities are closed.

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I would say that the current social distancing guidelines are more important than ever given this new variant, lead author Nicholas Davies of the London School of Hygiene and Tropical Medicine said in an e-mail. People should be cautious, follow the guidelines, and self-isolate if they suspect they may have been infected.

But the estimated increased transmissibility of the new variant does not mean existing public-health advice for personal protection such as wearing masks when you may come in close contact with others, keeping two metres away from people outside your household and maintaining hand hygiene will be less effective, experts say.

Rather than changing the current guidelines, Leighanne Parkes, an infectious-disease specialist and microbiologist at the Jewish General Hospital in Montreal, said she would be happy to see people actually follow them.

People take little shortcuts from time to time and give themselves little cheat days. And I think thats where the danger lies, when we let down our guard and we fail to remain vigilant, she said.

Dr. Parkes said family members have contacted her over the holidays, expressing worry that this new variant adds another twist to an already calamitous year. But, she explained, there have been numerous variants since the very emergence of SARS-CoV-2. And some, such as a variant called D614G, have become predominant worldwide.

Dr. Parkes said it is important to note that large task forces and working groups at the global level are trying to determine the significance of the changes to the virus in the new variant.

Technically, she said, it involves a mutation within a part of the binding loop, which is part of the virus that sticks to our ACE-2 receptors, the part of the cell to which the virus binds to gain entry. The concern is that since this mutation affects an important part of the virus and how it attaches to cells, it raises questions such as whether it has increased tissue-specificity that is, it binds to cells in the nose and upper respiratory tract where it can be spread through droplets with greater ease, whether smaller quantities of the virus can lead to infection, and whether it changes the way people respond to it.

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While there are experts working to rapidly answer these questions, I think as of now, we just dont know. These are all kind of black holes in our knowledge, she said.

In an e-mailed statement, Health Canada said the government is closely monitoring the variant and is working with international groups, including the World Health Organization.

While early data suggest that the United Kingdom variant may be more transmissible, to date there is no evidence that the mutations have any impact on symptom severity, antibody response or vaccine efficacy, it said, but noted evidence is limited at this time.

But no matter the variant, SARS-CoV-2 is a virus that transmits very easily, and it is well known that people can spread it when they are minimally symptomatic or asymptomatic, Dr. Parkes said.

As always, given the high potential for asymptomatic transmission of SARS-CoV-2, the most prudent course of action for individuals is to act as though they might have the virus, Dr. Davies at the London school added in his e-mail.

While the mutations of the new variant may change how efficiently people contract the virus, they do not change the mechanism by which it spreads, said Emanuel Goldman, a virologist and professor of microbiology, biochemistry and molecular genetics at Rutgers New Jersey Medical School.

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The main route of transmission is still through what we breathe, so wearing a mask in public places, particularly indoors, is still the first line of defence, Dr. Goldman said. There is no need to go back to wiping down groceries as many did at the beginning of the pandemic, since transmission of the virus from surfaces is almost non-existent, he said.

The virus may be more transmissible, but its not less fragile, he said, explaining it degrades rapidly when exposed to the environment.

When it comes to behaviours that stop the virus, everything should stay the same. What works for the parent will work for the variants, Dr. Goldman said.

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Read the original:
Experts stress importance of following public-health advice as COVID-19 variant emerges - The Globe and Mail

The great but grumpy biologist J.B.S. Haldane was once asked what evidence would disprove evolution, whereupon he growled: Fossil rabbits in the Precambrian. He was referring to the evolutionary fact that complex multicellular creatures came along later than simple, unicellular ones. A bit surprising, perhaps, that one of the foremost evolutionary geneticists of the 20th century immediately reached for a paleontological example, but Haldanes reply was well-suited for public consumption, because thenas nowwhen most people thought of evolution, they were likely to conjure images of dinosaur fossils.

Donald Prothero is a research associate in vertebrate paleontology at the Natural History Museum of Los Angeles County. When I learned he had written a book that examined 25 different discoveries relating to evolution, I assumed that he, like Haldane, would deploy paleontology in making his case. Mr. Protheros book is indeed tilted toward examples from the world of ancestral creatures, but, refreshingly, also guides the reader through impressive discoveries in embryology and molecular genetics.

The Story of Evolution in 25 Discoveries is a parade of self-contained vignettes, often including biographical sketches of the scientists who made and interpreted each discovery. This particular story begins (like everything else) with the big bang, followed by the fascinating tale of how science gradually came to understand the age of the Earth: From biblical literalism; through Lord Kelvins famous underestimate, in the 1890s, of 20 million years; to our current understanding of 4.5 billion years. Then comes a whirlwind tour of evolutionary change as it occurs, in real time, among microbes, plants, insects, fish, birds and mammals, obliterating the creationist canard that evolution hasnt even been witnessed, let alone studied.

Some of the most impressive evolutionary stories involve common body plans, technically known as homologies. Thanks to Mr. Prothero, I now know that Aristotle first noticed this widespread phenomenon, of which Darwin wrote: What can be more curious than that the hand of a man, formed for grasping, that of a mole for digging, the leg of the horse, the paddle of the porpoise, and the wing of the bat, should all be constructed on the same pattern, and should include similar bones, in the same relative positions? Curious indeed. And strongly suggestive of common descentor, for anti-evolutionists, of a Creators insistence on sticking with the same divine blueprint, or archetype, even when other more direct routes should have been available. The Darwinian story provides scientific insight into why homologies occur, whereas the theological story simply reiterates that they occur.

And on we go, to the embryonic similarities of otherwise distantly related creatures (ontogeny recapitulates phylogeny) and then biogeography (the sinking of Noahs Ark), which shows, among other relevant findings, that the flora and fauna of islands resemble those of nearby continentsa phenomenon that wouldnt necessarily be expected if each had been a special, independent creation. The story of life continues, detailing how living things within natural categories share those common body plans, or, as Darwin put it, how organic beings have been found to resemble each other in descending degrees, so that they can be classed in groups under groups. As a result, instead of being arbitrary, our system of biological classification conforms perfectly with the nested, branching patterns of evolutionary relationships demonstrated by anatomy, physiology and genetics. Moreover, as Mr. Prothero points out, if life had been specially created rather than evolved, there would be no reason for the molecular systems to reflect this pattern of similarity seen in megascopic features . . . [and] not even Darwin could have dreamed that the genetic code of every cell in your body also shows the evidence of evolution.

Originally posted here:
The Story of Evolution in 25 Discoveries Review: The Branching Tree of Life - The Wall Street Journal

BY THOMAS J ERVIN, MD We have somehow made it to the final week of 2020. Humorously it can be said that we can all look back at the first year of the pandemic, with usually accurate 20/20 vision. As we all move into 2021, there is time to consider New Years resolutions. This year that opportunity should not go unfilled.

The effects of COVID-19 have spared no one. Even the most skeptical of us, and the unbelievers have noticed something. The negatives are obvious: illness, personal loss, death, social distancing, and isolation to name a few. Positives can also be identified, including personal faith, strengthening family relationships, considering collective wellbeing, and finding value in simple daily routines.

For each of us the balance of the positives and the negatives results in how we see the pandemic and the events of 2020. This balance determines how we consider resolutions for the future. As I am not a student of politics and race relations, I will avoid those events in my reflection of 2020.

My first resolution for 2021 is that this will be the last article I write about COVID-19 and the pandemic. I have spent 40 years teaching, studying, and practicing medicine. I have seen the impact of molecular genetics and biology in most specialties including cancer medicine and infectious diseases. To witness the development of the applied science that has given us potentially preventative vaccines (now there are at least four) within a year is both astounding and unprecedented.

Just 65 years ago injectable inactivated polio vaccine (Dr. Salk) became a reality. It then took six more years for the oral vaccine (Dr. Sabin) to be commercially developed. The overall research effort took more than 20 years. Two doses given four to eight weeks apart provide life-long immunity. Yet eradication of the disease was not immediate.

While the United States is considered polio-free, it has taken until 2017 for the number of wild-type polio cases in the world to fall under 1,000 cases a year. Over the past 30 years, things have gotten better. With continued development of effective vaccine platforms and better understanding of the variables that affect vaccine efficiency (number of doses, added immunostimulants, immunosenescence with age), the vaccines of the 21st century have been more rapidly developed. Successful vaccines are now possible using inactivated intact virus, attenuated virus, toxoids that induce illness such as tetanus, and diphtheria, or subunit viral pieces as in the vaccines for Hepatitis B and Herpes virus. Other forms of vaccines exist, including conjugate vaccine and heterotypic vaccines such as BCG used to prevent tuberculosis and bladder cancer. The list grows yearly.

Now we have the first of a new wave of vaccines. The mRNA platform has arrived just in time. The mRNA-based vaccines being offered by Pfizer-NBiotech and by Moderna have been produced in record time. They come as a result of a decade of research developing innovative vaccines attempting to stimulate an immunologic response to both cancers and emerging viral threats such as Ebola. Synthetic production of mRNA nucleotide fragments and synthetic nanoparticle delivery envelopes have made possible the rapid development of the safe and effective vaccines now available to prevent coronavirus infection and COVID-19 illness. Similarly, the vaccines being developed by AstraZeneca, Novavax and Johnson & Johnson will quickly add options for effective vaccination for us all.

I say BRING IT ON!!!

Yet, in closing 2020, I think back on the history of vaccine development. Without comprehensive programs that incorporate the basics of public health, vaccination programs can work only so well or so fast. Surely, the rollout of the available vaccines will occur. The Boca Grande Health Clinic is in line with four separate pipelines for distribution. Unfortunately, the process is still too early for us to be able to identify the exact sources and timeline of delivery.

It is very likely that we will all have an opportunity for vaccination before the summer, but the next 90 to 180 days (not six to 20 years as in the past) will be critical for many of us. Unless we all buy into doing the right things collectively, COVID-19 will continue among us.

As my last words on COVID-19 (I promise), please wash your hands. Please wear a mask, especially indoors. And please distance yourself and avoid unnecessary indoor gatherings. Before Jenner figured out how to prevent smallpox just before 1800, one of every 13 persons living in London died or was severely disfigured by the disease. Be delighted you are living in 2021, at a time when science and public health policy can help you live well if you listen.

Have a happy and healthy 2021.

Thomas J. Ervin, M.D.

Boca Grande Health Clinic

Marcy Shortuse is the editor of the Boca Beacon, and has been with the paper since 2007. She is also editor of the Boca Beacon's sister publication, Gasparilla Magazine.She has more than 20 years of experience writing and editing local newspapers and is originally from the Chicago area.

Continued here:
New Year's resolution 2021: A (last) word from Dr. Ervin - Boca Beacon

A study conducted by the World Health Organisation (WHO) estimated that 5.2 million children under five years of age died mostly from preventable and treatable causes in 2019. This staggering number can be brought down if advanced technology meets medicine to develop an early warning system.

This is the path taken by CognitiveCare, a healthtech startup founded by Venkata Narasimham Peri and Dr Suresh Attili and based out of Hyderabad and California, US.

Venkata Narasimham Peri, popularly known as PV, was a technology business consultant for more than two decades, having worked with PwC and other organisations. He decided to become an entrepreneur at the age of 48 when he realised artificial intelligence (AI) could become a valuable tool for the healthcare industry.

PV partnered with Dr Suresh Attili, a leading oncologist and scientist, to start CognitiveCare in 2018. The duo toyed with various segments like mental health and cancer, but decided to focus on maternal and infant healthcare, given the enormity of the problem.

He adds that the world loses 800 women to pregnancy-related complications every day and millions go through very complex pregnancies.

Both the founders bootstrapped CognitiveCare with an investment of $300,000 and decided to build an AI technology platform that could provide all relevant health indicators of an expectant mother to her doctor.

This AI platform, Maternal Infant Health Insights and Cognitive Intelligence (MIHIC), is a neural network that analyses all data of an expectant mother and come out with a score.

The development of such an open-sourced AI computing model also required an interdisciplinary approach as it was not just about medicine or computing algorithms. It also delved into other subjects such as mathematics, statistics,genetics, and even sociology.

The CognitiveCare team is inter-disciplinary and includes research scientists with a mathematics background and others with a focus on molecular genetics and software codes.

CognitiveCare founders: Dr Suresh VS Attili (left) and Venkata Narasimham Peri

Risk assessment

The MIHIC platform analyses all medical, clinical, genetic, radiological, social, and lifestyle determinants to predict early signs of maternal, infant, and foetal risks.

In short, MIHIC provides scores on all 48 indicators. For example, PV says, their studies have shown that women who stay near the sea have a higher probability of developing folic acid deficiency.

The score we provide allows for early-risk detection so doctors can take preventive action, PV says. He clarifies that the job of CognitiveCare is to only provide indicators; the decision on the treatments is the doctors alone.

CognitiveCare has taken all mandatory approvals and is HIPAA-compliant; it meets the highest standards in terms of maintaining privacy of the patients identity and data.

The healthtech startup has been in stealth mode till now and its technology platform has evinced interest from leading medical schools and institutions in United States and India. For example, Brigham and Womens Hospital in Boston, Massachusetts, is directing the research study to test MIHIC.

PV believes the application and benefits of their technology platform are not restricted to just hospitals as others like the government, pharmaceutical companies, and even health insurance firms stand to gain.

It can also accelerate the drug discovery process for pharmaceutical companies with better insights on maternal and infant care. Insurance companies can assess risks more accurately by using this platform.

CognitiveCare will primarily look at markets in the US, the UK, and India.

PV says many medical institutes are willing to share data, and feels the healthtech startup has no direct competition as it provides a 360-degree view of womens maternal health.

The founder says CognitiveCare's focus for the next three to four years would be maternal and infant healthcare. The startup, which has already $900,000 in a seed round with a pre-money valuation of $8 million, says they will later explore other areas of health.

We not only want to empower the doctor, but our eventual goal is that every woman - not just an expectant mother - can gauge her obstetric health," PV says.

More:
This healthtech startup uses AI to assess health risks of expectant mothers - YourStory

The genetic cause of a common brain malformation has been traced to variations in two genes associated with brain development, according to researchers atWashington University in St. Louis (WUSTL). This news, published in the American Journal of Human Genetics, enables researchers to develop early screening methods before the most serious symptoms arise, and thus intervene.

Chiari 1 malformation is a common, yet poorly understood condition. It is present in about 1% of children and occurs when the cerebellum is displaced through the foramen magnum into the spinal canal, thus placing part of the brain below the base of skull.

Usually, the condition is harmless, causing no or only minor medical issues. In 10% of those children, however, Chiari 1 malformation causes problems severe headaches, neck pain, and issues with hearing, vision, and balance or other neurological manifestations.

Gabriel Haller, Ph.D., an assistant professor of neurosurgery, neurology and of genetics, and his colleagues conducted whole-exome sequencing on 668 children diagnosed with Chiari 1 malformation. It revealed significant enrichment of variants in the chromodomain genes. They found, specifically, a significant burden of rare, transmitted variants in CHD3 and three loss of function variants in CHD8. Many of these variations were de novo, occurring during fetal development and not among family members.

The researchers also found that children with Chiari 1 who had larger heads (compared to age-matched controls and to population averages provided by the Centers for Disease Control and Prevention) often had CHD variants. Specifically, those whose heads were larger than 95% of children of the same age were four times more likely to be diagnosed with the malformation.

Its a significant factor, and easy to measure. If you have a child with an enlarged head, it might be worth checking with your pediatrician, Haller, senior author of the paper, said in a statement.

For severe symptoms, the Mayo Clinic says surgery is the most common treatment. Its goal is to to reduce the pressure on the brain and to halt further anatomic changes to the brain and spinal canal. Surgery may involve removing bone at the base of the skull, opening the dura mater covering the brain, or removing part of the spinal column to provide more room for the brain or spinal cord.

A lot of times people have recurrent headaches, but they dont realize a Chiari malformation is the cause of their headaches, Haller said. And even if they do, not everyone is willing to have brain surgery to fix it. We need better treatments, and the first step to better treatments is a better understanding of the underlying causes.

Theres an increased risk for Chiari malformations within families, which suggests a genetic underpinning, but nobody had really identified a causal gene, Haller said. Of the 232 family members who also underwent gene sequencing, 76 also had Chiari 1 malformation and 156 were unaffected.

The involvement of the CHD8 gene in regulating brain size was confirmed, in further experiments, on transparent zebrafish. When the researchers inactivated one copy of the fishschd8gene, the animals developed unusually large brains, with no change in their overall body size.

The implications of the finding extend beyond Chiari 1 malformations. Chromodomain genes are involved in regulating multiple sets of genes. As such, they also play a role in a variety of neurodevelopmental conditions, such as autism and developmental delays.

Its not well known how chromodomain genes function, since they have such a wide scope of activity and affect so many things at once, Haller said. But they are very intriguing candidates for molecular studies, to understand how specific mutations lead to autism or developmental delay or, as in many of our Chiari patients, just to increased brain size without cognitive or intellectual symptoms.

Wed like to figure out the effects of each of these mutations so that in the future, if we know a child has a specific mutation, well be able to predict whether that variant is going to have a harmful effect and what kind.

More than 20 clinical trials are underway for this condition, according to ClinicalTrials.gov. Most involve surgical procedures, although a few involve diagnostics. The trial most relevant to drug developers may be a genetics study of 1,000 patients completed by researchers at Duke University in 2017.

While not definitive, it implicated the COL5A2, COL7A1, COL1A2 genes, associated with Ehlers-Danlos syndrome, epidermolysis bullosa, and other conditions; and NRP1, FLT1, VEGFA and VEGFB genes because of their roles in the growth signaling pathway and in placental and vascular development. It confirmed the role of genetics in Chiari malformations and implicated linkages to variations in 21 genes.

Data from a December 2020 study is still being analyzed by the National Institute of Neurological Disorders and Stroke to analyze genetic linkages.

A lot of kids that have autism or developmental disorders associated with chromodomain genes may have undiscovered Chiari malformations, Haller said. The only treatment right now is surgery. Discovering the condition early would allow us to watch, knowing the potential for serious symptoms is there, and perform that surgery as soon as its necessary.

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WUSTL Researchers ID Elusive Cause of Chiari 1 Brain Malformation - BioSpace

The lowest part of a childs brain is visible below the bottom of the skull in this MRI scan and shows evidence of a Chiari 1 malformation. Researchers at Washington University School of Medicine in St. Louis have shown that Chiari 1 malformation can be caused by variations in two genes linked to brain development, and that children with large heads are at increased risk of developing the condition. Credit: David Limbrick

Discovery could aid early screening, shed light on how Chiari malformation arises.

About one in 100 children has a common brain disorder called Chiari 1 malformation, but most of the time such children grow up normally and no one suspects a problem. But in about one in 10 of those children, the condition causes headaches, neck pain, hearing, vision and balance disturbances, or other neurological symptoms.

In some cases, the disorder may run in families, but scientists have understood little about the genetic alterations that contribute to the condition. In new research, scientists at Washington University School of Medicine in St. Louis have shown that Chiari 1 malformation can be caused by variations in two genes involved in brain development.

The condition occurs when the lowest parts of the brain are found below the base of the skull. The study also revealed that children with unusually large heads are four times more likely to be diagnosed with Chiari 1 malformation than their peers with normal head circumference.

The findings, published Dec. 21 in the American Journal of Human Genetics, could lead to new ways to identify people at risk of developing Chiari 1 malformation before the most serious symptoms arise. It also sheds light on the development of the common but poorly understood condition.

A lot of times people have recurrent headaches, but they dont realize a Chiari malformation is the cause of their headaches, said senior author Gabriel Haller, PhD, an assistant professor of neurosurgery, of neurology and of genetics. And even if they do, not everyone is willing to have brain surgery to fix it. We need better treatments, and the first step to better treatments is a better understanding of the underlying causes.

If people start experiencing severe symptoms like chronic headaches, pain, abnormal sensations or loss of sensation, or weakness, the malformation is treated with surgery to decompress the Chiari malformation.

Theres an increased risk for Chiari malformations within families, which suggests a genetic underpinning, but nobody had really identified a causal gene, Haller said. We were able to identify two causal genes, and we also discovered that people with Chiari have larger head circumference than expected. Its a significant factor, and easy to measure. If you have a child with an enlarged head, it might be worth checking with your pediatrician.

To identify genes that cause Chiari 1 malformation, Haller and colleagues sequenced all the genes of 668 people with the condition, as well as 232 of their relatives. Of these relatives, 76 also had Chiari 1 malformation and 156 were unaffected. The research team included first author Brooke Sadler, PhD, an instructor in pediatrics, and co-authors David D. Limbrick, Jr., MD, PhD, a professor of neurosurgery and director of the Division of Pediatric Neurosurgery, and Christina Gurnett, MD, PhD, a professor of neurologyand director of the Division of Pediatric and Developmental Neurology, among others.

Sequencing revealed that people with Chiari 1 malformation were significantly more likely to carry mutations in a family of genes known as chromodomain genes. Several of the mutations were de novo, meaning the mutation had occurred in the affected person during fetal development and was not present in his or her relatives. In particular, the chromodomain genes CHD3 and CHD8 included numerous variants associated with the malformation.

Further experiments in tiny, transparent zebrafish showed that the gene CHD8 is involved in regulating brain size. When the researchers inactivated one copy of the fishs chd8 gene, the animals developed unusually large brains, with no change in their overall body size.

Chromodomain genes help control access to long stretches of DNA, thereby regulating expression of whole sets of genes. Since appropriate gene expression is crucial for normal brain development, variations in chromodomain genes have been linked to neurodevelopmental conditions such as autism spectrum disorders, developmental delays, and unusually large or small heads.

Its not well known how chromodomain genes function since they have such a wide scope of activity and they are affecting so many things at once, Haller said. But they are very intriguing candidates for molecular studies, to understand how specific mutations lead to autism or developmental delay or, as in many of our Chiari patients, just to increased brain size without cognitive or intellectual symptoms. Wed like to figure out the effects of each of these mutations so that in the future, if we know a child has a specific mutation, well be able to predict whether that variant is going to have a harmful effect and what kind.

The association between chromodomain genes and head size inspired Haller and colleagues to measure the heads of children with Chiari malformations, comparing them to age-matched controls and to population averages provided by the Centers for Disease Control and Prevention. Children with Chiari tended to have larger than average heads. Those children with the largest heads bigger than 95% of children of the same age were four times more likely to be diagnosed with the malformation.

The findings suggest that children with larger heads or people with other neurodevelopmental disorders linked to chromodomain genes may benefit from screening for Chiari malformation.

A lot of kids that have autism or developmental disorders associated with chromodomain genes may have undiscovered Chiari malformations, Haller said. The only treatment right now is surgery. Discovering the condition early would allow us to watch, knowing the potential for serious symptoms is there, and perform that surgery as soon as its necessary.

Reference: Rare and de novo coding variants in chromodomain genes in Chiari I malformation by Brooke Sadler, Jackson Wilborn, Lilian Antunes, Timothy Kuensting, Andrew T. Hale, Stephen R. Gannon, Kevin McCall, Carlos Cruchaga, Matthew Harms, Norine Voisin, Alexandre Reymond, Gerarda Cappuccio, Nicola Burnetti-Pierri, Marco Tartaglia, Marcello Niceta, Chiara Leoni, Giuseppe Zampino, Allison Ashley-Koch, Aintzane Urbizu, Melanie E. Garrett, Karen Soldano, Alfons Macaya, Donald Conrad, Jennifer Strahle, Matthew B. Dobbs, Tychele N. Turner, Chevis N. Shannon, Douglas Brockmeyer, David D. Limbrick, Christina A. Gurnett and Gabe Haller, 21 December 2020, American Journal of Human Genetics.DOI: 10.1016/j.ajhg.2020.12.001

This study was funded by Sam and Betsy Reeves and the Park-Reeves Syringomyelia Research Consortium; the University of Missouri Spinal Cord Injury Research Program; the Childrens Discovery Institute of St. Louis Childrens Hospital and Washington University; the Washington University Institute of Clinical and Translational Sciences, grant number UL1TR000448 from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH); the Eunice Kennedy Shriver National Institute of Child Health & Human Development, award number U54HD087011 to the Intellectual and Developmental Disabilities Research Center at Washington University; the Swiss National Science Foundation, grant number 31003A_182632; and the Jrme Lejeune Foundation.

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Common Brain Malformation Affecting About 1 in 100 Children Traced to Its Genetic Roots - SciTechDaily

The Oxford team is led by Sarah Gilbert, professor of vaccinology at the universitys Jenner institute. She has hailed thefirst authorisation of use of the vaccine outside clinical trialsas aday for the team developing the vaccine to celebrate, after a year of extremely hard work under difficult circumstances. Although in the same sentence she struck a typically cautionary note: We still have more to do

Even after their vaccine has become just the third in the world to be granted regulatory approval (following the Pfizer/BioNTech and Moderna vaccines), nobody could accuse the Oxford researchers of being swept away in the hype. Indeed Gilbert and others in her team have spoken openly about how little they have enjoyed the constant attention over the past year, preferring instead to focus on their life-saving work.

During that time, lucrative offers for after dinner speaking gigs have started to roll in for Gilbert, which she has rejected in turn. Another key member of the Oxford group, Professor Catherine Green, who heads the universitys clinical biomanufacturing facility, recently described the media attention as awful. Of their new-found fame, she added: Its not something that we got into our careers to do.

The motivations of the Oxford team can instead be neatly surmised by a mug that Gilbert keeps in her office at the Jenner Institute, which says: Keep calm and develop vaccines. It is a mantra that has served her and her colleagues well this year, juggling the exhaustion of constant work with family life.Gilbert, after all, is the mother of 21-year-old triplets (biochemistry students at Oxford and Bath Universities) who took part in the phase 1 clinical trials of the vaccine. Her regime has involved getting up at about 4am each day, cycling to the laboratory and returning home at about 8pm.

Read more:
'Keep calm and develop vaccines': Meet the scientists behind the Oxford jab - Telegraph.co.uk

The latest market intelligence study on Nucleic Acid-based Therapeutics Market relies on the statistics derived from both primary and secondary research

Nucleic Acid-Based Therapeutics are used to target genes responsible for either the expression of a disease causing proteins or to correct the decreased protein expression in diseases where the absence of the protein contributes to a disease state. The Global Nucleic Acid-Based Therapeutics Market is expected to reach around USD 741.98 million by the end of the forecast period and is expected to grow at a CAGR of ~6.8%.

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Nucleic acid-based therapeutics are target deficiencies or dysfunctions at the molecular level and are targeted therapies. These are used specifically to target genetic diseases and disorders for which there exists no permanent cure such as thalassemia, sickle cell anemia, hemophilia, cystic fibrosis, diabetes etc. The nucleic acid-based therapeutics are based on accurate target identification and genetic profiling and the human gene project has formed the backbone of these class of drugs. As such nucleic acid-based medication have one of the most versatile and revolutionary potential.

The critical market driver for nucleic acid-based therapies is the poor cure rates for genetic diseases with traditional drugs. Other market drivers include increasing understanding of the human genetics, growing capabilities of mapping human tissue molecular targets, rising power of softwares to mimic the human molecular entities such as receptors etc.

Global Nucleic Acid-Based Therapeutics Market Study Objectives

To provide detail analysis of the market structure along with forecast for the next 6 years of the various segments and sub-segments of the global nucleic acid-based therapeutics market To provide insights about factors affecting the market growth To analyze the market based on various factors- price analysis, supply chain analysis, porters five force analysis etc. To provide historical and forecast revenue of the market segments and sub-segments with respect to four main geographies and their countries- Americas, Europe, Asia-Pacific, and Middle East & Africa.

Global Nucleic Acid-based Therapeutics Market Key Players

Some of the key players in this market are: Wave Life Sciences Ltd., Copernicus Therapeutics Inc., Imugene, Caperna, Phylogica, Protagonist Therapeutics, Benitec Biopharma, EGEN (Expression Genetics), Benitec Biopharma, BioMedica (Oxford BioMedica), Transgeneand others.

Global Nucleic Acid-based Therapeutics Market Regional Analysis

Globally America is the largest market for nucleic acid-based therapeutics. The presence of strong research base, excellent reimbursement scenario, the good provisions for orphan diseases and drugs and the rapid uptake of new drugs and technology are the prime reasons for this dominance. Europe is the second-largest market for nucleic acid-based therapeutics. The developed markets are likely to maintain their leads due to the nonexistence of regulatory framework in the developing and poor regions of the world such as Asia pacific region and Africa.

Global Nucleic Acid-based Therapeutics Market Intended Audience

Nucleic Acid-based Therapeutics Manufacturers

Nucleic Acid- based Therapeutics Suppliers

Private Research Laboratories

Research and Development (R&D) Companies

Market Research and Consulting Service Providers

Government Research Laboratories

Contract Manufacturing Organizations

Global Nucleic Acid-based Therapeutics Market Segments

Global nucleic acid-based therapeutics market has been segmented on the basis of technology which comprises anti-sense and anti-gene, short inhibitory sequences, gene transfer therapy, nucleoside analogs, ribozymes, aptamers and others. On the basis of applications; market is segmented into monogenetic disorders which is further sub segmented into thalassemia, sickle cell anemia, hemophilia, cystic fibrosis etc. and multi-genetic disorders which is sub segmented into cancer, diabetes, neurodegenerative diseases, cardiovascular diseases etc. On the basis of end users; market is segmented into hospitals, academic & research institutes.

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