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Emoji, that universal lexicon of colorful and clever symbols meant to replace levitra online coupons the written and spoken word, could be a valuable tool in the field of medicine, allowing patients to better communicate symptoms, concerns, and other clinically relevant information, argue a Massachusetts General Hospital (MGH) physician and others. In a commentary in the Journal of the American Medical Association, senior author Shuhan He, MD, an emergency department attending, suggests that each medical discipline begin discussions around the creation of its own unique set of iconography for official adoption and incorporation into everyday practice."The need to listen to patients is at the core of our mission as physicians, and the use of emoji is a great opportunity to take communication to another level," says He, who is director of growth for the MGH Center for Innovation in Digital HealthCare and a member of MGH's Lab of Computer Science. "Emoji could be particularly important in treating children with still-developing language skills, people with disabilities that impair their ability to communicate, and the many patients who speak a different levitra online coupons language."Emoji (which means "picture character") originated in Japan over a decade ago and today an estimated five billion are used daily on Facebook and Facebook Messenger alone.

While around 3,500 emoji are currently within the domain of the Unicode Consortium -- the nonprofit organization that maintains text standards across computers and which must approve every emoji before it can be digitally used -- only about 45 emoji can be considered relevant to medicine. The first, introduced in 2015, were the syringe levitra online coupons and the pill. In 2017, Apple added emoji to represent people with disabilities, followed by symbols of the stethoscope, bone, tooth and microbe in 2019.

He was co-creator of the anatomical heart and the lung emoji introduced globally in 2020 and is now working with co-authors Debbie Lai and Jennifer levitra online coupons 8. Lee, who are active in the field, as well as with a wide range of medical societies and organizations to advocate for an additional 15 medically related emoji."It's tempting to dismiss emoji as a millennial fad, but they possess the power of standardization, universality and familiarity, and in the hands of physicians and other health care providers could represent a new and highly effective way to communicate pictorially with patients," says He. In emergency medical settings where time is critical, emoji could lead levitra online coupons to a point-and-tap form of communication that could facilitate important clinical decisions, he adds.

The tiny graphic symbols which now span all digital platforms -- from mobile to tablet to desktop -- could also have utility as annotations to hospital discharge instructions, which are often confusing if not incomprehensible to some patients.In addition, the recent growth of telemedicine could be a rich opportunity for emoji to make medical inroads. The interactive platform is seen as particularly well suited for patients to transmit to health care providers visual information that charts the intensity of pain they have experienced over a period of days, weeks or months, and for those providers to make levitra online coupons it part of the patient's digital health record for ongoing treatment.He is continuing his research to better understand how emoji could help patients and doctors communicate common symptoms -- such as mobility, mood, and duration and quality of pain - that are associated with various diseases and conditions. "It's clear that emoji have become part of the global, mainstream conversation, and that medical societies and physician committees and organizations need to take them seriously," says He.

"Which means they should be determining now which emoji would best serve the interests of their patients, building consensus around the medical accuracy of these emoji, then working to get them approved through the global standard-setting body and working through the long adaptation and implementation process."Co-author Jennifer 8 levitra online coupons. Lee is founder of Emojination, a grassroots group that has led successful campaigns for over 100 new emoji over the past five years. Co-author Debbie Lai is chief operating officer of the Act Now Coalition, levitra online coupons a nonprofit that provides visualizations of data on erectile dysfunction treatment and climate change.

Story Source. Materials provided levitra online coupons by Massachusetts General Hospital. Note.

Content may be edited for style and length.Tiny brains-in-a-dish that mimic the major levitra online coupons pathological features of Parkinson's disease have been made for the first time. The research, led by scientists from the Agency for Science, Technology and Research (A*STAR)'s Genome Institute of Singapore (GIS), the National Neuroscience Institute (NNI) and Duke-NUS Medical School, published in the Annals of Neurology, offers a new way to study how the degenerative brain disease progresses and explore possible new treatments.Parkinson's disease is a common age-related neurodegenerative disorder affecting three in 1,000 Singaporeans aged 50 years and above. Worldwide, neurological disorders are the leading cause of levitra online coupons disability, and Parkinson's disease is the fastest growing disorder.

Prior research has mostly relied on mice, which do not reproduce all major pathological features seen in patients."Recreating models of Parkinson's disease in animal models is hard as these do not show the progressive and selective loss of neurons that produce the neurotransmitter dopamine, a major feature of Parkinson's disease," said Professor Ng Huck Hui, Senior Group Leader at GIS, A*STAR, who is a senior co-author of the study. "Another limitation is that experimental mouse models of Parkinson's disease do not develop characteristic clumps of proteins called Lewy bodies, which are often seen in the brain cells of people with Parkinson's disease and a type of progressive dementia known as levitra online coupons Lewy body dementia."The team decided to turn to human mini-brains that they created previously."We called these 'human midbrain-like organoids'," said first author Dr Junghyun Jo, previously a Research Fellow at GIS and now a Principal Investigator at the Okinawa Institute of Science and Technology Graduate University. "They are essentially three-dimensional, multicellular, in vitro tissue constructs that mimic the human midbrain."The small pea-sized human midbrain-like organoids are grown from human stem cells into a bundle of neurons and other cells found in the brain.

The organoids levitra online coupons enable scientists to study how the human brain develops and communicates."These experiments are the first to recreate the distinctive features of Parkinson's disease that we see only in human patients," said Associate Professor Hyunsoo Shawn Je, a senior co-author from the Neuroscience and Behavioural Disorders Programme at Duke-NUS. "We have created a new model of the pathology involved, which will allow us to track how the disease develops and how it might be slowed down or stopped."By manipulating the DNA of the starting stem cells to match genetic risk factors found in patients with Parkinson's disease, the study scientists were able to grow organoids with neurons that showed both Lewy bodies and the progressive loss of dopamine-producing neurons."It's a major challenge to extend healthy living years in an ageing global population, whose physical and cognitive performance often declines due to neurodegenerative disorders," said Professor Tan Eng King, Deputy Medical Director, Academic Affairs, at NNI, a senior co-author of the study. "This discovery levitra online coupons provides insights and a 'humanised' disease model that can facilitate drug testing against Parkinson's disease and dementia.

Our organoid model with a genetic mutation on the GBA gene is also highly relevant as we have several of these genetic mutation carriers locally."The organoid system will enable research into Parkinson's disease and other conditions not possible with current animal models. The team is already using organoids to investigate levitra online coupons why and how Lewy bodies form in human brain cells, and screen drugs that can potentially stop disease progression. Story Source.

Materials provided by Duke-NUS Medical levitra online coupons School. Note. Content may be edited for style and length.Stepping patterns become slower and more variable if a person is uncomfortable with their surroundings, researchers have found.Scientists at the levitra online coupons University of Bristol have discovered that people who felt more at ease in urban environments had as regular stepping patterns as folk who felt relaxed walking in nature.The findings, published in PLoS One, show that rather than being a quality exclusive to natural environments, the key factor of an environment is how comfortable people feel in it and that defines how beneficial it is for wellbeing.

This means that a well-designed urban environment can be similarly beneficial for concentration and attention as natural surroundings.Lead author Daria Burtan of Bristol's School of Psychological Science said. "Measuring the changes of a person's walking patterns through an environment allows us to understand their experienced comfort on a moment-to-moment basis.""This is an important step toward being able to objectively quantify the impact of particular architectural designs on people's wellbeing."Scientists have previously shown that spending time in green spaces such as parks helps improve attention spans, concentration and wellbeing which can be shown by improvements in measured stepping patterns when walking in different environments.Daria added. "As our cognitive faculties begin to decline in older age, the stepping patterns we make with our feet become slower and more variable, relative to when we are younger in the prime of our health levitra online coupons.

We found that the same thing happened when people walked toward images of urban and nature scenes they didn't feel comfortable with -- their stepping patterns became slower and more varied, relative to when they were looking at scenes they found comfortable and which they liked. ""Not only does this suggest that environments in which we levitra online coupons feel comfortable and safe, place fewer processing demands on our brains. It demonstrates how measuring the real-time dynamics of our gait provides us with a powerful new tool for informing on the cognitive impacts of architecture and urban design."The researchers are now looking to understand which psychological factors contribute to sensory discomfort.

Story Source levitra online coupons. Materials provided by University of Bristol. Note.

Content may be edited for style and length.Neuroblastoma is a type of childhood cancer that develops in infants and young children. Whilst it is a relatively rare form of cancer, it is still responsible for approximately 15 percent of all cancer deaths in children. In a new study published today in Nature Communications, researchers at Karolinska Institutet in Sweden have discovered that low-risk and high-risk neuroblastoma have different cell identities, which can affect the survival rate.Neuroblastoma often starts in the sympathetic nervous system or the adrenal glands.

This cancer has a high variability in outcome, ranging from spontaneous regression and complete disappearance to relentless disease progression with very few treatment options.The child's age at the time of diagnosis is one of the most important prognostic factors for a favourable outcome. However, the importance of age is a question that has previously been left unanswered."In our research we have studied single cell sequencing in healthy adrenal tissues from fetuses, babies and older children, and compared this to tumor tissue from different neuroblastoma risk groups," says Susanne Schlisio, associate professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet in Solna, and co-corresponding author of the study.Different cell types with different malignancy potentialsTumor tissue samples have been collected from children where the age at diagnosis ranged from less than a month to 6,5 years. Approximately 50 percent of the tumors were classified as high-risk and 50 percent as low-risk.

advertisement "We discovered that low-risk and high-risk neuroblastoma tumors are composed of different cell types. The different cell types also showed to have a different malignancy potential," explains Susanne Schlisio.The research group were able to match low-risk neuroblastoma to a cell type, which grows during the development of the fetal adrenal, while aggressive high-risk neuroblastoma matched a cell type that can only be found in children's adrenal tissue after birth.Analyses of these cell types also revealed different gene expression programs that control the conditions for survival in correlation with age at diagnosis. Furthermore, the study shows that the cell type found in the adrenal tissue of children after birth has the characteristics of a progenitor cell, a form of a stem cell, which can develop into specialised cell types."These specialised cells can help to regenerate the healthy tissue after birth, but when they become abnormal and cancerous they may also be responsible for the aggressive neuroblastoma.

This would explain why high-risk neuroblastoma arises in older children, and cannot be seen in fetuses or very young babies, says Oscar Bedoya Reina, the study's first author and assistant professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet in Solna.Increased understanding can contribute to less malignant tumorsThe researchers will now expand their study in order to understand how the identified progenitor cell type further changes after birth to create specialised cell types."Understanding this progenitor cell type in detail, we might be able to make predictions and preliminary validations for future therapy strategies based on tumor differentiation. Discovering pathways that can lead to childhood tumors being less malignant will be important for the development of treatments that are currently non-existent for high-risk neuroblastoma, concludes Susanne Schlisio.At the end of 2020, another study in the same field conducted by the Schlisio group, was published in the journal Cancer Cell.The current study has been funded with grants from, among others, the Swedish Research Council, the Swedish Childhood Cancer Fund, the Swedish Cancer Society, Knut and Alice Wallenberg Foundation, the Paradifference Foundation and ERC Synergy grant (project "Kill-or-differentiate").Psychiatric and cognitive symptoms emerge at an early stage in Huntington's disease. However, research so far has mainly focused on movement impairment, a symptom associated with the more advanced stages of the disease.

A new study from Lund University in Sweden now shows that the emotional brain -- the limbic system - is affected earlier in the course of the disease, and should therefore be given more attention in the development of new treatments.Huntington's is a fatal illness with no treatment to slow its course. The new research findings provide knowledge about where the early changes take place in the brain. This is important for the development of new treatments which, according to the researchers, should target the earliest disease-related changes."Our results show that the emotional brain is affected at an early stage, and that this can contribute to the development of psychiatric and cognitive symptoms, which are the most difficult for the patients and their relatives.

It is not only nerve cells that are affected, but also other cells, oligodendrocytes, which enable communication between different parts of the brain, that are affected early in the course of the disease," explains Åsa Petersén, professor of neuroscience at Lunds University and senior consultant in psychiatry at the Huntington Centre in Lund.Huntington's disease is caused by a known genetic mutation that results in the production of a protein known as mutant huntingtin in all the cells of the body. However, only certain cells are very sensitive to the protein mutation and these are in specific areas of the brain."It is still a mystery why certain cells are sensitive to the protein mutation and why the disease starts to break out at a certain time, even though it was there all along. However, our study shows for the first time that changes in the oligodendrocytes in the emotional brain are expressed in the brains of individuals suffering from Huntington's disease," says researcher and first author of the study, Sanaz Gabery.The researchers believe that previous research focused too much on the typical movement impairments associated with Huntington's disease and the link to effects on the movement control centre."The emotional brain and cells other than just nerve cells are affected by the development of Huntington's disease.

The nerve-fibre system in the emotional brain is already reduced before the typical movement impairments emerge. The changes consist of damage to myelin, i.e. The insulation system in the white matter of the brain, which is important for information transfer, and an effect on genes that are important for oligodendrocytes' identity and function," explains Åsa Petersén."Today, many researchers are focused on reducing the levels, and thereby the effect, of the disease-inducing mutant huntingtin in the nerves cells and in the brain's movement control centre.

But our findings indicate that there is also a need to examine the white matter in the emotional brain. Why are oligodendrocytes sensitive to mutant huntingtin?. Is it possible to slow down Huntington's disease by affecting the changes that we have identified?.

" Story Source. Materials provided by Lund University. Note.

Content may be edited for style and length..

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Epinephrine doses of 0.01 mg/kg and 0.03 mg/kg were compared and flush volumes of 1 mL or 3 mL were compared in randomised purchase levitra online canada groups. Epinephrine was repeated at the same dose every 3 min until return of spontaneous circulation. The higher dose of epinephrine was more effective than the lower dose and, with either dose, the response was better after purchase levitra online canada the higher flush volume. The higher flush volume may be more effective at ensuring that the drug gets as far as the right atrium. See page F578Thermal management immediately after birth with and without servo-controlFrancesco Cavallin and colleagues performed a randomised controlled study in 15 Italian tertiary hospitals.

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They studied infants with levitra online coupons estimated birthweight <1500 g or gestation <30+6 weeks. In one group manually adjusted thermal control was provided during initial stabilisation, with the heater set on full. In the other group servo control was used. There were 450 levitra online coupons infants in the study. There was no difference in the rate of normothermia (temperature 36.5–37.5 C) at the time of neonatal unit admission.

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See page F572Osteopathic manipulative treatment to improve breast feedingIt is unusual for the Fetal and Neonatal Edition to receive a trial of a complimentary therapy. Osteopathic manipulative treatment (OMT) has been used to treat various health issues, including breastfeeding levitra online coupons difficulties. Marie Danielo Jouhier and colleagues performed a double blinded randomised controlled trial. Mother baby dyads levitra online coupons were eligible if there was suboptimal breastfeeding behaviour, maternal cracked nipples or maternal pain. The intervention consisted of two sessions of early OMT.

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As with so many areas of current practice, the evidence is weak in many areas. It is useful levitra online coupons to learn more about the hypothetical risks and benefits of newer preparations and to have knowledge gaps and research priorities identified so clearly. See page F676Treatment thresholds in extremely preterm infants in the UKFollowing the publication in 2019 by the British Association of Perinatal Medicine of professional guidance for the perinatal management of birth before 27 weeks of gestation, Lydia Mietta Di Stefano and colleagues surveyed UK health professionals to determine the lowest gestation at which they would now be willing to offer active treatment to an extremely preterm infant at parental request and the highest gestation at which they would agree to withhold treatment. The majority of respondents were willing to offer active treatment from 22+0 weeks. The highest gestation at levitra online coupons which respondents would offer palliative care at parental request was 23+6/24+0 weeks for 59% of those surveyed (n=172).

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