Conway School of Landscape Design. V. Gnar, MD: "Purchase online Provigil cheap - Best online Provigil".
Determining the precise mechanisms involved in communication between each step may have important clinical signiﬁcance in the future discount provigil express insomnia shop sofia. The novel ﬁndings that probiotics may have an impact on normal cognitive behaviors is particularly interesting generic provigil 100mg line sleep aid infants, since it suggests that there exists a certain ﬂexibility within the gut-brain- microbiota axis buy provigil cheap insomniax pajamas, well into adulthood and after completion of developmental stages thought to be the critical time for mediating potential changes generic 100mg provigil mastercard insomnia netflix. Bercik P, Denou E, Collins J, Jackson W, Lu J, Jury J et al (2011) The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Matsumoto M, Kibe R, Ooga T, Aiba Y, Sawaki E, Koga Y et al (2013) Cerebral low-molecular metabolites inﬂuenced by intestinal microbiota: a pilot study. Am J Physiol Gastrointest Liver Physiol 283(6):G1257–G1263 16 Microbiota-Gut-Brain Axis and Cognitive Function 369 26. Barreau F, Ferrier L, Fioramonti J, Bueno L (2004) Neonatal maternal deprivation triggers long term alterations in colonic epithelial barrier and mucosal immunity in rats. Baudin A, Blot K, Verney C, Estevez L, Santamaria J, Gressens P et al (2012) Maternal deprivation induces deﬁcits in temporal memory and cognitive ﬂexibility and exaggerates synaptic plasticity in the rat medial prefrontal cortex. Ringel Y, Maharshak N (2013) The intestinal microbiota and immune function in the patho- genesis of irritable bowel syndrome. Stasi C, Rosselli M, Bellini M, Lafﬁ G, Milani S (2012) Altered neuro-endocrine-immune pathways in the irritable bowel syndrome: the top-down and the bottom-up model. Tillisch K, Labus J, Kilpatrick L, Jiang Z, Stains J, Ebrat B et al (2013) Consumption of fermented milk product with probiotic modulates brain activity. Asia Pac J Clin Nutr 18(3):326–334 16 Microbiota-Gut-Brain Axis and Cognitive Function 371 63. Benton D, Williams C, Brown A (2007) Impact of consuming a milk drink containing a probiotic on mood and cognition. Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A et al (2011) Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Biﬁdobacterium longum R0175) in rats and human subjects. Br J Nutr 105(5):755–764 Chapter 17 The Impact of icrobiota on Brain and Behavior: echanisms & Therapeutic Potential Yuliya E. Cryan Abstract There is increasing evidence that host-microbe interactions play a key role in maintaining homeostasis. Alterations in gut microbial composition is asso- ciated with marked changes in behaviors relevant to mood, pain and cognition, establishing the critical importance of the bi-directional pathway of communication between the microbiota and the brain in health and disease. Dysfunction of the microbiome-brain-gut axis has been implicated in stress-related disorders such as depression, anxiety and irritable bowel syndrome and neurodevelopmental dis- orders such as autism. Moreover, there is now expanding evidence for the view that enteric microbiota plays a role in early programming and later response to acute and chronic stress. This view is supported by studies in germ-free mice and in animals exposed to pathogenic bacterial infections, probiotic agents or antibiotics. Borre Laboratory of NeuroGastroenterology, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland R. Moloney Laboratory of NeuroGastroenterology, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland Department of Psychiatry, University College Cork, Cork, Ireland G. Clarke Department of Psychiatry and Laboratory of NeuroGastroenterology Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland T. Cryan (*) Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland e-mail: j. This is due to the signiﬁcant increase in research investigating the role of the microbiota and in particular the gut microbiota in a wide spectrum of scientiﬁc and medical ﬁelds. The human microbiota, a collection of various microorganisms, comprises about 1–3 % of total body mass, hosting an impressive 100 trillion bacteria, most of which ﬁnd their niche in the intestine 17 The Impact of Microbiota on Brain and Behavior: Mechanisms & Therapeutic. The majority of the microbial cells are comprised of bacteria from 500 to 1,000 different species varying in diversity and stability, adding over eight million genes to the human genome [2–4]. An individual’s intestinal microbiota outnumbers somatic cells of the human body by approximately a factor of 10 , suggesting that an individual organism can no longer be identiﬁed as a single entity but rather as a complex ecosystem. Microbes colonize the digestive tract, reaching high numbers following birth and immediately thereafter , evolving and dynamically changing throughout one’s lifespan . The importance of microbiota for human health has been known since the early twentieth century, when Metchnikoff, the father of the modern probiotics, hypothesized that rebalancing bacteria in the gut with lactic acid could normalize bowel health and prolong life . We now know that the microbiota plays a crucial role in maintaining physio- logical homeostasis including digestion, metabolism, growth, development and function of the immune system and resistance to pathogens [8–11]. More recently, an increasing volume of evidence has supported the relationship between the enteric microbiota and brain function  both in pre-clinical [12–14] and clinical settings [15–17]. Microbiota Throughout Lifespan Although a stable core microbiome is shared among individuals, certain gut micro- bial populations ﬂuctuate over time, depending on several factors such as mode of delivery, feeding regimen, maternal diet/weight, probiotic and prebiotic use and antibiotic exposure pre-, peri- and post-natally . Bacterial colonization follows a relatively consistent pattern, under the inﬂuence of a variety of exogenous and endogenous factors. Exogenous factors include exposure to microorganisms from maternal origin such as gut, vaginal canal, or skin but also the environment in general. Endogenous factors encompass the birth delivery mode (vaginally or via cesarean section), gestational age, the type of feeding (breastfeeding or formula), and antibiotic or drug use . The human host-microbe symbiosis is initiated in early life and its establishment is an intriguing and dynamic biological process. The developing microbiome undergoes its own evolution throughout the host’s lifetime, in particular the ﬁrst 3 years, during which a stable microbiome is established [20–22]. Despite the general dogma that a developing fetus is sterile up until birth [20, 23], increasing evidence suggests that an infant’s initial microbiome might in fact be seeded by its mother prior to birth [24, 25] and is then supported by the presence of maternal microbes during birth  and breastfeeding [27, 28]. During and shortly after birth, infants are exposed to microbes mainly originating from the mother [29, 30]. Growing evidence suggests that it is this initial inoculation and subsequent 376 Y. The mode of delivery at birth has recently attracted attention from the scientiﬁc community since infants delivered by C-section are more likely to suffer from allergies, asthma and diabetes later in life [21, 31, 32]. Although reasons for these correlations are difﬁcult to tease apart, it has been linked to the crucial role of the early life environment in the development of a healthy microbiome. While the microbial composition of vaginally delivered infants initially resembles that of their mother’s vaginal canal, the microbiota of infants delivered via C-section is more similar to the microbiota of their mother’s skin . Although infants delivered by C-section exhibit a delayed acquisition of the members (Firmicutes and Bacteroidetes) which dominate the adult microbiome, their microbiota composition does eventually match that of their vaginally delivered counterparts in later life . It is currently unclear if birth mode can inﬂuence brain development and behavior. In addition to the birth delivery mode, gestational age is thought to contribute to the microbial composition of the host. For example, the microbiota of the pre-term infants lacks two of the main bacterial genera, Biﬁdobacterium and Lactobacillus, usually present in full-term infants, and instead display a dominance of the Proteobacteria . However, breastfeeding enriched the microbiota of the pre-term infants with the absent microbial species, enhancing the ability of the infant microbiome to utilize human milk oligosaccharides . In addition to the maternal role in the developing infant’s microbiome , genetic and environ- mental factors play a role in deﬁning the adult core microbiome. For example, twin studies revealed higher similarities in the microbiota composition between mono- zygotic and dizygotic twins in comparison to other family members, suggesting a signiﬁcance of the environmental factors over genetics [36, 37] and that microbial ecologies tend to cluster in family members .
Second order generic provigil canada sleep aid remedies, the hazard Despite the emphasis on removing or minimizing the effects due to a risk factor may depend on the presence of other risk of confounding in epidemiological research purchase provigil online insomnia 37 weeks pregnant, mediated and factors (Koopman 1981; Rothman and Greenland 1998) stratiﬁed hazards have received disproportionately little (effect modiﬁcation) purchase cheap provigil insomnia event. We therefore reviewed the literature and exposures to multiple risk factors because they are affected reanalyzed cohort data to strengthen the empirical basis for by the same distal factors and policies provigil 200mg on-line insomniac countdown. The sensitivity of estimates to nutrition, unsafe water and sanitation, and use of solid fuels these assumptions were negligible as described in detail else- are more common among poor rural households in devel- where (Ezzati, Vander Hoorn, and others 2004; Ezzati and oping countries and smokers generally have higher and others 2003). The epidemiological literature refers to the ﬁrst and second Epidemiological studies of the effects of overweight and issues as biological interaction and the third issue as statistical obesity, physical inactivity, and low fruit and vegetable interaction (Miettinen 1974; Rothman and Greenland 1998; intake on cardiovascular diseases have illustrated some Rothman, Greenland, and Walker 1980). This distinction is, attenuation of the effects after adjustment for intermediate however, somewhat arbitrary, and the three scenarios may factors such as blood pressure or cholesterol (Berlin and occur simultaneously. For example, zinc deﬁciency affects Colditz 1990; Blair, Cheng, and Holder 2001; Eaton 1992; mortality from diarrhea directly as well as by reducing growth Gaziano and others 1995; Jarrett, Shipley, and Rose 1982; (ﬁrst issue) (Brown and others 2002; Zinc Investigators’ Jousilahti and others 1999; Khaw and Barrett-Connor 1987; Collaborative Group 1999), and may also be correlated with Liu and others 2000, 2001; Manson and others 1990, 2002; Comparative Quantiﬁcation of Mortality and Burden of Disease Attributable to Selected Risk Factors | 253 Rosengren, Wedel, and Wilhelmsen 1999; Tate, Manfreda, nutrition and previous infection (Pelletier, Frongillo, and and Cuddy 1998). The extent of attenuation has smoke from household use of solid fuels and unsafe water, varied from study to study, but has consistently been less sanitation, and hygiene, which result in lower respiratory than half of the excess risk of the distal factors. We used an infections and diarrhea respectively, may be mediated estimate of 50 percent as the proportion of the excess risk through underweight. In a review of the literature, Briend from these risk factors mediated through intermediate fac- (1990) concludes that attempts to disentangle direct tors that are themselves among the selected risks. To include and mediated contributions,especially over the long periods effect modiﬁcation, we used deviations from the multiplica- needed to affect population-level anthropometry, have not tive model of 10 percent for ischemic heart disease and established diarrhea as a signiﬁcant cause of underweight. To account for potential mediated effects, Joint Hazards of Smoking and Other Risk Factors. Liu we considered an upper bound of 50 percent on the pro- and others (1998, ﬁgures 4 and 6) ﬁnd that in China, the portion of the excess risks from indoor smoke from house- relative risks of mortality from lung and other cancers, hold use of solid fuels and unsafe water, sanitation, and respiratory diseases, and vascular diseases are approximately hygiene mediated through underweight in regions where constant in different cities where mortality rates for these underweight was present. Studies that stratiﬁed hazards of smoking on serum choles- terol have conﬁrmed this ﬁnding (Jee and others 1999). Risk Factor Correlation Joint Hazards of Childhood Undernutrition for To estimate the joint effects of risk factors with a continuous Infectious Diseases. Abel 1995; Ramakrishnan and Martorell 1998; West and Similarly, for categorical risk factors, positive correlation others 1991). Anthropometric (growth) be considerably smaller than the joint attributable indicators of childhood nutrition, such as weight-for-age, fraction, as described in detail elsewhere (Ezzati and are aggregate measures of multiple factors that include others 2003). This conﬁrms that the joint actions of more than one of All Selected Risk Factors these risk factors acting simultaneously or through other Table 4. Globally, an estimated 45 percent of (96 percent), diarrhea (92 percent), ischemic heart disease mortality and 36 percent of the disease burden were attrib- (80 percent), lung cancer (74 percent), stroke (65 percent), utable to the joint effects of the 19 selected risk factors. Sub- chronic obstructive pulmonary disease (64 percent), and Saharan Africa (49 percent of the disease burden) and lower respiratory infections (53 percent) were attributable Europe and Central Asia (46 percent of the disease burden) to the joint effects of the 19 risk factors considered here. As the table shows, for most diseases the joint a number of other diseases were attributed to the risk factors effects of these risk factors were substantially less than the considered here. Comparative Quantiﬁcation of Mortality and Burden of Disease Attributable to Selected Risk Factors | 255 Table 4. These factors also contribute to other diseases that are not among the leading 10. Affected by smoking in the category “other respiratory diseases” or “selected other medical causes” (Ezzati and Lopez 2003, 2004; Peto and others 1992). An important ﬁnding of this analysis is the key role of high cholesterol, smoking, overweight and obesity, alcohol nutrition in health worldwide. Approximately 11 percent of use, physical inactivity, low fruit and vegetable intake, and the global disease burden was attributable to the joint effects urban air pollution), and child mortality (childhood under- of underweight or micronutrient deﬁciencies. In addition, weight; vitamin A deﬁciency; zinc deﬁciency; iron deﬁciency almost 16 percent of the burden (28 percent for those aged anemia; unsafe water, sanitation, and hygiene; and indoor 30 years and older) can be attributed to risk factors that have smoke from household use of solid fuels). The joint effects of these risk factors were mitigation of many such conditions, including malaria, much lower than the crude sum of individual effects (64 per- tuberculosis, and injuries, may be better guided by analyses cent versus 126 percent for the disease burden), pointing to of the effects of interventions tailored to individual settings the extensive overlap in their hazards for cardiovascular dis- than by risk factor analysis. The overlap is partly because the hazardous effects of some risks are mediated through others and partly because multiple risk factors act in combination. Coupled with substantially risks that may be of particular interest to disease prevention more cardiovascular deaths and a larger disease burden in policies and programs. The risk factor clusters were those low- and middle-income countries, these risk factors result in affecting cancers (alcohol use, smoking, low fruit and veg- a much larger loss of healthy life in these nations. By considering the health consequences of past and current exposure, nearly all sexually transmitted diseases are attributable to unsafe sex. This is because, in the absence of sexual transmission in the past, current infections transmitted through other forms of contact would not occur if the infected hosts acquired their infection sexually (and so on in the sequence of past infected hosts). Practically all the mortality and disease burden from proximal exposures using multiple interventions. Examples childhood diseases attributable to major risk factors of such integrated strategies include using education and occurred in low- and middle-income countries (table 4. In such research, risk factor groups should be selected based on both biological relationships and socioeconomic factors that affect multiple diseases. Once risk exposure and hazard for different risks and the existing data factors are selected, the emphasis on reducing confounding gaps revealed the areas where data and monitoring need to should be matched by equally important inquiry into inde- be improved for better quantiﬁcation of important risks and pendent and mediated hazard sizes that are stratiﬁed based for more effective intervention. Important examples regional levels, for example, rural and urban areas or differ- include detailed data on alcohol consumption volumes and ent geographical regions of individual countries, and should patterns, dietary and biological markers for micronutrients, include micro-level data and possibly a more comprehen- physical activity, and indoor smoke from household use of sive list of both distal and proximal risk factors, such as solid fuels, all of which were quantiﬁed using indirect meas- adverse life events and stress, risk factors for injuries, salt ures with limited resolution. These are coupled with hazards such as alcohol use, The limited evidence on the effects of multiple risk fac- smoking, high blood pressure, high cholesterol, and over- tors and risk factor interactions also points to important weight and obesity that are globally widespread and have gaps in research on multirisk and stratified hazards. Including multiple layers of causality in epidemiological The large remaining burden due to childhood mortality research and risk assessment would allow investigators to risks such as undernutrition; unsafe water, sanitation, and estimate the beneﬁts of reducing combinations of distal and hygiene; and indoor smoke from household use of solid Comparative Quantiﬁcation of Mortality and Burden of Disease Attributable to Selected Risk Factors | 267 fuels indicates the persistent need for developing and deliv- tions to the disease burden in policy debate. Finally, while ering effective interventions, including lowering the costs of the burden of disease due to a risk factor may be compara- pertinent technological interventions. At the same time, tively small, effective or cost-effective interventions may be four of the ﬁve leading causes of lost healthy life affect known. Examples include reducing the number of unneces- adults: high blood pressure, unsafe sex, smoking, and alco- sary injections at health facilities coupled with the use of hol use (ﬁgure 4. Risk factors for both adult communica- sterile syringes and the reduction in exposure to urban air ble and noncommunicable diseases already make substan- pollution in industrial countries in the second half of the tial contributions to the disease burden even in regions with 20th century, which often also led to beneﬁts such as energy low income and high infant mortality. Risk factors that were not among the leading global The estimates of the joint contributions of 19 selected causes of the disease burden should not be neglected for a global risk factors showed that these risks together con- number of reasons. First, the analysis could be expanded tributed to a considerable loss of healthy life in different with other risk factors that are both prevalent and regions of the world. For example, in the low- and stroke, substantial proportions were attributable to these middle-income countries of East Asia and the Paciﬁc, which selected risk factors. This concentration of the disease bur- is dominated by China in terms of population, urban air den further emphasizes the contribution of leading risks pollution from transportation and industrial and household such as undernutrition, unsafe sex, high blood pressure, energy use based on coal has health effects comparable to and smoking and alcohol use to the loss of healthy life glob- those of micronutrient deﬁciencies. The results further emphasize that for more effective use of ineffective methods of contraception was associated and affordable implementation of a prevention paradigm, with a larger disease burden than most chronic disease risk policies, programs, and scientiﬁc research should acknowl- factors among females in South Asia and Sub-Saharan edge and take advantage of the interactive and correlated Africa. Third, for other risk factors, such as child sexual role of major risks to health, across and within causality abuse, ethical considerations may outweigh direct contribu- layers. Comparative Quantification of Mortality and Burden of Disease Attributable to Selected Risk Factors | 269 Table 4A.
In this activity order provigil american express sleep aid without diphenhydramine, students will remove the living cellular material from animal tissue to reveal the scaffolding of the tissue order 200 mg provigil with mastercard xanax sleep aid dosage. Solid organs may take weeks to decellularize and require more specialized equipment to perfuse the tissues quality provigil 100 mg sleep aid health a2z. The teacher may speed up the process by cutting the tissue into the pieces for the student groups effective 200 mg provigil sleep aid pillows. Provide time for each student group to observe the tissue before and after decellularization. Plan ahead before implementing the activity to ensure the lab can be completed in back-to-back days. This process uses animal tissue, so proper care should be taken in handling the materials. Allow the students to discuss the cells and ask to see if they think there is any structure supporting the cell. Explain that in this activity they will investigate the supportive materials that surround the outside of cells. Students should work together to create a poster explaining how scaffolding is the basis for tissue and organ engineering. Extension The activity may be extended by allowing students to fgure out the most effective protocol. Students may try different types of detergent or compare forms of tissue, such as frozen, defrosted or fresh. The base structure for animal tissues and organs is called the extracellular matrix. It functions as a supportive structure, or scaffold, for tissue growth and repair. However, doctors have learned to use extracellular matrix from pig intestines to help repair human injuries and scientists are experimenting with creating artifcial scaffolds in the laboratory. What other types of materials could be used as scaffolding for tissue engineering? Key Vocabulary • Regenerative medicine • Organ engineering • Scaffold Time Required • Approximately 15 minutes of teacher prep time • Approximately 90 minutes of class time for lab and discussion Materials For Demonstration For 15 Lab Sets 25mL Gaviscon (over-the-counter 375mL Gaviscon (over-the-counter heartburn medication) heartburn medication) 100mL 1% w/v calcium chloride 1. This kind of scaffolding is a temporary support for people and supplies to build and remodel the building. In regenerative medicine, tissue and organs can be engineered and built, then placed in the body. In animals this support is provided naturally by the extracellular matrix, which is made by the cells themselves. Scientists at the Wake Forest Institute for Regenerative Medicine are experimenting with various ways to provide this supportive structure for replacement tissues and organs. Another way is create a scaffold with synthetic or biocompatible materials that will support new cell growth then gradually break down and be replaced by the extracellular matrix created by the patient’s own cells. They also are working on adding benefcial chemicals such as growth factors and anti-infammatory agents. In this activity students will create a chemically engineered support to hold another chemical together in a threadlike structure. Scientists must investigate which materials have the right characteristics to support and direct the growth of the engineered tissue. In this activity, the students will be materials engineers and will try to discover the best way to create structures to hold a given liquid. In the past 10 years, sodium alginate (NaC H O ) has been cross-linked with calcium ions to form6 7 6 spheres and threads in which food has been presented in unique ways, such as the fruit caviar you might fnd as a topping in a frozen yogurt shop. In this experiment students will cross-link alginate with the calcium ions to form threads and spheres. It also is the main component of the moisture absorber DampRid, which is available at building supply and drug stores. The calcium chloride solution can be created by making 100mL of 1% w/v (weight of solute/volume of solution) solution by adding 1 gram of calcium chloride (or DampRid) to 100mL of water. In medicine, alginate is used in making scaffolds for tissue engineering and cell culture as well as to create bandages. Alginate dressings aid in wound healing because they can slowly release medications and eventually be absorbed by the body. Even though this process is used in food processing, the materials used in this lab should not be ingested. Encourage the students to see that scaffolding provides support for building and for supplies. Explain that the activity will show how chemicals can be manipulated to create support like this scaffolding. Do not to allow the calcium chloride solution to be sucked back into the sodium alginate pipette. If the calcium chloride goes into the pipette, it will become clogged with cross-linked ions. Allow the students to take their creations out of the calcium chloride solution and onto a paper plate for observation. Students should work together to create a poster explaining how scaffolding is the basis for tissue and organ engineering. Extension The activity may be extended by researching the types of materials used to create scaffolds and the advantages and disadvantages of each type. Students may use the resources found on selected websites, such as the Regenerative Medicine Foundation (http://www. How could the different shapes created in this activity help in organ engineering? But the media often neglects to discuss what stem cells really are, how they are being used in research and treatments, the many different kinds of stem cells and recent advances in stem cell research that may reduce or eliminate the need for controversial embryonic stem cells. Stem cells can be used as unique building blocks in bioengineering and growing tissues and organs. This activity will provide students opportunities to defne stem cells and research their characteristics. Theaching Notes This activity asks students to use the Internet to research what stem cells are and the different types of stem cells. The students will research the characteristics, advantages and disadvantages of different stem cells. To make the most effective use of student research time, suggested resources have been provided. Depending on student access to the Internet, you may choose whether to have students do this research in or out of class. After gathering and synthesizing information, the students will create a commercial to share their fndings with other students.
Place four (or more) posters on the wall with the following labels: Pluripotent Advantages cheap provigil 200mg on-line qivana sleep aid, Pluripotent Disadvantages purchase provigil line insomnia online test, Multipotent Advantages buy cheap provigil on-line insomnia 6 hours sleep, Multipotent Disadvantages discount 100mg provigil visa insomnia xbox one. Students in each group will write down as many facts on the sheet as they can remember in three minutes. After three minutes, the posters will be passed to the next group and the process repeated until all groups have written on each of the posters. Place the posters on the wall and allow students to walk around the room silently and place two checks on each paper for the strongest point. These posters will provide a visual representation of the research that can be posted in the class and referred to throughout this course. They should be shared with students in advance and may be developed with students. Theachers may adjust this rubric to ft their grading system and to emphasize different aspects of the project as appropriate for their curriculum. Extension This activity may be extended by asking students to research how stem cells may be used to combat chronic disease, such as cancer. Because this research area is evolving rapidly, online information is more likely to be up-to-date than information in print. Some options include: National Institutes of Health The National Institutes of Health has a number of resources on stem cells, including: • Current Research http://stemcells. Does not seem Shows a full Shows a good Shows partial Commercial to understand the understanding of understanding of understanding of content stem cell very the stem cell. Student uses Accuracy (of both appropriate Presents accurate Presents accurate Hard to tell if the written notes and sources. Material material 90% to material 75% to student knew the oral presentation) accurate based on 95% of the time. Student is able Student is able Student is able Student is unable to accurately to accurately to accurately to accurately Comprehension articulate the articulate most of articulate part of articulate the topic. Provides a Performs the Provides an complete Provides a simple commercial exceptional Commercial commercial that commercial that in-person for the commercial that quality falls within 30 does not meet the class and/or does meets the time seconds of the time requirements. Before delving deeper into the uses of different types of stem cells, defne the phrase “stem cell. On another sheet of paper make a chart similar to this one but with enough space to record all your fndings. Key Vocabulary • Regenerative medicine • Organ engineering • Scaffold • Bioprinting Time Required • Approximately 90 minutes to research regenerative medicine (may be done outside of class) • Approximately 60 minutes to create regenerative medicine magazine cover (may be done outside of class) • Approximately 90 minutes to present regenerative medicine covers (for class of 30 students) Materials • Computers with Internet access and print materials for research • Rubric Background Information Regenerative medicine holds the possibility of using stem cells to engineer and grow tissues and organs. In the past, if someone had a diseased bladder he or she most likely would develop kidney disease and possibly would die. But in 2001, a young boy was given a new bladder that had been grown for him in the lab. This feld of medicine continues to evolve, thus students must keep up with new advances by reading current research. Depending on student access to the Internet, you may choose to have students do this research in or out of class. After gathering and synthesizing information, the students will create a magazine cover highlighting their favorite advances in regenerative medicine. Safety Students should follow school/district Internet access guidelines to ensure safe browsing. Procedure Begin by watching a video on regenerative medicine, such as Heal, Feed, Sustain: How Biotechnology Can Help Save the World (http://www. Explain that they will be able to answer many of these questions and others after completing this project. Explain that regenerative medicine is a constantly changing feld, thus they will be using online resources to discover current advances. The student will work in groups of two to complete the following Regenerative Medicine: Changing Life handout. In order to move to the next section, the teacher may use the student sheet as a formative assessment. After the students have completed the research, the students will create a magazine cover highlighting a key use of regenerative medicine and details of this use. They should be shared with students in advance and may be developed with students. Theachers may adjust this rubric to ft their grading system and to emphasize different aspects of the project as appropriate for their curriculum. Extension This activity may be extended by asking students to research and create a projected timeline for the research and clinical trial process for the new applications of regenerative medicine. Because this research area is evolving rapidly, online information is more likely to be up-to-date than information in print. Shows a complete Shows a good Shows partial Does not seem understanding understanding understanding to understand of a regenerative of regenerative of regenerative regenerative Content from the medicine medicine medicine medicine webquest advancement. All material taken Presents current Presents current Presents little Current nature of from current material 90% to material 75% to to no current sources sources. Creates a Creates a magazine cover magazine cover about regenerative about regenerative Creates a Creates a basic medicine with medicine with magazine cover magazine cover an appropriate an appropriate about regenerative Magazine quality about science with picture and title picture and title medicine with an an appropriate that highlights that highlights appropriate picture picture and title. Occasionally Speaks clearly Speaks speaks clearly Does not speak with correct clearly with with some correct clearly or pronunciation of mostly correct pronunciation of pronounce terms. Maintains eye contact contact because magazine pitch Presents the eye contact most some time but the presentation information in of the time. You will be researching regenerative medicine and the current advancements in this feld. At the end of this process, you will have the opportunity to pitch your magazine cover to the publication board. Whenever this information is used in part or in whole, or when referencing it as part of a report or article, we request that acknowledgment be given to the American Board of Medical Specialties. The anesthesiologist also diagnoses and treats acute, chronic, disease, organ transplantation, or malignancies of the immune system. However, formal special pathways are available for physicians seeking Specialty training required prior to certifcation: Four years dual certifcation in Allergy/Immunology and Pediatric Pulmonology; Allergy and Immunology and Pediatric Rheumatology; and Allergy and Subspecialties Immunology and Adult Rheumatology. Additional information is available To become certifed in a particular subspecialty, a physician must be from the board. Critical Care Medicine An anesthesiologist who specializes in Critical Care Medicine diagnoses and treats patients with critical illnesses or injuries, particularly trauma victims and patients with multiple organ dysfunction who require care over a period of hours, days, or weeks. Hospice and Palliative Medicine An anesthesiologist who specializes in Hospice and Palliative Medicine provides care to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing the physical, psychological, social, and 4 5 spiritual needs of both patient and family. Sleep Medicine Colon and Rectal Surgery An anesthesiologist who specializes in Sleep Medicine has expertise A colon and rectal surgeon diagnoses and treats various diseases of in the diagnosis and management of clinical conditions that occur the small intestine, colon, rectum, anal canal, and perianal area including during sleep, that disturb sleep, or that are affected by disturbances the organs and tissues related with primary intestinal diseases (liver, in the wake-sleep cycle. This specialist is skilled in the analysis and urinary, and female reproductive system). They treat conditions such interpretation of comprehensive polysomnography, and well versed in as hemorrhoids, fssures (painful tears in the anal lining), abscesses and emerging research and management of a sleep laboratory.