#Cell Reports Physical Science

[pillarsalt]

hi! i was wondering your opinions on how hrt affects the body? i hold a lot of radfem beliefs but i am trans (taking testosterone). would being a woman to you have to be completely about chromosomes? for example, trans men years on T do not have the same genetic makeup as cis women. same with trans women on E, their genetic makeup would be very different to cis men, and would more correlate to cis women. does this factor in who you consider female/male or having experience as women?

Hi there, thanks for reaching out.

Firstly, I think you may be a bit confused. Taking exogenous hormones does not affect your genetic makeup. Your dna will stay the same unless you're exposed to something extreme like radiation - this is a good thing because dna mutation is bad for you and causes cancer! Your genetic sex is immutable, a person with XY chromosomes cannot have their dna altered to have XX chromosomes instead.

Hormones will affect the expression of your genes, for example turning on facial hair production in women who are taking testosterone. This is why those patterns of facial hair, even in women, differ from person to person. The genes for it were already there, but hormone replacement therapy uses the endocrine system to change what signals get sent to your genes to tell them what features to express.

Beyond chemically induced genetic expression, there are particular physical features in males that do not occur in males, and vice versa. This is a feature of the /ancient/ evolution of sexual reproduction. Despite the variety of metaphysical beliefs about identity and personhood, the truth is that humans evolved to reproduce between two sexes, and human beings cannot change sex. Every cell of your body has your sex encoded within it. This affects us physically in many ways. I and most feminists believe that this fact should be irrelevant to any person's ability to pursue their passion, be themselves, and love who they love. Even so, recognition of biological sex is something important. This is really critical in a medical context. For example: men who receive a blood transfusion from a pregnant or recently pregnant woman have an increased risk of death by transfusion-related lung injury. Another example: tracheostomy tubes differ in size depending on sex due to dimorphism in average tracheal diameter. A women who is reported as a male risks considerable injury by having a male sized tracheostomy tube forced into her windpipe. A considerable amount of medications differ in dose effectiveness and side effects based on biological sex. Something as straightforward as a heart attack has different symptoms depending on if the patient is female or male. Denial of biological sex is dangerous, and as it stands, medical science has not advanced enough to change the biological sex of an individual. If you are born male, you will stay male for your entire life. You say that a transwoman who has taken estrogen is more genetically similar to a woman, I'm sorry but that simply isn't true. A male person will always be more genetically similar to other males than to a female person.

Determination of sex is very simple, it's about the easiest genetic test to do. They have kits for high school classrooms to try out ffs. We need to leave the "meaningful sex change is possible through medical intervention" thing in the past, all we accomplish with that is giving people false hope and an unattainable goal to fixate on. Sex is real and immutable, I wish it didn't matter, but it does.

And why it matters is, maleness and femaleness have become inseparable from certain stereotypes and assigned qualities by societies in human history. Overwhelmingly, the male people subjugate the female people. Since men, male humans, discovered womens' ability to give birth could be taken advantage of, it was capitalized upon. And this is the foundation of patriarchal society. Religions were founded to justify this as the will of god. To deny that women have historically been persecuted due to their sex is, well, misogynistic. There is no "woman feeling" that makes us targets for child marriages, FGM, trafficking/prostitution, and other horrors from the minute we're born and even before. No, it's the sex we were born with that makes the world think it can decide our fate. In fact, the way that people treat male children differently from female children is so different so early, that we are genuinely unable to study human behaviour unaffected by gendered expectations. This is what feminists are talking about when they discuss "socialization". There is not a single man on the planet who knows exactly what it's like to see the world from a woman's eyes, no matter how feminine that man is. Womanhood isn't something you can achieve or acquire through effort: you were either born a woman or you weren't, just like you were either born with detached earlobes or not. It's so simple.

All that to get to my final point: Yes, I believe the definition of womanhood comes down to biology, because anything beyond that is a meaningless stereotype. Women can do anything, be anyone, look any way they want, go through any experience they do. The one thing they have in common is that they are female adult human beings. There is not way to fail at being a woman or do it wrong, you just are. Womanhood is the experience of having been a female person in this world, and nothing else. There are certain things only female human beings need, like abortion and female contraceptive rights, access to spaces where we can be safe from our subjugators (male human beings), and the ability to define ourselves and fight for our collective rights.

(At this point you may object and point out that male people who identify as trans women are also subject to violence and scorn from men: unfortunately that is often the case, but this does not make male people who identify as women, well, female. We need solutions for them that do not involve requiring women to sacrifice our comfort and safety for the sake of a particular subset of men, because of the inherent risks involved and the fact that women do not owe men anything even when those men have it bad.)

One last thing: my opinion is that prescribing exogenous cross-sex hormones is unethical (so are all elective cosmetic medical procedures but that's a post for a different day). I understand the distress that gender dysphoria inflicts on people, however the ill effects of hrt are too numerous to condone. The huge increase in risk of stroke with estrogen, heart disease and uterine atrophy with testosterone, and the way that trans medicine studies are notorious for losing followup with patients after a year or less... it's short sighted and frankly, financially motivated. The amount of trans patients who are prescribed hormones without access to an endocrinologist, it's honestly infuriating. People deserve the best care possible, not lab rat bullshit where they cut you loose when it's not working out. I won't judge anyone for what they do to themselves to cope with distress, but I want everyone, especially girls, to be aware of the lifetime effects medical decisions may have, and that you also can find happiness within yourself without hurting your body.

Thanks again for your question, be well ✌️

[materialsscienceandengineering]

Researchers discover new mechanism to cool buildings while saving energy

With temperatures rising globally, the need for more sustainable cooling options is also growing. Researchers at UCLA and their colleagues have now found an affordable and scalable process to cool buildings in the summer and heat them in the winter. Led by Aaswath Raman, an associate professor of materials science and engineering at the UCLA Samueli School of Engineering, the research team recently published a study in Cell Reports Physical Science detailing a new method to manipulate the movement of radiant heat through common building materials to optimize thermal management. Radiant heat, which is felt whenever a hot surface warms our bodies and homes and is carried by electromagnetic waves, travels across the entire broadband spectrum at ground level between buildings and their environments, such as streets and neighboring structures. On the other hand, heat moves between buildings and the sky in a much narrower portion of the infrared spectrum known as the atmospheric transmission window. The difference in how radiant heat travels between buildings and the sky versus the ground has long presented a challenge to cooling buildings with less skyward-facing surfaces. These buildings have been hard to cool in the summer as they retain heat from the ground and neighboring walls when the outside temperature is high. They are equally difficult to warm in wintertime as the outdoor temperature drops and the buildings lose heat.

Read more.

[mindblowingscience]

University of Central Florida College of Medicine researcher Renee Fleeman is on a mission to kill drug-resistant bacteria, and her latest study has identified a therapy that can penetrate the slime that such infections use to protect themselves from antibiotics. In a study published in Cell Reports Physical Science, Fleeman showed that an antimicrobial peptide from cows has potential for treating incurable infections from the bacterium Klebsiella pneumoniae.

Continue Reading.

[wumblr]

cell reports physical science

[junosmindpalace]

Hey please may I ask for dr.stone Gen and Hyoga with a s/o who got badly injured, then being protective perhaps ❣️

thank you for your request! manga spoilers for hyoga’s part- i hope that’s alright!

warnings: blood, stabbing

Though impressed by Gen’s betrayal of the Tsukasa Empire, Hyoga wouldn't allow him to get away with it. He needed to be reminded of the might they had, that they were no fools.

And so when he remembers a comment Gen had made about a certain villager when reporting back to the Tsukasa Empire, he immediately knows how he wants to deliver that reminder.

As if the situation couldn’t have gotten any worse with Hyoga’s attack on the Kingdom of Science, he revealed that his ambush was merely a distraction as his right hand Homura set fire to Ishigami Village. To deal the final blow on not only the double crosser himself but the rest of the villagers, Hyoga caught you when you were off guard staring in horror at the sight of your home being burned down and stabbed you with his spear. As the others dealt with fending off Homura, Hyoga and his men, Gen and the other villagers stayed behind to help tend to your massive stab wound. Suika had run off in an effort to lure the group away from the village, giving the villagers the opportunity to take care of you without having to be on guard. Senku called out some instructions to Gen on how to help with your wound until he got back before running off after Suika with Kohaku. Through shaky hands, Gen immediately got to work. 

He was relieved when Senku later did a proper assessment of your condition and assured him that you’d eventually recover. Though horribly wounded, your condition was similar to Gen’s from when he’d been stabbed. 

Gen knew better than anyone the pain you were in, being victim of one of Hyoga’s spear assaults himself. It was tremendous, and you were weak in every sense. Just watching you in your frail state made all those feelings wash over him again, and his guilt was just as immense.  

He watches you throughout your entire recovery. When you manage to feel well enough to talk, he talks your ear off. He tries to take your mind off your inability to move and redirect your focus to more lighthearted matters, whether it be the Kingdom of Science’s progress in creating cell phones or his magic tricks. Gen’s company helped you pass the time instead of spending it basking in your agony. 

When you’re entirely healed, he teaches you some of his own tricks to self defense, such as his fake blood bags, to help keep you even the slightest bit safer in the future. He’s nervous to have you involved in any battles after that, especially against the Tsukasa Empire, but he knows it's unavoidable and that you’ll want to fight. So though he can’t physically protect you himself, he does what he can to keep you safe in the ways he knows how. 

In future conflicts, despite his fear, he still puts a protective arm in front of you and tries at all cost to manipulate the battle away from you, so you could stay clear of danger for as long as he could control it.

The Kingdom of Science was backed into a corner- or so the enemy thought. It just so happened that Senku purposely chose the room Hyoga was being held in on the Perseus, and he just so happened to have the last remainder of revival fluid to use on him. Being in the tricky situation they were in, Senku was left with no other option. 

As Hyoga emerged from his stone stature and took hold of Kinro’s spear, he surveyed his new surroundings. He quickly understood the dilemma the Kingdom of Science faced and searched for you within the panicked group. His eyes landed on yours, shocked and doubtful, with the slightest sliver of guilt. From the very beginning you had sided with Senku, disgusted over your friend’s cruel vision for the new world and what he was willing to do to bring it to fruition. Having to help take down someone you were so close to hurt your heart, but for the sake of others, you did what had to be done. On the surface, it was as if Hyoga had no room in his seemingly miniscule heart for you anymore, but your dedication was true and your means of protecting others impressive. 

Which is why when he was torn between siding with Moz or the Kingdom of Science, his eyes settled on you almost tauntingly, cold steel gaze pinning a sort of blame on you. 

But then his eyes trailed downward.

You were hunched over and holding your shoulder with your opposite hand, blood seeping down your arm and all over your fingers and the palm of your hand. You looked tired, presumably from the excessive loss of blood and the need to keep moving in order to stay safe. Yet you stood with your friends once again, not letting yourself submit to Moz’s wrath. 

And so Hyoga lunged forward with the golden spear toward Moz, and a fierce battle between the two spearsmen ensued. Senku’s risky “wild card” paid off in the end, as Hyoga was eventually able to bring Moz to his knees and force him to surrender.

His strength and skill is just as admirable as ever, was your final thought before the loss of blood caused you to pass out near the end of the battle. 

When you woke, you were met with the sound of incoherent talking and the familiar walls of the Perseus bunker. You slowly blinked as your eyes adjusted to the sight of Senku and Hyoga talking over your body, serious looks etched into their faces and tones as you started to comprehend their words.

“...no longer has any affiliation with me. Even then, your Kingdom of Science wouldn’t resort to such violent means.”

“And we have no way of knowing you won’t do the same.”

“I see aiding you in your battle was a mistake.”

As you shifted in your bed, both pairs of eyes snapped toward you in surprise. Hyoga’s eyes widened at the same time Senku smirked. “Good morning, sleeping beauty. Feeling well rested?” 

You yelped as you attempted to prop yourself up on your injured arm, and Hyoga quickly forced you back to lie down. “Think before you act, you fool.” 

His sharp gaze returned to Senku as he narrowed his eyes. “I will look over Y/N alongside you. Whether I have your permission or not doesn’t matter to me.”

Senku shrugged. “I have no problem with that so long as you’re serious.” 

An agreement was reached. Hyoga would take over Senku’s place in monitoring your recovery in order for Senku to focus on the next steps the Kingdom of Science should take. Like that, Hyoga had joined the Kingdom of Science. 

You did a lot of catching up while under his care. What had you been doing while he was petrified? What was the Kingdom of Science working toward now? What other injuries had you sustained? Why the hell weren’t you more careful? There was a conflicting mix between care and resentment in his questions and comments, the contrast between each putting you on edge. You didn’t know exactly where you stood with Hyoga, and his dual responses made it difficult to deduct where he stood on the matter.

It had to be somewhere neutral, because why else would he be so insistent on looking out for you? Why would he constantly put you down for your mistake if there wasn’t some part of him that still cared about you? Why was he so quick to shield you from the other members of the Kingdom of Science? Why did his eyes hold such strong resentment when you told him of the way Moz hurt you? 

In a strange way, you almost felt the need to thank Moz, because you were able to reunite with an old friend and rekindle feelings of something more.

[mortumslab]

My first attempt at Fanfic for the Fallen Hero universe. I am a science nerd in healthcare, so I'd like to try the first Dr. Halabi note as a SOAP (physician) note at Dr. Mortum's facility for my Sidestep (Arya).

Arya, as Retribution, is an anarchist set on justice and has been revealed to the Rangers, but Sky-Raider got her out before any of the Rangers could make a move.

__________________________

Note: These records are for internal use ONLY. Disclosure of these forms will be met with swift recourse.

Date: 5-10-21 

Facility: Mortum Site 01

Patient #: 2344

Patient Name: Arya Skovsgaard

Gender: Female (She/Her)

Attending: Dr. Halabi, MD

CC: Traumatic MVA

HPI:

Arya Skovsgaard is a 30 y.o. AFAB transferred to Site 01 two days following a motor vehicle accident. Per LDPD reports, the patient was restrained, and airbags were deployed. The patient appeared to be driving down the opposite lane on a two-lane highway and struck an oncoming truck. The larger truck was undamaged, but the vehicle the patient was driving was no longer operable. The patient is a known telepath (T12345678), Alpha level. She is known to be capable of operating other individuals through telepathy. The patient was transferred from the care of the Los Diabolos’ Rangers prior to arrival at Site 01. Previous to this, they were at Memorial Hospital under the care of another, unknown physician, wherein lower extremity injuries were treated. The patient chart was consulted prior to transfer. During their stay at this facility, the patient was discharged to inpatient care with a bilateral tibial fracture along the mid-diaphyseal line and a right femoral fracture at the mid-epiphyseal line. Lastly, physicians at the Ranger facility note left SI joint disjunction. It is not known if the accident was intentional, but the Ranger discharge notes allude to this as a possibility. For this reason, the patient will be under constant security detail. 

HPI is incomplete due to the current AMS.

ROS:

Patient arrived to facility in a state of alterted mental status leading to an incomplete ROS

Head: Positive for trauma

ENT: Negative for dental trauma

MSK: Grossly apparent damage to bilateral lower extremities

Integumentary: Positive for abrasions, lacerations, ecchymosis

Psych: Altered mental status

Neuro: Loss of consciousness

Physical Exam:

Physical exam from Dr. Petroza at time of surgery and reconstruction is included as a separate document. Below is Dr. Halabi’s secondary PE upon admission to Site 01.

Head: Trauma noted to bilateral orbitals. Ecchymosis around orbitals with classic appearance of trauma.

Neck: No trauma noted

Lymph: No abormalities noted.

Musculoskeletal: See diagram. Dr. Petroza and team applied bilateral leg casting to patient from femural head distally to ankle. Difficult to assess. Otherwise noted 

CV: No murmurs, rubs, gallops. Normal rate, rhythm. 

Respiratory: Some wheezing. Imaging from Ranger HQ shows no pneumothorax. Brusing to ribs, possibly due to CPR on scene.

GU: No abnormalities noted

Integumentary: Diffuse ecchymosis and bruising to regions visible, patient has [REDACTED] on skin noting them to be [REDACTED].

Psych: Unable to assess

Neuro: Unable to assess. Known telepath.

Assessment:

Agreement with prior disagnosis of bilateral tibial fracture along the mid-diaphsyeal line and right femoral fracture at the mid-epiphyseal line with protrusion from the medial right femur and bilateral media tibia.

Dipostion:

Inpatient discharge.

Progress notes:

5-20-21

2320: Call recieved that patient is en route.

5-21-21

0023: Patient arrives to Site 01.

0024: Dr. Halabi, attending, in room and performing phyical exam. 

0100: Patient woke briefly and [REDACTED] attacked them - they were removed from the premises. Security was tightened on the room.

0300: Patient awakens and requests food. Dr. Mortum in room and discussion plan with patient.

0800: Phone call received on patients cell phone from number listed “Julia.” Voicemail left. 

TRANSCRIPTION: “Arya, I know you’re out there. I… I’m glad. We’ll talk when you’re ready. I know you don’t want me to be around for this - but we need to talk. I want to help. I had some time to think… you might not have gone about this in the way I would have expected, but I think you have the right idea. Please call me. I love you.”

0830: Patient requesting discharge to their home. The Site will send her with an escort.

Electronic Signature:

Dr. Halabi, MD

This report is to remain within Site 01. If it is found outside of these servers, it should be destroyed, and the aforementioned party should be warned.

[religion-is-a-mental-illness]

My name is Dr Jill Simons. I'm a board-certified pediatrician and the executive director for the American College of Pediatricians. Today I'm here alongside my colleagues representing the Coalition of co-signers of the Doctors Protecting Children Declaration. Our coalition consists of physicians together with nurses, behavioral health clinicians, other health professionals, scientists, researchers and public health and policy professionals. And we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.

This declaration was authored by the American College of Pediatricians, but really it was developed from the expertise of hundreds of doctors researchers and other healthcare workers and leaders wh, for years have been sounding the alarm on the harmful protocols that continue to be promoted by the medical organizations in the United States. Despite recent revelations from the leaked WPATH Files and the recent release of the final report from the Cass Review, these medical organizations have not changed course.

So, we are calling on these medical organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, the American Medical Association, the American Psychological Association and the American Academy of Child and Adolescent Psychiatry to follow the science and their European colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex.

In our declaration, we affirm that sex is a dimorphic, innate trait defined in relation to an organism's biological role in reproduction: male and female this genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions. Consideration of these innate differences is critical to the practice of good medicine and to the development of sound policy for children and adults alike. Medical decision-making should be based upon an individual's biological sex. It should respect biological reality and the dignity of the person by compassionately addressing the whole person.

We are here defying the claims made by these medical organizations in the US that those of us who are concerned are a minority and that their protocols are consensus. They are not consensus, and we are speaking in a loud unified voice: enough.

[ Full press conference: https://youtu.be/C2tU90XPFlg ]

--

Doctors Protecting Children Declaration

As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.

We affirm:

1. Sex is a dimorphic, innate trait defined in relation to an organism’s biological role in reproduction. In humans, primary sex determination occurs at fertilization and is directed by a complement of sex determining genes on the X and Y chromosomes.  This genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions

2. Consideration of these innate differences is critical to the practice of good medicine and to the development of sound public policy for children and adults alike.

3. Gender ideology, the view that sex (male and female) is inadequate and that humans need to be further categorized based on an individual’s thoughts and feelings described as “gender identity” or “gender expression”, does not accommodate the reality of these innate sex differences. This leads to the inaccurate view that children can be born in the wrong body. Gender ideology seeks to affirm thoughts, feelings and beliefs, with puberty blockers, hormones, and surgeries that harm healthy bodies, rather than affirm biological reality.

4. Medical decision making should not be based upon an individual’s thoughts and feelings, as in “gender identity” or “gender expression”, but rather should be based upon an individual’s biological sex. Medical decision making should respect biological reality and the dignity of the person by compassionately addressing the whole person.

We recognize:

1. Most children and adolescents whose thoughts and feelings do not align with their biological sex will resolve those mental incongruencies after experiencing the normal developmental process of puberty.

Desistance is the norm without affirmation as documented by Zucker in his article “The Myth of Peristence”. (1) Zucker, KJ. The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender nonconforming children” by Temple Newhook et al. International Journal of Transgenderism. 2018: 19(2), 231–245. Published online May 29, 2018.http://doi.org/10.1080/15532739.2018.1468293 [1]

In the “largest sample to date of boys clinic-referred for gender dysphoria,” there was a desistance rate of 87.8%. (2) Singh D, Bradley SJ and Zucker KJ. A Follow-Up Study of Boys With Gender Identity Disorder. Front Psychiatry. 2021;12:632784. doi: 10.3389/fpsyt.2021.632784

The pro-affirmation Endocrine Society Guidelines (2017) admit: “…the GD/gender incongruence of a minority of prepubertal children appears to persist in adolescence.” (3) Hembree, W., Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline J Clin Endocrinol Metab. 2017; 102:1–35.

A longitudinal study from the University of Groningen in the Netherlands followed 2772 adolescents (recruited from a psychiatric clinic) from age 11 years through 22 – 26 years. “In early adolescence 11% of participants reported gender non- contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26).” Even in this psychiatric patient study group for which interventions were not addressed, but “gender affirmation” is most likely, gender non-contentedness (essentially gender noncongruence) decreased substantially from early adolescence to young adulthood.(4) Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5

2. Responsible informed consent is not possible in light of extremely limited long-term follow-up studies of interventions, and the immature, often impulsive, nature of the adolescent brain. The adolescent brain’s prefrontal cortex is immature and is limited in its ability to strategize, problem solve and make emotionally laden decisions that have life-long consequences.[2]

3. Sex-trait modification or “Gender affirming” clinics in the United States base their treatments upon the “Standards of Care” developed by the World Professional Association for Transgender Health (WPATH). However, the foundation of WPATH guidelines is demonstrably flawed and pediatric patients can be harmed when subjected to those protocols.

The two Dutch studies that form the foundation for treatment guidelines as documented in the WPATH “Standards of Care” guidelines version 7 (SOC 7) had serious flaws.[3]

These studies did show that the appearance of secondary sex characteristics in adolescents and young adults could be changed by hormonal and surgical interventions, but they failed to demonstrate meaningful long-term improvement in psychological well-being.

Scientific concerns with these studies also include a lack of a control group, small sample sizes, significant numbers of patients lost to follow up, and the elimination of patients who experienced significant mental illness from entering the studies.

It is concerning that the Dutch studies did not address complications and adverse outcome in the adolescent cohort that underwent transition. These complications included new onset diabetes, obesity and one death.[4]

4. There is now sufficient research to further demonstrate the failure of the WPATH, American Academy of Pediatrics and Endocrine Society protocols.

The Cass Review was released on April 10, 2024, as an “independent review of gender identity services for children and young people”. The following points are from Cass’s final report:[5]

Commissioned by the National Health Service (NHS) England, and chaired by Dr. Hilary Cass, the 388-page report utilized systematic reviews, qualitative and quantitative research, as well as focus groups, roundtables and interviews with international clinicians and policy makers.

As part of the evaluation, they reviewed the research on social transition, puberty blockers, and cross-sex hormones.

Social transition

“The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence.

However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.”

Puberty blockers

“The systematic review undertaken by the University of York found multiple studies demonstrating that puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression. However, no changes in gender dysphoria or body satisfaction were demonstrated [emphasis added].”

“There was insufficient/inconsistent evidence about the effects of puberty suppression on psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk or fertility.”

“Moreover, given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinizing/ feminizing hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.”

Cross-sex hormones

“The University of York carried out a systematic review of outcomes of masculinising/feminising hormones.” They concluded, “There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up. No conclusions can be drawn about the effect on gender dysphoria, body satisfaction, psychosocial health, cognitive development, or fertility.”

“Uncertainty remains about the outcomes for height/growth, cardio-metabolic and bone health.”

The Cass Review further stated, “Assessing whether a hormone pathway is indicated is challenging. A formal diagnosis of gender dysphoria is frequently cited as a prerequisite for accessing hormone treatment. However, it is not reliably predictive of whether that young person will have longstanding gender incongruence in the future, or whether medical intervention will be the best option for them.”

A 2024 German systematic review on the evidence for use of puberty blockers (PB) and cross-sex hormones (CSH) in minors with gender dysphoria (GD) also found “The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn’t suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD.”[6]  

5. There are serious long-term risks associated with the use of social transition, puberty blockers, masculinizing or feminizing hormones, and surgeries, not the least of which is potential sterility.

Youth who are socially affirmed are more likely to progress to using puberty blockers and cross-sex (masculinizing or feminizing) hormones.

“Social transition is associated with the persistence of gender dysphoria as a child progresses into adolescence.”[7]

“Gender social transition of prepubertal children will increase dramatically the rate of gender dysphoria persistence when compared to follow-up studies of children with gender dysphoria who did not receive this type of psychosocial intervention and, oddly enough, might be characterized as iatrogenic.”[8]

Puberty blockers permanently disrupt physical, cognitive, emotional and social development.

Side effects listed in the Lupron package insert include emotional lability, worsening psychological illness, low bone density, impaired memory, and the rare side-effect of pseudotumor cerebri (brain swelling).[9]

A coalition of physicians and medical organizations from around the world submitted a petition to the Commissioner of the U.S. Food and Drug Administration requesting urgent action be taken to eliminate the off-label use of GnRH (growth hormone) agonists in children.[10]

Testosterone use in females and estrogen use in males are associated with dangerous health risks across the lifespan including, but not limited to, cardiovascular disease, high blood pressure, heart attacks, blood clots, stroke, diabetes, and cancer.[xi],[12]

Genital surgeries affect future fertility and reproduction.

6. A report from Environmental Progress released on March 4, 2024, entitled “The WPATH Files” revealed “widespread medical malpractice on children and vulnerable adults at global transgender healthcare authority.”[13]

“The WPATH Files reveal that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along.”

“Members are fully aware that children and adolescents cannot comprehend the lifelong consequences of ‘gender-affirming care’ and, in some cases due to poor health literacy, neither can their parents.”

In addition, developmentally challenged and mentally ill individuals were being encouraged to “transition”, and treatments were often improvised.

7. Evidence-based medical research now demonstrates there is little to no benefit from any or all suggested “gender affirming” interventions for adolescents experiencing Gender Dysphoria. Social “affirmation”, puberty blockers, masculinizing or feminizing hormones, and surgeries, individually or in combination, do not appear to improve long-term mental health of the adolescents, including suicide risk.[14]

8. Psychotherapy for underlying mental health issues such as depression, anxiety, and autism, as well as prior emotional trauma or abuse should be the first line of treatment for these vulnerable children experiencing discomfort with their biological sex.

9. England, Scotland, Sweden, Denmark, and Finland have all recognized the scientific research demonstrating that the social, hormonal and surgical interventions are not only unhelpful but are harmful. So, these European countries have paused protocols and are instead focusing on evaluating and treating the underlying and preceding mental health concerns.

10. Other medical organizations are adhering to the evidence-based medicine documented in the Cass Review Final Report.

The constitution of the National Health Service in England will be updated to state, “We are defining sex as biological sex.”[15]

The European Society of Child and Adolescent Psychiatry issued a document titled “ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards.”

In this paper, they stated, “The standards of evidence-based medicine must ensure the best and safest possible care for each individual in this highly vulnerable group of children and adolescents. As such, ESCAP calls for healthcare providers not to promote experimental and unnecessarily invasive treatments with unproven psycho-social effects and, therefore, to adhere to the “primum-nil-nocere” (first, do no harm) principle”.[16]

11. Health care professionals around the world are also acknowledging the urgent need to protect children from harmful “gender-affirming” interventions.

In a letter to the British newspaper, The Guardian, sixteen psychologists, some of whom worked at the Tavistock Center for Gender Identity Development Service, acknowledged the role clinical psychologists played in placing children on an “irreversible medical pathway that in most cases was inappropriate.”[17]

In the United States, a group of psychiatrists, physicians and other health care workers wrote an open Letter to the American Psychiatric Association (APA), calling on the APA to explain why it glaringly ignored many scientific developments in gender-related care and to consider its responsibility to promote and protect patients’ safety, mental and physical health.[18]

12. Despite all the above evidence that gender affirming treatments are not only unhelpful, but are harmful, and despite the knowledge that the adolescent brain is immature, professional medical organizations in the United States continue to promote these interventions. Further, they state that legislation to protect children from harmful interventions is dangerous since it interferes with necessary medical care for children and adolescents.

The American Psychological Association states it is the largest association of psychologists worldwide. The organization released a policy statement in February 2024 stating, “The APA opposes state bans on gender-affirming care, which are contrary to the principles of evidence-based healthcare, human rights, and social justice.”[19]

The Endocrine Society responded to the Cass Review by reaffirming their stance. “We stand firm in our support of gender-affirming care…. NHS England’s recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care.”[20]

The American Academy of Pediatrics (AAP) Board of Directors in August 2023, voted to reaffirm their 2018 policy statement on gender-affirming care. They did decide to authorize a systematic review but only because they were concerned “about restrictions to access to health care with bans on gender-affirming care in more than 20 states.”[21]

Of note, Dr. Hilary Cass called out the AAP for “holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”[22]

In Conclusion

Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the  Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex.  Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.

[covid-safer-hotties]

Also preserved on our archive! (Follow the link to read this whole story and over 1,000 other news and opinion articles about covid!)

by Katherine Poinsatte, PhD

Case report 'emphasizes' possible COVID-19 link to autoimmune conditions

A 26-year-old man in Nepal developed pulmonary sarcoidosis after a mild COVID-19 infection, per a new case report that suggests “sarcoidosis as a potential complication of COVID-19,” according to researchers.

The man was initially diagnosed with post-COVID fibrosis, or thickening and scarring of lung tissue following a COVID-19 infection. However, after not improving for three months, clinicians performed additional tests and confirmed his lingering symptoms — including shortness of breath, repeated fevers, and weight loss — were due to sarcoidosis.

“This case report emphasizes the potential link between COVID-19 and autoimmune conditions like sarcoidosis, highlighting the need for a comprehensive diagnostic approach and long-term observation to distinguish between sarcoidosis and post-COVID fibrosis,” the researchers wrote.

The report, titled “Sarcoidosis in a young adult: A rare sequelae of COVID-19 infection,” was published in Clinical Case Reports.

Symptoms of COVID-19 infection continued despite treatment An autoimmune disease, sarcoidosis is characterized by an overactive immune system that causes granulomas, or small clumps of inflammatory cells, to form on different tissues and organs.

Sarcoidosis can be triggered by viral, bacterial, and fungal infections. During an infection, the immune system sometimes forms granulomas to surround the threat to the body so the clump of immune cells can destroy it later. In most people, these granulomas naturally go away once the infection is gone. However, when they are long-term, they can cause serious, permanent damage to organs.

In about 90% of cases, patients exhibit some level of pulmonary sarcoidosis, marked by the formation of granulomas on the lungs. These granulomas negatively impact lung function, causing symptoms like shortness of breath, coughing, chest pains, and wheezing. Granulomas can also lead to long-term lung scarring, also known as fibrosis, in which the lung tissue becomes stiff and thick, making it difficult for patients to breathe and reducing the amount of air the lungs can hold.

Infections with COVID-19, caused by the SARS-CoV-2 coronavirus that spread worldwide, can lead to many upper respiratory symptoms, including coughing and shortness of breath. In about 7% of cases, COVID-19 patients will also develop lung fibrosis.

Now, a team led by a researcher at the Nepalese Army Institute of Health Sciences College of Medicine described the case of a young man who had a five-day infection with COVID-19, exhibiting mild symptoms like coughing, fever, sore throat, and muscle soreness.

The man’s fever and cough did not go away, and one month after his initial COVID-19 infection he returned to the clinic. At that time, he tested negative for COVID-19, but his chest X-ray showed signs of lung inflammation and scarring.

He was preliminarily diagnosed with post-COVID fibrosis and prescribed a corticosteroid and a bronchodilator to help reduce inflammation and relax the muscles in the airways.

Further research needed to better understand disease links Despite treatment with those medications, however, the man’s symptoms lingered, leading him to seek medical care again three months after the initial COVID-19 infection. He reported symptoms like low-grade fevers, coughing, shortness of breath with physical activity, and weight loss.

Doctors did additional imaging of the man’s lungs, revealing multiple abnormalities. These included larger than normal lymph nodes, clumps of immune cells, and thickening of the connective tissue around the lung’s blood vessels and bronchi, the airways that lead from the windpipe to a lung.

After ruling out tuberculosis, the doctors analyzed biopsies obtained from the patient’s lymph nodes within the lungs, confirming the presence of granulomas. This led to a confirmed diagnosis of pulmonary sarcoidosis.

“Distinguishing between COVID-19 and sarcoidosis based on clinical and imaging features can be difficult due to significant overlap,” the researchers wrote. “Therefore, for symptomatic patients, obtaining a [biopsy-based] diagnosis of sarcoidosis is crucial to initiate early treatment.”

The patient’s previous treatment regimen was increased. When his cough worsened, the man was temporarily given the oral steroid prednisone until his cough went away. NADI'S NOTE: A recent large study of the effects of general steroids in long covid treatment showed no statistically significant results. Just goes to show you how far behind we are on finding effective treatment for covid and its lingering systems: They just keep cramming the same old chemicals down our throats and expecting different results. It's insanity. (little rant over lol)

At the time of the study’s publication, the patient did not have any sarcoidosis-related symptoms nor was taking any medications. He now has regular follow-up appointments every three months.

“This case report emphasizes that sarcoidosis like many autoimmune conditions arises due to immune system dysfunction following COVID-19 infection,” the researchers wrote.

Additional study is needed to learn more, per the researchers.

“Further research and extended follow-up are necessary to clarify these associations and understand the underlying mechanisms comprehensively,” the team concluded.

Study Link: onlinelibrary.wiley.com/doi/10.1002/ccr3.9445

[darkmaga-returns]

10 shocking stories the media buried today.

The Vigilant Fox

Oct 24, 2024

#10 - Doctors who defied the COVID narrative compile 18 alternative cancer treatments that WORK!

These interventions are not only backed by science, but most of them are affordable or completely free.

The first anti-cancer therapy is glucose management through a ketogenic diet. By drastically reducing carbohydrate intake, the ketogenic diet helps starve cancer cells of their primary fuel source, glucose, according to 

The FLCCC Alliance

.

Second on the list is exercise. The report says that regular physical activity boosts immune function (critical for fighting cancer), reduces inflammation, and combats fatigue.

Vitamin D3 is also essential. The report says, “Low levels of vitamin D have been linked to an increased risk of cancer. Supplementing with vitamin D3 may support the immune system and help prevent cancer cell proliferation.”

One of the more interesting items on the list is the inclusion of Ivermectin and Fenbendazole. Ivermectin is believed to “interfere with cellular processes essential for cancer cell viability,” whereas Fenbendazole inhibits cancer cell division and induces cancer cell death.

Here are all 18 therapies ranked in order, as compiled by 

The FLCCC Alliance

:

1. Glucose Management & Keto Diet

2. Exercise

3. Stress Reduction, Sleep, and Sunshine

4. Vitamin D3

5. Propranolol

6. Melatonin

7. Metformin

8. Curcumin (Nanocurcumin)

9. Ivermectin

10. Mebendazole/Fenbendazole/Albendazole

11. Green Tea

12. Omega-3 Fatty Acids

13. Berberine

14. Atorvastatin or Simvastatin

15. Sildenafil, Tadalafil, and Vardenafil

16. Disulfiram

17. Ashwagandha

18. Itraconazole

Read the full details about each treatment here.

[crimson-dahliaa]

Research Report: Dissecting Misteln’s Crude Techniques and Proposing Superior Methods

Subject: Revisiting the Brain’s Role in Aging and the Path to True Immortality Quick glossary:

Neuromodulation: A therapeutic technique that involves directly altering the activity of the nervous system using electrical, chemical, or magnetic stimulation. Neuromodulation can target specific brain areas to enhance or suppress neural activity, often used to treat neurological conditions or influence cognitive functions.

Nanotechnology: A field of science and engineering focused on manipulating matter at the atomic or molecular level, typically at scales of less than 100 nanometers. In medicine, nanotechnology is used to develop tools like drug-delivery systems and microscopic devices that can repair cells or alter biological processes with extreme precision.

Biophysical Mapping: A process of creating detailed maps of biological systems, often using advanced imaging techniques, to understand the physical and functional structures of cells, tissues, or organs. In brain research, biophysical mapping refers to charting neural connections and activity patterns to study how different parts of the brain work together.

Misteln’s research presents a deeply flawed approach to understanding the brain’s involvement in the aging process. Her belief that the brain functions as a biological clock, slowly winding down until death, may have been compelling to her, but to anyone with real expertise, it’s clear her methods were laughably crude. Her entire premise relies on an imagined "biological timer" that determines when the body will deteriorate, a concept that might appeal to the untrained mind, but falls apart under any serious scrutiny.

Misteln’s ideas never reached beyond the surface of the problem. Her attempts to understand the brain’s role in aging were clumsy at best, constrained by a lack of real education in neurology. She relied on theories built on outdated principles, never bothering to dig deeper into the actual workings of the neural networks she claimed to control. The crude nature of her experiments is reflected in her surgical techniques — if one could even call them that. Misteln’s approach was little more than exploratory mutilation, leaving her subjects with irreversible damage rather than any meaningful insight.

Misteln’s Crudeness and My Proposed Refinement

Her most laughable failure was her belief that the brain could simply be "altered" to achieve immortality through physical removal of a so-called "kill switch." Misteln's tools were primitive, and her methods were barely worthy of a beginner. She approached the brain as if it were a mechanical device, expecting to find a single point to snip and sever. Her surgery relied on brute force, attempting to cut away at complex neural structures in search of this mythical switch.

Where Misteln’s techniques were barbaric, I intend to advance with precision. Instead of recklessly cutting through delicate structures, I will employ advanced neuromodulation techniques — methods Misteln was barely aware existed. By using targeted stimulation and high-resolution brain mapping, I will isolate specific areas responsible for cognitive decline and systematically repair them without the unnecessary destruction that Misteln left in her wake. My methods are rooted in modern science, utilizing nanotechnology and gene editing, two areas Misteln was clearly too ignorant to explore.

Vision for Improvement

Misteln’s attempts to manipulate the brain relied on sheer guesswork, and her results reflect that. Her failures are evident in the remains of her patients — twisted experiments, barely human by the time she was done with them. This was the result of her crude understanding of neuroanatomy. Her approach was essentially like using a sledgehammer to perform delicate surgery. The fact that she even referred to her methods as “scientific” is an insult to the field.

I, on the other hand, will not be so careless. My methods will involve sophisticated biophysical mapping, using real-time neural tracking to adjust individual synaptic pathways. By leveraging computational modeling, I can predict and prevent cognitive decay before it ever begins. Instead of trying to remove a mythical “kill switch,” I will modify the brain’s aging mechanisms at the molecular level, carefully reconstructing the networks that Misteln thought could simply be severed.

Misteln was barely educated, grasping at theories with the understanding of an amateur. She viewed immortality as something to be “cut out,” rather than something to be fostered through careful enhancement. She was playing at science, pretending she could achieve real results with brute force and guesswork. Her tools were as primitive as her thinking — and her failures were inevitable.

My approach will revolutionize what she could not even begin to grasp. With access to the proper tools and a mind grounded in real science, I will succeed where Misteln faltered. Her crudeness and ignorance left her fumbling in the dark, but with my expertise, immortality will no longer be a distant dream, but an achievable reality.

Dr. Ougai Suiren Lead Researcher, Bleeding Heart Orphanage

@tilskkarishma

Can you tell biology and this kinda stuff is my favorite?

[sarajcsmicasereports]

Visceral Leishmaniasis presenting with Hemophagocytosis and Myelodysplasia: A Case report and review of the literature in Annika Kasprzak by Journal of Clinical Case Reports Medical Images and Health Sciences 

Abstract

A 62-year-old patient presented with fever persisting despite antibiotic treatment, weight loss and sweating for a period of several weeks. On physical examinations hepatosplenomegaly was noticed. Increasing pancytopenia triggered bone marrow biopsy, showing expanded and dysplastic erythropoiesis, dysmegakaryopoiesis and hypoplastic granulopoiesis. The patient was diagnosed with low-risk myelodysplastic syndrome (MDS). Bone marrow cells displayed a normal karyotype. Infectious disease diagnostics were negative. During the course of the disease liver enzymes, d-dimers, laboratory markers of inflammation, coagulation parameters and pancytopenia worsened. Liver puncture revealed severe hemophagocytic syndrome. Treatment with corticosteroids and etoposide was initiated, but the patient continued to be febrile and failed to improve. After transfer to our department, bone marrow biopsy was repeated and visceral leishmaniasis was detected, further confirmed by serologic testing and PCR. The patient was treated with amphotericin B and fully recovered.

Conclusion: Leishmaniasis should be included in the differential diagnosis of myelodysplastic bone marrow failure accompanied by systemic inflammation, and should be recognized as a possible cause of hemophagocytic syndrome.  Since leishmaniasis is not confined to tropical zones, but also occurs in the Mediterranean region, increasing travel activities, migration and climate changes may lead to a rising incidence of this disease in Europe.

Key words: Leishmaniasis, myelodysplastic syndrome, myelodysplasia, hemophagocytosis

Case presentation

A 62-year old man presented in February 2017 with fever, sweating and weight loss (12 kg over two months). Initial symptoms, mainly fever and weakness, already started two months earlier and were attributed to a suspected pneumonia. Treatment with clarithromycin achieved only temporary improvement and eventually clinical symptoms indicated further deterioration. The patient did not report any comorbidities and negated the use of regular medications, drugs, alcohol or smoking.

As the patient spent most of his time on one of the Balearic Islands, but was also engaged in a lot of business travel, diagnostic tests, including bone marrow biopsy, were performed to rule out infectious diseases. There was no evidence of leishmaniasis and borreliosis. Since the patient had acquired malaria quartana thirty years earlier, a blood film was examined and reported to be suggestive of malaria. Therefore, he received treatment with chloroquine. However, this medication was soon discontinued when a repeated blood film and a PCR test for malaria yielded negative results. Bone marrow cytomorphology showed dysplastic features of erythropoiesis and megakaryopoiesis without elevated blast count suggesting a diagnosis of MDS-MLD (myelodysplastic syndrome with multilineage dysplasia).

In March 2017, the patient was admitted to the hematology/ oncology department of another hospital, where the diagnostic workup for malignancies and infections did not yield a clear diagnosis.  By that time, the patient had developed severe pancytopenia (white blood cell count 400/µl, hemoglobin 7,1 g/dl, platelets 45.000/µl) without evidence of hemolysis (normal haptoglobin). He still suffered from persistent fever, despite treatment with broad-spectrum antibiotics. No pathogens were detected in the blood or urine. Virological tests were negative for HIV, CMV, EBV, HAV, HBV, HCV and parvovirus B19. Serological tests for leishmaniasis were also negative.

Abdominal ultrasonography showed hepatomegaly (19 cm in MCL) and a CT scan of thorax and abdomen also confirmed splenomegaly (18 cm). Lymph nodes were not enlarged and other organs did not show any pathological findings. A CT scan of the neck and paranasal sinuses was inconspicuous. The same was true for a colonoscopy. A second bone marrow biopsy showed hyperplastic and dysplastic erythropoiesis, dysmegakaryopoiesis and hypoplastic granulopoiesis with normal maturation. The blast count was not elevated, as assessed by cytomorphology and flow cytometry. On histopathology, only reactive changes were noted. Conventional cytogenetics showed a normal karyotype (46, XY [24]). Next generation sequencing with a myeloid panel covering 54 genes did not show any mutations. In particular, none were found in TP53, ASXL1, EZH2, NRAS, KRAS, SRSF2, and SF3B1. Therefore, the suspected diagnosis of low-risk MDS remained solely, based on cytomorphological features of dysplasia.

In view of unclear hepatosplenomegaly, elevated liver enzymes, CRP, ferritin and d-dimers as well as an unexplained coagulopathy, a liver biopsy was performed in April 2017. On histopathology, activated sinusoidal macrophages were found, displaying phagocytosis of granulocytes and erythrocytes. Accordingly, hemophagocytosis or macrophage activation syndrome (MAS) was diagnosed.

The patient received high-dose dexamethasone for five days, followed by two doses of etoposide and stimulation of granulopoiesis with G-CSF for five days. After a brief increase the white blood cell counts rapidly decreased again.

Seeking a second opinion, the patient presented to our center in May 2017. His general condition had further deteriorated. On repeat bone marrow biopsy, we confirmed marked dyserythropoiesis (Figure 1) as well as hemophagocytosis. Strikingly, abundant leishmanias (including kinetoplasts) were detected in and outside of macrophages. Besides microscopic detection of leishmania (Figure 2), antibody testing and PCR on bone marrow material was performed in a reference laboratory, yielding was positive results with all methods. PCR of the parasitic cytochrome B-complex showed 99% accordance with Leishmania donovani and Leishmania infantum, confirming the diagnosis of visceral leishmaniasis.

Intravenous amphotericin B was administered for three cycles (five days per cycle, every ten days, at 3 mg/kg body weight per application) [2]. After the second cycle, pancytopenia and fever diminished. After the third cycle, the patient gained weight, was no longer fatigued and fully recovered. Subsequent to the inpatient treatment, he received two more cycles of amphotericin B as an outpatient. After the last round of amphotericin B in August 2017, bone marrow was reevaluated and showed neither hemophagocytosis nor leishmaniasis. Antibody testing remained positive, but PCR on bone marrow cells was negative. Therefore, amphotericin B was discontinued. Cytomorphologically, the bone marrow recovered completely, but mild pancytopenia persisted in the peripheral blood, probably due to lingering splenomegaly.

Discussion

Visceral leishmaniasis is a parasitic infectious disease occurring in tropical climate zones, but also endemically in the mediterranean region. About 400.000 people become infected per year, and up to 40.000 die of leishmaniasis every year, especially in regions where appropriate medical treatment is not available. The female phlebotomine sand fly is the vector that transmits the parasites by biting the victims. About 20 leishmania species are known to cause the infection, which can present as cutaneous (CL), mucocutaneous (MCL), or visceral leishmaniasis (VL). After the bite of the sand fly, which causes a dermal lesion, the leishmanias persist in the skin of the mammal and are being incorporated by cells of the mononuclear phagocyte system, where the leishmanias develop into amastigote forms and reproduce. Due to their adherence to macrophages, leishmanias can visceralize via the lymphatic system as well as spleen and liver, provoking severe hepatosplenomegaly. Especially the species of leishmania donovani and leishmania infantum are well known for high rates of visceralization. Visceralization of the bone marrow can lead to pancytopenia resulting in secondary immunosuppression, explaining the appearance of superinfections in patients with VL. Incubation of VL ranges from 2 weeks to 18 months or, in some cases, even years until first symptoms are recognized. The mortality rate of untreated VL is 75-95% within two years [1].

The history of our patient underlines the importance of considering leishmaniasis as a differential diagnosis even in countries where this infection is not endemic. Several factors may contribute to a rising incidence of leishmania infections in the near future, like increasing travel activities, migration, climate changes, HIV infections compromising the outcome, immunosuppression due to cytotoxic treatment and malnutrition [3,4].

Diagnostic tools for leishmania detection include microscopy (e.g., blood smears, lymph node, liver, spleen, or bone marrow), serologic testing and PCR. Leishmania detection on microscopy only succeeds in patients with a high disease burden. Serologic testing is not reliable, as it often remains negative despite an underlying infection and, if positive, does not differentiate between active and former infection. As in our patient, both IgM and IgG antibodies remain elevated for several months, even after successful treatment, and can thus not be used for treatment evaluation. Only the detection of the leishmania kinetoplast or RNA via PCR provides reliable information on disease status and therapeutic success. However, on a worldwide scale, this methodology is not easily accessible [4].

The delay between first symptoms and diagnosis in our patient is not unusual. Several serologic tests did not show leishmania-specific antibodies. The diagnosis was finally made, when leishmania were detected on bone marrow microscopy after the patient had received immunosuppression for hemophagocytic syndrome. Subsequently, the diagnosis was confirmed by PCR.

The MDS-like features in the bone marrow and the histopathological finding of hemophagocytosis in the liver did not help in making the correct diagnosis, since they suggested a hematological malignancy.

Leishmaniasis can present with a variety of symptoms and is therefore difficult to diagnose. To the best of our knowledge, this is the first case report of visceral leishmaniasis associated with hemophagocytosis in the liver. After hemophagocytosis had been detected in the liver of our patient, it was also found in the bone marrow together with cytomorphologic evidence of leishmaniasis. None of the previous case reports or studies described hemphagocytosis in the liver of patients with leishmaniasis [5-15]. There is a case report from Sweden alluding to hemophagocytosis in the spleen of a child with VL [5], without mentioning a liver biopsy. Experiments in mice by Morimoto et al. did not indicate hemophagocytes in the liver of these animals [6]. Therefore, our case report provides unique information regarding the possible occurrence of hemophagocytosis in both liver and bone marrow in patients with visceral leishmaniasis.

Review of the literature

The frequency of leishmania infections is increasing worldwide. A long incubation time together with busy international air travel may foster infections even in countries where the disease has not been endemic so far. Accordingly, leishmaniasis should be considered as a differential diagnosis in patients with splenomegaly and myelodysplasia, especially in patients who have travelled to tropical zones or mediterranean countries.

In conjunction with our case report, we reviewed the pertinent literature, focusing on the combination of leishmaniasis with hemophagocytosis or myelodysplasia.

Leishmaniasis and hemophagocytosis:

Several case reports point out that hemophagocytosis in the bone marrow can be caused by visceral leishmaniasis. Granert et al. Described how this finding initially raised suspicion of hemophagocytic lymphohistiocytosis (HLH) in a pediatric patient before reevaluation yielded the diagnosis of visceral leishmaniasis [5]. Physicians in endemic regions, e.g., India, employ hemophagocytosis as a diagnostic clue to visceral leishmaniasis, and efforts have been made to classify the morphologic features in the bone marrow of such patients [7-9].

Chandra et al. and Dhingra et al. [8, 9] looked at both aspirates and biopsies and described increased cellularity, erythroid hyperplasia, and mild to severe hemophagocytosis. Chandra et al. detected uncommon bone marrow manifestations such as granuloma and necrosis, and reported an association with worse prognosis, based on their clinical experience [8]. Both findings were also reported by Bhatia et al. [7]. Experiments by Cotterell et al. [10] showed that stromal macrophages serve as a target for Leishmania donovani. Infection of macrophages then induces secretion of granulocyte macrophage-colony stimulating factor (GM-CSF) and  tumor necrosis factor -alpha (TNF-alpha), thereby contributing to increased bone marrow cellularity.

Leishmaniasis and myelodysplasia:

Besides hemophagocytosis, nonclonal myelodysplasia may contribute to ineffective hematopoiesis and peripheral cytopenia in visceral leishmaniasis [11]. We found reports of pediatric and adult patients presenting with myelodysplasia secondary to visceral leishmaniasis [12-14]. The case reports describe trilineage dysplasia and emphasize bone marrow hypercellularity and erythroid hyperplasia as the most striking features [13,14]. Megaloblastic changes in erythroblasts have also been reported [13]. Dhingra et al. point out that nonclonal myelodysplasia can affect all three myeloid lineages and might be caused by increased TNF-alpha [9].

Regarding granulopoietic precursor cells both hypo- and hypergranulation were observed. In addition, increased megakaryopoiesis and nuclear dysplasia such as nuclear fragmentation or nonlobated nuclei were reported by several authors [12-14]. Despite distinct signs of myelodysplasia, intra- or extracellular leishmania parasites were not seen in every case, challenging the diagnosis of visceral leishmaniasis. It has been suggested that disease duration has a more profound impact on cytomorphological changes in the bone marrow than the number of infected mononuclear cells [15]. Therefore, Varma et al. recommend repeat bone marrow examination and serologic testing in patients with suspected visceral leishmaniasis. Serologic testing helps to identify patients with early stages of VL, whereas bone marrow microscopy can serve as a diagnostic tool in patients with more advanced infection.

Conclusion

Similar to the course of disease in our patient, several reports in the literature describe patients where visceral leishmaniasis was initially misdiagnosed as myelodysplastic syndrome. Such cases were mainly reported from non-endemic regions. In contrast, physicians in endemic areas like India employ myelodysplastic features as a clue to underlying infection such as VL. Both hemophagocytosis and myelodysplasia can be found in association with visceral leishmaniasis. Treatment with amphotericin B is effective and can rapidly cure the patient. Therefore, we recommend to consider visceral leishmaniasis as a possible cause of myelodysplasia and/ or hemophagocytosis even in non-endemic regions, and to repeat diagnostic procedures (serologic testing as well as bone marrow examination) if the disease is suspected [16].

Acknowledgements: No financial or material support was implied in the preparation of this manuscript.

[materialsscienceandengineering]

An enzyme used in laundry detergent can recycle single-use plastics within 24 hours

Scientists at King's College London have developed an innovative solution for recycling single-use bioplastics commonly used in disposable items such as coffee cups and food containers. The novel method of chemical recycling, published in Cell Reports Physical Science, uses enzymes typically found in biological laundry detergents to "depolymerize"—or break down—landfill-bound bioplastics. Rapidly converting the items into soluble fragments within just 24 hours, the process achieves full degradation of the bioplastic polylactic acid (PLA). The approach is 84 times faster than the 12-week-long industrial composting process used for recycling bioplastic materials. This discovery offers a widespread recycling solution for single-use PLA plastics, as the team of chemists at King's found that in a further 24 hours at a temperature of 90°C, the bioplastics break down into their chemical building blocks. Once converted into monomers—single molecules—the materials can be turned into equally high-quality plastic for multiple reuse.

Read more.

[mindblowingscience]

Imagine the possibility of life forms on other planets that don't resemble any on Earth. What might they look like, and why would they be so different? Juan Pérez-Mercader says it may be possible and the answer may be that they developed from a different type of chemistry. For more than 10 years, the senior research fellow in the Department of Earth & Planetary Sciences and the Origins of Life Initiative at Harvard has studied how to produce synthetic living systems—without relying on biochemistry, or the chemistry that has enabled life on Earth. "We have been trying to build a non-biochemical system, which unaided is capable of executing the essential properties common to all natural living systems," Pérez-Mercader explained. The Pérez-Mercader lab's latest study, published last month in Cell Reports Physical Science, even finds such a system engaged in what Charles Darwin called "the struggle for life." The paper features Pérez-Mercader with co-authors Sai Krishna Katla and Chenyu Lin describing how they created two synthetic models (or "species") and observed the ensuing competition between them.

Continue Reading

[jcsmicasereports]

Acute kidney injury following exposure to a formaldehyde –free hair straightening products by Dr. Nabil Abu-Amer in Journal of Clinical Case Reports Medical Images and Health Sciences

ABSTRACT

Formaldehyde- free hair straightening products are hair smoothening solutions widely used by professional beauty salons. Formaldehyde-free hair straighteners do not technically contain formaldehyde, however they contain other chemicals such as glyoxyloyl carbocysteine which releases formaldehyde upon contact with heat. Moreover, its by-product glyoxylate may convert to oxalate, both compounds have potential nephrotoxic effect.

Case presentation: 41-year-old woman presented to the emergency room with weakness, nausea , vomiting and  stage three acute kidney injury according to Kidney Disease: Improving Global Outcomes acute kidney injury staging (KDIGO) shortly after exposure to formaldehyde - free hair straightening product, other causes of acute kidney injury were excluded such as preceding acute illness, drug history or others nephrotoxic agent exposure On physical examination the patient was pale, her vital signs were normal. The urine microscopy and serologic workup was not indicative. Kidney core biopsy reveal interstitial edema, acute interstitial nephritis and oxalate crystal nephropathy. Kidney function completely recovered after a short course of steroid therapy.

Conclusions: We present a case of severe kidney injury after exposure to hair straightening products branded as formaldehyde free but actually contain other chemicals products which release formaldehyde and other toxic chemicals when heated during the straightening procedure and  may cause systemic toxicity, particularly kidney injury. Different cosmetic products are widely in use, not all are under a tight regulation, and therefore it is important to raise the awareness of both medical teams and consumers of possible adverse health effects of different cosmetic products.

INTRODUCTION

Nephrotoxicity is defined as kidney injury due to toxic effects of chemicals. There are various forms of chemicals and drugs that may affect renal function in various mechanism including acute tubular necrosis (ATN), tubulopathy and electrolyte imbalance, acute interstitial nephritis (AIN), glomerular damage, crystal nephropathy, and thrombotic microangiopathy [1-3].

Formaldehyde- free hair straightening products contain potentially toxic chemicals other than formaldehyde. One potential such substance is glyoxyloyl carbocysteine, which is composed of glyoxylic acid, cysteine and acetic acid. Glyoxylic acid both releases formaldehyde when heated and is converted into either glycine by AGT1 (alanine:glyoxylate aminotransferase 1) or oxalate by glycolate oxidase in the human cell peroxisomes [4].

Formaldehyde is a colorless aldehyde poisonous gas at room temperature [5]. It is usually mixed with water and when the small fraction of soluble formaldehyde reacts with water, it quickly forms methylene glycol. For every molecule of free formaldehyde, 1,820 molecules of methylene glycol are formed [6]. Methylene glycol reverts back to free formaldehyde almost immediately upon contact with air or skin. Formaldehyde is thus absorbed through skin, eyes, and inhalation, and is eliminated through the urine [7-8]. During the hair straightening process, high levels of formaldehyde are found in samples of air taken from beauty salons [9] and in specimens of hairstylist workers skin [10-11].

In the kidney, formaldehyde has been reported to cause direct cytotoxic effect resulting in acute toxic tubular necrosis [12-13], and may also cause an immune system response leading to acute interstitial nephritis.

Another potential nephrotoxic component of hair straightening products is oxalate, which is an end product of glyoxylic acid.  Increased levels of oxalate promote calcium oxalate precipitation in various tissues including the kidneys, resulting in toxic injury.

Case presentation

A 41-year-old woman with a history of hypothyroidism and sleeve gastrectomy five years ago, presented to the emergency department with profound weakness, nausea and vomiting. Her symptoms began three days earlier, immediately after using a professional hair straightening formaldehyde- free product in a professional beauty salon.

On physical examination the patient was pale, her vital signs were normal, heart rate  was 66 bpm, blood pressure was 125/70 mmHg, she had no fever or respiratory distress and appeared euvolemic.

Laboratory investigations revealed a serum creatinine of 3.46 mg/dl (one year prior to the event Cr. value was 0.6 mg/dl), urea 77 mg/dl, and electrolytes, liver function tests, Beta human chorionic gonadotropin (β-hCG) and complete blood count were normal. Blood venous gases revealed: pH 7.375, HCO3 21 mmol/L and base excess 3 mmol. The anion gap and serum osmolar gap were normal. Urinalysis demonstrated leukocyturia +1 without hematuria or proteinuria.

During hospitalization urine output was normal, repeat urinalysis demonstrated leukocyturia +1 without hematuria or proteinuria, and Bence-Jones protein was negative. Urine microscopy demonstrated epithelial cells with few white blood cells without any casts or crystals. Renal ultrasound showed 14.4 cm bilateral echogenic, edematous renal parenchyma (shown in  Fig. 1).

A full serologic workup including hepatitis B and C, Human immunodeficiency virus (HIV), syphilis, antinuclear antibody (ANA) , Anti-double stranded DNA, Antineutrophil cytoplasmic antibody (ANCA), Anti-Phospolipid antibody (APLA) was normal except for a complement C3 level of 80 mg/dl (normal range 90-110 mg/dl).

On the 4th hospitalization day a renal core biopsy was performed. The histologic examination (shown in Fig. 2) was correlatd with  acute tubular necrosis, tubulo- intersitial nephritis and oxalate crystals . With the diagnosis of interstitial nephritis, the patient was started on prednisolone 1 mg/kg, one week later serum creatinine decreased to a level of 0.98 mg/dl.

A: Glomeruli were normo-cellular and without signs of active glomerular disease (arrow heads), tubules showed signs of diffuse tubular injury (black arrow) and tubules contained oxalate crystals (blue arrow). B:The interstitium showed edema associated with multifocal mixed inflammatory infiltration with multiple eosinophils and foci of tubulitis. C:There was one epithelioid granuloma. D:Tubules contained oxalate crystals (blue arrow) observed under polarized light-microscopy. Immunofluorescence analysis revealed C3 1+ in blood vessel walls only.

Discussion

This patient presents an unusual case of kidney toxic and inflammatory injury accompanied with oxalate deposition secondary to hair straightening product. In a literature review, only few cases [14-15] of acute kidney injury (AKI) following hair straightening formaldehyde- free product exposure were reported. All cases were reported after 2019. The spectrum of kidney injury following hair straightening ranges from mild to severe kidney injury requiring renal replacement therapy. The histopathologic changes reported mainly depicted severe acute tubular necrosis and acute interstitial nephritis.

Our patient presented with stage 3 AKI following hair straightening formaldehyde - free product exposure. Other causes of AKI were excluded such as preceding acute illness, drug history or other nephrotoxic agent exposure. Laboratory workup revealed leukocyturia +1, and ultrasonography was significant for enlarged edematous echogenic renal parenchyma. Kidney biopsy demonstrated acute interstitial nephritis, oxalate crystal precipitation and acute tubular necrosis. We speculate that the clinical presentation and the histopathologic changes directly resulted from exposure to the hair straightening formaldehyde- free product.

In reviewing the ingredients of the specific product used in this case, it included glyoxyloyl carbocysteine, glyoxyloyl keratin amino acid, propylene glycol glycerin, phenoxyethanol, ethylhexylglycerin disodium and other collagen, surfactant and fragrance components. We did not find evidence in the medical, pharmacological and chemical literature that any of these substances causes acute kidney injury other than glyoxyloyl carbocysteine.

Many hair straightening products are labeled as formaldehyde "free" but actually contain chemicals such as glyoxyloyl carbocysteine or methylene glycol which release formaldehyde and other toxic chemicals when heated, e.g the carbocysteine hair treatment represents the combination of glyoxylic acid + cisteine + acetic acid. Glyoxylic acid contains an aldehyde functional group, glyoxylic acid behaves as an aldehyde by  heating during the hair straightening process thus releasing high levels of formaldehyde gas exceeding the capacity of exposure[16]. On top of that, glyoxylic acid absorbed through the scalp may had converted to oxalic acid [17] which may precipitate in kidney tissue. It is possible that other components such as propylene glycol may cause osmotic renal injury. In this case, serum osmotic gap was not available since it calculated four days after exposure.

Conclusion

In conclusion, a case of severe kidney injury after exposure to hair straightening products branded as formaldehyde free is presented. This case highlights the sensitivity of the kidney to various environmental and commercial products, some of which have not been fully characterized or identified yet.

It is important to raise the awareness of both medical teams and consumers, of possible adverse health effects of different cosmetic products, including acute kidney injury, and perhaps promote tighter regulation of such products.

Statement of Ethics:

Ethical approval is not required for this study in accordance with local or national guidelines.

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available.

Conflict of Interest interests

The authors have no conflict of interest to disclose

Funding

No funding was obtained for this study.

Authors’ contributions

NAA, NZ, SM, PB, were involved in the clinical management of the patient.

NAA, MK, collected the data and wrote the first version of the manuscript.

NAA, NZ, MK, SM, PB approved the final version of the manuscript.

The authors read and approved the final manuscript.

Data Availability

All data that support the findings of this study are included in this article.

[jcmarchi]

New transistor’s superlative properties could have broad electronics applications

New Post has been published on https://thedigitalinsider.com/new-transistors-superlative-properties-could-have-broad-electronics-applications/

New transistor’s superlative properties could have broad electronics applications

In 2021, a team led by MIT physicists reported creating a new ultrathin ferroelectric material, or one where positive and negative charges separate into different layers. At the time they noted the material’s potential for applications in computer memory and much more. Now the same core team and colleagues — including two from the lab next door — have built a transistor with that material and shown that its properties are so useful that it could change the world of electronics.

Although the team’s results are based on a single transistor in the lab, “in several aspects its properties already meet or exceed industry standards” for the ferroelectric transistors produced today, says Pablo Jarillo-Herrero, the Cecil and Ida Green Professor of Physics, who led the work with professor of physics Raymond Ashoori. Both are also affiliated with the Materials Research Laboratory.

“In my lab we primarily do fundamental physics. This is one of the first, and perhaps most dramatic, examples of how very basic science has led to something that could have a major impact on applications,” Jarillo-Herrero says.

Says Ashoori, “When I think of my whole career in physics, this is the work that I think 10 to 20 years from now could change the world.”

Among the new transistor’s superlative properties:

It can switch between positive and negative charges — essentially the ones and zeros of digital information — at very high speeds, on nanosecond time scales. (A nanosecond is a billionth of a second.)

It is extremely tough. After 100 billion switches it still worked with no signs of degradation.

The material behind the magic is only billionths of a meter thick, one of the thinnest of its kind in the world. That, in turn, could allow for much denser computer memory storage. It could also lead to much more energy-efficient transistors because the voltage required for switching scales with material thickness. (Ultrathin equals ultralow voltages.)

The work is reported in a recent issue of Science. The co-first authors of the paper are Kenji Yasuda, now an assistant professor at Cornell University, and Evan Zalys-Geller, now at Atom Computing. Additional authors are Xirui Wang, an MIT graduate student in physics; Daniel Bennett and Efthimios Kaxiras of Harvard University; Suraj S. Cheema, an assistant professor in MIT’s Department of Electrical Engineering and Computer Science and an affiliate of the Research Laboratory of Electronics; and Kenji Watanabe and Takashi Taniguchi of the National Institute for Materials Science in Japan.

What they did

In a ferroelectric material, positive and negative charges spontaneously head to different sides, or poles. Upon the application of an external electric field, those charges switch sides, reversing the polarization. Switching the polarization can be used to encode digital information, and that information will be nonvolatile, or stable over time. It won’t change unless an electric field is applied. For a ferroelectric to have broad application to electronics, all of this needs to happen at room temperature.

The new ferroelectric material reported in Science in 2021 is based on atomically thin sheets of boron nitride that are stacked parallel to each other, a configuration that doesn’t exist in nature. In bulk boron nitride, the individual layers of boron nitride are instead rotated by 180 degrees.

It turns out that when an electric field is applied to this parallel stacked configuration, one layer of the new boron nitride material slides over the other, slightly changing the positions of the boron and nitrogen atoms. For example, imagine that each of your hands is composed of only one layer of cells. The new phenomenon is akin to pressing your hands together then slightly shifting one above the other.

“So the miracle is that by sliding the two layers a few angstroms, you end up with radically different electronics,” says Ashoori. The diameter of an atom is about 1 angstrom.

Another miracle: “nothing wears out in the sliding,” Ashoori continues. That’s why the new transistor could be switched 100 billion times without degrading. Compare that to the memory in a flash drive made with conventional materials. “Each time you write and erase a flash memory, you get some degradation,” says Ashoori. “Over time, it wears out, which means that you have to use some very sophisticated methods for distributing where you’re reading and writing on the chip.” The new material could make those steps obsolete.

A collaborative effort

Yasuda, the co-first author of the current Science paper, applauds the collaborations involved in the work. Among them, “we [Jarillo-Herrero’s team] made the material and, together with Ray [Ashoori] and [co-first author] Evan [Zalys-Geller], we measured its characteristics in detail. That was very exciting.” Says Ashoori, “many of the techniques in my lab just naturally applied to work that was going on in the lab next door. It’s been a lot of fun.”

Ashoori notes that “there’s a lot of interesting physics behind this” that could be explored. For example, “if you think about the two layers sliding past each other, where does that sliding start?” In addition, says Yasuda, could the ferroelectricity be triggered with something other than electricity, like an optical pulse? And is there a fundamental limit to the amount of switches the material can make?

Challenges remain. For example, the current way of producing the new ferroelectrics is difficult and not conducive to mass manufacturing. “We made a single transistor as a demonstration. If people could grow these materials on the wafer scale, we could create many, many more,” says Yasuda. He notes that different groups are already working to that end.

Concludes Ashoori, “There are a few problems. But if you solve them, this material fits in so many ways into potential future electronics. It’s very exciting.”

This work was supported by the U.S. Army Research Office, the MIT/Microsystems Technology Laboratories Samsung Semiconductor Research Fund, the U.S. National Science Foundation, the Gordon and Betty Moore Foundation, the Ramon Areces Foundation, the Basic Energy Sciences program of the U.S. Department of Energy, the Japan Society for the Promotion of Science, and the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan.

[highestoctanegarbage]

"I was unsure what the effects of water was going to have on the leaf but overall, it is still science"

"This proves that science can be tested with anything. That is what makes it science!"

"Osmosis is a physical phenomenon that's been used since early mankind"

"This is very impactful to humans because we are made up of cells and molecules, and it is constantly going on in our body right now as you read this"

As per popular demand, here are some of the masterpieces that my students included in their lab reports. Enjoy.