Category Archives: Physiology

The mysterious existence of a leafless kauri stump, kept alive by its forest neighbours – The Conversation AU

Plants use their leaves to make food from the suns energy and carbon dioxide. With very few exceptions of parasitic plants, no tree is known to grow without green foliage or to be more precise, no tree can start life without leaves or some sort of green tissue containing chlorophyll.

But some may end up as zombie trees long after they lose all leaves and large parts of their trunk, either to disease or the chainsaw.

Such undead tree stumps have been observed for almost 200 years, but the evolutionary and physiological processes leading to their existence remain a mystery. One reason is because they are rare. Another is because whatever happens on their journey from feeding themselves to being fed happens out of sight likely below ground.

American forest ecologist Suzanne Simard has shown that trees send each other signals through a network of fungi buried among their roots. This underground communication includes warning signals about environmental change and the transfer of nutrients to neighbouring trees before they die.

We suggest this supply can continue beyond the apparent death of an individual tree. By measuring water flow in the stem of a living kauri (Agathis australis) stump and its neighbouring trees, we show underground connections are indeed likely responsible for the survival of the stump.

A living tree stump is clearly a biological oddity, and our key question is why such root grafts form.

It is unlikely a tree that has lost its foliage (through windthrow, disease, or when it is felled) subsequently knocks on its neighbours door (or, more accurately, roots) to ask for carbohydrates. Instead, we must assume that these root connections had been in place earlier, while the stump was still a normal tree.

If that is the case, we can assume root grafting to be the rule rather than the exception, at least in species in which living stumps have been observed. But what are the evolutionary advantages? And why are the connections maintained when a leafless stump is no longer actively contributing resources?

The short answer to these questions is we dont know. Root grafting, a phenomenon well known to foresters and gardeners, has barely been studied on a physiological basis. Much remains speculation.

Read more: Climate change: having the right combination of tree personalities could make forests more resilient

A few evolutionary advantages for root grafting have been suggested, including increased resistance to windthrow, kin selection (I will help you out if you are related to me), and increased access to water and nutrients coupled with the ability to shift those resources among trees.

The former two are more easily explained because all graft members benefit. But the latter is more difficult to understand.

If forests feature interconnected root networks where water, carbon and nutrients are exchanged, this would be equivalent to power, water and gas grids supplying a city.

But what mechanisms control who gives and who takes? There is evidence that shaded trees are supported by non-shaded trees and the fact that stumps (pensioners) are still supplied with resources gives rise to the much bigger idea that forests act and survive as a whole much like a single bee or ant has no chance to survive without being part of its colony.

Our discovery of the tight hydraulic coupling through root grafts suggests exactly that: a communal physiology among connected trees. This is a game changer for our general understanding of forest functioning. It shifts our perspective towards forest ecosystems as superorganisms.

Read more: Entire hillsides of trees turned brown this summer. Is it the start of ecosystem collapse?

But with all the advantages this may bring for the superorganism forest, root connections obviously imply a lack of social distancing. As with COVID-19, this makes it easy for pathogens to spread, especially in cases where the pathogen penetrates the vascular tissue, a trees main transport route for water and carbohydrates.

Well into the 21st century, some great mysteries remain about how forests function. Research is particularly timely and relevant, given the rise in climate-induced forest dieback events due to more frequent and severe droughts, increased vulnerability to pathogens and exposure to pests that come with warmer temperatures.

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The mysterious existence of a leafless kauri stump, kept alive by its forest neighbours - The Conversation AU

Evaluation of Stress and Associated Biochemical Changes in Patients wi | DMSO – Dove Medical Press

Kanchan Tyagi,1 Nidhi Bharal Agarwal,2 Prem Kapur,3 Sunil Kohli,3 Rajinder K Jalali4

1Department of Pharmaceutical Medicine, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India; 2Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, 110062, India; 3Hamdard Institute of Medical Sciences and, Research, HAH Centenary Hospital, New Delhi, 110062, India; 4Physician and Healthcare Consultant. Formerly, Sun Pharmaceuticals Industries Limited, Gurgaon, 122015, India

Correspondence: Nidhi Bharal AgarwalCentre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, 110062, IndiaTel +91 9818334770Email nidhi.bharal@gmail.com

Purpose: Type 2 diabetes mellitus (T2DM), a metabolic disorder, remains associated with a physiological impairment affecting large populations worldwide. Onset of T2DM is multifactorial where obesity and abnormal basal metabolic rate are considered most critical. Of people diagnosed with T2DM, about 80% are also obese. It is also reported that obese individuals have an increased odds of developing depression, whereas T2DM is estimated to increase the incidence by two-fold. The preponderance of research data demonstrates that T2DM alters the serum level of cortisol and adiponectin which are known to be associated with neuronal physiology. The study explored, how a metabolic disorder like T2DM is linked with the altered plasma level of cortisol and adiponectin, the risk factors for stress and depression.Patients and Methods: A cross-sectional population study was conducted in T2DM patients using a bimodal approach. First approach used questionnaires, (1) Patient Health Questionnaire (PHQ-9) and (2) Stress Coping Inventory Questionnaire (SCQ) to assess signs and symptoms of depression and stress, respectively, in T2DM patients. In the second approach, robust biochemical analysis was conducted for serum adiponectin and cortisol levels.Results: An association of T2DM in stress and depression was evaluated in 158 subjects (105 T2DM obese patients and 53 healthy controls). A lower PHQ-9 score and adiponectin levels were seen in T2DM obese patients compared to healthy controls (p< 0.05). Further, results also depicted a lower adiponectin levels in T2DM obese patients with depression compared to T2DM obese patients without depression (p< 0.05). The study did not find a significant difference in cortisol serum levels among the T2DM and control groups. However, a higher level of serum cortisol was reported in T2DM obese patients with depression over those T2DM obese patients who lacked depression (p< 0.05).Conclusion: The findings suggest that T2DM obese patients might have a higher risk of developing stress and depression. Further, biochemical parameters, adiponectin and cortisol, might be the potential biomarkers for T2DM and may help in early diagnosis of these comorbid conditions.

Keywords: type 2 diabetes mellitus, depression, stress, PHQ-9, SCQ, adiponectin, cortisol

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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Evaluation of Stress and Associated Biochemical Changes in Patients wi | DMSO - Dove Medical Press

PhysIQ and U.S. Veteran’s Affairs Advance to Interventional Trial Phase – Business Wire

CHICAGO--(BUSINESS WIRE)--physIQ, Inc. and the US Department of Veterans Affairs (VA) have advanced their collaboration to address heart failure care to an interventional trial phase. In this next phase, Veterans will be actively monitored so care can be administered in near real-time to avoid or lower the chance of re-hospitalization, allowing the VA to improve patient care while driving down costs.

In early 2020, physIQ and the VA shared the results of a breakthrough study aimed at validating the ability to detect the onset of heart failure exacerbation using wearable sensors and machine learning-based personalized physiology analytics. Published in Circulation Heart Failure, a journal of the American Heart Association, the observational phase of the LINK-HF study was designed to assess the ability to predict rehospitalization due to heart failure exacerbation using sophisticated analytics applied to continuous wearable sensor data. This study demonstrated a 7-10-day early warning timeframe, which showed promise to reduce hospitalization and improve quality of life of patients with heart failure.

This new interventional study will provide the real life experience needed to demonstrate how this cutting-edge technology can be leveraged to provide clinicians with more proactive information to manage at risk patients, such as those with heart failure, to keep them out of the hospital. Utilizing this type of innovative solution will enable VA to provide the best possible care to Veterans at the highest value, says Dr. Stephen L. Ondra, former Senior Advisor for Health Affairs to the VA Secretary under President Obama. The LINK-HF study demonstrated the potential to detect clinical changes early enough in the process to intervene before a patient became more seriously ill. This study will put the technology to the test in clinical practice, and in doing so, has the potential to improve care and the quality of life of patients with heart failure and eventually other high risk medical conditions.

Heart failure patients are most vulnerable in the weeks following a recent hospitalization, and often find themselves readmitted. In this multi-site interventional study, patients at discharge will be provided a set of disposable adhesive biosensor patches for the chest, and a smartphone to upload their data to the pinpointIQTM platform. Within the platform, sophisticated FDA-cleared artificial intelligence-powered algorithms learn the dynamic digital signature of each patients individual vital sign behavior and detect changes, even subtly. Such changes in vital signs can be an early warning of a deteriorating physiological condition reflecting exacerbation of the underlying disease.

In the study, patients will be contacted in the event that the analytics suggest a need for early intervention to avoid an exacerbation before it becomes an acute care emergency. PhysIQs innovative solution addresses a critical, unmet need for continuous remote monitoring of patients vital signs which could mitigate the cost and risk of invasive heart failure hemodynamic monitoring devices that have shown effectiveness in the last decade.

PhysIQs technology is allowing doctors and nurses to be proactive, as opposed to reactive, in the management of chronic illnesses, which could result in preventing any further deterioration, said Gary Conkright, CEO of physIQ. As we continue to push the boundaries of this emerging technology, we are thankful for a partner like the VA and are proud for the opportunity to serve those that have served us.

In the U.S., hospitalizations for heart failure (HF) represent 80% of costs attributed to HF care. HF is the most common hospital discharge diagnosis for Veterans. Furthermore, hospitalization for HF is associated with adverse prognosis - the risk of mortality increases more than 4-fold in the first 3 months after discharge. Within the VA system, the importance of decreasing preventable HF hospitalizations has been recognized by The Chronic Heart Failure Quality Enhancement Research Initiative (CHF QUERI), and the 30-day readmission rate is one of the VAs Strategic Analytics for Improvement and Learning (SAIL) measures.

About physIQ

PhysIQ is the leader in digital medicine, dedicated to generating unprecedented health insight using continuous wearable biosensor data and advanced analytics. Its enterprise-ready cloud platform continuously collects and processes data from any wearable biosensor using a deep portfolio of FDA-cleared analytics. The company has published one of the most rigorous clinical studies to date in digital medicine and are pioneers in developing, validating, and achieving regulatory approval of Artificial Intelligence-based analytics. With applications in both healthcare and clinical trial support, physIQ is transforming continuous physiological data into insight for health systems, payers, and pharmaceutical companies.

For more information, please visit http://www.physIQ.com. Follow us on Twitter and LinkedIn.

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PhysIQ and U.S. Veteran's Affairs Advance to Interventional Trial Phase - Business Wire

L-Cysteine Provides Neuroprotection of Hypoxia-Ischemia Injury in Neon | DDDT – Dove Medical Press

Tingting Li,1,* Jiangbing Li,1,2,* Tong Li,3,* Yijing Zhao,1 Hongfei Ke,1 Shuanglian Wang,1 Dexiang Liu,4 Zhen Wang1

1Department of Physiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, Peoples Republic of China; 2Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, Peoples Republic of China; 3Department of Neurosurgery Surgery, Qingdao Municipal Hospital, Shandong Province, Peoples Republic of China; 4Department of Medical Psychology and Ethics, School of Basic Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, Peoples Republic of China

*These authors contributed equally to this work

Correspondence: Dexiang LiuDepartment of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, Peoples Republic of ChinaEmail liudexiang@sdu.edu.cnZhen WangDepartment of Physiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong, 250012, Peoples Republic of ChinaEmail wangzhen@sdu.edu.cn

Background: Previous work within our laboratory has revealed that hydrogen sulfide (H2S) can serve as neuroprotectant against brain damage caused by hypoxia-ischemia (HI) exposure in neonatal mice. After HI insult, activation of the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway has been shown to be implicated in neuro-restoration processes. The goal of the current study was to determine whether the neuroprotective effects of H2S were mediated by the PI3K/Akt signaling pathway.Methods: The mouse HI model was built at postnatal day 7 (P7), and the effects of L-Cysteine treatment on acute brain damage (72 h post-HI) and long-term neurological responses (28 days post-HI) were evaluated. Nissl staining and Transmission electron microscopy were used to evaluate the neuronal loss and apoptosis. Immunofluorescence imaging and dihydroethidium staining were utilized to determine glial cell activation and ROS content, respectively.Results: Quantitative results revealed that L-Cysteine treatment significantly prevented the acute effects of HI on apoptosis, glial cell activation and oxidative injury as well as the long-term effects upon memory impairment in neonatal mice. This protective effect of L-Cysteine was found to be associated with the phosphorylation of Akt and phosphatase and a tensin homolog deletion on chromosome 10 (PTEN). Following treatment with the PI3K inhibitor, LY294002, the neuroprotective effects of L-Cysteine were attenuated.Conclusion: PTEN/PI3K/Akt signaling was involved in mediating the neuroprotective effects of exogenous H2S against HI exposure in neonatal mice.

Keywords: Akt, H2S, hypoxia-ischemia, neuroinflammation

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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L-Cysteine Provides Neuroprotection of Hypoxia-Ischemia Injury in Neon | DDDT - Dove Medical Press

Chocolate-flavored e-cigarettes are ‘particularly harmful’ to the lungs, study shows – News-Medical.Net

New research shows chocolate-flavored e-cigarettes are "particularly harmful" to the lungs. In fact, scientists found all 10 flavors tested caused some level of toxicity in the cells lining the lungs, resulting in cell death in some instances. The toxins also significantly reduced the ability of immune system cells to remove bacteria and regulate inflammation. The research article was published in the America Journal of Physiology-Lung Cellular and Molecular Physiology and has been chosen as an APSselect article for February.

The data show that the chemical profiles of the e-liquid flavors studied (apple, banana, bubblegum, cappuccino, cherry, chocolate, cinnamon, mango, peppermint and tobacco) contained as many as 15 chemicals. The most harmful flavors, such as chocolate and banana, included high levels of a chemical component called a benzene ring. Flavors with a lower concentration of benzene ring were less harmful. The researchers also found different brands of chocolate and banana flavored e-liquids with lower amounts of benzene ring chemicals were also less harmful.

The purpose of the study, according to researchers, was to determine whether immune dysfunction and toxicity in the lungs previously observed in earlier studies were dependent on the flavor used, independent of the presence of nicotine. To find out, they exposed lung cells of healthy, non-smoking subjects to the e-cigarette vapor produced from different flavors.

We believe that this study provides evidence that the potential harm from using flavors does not come from the name on the bottle, but rather the flavoring chemical composition, the flavoring chemicals present and their concentration. This suggests that any limits on permitted flavors should be based on this sort of data specifically to ensure that allowed products truly represent the lowest level of harm possible."

Miranda Ween, PhD, Researcher, Royal Adelaide Hospital, Australia

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Chocolate-flavored e-cigarettes are 'particularly harmful' to the lungs, study shows - News-Medical.Net

Dr. Maria Delivoria-Papadopoulos, Saved Thousands of Infants, 90 – The National Herald

PHILADELPHIA Dr. Maria Delivoria-Papadopoulos, 90, of Lansdowne, PA, an internationally renowned scientist in the field of neonatal medicine who helped save thousands of infants through her groundbreaking research, died on September 11, 2020 of endometrial cancer at the Hospital of the University of Pennsylvania (HUP), the Philadelphia Inquirer reported.

A professor emeritus of pediatrics at the Perelman School of Medicine, former director of newborn services at HUP, and a pioneer in neonatal and pediatric medicine, she joined the faculty at Penn in 1967 as an instructor in pediatrics, according to the Penn Alumni magazine, the Pennsylvania Gazette. She became an assistant professor in physiology and pediatrics a few years later, moving up to associate professor and then, in 1976, full professor of pediatrics, physiology, and obstetrics-gynecology. She also served as the director of newborn services and the intensive care nursery at HUP from 1974 to 1996. She was associate dean for International Medical Programs, and she was also an associate physician at Childrens Hospital of Philadelphia. She retired in 1996.

Dr. Delivoria-Papadopoulos is perhaps best known for performing the worlds first successful ventilation treatment for premature infants in North America. She received continuous funding from the National Institutes of Health for decades for her research, as well as numerous awards, including the American Academy of Pediatrics Lifetime Achievement Award, Penns Lindback Award for Distinguished Teaching, and the Leonard Berwick Memorial Teaching Award from the Perelman School of Medicine.

During a 50-year career, Dr. Delivoria-Papadopoulos was a professor of pediatrics, physiology, and obstetrics/gynecology at Drexel University College of Medicine, and director of neonatal intensive care at St. Christophers Hospital for Children.

She was regarded as the mother of neonatology and a legend in the field," Greeces Neonatal Society said in an online tribute, the Inquirer reported.

She remains alive in the hearts and memories of the hundreds of doctors she trained and inspired to have a love for sick children, of the hundreds of Greek doctors she opened the way for, and of the thousands of Greek patients who found treatment at specialized centers with her help, the Society said on Sept. 14.

Born in Athens, she was the daughter of Constantine and Kalliopi Delivoria and earned a medical degree from Athens University. Dr. Delivoria-Papadopoulos came to the United States in 1957 to pursue postdoctoral study in physiology at the University of Pennsylvania. She joined the faculty and created the neonatal unit at Penn, which she ran before leaving as professor emeritus in 2000.

She was on the Drexel faculty from 2000 to 2006, where she held the Ralph Brenner Endowed Chair in Pediatrics at St. Christophers Hospital.

Dr. Delivoria-Papadopoulos was honored globally for her achievements and continued research in neonatal medicine throughout her life, the Inquirer reported, noting that her most important contribution was taking the iron lung used to treat polio victims in the 1950s and adapting it to support the breathing of premature babies. Another was the use of magnetic resonance imaging to assess the infants' brains.

She was the first doctor to place an infant on a respirator to help with respiratory distress syndrome, her family said in a statement, adding that she was also the first woman and doctor to demonstrate the effective use of mechanical ventilation to treat lung disease in premature infants, the Inquirer reported.

Her nearly 60-year medical career was dedicated to at-risk newborns, and she touched the lives of countless children, St. Christophers Hospital said in an online post, the Inquirer reported.

Among the cases on which she consulted was in 1963 for Patrick Bouvier Kennedy, the infant son of President John F. Kennedy and first lady Jacqueline Kennedy, the Inquirer reported, noting that Dr. Delivoria-Papadopoulos was working at the Hospital for Sick Children in Toronto at the time and was called when the baby developed breathing problems.

She did not treat the child, because it was considered unseemly for a Canadian physician to treat the child of a U.S president, the Inquirer reported, adding that a Boston specialist placed the infant in a hyperbaric chamber filled with 100% oxygen, similar to the ones used by divers and despite frantic efforts by doctors, the child lived for only 39 hours, dying at 4:04 AM Aug. 9.

Dr. Delivoria-Papadopoulos served as an adviser to the National Institutes of Health and was the author of 400 scientific publications and had an extensive network of scientific protgs as well as thousands of surviving patients, including many for whom she was the only hope, the Inquirer reported.

They kept in touch with her always, said her son, James C. Patterson, the Inquirer reported.

Joseph McGowan, a family friend for 40 years, told the Inquirer that she spent a month in Greece every summer, providing free medical care to Greek children.

Dr. Delivoria-Papadopoulos worked from a tent and gave each child a toy so they wouldnt fear doctors, the Inquirer reported.

After her mother passed away in 1985, Dr. Delivoria-Papadopoulos wore black, sometimes punctuated with a signature white blouse, for the rest of her life, the Inquirer reported.

She was predeceased by her husband, Christos Papadopoulos, who died in 2002. Besides her son James, she is survived by another son, Constantine C. Patterson, and a grandson.

Services were private. Memorial donations may be made to any veterans organization.

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Dr. Maria Delivoria-Papadopoulos, Saved Thousands of Infants, 90 - The National Herald

Florida mothers of color, seeking better care, turn to midwives and doulas – Tampa Bay Times

ST. PETERSBURG Courtney West stepped into the house and ran with her arms wide open to greet Samara Jackson.

Moments later, Jacksons 8-year-old son, Orion, strolled down the hall, past the family wedding portraits and toward the pair who were laughing and hugging like lifelong friends.

How are you baby boy? West asked Orion as she turned and wrapped her arms around him, too. Well, I cant call you baby boy anymore, can I?

Orion is a big brother now. Two weeks earlier, Peace Jackson just over 6 pounds the last time his mother checked was born on the bathroom floor, a few feet from where they stood. West had arrived just in time, followed by a midwife.

Whens the last time you ate? West asked Jackson during her visit that Friday afternoon. Then she checked on how mother and baby were sleeping.

The day before, West had assisted with another delivery. Shes booked until June, she said. When she makes plans, they come with the disclaimer, unless Im at a birth.

West sees doulas as the mothers of mothers. In her own practice, she serves as caretaker, chef, masseuse and often times advocate for families in hospitals and doctors offices. She assists with home births and hospital deliveries, offering additional comfort and expertise for families. The vast majority of the mothers she cares for are women of color.

Pregnant with her second child in the midst of the pandemic and the intensity of last summers Black Lives Matter protests, Jackson, 30, shied away from the hospital where Orion was born. They had induced her, and she felt forced into using formula instead of breastfeeding.

This time, she sought the care of a Black midwife and a Black doula. This time, she wanted more support.

Zulgeil Ruiz Gins, who heads the only Hispanic-owned midwife practice in Hillsborough County, is booked until August. She receives a handful of calls every week from women of color who are scared, determined to avoid traditional health systems that have discriminated against them.

But with limited capacity, Im turning people away, said Gins, whose own childbirth was rife with mistreatment.

Its no way to come into the world with trauma, she said.

Black women once dominated the field of midwifery in southern states. Their enslaved forbears had passed down West African childbirth techniques through generations.

From the 1930s to the 1960s, the Florida Department of Health recruited midwives for women who had no access to medical care due to poverty and segregation, according to Sharon Hamilton, former president of the Midwives Association of Florida. Back then, Black people were often not allowed in hospitals.

Since then, the number of Black maternal health care providers has dwindled.

And the rates of maternal mortality and preterm births have increased in the U.S., even as medicine and technology have advanced, according to an analysis by the Kaiser Family Foundation, which noted trends since the 1980s.

Black women face death rates related to pregnancy that are over three times those for white women. For American Indian and Alaska Native women, pregnancy-related death rates are more than twice as high as white counterparts. The rate for Hispanic women was similar to white women, the Kaiser analysis found.

The outlook is somewhat brighter in Florida, which has seen a significant drop in the rate of maternal mortality over the last 10 years, particularly among Black and Hispanic women, said Dr. William Sappenfield, a University of South Florida professor and the director of the Florida Perinatal Quality Collaborative.

Still, disparities persist, Sappenfield said.

For so long, researchers studied race as a physiological cause for the disparities, said Jessica Brumley, director of the division of midwifery in USF Healths department of obstetrics & gynecology. But its really racism and the social and systematic effects of that over generations that are affecting health outcomes.

Patients who are cared for by a provider who looks like them have better outcomes, said Brumley, and if youre Black or brown, youre less likely to have a provider who looks like you.

Throughout her pregnancy, Delaine Williams mastered the art of dropping hints in conversations with nurses and doctors.

Shed mention her college degree and say her husbands name in passing. Shed bring up the clients she worked with as a group insurance consultant. Shed let them know about her journey with in vitro fertilization.

I felt like I needed to wear that privilege on my sleeve in order to be treated with kindness, Williams said.

Still, it didnt protect her.

After the birth of her daughter, an awful headache took hold, a side effect of her C-section. Williams could hardly walk, her vision blurred, she could barely hold her baby, she said. She returned to the hospital and, after hours of begging for medication, the pain management team refused, saying her pain wasnt as severe as she let on.

Everyone was working really hard to convince me that what I was experiencing was not what I was experiencing, said Williams, a Tampa native and Florida A&M University graduate. I had a lot of trouble advocating for myself.

With the pandemic raging, her husband couldnt stand by her side at the hospital. And as a Black woman, not having a partner with you changes the way youre perceived, said Williams, 35. At the hospital, attendants assumed she was on welfare.

After her mother called demanding to speak with the administrator on duty, the head of the emergency team came to her room. Deeply apologetic, the doctor explained his wife had experienced the same issue and offered medication to ease the pain.

Since then, Williams has steered clear of the hospital and used a doula for postpartum care.

Black emergency room patients were 40 percent less likely to receive pain medication than white patients, and Hispanic patients were 25 percent less likely, according to a study published in 2019 by a researcher at George Washington University School of Medicine & Health Sciences.

Dismissing Black and Hispanic womens pain is one of many ways implicit bias affects their quality of care, experts say.

West, the doula, says she cares for many second-time moms afraid of hospitals after their first experiences: women stitched up wrong after surgery, or consistently talked down to. Shes heard from Black and brown fathers who said they were removed from the delivery room for asking why their partners were being mistreated. A mother of 10 who said she sought her help after bad experiences during every pregnancy, finally hoping to have a good birth.

The traditional medical structure traumatized West, much as it does her clients.

When her blood pressure increased throughout her pregnancy, doctors threw medication at her, she said. And when her baby was delivered, no one checked on her. I could be bleeding out right now, she recalled thinking. Wheres the care?

Then came severe postpartum depression and sleep deprivation. Again, they threw me on some meds and that was it, said West. During that period, West was offered a copper intrauterine device for birth control and an allergic reaction left her sterilized.

In response, nurses made remarks suggesting she didnt need to have more children anyway.

I trusted them, West said. How dare you take something so precious from me?

When Ciara Tucker of St. Petersburg started having chest pain, she went to a community health clinic. After four visits, a multitude of tests and repeated radiation, doctors took a urine specimen. Tucker, 38, was pregnant. A complication with her twins was causing her heart problems.

At 17 weeks, she lost one of the babies due to causes she says were unrelated to the radiation. Still, Tucker describes her care at the clinic as total chaos and is angry her babies were put at risk.

Another St. Petersburg resident, registered nurse Briana Hickman, was aware of the disparities facing mothers of color when she got pregnant with her son. So she recruited West as her doula for additional support.

Being a nurse kind of works in your favor, said Hickman, 27, who noticed the gaps in care firsthand as a Black patient. Having West as her advocate allowed Hickman to ask doctors more questions and push back when she felt pressured into taking certain medications.

A week before NiChelle Lawson gave birth, harsh contractions forced her to check into the hospital. With no rooms available when she arrived, Lawson, 27, said she sat in the lobby with West as nurses walked by almost like they were smirking and making fun of what Im going through.

In the Black community, were pushed to get an epidural, to get a C-section. Were pushed to feel like there is no other option than the option that is given by the doctor, Lawson said. But throughout the pregnancy, West helped her speak up when she didnt want to go with what the doctor was pushing on her, she said.

I had more of a voice than I thought that I had.

As doctors become more aware of the discrimination and communication barriers permeating maternal health care, some hospital systems are looking to bridge the gap by incorporating midwives and doulas into their operations.

There are certainly differences in philosophy between the practice of obstetrics gynecology and midwifery, said Brumley, the USF professor. While obstetrics and gynecology specialists are experts in the management of medical complications and surgery, midwives are experts on the physiology of pregnancy and birth. They complement one another, she said.

Hospital midwives traditionally treat high-risk patients who may have multiple conditions, she said. The personalized care families may find with licensed midwives who work outside hospitals is difficult to recreate in a facility because of the sheer volume of patients.

Licensed midwives dont see high-risk patients. So, to ease the concerns of women who are high-risk but do not feel safe in hospitals, some hospitals offer team-based care that includes nurse midwives.

In Hillsborough County, ReachUp Inc., an organization working toward equality in health care, has been incorporating the use of doulas to chip away at maternal health disparities for the past two decades.

We need to listen to women, said Estrellita Lo Berry, ReachUps president and CEO, and really, truly be able to have dialogues about implicit bias.

As the disparities persist, advocates are pushing for structural change and in some cases starting to make them on the grassroots level.

The numbers dont lie, said Yamel Belen, owner of One Love Doula Services, which serves women across the region. Every provider should be very well-versed in diversity and inclusion.

Belens practice offers free planning sessions to families of color in hopes of combatting the disparities. While she doesnt have the funding to offer all of her services at no cost, a single session can help families feel empowered, Belen said.

It gives us an opportunity to educate you, she said.

Back inside Samara Jacksons kitchen, West, the doula, gazed at baby Peace in her arms. Hes the most precious thing, she said. Im so proud of you.

Jackson said she was going to miss her.

You dont have to miss us, West said. Were here. Were not going anywhere.

I want to be at all the birthdays.

The Foundation for a Healthy St. Petersburg provides partial funding for Times stories on equity. It does not select story topics and is not involved in the reporting or editing.

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Florida mothers of color, seeking better care, turn to midwives and doulas - Tampa Bay Times

Pueblo Community College names its 2020 employees of the year – Pueblo Chieftain

Joe McQueen|The Pueblo Chieftain

Pueblo Community College has named four of itsstaff the school's 2020 employees of the year.

The faculty were given the award during PCC's virtual spring semester kickoff event. According to a news release, they were selected based on their professional excellence.

"I'm very appreciative and honored. My colleagues are the ones who nominated me for the award. It's really just an amazing group of people I work with," PCC academic excellence administrator Bonnie Housh, one of the award recipients, said. "Everybody helps everyone, it's been a good run."

MORE: Pueblo Pro Bono Mental Wellness program celebrates its 10th anniversary

Housh has worked at PCC for30 years, 22 of them as a part-time instructor in the science department. She said she enjoyed teaching during her time as a part-time instructor since her schedule worked out with raising a family.

"When you see the lightbulb go on for students when you're explaining anatomy and physiology and when they understand what you're talking about, that's just a great feeling," she said.

Health information technology program coordinator and faculty memberMarianne Horvath also was named an employee of the year. She has been with PCC for four years and received the award for her dedication to student success.

MORE: State hospital staff in Pueblo fear for safety with new policing plan

"It's a really amazing honor and certainly something I did not expect. Getting this award is kind of unbelievable," Horvath said.

She said she enjoys everything about the school andhow everyone rallies around the students to provide them the best education.

"Providing top-notch current content that they need to know to be successful in the workforce. PCC has assembled an arsenal of tools to help students with just about any need that comes up," she said.

The other award recipients included administrative assistant for Pueblo Corporate College Debbie Clement and mathematics instructor Nancy Hunt.

Chieftain Education Reporter Joe McQueen can be reached at jmcqueen@gannett.com or on Twitter @jmcqueennews

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Pueblo Community College names its 2020 employees of the year - Pueblo Chieftain

Novel hybrid device to boost research on metastatic process of breast cancer cells – News-Medical.Net

European researchers are working on a novel hybrid device to better understand the metastatic process of cancer cells traveling from breast to bone and fast screen new drugs against it.

The spread of cancer cells to other parts of the body, known as metastasis, is the main cause of cancer-related deaths. According to the US National Cancer Institute, in 2018 there were 9.5 million deaths caused by cancer worldwide, and a high percentage of those involved tumors that had spread across the body.

However the metastatic process remains one of the most enigmatic aspects of the disease. To understand it, we have to take a step back and look at the biology of the primary tumor.

Roger Gomis, head of the group growth control and cancer metastasis at the Institute for Research in Biomedicine, in Barcelona, explains: "Essentially what you have in a tumor is an original cell or a small group of cells that receive oncogenic signals, such as tobacco or UV light. Those inputs induce alterations known as mutations, which make the cells start proliferating in a dysregulated manner. The tumor mass starts growing and expanding and, in order not to run out of supplies and collapse, some cancer cells spread to other organs. Cancer cells spread not because they are encoded to the metastasis but just because it's crowded."

What we observe in cancer is an accelerated process of evolutionary species, trying to leave one site to grow on foreign soil. The site where tumor cells metastasize is not random, it rather follows a specific tissue pattern based on the Darwinian theory of evolution.

Gomis uses the Galapagos Islands as an example to explain. "You have a population of birds that have flown from Ecuador. They reach the islands and they adapt to the conditions of each island, forming new bird species. Why did birds colonize the Galapagos Islands and not dogs or reptiles? Because they could fly! So the genetics made them the candidates. But then, there is a process of adaptation that is imposed by the characteristics of the destination; for example the latitudes and where the food is," he says.

In terms of metastasis, it is the same. The fact that metastatic cells metastasize on a particular site depends on the genetics of the cells, the characteristics of the metastatic tissue and the ability of the tumour cells to adapt to and grow in the new environment. A great example of this is breast cancer.

The bones are the most common place where metastatic breast cancer cells tend to go. Although the research on tumors has exponentially grown in the past years, the major hurdle to decreasing mortality is to find out where the cancer cells will spread. To understand the process, scientists need relevant cancer models, which are lacking.

The main reason why it has been so difficult to translate the findings into the clinical settings is that the models of the laboratory sometimes do not factor in everything we have in the clinics. The laboratory mice, in terms of metastasis, do not always recapitulate what we see in the patients. For example, the breast cancer that we generate in the mouse tends to metastasize to the lung but it's rare to see it in the bones."

Roger Gomis, Institute for Research in Biomedicine, Barcelona

Providing better models to shed light on the bone metastatic process is the aim of the B2B project, supported by the EU Future and Emerging Technologies (FET) programme. Its interdisciplinary consortium are creating a cutting-edge device that mimics the spontaneous metastasis process from the breast to the bone.

Their innovative technology includes a patient-derived breast cancer lesion connected to a reconstructed bone via a complex vascular network. "The fluidic system mimics the features of human blood vessels feeding and connecting living tumour cells from breast cancer to the target metastatic tissue, which is the bone," explains Silvia Scaglione, group leader of the CNR-IEIIT Bioengineering laboratory of Genoa, and coordinator of the project.

The level of physiological complexity of the project is really high but this is necessary if we are to capture all the key elements of the metastatic process. "Usually cancer is studied either using in vitro static models or in vivo animal models. However, both approaches fail to recapitulate the metastatic process for different reasons. The static model can't mimic the fluidic connections between the breast cancer and the metastatic side, while the animal model doesn't resemble the spontaneous breast metastatic onset," she says.

If successful, the B2B device will be an in vitro alternative that features three new complementary technologies. The first is clinically relevant-sized organoids that are able to resemble what is happening in vivo. "If you miniaturize too much the cancer tissue, as in some other in vitro approaches, you lose some biochemical and molecular features such a hypoxic core within the tumor tissue," Scaglione explains.

The second is the generation of the ossicle, the bone tissue containing the target of metastasis, in vitro. "We started using mice models to make the ossicle, since it is impossible with our knowledge in the world to create the bone marrow, which is the target of the metastatic cancer cells. In parallel, the partner involved in this task is working on a novel in vitro approach using patient-derived stem cells to create bone tissue and thus by passing completely the animal step," says Scaglione.

The third is the fluidic system that connects the breast and bone tissues, which is entirely based on human physiology. The system consists of a micro-vascular capillary network, which is formed spontaneously around the tumour tissue, connected to a functional bioprinted macro-vascular tree.

Scaglione sees a future whereby any crosstalk between organs can be studied using the B2B platform, reducing the need for animal models and supporting scientists in advancing knowledge on tumors. "We have selected the breast metastasis as a case study but, of course, our platform will be adapted for many other diseases," she says, "Not necessary for cancer, but, for instance, fibrosis or other cases where you have an interaction between different tissues that are vascularised and fluidically connected. Also, the platform will be useful for studying the pharmacokinetics of any type of drugs."

Scaglione also believes that this technology will accelerate the identification of metastasis-suppressing therapies for breast cancer patients and will help pre-screen novel personalized cancer therapies, which will ultimately have a high impact for oncological patients.

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Novel hybrid device to boost research on metastatic process of breast cancer cells - News-Medical.Net