English 105 Spring 2017

Introduction to Composition and Rhetoric

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Discovering the Mystery Behind Autism

Brain-Scans-Autism

Friendship Circle — Special Needs Blog. 2013 May 5 [accessed 2017 Feb 19]. http://www.friendshipcircle.org/blog/2013/05/06/3-studies-that-show-the-benefits-of-an-early-diagnosis-of-autism/

There is a mystery behind may things in life especially those about the health of human beings. Many diseases and disorders affect humans, some we know what causes them and some we have no clue why they occur. One disorder, in particular, is autism. Autism, or Autism Spectra Disorder (ASD), is a disorder caused by an abnormality in the brain that affects more than 3.5 million Americans (Facts and Statistics). This disorder usually causes individuals to have difficulties in communication and performing everyday social skills. Although autism and ASD are often used interchangeably, Autism Spectra Disorder is treated as an umbrella term that contains any abnormality in the brain that hinders it from acting accordingly in the social and communication realms (Facts and Statistics). When observing autistic children, it may be easy to categorize behaviors and characteristics similarly. Although most people think that all behavioral characteristics, like being violent, pertain to all individuals with autism it is important to remember and to think of ASD as an umbrella term. With a variety of characteristics comes many reasons for why a person can get diagnosed with the disorder. Many neurological abnormalities  can occur and cause ASD because of this; researchers are working on finding out the exact cause of the disorder.

For decades, researchers have been searching for the causes of ASD and how it determines behavioral characteristics (Anderson, George M.). Although the source is unknown, it has been found that ASD effects more men than women. Because diversity comes naturally in the research field, different routes have been taken to better understand ASD. For example, Shantel E. Meek of Arizona State University and her colleagues approached the process of understanding the origins of the disorder by discussing a conceptual model. The role of the conceptual model that was created is to explain “how gene-environment correlation…function in the context of social development in individuals with autism (Meek, Shantel E., et al.)” With this approach the researchers focus on genes that are associated with parts of the brain, the striatum and the amygdala, that control social behaviors (Meek, Shantel E., et al) . Genes play a major role in physical and mental growth because they contain DNA that has the blueprint to a person. By keying in on these regions, they were able to point out four genes that may play a role in social development. The oxytocin receptor gene made in the hypothalamus, arginine vasopressin also produced in the hypothalamus, and dopamine receptors one and two (Meek, Shantel E., et al). With these detected genes, researchers were able to connect their possible relationships with genetic influence on behavior patterns such as visual orientation and eye contact.

There is rarely a similarity in characteristics,  because there are many factors that work differently to create different behavior patterns for each person. In the environmental side of the conceptual model, created by the researchers above, external and internal factors are discussed that can possibly effect the social development of a child. Internal factors that are crucial for social interactions are self-motivation and interest. A study found that autistic children, are less likely to interact with other children, this more than likely is due to a lack of interest. External environmental factors, like how parents raise their children and other factors,  may affect social behaviors of a developing child. Based off the information provided it is easier to understand why behavioral characteristics of autistic people or people with ASD cannot be seen as similar. It is important for researchers to understand and analyze multiple characteristics of ASD before discovering its cause.

Another route to figuring out the mystery on what causes autism spectrum disorder involves using biomarkers. A biomarker can be defined as a biological measure that differs across groups or is associated with some aspect of a condition (Mandal, Ananya). In short it can be thought of as an indicator of some sort that can give a clue on a human’s condition. With the use of biomarkers, the goal is that reasons behind how or why different behaviors occur is discovered.  Biomarkers that have been used in research include oxytocin, immune measures, placental research, omic research, serotonin, melatonin, and oxidative stress/Redox status. Melatonin is a hormone made in the pineal gland that control your sleep.  Serotonin is a very important neurotransmitter in the body that can affect social behavior and more (Mclntosh, James). These markers play crucial roles and have impacts on the brain and social developments for children. For example, oxytocin, a necrohormone produced in the brain’s hypothalamus, plays a large role in “social learning and affiliative behavior in animals and humans (Anderson).” It has been said that oxytocin plays a role in helping eye coordination or the focus of an eye. Figuring out exactly how to use the biomarkers to finddisparities between autistic individuals and control groups is a hurdle the researchers must get over. The disparities that researchers are looking for are differences in the biomarkers when comparing both groups. If there is a large enough difference of  a particular biomarker then, more or less of it may lead to ASD. Let us take serotonin into consideration.  Although it is a neurotransmitter that has been of interest in autistic research, there have been troubles with determining observations and what certain concentrations and conditions intel.  By understanding the importance of biomarkers and how they correlate to social behaviors, researchers will bring themselves closer to figuring out what exactly causes autism.

After further studies, in the next upcoming years, scientist will hopefully not only discover what causes autism but also why it affects its victims differently. In addition, it will also be very beneficial if scientists figure out how to prevent the disorder or how to treat. If that is accomplished then there will be one less mystery to be discovered in the medical field.

 

Works cited:

Anderson, George M. “Autism Biomarkers: Challenges, Pitfalls and Possibilities.” Journal of Autism and Developmental Disorders, vol. 45, no. 4, 2015., pp. 1103-1113 ProQuest Central, http://libproxy.lib.unc.edu/login?url=http://search.proquest.com/docview/1664734680?accountid=14244.doi:http://dx.doi.org/10.1007/s10803-014-2225-4.

Facts and Statistics. Autism Society. 2015 Aug 26 [accessed 2017 Feb 19]. http://www.autism-society.org/what-is/facts-and-statistics/

Mandal, Ananya. What is a Biomarker? 2014 Oct. 7. News Medical Life Sciences http://www.news-medical.net/health/What-is-a-Biomarker.aspx

Mclntosh, James. Serotonin Facts: What does Serotonin Do? Medical News Today.  http://www.medicalnewstoday.com/kc/serotonin-facts-232248

Meek, Shantel E., et al. Psychological Review: A Review of Gene-Environment Correlations and their Implications for Autism. 120 Vol. American Psychological Association, 07/01/2013. Web. 26 Jan. 2017. http://vb3lk7eb4t.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+Review+of+Gene-Environment+Correlations+and+Their+Implications+for+Autism&rft.jtitle=Psychological+Review&rft.au=Meek%2C+Shantel+E&rft.au=Lemery-Chalfant%2C+Kathryn&rft.au=Jahromi%2C+Laudan+B&rft.au=Valiente%2C+Carlos&rft.date=2013-07-01&rft.pub=American+Psychological+Association&rft.issn=0033-295X&rft.eissn=1939-1471&rft.volume=120&rft.issue=3&rft.spage=497&rft.epage=521&rft_id=info:doi/10.1037%2Fa0033139&rft.externalDBID=n%2Fa&rft.externalDocID=rev_120_3_497&paramdict=en-US

 

The Effects of Sleep Deprivation

Most people assume that they are getting a healthy amount of sleep. However, research has shown that every year the percentage of sleep-deprived Americans increases. Sleep deprivation has been shown to cause many unhealthy side-effects that, if allowed to affect an individual for an extended period, can bring about a much less fulfilling and successful life both at home and at work. In this paper, I will argue that information regarding the effects of sleep deprivation must be made more available to the public and held in higher regard in the business world.

The term “sleep deprived” refers to an individual who does not get any sleep for at least one night. This paper will be focused on “partial sleep deprivation,” which refers to an individual who sleeps for less than seven hours per night . In order to test the effects of sleep deprivation on different cognitive processes, a study was done comparing a group of subjects undergoing partial sleep deprivation with another group of subjects that received seven hours of sleep per night. All participants in the study were required to take multiple tests at the same time every morning. Those who were sleep deprived performed similarly to those in the control group on the logical reasoning tests, however they performed significantly worse on the innovative and strategic thinking tests.

The sleep deprived were observed to be irritable and incapable of controlling their emotions when compared to those who got enough sleep. These individuals displayed signs of increased hostility, difficulty in holding back from lashing out, and impulsive decision-making. The pre-frontal cortex, which is responsible for managing emotions, is thought to be impaired by sleep deprivation which is likely the reason for such behavioral instability. These effects are damaging not only to those directly experiencing them but also to coworkers and family members. A sleep-deprived employee will not be capable of performing to his maximum capacity and will thus not be as beneficial and friendly to his coworkers as he could be. A sleep deprived family member will be more irritable and thus will be more likely to handle complicated family issues and conflicts in a more confrontational manner. Also, the difficulties brought about by sleep deprivation get worse over time.

These effects are discussed more specifically in this video.

The number of hours slept is not the only variable of sleep that has an effect on one’s health and happiness. The time at which people typically wake up also has a strong correlation with their level of success. A study was done in which individuals who sleep the same amount of time per night but who fall asleep and wake up at different times showed that those who go to bed earlier on average earn four to five percent higher incomes than those who go to bed late and wake up late. Thus, being an evening person who goes to bed late and wakes up late in combination with getting less than seven hours of sleep per night could be detrimental to one’s health and success.

The dangerous effects of sleep deprivation are becoming more relevant every year. According to the National Sleep Foundation, the number of Americans who get less than 6 hours of sleep per night has increased from 13 to 20 percent from 1999 to 2009. As Americans work more hours per day on average, they have less time to sleep and thus can become sleep deprived. In fact, the average work week for American workers has increased from forty hours per week to forty-seven in the past decade. Furthermore, it has been proven that both men and women get even less sleep when they have children and a spouse. Due to this, in 2009 a fifth of the American workforce was suffering from sleep deprivation.

In conclusion, more and more Americans are suffering from the harmful effects of sleep deprivation such as decreased self-control, impaired strategic thinking, and irritability. These effects can have a negative impact on one’s life both at work and at home, potentially damaging the potential for many to be successful. Furthermore, the number of Americans affected by sleep deprivation is on a strictly upward trend, meaning every year it becomes more important for individuals to consider the number of hours they can sleep per night when making decisions regarding employment or anything else that involves a significant time commitment. In order to slow or stop the current trend, information regarding the impact on productivity by sleep deprived workers should be made common knowledge among employers.

Is Artificial Skin Better Than Real Skin?

Artificial Skin Prosthetic

Photo from Korea

It is easy to take something for granted when that something is attached to your body. If you were out in the snow one day and grabbed some snow with your gloves on you wouldn’t feel it but if you were to take the gloves off, then you would feel the cold and wetness of the snow. One can feel it because of the nerves in your skin that rush to the brain to tell yourself it is cold and wet. Skin is so innocuous that oftentimes we forget that it is there. Its purpose is to not just cover the body but to also tell the brain when someone or something is touching or pressing against you.

One’s sense of touch is highly overlooked. Most people assume that the sense of touch is a common characteristic and it is, but there are some people who are not able to sense touch due to the loss of a limb or serve burn. They are similar to those who keep their gloves on when touching snow because they don’t actually feel it. In An Artificial Skin Based on Optoeletronic Technology, a study for electronic devise to sense pressure and heat, has shown that there are many people who use silicon prosthetics are unable to regain the ability to feel when someone is touching them like they were able to before. However, there are sensors being developed to give them that ability. Although artificial skin may not feel or look completely like real skin, it is being developed to be able to function as if it was real skin.

The brain is always communicating with the nerves to make us feel objects or other people. However, there can be a defect between the brain and nerves. For instance, when one has lost a limb or has been brutally burned they lose the ability to sense touch. This is because either they have lost their limb completely or have too much nerve damage that leaves them with the only option of using prosthetics. Prosthetics can only do but so much. At least that is what we choose to believe.

Now, there is a new discovery–artificial skin. According to Ximena Wortsman and Nelson Navarrete in Two-Dimensional and Three-Dimensional Ultrasound of Artificial Skin, a patient with artificial skin can regain their sense of touch using special sensors. This silicon skin coats the prosthetics mimicking exactly what your arm or leg would look like if it was still there. Navarrete and Wortsman developed a material that can heal the wounds, while acting as a prosthetic (2016). They wanted to not just make a functional body part, but allow people to feel another’s presence on a prosthetic arm or leg. The silicon would cover the prosthetics with sensors implanted in it to be able to feel pressure. These sensors can be most commonly related to the sensors in smartphones because of the multi-touch technology.

Artificial Hand Prosthetic

Photo from engadget

Those who have prosthetics whether it be an arm or a leg are able to move it anyway a normal person can because of the stretchable silicon across the mechanical limb. In the 2014 report by Sensors and Actuators, specified that the silicon contains paper thin chips that cause electronic signals to run through the artificial skin making it sensitive to pressure. These signals are carbon nanofibers– tiny tubes of carbon that are extremely conductive to electricity- and when pressed they send out electric impulses allowing one to know how hard and what circumferences someone is touching. To get the complete sensation of normal skin the electronic pulses must be connected to nerve cells. Navarrete and Wortsman addresses a similar sensor would need to be attached to the outside of the brain that would help code for the missing nerve cells (2016). It would send impulses to the brain whenever the electrical impulses were disrupted in the area of the artificial skin.

The sensors have been recognized to be precise when responding to contact forces. This is seen when the sensors were placed in a silicon prosthetics of many individuals to be tested. The outcome of this test astonished Scientist A. Cirillo, P. Cirillo, G. De Maria, C. Natale, and S. Pirozzi because each individual was able to sense touch (2014). A major component of artificial skin was the connection of a sensor to the brain because without it being attached individuals were unable to sense touch. Many tests have been done to show the the qualities of the sensors. The 2014 report, by Sensors and Actuators, presented that the sensors features were “availability of a pressure map—coverage of the artificial skin, discrimination of multiple contacts—sense a variety of pressures, estimation of a force vector for each sensing module—overall amount of force one can feel, and estimation of force resultant for each contact area—sensitive to touch in specific areas ”. All these things endure together to bring back someone’s sense of touch. This discovery still has further progress to make.

Artificial Skin Silicon

Photo from memiocall

At this present time, artificial skin is able to give someone back their sense of touch but now are working towards making the prosthetic physically similar. This will include making artificial skin look and feel like real skin. This is something that has not been accomplished but with the past progress of artificial skin it shows nothing but potential. As for Navarrete and Wortsman, they are going to continue their research on artificial skin to make it even more compatible with real skin for those who have prosthetics (2016).

 

References

Artificial Skin. Digital Image. Stretchable Artificial Skin Can Give Prosthetics the Sense of Touch. 10 December 2014.   Web. 12 February 2017. https://www.engadget.com/2014/12/10/stretchable-artificial-skin/

Artificial Skin. Digital Image. Artificial Skin Sensitive As the Human Skin. 25 April 2016. Web. 12 February 2017. https://memiocall.com/artificial-skin-sensitive-human-skin/

Artificial Skin. Digital Image. Artificial Skin Can Sense Heat, Pressure. 16 December 2014. Web. 18 February 2016. http://www.korea.net/upload/content/editImage/Artificialstkin_L1.jpg

Cirillo, A., Cirillo, P., De Maria, G., Natale, C., & Pirozzi, S. (2014). An Artificial Skin Based on Optoelectronic Technology. Sensors and Actuators A: Physical, 212, 110-122. http://www.sciencedirect.com.libproxy.lib.unc.edu/science/article/pii/S0924424714001551?np=y&npKey=8932462059a286e33a331ceb0598447c104158d7433b2b9afdf47f4711093187

Navarrete, N., & Wortsman, X. (2016). Two-Dimensional and Three-Dimensional Ultrasound of Artificial Skin. Journal of Ultrasound, 36, 225-230. http://onlinelibrary.wiley.com.libproxy.lib.unc.edu/doi/10.7863/ultra.16.02027/full

 

A College Student’s Worst Nightmare

A College Student’s Worst Nightmare

 

            The trance of indulgence; the coma of delectation; the utopia of the unconscious; the ultimate bliss. Within these four facets resides, perhaps the most significant and vital aspect of the college lifestyle. Ironically enough though, it can also be the most detrimental. It can become our greatest downfall. With it comes something that we, as human-beings, spend over a third of our entire lifetimes doing. With it, comes something that our bodies cannot physically live without; something that we innately crave; something that, if we were to even merely attempt to live without, would ravage our precious minds and completely eradicate our very existence.

The “anomaly” being marveled at here is sleep.

The sensation being referenced that could potentially lead to the complete and utter mental dilapidation of someone is sleep’s long-time foe, sleep deprivation.

Sleep is not a recommended function, in fact, it is an imperative function. One cannot physically or mentally function properly after extended periods of sleep deprivation.

 

 

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Sleep deprivation is a common occurrence for college-aged students, but more alarmingly, voluntary sleep deprivation is its most frequently practiced form. “Voluntary sleep deprivation” is simply when one partially deprives themselves of sleep during the week and then attempts to compensate for their lack of sleep by sleeping in later on the weekends. As June Pilcher and Amy Walters write in their article titled “How Sleep Deprivation Affects Psychological Variables Related to College Students’ Cognitive Performance”, “This pattern of sleep deprivation and rebound becomes more pronounced around examination periods, sometimes resulting in 24 to 48 hours of total sleep deprivation.” This generates an increase in daytime sleepiness (feeling sleepy during the day), which decreases the student’s ability to pay attention during class, and it negatively affects their ability to perform well on their exams.

Daytime sleepiness reduces academic achievement and learning, but also impairs behavioral performance. One suggestion for this is that the prefrontal cortex (the part of the brain responsible for coordinating and adjusting behavior, for handling emotions, for focusing and organizing attention, and for prioritizing simultaneous and competing information) is affected by insufficient amounts of sleep. “Sleep is a time when brain activity for restoration of neurocognitive functioning takes place (Dewald, Meijer, Oort, Kerkhof, & Bögels, 2010 ).” The insufficient amount, the disruptions in, and the lapses of sleep that can occur will lead to the impairment of behavioral, physiological (relates to the normal functions of living organisms and their body parts), and neurocognitive (relates to the processes within the brain that help us think) processes, which are critical for our learning capacities and our academic performances.

 

Effects of Sleep Deprivation:

With the development of poor sleeping patterns and sleep deprivation in general, comes a whole slew of negative consequences. It is well established that sleep deprivation can lead to noticeable decrements in performance levels (primarily in cognitive, or mental, functioning), but decreases in attention spans and lapses in one’s abilities to focus may also occur. In addition to these impacts, the issues faced by those who are sleep deprived may range anywhere between mood irregularities, abnormal behavioral patterns, and increased risk of serious injury. Oftentimes these issues derive from a delayed sleep-wake cycle, which combats the natural, biological flow of one’s circadian rhythm (one’s own personal sleep/wake or body clock).

Common sleeping problems for college-aged students and adolescents to develop are DSPT (delayed sleep phase type), which is simply the “delay of circadian rhythms”, or when individuals fall asleep and wake up at consistent, but exponentially later times. Sleep apnea, which is the interruption of breathing during sleep, is also a sleeping problem in which college-aged students are prone to acquiring.

A lack of sleep, whether stemming from intrinsic (natural) factors or extrinsic (coming from outside) factors, affects one’s behavior and leads to increased difficulty of processing correctly. It also reduces academic achievement and one’s overall ability to learn. This lack of sleep can be most attributed to early school-starting hours, which forces teenagers to lose quality sleeping time; and also forces them to perform well academically during their least productive time of day. It is consistently illustrated in reviews that sleepiness during the day dramatically affects academic performance.

Sleep deprivation can have a major influence on the quality of one’s life. Poor sleeping patterns are often associated with the leading causes for increases in unhealthy behavioral choices, for increases in emotional or mood disorders, and for increases in substance abuse. Adolescents and young adults account for over 50 percent of serious, fall-asleep motor vehicle accidents. The demands of college also put a burden on adolescents and young adults who are entering it. Many “hop on board” the “stimulation-sedation loop cycle,” meaning that many consume caffeine or other stimulants to stay awake during the day, and then proceed to use depressants at night to counter the influences of the stimulants. It is also worth noting that well above 50 percent of adolescents who are entering drug rehabilitation programs, have self-medicated themselves to try to manage their schedules more efficiently.

 

 

 

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Treatment Options:

As for treatment options, practicing good sleep hygiene, working on circadian rhythm management, and utilizing white noise are listed as the most effective combatants to sleep deprivation. Sleep hygiene practices can include anything from avoiding late-afternoon naps, avoiding the use of alcohol or stimulants before bed, avoiding caffeine, and refraining from doing anything too active right before going to sleep. Circadian rhythm management is simply going to bed and waking up at the same time every day. All of these, strategies though, can improve the quality and quantity of one’s sleep.

If good sleep hygiene is ineffective, then several other methods may have to be approached. Nurses must first assess for an underlying medical or sleep disorder before proceeding to anything further though.

  • Psychotherapeutic (resynching of the circadian rhythm) practices may be suggested. This involves delaying sleep times by 3 hours every day over a 5-day period.
  • Psychopharmacological (branch of psychology concerned with the effects of drugs on the mind and behavior) practices may be suggested. This involves the administration of melatonin, which is a hormone that plays a key role in controlling one’s circadian rhythm by inducing sleep.
  • A dual-treatment approach may be suggested. This is simply combining melatonin administrations at night with bright light in the morning. Gradually, the time of treatment for both options will increase about 15-30 minutes every few days.
  • Psychiatric, family, pediatric and advanced practice nurses should also evaluate for sleep disturbances. This includes anxiety, depression, and somatic pain among others.

 

Cessation:

While sleep can certainly feel like heaven and reinvigorate our bodies and minds, it can be our (adolescents and young adults) worst nightmare. We fail to recognize the impact that sleep plays on the quality of our lives. Without sleep, our mind doesn’t function properly; our body doesn’t function properly; our attention span constricts; our reaction times deteriorate; our abilities and performances dwindle. Our quality of life simply languishes before our eyes. Sleep just may be, perhaps, the most significant aspect in life and the blueprint to all future successes.

 

Sources utilized and works cited:

Marhefka, Julie King,R.N., M.S.N. “Sleep Deprivation: Consequences for Students.” Journal of Psychosocial Nursing & Mental Health Services, vol. 49, no. 9, 2011., pp. 20-25 ProQuest Central, http://libproxy.lib.unc.edu/login?url=http://search.proquest.com/docview/887977636?accountid=14244.doi:http://dx.doi.org/10.3928/02793695-20110802-02.

Dewald J F , Meijer A M , Oort F J , Kerkhof G A , Bögels S M , (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14, 179—189, http://libproxy.lib.unc.edu/login?url=http://search.proquest.com/docview/887977636?accountid=14244.doi:http://dx.doi.org/10.3928/02793695-20110802-02

Pilcher, June J., PhD., and Amy S. Walters M.A. “How Sleep Deprivation Affects Psychological Variables Related to College Students’ Cognitive Performance.” Journal of American College Health, vol. 46, no. 3, 1997., pp. 121-126 ProQuest Central, http://libproxy.lib.unc.edu/login?url=http://search.proquest.com/docview/875111673?accountid=14244.

A Surgery that Worsens a Patient’s Health

Have you ever gone for a long run and said to yourself, “Wow, I feel so out of shape! My heart is beating like crazy!”? This is a daily struggle for people with damaged valves. The human heart is divided into four sections (called chambers), and each chamber has a valve that acts as a bridge for blood to enter and leave the heart to and from other parts of the body. When one valve is damaged, blood cannot flow into and out of the heart as effectively as it needs to, resulting in shortness in breath and an over-working heart.locations and names of the four heart valves

As years go on, the number of people with damaged heart-valves continues to increase. Heart-valve replacement surgeries are very common throughout the world; there are about 300,000 valve-replacement surgeries annually worldwide. Doctors have been unable to find the best way to perform this surgery that will give people the most favorable outcome post-surgery. Since the 1960s, around the time that heart valve-replacement surgeries began, the quest to find this “perfect” strategy has been far from easy. Doctors have attempted different strategies, and although none of them have been uniformly the best strategy for all patients, doctors continue to grow closer towards the most successful one.

The Quest for the Universal Strategy

Heart-valve replacement surgeries have tended to hurt the health of patients rather than improve health. For example, the most commonly used strategy for performing valve-replacements is not safe for most elderly patients. This strategy requires the work of a cardiopulmonary bypass machine (an instrument that takes over the job of the heart and lungs during surgery), which can place a lot of stress on a patient’s body. Elderly patients usually cannot undergo this surgery because of the amount of stress the surgery will place on them.

Younger patients are better suited for a different strategy, valve repair. The majority of younger patients have small tears in valves and do not need to go through a surgery that is very invasive to their body. Valve repair offers the option of repairing the valve torn rather than replacing it with an entirely new valve. While this is beneficial to younger patients, there are many older patients that have too large of tears in their valves which would make a valve-replacement the only option for them. Valve repair downsizes the number of eligible patients overall, making it a poor universal strategy. Since none of these surgery options are very compatible with the majority of the patient’s health, doctors began trying to place a small tube, called a catheter, which works on both younger and older patients. This strategy does not harm the body as much as previous strategies, and for the most part, this option is considered to be the best yet.

How Helpful is Medicine?

Another strategy that is intended to improve the life of patients with damaged valves is the use of medicine. Warfarin, for example, is an anticoagulant (an agent that can prohibit blood from clotting) used amongst the majority of patients in need of heart-valve replacement. When someone has a damaged valve, the healthy valves must compensate for the work the damaged valve loses. This can result in atrial fibrillation (a condition where the heart beats irregularly and quickly), and a common side effect of atrial fibrillation is blood clots. Patients use anticoagulants such as Warfarin to control their blood flow so that their blood doesn’t clump together and form a blood clot.

Although Warfarin is successful in controlling blood flow, major complications have risen from the use of Warfarin. Intracerebral hemorrhages (ICH), strokes that are caused when there is bleeding in the brain, have been linked to the use of warfarin and, in general, is a major side effect of anticoagulation. To develop a deeper understanding of the relationship between anticoagulants and conditions such as ICH, different studies have been conducted. One specific study observed the outcomes of patients with prosthetic valves that develop ICH’s.Scan/graphic image of intracerebral hemorrhage

This computer-based study was based off of 38 patients with a prosthetic valve and ICH. Data was pulled randomly through the hospital’s database. Twenty-five of the patients had mechanical prosthetics valves and thirteen had bioprosthetic valves. Of these 38 patients, 31 of the patients were taking warfarin once admitted into the hospital. Results showed that eight patients of the 38 suffered hematoma enlargement, which is when the blood clot caused by ICH enlarges, four patients had an ischemic stroke (an obstruction in the blood vessel blocks blood, prohibiting the blood to get to brain), and three patients developed other hemorrhagic complications. Even though anticoagulation has proven to worsen the patient’s health, the patient must continue to use anticoagulation post ICH for his/her prosthetic valve. Without the continued use of anticoagulation, the risk of complications increases significantly.

Is there any Hope?

In the midst of searching for a universal strategy, a new issue became associated with strategies for performing heart-valve replacements. Doctors are now concerned with the fact that the prosthetic valve cannot grow with the patient as he/she grows. This greatly increases the risk of death for patients. Heart-valve replacement surgeries do not show preferable out-comes but rather complications that worsen the life-expectancy of the patient. The need for a more life-protecting surgery continues to increase, and some doctors believe one might be around the corner.

formation of TEHV from patient's own cells.

For about 30 years, scientists have created a different kind of prosthetic valve that can grow with the patient, and this invention has been improving each year. Tissue is used to create a prosthetic valve, often called TEHV (tissue engineered heart valve), and this tissue can regenerate and grow as the patient grows. Since TEHV is still fairly new, complications such as the valve degrading and the occurrence of inflammation arises frequently. As years of research continues, scientists have been able to practice using different materials that will help improve the quality of this tissue generating valve.

Currently, there are still many different things to be considered before releasing the TEHV strategy into the world for use. This prosthetic valve contains living cells, which makes it difficult to classify into a product group. The FDA and other regulating companies need to be able to produce regulations on this product before TEHV can be bought by biomedical companies. Also, for TEHV to be used regularly in practice, the handling/transportation, sterility, and overall care of the prosthetic valve must be improved. Although this new invention has not been tested enough to be approved for human surgery, this new strategy for heart-valve replacement surgery shows promise that will help about 300,000 worldwide live longer and healthier lives with their much healthier heart.

Planet Nine: Our Solar System’s Greatest Mystery

Planet 9 was recently discovered as a possibility earlier this year, sparking interest in the minds of astronomers and science enthusiasts alike. Two researchers at Cal-Tech hypothesized that there might be an object out in the universe with a gravitational pull strong enough to alter the orbital inclination of the trans-Neptunian objects, those far away asteroids and planets way past the orbit of Neptune and Uranus. Christoph Mordasini, a physicist at the University of Bern, and Esther Linder, an astrophysicist at the Physikalisches Institut in Bern, Switzerland, took to unearthing the thermodynamic evolution (basically just how the planet came to be, and what characteristics it might possess) surrounding this phenomena, formatting mathematical equations in hopes to find more about the massive object on the outskirts of our Solar System, and made some important findings. The magnificence behind their conclusions, which includes the relative luminosity (how bright an object in the sky is) and albedo (how the planet reflects light) of the planet, comes from the fact the planet itself has yet to be discovered. According to the article, there is a scenario (due to the unknown nature of the planet, different scenarios were run in their calculations in terms of what the components were) that the planet could be self-luminous, meaning that even in the absence of a central light source the planet could create glow on its own. This is important information, as it could help identify the planet from the other objects surrounding it.

In one of the simulations, they composed Planet 9 of 50% ice and 50% rock, similar of that to the composition of Neptune. This changes the results found, as the albedo (how light is reflected) is directly correlated to the make-up of a planet. The goal behind finding the albedo is to ultimately find the luminosity of the object. Luminosity is calculated by using the area of the star and multiplying it by the radius squared, and the temperature raised to the fourth power (4πr2σT4). By completing these hypothetical equations and findings, they can then set telescopes to eliminate all objects in the sky that aren’t the desired luminosity, making it much easier for the object to be correctly identified. One of the most prominent issues being discussed with this finding is figuring out exactly where the planet is on its orbital path. The distance from the perihelion, which is when the planet is closest to the orbit star, and to the aphelion, the furthest point from the orbit star, can be upwards of 1200 AU (astronomical unit, 1 AU is equal to the distance from the Sun to the Earth, around 93,000,000 miles). How bright an object is must be determined with distance in mind; a flashlight appears brighter when it is closer to you, and the same can be said for stars. The reasoning behind these calculations is to hopefully remove some of the possibilities on which light in the sky is the planet, which further expedites the discovery process.

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Artist rendering of Planet Nine. http://www.sciencealert.com/planet-nine-might-have-caused-the-solar-system-s-tilt

An issue with the planet theory is that due to the unfathomable size of space, it is nearly impossible to discover planets at these distances. Just to put it into perspective, if we were to take the size of the Sun and make it the diameter of an orange, Pluto would be the size of a grain of sand, and over 1,460 miles away! In order to make the impossible more manageable, Dr. Michael Brown and Konstantin Batygan from Cal-Tech looked to limit the constraints from a distance standpoint. In order to do this, they calculated the averages of different characteristics of all Kuiper Belt Objects, which is a collection of asteroids and metals arranged in a circumstellar disk beginning from Neptune and extending about 50 AU (1 AU is about 93 million miles, or the distance from the Earth to the Sun) out into space. From their findings, they concluded that Planet 9 must have a mass between 5 and 20 Earth masses, that it is approximately inclined at a 30-degree angle in its orbit, and at its closest distance it should be around 150 AU away, and its farthest around 980 AU. With such large parameters of orbit, the mass and orbit inclination is far more useful. Unfortunately, it seems as if the Planet recently left its perihelion (closest point to us), and is headed farther away as we speak. This means that progress needs to be made quickly, as we could soon lose it to the abyss of empty space. By combining the findings that Mordasini and Linder found with that of Brown and Batygan, the job of finding the once nonexistent became a much easier task. Soon we could discover the planet altering our Solar System, and from there we could learn much more about the space around us. Planet 9 is not simply a question to be answered, it is a pathway to more advanced questions, and better understanding.

In a Q&A with Mike Brown, Konstatin Batygin, and Elizabeth Bailey, questions regarding the importance and influence of Planet 9 are answered.

 

What Does the Future Hold for Corneal Transplants?

If perfected, the invention of synthetic and biomedically engineered corneas could have a major influence on the field of ophthalmology.

For patients suffering from severe corneal diseases, which can lead to blindness if left untreated, corneal transplants are considered an effective form of treatment. Corneal disease is one of the leading causes of blindness in the world and affects millions of people globally each year (Elisseeff, Madrid, Lu, Chae, & Guo, 2013). Research suggests that the number of corneal transplants needed each year will only grow as aging populations increase and donor cornea supplies decrease. In 2010, a study conducted in the Ukraine indicated that only 511 corneal transplants were performed despite the fact that 4,000 donor corneas were needed. The gap was caused by diminishing supplies of donor tissue and an increase in the number of cases involving transplant rejections, which occur when an individual’s immune system attacks and destroys the transplanted organ (Elisseeff, Madrid, Lu, Chae, & Guo, 2013). Luckily, the growing field of biomedical engineering provides endless possibilities for those who suffer from vision problems and corneal disease. Even now, many people, including my grandmother, are benefiting from the development of synthetic corneas.

Synthetic keratoprosthesis, a procedure that replaces diseased corneas with artificial ones, may provide the first step towards this future. While there are various types of keratoprosthesis with differing designs and prognoses, most artificial corneas are made up of synthetic polymers or plastics fused with corneal tissue. According to many ophthalmologists, a type of keratoprosthesis, called the Boston KPro, is viewed as a gold standard for all other types of synthetic corneas, because a majority of people who receive Boston KPro transplants can noticeably see a difference in their quality of vision.  Retention rates regarding the acceptance of the Boston KPro are also relatively high. One study suggests that the retention rates of the Boston KPro are typically 84 percent when examined over the course of about 17 months.

[Mohamed Fathy Oraby]. (2016, June 2). boston keratoprosthesis. [Video File]. Retrieved from https://www.youtube.com/watch?v=VGqh6aA_8CY

Nesta Ramazani, my 84-year-old grandmother, serves as further evidence that Boston KPro can drastically change one’s vision for the better. After my grandmother had four failed corneal transplants, she received a Boston KPro last March in hopes of restoring her vision. Before receiving the Boston KPro, my grandmother was practically blind in her right eye; now her vision is perfect in that eye. Additionally, my grandmother is less likely to need surgery in the future, because the chance of corneal rejection is lower in patients who receive the Boston KPro than patients who undergo corneal transplants (Ramazani, 2017).

While artificial corneas provide patients with many benefits, there are still many problems that must be addressed. According to my grandmother, she must return to the ophthalmologist’s frequently for check-ups, because problems with artificial corneas can advance more quickly than corneal transplants. She also has a permanent contact that can only be replaced by the ophthalmologists, which can be cumbersome when her vision becomes blurry due to the accumulation of particles, such as dust, on her contacts. Furthermore, most Boston KPro patients, including my grandmother, have to use multiple steroid and antibiotic eye drops each day (Ramazani, 2017). For these reasons, many ophthalmologists believe tissue-engineered corneas, rather than artificial corneas, would benefit people with corneal diseases more.

original_Layers_of_the_cornea

Cornea [Digital image]. (n.d.). Retrieved February 19, 2017, from http://www.corneatexas.com/cornea-disease

Tissue-engineering involves the regeneration or repair of organs through the use of cells, scaffolds, or growth factors.  According to Matthew Giegengack and Shay Soker, the cornea is a good candidate for biomedical engineering, because it contains only a few types of cells and it is avascular, which means it doesn’t contain any blood vessels. By having relatively few cell types, it is easier to reconstruct corneas biomedically compared to other more complex organs. Most biomedically engineered corneas are made up of various collagen proteins. These collagen proteins are critical to the structure and function of the cornea and compose a large portion of the stroma, which is one of the thickest corneal layers.

The importance of collagen regarding the construction of the cornea is evident in a recent study performed in the Ukraine, which gave three patients tissue engineered corneas comprised of collagen and synthetic phospholipids. All three of the patients were over fifty years old and were experiencing problems associated with corneal diseases, including pain and blindness. Two of the patients were experiencing problems due to burns, while the other patient was experiencing problems due to corneal rejection (Buznyk et al., 2015). According to the study, vision improved and pain and discomfort decreased in two of the three patients (Buznyk et al., 2015).  These positive results indicate that tissue engineered corneas may be more effective than corneal transplants with regards to patients suffering from pathologies, such as burns, transplant rejection, and autoimmune disease.  Additionally, a cost-minimization analysis was performed, suggesting that the production of tissue-engineered corneas is less expensive than donor corneas.

While more research needs to be done to create artificial eyes that can perfectly mirror the functionality of human eyes and to diminish the problems associated with artificial and tissue engineered corneas, my grandmother’s story provides hope for a future in which there are no more rejections.

References

Buznyk, O., Pasyechnikova, N., Islam, M. M., Iakymenko, S., Fagerholm, P. and Griffith, M. (2015), Bioengineered Corneas Grafted as Alternatives to Human Donor Corneas in Three High-Risk Patients. Clinical And Translational Science, 8: 558–562. doi:10.1111/cts.12293

Elisseeff, J., Madrid, M., Lu, Q., Chae, J., & Guo, Q. (2013). Future perspectives for regenerative medicine in ophthalmology. Middle East African Journal of Ophthalmology, 20(1), 38-45. doi:http://dx.doi.org/10.4103/0974-9233.106385

Giegengack, M., & Soker, S. (2013). Constructing the cornea: Hopes and challenges for regenerative medicine. Expert Review of Ophthalmology, 8(3), 209-211. doi:http://dx.doi.org/10.1586/eop.13.20

(N. Ramazani, personal communication, January 25, 2017).

Tan, T., Peh, G. S. L., George, B. L., Cajucom-Uy, H., Dong, D., Finkelstein, E. A., & Mehta, J. S. (2014). A cost-minimization analysis of tissue-engineered constructs for corneal endothelial transplantation. PLoS One, 9(6) doi:http://dx.doi.org/10.1371/journal.pone.0100563

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