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TO YOUR HEALTH: Inflammation can drive triple-negative breast cancer – Dover Post

February 29th, 2020 7:48 am

Study at ChristianaCare Cawley Center for Translational Cancer Research

While radiation is successfully used to treat breast cancer by killing cancer cells, inflammation caused as a side-effect of radiation can have a contrary effect by promoting the survival of triple-negative breast cancer cells, according to research published online in the International Journal of Radiation Biology by Jennifer Sims-Mourtada, Ph.D., director of Translational Breast Cancer Research at ChristianaCares Helen F. Graham Cancer Center & Research Institute.

Accounting for 15-20% of all breast cancers, triple-negative breast cancer is faster growing than other types.

Sims-Mourtadas latest study, Radiation induces an inflammatory response that results in STAT3-dependent changes in cellular plasticity and radioresistance of breast cancer stem-like cells, brings scientists closer to understanding the mechanisms behind this aggressive and hard-to-treat cancer. It shows that inflammation caused by radiation can trigger stem-cell-like characteristics in non-stem breast cancer cells.

This is the good and the bad of radiation, Sims-Mourtada said. We know radiation induced inflammation can help the immune system to kill tumor cells thats good but also it can protect cancer stem cells in some cases, and thats bad.

She added, Whats exciting about these findings is were learning more and more that the environment the tumor is in its microenvironment is very important. Historically, research has focused on the genetic defects in the tumor cells. Were now also looking at the larger microenvironment and its contribution to cancer.

The term triple-negative breast cancer refers to the fact that the cancer cells dont have estrogen or progesterone receptors and also dont make too much of the protein called HER2. The cells test negative on all 3 tests. These cancers tend to be more common in women under age 40, who are African-American, Latina or who have a BRCA1 mutation.

My work focuses on cancer stem cells and their origination, Sims-Mourtada said. They exist in many cancers, but theyre particularly elusive in triple-negative breast cancer. Their abnormal growth capacity and survival mechanisms make them resistant to radiation and chemotherapy and help drive tumor growth.

She and her team applied radiation to triple-negative breast cancer stem cells and to non-stem cells. In both cases, they found radiation induced an inflammatory response that activated the Il-6/Stat3 pathway, which plays a significant role in the growth and survival of cancer stem cells in triple-negative breast cancers. They also found that inhibiting STAT3 blocks the creation of cancer stem cells. As yet unclear is the role IL-6/STAT3 plays in transforming a non-stem cell to a stem-cell.

For women living in Delaware, Sims-Mourtadas research is especially urgent: The rates of triple-negative breast cancer in the state are the highest nationwide.

At ChristianaCare, we are advancing cancer research to help people in our community today, while we also advance the fight against cancer nationwide, said Dr. Nicholas J. Petrelli, Bank of America endowed medical director of the Helen F. Graham Cancer Center & Research Institute. Dr. Sims-Mourtadas research is a dramatic step toward better treatments for triple-negative breast cancer.

To advance her research on inflammation, last year Sims-Mourtada received a $659,538 grant from the Lisa Dean Moseley Foundation. The three-year grant will enable her and her team at the Cawley Center for Translational Cancer Research to continue investigating the role of cells immediately around a tumor in spurring the growth of triple-negative breast cancer and a possible therapy for this particularly difficult cancer.

Our next step is to understand the inflammatory response and how we might inhibit it to keep new cancer stem cells from developing, Sims-Mourtada said.

Sims-Mourtadas research team previously identified an anti-inflammatory drug, currently used to treat rheumatoid arthritis, that has the potential to target and inhibit the growth of cancer stem cells and triple-negative breast cancer tumors. That research could set the stage for clinical investigation of the drug, alone or in combination with chemotherapy, to improve outcomes for patients with triple-negative breast cancer.

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TO YOUR HEALTH: Inflammation can drive triple-negative breast cancer - Dover Post

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A new approach to both high safety and high performance of lithium-ion batteries – Science Advances

February 29th, 2020 7:48 am

RESULTS

As a proof of concept, we prepare a baseline cell composed of a standard electrolyte, 1 M LiPF6 in ethylene carbonate (EC)/ethyl methyl carbonate (EMC) (3/7 wt) + 2 weight % (wt %) vinylene carbonate (VC), and a graphite anode and an NCM622 cathode. Protective layers of solid electrolyte interphase (SEI) on graphite and cathode electrolyte interphase (CEI) are formed during initial charge/discharge cycles. To yield low DCR and hence high power, these interfacial layers are usually thin, lacking sufficient density and resilience to resist decomposition under abuse conditions, to suppress continuous reaction of the solvent EC in the SEI, or to hinder continuous oxidation of EC with oxygen released from cathode materials in the CEI, thereby leading to Li consumption and loss of cell capacity. In contrast, in SEB cells, we create highly stable, flame-retardant EEIs through the addition of a small amount of TAP in the standard electrolyte. This electrolyte modification is accompanied by the simultaneous reduction of EC content, i.e., EC/EMC (1/9 wt) + 2 wt % VC, intended for further reduction in gas production via side reactions. In this work, we present results for three prototype SEB cells, identified as SEB-1, SEB-2, and SEB-3 and corresponding to 0.5, 1, and 1.5 wt % TAP, respectively. The charge-transfer resistance of the SEB cells, measured by electrochemical impedance spectroscopy (EIS), increases by 3 to 5 as compared to the baseline cell without the electrolyte additives, as shown in Fig. 2A. The high impedance comes from the polymerization of TAP molecules that form thick and dense interfacial films at the surfaces of both the anode and cathode (2). On the anode side, the film serves as an enhanced SEI layer to stabilize further growth. On the cathode side, the film hinders EC in the electrolyte from reacting with lattice oxygen on the NCM surface at high temperature or high voltage (3), as shown schematically in Fig. 2B.

(A) Nyquist plots showing measured charge-transfer resistances of SEB cells versus the baseline LIB cell. (B) Schematic showing the in situ formed interfacial layers on the surface of graphite and NCM particles. The enhanced SEI layer on graphite slows down EC transport though the film and suppresses further SEI growth. The CEI layer hinders EC oxidation with lattice oxygen over the NCM surface at high temperatures or high voltages. (C and D) Cell voltage and temperature evolutions during nail penetration of a SEB cell and the baseline LIB cell along with qualitative temperature distributions. Both cells are 2.8-Ah pouch cells composed of the same graphite anode and NMC622 cathode materials. The baseline LIB cell is filled with a standard electrolyte: 1 M LiPF6 in EC/EMC (3/7 wt) + 2 wt % VC. The SEB cell has the electrolyte of 1 M LiPF6 in EC/EMC (1/9 wt) + 2 wt % VC with TAP as electrolyte additive. RT, room temperature.

PolyTAP and its composites are flame-retardant materials. In addition, the PolyTAP has electrically insulative properties and stability at elevated temperatures (4). All these properties make PolyTAP well suited to enhance the safety of SEB cells under abuse conditions. This is confirmed by nail penetration tests shown in Fig. 2C, where the temperature rise is only 100C (without cell deformation, smoking, or fire) versus almost 1000C (catching fire) in the baseline case (Fig. 2D). The superior safety performance of the SEB cell is further illustrated by the electrical performance of the cell during nail penetration. For the baseline cell, the cell voltage decreases to 0.1 V within 5 s after the nail penetration. The sharp voltage drop indicates that the shorting current is extremely high due to low internal resistance of the baseline cell. In contrast, the voltage of the SEB cell drops from 4.171 to 3.085 V within 5 s after penetration, showing a slow and controlled discharge due to the high internal resistance of the SEB cell. The substantially higher resistance in the SEB cell than the baseline is caused by the electrically nonconductive layers formed on the surface of the graphite and NCM particles, as schematically shown in Fig. 2B.

The stability and safety of SEB cells are further evident in high-voltage charge and high-temperature calendar life tests (figs. S1 and S2). The SEB cells can undergo 1254 exposures to high-voltage abuse [constant current (CC) charge to 4.4 V, constant voltage (CV) to C/20] at 40C with a capacity retention of 80%, whereas the baseline cell sustains only 40 cycles at the same capacity loss and operating temperature, indicating that the SEB cell is >30 more stable and hence safer than the baseline cells under high-voltage charging conditions. Calendar life testing further shows that the passivated SEB cells can effectively suppress self-discharge. The self-discharge current is measured by holding the cell voltage constant at a required value, such as 4.187 V for 100% state of charge (SOC). Both baseline and SEB cells display a fast decrease of self-discharge current density in the beginning of calendar aging due to anode SEI layer growth. Fresh SEB cells show self-discharging currents ~5 lower than the baseline cell at room temperature and 50% SOC, 6 lower at room temperature and 100% SOC, and ~7 lower at 60C at both 50 and 100% SOC. After 60 days of storage, the self-discharge current begins to plateau; however, the self-discharge current in the SEB cell is still 2 lower than that in the baseline cell at room temperature and 50% SOC and 3 lower at room temperature and 100% SOC. The self-discharge becomes 4 lower at high temperature (60C) at both 50 and 100% SOC, indicating that at elevated temperatures, the SEB cells maintain superiority in calendar life over the baseline cell.

A distinctive feature of SEB cells is high power on demand. When batteries are not in operation, SEB cells are left idle at room temperature, exhibiting high stability and safety. However, upon operation, a SEB cell switches to high-reactivity conditions through rapid thermal stimulation. This can be illustrated through DCR, which is inversely proportional to power performance. Here, DCRs upon discharge and charge for SEB and baseline LIB cells are measured at 50% SOC by a 10-s hybrid pulse power characterization (HPPC) method. As expected, the DCR values increase substantially by adding a small amount of TAP in the electrolyte, as shown in Fig. 3 (A and B), which also demonstrates that adding more TAP in SEB-3 (e.g., 1.5 wt %) results in a further increase in DCR, owing to the formation of thicker protective layers.

(A and B) DCRs of discharge and charge, respectively, at 50% SOC for SEB cells versus the baseline LIB cell. (C) Relative discharge power (DCRbaseline@RT/DCR) of a SEB cell versus the baseline LIB cell. (D) Relative reactivity (Rct,baseline@RT/Rct) of a SEB cell versus the baseline LIB cell, showing that SEB cells operated at appropriate elevated temperatures, e.g., SEB-3 at 50C, can deliver sufficient power at all ambient temperatures (labeled as line a), that SEB cells are 5 safer and less aging at room temperature (labeled as line b), and that SEB cells are 2.6 less prone to thermal runaway at 60C (labeled as line c).

Figure 3C shows the relative power of SEB cells versus the baseline LIB, where the power of the baseline cell at room temperature is normalized to be unity, thus demonstrating that SEB cells can provide sufficient, higher power by operating at higher temperatures. At 50% SOC, SEB-1 operated at 29.2C provides the same power as the baseline cell at room temperature. The safest cell, SEB-3, with 1.5 wt % TAP additive requires an operation temperature of 44.6C to deliver the same power as the baseline cell at room temperature. The baseline cell has a narrow temperature window of 15 to 35C, whereas the SEB cells have much higher maximum operating temperature without becoming excessively reactive. Thus, the necessity of higher temperature operation for power recovery does not pose an issue for SEB cells. At 50% SOC, the discharge power boost over the baseline Li-ion cell is 2.05, 1.81, and 1.39 for the SEB-1, SEB-2, and SEB-3, respectively (Fig. 3C). Moreover, at the ambient temperature of 0C, the baseline LIB cell has a relative power of 0.38, while SEB-2 has a relative power of 1.81 when operated at 60C [it takes 30 s to heat up a cell from 0 to 60C at a speed of 2C/s, typical of the self-heating structure of Wang et al. (1)]. This is ~5 boost in power over the LIB cell for SEB cells working in the freezing environments. Generally, SEB cells perform independent of ambient temperatures or weather, as they are always heated up in a matter of seconds and operate at a constant elevated temperature. Although heating a cell to an elevated temperature consumes cell energy, the total deliverable energy of a cell, counterintuitively, is not reduced. As shown in fig. S3, the C/3 discharge energy was 9.62 watt-hours (Wh) for the baseline cell at room temperature and 10.15 Wh for the SEB-3 cell at 60C. According to our previous work (1), it takes ~1% cell energy for a 10C temperature rise, meaning that the SEB-3 cell needs 3.5% of its energy for heating from 25 to 60C; the remaining discharge energy is thus 9.79 Wh, which is 2% higher than that of the baseline cell at room temperature.

As mentioned, such rapid heating is achieved through the insertion of a micrometer-thick nickel sheet. The impact of this additional component on cell power density can be evaluated through Eq. 1, where m is the mass of the given cell and the ratio of discharge power evaluated through HPPC is inversely proportional to the ratio of DCRs(Power Density)SEB(Power Density)baseline@RT=(DCRbaseline@RTDCRSEB@60C)(mbaselinemSEB)(1)

The addition of the nickel foil increases cell mass by 1.3%, while the ratio of DCRs in Eq. 1 is the relative power presented in Fig. 3C at 60C. On the basis of these values, the power density is not reduced but rather increased by a factor of 2.02, 1.79, and 1.37 in the case of SEB-1, SEB-2, and SEB-3, respectively. Thus, in the case of SEB-3 with the highest internal resistance, the power density is still 37% higher than the baseline cell operated at room temperature.

Figure 3D presents the relative interfacial reactivity as derived from the charge-transfer resistance of EIS results. This further confirms that increased operational temperature effectively decreases the charge-transfer resistance of SEB cells and consequently increases the cell reactivity and power. The reactivity boost over the baseline LIB cell is 2.06 for SEB-2. Overall, both relative power and relative reactivity illustrate the ability of SEB cells to achieve high power on demand. On the other hand, the values of relative reactivity of these two cells shown in Fig. 3D indicate that the SEB cell will be 5 safer and undergo 5 less aging at room temperature, which is supported by self-discharge and capacity retention tests displayed in fig. S2. Furthermore, the comparison of relative reactivity for the two cell types at 60C indicates that the SEB cell is more than 2 less prone to thermal runaway.

Beyond safety and high power, there is an ever-increasing need for long cycle life of LIBs. Low-reactivity SEB cells built with highly stable materials offer longer calendar life (fig. S2), evident from the slow capacity fade when the battery is in idle conditions at room temperature. At elevated temperatures, cycling of SEB cells is also stable. Figure 4A compares capacity retention of the baseline cell with SEB cells during cycling at 60C of 1C CC charge to 4.2 V CV charge till C/20 and then 1C discharge to 2.8 V. Clearly, the SEB cells outperform the baseline cell as evidenced by a 20% capacity loss at 481 cycles with visible signs of cell deformation due to gas evolution and graphite anode swelling for the baseline cell, while SEB-3 can achieve 2821 cycles before reaching 20% capacity loss. This corresponds to ca. 6 improvement in cycle life. In addition, SEB-3 achieves 4014 cycles at 75% capacity retention while still showing signs of a healthy cell capable of cycling stably (no perceptible gassing or lithium plating). The average discharge capacity of these 4014 cycles is 84.2% of an equivalent full cycle (EFC). Assuming a 153-mile driving range per EFC for an electric vehicle (e.g., 2019 BMW i3), the 4014 cycles mean >517,000 miles of lifetime. That is more than 5 the warranty for commercial electric cars (e.g., BMW i3, 70% capacity for 8 years or 100,000 miles). Improvement of cell lifetime can be further demonstrated by considering the rate of capacity fade during calendar aging at room temperature (i.e., the stable state), which is 7 lower than that at 60C (the reactive state). The SEB cell will only be heated to the reactive state for situations requiring high power or fast charging. The greater part of its lifetime (>90%) would be spent in idle conditions (the stable state). Therefore, in the field, the SEB cycle life is expected to extend much beyond 4014 cycles before reaching 25% capacity loss.

(A and B) Capacity retention and DCR of the SEB cells versus the baseline LIB cell during cycling at 60C. The cells are charged with CCCV protocol at 1 C to 4.2 V with a cutoff current of C/20 and then discharged at 1 C to 2.8 V. (C and D) Discharge curves of the fresh SEB cell versus aged cell.

The tremendous extension of cycle life of the SEB over the baseline cell may stem from the denser and more stabilized SEI layer formed on graphite particles and CEI layer on NCM622 particles in the presence of the electrolyte additives. For the baseline cell, the nickel-rich NCM particles are prone to microcracks along grain boundaries (5, 6) that provide gaps for electrolyte penetration and lead to more severe electrolyte oxidation and rock salt formation (7). Particle cracking also sets free new, fresh surface area from which oxygen can be released (8). The microcracks on NCM622 particles for the baseline cell are observed after only 50 cycles (Fig. 5D). The formation of cracks becomes much more notable throughout the micrograph domain after 956 cycles (Fig. 5F). For the SEB cells, cracks on NCM particles are not observed at 50 cycles, and a small amount of cracks are observed after 4021 cycles (Fig. 5J). The presence of microcracks not only causes a loss of contact but also accelerates NCM capacity fade. For the SEB cells, the polymer coating from TAP likely forms a robust CEI, reducing formation of microcracks (Fig. 2B). This is also evidenced by optical images (fig. S4) and no observable cell deformation or swelling after 4021 cycles even at an elevated temperature of 60C.

(A) Pristine anode. (B) Pristine cathode. (C) Baseline anode after 50 cycles. (D) Baseline cathode after 50 cycles. (E) Baseline anode after 956 cycles. (F) Baseline cathode after 956 cycles. (G) SEB-3 anode after 50 cycles. (H) SEB-3 cathode after 50 cycles. (I) SEB-3 anode after 4021 cycles. (J) SEB-3 cathode after 4021 cycles. ETD, Everhart-Thornley Detector; HV, electron accelerating voltage; WD, working distance; HFW, horizontal field width.

The use of the TAP additives altered the EEI compositions markedly. We performed x-ray photoelectron spectroscopy (XPS) on the graphite and NCM electrodes after 4021 cycles and compared the EEI structure of the samples from the baseline cell after 956 cycles. At the graphite anode, the TAP-containing electrolyte-derived SEI contains high concentrations of C, O, and P elements, compared to the control sample of the baseline cell (Fig. 6 and fig. S5). In addition, a higher content of CC species in the entire C-containing species was also found in the TAP-containing electrolyte-derived SEI, suggesting the decomposition of the TAP at the anode (fig. S5). Meanwhile, the composition of the cathode CEI was also changed. With the TAP additive, the SEI layer has more C, P, and F and less Li and O, compared to the baseline SEI (Fig. 6 and fig. S5). High contents of LiF and P-containing species (OPO, LixPyOFz, and LixPyFz) (9) were found in the cathode CEI layer, owing to the use of the TAP additive (Fig. 6). A detailed peak interpretation is as follows: peaks at 284.6, 286.1, 288.8, and 290.1 eV in the C 1s spectrum are attributed to CC, CO, OCO, and poly(OCO) (10), respectively; peaks at 684.6 eV in the F 1s spectrum are attributed to LiF; peaks at 686.9 eV in the F 1s spectrum and 136.7 eV in the P 2p spectrum are attributed to OPO and LixPyOFz; and peaks at 686.3 eV in the F 1s spectrum and 134.5 eV in the P 2p spectrum are attributed to LixPyFz. In comparing O 1s spectrum of the aged baseline (956 cycles) and SEB-3 electrodes (4021 cycles), the peak at 529.2 eV for SEB-3 cathode is effectively eliminated in comparison to that for the baseline cathode (Fig. 6). This indicates that less lattice oxygen of NCM622 is detected for SEB-3 cathode attendant to a relatively thicker CEI layer. This is consistent with the thicker CEI layer detected by Xia et al. (2) on the coated NMC442 surface in the presence of TAP additive. Thus, the XPS result confirms that the TAP additive leads to a thick CEI layer and, in consequence, slower crack evolution, less gas generation, and longer cycle life.

The graphite and NCM622 electrodes are taken from the baseline cell after 956 cycles and the SEB-3 cell after 4021 cycles.

The three SEB cells show very close rates of capacity fade within 1000 cycles (Fig. 4A). Beyond 1000 cycles, SEB-3 shows a much lower rate of capacity fade than the other two SEB cells, as expected from its lowest reactivity. In comparison with the baseline cell, the stability and long cycle life of SEB cells are clearly evident, the reasons of which can be delineated from the differences in the capacity retention trend at various stages of aging. For the baseline cell, we see a sharp decrease in C/3 capacity retention during the initial stage and a slow decrease in the secondary stage. This is primarily attributed to the loss of lithium inventory during the quick and slow growth of the SEI layer. For the SEB cells, the capacity fade is linear with cycle number, indicating that there is no quick growth in the initial stage of aging as SEI layer growth is suppressed by in situ formation of the flame-retardant protective layer. Moreover, a sharp, nonlinear capacity loss due to lithium plating can usually be observed in the baseline cell at room temperature and at low temperatures in final stages of cell aging (11). In all SEB cells operated at 60C, this lithium plating-induced capacity loss is, however, absent, indicative of no lithium plating in SEB cells. The SEB cell free of Li plating offers a significant improvement in safety over conventional LIB cells.

There is another advantage of SEB cells promising for ultralong cycle life when deployed in the field. While conventional LIB cells undergo a large environmental temperature swing, the SEB cells almost always operate at a single, constant temperature (say 60C) regardless of ambient temperatures and after an extremely short period of initial transition by self-heating (on the order of tens of seconds). The latter feature guarantees minimal damage of battery materials in SEB cells caused by wide temperature variations.

For the baseline cell, the capacity loss at elevated temperatures is mainly due to SEI growth on the anode side and solvent oxidation on the cathode side. As a consequence, the DCR increases markedly with cycle number (Fig. 4B). In the case of SEB cells, the DCR of the fresh cell is initially much larger than the baseline cell; however, its rate of increase is much slower due to the protective coating on both the anode and cathode (Fig. 2B). Figure 4 (C and D) shows discharge curves of the fresh SEB cell versus the aged cell, respectively. Because of its DCR increase with cycle number, SEB-3 shows slight power fade after 2821 cycles at 60C. In contrast, the baseline cell shows a drastic DCR increase and, hence, substantial power loss within only 556 cycles (fig. S6). For all the SEB cells with TAP additive, their DCRs increase linearly and increased additive content leads to higher DCR in fresh cells but slower DCR evolution with cycle number (Fig. 4B). The SEB cells do not produce gas during cycling tests, yielding more safety than the baseline cell. In addition, cells containing TAP produce less gas during formation than the baseline cell (2, 12).

Because of the high-voltage tolerance of SEB cells, when charged to a high voltage of 4.4 V as compared to 4.2 V, the SEB cell discharge capacity increases 12.7%, and its discharge energy increases 14.5% (fig. S1B). Thus, the high-voltage tolerance can be used to increase cell energy density.

The electrolytes for SEB cells were formulated by reducing EC content and adding TAP as an additive. Although EC is an essential solvent for SEI layer formation, it also leads to gas generation, especially at high voltage (13). Calendar aging testing shows that high-temperature and high-SOC conditions accelerate capacity fade and increase in internal resistance while also promoting gas generation. SEB cells initially contains 10 wt % EC in the electrolyte. Some EC is consumed during the formation cycle, resulting in an EC content much less than 10% in formed SEB cells. This is advantageous since the rate of gas generation in an EC-less electrolyte would be lower than that in an electrolyte with high EC content.

With the introduction of new materials into the electrolyte, the effect on cell cost, weight, and fabrication should be evaluated. The electrolyte additive, TAP, has a comparable price and density when compared to current standard solvents; thus, no notable material cost difference is expected with the introduction of SEB electrolytes. Unlike superconcentrated electrolytes (14), the electrolytes with TAP do not increase the viscosity compared to the standard electrolyte. From a fabrication perspective, the SEB electrolytes will also add no additional cost due to the similarity in processing during and after introduction into a cell.

Last, the SEB cells offer an important benefit associated with thermal management of a battery pack. When high power is required, the SEB cells are to be heated internally (1) and operated at elevated temperatures. Assuming the environmental temperature is 25C, and the SEB and baseline cells operate at 60 and 30C, respectively, the SEB provides a temperature difference driving heat dissipation that is 7 larger than the baseline case. Further, the SEB cell has lower DCR at its operational temperature of 60C (17.1 ohmcm2 for SEB with 1 wt % TAP) than the baseline cell at 30C (25.3 ohmcm2), indicating ~1.5 lower heat generation at the same current. The combination of these two factors eases the burden of thermal management by a factor of approximately 10 for SEB cells.

We fabricated 2.8-Ah pouch cells using LiNi0.6Co0.2Mn0.2O2 (Umicore) for cathodes and graphite (Nippon Carbon) for anodes. The capacity ratio of negative to positive electrode, or NP ratio, was designed at 1.2. The 2.8-Ah pouch cell contains a stack of 20 anode and 19 cathode layers. A Celgard-2325 separator of 25 m in thickness was used. The loadings of NMC622 on the positive electrode and graphite on the negative electrode were 10.5 and 6.6 mg/cm2, respectively.

The cathodes were prepared by coating an N-methyl-2-pyrrolidone-basedbased slurry onto 15-m-thick Al foil, whose dry material consists of NCM622 (91.5 wt %), Super-P (TIMCAL) (4.1 wt %), and polyvinylidene fluoride (Arkema) (4.4 wt %) as a binder. The anodes were prepared by coating deionized waterbased slurry onto 10-m-thick Cu foil, whose dry material consists of graphite (95.4 wt %), Super-P (1.0 wt %), styrene-butadiene rubber (Zeon) (2.2 wt %), and carboxymethyl cellulose (Dai-Ichi Kogyo Seiyaku) (1.4 wt %).

One molar of LiPF6 dissolved in EC/EMC (3:7 by wt) + 2 wt % VC was used as control electrolyte (BASF). One molar of LiPF6 dissolved in a mixture of EC/EMC + 2 wt % VC was mixed in-house. To build SEB cells, 0.5 to 1.5 wt % TAP were mixed into the conventional electrolyte as additives.

Each pouch cell has a 110 mm 56 mm footprint area, weighs 63 g, and has 2.8-Ah nominal capacity with a specific energy of 166 Wh/kg and an energy density of 310 Wh per liter. Discharge performance of the baseline and SEB cells at room temperatures is shown in fig. S7 as a function of C-rate.

Cycle aging tests of the pouch cells were performed using a Land instrument battery testing system (Model CT2001B, Land Instruments). A forced-air oven was used to control different ambient temperatures. For each aging cycle, the cell was charged to 4.2 V at a constant current of 2.8 A (1C-rate) and then charged at a constant voltage of 4.2 V until the current decreased to 0.14 A (C/20). After resting for 5 min, the cell was discharged to 2.8 V at a constant current of 2.8 A (1C-rate) followed by a final rest period of 5 min. When the aging cycle number reached a specific value (e.g., 403, 1006 cycles), the cell was cycled at a charge and discharge rate of C/3 to determine the capacity (designated as C/3 capacity) of the cell. For impedance tests at different temperatures, the cells were fully charged and then discharged at a rate of C/3 to 90% SOC. Impedance testing was performed with an AC voltage amplitude of 5 mV in the frequency range of 50 kHz to 0.005 Hz. For DCR test, the cells were fully charged and then discharged to 50% SOC at C/3-rate. A discharge rate of 5C and a charge rate of 3.75C were used to determine the value of DCRDischarge and DCRCharge.

Calendar aging tests were performed at different ambient temperatures and SOCs. The forced-air oven was used to control different ambient temperatures. The cell voltage was kept constant, and the current was collected. When the calendar aging time reached a specific value (e.g., 25, 60, 120, and 180 days), the cell was cycled at a charge and discharge rate of C/3 to determine capacity of the cell. Then, impedance and DCR tests were conducted under the same conditions as that for the cycle-aged cells.

For the nail penetration test, the cell was fully charged (1C CCCV charge with a cutoff voltage of 4.2 V and a cutoff current of C/20). Thermocouples were placed at 10 mm to the geometry center of the cell and at the negative tab of the cell. The nail diameter is 5 mm, made of heat-resisting steel (point angle of the nail is 60; nail surface is clean, without rust or oil). Rate of penetration was at 30 mm/s; the nail penetrated through the geometrical center of the electrode plane perpendicularly and stayed inside the cell. The observation time was 1 hour until the cell cooled down and the cell voltage dropped to nearly zero.

The SEM and XPS analyses were performed by first extracting the electrode samples from the fully discharged graphite/NCM622 pouch cells after cycling and washing 3 with EMC. XPS tests were conducted on a PHI VersaProbe II Scanning XPS Microprobe. The samples were loaded in a glove box and transferred into the instrument through a vacuum transfer vessel. SEM imaging was performed on an FEI Nova NanoSEM 630 SEM instrument.

Acknowledgments: Funding: This work was partially supported by U.S. Department of Energys Office of Energy Efficiency and Renewable Energy under award number DE-EE0008447. Author contributions: S.G. and C.-Y.W. developed the concept and wrote the manuscript. S.G. and R.S.L. designed and built the cells. S.G. built the test stand and carried out the performance characterization. T.L. carried out the nail penetration test. Y.L. performed the impedance analysis. Y.G. and Daiwei Wang carried out the XPS and SEM analysis. All authors contributed to development of the manuscript and to discussions as the project developed. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

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A new approach to both high safety and high performance of lithium-ion batteries - Science Advances

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Global Chemotherapy Induced Peripheral Neuropathy Treatment Market 2020 Swot (Strengths, Weaknesses, Opportunities, And Threats) analysis By…

February 29th, 2020 7:48 am

Chemotherapy Induced Peripheral Neuropathy Treatment market Research Report 2020 offers a comprehensive analysis of the market growth drivers, trends, opportunities, prospects, drivers and restrictions inside the market. The report emphasizes to meet the requirement of customers by providing complete knowledge of the Chemotherapy Induced Peripheral Neuropathy Treatment Industry. This carefully organised report is formulated by industry experts and professional experts, in terms of demand and supply, cost organization, barriers and challenges, product category, crucial market players, technology, regions, and applications.

The Chemotherapy Induced Peripheral Neuropathy Treatment market study is based on historical information and present market requirements. As well as includes different business approaches preferred by the decision-makers. That enhanced the Chemotherapy Induced Peripheral Neuropathy Treatment industry growth and make a phenomenal stand in the industry. The market will raise with a prominentCAGRby 2020 to 2025.

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Furthermore, it also evaluates the most recent improvements while estimating the growth of theleading playerslike

Aptinyx Inc, Sova Pharmaceuticals Inc, MAKScientific LLC, Asahi Kasei Pharma Corp, PledPharma, Regenacy Pharmaceuticals, Immune Pharmaceuticals Inc, Nemus Bioscience Inc, Metys Pharmaceuticals AG, DermaXon LLC, WinSanTor, Kineta Inc, Solasia Pharma K.K., Apexian Pharma, Krenitsky Pharmaceuticals Inc, PeriphaGen,

Segmentation by Product Type

By TypeChemotherapy Induced Peripheral Neuropathy Treatment market has been segmented into Calcium Channel 2-delta Ligands, Antidepressants, Opioids, Others, etc.

Segmentation by Application/ End uses:

By Application Chemotherapy Induced Peripheral Neuropathy Treatment has been segmented into Platinum Agents, Taxanes, Vinca Alkaloids, Others, etc.

Regional Analysis for Chemotherapy Induced Peripheral Neuropathy Treatment Market:

North America (the United States, Canada & Rest of the countries)

Europe (Germany, The UK, France, Netherlands, Italy, Spain & the rest of the countries)

Asia-Pacific (China, Japan, Korea, India, & rest of the countries)

Middle East & Africa (South Africa, Israel, UAE & rest of the countries)

South America (Brazil, Colombia, Argentina & the rest of the countries)

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What is the regional structure of the market? Our analysis-

The Chemotherapy Induced Peripheral Neuropathy Treatment Industry report analyses footprint of every product and its significance analyzes examine each geographical segment of the market with import, export, consumption, and production in these regions to provide a complete understanding of the Chemotherapy Induced Peripheral Neuropathy Treatment market

In addition, the Chemotherapy Induced Peripheral Neuropathy Treatment Industry report covers an analysis of different products available in the global market built on production, volume, revenue, and cost and price structure. The Chemotherapy Induced Peripheral Neuropathy Treatment Market report also highlights key strategies that proved to be profitable for the business in-line with the policies involved in business expansion, partnership deals, composition, and new product/service launches.

YEARS CONSIDERED FOR THIS REPORT:

Historical Years:2015-2019

Base Year:2019

Estimated Year:2020

Forecast Period:2020-2025

DEFINITE SEGMENTS OF GLOBAL Chemotherapy Induced Peripheral Neuropathy Treatment INDUSTRY:

The analysis highlights a region-wise as well as a worldwide study of the Chemotherapy Induced Peripheral Neuropathy Treatment market. Proportionately, the regional study of the industry comprisesJapan, South East Asia, India, the USA, Europe, and China.Moreover, the report reviews an in-depth market analysis of distinct manufacturers and suppliers. It explainsindustry chain structure, competitive scenario, and study of Chemotherapy Induced Peripheral Neuropathy Treatment industry costin detail. It evenly analyzes global industry size pursued by forecast period (2020-2025) and environment.

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The analysis covers basic information about the Chemotherapy Induced Peripheral Neuropathy Treatment product likeindustry scope, segmentation, anoverviewof the market. Likewise, it providessupply-demand data, investment feasibleness, and elements that limiting the growth of an industry. Predominantly, it helps product demand, annual revenue and growth prospects of the industry. The foreseen Chemotherapy Induced Peripheral Neuropathy Treatment market regions along with the present onesassist leading vendors, decision-makers, and viewers/readersto plan effective business strategies respectively.

KEY TOPIC COVERED

Growth Opportunities

Market Growth Drivers

Leading Market Players

Market Size and Growth Rate

Market Trend and Technological

Company Market Share

TOC OF Chemotherapy Induced Peripheral Neuropathy Treatment MARKET REPORT INCLUDES:

1 Industry Overview of Chemotherapy Induced Peripheral Neuropathy Treatment

2 Industry Chain Analysis

3 Manufacturing Technology

4 Major Manufacturers Analysis

5 Global Productions, Revenue and Price Analysis of Chemotherapy Induced Peripheral Neuropathy Treatment by Regions, Creators, Types, and Applications

6 Global and Foremost Regions Capacity, Production, Revenue and Growth Rate by 2013-2019

7 Consumption Volumes, Consumption Value, Import, Export and Sale Price Analysis by Regions

8 Gross and Gross Margin Analysis

9 Marketing Traders or Distributor Analysis

10 Global and Chinese Economic Impacts on the Chemotherapy Induced Peripheral Neuropathy Treatment Industry

11 Development Trend Analysis

12 Contact information

13 New Project Investment Feasibility Analysis

14 Conclusion of the Global Chemotherapy Induced Peripheral Neuropathy Treatment Industry 2019 Market Research Report Continued

Finally, the feasibility of new investment projects is assessed, and overall research conclusions are offered.

Key questions answered by the Chemotherapy Induced Peripheral Neuropathy Treatment Report:

What are some of the most favourable, high-growth prospects for the global Chemotherapy Induced Peripheral Neuropathy Treatment market?

Which products segments will raise at a faster pace throughout the forecast period and why?

What are the foremost factors impacting market prospects?

What are the driving factors, restraints, and challenges in this Chemotherapy Induced Peripheral Neuropathy Treatment market?

What are the competitive threats and challenges to themarket?

What are the evolving trends in this Chemotherapy Induced Peripheral Neuropathy Treatment market and reasons behind their emergence?

What are some of the changing customer demands in the Chemotherapy Induced Peripheral Neuropathy Treatment Industry market?

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Possible Associations of Vitamin D, Vitamin D-Binding Protein, and Vit | JPR – Dove Medical Press

February 29th, 2020 7:48 am

Asuman Celikbilek

Department of Neurology, Kudret International Hospital, Ankara, Turkey

Correspondence: Asuman CelikbilekKudret International Hospital, Department of Neurology, Ankara 06600, TurkeyTel +90 505 6532615Fax +90 312 229 98 68Email asunebioglu@yahoo.com

We read with great interest the article recently published in Journal of Pain Research by Sari et al,1 examining the effect of vitamin D replacement therapy on neuropathic pain and imbalance in patients with diabetic neuropathy (DN). They found that vitamin D replacement reduced neuropathic pain and improved balance scores in patients with DN. They suggested that a vitamin D replacement schedule might be planned in diabetic patients with vitamin D deficiency in order to resolve neuropathic pain and balance problems. However, we would like to add some points which may be taken into consideration.

View the original paper by Sari and colleagues

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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Mersana Therapeutics Announces Fourth Quarter and Full Year 2019 Financial Results and Provides Business Updates – BioSpace

February 29th, 2020 7:48 am

XMT-1536 Phase 1 dose escalation data update selected for late-breaker oral presentation at upcoming Society of Gynecologic Oncology (SGO) 2020 Annual Meeting on Womens Cancer

XMT-1536 interim Phase 1 dose expansion data to be presented in 2Q 2020 with more mature data expected in 2H 2020

Company to present preclinical data on ADCs created with the Dolasynthen and Immunosynthen platforms at the American Association for Cancer Research (AACR) Annual Meeting

CAMBRIDGE, Mass., Feb. 28, 2020 (GLOBE NEWSWIRE) -- Mersana Therapeutics, Inc. (NASDAQ:MRSN), a clinical-stage biopharmaceutical company focused on discovering and developing a pipeline of antibody-drug conjugates (ADCs) targeting cancers in areas of high unmet medical need, today reported financial results and provided a business update for the fourth quarter and full year ended December 31, 2019.

We are excited to present updated data from our ongoing dose escalation study in heavily pre-treated and biomarker unselected patients at the upcoming SGO 2020 Annual Meeting on Womens Cancer. We plan to demonstrate that, at doses up to 43 mg/m2, XMT-1536 is well tolerated without the severe neutropenia, neuropathy or ocular toxicities typically observed with other ADC platforms, said Anna Protopapas, President and Chief Executive Officer of Mersana Therapeutics. Additionally, we continue to execute on our proof-of-concept expansion cohorts in ovarian and non-small cell lung cancer for XMT-1536 and are on track for additional data disclosures throughout the year. These data readouts will be important milestones as we chart a fast-to-market path to registration in ovarian cancer.

Recent Highlights and Updates

Clinical Programs

Discovery & Platform Progress

Upcoming First Quarter 2020 Events

2019 Financial Results

Cash, cash equivalents and marketable securities as of December 31, 2019, were $99.8 million, compared to $70.1 million as of December 31, 2018. In addition, the Company has the option to draw additional funds of up to $15.0 million through the existing debt financing agreement with Silicon Valley Bank. The Company expects that its current cash, cash equivalents and marketable securities will enable it to fund its operating plan through important milestones, including the XMT-1536 Phase 1 clinical study and the planned dose escalation study for XMT-1592.

Fourth Quarter 2019

Full Year 2019

Conference Call DetailsMersana Therapeutics will host a conference call and webcast today at 8:00 a.m. ET to report financial results for the fourth quarter and year-end of 2019 and provide certain business updates. To access the call, please dial 877-303-9226 (domestic) or 409-981-0870 (international) and provide the Conference ID 4849085. A live webcast of the presentation will be available on the Investors & Media section of the Mersana website at http://www.mersana.com.

About Mersana TherapeuticsMersana Therapeutics is a clinical-stage biopharmaceutical company using its differentiated and proprietary ADC platforms to rapidly develop novel ADCs with optimal efficacy, safety and tolerability to meaningfully improve the lives of people fighting cancer. Mersanas lead product candidate, XMT-1536, is in a Phase 1 proof-of-concept clinical trial in patients with tumors likely to express NaPi2b, including ovarian cancer and NSCLC adenocarcinoma. Mersanas second product candidate targeting NaPi2b-expressing tumors, XMT-1592, is an ADC created using Mersanas customizable and homogenous Dolasynthen platform. The Companys early stage programs include a B7-H4 targeting ADC, as well as a STING agonist ADC developed using the Companys Immunosynthen platform. In addition, multiple partners are using Mersanas Dolaflexin platform to advance their ADC pipelines.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of federal securities laws. These forward-looking statements are not statements of historical facts and are based on managements beliefs and assumptions and on information currently available to management. Forward-looking statements include information concerning the Companys business strategy and the design, progression and timing of its clinical trials. Forward-looking statements generally can be identified by terms such as anticipates, believes, could, seeks, estimates, intends, may, plans, potential, predicts, projects, should, will, would or similar expressions and the negatives of those terms. Forward-looking statements represent managements beliefs and assumptions only as of the date of this press release. The Companys operations involve risks and uncertainties, many of which are outside its control, and any one of which, or combination of which, could materially affect its results of operations and whether the forward-looking statements ultimately prove to be correct. Factors that may materially affect the Companys results of operations and whether these forward-looking statements prove to be correct include, among other things, that preclinical testing may not be predictive of the results or success of ongoing or later preclinical or clinical trials, that the development and testing of the Companys product candidates and new platforms will take longer and/or cost more than planned and that the identification of new product candidates will take longer than planned, as well as those listed in the Companys Annual Report on Form 10-K filed on February 28, 2020, with the Securities and Exchange Commission (SEC) and subsequent SEC filings. Except as required by law, the Company assumes no obligation to update these forward-looking statements publicly, or to update the reasons actual results could differ materially from those anticipated in the forward-looking statements, even if new information becomes available in the future.

Mersana Therapeutics, Inc.Selected Condensed Consolidated Balance Sheet Data(in thousands)(unaudited)

Mersana Therapeutics, Inc.Condensed Consolidated Statement of Operations(in thousands, except share and per share data)(unaudited)

Contact:

Investor & Media ContactSarah Carmody, 617-844-8577scarmody@mersana.com

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Indiana Regenerative Medicine Institute Offers Innovative Approaches in Regenerative Medicine, Hormone Replacement and Pain Management – Zionsville…

February 29th, 2020 7:48 am

February 2020

Are you looking for a health care provider who offers innovative alternatives and a customized approach to your health issues? Indiana Regenerative Medicine Institute (IRMI) believes in offering specialized alternatives to health care. Its medical team, headed by Doctor of Chiropractic Preston Peachee, utilizes the latest developments in regenerative medicine, hormone replacement and pain management.

Dr. Peachee is a native of Jasper, Indiana. He graduatedfrom Logan College of Chiropractic and has been in practice since 2003. Hisareas of specialty include patients with chronic and severe back, neck andjoint pain as well as other complex neurological conditions.

Dr. Peachee has earned a reputation as an innovative thinkeras well as a compassionate practitioner who brings his wide expertise andexperience to the Greater Indianapolis area. His ability to help those in needof regenerative medicine, neuropathy pain relief, low testosterone or otherphysical ailments, such as back pain or fibromyalgia, makes him not only uniquebut highly sought-after.

A key member of the IRMI team is Leann Emery, FNP. Emery isa family nurse practitioner with more than 20 years of experience in hormonereplacement and alternative pain management. Emery provides optimal patientcare through personal consultations and assessments to identify her patientsspecific health needs. She was rated in the top 10% of providers in the U.S.with patient satisfaction.

Regenerative medicine is making huge leaps in our understanding of the human body, and it is offering real, possible treatments that would have seemed like science fiction a few short years ago, according to IRMI. Most patients we see have tried other more traditional treatments and have either not gotten any better or have gotten even worse. Unfortunately, a lot of people we see depend on multiple medications per day to try and function but still are not happy with how they feel or how they live their lives. It is unfortunately the nature of deteriorating and degenerative joints, they will get worse with time, and generally the pain increases as well.

Depending on the injury, Dr. Peachee will often combinelaser therapy with the regenerative medicine protocols to improve the outcomesand try and speed the recovery process.

We offer mesenchymal stem cell therapy, Dr. Peachee said. With the combination of laser therapy, mesenchymal stem cell therapy is incredibly effective for rotator cuff problems and treating knee pain. Eighty percent of our stem patients are dealing with knee pain or Osteoarthritis. Osteoarthritis-or O.A. of the knee- is a huge problem for a lot of people, and we get great results from these therapies. Most people can even avoidknee surgery.

Dr. Peachee recently introduced hormone treatments for low testosterone. Family Nurse Practitioner Leann Emery has been doing [hormone] treatments for 20 years, and that area of medicine became a natural fit for IRMI.

I have several patients who were seeking this type ofcaremany who are police officers and firefighterswho couldnt find thetherapy and individualized care and attention that they needed.

Dr. Peachee explained that low T treatments help patients with unique and even complicated cases of Erectile Dysfunction (E.D.). Most people seek us out for treatment because they are tired, worn out, stressed out and just simply lack the energy they used to have.

We are able to fill a niche with patients who hadcomplicated cases that were not responding well with their primary careproviders or other places, Dr. Peachee shared. We have a patient who hasstruggled for a long time with fertility issues but has done very well [withtreatments], and we just got good news that he and his wife are expecting aftertrying for a really long time. So, he is really enthused about that.

The typical candidates for low T treatments, according toDr. Peachee, are men who feel worn out, are lethargic and have lost theirzest for life.

Our patients dont have the same pep that they had 10 or20 years ago, Dr. Peachee stated. They struggle getting up in the morning andmight be struggling in the afternoon after having six cups of coffee or threeRed Bulls just to get through the day. We have a lot of people that want to getback into the gym and get the maximum benefit of their workouts. We can helpthem improve their overall health and energy so that they can enjoyrecreational activities like working out or practice with the Little Leaguewith their kids. Many times we hear from spouses, friends and family how muchbetter they feel and that they seem happier and get more out of life again.

It goes without saying that proper hormonal balance canimprove a patients personal relationships as well and improve the overallmental health of a patient by reducing stress, anxiety and depression oftencaused by symptoms related to low testosterone levels.

We focus on injectable [low T] treatments because we canmodify the dosage and give more frequent doses to keep our patients at a levelthats going to give them the maximum benefit and improvement for theirconditions, Dr. Peachee explained.

With the modern changes in medicine over the last 20 and 50years, were helping people to live a lot longer and adding 20 to 30 years totheir lives, but we have not given them an improved quality of life as theyage. By working with their hormones and getting them in balance, their qualityof life becomes way better, and were seeing a positive improvement for manypeople with these treatments.

Patients suffering from severe disc injuries, such a bulgingor herniated disc or discs, or who suffer from degenerative disc disease mayhave undergone treatment from chiropractors or have seen physical therapistsbefore coming to Indiana Regenerative Medicine Institute.

Our typical patient who comes in for this type of treatmenthas seen other therapists or chiropractors but hasnt found lasting relief,Dr. Peachee said. Many of our patients want to get off the rollercoaster ofopioids and pain medications. They are looking for a solution without narcoticsand risk of addiction or other possible negative side effects of narcoticsand/or surgery. We are generally able to alleviate the pain in 90% of patientsand are able to keep them from having surgery or from taking addictivemedications.

Laser therapy allows Dr. Peachee to work on the damaged tissue so that it can heal, and the method reduces inflammation and swelling in a way that traditional treatments cannot.

Its an innovative new therapy within the last decade thatallows us to do some amazing things, Dr. Peachee stated. We perform ourprocedures in our office and have several different devices for the specificneeds and issues of our patients. For instance, we have a unique device forpeople with knee pain that can help the majority of our patients walk betterand live more pain-free. We get a phenomenal outcome with this procedure.

One of the other major differentiators that sets IndianaRegenerative Medicine Institute apart from other offices and clinics is thatthey are advocates for their patients, especially when it comes to dealing withtheir patients insurance providers.

A lot of our low T patients are able to get their insurancecarriers to cover the services so that it doesnt cost them as much out ofpocket for the care they seek, Dr. Peachee said. Weve partnered with abilling company that has helped us to be able to navigate the craziness of ourmodern insurance companies, and by doing so, were able to keep the cost downfor a lot of patients. Not every insurance plan will cover this type of care,but a lot of them will. When its possible and ethical, we do whatever we canto benefit our patients to help keep the cost low. I have spent a lot of freetime writing letters on behalf of our patients. We go above and beyond with ourservice and care of our patients.

The Indiana Regenerative Medicine Institute team will make housecalls or come to a patients place of work when the situation calls for thatlevel of care.

We will go and draw blood for blood work, bring medications and even do exams in some situations, Dr. Peachee said. As I mentioned before, we see a lot of police officers and firemen all over the statefrom Mishawaka to South Bend and all over Indiana. We go once a month to see these patients at their departments and stations so that we see them all in one day versus making 10 to 15 guys drive hours to come in to see us. Its a service we can offer because we are a small clinic and we are focused on that one-on-one patient attention and relationship building. We have great relationships with our patients, and thats something that we work very hard at.

Building trust and transparency is crucial to the success ofhis practice, Dr. Peachee emphasized. The trust that we build with ourpatients is crucial to not only the success of the practice but to thepatients outcomes. And not just with hormone therapy but also with ournonsurgical spinal decompression patients. These are patients with significant discinjuries, and we need them to tell us everything we need to know so we can givemore accurate and complete care for a better outcome.

I would say to anybody if you have any doubts or reservations to take some of the burden and some of the anxiety out of the equation and schedule an initial consultationabsolutely free of charge, Dr. Peachee encouraged.

Dont put off living your best life any longer. Visit Indiana Regenerative Medicine Institutes website at indianaregen.com or call (317) 653-4503 for more information about its services and specialized treatments and schedule your free consultationtoday!

Writer:

Janelle Morrison

Photography:

Laura Arick and submitted

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Common sources of shoulder pain and how to treat it – Summit Daily News

February 29th, 2020 7:47 am

Editors Note: Sponsored content brought to you by Panorama Summit Orthopedics

Shoulder pain can range from temporary to long-lasting, from motion-related to constant, but one of the most disruptive symptoms of any shoulder injury is its effect on sleep.

When you dont sleep, everything in life becomes harder, said Dr. Aaron Black, a shoulder, knee and trauma specialist at Panorama Summit Orthopedics.

Some of the most common sources of shoulder pain include rotator cuff injuries and arthritis. In Summit County, its common to see patients who develop shoulder arthritis as a result of previous injuries to the shoulder, such as a shoulder dislocation earlier in life, Dr. Black said.

A specific diagnosis and treatment plan can result in years or perhaps a lifetime of pain relief and increased mobility in this important joint. Its Dr. Blacks mission to make sure hes helping patients not only eliminate shoulder pain and weakness, but also get back to consistently healthy and restful sleep.

Primary arthritis vs. rotator cuff arthropathy

The two broad categories of arthritis most commonly seen in Summit County are primary arthritis and rotator cuff arthropathy, or secondary arthritis. Primary arthritis has no specifically known cause and is usually related to age, sex and genes, according to the Arthritis Foundation. Rotator cuff arthropathy happens after a large, long-standing rotator cuff tendon tear that no longer holds the head of the humerus in the socket, causing it to move upward and damage the surface of the bones, according to the American Academy of Orthopaedic Surgeons.

Shoulder arthritis is experienced as achy pain and stiffness around the shoulder that often feels worse in the morning, Dr. Black said. Rotator cuff arthropathy is usually associated with stiffness and weakness.

Nonoperative arthritis treatment

Nonoperative shoulder arthritis treatment includes physical therapy and injection therapies.

As with any arthritic joint, the more you use it, the less stiff it is and the less pain you have, Dr. Black said.

PT can help improve range of motion in the shoulder, while icing the shoulder two or three times a day can reduce inflammation and ease pain.

Dr. Blacks injection therapy options include cortisone and biologic agents, such as platelet-rich plasma (PRP), all of which act primarily as anti-inflammatories.

No biologic injection therapies contain stem cells for tendons or cartilage, despite advertisements to the contrary, and thus do not regrow cartilage or tendons, he said.

Cortisone injections can offer pain relief for three to six months, while PRP tends to last a bit longer, Dr. Black said. The procedures are performed in the office under ultrasound guidance.

Shoulder joint replacement (arthroplasty)

If shoulder arthritis is severe, its less likely that the nonoperative options will get the job done. The next option for these patients would be shoulder joint replacement surgery.

Dr. Black said there are two types of shoulder replacements: anatomic total shoulder replacement and reverse total shoulder replacement. There are roughly 53,000 of these surgeries performed each year in the United States, according to the American Academy of Orthopaedic Surgeons.

Both procedures have differing benefits. Dr. Black said that anatomic replacements can be done on patients of any age, but those who have it at a younger age might require another surgery later in life. The procedure works well for getting patients back to their normal activities.

Reverse replacements are extremely reliable for reducing or eliminating pain, but less reliable for getting full range of motion back, he said.

I do all of my shoulder replacements with custom 3D modeling and patient-specific guides made to ensure the components are in exact right position, Dr. Black said.

Dr. Black stresses that all joint replacements are elective surgeries.

I will never tell a patient they have to have a joint replacement, he said. This is symptom-based when you say its time, its something Ill say you should have. I want all of my patients to be informed about the options.

Shoulder joint replacement recovery includes about six weeks in a sling, and in three to four months most patients are back to regular activity with continued improvement from there.

Rotator cuff injuries

Another common local shoulder affliction is to the rotator cuff, which is the combination of muscles and tendons that keep your arm bone centered in your shoulder socket to provide shoulder motion and stability. Dr. Black said these injuries can happen during a fall when the arm is thrown away from the body, but sometimes rotator cuff injuries are chronic and happen over time.

Some people even have large tears to the rotator cuff without ever feeling any symptoms.

The good news is that there are a lot of treatment options, from physical therapy and injections to repair or reconstruction surgery.

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Rheum Round-up: Heres What Rheumatologists and Patients Value in Rheumatoid Arthritis Treatment, Plus How Kidney Injury Affects Surgery Complications…

February 29th, 2020 7:47 am

Here are the top stories recently covered by DocWire News in the Rheumatology section. In this edition, read about what rheumatologists and patients believe is the most important in rheumatoid arthritis treatment, the effects of acute kidney injury on hip arthroplasty complications, the best technique for traumatic finger amputation, and seasonal effects on symptoms including fatigue on primary Sjgrens syndrome.

A new study assessed the preferences of patients and rheumatologists regarding treatment attributes for rheumatoid arthritis (RA) as well as their feelings regarding shared decision-making. Three steps were taken: literature review, RA patient focus group discussion, and rheumatologist focus group discussion. A total of 90 rheumatologists (mean years of experience, 18.1 years; 52.2% were female; average RA patients per week, 24.4) and 137 RA patients (mean age, 47.5 years; 84.0% were female; mean time since RA diagnosis, 14.2 years; mean time in treatment, 13.2 years) were included in the study. Although the top three attributes were the same between patients and rheumatologists, the order in which they were ranked differed, with patients placing the highest value on time with optimal quality of life (QoL) followed by mode of administration and time to onset of treatment action, compared to rheumatologists, who ranked the top three attributes as mode of administration, time with optimal QoL, and time to onset of treatment action.

A new study highlighted the effects of acute kidney injury (AKI) on complication risk in total hip arthroplasty (THA) patients. The study authors concluded that AKI significantly increases postoperative complication risks, including mortality, and recommend that increased focus be placed on reducing AKI risk. A total of 4.1 million primary THAs were performed during the study period, of which 61,077 (1.5%) included AKI during hospitalization. Unadjusted analyses unearthed a correlation between AKI and higher rate of complications and healthcare utilization. When adjusting for age, gender, race, income, underlying diagnosis, medical comorbidity, and insurance payer, AKI presenting in primary THA was significantly increased risks for implant infection, transfusion, revision, death, total hospital discharges above the median, discharge to a rehabilitation facility, and hospital length of stay longer than three days.

A new study examined whether season has an impact on symptoms of fatigue, pain, and dryness in primary Sjgrens syndrome. The present study evaluated patient data from the French nationwide multicenter pSS cohort Assessment of Systemic Signs and Evolution in Sjgrens Syndrome (ASSESS) (n=395). ASSESS was created in 2006 and houses five-year prospective follow-up data as well as data from three randomized, placebo-controlled trials of infliximab, rituximab, and hydroxychloroquine. In each study, visits included data collection on visual analog scale (VAS) scores for pain, fatigue, and dryness. Data were assessed by the day, month of the year, and season. VASs did not largely differ among the seasonal groups. The EULAR Sjgrens Syndrome Patient Reported Index scores did not significantly differ by season: spring, 57.7; summer, 59.5; fall, 55.9; and winter, 57.2.

A study questioned which is the best strategy to employ in traumatic finger amputations and concluded that the target technique will depend on the patient. The researchers reviewed data from a retrospective cohort study who underwent revision amputation or replantation at 19 U.S.- and Asia-based centers between Aug. 1, 2016, and April 12, 2018. The present analysis included data on 185 patients. The primary outcomes were hand strength, dexterity, hand-related quality of life, and pain, and the study authors employed a tree-based statistical learning method to obtain clinical decision rules for traumatic finger amputation treatment. Implementation of the tree-based statistical learning estimates found that different strategies were associated with different outcomes. Maximal hand dexterity or minimal patient-reported pain was obtained through replantation. Maximal hand strength was obtained through revision amputation in the case of a single-finger amputation; in all other cases, replantation was the best approach. Maximal patient-reported quality of life was obtained through revision amputation in patients with dominant hand injuries, and replantation was favorable in the case of nondominant hand injuries.

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YOUR HEALTH: Knee relief can be found in the womb – WQAD.com

February 29th, 2020 7:47 am

CHICAGO About 54 million Americans suffer from the aches and pains of arthritis.

Treatments range from pain medications to injections to surgery.

None of it seemed to work for 77-year-old Marty Ciesielczyk.

And it jeopardized something he loved: jogging.

"For me, it's just enjoyable, and if you're not a runner, then you would have no idea what I'm talking about."

But Marty's active lifestyle was in jeopardy when knee pain took over.

"When you got to lay on the floor to get dressed, it's tough."

It happens when there's a loss of cartilage in the joint.

"It's like a tire, and as you slowly lose rubber on the tire, it wears away," explained Dr. Adam Yanke, a surgeon with Midwest Orthopaedics at Rush University.

"You might need to have the tire replaced at some point."

Marty's arthritis was too advanced for a scope procedure but not bad enough for a joint replacement.

So he enrolled in a study testing whether amniotic fluid, which surrounds a growing baby in the uterus, could help his pain.

"Amniotic products come from patients that are having healthy, elective C-sections, and they choose to donate these products at the time of the delivery," said Dr. Yanke.

It's thought to increase tissue healing and lower inflammation.

Doctor-diagnosed arthritisis more common in womenthan in men. Arthritis and other joint disorders are among the five most costly conditions among adults 18 and older.

Your bone marrow makes mesenchymal stem cells, or MSCs. They are known to grow into new tissues, including cartilage.

By gathering these cells and injecting them into the knee joint, the hope is that they will give growth to new cartilage and reduce inflammation.

Marty received a placebo during the study, but then chose to have the amniotic fluid when the study ended.

"I mean I didn't care if it was Pixie dust, as long as my knee was going to feel better."

He went from not being able to get dressed to jogging about a week after having the injection.

"This morning, I ran three, three miles, and I had no problem at all."

Amniotic fluid is also being used to treat ulcers in the eye.

Rush University will be enrolling patients for a larger follow-up study on amniotic fluid for joint pain in the future.

Clinical trialsare still going on and most studies are still early.

A review published in 2016 in BMC Musculoskeletal Disorders concluded that MSC-based therapies offer an "exciting possibility" for treatment, but further studies need to be done on how they can best be used and how well they work.

They are also known to be very expensive.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens atjim.mertens@wqad.comor Marjorie Bekaert Thomas atmthomas@ivanhoe.com.

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What is gout? How to know if you have it and recommended treatment – Business Insider

February 29th, 2020 7:47 am

captionGout is associated with frequent joint pain.sourceljubaphoto/Getty Images

Gout is an intensely painful form of arthritis that affects over 8 million Americans. As our diets change to include more processed foods, and with the increase in popularity of high protein diets, gout is on the rise, especially for older men. Heres what you need to know about the causes, symptoms, and treatment for gout.

Gout causes your joints to swell up and become extremely painful. Its the most common type of inflammatory arthritis and is caused by a buildup of uric acid, a waste product that is produced when your body breaks down a chemical called purine in certain foods.

Gout is caused by a condition called hyperuricemia, which means there is an excess of uric acid in the blood. Uric acid is normally diluted in your blood and leaves the body through your urine, but when you have too much uric acid in your blood, the acid can crystallize and build up in your joints, causing gout symptoms.

Foods with high concentrations of purines include red meat, alcohol, and fruit juices even if they are naturally sweetened. In addition, seafood like sardines, tuna, and shellfish also contain purine and should be eaten only in moderate amounts. Read our article on the best diets for gout for more information on what you should be eating and avoiding.

Western-style dietary patterns seem to increase the risk of gout, says Hyon K. Choi, MD, a professor of Medicine at Harvard Medical School. A typical Western diet includes large amounts of processed carbohydrates like high fructose corn syrup, red meat, and saturated fats.

Obesity may also be a risk factor: A study, published in Arthritis Care & Research in 2012, found that people who are obese are around twice as likely to suffer from gout compared with people whose body mass index falls in the normal range.

Other risk factors include sex and age. Men are more likely to develop gout, in general, and women are at greater risk after menopause.

Some people may only have gout attacks periods of acute pain and swelling in joints once or twice in their lifetime, while others with chronic gout may have frequent attacks, several times a year, that dont fully heal in between episodes.

Some of the most common symptoms of gout are:

The symptoms of gout usually come and go, says Choi, although patients can have chronic joint pain if the gout is severe or longstanding.

When you have an acute attack of gout, your doctor will likely focus on treating your immediate symptoms first by prescribing non-steroidal anti-inflammatory drugs to help bring down the pain and swelling. For patients who get frequent flares of gout, long-term treatment with a medication that lowers uric acid levels, such as allopurinol, is recommended, Choi says.

However, while symptoms of gout can be controlled with medications, it is also important to implement lifestyle changes, Choi says, adding that a good place to start is adopting a healthy diet and exercise.

Left untreated, gout can increase your risk of developing heart disease, type 2 diabetes, and chronic kidney disease.

Over the long term, losing weight may be an important step to treat gout, as being overweight increases your chances of developing gout. However, you should avoid extreme dieting, as losing weight too quickly can actually trigger gout attacks.

Avoiding high purine foods can help lower uric acid in your body, and consuming certain foods like vitamin C and coffee may help treat gout, according to some research.

Choi says that overall, the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets seem to be beneficial for patients with gout. This means adding more whole grains, vegetables and fruits, and legumes to your diet and eating less meat. For more information about what to eat for each of these diets, check out our articles about the Mediterranean diet and the DASH diet.

Gout can be painful in the short term and can lead to serious illnesses in the long term, but there are treatments available to lower your risk. The best place to start is to talk to your doctor about diet and lifestyle changes you can make to improve your health.

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What is gout? How to know if you have it and recommended treatment - Business Insider

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Rheumatoid Arthritis and Lupus Treatments Market Share, Trends and Leading Players By 2026 – News Times

February 29th, 2020 7:47 am

Rheumatoid Arthritis and Lupus Treatments Market with Key Business Insights

Global Rheumatoid Arthritis and Lupus Treatments Market report is a comprehensive study of the market and the growth prospects in the market. The information offered in the report has been accumulated through both primary and secondary sources of data collection and also through interviews of industry experts. The study is an exhaustive database of authentic and relevant information that readers, researchers, analysts, and executive professionals for the purposes of academic or commercial research on the market can use to their benefit. The report includes essential market aspects like industry trends, segmentation, growth prospects, promising opportunities, prevalent growth trends, challenges, and competitive analysis.

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Leading Players studied in this report are as follows:

AbbVieAmgenBayerBiogen IdecRocheJohnson and JohnsonMerckMitsubishi Tanabe PharmaNovartisPfizer

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In market segmentation by types of Rheumatoid Arthritis and Lupus Treatments, the report covers-

Rheumatoid Arthritis TreatmentsLupus Treatments

The evaluation also includes the rates of production and consumption, gross revenue, and average product price and market shares of key players. The information gathered is further broken down by including regional markets, production plants, and product types available in the market. Other key points, like competitive analysis and trends, concentration rate, mergers & acquisitions, expansion tactics, which are vital to establishing a business in the sector, have also been included in the report.

In market segmentation by applications of the Rheumatoid Arthritis and Lupus Treatments, the report covers the following uses-

Hospitals and ClinicsAmbulatory Surgery CentersHomecare Settings

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Manufacturing Analysis:The report gives an extensive analysis of various segments of the market by studying the product range, applications, major regions, and leading companies in the industry. Additionally, the report also dedicates an individual section to give a detailed analysis of the manufacturing process, which includes information collected through both primary and secondary sources of data collection. The primary source of data collection contains interviews of industry experts who offer accurate insights into the future market scenario.

Sales and Revenue Estimation:By employing both top-down and bottom-up approaches to evaluate the past data relating to the sales and revenue, along with the current market scenario. Our team of analysts predicts the future growth of the market and the development of the market in the leading geographies. The study also includes a comprehensive study of the product types, applications, end-users, leading regions, and critical participants in the industry. It also offers other critical data relating to the regulatory framework and guidelines, along with the macro-economic indicators influencing the growth of the market through detailed market estimation.

Rheumatoid Arthritis and Lupus Treatments Market Regional landscape includes: North AmericaAsia-PacificEuropeLatin AmericaMiddle East & Africa

Demand & Supply Assessment:The report also offers key highlights relating to the manufacturing processes, along with a cost analysis, rates of consumption and production, import/export status, product range, and supply chain assessment.

Competitive landscape:The report sheds light on critical information relating to the company profiles, product portfolio, growth prospects, cost assessment, total sales, revenue generated, market shares held by key regions, established companies, and emerging players.

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In conclusion, the Rheumatoid Arthritis and Lupus Treatments Market report is a reliable source for accessing the Market data that will exponentially accelerate your business. The report provides the principal locale, economic scenarios with the item value, benefit, supply, limit, generation, request, Market development rate, and figure and so on. Besides, the report presents a new task SWOT analysis, speculation attainability investigation, and venture return investigation.

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Rheumatoid Arthritis and Lupus Treatments Market Share, Trends and Leading Players By 2026 - News Times

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Adherence to ophthalmological screening recommendations and course of uveitis in children with juvenile idiopathic arthritis: data from the Inception…

February 29th, 2020 7:47 am

As JIA-associated uveitis (JIAU) is asymptomatic in the majority of patients, ophthalmologic screening examinations are recommended, depending on the risk constellation for uveitis development. This study analyses disease characteristics in JIAU depending on adherence with the screening intervals.953 patients were included in the ICON registry. In patients without uveitis, ophthalmologic screening was recommended in accordance with the standards currently applied in Germany. Dates and results of the screening examinations were noted for each patient.Until the 3-year-follow up, uveitis developed in 133 of 953 JIA patients. In 56 of them, uveitis was present before study inclusion, and those were excluded from the prospective analysis. For the remaining 897 JIA patients, screening results were available in 557, 46 of whom developed uveitis. In those patients, adherence with the suggested screening intervals until uveitis onset was assessed, and patients were classified accordingly: screenings as recommended (Sc+ group, n=356) vs. infrequent screening (Sc- group, n=201). Non-adherence with the screening schedule significantly correlated with younger age at study inclusion and JIA diagnosis, shorter JIA disease duration, JIA oligoarthritis subtype and positive antinuclear antibody status. The Sc+ group had a better visual acuity (VA) at initial uveitis diagnosis, however, at the 3-year-follow up, VA and uveitis complication rates did not differ significantly.Especially high-risk patients often do not adhere to the initial frequently recommended screening intervals, resulting in a reduced visual acuity at initial uveitis diagnosis. A recommendation for changing the current screening intervals cannot be deduced from our data.

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Local Hand Surgeon Helps Patients with Painful Wrist Injury – Patch.com

February 29th, 2020 7:47 am

Over the past three decades, hand surgeon Scott Wolfe, who sees patients at Hospital for Special Surgery (HSS) in New York City and at HSS Stamford, has been conducting research to find a better way to repair a common wrist injury that results in pain and disability.

Now a new surgical procedure to repair a torn scapholunate ligament shows promise in relieving wrist pain and restoring function, according to Dr. Wolfe, Chief Emeritus of the Hand and Upper Extremity Service at HSS. He believes it may also prevent the arthritis that many people with the injury develop over time.

Forty-year-old Asad Spahic, a mechanical engineer from Southington, Connecticut, is among the patients who say the procedure has relieved their pain and enabled them to return to activities they enjoy.

The scapholunate is a critical ligament that connects and stabilizes the scaphoid and lunate, two small bones near the center of the wrist. When an injury, often a fall on an outstretched hand, causes the ligament to rupture, patients can experience pain, lose grip strength and develop arthritis that gets worse as time goes on.

"When the ligament tears, the scaphoid and lunate bones will separate, start to rotate and degenerate. Some patients can feel the scaphoid popping in and out of its normal position," Dr. Wolfe explains. Without treatment to repair the torn ligament, people ultimately develop a condition known as SLAC wrist. SLAC, which stands for "scapholunate advanced collapse," is the most common form of post-traumatic arthritis in the wrist, affecting about four million people. As the bones rub abnormally against each other, their protective cartilage wears away.

"The injury most often affects healthy active people. When the ligament ruptures, any activity that combines wrist motion and wrist strength becomes difficult, if not impossible," Dr. Wolfe says. "Affected patients report problems performing jobs that require manual work. They can no longer play sports such as golf or tennis, do yoga or Pilates, or work out with weights at the gym."

Until now, surgery to reconstruct a torn scapholunate ligament has not been ideal, Dr. Wolfe says. The most common repair, which entails the use of metal wires and pins, fails in about 30 percent of patients.

Dr. Wolfe is one of just a few hand surgeons in the U.S. performing the new procedure, known as ANAFAB (anatomic front and back repair). "The goal is to reconnect the bones and restore their normal motion to provide pain relief, make the wrist stable again and stop the arthritic process," he explains.

Dr. Wolfe describes the surgery as a complex and highly technical procedure. "The critical ligaments in the front and the back of the wrist are reconstructed by using a portion of one of the tendons in the patient's wrist, combined with a synthetic tape that's 10 times stronger than steel, weight for weight. The tape is very strong, but also very lightweight and very thin," he says. "The patient's own tendon and this synthetic material are woven through the bones in such a way that the scapholunate ligament, as well as two other nearby ligaments, are repaired all at once. This brings the bones back into the proper position and stabilizes them, so abnormal movement is stopped."

The new procedure is performed without the use of wires and pins, a major advantage, he says, as metal hardware in the wrist can loosen, become infected, fail and necessitate another surgery.

Dr. Wolfe has performed the ANAFAB procedure on 14 patients to date and is monitoring their progress. So far, so good. Asad Spahic, Dr. Wolfe's patient from Southington, found Dr. Wolfe online. His ligament injury, sustained nine years earlier, had led to worsening wrist instability and weakness. He enjoyed participating in sports, but his wrist felt like it was giving way during certain activities, and he began to experience a dull ache. X-rays showed that arthritis was developing.

"A local doctor said the arthritis would get worse, the longer I waited to have surgery. I searched online for the best doctor I could find, reading medical journals," Mr. Spahic said. He knew that once arthritis became severe, a wrist fusion was the standard procedure for pain relief, but a fusion would limit wrist motion and curtail his athletic activities.

He opted for the new surgery with Dr. Wolfe in May 2019. "My experience has been nothing short of phenomenal," Mr. Spahic says. "I don't even think about my wrist. I go skiing, I play soccer, although I use a wrist brace in case I fall because it's been less than a year since my surgery. I have zero pain, zero problems, and the same strength as in my other wrist."

Dr. Wolfe says he will continue to conduct follow-up to gauge the outcomes of ANAFAB surgery to see how patients fare over the long term. "The results are preliminary, but in my 30-year career I have not been this excited about this kind of ligament repair. We're seeing patients who are now pain-free and back to activities they enjoy."

# # #

About HSS

HSS is the world's leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the tenth consecutive year), No. 3 in rheumatology by U.S. News & World Report (2019-2020), and named a leader in pediatric orthopedics by U.S. News & World Report "Best Children's Hospitals" list (2019-2020). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In addition, HSS will be opening a new facility in Florida in early 2020. In 2018, HSS provided care to 139,000 patients and performed more than 32,000 surgical procedures, and people from all 50 U.S. states and 80 countries travelled to receive care at HSS. There were more than 37,000 pediatric visits to the HSS Lerner Children's Pavilion for treatment by a team of interdisciplinary experts. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is the world's leading provider of education on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. http://www.hss.edu.

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Rheumatoid Arthritis Treatment Market Analysis and Forecast to 2026 by Recent Trends, Developments in Manufacturing Technology and Regional Growth…

February 29th, 2020 7:47 am

In this new business intelligence Rheumatoid Arthritis Treatment market report, PMR serves a platter of market forecast, structure, potential, and socioeconomic impacts associated with the global Rheumatoid Arthritis Treatment market. With Porters Five Forces and DROT analyses, the research study incorporates a comprehensive evaluation of the positive and negative factors, as well as the opportunities regarding the Rheumatoid Arthritis Treatment market.

With having published myriads of Rheumatoid Arthritis Treatment market reports, PMR imparts its stalwartness to clients existing all over the globe. Our dedicated team of experts deliver reports with accurate data extracted from trusted sources. We ride the wave of digitalization facilitate clients with the changing trends in various industries, regions and consumers. As customer satisfaction is our top priority, our analysts are available 24/7 to provide tailored business solutions to the clients.

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The Rheumatoid Arthritis Treatment market report has been fragmented into important regions that showcase worthwhile growth to the vendors Region 1 (Country 1, Country 2), region 2 (Country 1, Country 2) and region 3 (Country 1, Country 2). Each geographic segment has been assessed based on supply-demand status, distribution, and pricing. Further, the study provides information about the local distributors with which the Rheumatoid Arthritis Treatment market players could create collaborations in a bid to sustain production footprint.

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To support companies in overcoming complex business challenges, we follow a multi-disciplinary approach. At PMR, we unite various data streams from multi-dimensional sources. By deploying real-time data collection, big data, and customer experience analytics, we deliver business intelligence for organizations of all sizes.

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Rheumatoid Arthritis Treatment Market Analysis and Forecast to 2026 by Recent Trends, Developments in Manufacturing Technology and Regional Growth...

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Rheumatoid Arthritis Stem Cell Therapy Market Key Development by 2025 – News Times

February 29th, 2020 7:47 am

As per a report Market-research, the Rheumatoid Arthritis Stem Cell Therapy economy is likely to see a CAGR increase of XX% within the forecast period (2019-2029) and reach at a value of US$ at the ending of 2029. The macro economic and micro elements which are predicted to influence the trajectory of this market are examined from the market analysis that was presented.

Light onto the material throws Providers, vendors, manufacturers, and market participants at the value string of their industry that is Rheumatoid Arthritis Stem Cell Therapy . Whats more, its particular influence on the market and the political and economic scenarios of regions are discussed within the analysis.

Critical Details included from this record:

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Competitive Outlook

Light onto the throws Business prospects of players operating from the industry that is Rheumatoid Arthritis Stem Cell Therapy . The item pricing plans, marketing stations that were preferred and product portfolio of most players, and promote presence of every and every provider is contained in the title. The players comprise Business 4, Business two, Business 3, and Business.

Regional Assessment

The marketplace research that is introduced sheds light onto the Marketplace Scenario in numerous markets. Additionally, the effects of the governmental and regulatory policies to this market in every regions prospects is examined from the report.

Competitive landscape

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Rheumatoid Arthritis Stem Cell Therapy Market Key Development by 2025 - News Times

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Anti-IL-1 Agents May Be Effective in the Treatment of Familial Mediterranean Fever in Patients With Colchicine Resistance/Intolerance – Rheumatology…

February 29th, 2020 7:47 am

Anti-interleukin-1 (anti-IL-1) agents anakinra and canakinumab may be safe and effective in the treatment of familial Mediterranean fever (FMF), according to study results published in Advances in Rheumatology. Researchers showed that these anti IL-1 agents were effective in reducing proteinuria but less effective in cases with FMF associated with arthritis and sacroiliitis.

Colchicine is typically the primary treatment for FMF attacks and amyloidosis; however, 5% to 15% of patients become resistant/unresponsive to colchicine for whom biologic agents including anti-IL-1 are indicated. In this study, the researchers investigated the safety and efficacy of anakinra and canakinumab in patients with colchicine-resistant FMF.

Investigators enrolled 65 patients (median age, 32 years [range, 17-60 years]; 50.8% men) from the Sivas Cumhuriyet University between January 2014 and March 2019 who were diagnosed with FMF, according to Tel-Hashomer criteria, and had colchicine resistance/intolerance. Researchers collected data from laboratory values, clinical features, and disease activities, and analyzed the information every 3 months. More than half (63.1%) of the patients received anakinra (100 mg/d subcutaneous) and 36.9% of the patients received canakinumab (150 mg/8 week subcutaneous). Median duration of the anti-IL-1 agents was 6 and 8 months for anakinra and canakinumab, respectively.

Researchers found a statistically significant improvement in the visual analog scale, erythrocyte sedimentation rate, C-reactive protein, and attack duration with anti-IL-1 treatment. A total of 96.9% patients (n=63) achieved FMF-50 score response for the anti-IL-1 treatments. Anti-IL-1 agents significantly decreased proteinuria in patients with glomerular filtration rate 60 mL/min/m2; the median proteinuria decreased from 2390 mg/d (range, 1400-7200 mg/d) to 890 mg/d (range, 120-2750 mg/d; P =.008). For the group with glomerular filtration rate <60 mL/min/m2, the median proteinuria decreased from 4472 mg/d (range, 1950-11,200 mg/d) to 3960 mg/d (range, 2050-12,200 mg/d), although the difference was not statistically significant (P =.345). In terms of safety issues, there were serious infections or tuberculosis or malignancy, except in 1 patient.

Study limitations included the small sample size, lack of a randomized controlled trial, and the fact that there was no adjustment for confounding factors such as blood pressure, use of angiotensin receptor blocker drugs, and diet.

[Randomized controlled trials] should be conducted to demonstrate the efficiency of the treatment in these clinical situations. Further studies are needed to determine the safety and long-term side effects of anti-IL-1 therapies, the researchers concluded.

Reference

Sahin A, Derin ME, Albayrak F, Karakas B, Karagoz Y. Assessment of effectiveness of anakinra and canakinumab in patients with colchicine-resistant/unresponsive familial Mediterranean fever. Adv Rheumatol. 2020;60(1):12.

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Anti-IL-1 Agents May Be Effective in the Treatment of Familial Mediterranean Fever in Patients With Colchicine Resistance/Intolerance - Rheumatology...

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Antibe Therapeutics Announces Enrollment of Last Patient in Phase 2B Dose-ranging, Efficacy Study of Lead Drug, ATB-346 – Business Wire

February 29th, 2020 7:47 am

TORONTO--(BUSINESS WIRE)--Antibe Therapeutics Inc. ("Antibe" or the Company) (TSXV: ATE, OTCQB: ATBPF), a leader in developing safer, non-addictive therapeutics for pain and inflammation, is pleased to announce that the last patient has been enrolled and is on treatment in the Phase 2B dose-ranging, efficacy study of Antibes lead drug, ATB-346. The study is evaluating the effectiveness of ATB-346 in reducing osteoarthritis (OA) pain compared to placebo in 360 patients.

The final patients will be on treatment for two weeks, followed by a two-week monitoring period and analysis of the primary endpoint data. The primary endpoint in the study is the change in OA knee pain of ATB-346 versus placebo as measured by the WOMAC subscale pain score, considered the gold standard in pain assessment for arthritis trials. Patients have been randomized to placebo or one of three doses of ATB-346 administered once daily: 150 mg, 200 mg or 250 mg.

The Company anticipates the release of top-line results within six weeks.

About ATB-346

ATB-346 is a hydrogen sulfide-releasing derivative of naproxen. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used therapy for osteoarthritis, but their use is associated with a high incidence of gastrointestinal ulceration and bleeding. NSAIDs are also widely used in conditions such as rheumatoid arthritis, ankylosing spondylitis, gout, and general pain reduction, with a similarly high rate of gastrointestinal ulceration and bleeding. It is well-accepted that patients with these conditions would benefit greatly from an effective, non-addictive, GI-sparing anti-inflammatory/analgesic agent such as ATB-346.

About Antibe Therapeutics Inc.

Antibe develops safer, non-addictive medicines for pain and inflammation. Antibes technology involves linking a hydrogen sulfide-releasing molecule to an existing drug to produce an improved medicine. Antibes lead drug, ATB-346, targets the global need for a safer, non-addictive drug for chronic pain and inflammation. ATB-352, the second drug in Antibes pipeline, targets the urgent global need for a non-addictive analgesic for treating post-surgical pain, while ATB-340 is a GI-safe derivative of aspirin. Citagenix Inc., an Antibe subsidiary, is a market leader and worldwide distributor of regenerative medicine products for the dental marketplace. http://www.antibethera.com.

Forward Looking Information

This news release includes certain forward-looking statements, which may include, but are not limited to, the proposed licensing and development of drugs and medical devices. Any statements contained herein that are not statements of historical facts may be deemed to be forward-looking, including those identified by the expressions "will", "anticipate", "believe", "plan", "estimate", "expect", "intend", "propose" and similar wording. Forward-looking statements involve known and unknown risks and uncertainties that could cause actual results, performance, or achievements to differ materially from those expressed or implied in this news release. Factors that could cause actual results to differ materially from those anticipated in this news release include, but are not limited to, the Companys inability to secure additional financing and licensing arrangements on reasonable terms, or at all, its inability to execute its business strategy and successfully compete in the market, and risks associated with drug and medical device development generally. Antibe Therapeutics assumes no obligation to update the forward-looking statements or to update the reasons why actual results could differ from those reflected in the forward-looking statements except as required by applicable law.

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Antibe Therapeutics Announces Enrollment of Last Patient in Phase 2B Dose-ranging, Efficacy Study of Lead Drug, ATB-346 - Business Wire

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Too Lazy to Exercise? Is It Genetic? – Science Times

February 29th, 2020 7:46 am

(Photo : Piqsels)A recent study suggests that laziness can be blamed on one's genes.

Do you ever wonder why you find it hard to exercise everyday, while others don't? It must be your genes. A recent study found that a certain genetic mutation reduces one's ability to exercise.

For quite some time now, it has been thought that some people consider exercising much easier than others. While some find joy in jogging off to the gym, others find it terrifying to even do anything that may possibly lead to shortness of breath or perspiration. Now this is no longer just some random situation. In fact, scientists have already discovered the link between one's ability to efficiently exercise and certain genes.

The study, published in the New England Journal of Medicine, reported that a genetic mutation in some individuals are making it more difficult for them to exercise. The mutation can impact the "cellular oxygen sensing" that is linked to ahuman's ability to effectively work out.

The research team also found that those with the gene had reduced growth rate, constantly low blood sugar, limited capacity for exercise and an extremely high red blood cell number. With these findings, it can then be said that laziness is indeed, hereditary.

ALSO READ:Wearable Medical Devices: The Next Most Popular Gadgets for Health and Fitness Enthusiasts

(Photo : Photo by bruce mars on Unsplash)

In an attempt to figure out why individuals with a limited capacity to exercise behave the way they do, the team of researchers thoroughly evaluated one case study.

After several tests, including genetic analysis, the scientists found that themutated genebeing examined was thevon Hippel-Lindau, or the VHL gene. It is a type of gene playing a vital role in one's genetic makeup, mainly contributing to the survival of human cells when the ability to take in oxygen is reduced.

Additionally, the researchers also found that the VHL gene was damaged in some individuals struggling to exercise. The main reason for this is that this gene is associated with the mitochondria. When the mitochondria fail to fire on all cylinders, which is the usual case in those with mutated VHL, exercising is certainly quite a hard thing to do.

Dr. Federico Formenti, one of the study's lead authors said that they find this discovery of mutation, as well as the linked phenotype, exciting as it allows for a deeper understanding of human physiology, particularly when it comes how the human body senses and responds to the reduced availability of the oxygen.

The researchers experimented on mice, which were bred to have a mutation ingenesclose to that of humans in order to interrupt its function. In relation to this, researchers characterized the mice in terms of obesity, physical activity, as well as the cellular biology to understand how this gene was associated with obesity.

The saidstudyshowed the levels of physical activity, body weight and how much the mice ate. The study also showed othercellular level measurements that are obesity-related, such as the expression of the protein on the brain cells' surface.

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They Recovered From the Coronavirus. Were They Infected Again? – The New York Times

February 29th, 2020 7:46 am

Can people who recover from a bout with the new coronavirus become infected again and again?

The Japanese government reported this week that a woman in Osaka had tested positive for the coronavirus for a second time, weeks after recovering from the infection and being discharged from a hospital.

Combined with reports from China of similar cases, the case in Japan has raised some uncomfortable questions. Reinfections are common among people who have recovered from coronaviruses that cause the common cold.

But those pathogens are very different from the new coronavirus, and experts said its unlikely that these are cases of people getting infected a second time.

Im not saying that reinfection cant occur, will never occur, but in that short time its unlikely, said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai in New York.

Even the mildest of infections should leave at least short-term immunity against the virus in the recovering patient, he said.

More likely, the reinfected patients still harbored low levels of the virus when they were discharged from the hospital, and testing failed to pick it up.

Even if there were occasional cases of reinfection, they do not seem to be occurring in numbers large enough to be a priority at this point in the outbreak.

Updated Feb. 26, 2020

A report published Thursday in JAMA supports the idea that people may test positive for the virus long after they seem to have recovered.

In four medical professionals exposed to the virus in Wuhan, China, the epicenter of the epidemic, a test that detects the viral genetic material remained positive five to 13 days after they were asymptomatic.

This does not necessarily mean that they were still able to infect others, however.

The PCR diagnostic test is highly sensitive and can amplify genetic material from even a single viral molecule. As such, the test could merely be picking up fragments of the virus.

PCR tests may detect remnants of the measles virus months after people who had the disease stop shedding infectious virus, Dr. Krammer said.

The other possibility is that the negative test was done poorly, or the samples were stored at a temperature at which the virus deteriorates. The throat swab may also simply miss the virus that is hiding elsewhere in the body.

A virus test is positive if the virus was there on the swab in sufficient quantities at the time you swabbed the person, said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health.

A negative test is not a definitive that there is no more virus in that person.

Dr. Lipsitch offered an analogy: a jam jar with mold on top. Scraping off the surface might give the impression that the jam is now mold-free, but in fact the jar may still contain mold that continues to grow.

The Japanese woman initially had mild symptoms of coronavirus infection and tested positive in late January. She was released from the hospital on Feb. 1. She tested positive again on Wednesday after coming in for a sore throat and chest pain.

That certainly sounds like it could be an actual resurgence of the virus in infectious form, Dr. Lipsitch said. But, he added, Single anecdotes are really hard to interpret.

One worrisome possibility is that the coronavirus follows what is known as a biphasic infection: the virus persists and causes a different set of symptoms than observed in the initial bout.

In patients infected with Ebola, the virus may persist for months in the testes or eyes even after recovery and can infect others and keep the epidemic going.

The recovered person, too, can develop other symptoms, including insomnia and neurological problems, said Angela Rasmussen, a virologist at Columbia University.

We dont know if thats the case with this coronavirus, Dr. Rasmussen said. We dont know anything about this virus.

Coronaviruses are on the whole poorly understood, she said. Before the SARS epidemic, coronaviruses were not known to cause serious illnesses.

Some scientists have said that people infected with the new coronavirus produce antibodies that will protect them in the future. And a single-patient report suggests that the immunity may last at least seven days.

But this finding is neither surprising nor reassuring, said Dr. Stanley Perlman, a coronavirus expert at the University of Iowa. The issue is whether youll see it in seven months or in a year, he said. Thats what you care about.

The new coronavirus closely resembles the ones that cause SARS and, to a lesser extent, MERS. There are no reports of reinfections with the SARS virus, Dr. Perlman said, and only one that he has heard of in a patient recovering from MERS.

Dr. Perlmans research with MERS has shown that the strength of the immune response depends on the severity of the infection, but that even in those with severe disease which should produce the strongest immune responses the immunity seemed to wane within a year.

How long immunity lasts will also be a key question to resolve when designing a vaccine for the new coronavirus, particularly if the virus becomes a seasonal threat like influenza.

What is the nature of immunity to this virus after infection? Dr. Lipsitch said. Thats a research question thats urgent.

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They Recovered From the Coronavirus. Were They Infected Again? - The New York Times

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Working on ‘the human side’ of heritable cancers – Penn: Office of University Communications

February 29th, 2020 7:46 am

I love working with people, says Allison Werner-Lin of the School of Social Policy & Practice (SP2). Werner-Lins office overlooking Locust Walk is homey and lamp-lit, with student gifts sharing space with scholarly tomes. This is just one of her workspaces, however. Recently returned from sabbatical, Werner-Lin has been working with the National Cancer Institute (NCI), as well as out of her home in upstate New York, which doubles as a private practice for families seeking bereavement therapy. The divide between academia and clinical practice suits her. I feel like I have one foot in each world and in a very positive way, Werner-Lin says.

Werner-Lin has extensive clinical and research experience and uses both to inform her work, which centers on heritable cancers. She began her academic work studying young adults with mutations in genes associated with breast and ovarian cancer, BRCA1 and BRCA2. Recently, her work with the NCI has branched out to the study of Li-Fraumeni syndrome (LFS). Patients with LFS have a mutation in a tumor-suppression gene, resulting in a high incidence of cancer starting in childhood, and 50% of LFS patients develop cancer by age 40. Both patient populations make life-altering decisions based upon their family histories and medical diagnoses.

Dr. Werner-Lins groundbreaking research merges science with social work at the intersection of qualitative health research, the structure and evolution of genes, hereditary cancer, and how it impacts individuals and families at various stages of life, says SP2 Dean Sara Sally Bachman. Each day, Allison is pushing the frontiers of genomic study and oncological social work while also mentoring other social change agents who will undoubtedly make a difference locally, nationally, and internationally.

For more than a decade, Werner-Lin has worked in the Clinical Genetics Branch of the Division of Cancer Epidemiology and Genetics of the NCI organizing the human side of research. Patients come annually to the NCI to receive full-body MRI cancer screenings and participate in data collection that covers everything from cancer history to family communication to risk management. Werner-Lin mentors an interdisciplinary team of predoctoral and postdoctoral fellows to explore how these families understand and cope with genetic information. Her work is used to train providers in delivering holistic medical and psychological care.

We talk with families about their experiences communicating cancer-risk information with loved ones, making reproductive decisions, and managing the endless cycle of screening, Werner-Lin says. She has seen patterns in how families share cancer-risk information and seek support, noting that information travels based on relationship patterns and emotional closeness, not necessarily degree of risk.

People with LFS have limited options for cancer prevention, and expectations for a cancer diagnosis and early death are common. Were seeing a lot of physical loss, where amputations and other changes in physical function are common consequences of treatment.

Many of the people Werner-Lin speaks with are looking at different pathways to parenthood or are choosing not to have children at all, she says. Grief becomes a chronic part of their lives, and those kinds of sustained of losses can connect individuals in and across families.

Former SP2 graduate student Catherine Wilsnack is a Cancer Research Training Award Fellow at the NCI, doing qualitative research as part of Werner-Lins team. Wilsnack first met Werner-Lin while in her second year at SP2 and calls the encounter transformative. Werner-Lin is a phenomenal mentor in every way, says Wilsnack, who earned her masters in social work (MSW) in 2019. She always goes above and beyond for her students. I would not be where I am today if it were not for her and her guidance, so I just feel extremely lucky.

Now in midcareer, Werner-Lin is taking the time to mentor younger generations. There are so many opportunities to focus on other peoples career development without such a bounded focus on my own professional needs, she says, crediting her own mentors with the ability to achieve professional success.

At Penn, Werner-Lin is involved in the Cancer Moonshot initiative led by Katherine Nathanson and Steve Joffe, an effort designed to accelerate cancer research aimed at prevention, detection, and treatment. Werner-Lins aspect of the project, based at the Abramson Cancer Center at Penn Medicine, involves issues surrounding genetic testing in people aged 18 through 40. Susan Domchek, executive director of the Basser Center for BRCA, says, Allisons work in terms of the psychosocial implications of having a BRCA mutationhow an individual can come to terms with that and how that information gets disseminated between familieshas been extremely helpful. She has a deep expertise on helping families navigate these situations.

Approximately 1 in 400 people carry mutated breast cancer genes, though mutations are more common in certain groups of people. The gene mutations are passed in an autosomal dominant pattern, meaning each parent with a mutation has a 50% chance of passing it on. Children of a BRCA-positive parent can pursue genetic testing to learn if they carry the mutation, adding pressure to family planning.

Werner-Lin was one of these children. Her mother has a BRCA1 mutation. She recovered from colon cancer when Werner-Lin was in college and is currently in remission from a rare ovarian cancer. When I was 23 and was thinking about having kids, I couldnt figure out how to do it, Werner-Lin says. I started talking to people, talking to other women, and that became my dissertation.

This curiosity and compassion led Werner-Lin to operate a private therapy practice out of her home, where she exclusively sees children and young adults with a deceased parent. People often dont see how therapy is connected to the genetics part of my work, but for me they are inseparable, Werner-Lin says. In my cancer work, parents often die young, leaving small children. Frequently, the children of cancer patients conflate their parents lives with their own, not seeing options, degrees of freedom, or technological innovation.

Working together with an MSW student, Werner-Lin does whole family-therapy, from diagnosis to end-of-life, through the grieving process. She helps to facilitate goodbyes, talks about legacy building, and makes the concept of death more concrete for young people.

The language adults use to talk about death is often confusing and shrouded in existential concepts, Werner-Lin says, citing references to angels or going to a better place. Young kids dont necessarily understand time or geography, she says. If were in New York, and Mommy went to the other side, is that a better place?

Instead, she says, we talk about the brain being a light switch, and once you turn it off you cant turn it on again. We talk about how the heart stops beating and the eyes stop seeing. These practical realities are important, Werner-Lin says. Kids need to understand the way the world is predictable, especially when people they love and need can fall off the earth at any moment.

Now back on campus, Werner-Lin is focusing on teaching and engaging with her graduate students. Acting in service to her patients, her students, and her colleagues is a core part of Werner-Lins brand of academia. If you tell her that you want to do something, Wilsnack says, she will go out of her way to help.

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Working on 'the human side' of heritable cancers - Penn: Office of University Communications

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