StemCell Therapy

Dr. Phillip Nelson of Western University of Health Sciences is the incoming president, while Dr. Calvin M. Johnson is the new president-elect.

From left: Past-President Dr. Douglas Freeman, dean of the Western College of Veterinary Medicine at the University of Saskatchewan; President Dr. Phillip Nelson, dean of the Western University of Health Sciences College of Veterinary Medicine; and President-Elect Dr Calvin M. Johnson, dean of the Auburn University College of Veterinary Medicine. | Photo courtesy of the AAVMC.

New leadership was installed at the American Association of Veterinary Medical Colleges (AAVMC) summer meeting. Phillip Nelson, DVM, PhD, dean of Western University of Health Sciences College of Veterinary Medicine, assumed the role of AAVMC president, while Calvin M. Johnson, DVM, PhD, DACVP, dean of the Auburn University College of Veterinary Medicine, became the president-elect, according to an association release.

Douglas A. Freeman, DVM, PhD, dean of the Western College of Veterinary Medicine at the University of Saskatchewan, transitioned to the immediate past-president position. Mark Markel, DVM, PhD, DACVS, dean of the University of Wisconsin School of Veterinary Medicine, will remain treasurer, and Paul Lunn, BVSc, PhD, MRCVS, DACVIM, dean of the North Carolina State University College of Veterinary Medicine, was named secretary, the release states.

Dr. Nelson earned his DVM from the Tuskegee Institute in 1979 and his PhD in immunology and biotechnology from North Carolina State University in 1993. He earned his bachelor's degree from Jackson State University. Before he became dean at Western Universitys veterinary school, he served as executive associate dean for the preclinical program. Prior to that Dr. Nelson was the head of the department of small animal medicine and surgery at Tuskegee University's College of Veterinary Medicine, and he also served as associate dean at the Mississippi State University College of Veterinary Medicine for 11 years.

New at-large board members include Oregon State University College of Veterinary Medicine Dean Susan Tornquist, DVM, PhD, DACVP, who represents Region 1 (U.S.); Ted Whittem, BVSc, PhD, FANZCVS, DACVCP, head of the University of Melbourne School of Veterinary Medicine, who represents Region 3 (Australia, New Zealand and Asia); and Tiffany Whitcomb, DVM, DACLAM, Pennsylvania State University assistant professor of comparative medicine, who represents departments of comparative medicine, the release states.

New board liaisons (nonvoting) include Bryan Slinker, DVM, PhD, dean of the Washington State University College of Veterinary Medicine, representing the Association of Public and Land Grant Universities, and Aaron Colwell, representing the Student American Veterinary Medical Association.

These appointments will be slightly truncated during this transition year as the AAVMC formally moves its annual assembly from the former summer meeting to the annual meeting, which is typically held in early March, the release states.

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Veterinary school deans take on new leadership roles with AAVMC - dvm360

A procedure combining surgery with stem cell treatment has aided two bulldog puppies with spina bifida and a team of UC Davis researchers hopes to test the therapy in human clinical trials.

The puppies were treated with a therapy developed at UC Davis to help preserve lower-limb function in children with spina bifida, according to a university news release.

Spina bifida occurs when spinal tissue improperly fuses in utero causing cognitive, mobility, urinary and bowel disabilities. Approximately 1,500 to 2,000 children in the United States are born with the condition each year.

Because dogs with the birth defect have little control of their hind quarters, they typically are euthanized as puppies.

After their post-surgery checkup at 4 months old, the sibling pups, Darla and Spanky, showed off their ability to walk, run and play.

The initial results of the surgery are promising, as far as hind limb control, veterinary neurosurgeon Beverly Sturges said in a written statement. Both dogs seemed to have improved range of motion and control of their limbs.

The dogs have since been adopted and continue to do well at home in New Mexico.

The dogs procedure involved surgical techniques developed by fetal surgeon Diana Farmer of UC Davis Health together with a cellullar treatment developed by stem cell scientists Aijun Wang and Dori Borjesson, director of the universitys Veterinary Institute for Regenerative Cures.

Farmer pioneered the use of surgery prior to birth to improve brain development in children with spina bifida. She later showed that prenatal surgery combined with cells derived from the human placenta held in place with a cellular scaffold helped research lambs born with the disorder walk without noticeable disability, the news release said.

Sturges wanted to find out whether the surgery-plus-stem-cell approach could give dogs more normal lives, as well as better chances of survival and adoption.

Darla and Spanky were transported from Southern California Bulldog Rescue to the UC Davis Veterinary hospital when they were 10 weeks old. They were the first dogs to receive the treatment, this time using canine instead of human placenta-derived cells.

The dogs treatment also occurred after birth, because the prenatal diagnosis of spina bifida is not performed on dogs, Sturges said. The disorder becomes apparent between 1 and 2 weeks of ages, when puppies show hind-end weakness, poor muscle tone, and abnormal use of their tails.

The research team wants dog breeders to send more puppies with spina bifida to UC Davis for treatment and refinements that will help researchers correct another hallmark of spina bifida, incontinence. Although Darla and Spanky are mobile and doing well, they still require diapers, the news release said.

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Puppies receive stem cell treatment developed to help children with spina bifida - Sacramento Bee

Women make up 55 percent of active veterinarians and nearly 80 percent of the students in veterinary medicine. Despite this, women only make up 25 percent of leadership roles, and average salaries in the profession have dropped.

The book Leaders of the Pack: Women and the Future of Veterinary Medicine, published by Purdue University Press, was written by Julie Kumble M.Ed. and the late Dr. Donald Smith, dean emeritus of Cornell University's College of Veterinary Medicine, to address the gender gap between men and women in leadership.

Kumble, a researcher and writer whose career focused on empowering women, said that the gender gap isnt unique to veterinary medicine but can be found in every other field.

I just want to stress that every profession has a gender gap at the top of every single profession, Kumble said. The people at the top echelons of nursing, the CEOs and CFOs, those tend to be more men. Look at our Congress, its 20 percent women. If you look at who the partners are in law firms, only 20 percent are women, so its across the board. Veterinary medicine isnt unique.

According to Kumble, the gender gap is the result of many factors and there isnt one gleaming answer. One factor is that men were traditionally in the profession longer than women and own specialty practices like orthopedics or dentistry; these specialty practices pay higher salaries. Kumble encourages women to own their own practices.

Another factor is the linear trajectory of a career that doesnt accommodate women with children.

Women are the ones bearing children and raising children so how are we going to build into our system ways for them to get back to work when theyre ready and not miss out on salary and not miss out on promotions, Kumble said.

Kumble cited the Scandinavian countries as a source for solutions, which include policies on family leave or requiring minimum percentages of women on directory boards.

In the book, she gives advice on how women can close the gender gap. One thing she would say to a new student studying veterinary medicine is to be open-minded to the vast opportunities in the profession, from research to the government.

The second is to find mentors during all stages of your career who can offer advice and shine light on your path, (and) then to do the same for others, Kumble said.

Willie Reed, the Purdue dean of veterinary medicine, acknowledges the gender gap and hopes to be a mentor for his students.

Encouraging women to consider leadership positions and providing training for them is something we have fostered here in the college, Reed said.

Reed nominates women for a training program through the Association of American Veterinary Medical Colleges, and the senior administration in Purdues college has more women than men, unlike most colleges.

One of the women who went through the program is Doctor of Veterinary Medicine Ann Weil, a clinical professor of anesthesiology.

I think my dean has done a lot to help me personally in terms of improving my leadership skills, Weil said. The AAVMC sponsors leadership training, and I had the privilege of being asked to participate in the program. You learn media training, conflict resolution, team building, and listening skills. Its a pretty intense program.

Reed believes leadership development is important not just for the faculty but also the students in his college, who are predominately women.

Leadership is something that is needed and is expected, Reed said. Its like many things, you have to study leadership and be trained and thats part of what were doing here in the curriculum of veterinary medicine.

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Authors believe gender gap in veterinary medicine is fixable - Purdue Exponent

ByStephen Asante, GNA

Kumasi, Aug. 21, GNA - The Veterinary Councilof Ghana has appealed to the government to resource the Kwame NkrumahUniversity of Science and Technology (KNUST) School of Veterinary Medicine, toimprove its infrastructure and faculty to advance veterinary training, researchand healthcare delivery.

Dr. Jonathan Amakye-Anim, Chairman of theCouncil, said this was urgent since the country currently had only 32 certifiedpracticing veterinary doctors.

He said at least 200 of such practitionerswere needed to enhance effective veterinary care for the benefit of the nation.

Dr. Amakye-Anim, who was addressing an oath-swearingand induction ceremony for the School of Medical Sciences, Dental School andthe School of Veterinary Medicine of the Kwame Nkrumah University of Scienceand Technology (KNUST), Kumasi, called for a change in attitude towardsveterinary education.

About 70 per cent of all human diseasesemanates from animals, he noted, stressing that given the current shortage ofveterinary doctors, it would be difficult for the country to effectively dealwith the emerging challenges such as the outbreak of more sophisticatedanimal-related diseases.

The ceremony was held under the jointsupervision of the Ghana Medical and Dental Council and Veterinary Council ofGhana, and had a total of 241 newly-qualified doctors taking the HippocraticOath.

This included 29 dentists and seven veterinarydoctors.

Dr. Andrew Bremang of the School of VeterinaryMedicine swept a total of ten awards, including the Dr. William BlanksonAmanfu Prize for the Best Student in Infectious Diseases, Dr. Andrew QuarcoopomePrize for the Overall Best Student in the DVM programme, and Deans Prize forthe Overall Best Student in the DVM Programme.

Other award-winners were Dr. Obed OwusuYeboah, also a veterinary doctor, who received a total of nine awards, as wellas Dr. Abigail Omani and Dr. Boniface Mensah, both of the School of MedicalSciences, who claimed four prizes each.

The School of Veterinary Medicine, since itsestablishment in 2009, had so far trained 25 veterinary doctors.

This brings to about 1, 500, the number ofmedical, dental and veterinary doctors trained by the KNUST in the last threedecades.

Hitherto, the majority of veterinarypractitioners received their training abroad which came with its own cost tothe nation.

Dr. Amakye-Anim proposed a One District, OneVeterinary Doctor concept for the nation, explaining that, this was the onlyway we could ensure the safety and health of the citizenry.

Professor Kwasi Obiri-Danso, Vice-Chancellorof the University, charged the graduating doctors to avoid practices thatcompromised on their professional ethics.

Professor Tsiri Agbenyega, Provost of theCollege of Health Sciences, affirmed their resolve to work assiduously toaddress the health manpower needs of the nation.

GNA

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KNUST achieves landmark in veterinary medicine | Ghana News ... - Ghana News Agency

Posted: Tuesday, August 15, 2017 12:00 am

See the future of veterinary medicine

Midwestern University, home of Arizonas only veterinary school, is offering a free behind-the-scenes look at how the University is caring for Arizonas animals and training tomorrows veterinarians.

The College of Veterinary Medicine at Midwesterns Glendale Campus at 59th Avenue and Utopia Road will host an open house 9 a.m. to 3 p.m. Sept. 16. Everyone from pet owners to ranchers to aspiring veterinarians are welcome to attend with their families to see the future of animal healthcare in Arizona. Expert faculty and veterinary students will be on hand to answer questions and showcase the Colleges veterinary clinics and facilities. Over 25 informative booths and exhibits will be available for the public.

Attendees will be treated to facility tours of the state-of-the-art Companion Animal Clinic, Equine and Bovine Center, and Diagnostic Pathology Center. Families will be able to interact with animals, see a simulated cow birth, discover how pathology and forensics can help deter animal abuse and treat disease, and much more. Interested attendees can also learn about a career in veterinary medicine and opportunities available to Midwestern University graduates, such as maintaining a healthy food supply, researching and controlling infectious diseases, and advancing the science of animal health in connection with other healthcare disciplines.

For more information about the College of Veterinary Medicine open house, call 623-537-6360, or visit http://www.midwestern.edu/vetopenhouse.

Posted in News, Headlines on Tuesday, August 15, 2017 12:00 am.

Originally posted here:
See the future of veterinary medicine - Glendale Star

In 2013, University of Virginia researcher Michael McConnell published research that would forever change how scientists study brain cells.

McConnell and a team of nationwide collaborators discovered a genetic mosaic in the brains neurons, proving that brain cells are not exact replicas of each other, and that each individual neuron contains a slightly different genetic makeup.

McConnell, an assistant professor in the School of Medicines Department of Biochemistry and Molecular Genetics, has been using this new information to investigate how variations in individual neurons impact neuropsychiatric disorders like schizophrenia and epilepsy. With a recent $50,000 grant from the Bow Foundation, McConnell will expand his research to explore the cause of a rare genetic disorder known as GNAO1 so named for the faulty protein-coding gene that is its likely source.

GNAO1 causes seizures, movement disorders and developmental delays. Currently, only 50 people worldwide are known to have the disease. The Bow Foundation seeks to increase awareness so that other probable victims of the disorder can be properly diagnosed and to raise funds for further research and treatment.

UVA Today recently sat down with McConnell to find out more about how GNAO1 fits into his broader research and what his continued work means for all neuropsychiatric disorders.

Q. Can you explain the general goals of your lab?

A. My lab has two general directions. One is brain somatic mosaicism, which is a finding that different neurons in the brain have different genomes from one another. We usually think every cell in a single persons body has the same blueprint for how they develop and what they become. It turns out that blueprint changes a little bit in the neurons from neuron to neuron. So you have slightly different versions of the same blueprint and we want to know what that means.

The second area of our work focuses on a new technology called induced pluripotent stem cells, or iPSCs. The technology permits us to make stem cell from skin cells. We can do this with patients, and use the stem cells to make specific cell types with same genetic mutations that are in the patients. That lets us create and study the persons brain cells in a dish. So now, if that person has a neurological disease, we can in a dish study that persons disease and identify drugs that alter the disease. Its a very personalized medicine approach to that disease.

Q. Does cell-level genomic variety exist in other areas of the body outside the central nervous system?

A. Every cell in your body has mutations of one kind or another, but brain cells are there for your whole life, so the differences have a bigger impact there. A skin cell is gone in a month. An intestinal cell is gone in a week. Any changes in those cells will rarely have an opportunity to cause a problem unless they cause a tumor.

Q. How does your research intersect with the goals of the Bow Foundation?

A. Let me back up to a little bit of history on that. When I got to UVA four years ago, I started talking quite a lot with Howard Goodkin and Mark Beenhakker. Mark is an assistant professor in pharmacology. Howard is a pediatric neurologist and works with children with epilepsy. I had this interest in epilepsy and UVA has a historic and current strength in epilepsy research.

We started talking about how to use iPSCs the technology that we use to study mosaicism to help Howards patients. As we talked about it and I learned more about epilepsy, we quickly realized that there are a substantial number of patients with epilepsy or seizure disorders where we cant do a genetic test to figure out what drug to use on those patients.

Clinical guidance, like Howards expertise, allows him to make a pretty good diagnosis and know what drugs to try first and second and third. But around 30 percent of children that come in with epilepsy never find the drug that works, and theyre in for a lifetime of trial-and-error. We realized that we could use iPSC-derived neurons to test drugs in the dish instead of going through all of the trial-and-error with patients. Thats the bigger project that weve been moving toward.

The Bow Foundation was formed by patient advocates after this rare genetic mutation in GNAO1 was identified. GNAO1 is a subunit of a G protein-coupled receptor; some mutations in this receptor can lead to epilepsy while others lead to movement disorders.

Were still trying to learn about these patients, and the biggest thing the Bow Foundation is doing is trying to address that by creating a patient registry. At the same time, the foundation has provided funds for us to start making and testing iPSCs and launch this approach to personalized medicine for epilepsy.

In the GNAO1 patients, we expect to be able to study their neurons in a dish and understand why they behave differently, why the electrical activity in their brain is different or why they develop differently.

Q. What other more widespread disorders, in addition to schizophrenia and epilepsy, are likely to benefit from your research?

A. Im part of a broader project called the Brain Somatic Mosaicism Network that is conducting research on diseases that span the neuropsychiatric field. Our lab covers schizophrenia, but other nodes within that network are researching autism, bipolar disorder, Tourette syndrome and other psychiatric diseases where the genetic cause is difficult to identify. Thats the underlying theme.

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Researcher Seeks to Unravel the Brain's Genetic Tapestry to Tackle Rare Disorder - University of Virginia

In 2007, DNA pioneer James Watson became the first person to have his entire genome sequencedmaking all of his 6 billion base pairs publicly available for research. Well, almost all of them. He left one spot blank, on the long arm of chromosome 19, where a gene called APOE lives. Certain variations in APOE increase your chances of developing Alzheimers, and Watson wanted to keep that information private.

Except it wasnt. Researchers quickly pointed out you could predict Watsons APOE variant based on signatures in the surrounding DNA. They didnt actually do it, but database managers wasted no time in redacting another two million base pairs surrounding the APOE gene.

This is the dilemma at the heart of precision medicine: It requires people to give up some of their privacy in service of the greater scientific good. To completely eliminate the risk of outing an individual based on their DNA records, youd have to strip it of the same identifying details that make it scientifically useful. But now, computer scientists and mathematicians are working toward an alternative solution. Instead of stripping genomic data, theyre encrypting it.

Gill Bejerano leads a developmental biology lab at Stanford that investigates the genetic roots of human disease. In 2013, when he realized he needed more genomic data, his lab joined Stanford Hospitals Pediatrics Departmentan arduous process that required extensive vetting and training of all his staff and equipment. This is how most institutions solve the privacy perils of data sharing. They limit who can access all the genomes in their possession to a trusted few, and only share obfuscated summary statistics more widely.

So when Bejerano found himself sitting in on a faculty talk given by Dan Boneh, head of the applied cryptography group at Stanford, he was struck with an idea. He scribbled down a mathematical formula for one of the genetic computations he uses often in his work. Afterward, he approached Boneh and showed it to him. Could you compute these outputs without knowing the inputs? he asked. Sure, said Boneh.

Last week, Bejerano and Boneh published a paper in Science that did just that. Using a cryptographic genome cloaking method, the scientists were able to do things like identify responsible mutations in groups of patients with rare diseases and compare groups of patients at two medical centers to find shared mutations associated with shared symptoms, all while keeping 97 percent of each participants unique genetic information completely hidden. They accomplished this by converting variations in each genome into a linear series of values. That allowed them to conduct any analyses they needed while only revealing genes relevant to that particular investigation.

Just like programs have bugs, people have bugs, says Bejerano. Finding disease-causing genetic traits is a lot like spotting flaws in computer code. You have to compare code that works to code that doesnt. But genetic data is much more sensitive, and people (rightly) worry that it might be used against them by insurers, or even stolen by hackers. If a patient held the cryptographic key to their data, they could get a valuable medical diagnosis while not exposing the rest of their genome to outside threats. You can make rules about not discriminating on the basis of genetics, or you can provide technology where you cant discriminate against people even if you wanted to, says Bejerano. Thats a much stronger statement.

The National Institutes of Health have been working toward such a technology since reidentification researchers first began connecting the dots in anonymous genomics data. In 2010, the agency founded a national center for Integrating Data for Analysis, Anonymization and Sharing housed on the campus of UC San Diego. And since 2015, iDash has been funding annual competitions to develop privacy-preserving genomics protocols. Another promising approach iDash has supported is something called fully homomorphic encryption, which allows users to run any computation they want on totally encrypted data without losing years of computing time.

Kristen Lauter, head of cryptography research at Microsoft, focuses on this form of encryption, and her team has taken home the iDash prize two years running. Critically, the method encodes the data in such a way that scientists dont lose the flexibility to perform medically useful genetic tests. Unlike previous encryption schemes, Lauters tool preserves the underlying mathematical structure of the data. That allows computers to do the math that delivers genetic diagnoses, for example, on totally encrypted data. Scientists get a key to decode the final results, but they never see the source.

This is extra important as more and more genetic data moves off local servers and into the cloud. The NIH lets users download human genomic data from its repositories, and in 2014, the agency started letting people store and analyze that data in private or commercial cloud environments. But under NIHs policy, its the scientists using the datanot the cloud service providerresponsible with ensuring its security. Cloud providers can get hacked, or subpoenaed by law enforcement, something researchers have no control over. That is, unless theres a viable encryption for data stored in the cloud.

If we dont think about it now, in five to 10 years a lot peoples genomic information will be used in ways they did not intend, says Lauter. But encryption is a funny technology to work with, she says. One that requires building trust between researchers and consumers. You can propose any crazy encryption you want and say its secure. Why should anyone believe you?

Thats where federal review comes in. In July, Lauters group, along with researchers from IBM and academic institutions around the world launched a process to standardize homomorphic encryption protocols. The National Institute for Standards and Technology will now begin reviewing draft standards and collecting public comments. If all goes well, genomics researchers and privacy advocates might finally have something they can agree on.

Originally posted here:
To Protect Genetic Privacy, Encrypt Your DNA - WIRED

When Alex Shorheardthat he was a match for a stranger in Israel who would likely die without a stem cell transplant, he didn't think twice before saying "yes."

"If I today I help somebody, tomorrow I want somebody to help me too if I [am] sick," said Shor. "I don't think too much about it."

The request came from Ezer Mizion, an Israeli health service with the world's largest Jewish bone marrow registry, countingover 850,000 registrants worldwide. Shor said the representative told him the recipient would be a63-year-old man in Israel.

Shor, 41, had registered his DNA with the registry 10 years ago when he lived in Israel.

Shor and his family emigrated to Winnipeg nearly three years ago. In March, he got word that his stem cells were a match.

Stem cells are immature blood cells that can grow into healthy cells. They can make the difference between life and death for people with various forms of cancer, blood-related illnesses and metabolic disorders.

Shorwas agenetic match for the man based on the human leukocyte antigen (HLA) system, which codes the human immune system. The pair would have had to have 10 of the same HLA markers to be a viable match.

In May, Shorwent to a lab in Winnipeg to draw blood to send off to Israel to ensure hisblood would be compatible with the recipient's. Now, he plans to travel to Israel to donate his stem cells as soon as he hears from the physicians that the patient's condition has improved enough to tolerate the procedure.

Getting Shor's blood to Israel required a cooler, a courier and some creativity.

Vials of Shor's blood were transported to Israel in an ice-packed Thermos.

Dena Bensalmon, Canadian director of Israeli health service Ezer Mizion, put out a call on Facebook for a chaperone that could transport five vials of Shor's blood.

"Sixteen people came forward within about four minutes," she said.

One woman the perfect candidate was travelling from Winnipeg to Toronto, then on to Isreal. They packed the blood in ice in a Coleman thermos for the 12-hour journey.

"I met Dina in Toronto and then I switched the ice packs. They took the blood directly," she said.

Canada'sOneMatchregistry through Canadian Blood Serviceshas about 400,000 registrants.

But"if a person is Jewish, then the chances of them finding their match on a Jewish registry is far greater than them finding their match on a non-Jewish registry," saidBensalmon.

Canadian Blood Services has access to nearly 29 million volunteer donors and more than 720,000 cord blood units from dozens of countries around the world, as all the registries are connected under the umbrella of the World Marrow Donor Association, comprised of millions of people from across the world.

"I find the whole thing almost like watching a circle of life," said Bensalmon.

A volunteer brought vials of Shor's blood to Israel. She kept the thermos in her lap the whole 12-hour trip.

Shor said he just thought of his own father and how he would want someone to help him if he had a life-threatening illness. He encourages everyone to join a stem-cell registry.

"Tomorrow you may save somebody and tomorrow you don't know if you be sick and somebody save you," said Shor.

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Winnipeg man to donate stem cells to critically ill stranger in Israel - CBC.ca

Diabetes is a progressive, chronic disease related to your body's challenges with regulating blood sugar. It is often associated with generalized inflammation. Your pancreas produces the hormone insulin to convert sugar (glucose) to energy that you either use immediately or store. With type 2 diabetes, you are unable to use that insulin efficiently. Although your body produces the hormone, either there isn't enough of it to keep up with the amount of glucose in your system, or the insulin being produced isn't being used as well as it should be, both of which result in high blood sugar levels.

While this can produce different types of complications, good blood sugar control efforts can help to prevent them. This relies heavily on lifestyle modifications such as weight loss, dietary changes, exercise and, in some cases, medication. But, depending on your age, weight, blood sugar level, and how long you've had diabetes, you may not need a prescription right away. Treatment must be tailored to you and, though finding the perfect combination may take a little time, it can help you live a healthy, normal life with diabetes.

Type 2 diabetes is most common is those who are genetically predisposed and who are overweight, lead a sedentary lifestyle, have high blood pressure, and/or have insulin resistance due to excess weight. People of certain ethnicities are more likely to develop diabetes, too. These include: African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders, and Asian Americans. These populations are more likely to be overweight and have high blood pressure, which increases the risk of developing diabetes.

As you age, you are also at increased risk of developing diabetes.

A poor diet and smoking can also affect your risk.

There are many complications of diabetes. Knowing and understanding the signs of these complications is important. If caught early, some of these complications can be treated and prevented from getting worse. The best way to prevent complications of diabetes is to keep your blood sugars in good control. High glucose levels produce changes in the blood vessels themselves, as well as in blood cells (primarily erythrocytes) that impair blood flow to various organs.

Complications of diabetes are broken into two categories: microvascular (damage to the small blood vessels) and macrovascular (damage to the large blood vessels). They can include:

Often people don't experience symptoms of diabetes until their blood sugars are very high. Symptoms of diabetes include: increased thirst, increased urination, increased hunger, extreme fatigues, numbness and tingling in the extremities (hands and feet), cuts and wounds that are slow to heal, and blurred vision. Some people also experience other less common symptoms including weight loss, dry itchy skin, increased yeast infections, erectile dysfunction, and acanthosis nigricans (thick, "velvety" patches found in the folds or creases of skin, such as the neck, that is indicative of insulin resistance).

If you are experiencing any of these symptoms, don't ignore them. Make an appointment to see your doctor. The earlier diabetes is caught, the more likely you can prevent complications.

A diagnosis of diabetes can be done using a variety of blood tests.

If you are at increased risk of diabetes, have symptoms of diabetes, or have pre-diabetes (a major warning sign for diabetes), your doctor will check to see if you have diabetes. Your doctor may also check to see if you have diabetes if you are over the age of 45, have a family history of the disease, are overweight, or if you are at increased risk for another reason. The tests used to check for diabetes are the same tests used to check for pre-diabetes.

Fasting blood sugar test: This test checks your blood sugar when you haven't eaten for at least eight hours. A fasting blood sugar above 126 could be indicative of diabetes. Your doctor will re-check this to determine if you have diabetes.

Glucose tolerance test: This is a test that checks how you respond to sugar. You will be given a sample of sugar (75 grams over the course of two hours). If your blood sugar is above target after that time, you may be diagnosed with diabetes.

Hemoglobin A1c: This test checks your blood sugar over the course of three months.

If your blood sugar is above 6.5 percent, you may be considered to have diabetes.

Random blood sugar test: Your doctor can do this test if you are experiencing symptoms of diabetesincrease thirst, fatigue, increased urination. If your blood sugar is above 200mg/dL, you may be considered to have diabetes.

If you have no symptoms and any of these tests are positive, the American Diabetes Association recommends that a new blood sample be drawn to confirm a diagnosis.

While you can't change getting older, your family history, or ethnicity, you can work on ways to reduce your weight and waist circumference, increase your activity, and lower your blood pressure.

Eating a balanced diet that is rich in fiber, non-starchy vegetables, lean protein, and healthy fat can help get you to your goal weight and reduce your waist size and body mass index (BMI). Reducing your intake of sweetened beverages (juices, sodas) is the easiest way to lose weight and reduce blood sugars. If you are someone who has high blood pressure and are salt sensitive, aim to reduce your intake of sodium; do not add salt to your food, read package labels for added sodium, and reduce your intake of fast food and take out. Don't go on a diet. Instead, adapt a healthier way of eating, one that you'll enjoy for a long time.

Exercising regularly, about 30 minutes a day or 150 minutes per week, can also help to reduce your weight and blood pressure. Finally, if you smoke, aim to quit. Smoking can increase your risk of stroke, blood pressure, and heart attack, and quitting can reduce your risk of diabetes.

The good news is that if you have diabetes, you have a great amount of control in managing your disease. Although it can be difficult to manage a disease on a daily basis, the resources and support for people with diabetes is endless. It's important for you to receive as much education as possible so that you can take advantage of all the good information that is out there (and weed out the bad).

Don't let others let you feel like a diabetes diagnosis means you are doomed.

All people with diabetes should also be seen by an ophthalmologist after diagnosis. Diabetes can affect the eyes before it is even diagnosed. After the initial session, people should be seen every two years if there are no issues, or more often if there are.

In addition, people with diabetes should have a comprehensive foot exam by a podiatrist once they are diagnosed or if they are experiencing issues, such as tingling of the feet, pain, sores, hammer toes, thick dry skin, or fungal nails.

A registered dietitian and/or certified diabetes educator will educate you on how to eat for diabetes and provide you the tools you need to self-manage your diabetes.

Some other doctors you may want to or have to add to your list as the disease progresses include a cardiologist (to make sure your heart is working efficiently and you have no blockages in your arteries), a vascular doctor (a doctor who specializes in veins and circulatory issues), and a therapist to help you cope with your diagnosis.

What you eat plays a major part in your diabetes controland your weight. Eating a balanced diet that is rich in non-starchy vegetables, lean protein, and healthy fats can help you improve your nutrition, lose weight, and lower your blood sugars.

These dedicated Verywell sections can help you improve your diabetes diet know-how:Type 2 Diabetes DietDietitian Advice and Recipes

It isn't always easy to start an exercise regimen, but once you get into a groove, you may be surprised at how much you enjoy it. Find a way to fit activity into your daily routine. Even a few minutes a day goes a long way. The American Diabetes Association recommends that adults with diabetes should perform at least 150 minutes of moderate-intensity aerobic physical activity per week (spread over at least three days with no more than two consecutive days without exercise). You don't have to start with this right away, though. Start with five to 10 minutes per day and go from there. To stay motivated, find a buddy, get a fitness tracker, or use another measurement tool that can help you see your progress.

The American Diabetes Association recommends that blood sugars be 80mg/dL-130mg/dL before meals and less than or equal to 180mg/dL two hours after meals. Blood sugar targets are individualized based on a variety of factors such as age, length of diagnosis, if you have other health issues, etc. For example, if you are an elderly person, your targets maybe a bit higher than someone else. Ask your physician what targets are right for you.

Read: High and Low Blood Sugar: Managing the Ups and Downs

The above tips are important for you. But it's also crucial to allow yourself time to cope with the diagnosis and commit to making lifestyle changes that will benefit you forever. The good news is the diabetes is a manageable disease; the tough part is that you must think about it daily. Consider finding supportsomeone that you can talk to about your strugglesbe that a friend, another person with diabetes, or a loved one. This may seem trivial, but it truly can help you take control of diabetes so that it doesn't control you. Some next steps that may help you to get on the right track at this early stage in your journey:

Diabetes is a chronic condition that must be managed daily, but it is manageable. You can live a long, healthy life with diabetes if you adapt a healthy lifestyle. By choosing to eat a healthy diet, exercise regularly, and quit smoking, and seeing your doctors regularly, you will increase your energy, feel better, and maybe even feel great.

Many people with diabetes also have other conditions such as sleep apnea, high cholesterol, and high blood pressure. Once they change their lifestyle, many of these other symptoms improve or go away. You are in the driver's seat. You have the ability to control diabetes.

And go easy on yourself: Sometimes you can be doing everything perfectly and your blood sugars start to creep up. Because diabetes is a progressive disease, your body slowly stops making insulin over time. If you've had diabetes for a very long time, try not to be discouraged if your doctor has to increase your medication or discusses insulin with you. Continue to do what you can to improve your health.

Sources:

American Diabetes Association, American Association of Diabetes Educators, and the American Academy of Nutrition and Dietetics. Diabetes Self-management Education and Support in Type 2 Diabetes 2015. https://www.diabeteseducator.org/docs/default-source/practice/practice-resources/position-statements/dsme_joint_position_statement_2015.pdf?sfvrsn=0

American Diabetes Association. Standards of Medical Care 2016. http://care.diabetesjournals.org/content/39/Supplement_1

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Type 2 Diabetes Articles - Symptoms, Treatment, and More

INDIANAPOLIS A lack of data about Hoosiers with diabetes is reason enough to require an annual report by the State Department of Health to help reduce the disease, a legislator said Wednesday.

Rep. Vanessa Summers, D-Indianapolis, cited limited data from the state health department as she spoke Wednesday before the first session of the Interim Study Committee on Public Health, Behavioral Health and Human Services.

They (health department) make the case for us needing an annual report about whats going on in the state of Indiana dealing with diabetes, Summers said.

State health department representatives told the panel that they did not have a statistical breakdown of Hoosiers with Type 1 or Type 2 (adult) diabetes. But a department representative informed the committee that more than 800,000 Hoosiers have diabetes.

Gary Dougherty, government affairs director for the American Diabetes Association, gave a different estimate: about 695,000 Hoosiers have diabetes.

Statistics from community health centers indicate that Hoosiers making below $35,000 a year are disproportionately affected by the disease.

Dougherty called for a collaborative effort among state agencies to address the health problem in Indiana. He also recommended that legislation be written without a fiscal earmark, instead relying on state staffs to carry out a program. The 2018 legislative session is not a budget session.

Others at the committee meeting Wednesday said the state should develop a diabetes education program, self-management efforts and a plan to reduce and prevent diabetes, which occurs when blood glucose, or sugar, levels rise higher than normal.

One commission member suggested that a statewide effort be financed through county health departments.

Summers, who is insulin dependent, is also a member of the commission.

She told the panel, We know that diabetes is 100 percent preventable and, I know you might be a little surprised about this, 100 percent reversible.

The American Diabetes Association said in 2016 that a study of 30 people showed that diabetes is a potentially reversible condition. An intense weight loss program was able to eliminate diabetes in participants for at least six months, the association reported.

The association also says that about 5 percent of those with diabetes have Type 1, which is usually diagnosed in children and caused by the bodys inability to produce insulin. The majority of those with diabetes have Type II (adult onset), which is often treated with lifestyle changes, pills or insulin.

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Statewide program proposed to address diabetes - The Rushville Republican

HICKORY YMCA of Catawba Valley has joined a nationwide campaign to raise awareness of pre-diabetes by launching its own Diabetes Prevention Program, according to a press release.

It's estimated that one in three people in North Carolina have pre-diabetes, which is a condition where blood glucose levels are high, but not high enough yet to be classified as type II diabetes, according to the Center for Disease Control and Prevention.

People with pre-diabetes have an increased risk of having a heart attack, stroke and developing type II diabetes.

The program, which will be led by a trained lifestyle coach in a classroom setting over a 12-month period, will have 16 weekly sessions followed by monthly maintenance.

The program hopes to reduce its participants body weight by 7 percent and increase physical activity to 150 minutes per week.

Nearly 90 percent of people with pre-diabetes are not aware they have it.

To help change that, the American Diabetes Association, American Medical Association, CDC and the Ad Council, are releasing new PSAs to build on a successful campaign that helped hundreds of thousands of Americans learn their risk for developing type II diabetes.

The new, lighthearted PSAs offer viewers a perfect way to spend a minute where they can take the one-minute pre-diabetes risk test while also doing something everyone loves watching adorable animal videos.

The campaign encourages people to take a short online test at DoIHavePrediabetes.org to learn their risk and speak with their doctor to confirm their diagnosis. The website features lifestyle tips and connects visitors to the CDC-led National Diabetes Prevention Program.

Pre-diabetes can be reversed through weight loss, diet changes and exercise, according to the release.

The key to preventing diabetes is moderate lifestyle changes through healthy eating habits and moderate physical activity, said Lala Kozischek, Diabetes Prevention Director, YMCA of Catawba Valley. Awareness of calorie and fat intake versus activity is empowering. Every small change that we make can add up to make a big difference in preventing this disease. I emphasize to our participants that its not a diet its a lifestyle.

For information on program fees and the campaign, email Lala Kozischek at lalak@ymcacv.org.

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YMCA of Catawba Valley launches diabetes awareness program - Hickory Daily Record

Friday, Aug. 25, 2017

AUGUSTA, Ga. (WRDW/WAGT) -- An expert at Augusta University has received a very important grant for a common disease.

Dr. Richard A. McIndoe, bioinformatics expert and associate director of the Center for Biotechnology and Genomic Medicine at the Medical College of Georgia at Augusta University, has received a $12.8 million grant to continue to lead a national research initiative focused on reducing the complications of diabetes, according to a press release.

This is the fourth time McIndoe has been selected to lead the administrative, scientific and informatics infrastructure for the Diabetic Complications Consortium, a program of the National Institute of Diabetes and Digestive and Kidney Diseases.

Nearly 10 percent of the U.S. population has diabetes, according to the Centers for Disease Control and Prevention. Complications from the pervasive disease include nerve and kidney damage, high blood pressure, cardiovascular disease and stroke as well as skin and eye complications, according to the American Diabetes Association.

The Diabetic Complications Consortium (see http://www.diacomp.org) provides a cross section of support designed to move science and ultimately patient care forward, including funding short-term studies in animals or humans to better understand and prevent complications, the primary cause of diabetes-related deaths, says McIndoe, who is also a Regents Professor in the MCG Department of Obstetrics and Gynecology.

DiaComp also supports summer programs for medical students to inspire the next generation of diabetes complications investigators as well as scientific gatherings on relevant topics.

The consortiums Pilot & Feasibility Program is a competitive, peer-reviewed program that provides $100,000 in funding for one year to enable researchers to pursue novel complications treatment and prevention strategies. About 20 grants are awarded each year from more than 80 proposals, a roughly 20 percent funding rate that is slightly above the average 18.1 percent success rate for the National Institutes of Healths research project grant. The research project grant, commonly called RO1, is the NIHs oldest grant mechanism for supporting health-related research and the NIHs largest single category of support. RO1s, which average today about $428,000, typically require significant justifying data be in hand when an application is made. One goal of the Pilot & Feasibility Program is to enable investigators to obtain the pilot data needed to secure an RO1, McIndoe says.

A recent five-year analysis indicates the consortiums approach works: 59 percent of consortium awardees submitted new NIH grants within five years and 37 percent received funding.

Early in the process each cycle, the consortiums External Evaluation Committee determines a short list of high impact areas of diabetic complications research that fall within the realm of the NIDDK and are eligible for DiaComp support. Applications are submitted in June, and award notices typically go out in September. This years foci include innovative technologies to analyze tissue from organs most affected by diabetes, such as the kidneys, and biosensors that can improve understanding of the damage diabetes does to various cell types.

Others include thin bacterial films called biofilms, a virulent community of microorganisms thats role in diabetic complications has not been well explored; the relationship between insulin resistance, an early indicator particularly of type 2 diabetes, and neurological problems like dementia; and novel ways to block diabetic complications.

The consortiums Summer Student Program provides support to first- and second-year medical students who want to do research at the nations NIDDK Diabetes Centers, see niddk.nih.gov/research-funding/research-programs/diabetes-centers, over the summer. This program funds about 18-20 students annually and concludes with an annual August gathering and poster presentation at Vanderbilt

University. A big message at that conference is encouraging students to become physician-scientists, McIndoe says. There also are roundtable discussions with residency program representatives about what they look for in future residents as well as future funding opportunities for the young investigators.

The Conference Support Program enables organizations to start new conferences in the area of diabetic complications. The Collaborative Funding Program looks to support novel clinical trials that will improve the outcome of diabetic foot ulcers, a common cause of lower leg amputation in patients with diabetes that can result from poor circulation and nerve damage.

McIndoe manages the myriad of information generated, disseminated and received through programs like the funding and student programs and has developed automated or semi-automated programs to ease the processes. This cycle he also plans to update the consortiums website.

The extensive raw scientific data generated through the work of the consortium and its awardees is shared broadly with the scientific community. I like the idea of providing a clearinghouse for diabetic complications data; there really is no other place that does that. You can think of it like an electronic lab notebook, McIndoe says.

Unlike data published in journals, which only provides a glimpse of the actual information obtained, the consortium makes complete data sets available to scientists who may have a different interest or angle. It also helps scientists reduce unnecessary replication and fine-tune their work.

Diabetes has been McIndoes career-long focus, beginning with his PhD work in immunology and molecular pathology at the University of Florida, which he completed in 1991. He joined the MCG faculty in 2002 and in 2008 was recognized as an emerging research and development leader at a Georgia research university with a Georgia Research Alliance Distinguished Investigator Award.

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Grant awarded for diabetic research - WRDW-TV

CHICAGO As a 22-year-old on the Giants A-ball club, Adam Duvall was hoping to achieve his dream of advancing to the majors without any setbacks. But then a lingering health concern changed the plan.

Duvall had lost 20 pounds over the course of the seasonas the symptoms ofType 1 diabetes took hold. Although the Louisville, Ky., native was diagnosed as a pre-diabetic during his childhood, he and his parents didnt worry because the condition was manageable even while playing sports.

Being a young, healthy athlete, I didnt think, Gee, I need to worry about that, Duvall said. But I would go low (on insulin) during games, and I would always have a payday (reaction). During the games when I was younger, Id be jittery.

MORE: Meet Chris Taylor, the Dodgers' anonymous star

Once the teams doctors confirmed the diagnosis, Duvall had to mentally adjust to the unanticipated setback. It would take work, even more than what's normally required to reach the majors, but Duvall was committed to keeping the disease in check so he would one day reach his goal of being a big-leaguer. That day came when he debuted with the Giants in 2014. Since then, Duvall has continued to elevate his game, and, now with the Reds, is putting up All-Star numbers.But managing his diabetes remains a priority.

Men with Type 1 diabetes lose around 11 years of their longevity in contrast to those without it, according to recent studies.Duvall could feel the effects of the disease on the field during that first season in the minors. Fatigue was common when his blood sugar wasn't right. Long bus rides and a lack of sleep didn't help. Staying vigilant wasn't always easy.

You get back from a long road trip, youre struggling and maybe you dont want to check your blood sugar, he said. And then it tailspins after that.

The Augusta GreenJackets training staff recommended that Duvall attended educational classes on diabetes. He subsequently figured out a plan to sustain his energy in and away from the ballpark; during games, a protein bar and Gatorade would sit on the dugout bench in case of an emergency.

Moreover, Duvall would need an insulin injection after any meal, along with one before bedtime.

After two and a half more seasons in the minors, he was called up to the Giants in June 2014.Soon after, Duvall was introduced to a cellphone-size device, designed to aid the users body with an attached cartridge of insulin. With the push of a button, Duvallcan have insulin delivered into his bodies through a plastic tube known as an infusion set, which is attached to his abdomen. It replaces the need for an injection.Duvall said the tail end of the insulin pump is stored his back pocket while roaming the outfield.

MORE: Every MLB team's worst regular season memory, revisited

On top of that, he carries a continuous glucose monitor (CGM), generating a blood sugar graph every five minutes. Occasionally, hell wake up in the middle of the night and see he needs extra insulin.

Competing at a high level, while also treating a major disease, has earned Duvall high respect from his teammates.

Im so proud of him because on some day games when its too hot, he has to drink a lot to be on that same level, Reds third baseman Eugenio Suarez said. Thats hard to do.

Once he became an everyday playerwith the Reds, Duvall earnedan All-Star berth in 2016, when he clubbed 33 home runs and drove in 103 runs. He's put up similar numbers so far in 2017.

There were a lot of people in the Giants organization that liked him very much, Reds TV play-by-play voice Thom Brennaman said. Now, they say, Man, how in the world did we not give this guy a chance to play the outfield (everyday)?

Since the start of 2016 season, Duvall has 188 RBIs, the most among NL outfielders; hes tied with Athletics outfielder Khris Davis for second among all MLB outfielders. He has also collected 62 home runs over that stretch, which is tied with Cubs third baseman Kris Bryant for fourth in baseball.

Duvall credits his power surge to regaining muscle mass that he lost before and immediately after his diabetes diagnoses, as well as making adjustments at the plate. TheAll-Star appearance in 2016 was a payoff of sorts, he said.

It wasnt something I really expected or was trying to achieve (being selected as an All-Star), Duvall said. It was one of those things where I put together a good year from working on my craft year round.

Reds third base coach Billy Hatcher said Duvall has asserted himself as a leader in the clubhouse during his ascendance at the plate, looking to aid veterans and youngsters alike, especially on defense. And on top of all his on-field and clubhouse duties, there's still the matter of Duvall staying vigilant to keep himself healthy.

You see him monitoring himself every single day and getting himself ready, Hatcher said. He has to worry about hitting a 98 mile an hour fastball; he has to worry about playing defense. A person whos doing all that and still competing while doing very well, you have to admire.

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Reds' Adam Duvall excels on field as he keeps diabetes in check ... - Sporting News

About one in 10 adults in Oklahoma suffers from diabetes, according to Centers for Disease Control and Prevention (CDC). The rate of diabetes diagnoses for adults in the state has more than doubled since the mid-1990s.

Diabetes educators are hoping to reverse that trend, with a year-long support and healthy lifestyles program aimed at preventing development of the disease.

Linda Yauk, a registered dietitian and certified diabetes educator at Integris Bass Pavilion Diabetes Center, has worked as a diabetes educator for25 years.

She said in 2015 she realized a new approach was needed, beyond just providing education,because it seemed like the people we were seeing with diabetes were getting younger and younger.

She applied for a grant through CDCsNational Diabetes Prevention Program in 2015. Integris was awarded the grant, which paved the way for Yauk to start an intense, year-long prevention program.

Since then,two classes of about 10 people each have completed the program.

Participants learn how to eat healthy, add physical activity to their routine, manage stress, stay motivated and solve problems that can get in the way of healthy changes. Diabetes prevention groups meet once a week for 16 weeks, then once a month for six months to maintain healthy lifestyle changes.

Yauk said the program has had about95 percent retention since it started, in part because she stresses up front that it is a long program that requires dedication and perseverance.

They know going in this is going to be a year-long commitment, Yauk said. We lay it down for them up front: If you dont think you can come for the full year, we need to rethink this.

Yauk said the formula for preventing diabetes isnt a secret, or complicated.

The bottom line is we need to eat more fruits, vegetables and whole grains, less refined foods and saturated fats, sit less and move more, Yauk said. Its really that simple.

Pamela Baggett, a registered and licensed dietitian with St. Marys Regional Medical Center, sees patients who already have been diagnosed with diabetes or prediabetes.

She said common-sense prevention is needed to reduce the risk of diabetes, especially for people with a family history of the disease, high blood sugar levels, or who are overweight.

Its just good health practices, Baggett said, whether were worried about diabetes, our heart, or even if our joints hurt because were overweight.The diabetic diet is really what we all should follow.

Baggett said people often develop diabetes without recognizing the warning signs, in part because they dont follow good preventive measures like healthy eating, regular exercise and an annual physical.

The thing with diabetes is we usually dont hurt, Baggett said. With diabetes, sometimes we can end up with a pretty high blood sugar and not have any symptoms, and might have just adjusted to it.

Yauk said the goal of the prevention program at Integris is to get people to change their lifestyles, and reduce their risk, before they develop diabetes.

One in three American adults has prediabetes, so the need for prevention has never been greater, Yauk said.

People with prediabetes higher-than-normal blood sugar levels are five to 15 times more likely to develop type 2 diabetes than those with normal blood glucose levels, according to the CDC.The same research shows that people with prediabetes who lost 5 to 7 percent of their body weight reduced their risk of developing type 2 diabetes by 58 percent.

Small changes can add up to a big difference, said Sarah Wamsley, a registered dietitian at Integris Bass. Working with a trained lifestyle coach who provides guidance, Integris participants are making lasting changes together.

Yauk said achieving those lasting changes requires more than just knowledge of the statistics.

To achieve long-term change, the program focuses on setting and regularly reviewing achievable goals, and by providing coaching and accountability.

Its all aimed at producing a positive experience, Yauk said, and increasing participants self-confidence in their ability to live healthier lives.

People have tried so many times, and not been successful, she said, so they dont have a lot of confidence in their ability to change.

That self-confidence is attained by providing support among the group members, Yauk said.

The goal is to get them to rely on each other, then become accountable to themselves and to their peers, Yauk said.Its not an easy task. They need to feel really confident with each other, because its a lot of sharing.

CDC is hoping more sites will take up the diabetes prevention program, and more participants will follow through with positive steps to prevent diabetes.

Nationwide implementation of the program could save the U.S. health care system $5.7 billion and prevent about 885,000 future cases of type 2 diabetes, according to CDC figures.

Participants now are being enrolled for the next session of the diabetes prevention program. Yauk said people diagnosed with prediabetes, high body mass index, or a previous diagnosis of juvenile or gestational diabetes are encouraged to apply.

Participation in the program is free of charge.

Prospective participants are encouraged to attend one of two orientation classes at Integris Heart and Vascular Institute, 707 S. Monroe: 6 p.m. Sept. 12 and 6 p.m. Sept. 14.

For additional information or questions, call Yauk at (580) 249-4104.

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Integris enrolling participants for diabetes prevention program - Enid News & Eagle

August 25, 2017 -As value-based care emphasizes preventative medicine, healthcare stakeholders aim to address social determinants of health to improve and maintain outcomes. But the lack of appropriate public health funding at federal, state, and local government levels prevents the healthcare system from developing the necessary infrastructure, a recent Health Affairs blogpost stated.

Former ONC National Coordinator Karen DeSalvo, MD, MSc, and Milken Institute School of Public Health professor Jeffery Levi, PhD, explained in the blogpost that out of the $3 trillion spent on healthcare, only about 3 percent goes to public health.

Public health is the natural and historic bridge between the healthcare system and the community both in terms of linking the healthcare system with services and organizations that address health-related social factors and in creating healthy conditions in the community, they wrote. But the sad truth is, the public health infrastructure is struggling to step up to serve as that bridge. Like other parts of our nations infrastructure, it has been chronically underfunded.

The industry experts added that the differential in healthcare versus public health funding may be even greater. Per capita healthcare spending is about $9,990, CMS estimates. But spending on key public health functions is roughly $109 per capita, including $22.66 of federal sources, $31.26 of state sources, and $55 of local sources.

The healthcare versus public health funding gap equates to over a 90-to-1 differential in spending.

DeSalvo and Levi pointed out that the national data does not reflect variations in state and local funding mechanisms for public health, indicating that the differential will rise according to zip code.

Without appropriate funding, government-based public health initiatives are failing to maintain their statutory responsibilities let alone address the rising demand to address social determinants of health through healthcare system partnerships, they stated.

To advance public health infrastructure and initiatives, DeSalvo and Levi offered four financing models that address the core values of public health, such as providing foundational public health services to all regardless of location, granting flexibilities to communities to meet specific health needs, incentivizing partnerships between public and private entities, and ensuring initiatives are data- and evidence-driven.

First, the federal government could create incentives for developing local public health capacity. Under this option, the federal government would match state investments for federal public health programs.

The financing structure mirrors the federal matching method in the Medicaid program, which aims to incentivize states to act as partners in achieving a shared goal.

Second, policymakers could establish value-based reimbursement models. CMS and CDC would collaborate to create and test value-based reimbursement arrangements that support partnerships between public health and healthcare system entities.

Third, the federal government could promote private sector investments in public health by identifying innovation partnerships between public and private organizations.

There is exciting, but nascent, interest in venture capital approaches to advancing population health and public health capacity through pay-for-success models, including the use of social impact bonds, wrote DeSalvo and Levi. The ability of any governmental agency to take on risk is very limited, but through partnerships with foundations there may be ways to demonstrate value for private sector investment in population and public health.

Fourth, policymakers could widen potential public health revenue sources. For example, a portion of health insurance premiums in each state could be reallocated to public health funds at the state and local level.

The federal government could also use revenue generated from a national sugar-sweetened beverage tax to boost public health financing. The tax would also encourage healthier lifestyles.

The industry experts emphasized that potential public health funding solutions may exist. But until policymakers adopt a financing structure to advance public health, successful initiatives may only be examples, rather than national standards.

At the end of the day, we must acknowledge that public health is part of the vital infrastructure of a modern, secure, economically competitive, and just nation, they stated. This means that public health will need robust, durable, and flexible funding to save lives not just in disaster but also every day.

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Scarce Public Health Funds Block Social Determinants of Health Aid - RevCycleIntelligence.com

Much like the Spanish Inquisition busting through my front door, this was completely unexpected. Square Enix talked a big game when they first announced Final Fantasy XV, pledging a steady support of content for the long-gestating latest entry in the core franchise. Why work on a sequel when you could take a pretty decent game and slot in new adventures ad-hoc for it, right?

If you do that full sequel model of expanding on an IP or a series, its good in certain ways. The negative of that is theres a very large open period where youre not releasing anything, director Hajime Tabata still said to Polygon.

Which makes sense, as Final Fantasy XV is plugging itself into the Animus to bring players all manner of Assassins Creed content in a crossover with Ubisofts premiere franchise of back-stabbery. No really, this is actually happening. August 30 will see the city of Lesatalium put on an Assassins Festival as Noctis and co. suit up in the garb of a familiar brotherhood. Heres a trailer to prove that I havent been smoking medical marijuana again. And even if I had, its for my glaucoma. I know I dont have glaucoma but its preventative medicine, okay?

That looks like a pretty decent slice of crossover action, borrowing quite a few familiar mechanics from the popular series. I kind of dig collaborations like this. Ubisoft has yet to mention if their upcoming return to the world of Assassins Creed will have a few Final Fantasy links, but I wouldnt be surprised if a certain stupidly massive sword or some familiar faces pop up as Easter eggs in that game come October 27.

Read Krillin and Piccolo are joining the roster of Dragon Ball FighterZ

A year on, and the future is still looking bright for Final Fantasy XV with an upcoming PC port and Ignis DLC in December thats keeping Square Enixs biggest franchise relevant in an ever-changing digital landscape.

Last Updated: August 25, 2017

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Final Fantasy XV is heading into the Animus with Assassin's Creed DLC - Critical Hit

Since the 2015 Zika outbreak, scientists around the world have been focused on learning as much as they can about the devastating, previously obscure virus. They've learned a lot about how it's transmitted, how long it can stay in a host's system and that it can lead to devastating birth defects. But, there are still some major blind spots.

"Zika virus has been very well studied for congenital disease, but we still do not know exactly what happens right after [the] mosquito bite," saidDr. Jae Jung, professor of molecular microbiology and immunology at USC and lead author of a new study in Nature Microbiology that aims to solve the mystery.

It's been unclear what happens immediately after the virus enters the bloodstream, particularly of pregnant women, that allows it to propagate before infecting an unborn baby. As it turns out, the mechanism of how the virus spreads is eerily similar to that of HIV.

"We found that Zika virus specifically targets the white blood cells," said Dr. Jung.

Once the virus enters the bloodstream of a pregnant woman, it tricks the immune system, suppresses it and spreads quickly.

When a healthy, non-pregnant person is infected with a virus, the immune system kicks into high gear. White blood cells don their pith helmets and turn into so-called " M1 macrophages" that act like little soldiers, catching the virus and killing it. Separate white blood cells (M2 macrophages)then come along to calm their M1 cousins to return the immune system to its neutral mode.

However, when the Zika virus enters the body of a pregnant woman it takes advantage of her unique biology. The immune systems of pregnant women are already compromised. Their bodies have been flooded with the chill M2 macrophages, which tell the body's immune system to relax. This immunity suppression allows the unborn baby to survive.

But, the Zika virus is sneaky. Since a pregnant woman's body is already predisposed to creating the chill cells, it convinces her body to create even more. So, rather than attack the Zika virus, the compromised immune system allows it to propagate. The virus then spreads, eventually crosses the placental barrier and infects the fetus. As a result, babies can be born with a host of neurological birth defects, including microcephaly.

Dr. Jung's team studied both the African and Asian strains of the Zika virus, but found that the Asian strain, which is spreading across the Americas and Southeast Asia, had a more profound impact on the immune systems of pregnant women particularly during the first and second trimester. During the third, the impact wasn't nearly as pronounced.

"It is very important to understand how the virus behaves in order to develop treatments and also ways to prevent this from happening," said Dr. Karin Nielsen from UCLA and one of the authors of the study.

Dr. Jung's lab previously identified the proteins in the Zika virus that can cause microcephaly in infants.

There's still a lot left to figure out. For instance, Dr. Jung said that it's possible that Zika vaccines, some of which have been proven effective on non-pregnant people, might not be as effective for pregnant women as ethical limitations have prevented their participation in vaccine trials.

"The Zika virus research has just began," Dr. Jung said."We've only studied for two years so far. HIV has been studied over 30 years."

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The Zika virus undermines immune system - 89.3 KPCC

News / Published: 24 August 2017

Researchers have shown for the first time how leprosy bacteria damage nerves by infiltrating the immune cells that are meant to protect us.

Credit: Bruce Paton/Panos

The research found that leprosy hijacks the immune system, turning an important repair mechanism into one that causes potentially irreparable damage to nerve cells.

The researchers used zebrafish that had been genetically modified to make their myelin fluorescent green.

They injected Mycobacterium leprae bacteria close to the fishes' nerve cells. The bacteria settled on the nerve and developed doughnut-like bubbles of myelin that had separated from the myelin sheath.

When the researchers examined these bubbles more closely, they found that they were caused by M. leprae bacteria inside macrophages the immune cells that consume and destroy foreign bodies and unwanted material in our bodies.But, crucially, although the M. leprae was consumed by the macrophages it wasnt destroyed.

The team also demonstrated how the damage occurs a molecule known as PGL-1 that sits on the surface of M. leprae reprogrammes the macrophage, causing it to overproduce a potentially destructive form of nitric oxide that damages mitochondria.

The international team, in the UK and USA, was part-funded by Wellcome.

The research findings mean that leprosy may share common characteristics with conditions such as multiple sclerosis and Guillain-Barr syndrome.

The researchers say its too early to say whether their study will lead to new treatments. There are several drugs being tested that inhibit the production of nitric oxide, but lead author Professor Lalita Ramakrishnan, at the University of Cambridge, says the key may be to catch the disease at an early enough stage to prevent damage to the nerve cells.

Leprosy is a neglected tropical disease. Its difficult to work with in the lab because its highly adapted to humans. Previously, armadillos were the only animal modelthat could reproduce aspects of the disease. The zebrafish model means researchers can now study the pathogenesis of leprosy in much more detail.

Credit: Bruce Paton/Panos

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Leprosy turns immune system against itself - Wellcome Trust

Like an invader spotting a weakness in a castles defenses, Zika targets specific white blood cells in a pregnant womans immune system, enabling the virus to spread and increasing the chances of harm to unborn babies, according to a new study by researchers at the University of Southern Californias Keck School of Medicine.

Because pregnant women are more prone to immune suppression a natural occurrence that prevents the body from rejecting the fetus Zika exploits that weakness to infect and replicate, stifling a bodys natural defenses in a way that resembles HIV, the study authors said.

The mosquito-borne virus that emerged in Miami last year has been mostly absent in Florida this year, with fewer infections and no local cases as of Monday. The Florida Department of Health has reported a total of 151 Zika cases, with all but one a sexually acquired case in Pinellas County contracted by Floridians while traveling outside the country.

The USC study, published in the journal Nature Microbiology, is the first to report that Zika targets certain white blood cells and converts those cells into immune system suppressors.

Researchers tested African and Asian Zika strains by infecting blood samples taken from men and women, including some who were pregnant, and then analyzing them at peak infection. They found that Zika made a beeline for white blood cells that help fight infections.

The Asian Zika strain pushed those white blood cells to transform into a different type of cell that tells the immune system to stand down because the threat is over, according to the study. The false signal stifles the immune system, allowing Zika to replicate.

Pregnant women have higher levels of the immune-suppressing cells, researchers said, which provides an opening for the Asian Zika virus to do more damage.

Previous clinical studies have found that Zika infection during the first and second trimesters of pregnancy increases the chances of delivering a baby with a birth defect or other abnormality. USC researchers found that the Asian Zika virus also is more harmful during a womans first and second trimester.

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Zika targets pregnant women's immune system, almost like HIV, study says - Miami Herald

This photomicrograph reveals Mycobacterium tuberculosis bacteria using acid-fast Ziehl-Neelsen stain; Magnified 1000 X. The acid-fast stains depend on the ability of mycobacteria to retain dye when treated with mineral acid or an acid-alcohol solution such as the Ziehl-Neelsen, or the Kinyoun stains that are carbolfuchsin methods specific for M. tuberculosis. Credit: public domain

Scientists have unlocked a key element in understanding how human lungs fight tuberculosis (TB). They hope their research findings, which were published today in the international peer reviewed journal Immunity, will help pave the way towards new treatment approaches for TB, particularly in an era of increasing antibiotic resistance to TB.

Multi drug resistant TB is a global problem. These strains are resistant to several or most of the antibiotics used to treat TB. The need to find new strategies for treating TB, beyond antibiotics, is therefore critical and urgent.

Scientists at Trinity College Dublin and St James's Hospital in Ireland, working in a team with the University of Cambridge and University of Seattle, have identified a way that TB hijacks our immune cells in the early stages of infection to allow it to establish an infection in the lung.

Tuberculosis is the world's number one infectious killer, but half of infected persons clear the invading TB bacteria (known as mycobacteria) after inhaling it into their lungs. To date, it has not been understood how the immune system in the lungs manages to do this.

The lung contains a population of specialised immune cells, known as alveolar macrophages, which are the first responders to bacterial infections. These alveolar macrophages patrol the lung engulfing and destroying any bacteria they encounter along the way.

Using transparent zebra fish, the University of Cambridge and University of Seattle researchers tracked the mycobacteria in real time and identified which cells they infected at different stages of the disease. They found that the more virulent strains of mycobacteria are able to hijack the macrophage immune cells in the lung causing them to produce a protein that attracts white blood cells from the circulation. These white blood cells fuse with the macrophages and in turn become infected.

The Trinity team of Dr Senadh O'Leary, Senior Research Fellow, Professor Joseph Keane, Professor in Medicine at Trinity and Consultant Respiratory Physician at St James's Hospital, and Dr Mary O'Sullivan, Associate Research Lecturer, used donated lung macrophage samples from patients in St James's Hospital to study the response of the human immune system to TB in the early stages of infection. They found that human alveolar macrophages behave similarly to zebrafish macrophages producing the same protein that attracts white blood cells to the lung. Unlike the resident alveolar macrophages these white blood cells lack the ability to curb the growth of mycobacteria which results in uncontrolled bacterial growth and inflammation and in the spread of the infection.

Dr Senadh O' Leary said: "We are fascinated how TB bacteria virulence factors can corrupt this human lung immune cell which is ordinarily exceptionally good at clearing infection. It's very exciting to work with our Cambridge colleagues on this research which improves our understanding of how TB infection compromises immunity. We are in a unique position to address the important challenges for TB treatment as we work with the human lung model. This allows us to continue in our research to design novel ways to support the effective lung cell and prevent infections in exposed people."

The Trinity/St. James's team is funded by the Health Research Board and the Royal City of Dublin Hospital Trust, and are now hoping to identify drugs that will enable these immune cells to stop the infection in its tracksby killing the mycobacteria before they attract white blood cells to the lung.

Mairead O Driscoll, Interim Chief Executive at the Health Research Board congratulated the team: "Antidrug resistant TB is a global problem. We're delighted to be able to facilitate international collaboration to tackle this challenge. These findings represent a significant breakthrough in our understanding of how the bacteria avoids our immune system."

"Ireland is lucky to have such brilliant researchers, who are genuine world leaders in their fields. The Health Research Board is determined to continue to develop Ireland's health research capacity, so that we have the people, the facilities, and the support structures to produce more results like this."

Explore further: Tuberculosis bacterium may undermine immune regulation to drive disease progression

Journal reference: Immunity

Provided by: Trinity College Dublin

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Scientists discover how tuberculosis hijacks the immune system - Medical Xpress